Search results for: nurse practitioners
Commenced in January 2007
Frequency: Monthly
Edition: International
Paper Count: 1219

Search results for: nurse practitioners

1039 Evaluation of Age-Friendly Nursing Service System: KKU (AFNS:KKU) Model for the Excellence

Authors: Roongtiwa Chobchuen, Siriporn Mongkholthawornchai, Boonsong Hatawaikarn, Uriwan Chaichangreet, Kobkaew Thongtid, Pusda Pukdeekumjorn, Panita Limpawattana

Abstract:

Background: Age-friendly nursing service system in Srinagarind Hospital has been developed continuously based on the value and cultural background of Thailand which corporates with the modified WHO’s Age friendly Primary Care Service System. It consists of 3 issues; 1) development of staff training, 2) age-friendly service and 3) appropriate physical environment. Objective: To evaluate the efficacy of Age-friendly Nursing Service System: KKU (AFNS:KKU) model and to evaluate factors associated with nursing perception with AFN:KKU. Study design: Descriptive study Setting: 31 wards that served older patients in Srinagarind Hospital Populations: Nursing staff from 11 departments (31 wards) Instrument: Age-friendly nursing care scale as perceived by hospitalized older person Procedure and statistical analysis: All participants were asked questions using age-friendly nursing care scale as perceived by hospitalized older person questionnaires. Descriptive statistics and multiple logistic regression analyses were used to analyse the outcomes. Results: There were 337 participants recruited in this study. The majority of them were women (92%) with the mean ages of 29 years and 77.45% were nurse practitioners. They had average nursing experiences of 5 years. The average scores of age-friendly nursing care scale were high and highest in the area of attitude and communication. Age, sex, educational level, duration of work among, and having experience in aging training were not associated with nursing perception where type of department was an independent factor. Nurses from department of Surgery and Orthopedic, Eye and ENT, special ward and Obstetrics and Gynecological had significant greater perception than nurses from Internal Medicine Department (p < 0.05). Conclusion: Nurses had high scores in all dimensions of age-friendly concept. The result indicates that nurses have good attitude to aging care which can lead to improve quality of care. Organization should support other domains of ageing care to achieve greater effectiveness in geriatric care.

Keywords: age-friendly, nursing service system, excellence model, geriatric care

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1038 Challenges for Nurses in the Medical Profession to Bring Their Expertise to the School Setting: Focusing on Supporting the School Life of Children with Complex Medical Care Needs

Authors: Ikuko Tomomatsu, Beverley Anne Yamamoto

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Background: There has been an increase in the number of Children with Complex Medical Care Needs (CCMCN) living outside hospital settings in Japan. Most CCMCNs require someone to provide or support them in the provision of care and to respond in the case of an emergency in their everyday lives, including in school settings. One or two yoga teachers qualified within the teacher-training system to work in the health rooms in schools, are assigned to schools in Japan based on enrollment numbers, and are responsible for all students' health. CCMCN requires individualized support, which the Yogo teachers cannot adequately provide. Clinically trained nurses have increasingly been allocated to mainstream schools to provide medical care support for the CCMCN as a new kind of school nurse, but the supply has fallen far short of demand. In 2021, the Act on Support for Children with Complex Medical Care Needs and their Families was passed, requiring local governments to assign school nurses to schools to support CCMCN. The study aimed to understand these nurses' experiences (job description, rewards, challenges) allocated to schools to provide medical care for CCMCN. The study also aimed to explore what professional development looks like for nurses working in schools. Methods: Using a semi-structured interview technique, we interviewed sixteen nurses currently providing care to CCMCN in mainstream schools. Using an interview guide, they were asked about their work, satisfaction, challenges and concerns, thoughts on professionalism, and the educational and training environment. The interviews were audio-recorded and transcribed. We conducted a thematic analysis of the data. Results: The main concerns and problems were not directly related to medical care delivery but to communication with the children, the teachers' understanding of educational policy, and the principal's philosophy. Unlike medical institutions, where treatment is the priority, most children do not need treatment in schools. Even those needing medical care do not need interventions for most of the day. In this environment, the nurses interviewed reported that it is important to understand the school situation and the teachers' philosophies when providing medical care. One of the main challenges is knowing what to do when not providing care, especially if requests from school staff have nothing to do with their professional skills. Conclusion: Through the analysis of concerns and challenges faced by the nurses, the process of providing medical care in a school setting as a health care provider was discussed as follows. Each nurse contemplates the methods and implications of safely implementing medical care in schools. This was considered a process of situating the implementation of medical care by the nurses in the context of education. This requires that the nurses develop new skills and knowledge, which some nurses find stimulating while others find challenging.

Keywords: school nurse, children with complex medical care needs, professionalization, mainstream school

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1037 A Theoretical Analysis on the Controversial Issue of Teaching Professional in the Institutionalized Perspective

Authors: Tien-Hui Chiang, Q. Zhou

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For structural-functionalism, one set of the common traits of traditional professionals, such as medical practitioners and engineers, can be viewed as the criteria for evaluating whether a given occupation has the right of claiming its professional status or not. Under the influence of this professionalism, teaching practitioners have devoted themselves to acquiring this right as evidenced by the fact that initial training has been extended to even the level of postgraduate. However, for interactionalists, professionalism adopts a predetermined assumption so that it ignores the dynamic nature of social development, which is able to regulate the professional status of a given occupation. Such an interactive approach highlights the concept of professionalization. Furthermore, Marxists argue that structural-functionalists have ignored the impact of proletarianization on the white collar. While professionals gradually lose their control over their practices, the title of profession functions as a self-regulated icon that prevents them from collaborating with the working class and, in turn, creates the ideology of de-politicization sustaining the interests of the ruling class. This article adopts a theoretical analysis on these contradictory arguments. It argues that these criticisms neglect the influence of the institutionalized value system on social operation, which is the core element in sustaining the notion of the profession.

Keywords: teaching profession, professionalism, professionalization, proletarianialization, institutionalized value system

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1036 Developing a Customizable Serious Game and Its Applicability in the Classroom

Authors: Anita Kéri

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Recent developments in the field of education have led to a renewed interest in teaching methodologies and practices. Gamification is fast becoming a key instrument in the education of new generations and besides other methods, serious games have become the center of attention. Ready-built serious games are available for most higher education institutions to buy and implement. However, monetary restraints and the unalterable nature of the games might deter most higher education institutions from the application of these serious games. Therefore, there is a continuously growing need for a customizable serious game that has been developed based on a concrete need analysis and experts’ opinion. There has been little evidence so far of serious games that have been created based on relevant and current need analysis from higher education institution teachers, professional practitioners and students themselves. Therefore, the aim of this current paper is to analyze the needs of higher education institution educators with special emphasis on their needs, the applicability of serious games in their classrooms, and exploring options for the development of a customizable serious game framework. The paper undertakes to analyze workshop discussions on implementing serious games in education and propose a customizable serious game framework applicable in the education of the new generation. Research results show that the most important feature of a serious game is its customizability. The fact that practitioners are able to manage different scenarios and upload their own content to a game seems to be a key to the increasingly widespread application of serious games in the classroom.

Keywords: education, gamification, game-based learning, serious games

Procedia PDF Downloads 133
1035 Communicating Safety: A Digital Ethnography Investigating Social Media Use for Workplace Safety

Authors: Kelly Jaunzems

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Social media is a powerful instrument of communication, enabling the presentation of information in multiple forms and modes, amplifying the interactions between people, organisations, and stakeholders, and increasing the range of communication channels available. Younger generations are highly engaged with social media and more likely to use this channel than any other to seek information. Given this, it may appear extraordinary that occupational safety and health professionals have yet to seriously engage with social media for communicating safety messages to younger audiences who, in many industries, might be statistically more likely to encounter more workplace harm or injury. Millennials, defined as those born between 1981-2000, have distinctive characteristics that also impact their interaction patterns rendering many traditional occupational safety and health communication channels sub-optimal or near obsolete. Used to immediate responses, 280-character communication, shares, likes, and visual imagery, millennials struggle to take seriously the low-tech, top-down communication channels such as safety noticeboards, toolbox meetings, and passive tick-box online inductions favoured by traditional OSH professionals. This paper draws upon well-established communication findings, which argue that it is important to know a target audience and reach them using their preferred communication pathways, particularly if the aim is to impact attitudes and behaviours. Health practitioners have adopted social media as a communication channel with great success, yet safety practitioners have failed to follow this lead. Using a digital ethnography approach, this paper examines seven organisations’ Facebook posts from two one-month periods one year apart, one in 2018 and one in 2019. Each of the years informs organisation-based case studies. Comparing, contrasting, and drawing upon these case studies, the paper discusses and evaluates the (non) use of social media communication of safety information in terms of user engagement, shareability, and overall appeal. The success of health practitioners’ use of social media provides a compelling template for the implementation of social media into organisations’ safety communication strategies. Highly visible content such as that found on social media allows an organization to become more responsive and engage in two-way conversations with their audience, creating more engaged and participatory conversations around safety. Further, using social media to address younger audiences with a range of tonal qualities (for example, the use of humour) can achieve cut through in a way that grim statistics fail to do. On the basis of 18 months of interviews, filed work, and data analysis, the paper concludes with recommendations for communicating safety information via social media. It proposes exploration of the social media communication formula that, when utilised by safety practitioners, may create an effective social media presence. It is anticipated that such social media use will increase engagement, expand the number of followers and reduce the likelihood and severity of safety-related incidents. The tools offered may provide a path for safety practitioners to reach a disengaged generation of workers to build a cohesive and inclusive conversation around ways to keep people safe at work.

Keywords: social media, workplace safety, communication strategies, young workers

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1034 Building Information Modeling-Based Approach for Automatic Quantity Take-off and Cost Estimation

Authors: Lo Kar Yin, Law Ka Mei

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Architectural, engineering, construction and operations (AECO) industry practitioners have been well adapting to the dynamic construction market from the fundamental training of its discipline. As further triggered by the pandemic since 2019, great steps are taken in virtual environment and the best collaboration is strived with project teams without boundaries. With adoption of Building Information Modeling-based approach and qualitative analysis, this paper is to review quantity take-off and cost estimation process through modeling techniques in liaison with suppliers, fabricators, subcontractors, contractors, designers, consultants and services providers in the construction industry value chain for automatic project cost budgeting, project cost control and cost evaluation on design options of in-situ reinforced-concrete construction and Modular Integrated Construction (MiC) at design stage, variation of works and cash flow/spending analysis at construction stage as far as practicable, with a view to sharing the findings for enhancing mutual trust and co-operation among AECO industry practitioners. It is to foster development through a common prototype of design and build project delivery method in NEC Engineering and Construction Contract (ECC) Options A and C.

Keywords: building information modeling, cost estimation, quantity take-off, modeling techniques

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1033 Human-Automation Interaction in Law: Mapping Legal Decisions and Judgments, Cognitive Processes, and Automation Levels

Authors: Dovile Petkeviciute-Barysiene

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Legal technologies not only create new ways for accessing and providing legal services but also transform the role of legal practitioners. Both lawyers and users of legal services expect automated solutions to outperform people with objectivity and impartiality. Although fairness of the automated decisions is crucial, research on assessing various characteristics of automated processes related to the perceived fairness has only begun. One of the major obstacles to this research is the lack of comprehensive understanding of what legal actions are automated and could be meaningfully automated, and to what extent. Neither public nor legal practitioners oftentimes cannot envision technological input due to the lack of general without illustrative examples. The aim of this study is to map decision making stages and automation levels which are and/or could be achieved in legal actions related to pre-trial and trial processes. Major legal decisions and judgments are identified during the consultations with legal practitioners. The dual-process model of information processing is used to describe cognitive processes taking place while making legal decisions and judgments during pre-trial and trial action. Some of the existing legal technologies are incorporated into the analysis as well. Several published automation level taxonomies are considered because none of them fit well into the legal context, as they were all created for avionics, teleoperation, unmanned aerial vehicles, etc. From the information processing perspective, analysis of the legal decisions and judgments expose situations that are most sensitive to cognitive bias, among others, also help to identify areas that would benefit from the automation the most. Automation level analysis, in turn, provides a systematic approach to interaction and cooperation between humans and algorithms. Moreover, an integrated map of legal decisions and judgments, information processing characteristics, and automation levels all together provide some groundwork for the research of legal technology perceived fairness and acceptance. Acknowledgment: This project has received funding from European Social Fund (project No 09.3.3-LMT-K-712-19-0116) under grant agreement with the Research Council of Lithuania (LMTLT).

Keywords: automation levels, information processing, legal judgment and decision making, legal technology

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1032 Mitigating Supply Chain Risk for Sustainability Using Big Data Knowledge: Evidence from the Manufacturing Supply Chain

Authors: Mani Venkatesh, Catarina Delgado, Purvishkumar Patel

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The sustainable supply chain is gaining popularity among practitioners because of increased environmental degradation and stakeholder awareness. On the other hand supply chain, risk management is very crucial for the practitioners as it potentially disrupts supply chain operations. Prediction and addressing the risk caused by social issues in the supply chain is paramount importance to the sustainable enterprise. More recently, the usage of Big data analytics for forecasting business trends has been gaining momentum among professionals. The aim of the research is to explore the application of big data, predictive analytics in successfully mitigating supply chain social risk and demonstrate how such mitigation can help in achieving sustainability (environmental, economic & social). The method involves the identification and validation of social issues in the supply chain by an expert panel and survey. Later, we used a case study to illustrate the application of big data in the successful identification and mitigation of social issues in the supply chain. Our result shows that the company can predict various social issues through big data, predictive analytics and mitigate the social risk. We also discuss the implication of this research to the body of knowledge and practice.

Keywords: big data, sustainability, supply chain social sustainability, social risk, case study

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1031 Sporting Events among the Disabled between Excellence and Ideal in Motor Performance: Analytical Descriptive Study in Some Paralympic Sports

Authors: Guebli Abdelkader, Reguieg Madani, Belkadi Adel, Sbaa Bouabdellah

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The identification of mechanical variables in the motor performance trajectory has a prominent role in improving skill performance, error-exceeding, it contributes seriously to solving some problems of learning and training. The study aims to highlight the indicators of motor performance for Paralympic athletes during the practicing sports between modelling and between excellence in motor performance, this by taking into account the distinction of athlete practicing with special behavioral skills for the Paralympic athletes. In the study, we relied on the analysis of some previous research of biomechanical performance indicators during some of the events sports (shooting activities in the Paralympic athletics, shooting skill in the wheelchair basketball). The results of the study highlight the distinction of disabled practitioners of sporting events identified in motor performance during practice, by overcoming some physics indicators in human movement, as a lower center of body weight, increase in offset distance, such resistance which requires them to redouble their efforts. However, the results of the study highlighted the strength of the correlation between biomechanical variables of motor performance and the digital level achievement similar to the other practitioners normal.

Keywords: sports, the disabled, motor performance, Paralympic

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1030 Medical/Surgical Skills Day Improves Nurse Competence and Satisfaction

Authors: Betsy Hannam

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Background: Staff nurses felt overwhelmed to learn new skills or complete competencies during their shift. Med/Surg units need to provide dedicated, uninterrupted time to complete training and mandatory competencies and practice skills. Purpose: To improve nurse satisfaction and competence by creating a Skills Day with uninterrupted time to complete competencies, brush up on skills, and evaluate skills learned through pre- and post-tests. Methods: The USL and CNL interviewed nurses to obtain input regarding skills needing reinforcement and included mandatory competencies relevant to Med/Surg to create the Skills Day agenda. Content experts from multiple disciplines were invited to educate staff to help address knowledge gaps. To increase attendance, multiple class days were offered. Results: 2018 Skills Day was held for an inpatient unit with 95% participation (n=35 out of 37RNs). The average pretest score, comprised of content questions from topics discussed, was 57%, and post test scoresaveraged 80%. 94% of test scores improved or remained the same. RNs were given an evaluation at the end of the day, where100% of staff noted Skills Day as beneficial, and 97% requested to repeat next year. Another Med/Surg unit asked to join Skills Day in 2019. In 2019, with 89% participation (n=57 out 64 RNs), the average pretest score was 68%, and the average post test score was 85%. 97% of scores improved or remained the same. 98% reported the class as beneficial, and 96% requested to repeat next year. Skills Day 2020-2022 on hold due to COVID. Looking forward to Skills Day 2023. Conclusion: Skills Day allows nurses to maintain competencies and improve knowledge in areas of interest without the stress of a patient assignment. Having unit leaders organize Skills Day, with the involvement of content experts from multiple disciplines, showed to be a successful and innovative team approach to support professional development.

Keywords: education, competency, skills day, medical/surgical

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1029 Parents, Carers and Young Persons’ Views Regarding Nursing ‘Workarounds’ Within Clinical Electronic Patient Record Systems

Authors: Patrick Nurse, Professor Neil Sebire, Polly Livermore

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The use of digital systems in healthcare is now highly prevalent. With further advancement of technology, these systems will become increasingly utilised within the healthcare sector. Therefore understanding how clinicians (for example, doctors, nurses) interact with technology and digital systems is critical to making care safer. Seven members from the Parent/Carers’ Research Advisory Group and the Young-Persons’ Research Group at a healthcare Trust in London and three staff members contributed to an engagement workshop to assess the impact of digital systems on the practice of nurses. The group also advised on the viability of a research study to investigate this further. A wide range of issues within digital system implementation in healthcare were raised, such as ‘workarounds’, system’s training, and upkeep and regulation of usage, which all emerged as early themes during the discussion. Further discussion focused on the subject of escalation of issues, ‘workarounds’, and problem solving. While challenging to implement, digital systems are hugely beneficial to healthcare providers. The workshop indicated that there is scope for investigation of the prevalence, nature, and escalation of ‘workarounds’, this was of key interest to the advisory group. An interesting concern of the group was their worry from a patient and parental perspective regarding how nurses might feel when needing to complete a ‘workaround’ during a busy shift. This is especially relevant if the reasons to complete the ‘workaround’ were outside the nurse’s control, driven by clinical need and urgency of care. This showed the level of insight that those using healthcare services have into the reality of workflows of those providing care. Additionally, it reflects the desire for patients and families to understand more about the administration and methodology of their care. Future study should be dedicated to understanding why nurses deploy ‘workarounds’, as well as their perspective and experience of them and subsequent escalation through leadership hierarchies

Keywords: patient engagement/involvement, workarounds, medication-administration, digital systems

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1028 Clinical Advice Services: Using Lean Chassis to Optimize Nurse-Driven Telephonic Triage of After-Hour Calls from Patients

Authors: Eric Lee G. Escobedo-Wu, Nidhi Rohatgi, Fouzel Dhebar

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It is challenging for patients to navigate through healthcare systems after-hours. This leads to delays in care, patient/provider dissatisfaction, inappropriate resource utilization, readmissions, and higher costs. It is important to provide patients and providers with effective clinical decision-making tools to allow seamless connectivity and coordinated care. In August 2015, patient-centric Stanford Health Care established Clinical Advice Services (CAS) to provide clinical decision support after-hours. CAS is founded on key Lean principles: Value stream mapping, empathy mapping, waste walk, takt time calculations, standard work, plan-do-check-act cycles, and active daily management. At CAS, Clinical Assistants take the initial call and manage all non-clinical calls (e.g., appointments, directions, general information). If the patient has a clinical symptom, the CAS nurses take the call and utilize standardized clinical algorithms to triage the patient to home, clinic, urgent care, emergency department, or 911. Nurses may also contact the on-call physician based on the clinical algorithm for further direction and consultation. Since August 2015, CAS has managed 228,990 calls from 26 clinical specialties. Reporting is built into the electronic health record for analysis and data collection. 65.3% of the after-hours calls are clinically related. Average clinical algorithm adherence rate has been 92%. An average of 9% of calls was escalated by CAS nurses to the physician on call. An average of 5% of patients was triaged to the Emergency Department by CAS. Key learnings indicate that a seamless connectivity vision, cascading, multidisciplinary ownership of the problem, and synergistic enterprise improvements have contributed to this success while striving for continuous improvement.

Keywords: after hours phone calls, clinical advice services, nurse triage, Stanford Health Care

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1027 Investigating Acute and Chronic Pain after Bariatric Surgery

Authors: Patti Kastanias, Wei Wang, Karyn Mackenzie, Sandra Robinson, Susan Wnuk

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Obesity is a worldwide epidemic and is recognized as a chronic disease. Pain in the obese individual is a multidimensional issue. An increase in BMI is positively correlated with pain incidence and severity, especially in central obesity where individuals are twice as likely to have chronic pain. Both obesity and chronic pain are also associated with mood disorders. Pain is worse among obese individuals with depression and anxiety. Bariatric surgery provides patients with an effective solution for long-term weight loss and associated health problems. However, not much is known about acute and chronic pain after bariatric surgery and its contributing factors, including mood disorders. Nurse practitioners (NPs) at one large multidisciplinary bariatric surgery centre led two studies to examine acute and chronic pain and pain management over time after bariatric surgery. The purpose of the initial study was to examine the incidence and severity of acute and chronic pain after bariatric surgery. The aim of the secondary study was to further examine chronic pain, specifically looking at psychological factors that influence severity or incidence of both neuropathic and somatic pain as well as changes in opioid use. The initial study was a prospective, longitudinal study where patients having bariatric surgery at one surgical center were followed up to 6 months postop. Data was collected at 7 time points using validated instruments for pain severity, pain interference, and patient satisfaction. In the second study, subjects were followed longitudinally starting preoperatively and then at 6 months and 1 year postoperatively to capture changes in chronic pain and influencing variables over time. Valid and reliable instruments were utilized for all major study outcomes. In the first study, there was a trend towards decreased acute post-operative pain over time. The incidence and severity of chronic pain was found to be significantly reduced at 6 months post bariatric surgery. Interestingly, interference of chronic pain in daily life such as normal work, mood, and walking ability was significantly improved at 6 months postop however; this was not the case with sleep. Preliminary results of the secondary study indicate that pain severity, pain interference, anxiety and depression are significantly improved at 6 months postoperatively. In addition, preoperative anxiety, depression and emotional regulation were predictive of pain interference, but not pain severity. The results of our regression analyses provide evidence for the impact of pre-existing psychological factors on pain, particularly anxiety in obese populations.

Keywords: bariatric surgery, mood disorders, obesity, pain

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1026 Sleep Health Management in Residential Aged Care Facilities

Authors: Elissar Mansour, Emily Chen, Tracee Fernandez, Mariam Basheti, Christopher Gordon, Bandana Saini

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Sleep is an essential process for the maintenance of several neurobiological processes such as memory consolidation, mood, and metabolic processes. It is known that sleep patterns vary with age and is affected by multiple factors. While non-pharmacological strategies are generally considered first-line, sedatives are excessively used in the older population. This study aimed to explore the management of sleep in residential aged care facilities (RACFs) by nurse professionals and to identify the key factors that impact provision of optimal sleep health care. An inductive thematic qualitative research method was employed to analyse the data collected from semi-structured interviews with registered nurses working in RACF. Seventeen interviews were conducted, and the data yielded three themes: 1) the nurses’ observations and knowledge of sleep health, 2) the strategies employed in RACF for the management of sleep disturbances, 3) the organizational barriers to evidence-based sleep health management. Nurse participants reported the use of both non-pharmacological and pharmacological interventions. Sedatives were commonly prescribed due to their fast action and accessibility despite the guidelines indicating their use in later stages. Although benzodiazepines are known for their many side effects, such as drowsiness and oversedation, temazepam was the most commonly administered drug. Sleep in RACF was affected by several factors such as aging and comorbidities (e.g., dementia, pain, anxiety). However, the were also many modifiable factors that negatively impacted sleep management in RACF. These include staffing ratios, nursing duties, medication side effects, and lack of training and involvement of allied health professionals. This study highlighted the importance of involving a multidisciplinary team and the urge to develop guidelines and training programs for healthcare professionals to improve sleep health management in RACF.

Keywords: registered nurses, residential aged care facilities, sedative use, sleep

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1025 Acquisition and Preservation of Traditional Medicinal Knowledge in Rural Areas of KwaZulu Natal, South Africa

Authors: N. Khanyile, P. Dlamini, M. Masenya

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Background: Most of the population in Africa is still dependent on indigenous medicinal knowledge for treating and managing ailments. Indigenous traditional knowledge owners/practitioners who own this knowledge are consulted by communities, but their knowledge is not known how they get it. The question of how knowledge is acquired and preserved remains one of the biggest challenges in traditional healing and treatment with herbal medicines. It is regrettable that despite the importance and recognition of indigenous medicinal knowledge globally, the details of acquirement, storing and transmission, and preservation techniques are not known. Hence this study intends to unveil the process of acquirement and transmission, and preservation techniques of indigenous medical knowledge by its owners. Objectives: This study aims to assess the process of acquiring and preservation of traditional medicinal knowledge by traditional medicinal knowledge owners/practitioners in uMhlathuze Municipality, in the province of KwaZulu-Natal, South Africa. The study was guided by four research objectives which were to: identify the types of traditional medicinal knowledge owners who possess this knowledge, establish the approach used by indigenous medicinal knowledge owners/healers for acquiring medicinal knowledge, identify the process of preservation of medicinal knowledge by indigenous medicinal knowledge owners/healers, and determine the challenges encountered in transferring the knowledge. Method: The study adopted a qualitative research approach, and a snowball sampling technique was used to identify the study population. Data was collected through semi-structured interviews with indigenous medicinal knowledge owners. Results: The findings suggested that uMhlathuze municipality had different types of indigenous medicinal knowledge owners who possess valuable knowledge. These are diviners (Izangoma), faith healers (Abathandazi), and herbalists (Izinyanga). The study demonstrated that indigenous medicinal knowledge is acquired in many different ways, including visions, dreams, and vigorous training. The study also revealed the acquired knowledge is preserved or shared with specially chosen children and trainees. Conclusion: The study concluded that this knowledge is gotten through vigorous training, which requires the learner to be attentive and eager to learn. It was recommended that a study of this nature be conducted but at a broader level to enhance an informed conclusion and recommendations.

Keywords: preserving, indigenous medicinal knowledge, indigenous knowledge, indigenous medicinal knowledge owners/practitioners, acquiring

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1024 Health Belief Model to Predict Sharps Injuries among Health Care Workers at First Level Care Facilities in Rural Pakistan

Authors: Mohammad Tahir Yousafzai, Amna Rehana Siddiqui, Naveed Zafar Janjua

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We assessed the frequency and predictors of sharp injuries (SIs) among health care workers (HCWs) at first level care facilities (FLCF) in rural Pakistan. HCWs working at public clinic (PC), privately owned licensed practitioners’ clinic (LPC) and non-licensed practitioners’ clinic (NLC) were interviewed on universal precautions (UPs) and constructs of health belief model (HBM) to assess their association with SIs through negative-binomial regression. From 365 clinics, 485 HCWs were interviewed. Overall annual rate of Sis was 192/100 HCWs/year; 78/100 HCWs among licensed prescribers, 191/100 HCWs among non-licensed prescribers, 248/100 HCWs among qualified assistants, and 321/100 HCWs among non-qualified assistants. Increasing knowledge score about bloodborne pathogens (BBPs) transmission (rate-ratio (RR): 0.93; 95%CI: 0.89–0.96), fewer years of work experience, being a non-licensed prescriber (RR: 2.02; 95%CI: 1.36–2.98) licensed (RR: 2.86; 9%CI: 1.81–4.51) or non-licensed assistant (RR: 2.78; 95%CI: 1.72–4.47) compared to a licensed prescriber, perceived barriers (RR: 1.06;95%CI: 1.03–1.08), and compliance with UPs scores (RR: 0.93; 95%CI: 0.87–0.97) were significant predictors of SIs. Improved knowledge about BBPs, compliance with UPs and reduced barriers to follow UPs could reduce SIs to HCWs.

Keywords: health belief model, sharp injuries, needle stick injuries, healthcare workers

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1023 Smart Signature - Medical Communication without Barrier

Authors: Chia-Ying Lin

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This paper explains how to enhance doctor-patient communication and nurse-patient communication through multiple intelligence signing methods and user-centered. It is hoped that through the implementation of the "electronic consent", the problems faced by the paper consent can be solved: storage methods, resource utilization, convenience, correctness of information, integrated management, statistical analysis and other related issues. Make better use and allocation of resources to provide better medical quality. First, invite the medical records department to assist in the inventory of paper consent in the hospital: organising, classifying, merging, coding, and setting. Second, plan the electronic consent configuration file: set the form number, consent form group, fields and templates, and the corresponding doctor's order code. Next, Summarize four types of rapid methods of electronic consent: according to the doctor's order, according to the medical behavior, according to the schedule, and manually generate the consent form. Finally, system promotion and adjustment: form an "electronic consent promotion team" to improve, follow five major processes: planning, development, testing, release, and feedback, and invite clinical units to raise the difficulties faced in the promotion, and make improvements to the problems. The electronic signature rate of the whole hospital will increase from 4% in January 2022 to 79% in November 2022. Use the saved resources more effectively, including: reduce paper usage (reduce carbon footprint), reduce the cost of ink cartridges, re-plan and use the space for paper medical records, and save human resources to provide better services. Through the introduction of information technology and technology, the main spirit of "lean management" is implemented. Transforming and reengineering the process to eliminate unnecessary waste is also the highest purpose of this project.

Keywords: smart signature, electronic consent, electronic medical records, user-centered, doctor-patient communication, nurse-patient communication

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1022 Referrals to Occupational Therapy Driving Assessors: A Qualitative Study of General Practitioners

Authors: Mary Butler

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Background: Screening programmes for older drivers in Europe (though not the UK), and in many states in the US and in Australia are based on medical assessment of fitness to drive. These programmes require physicians (including general practitioners) to carry out an assessment of fitness to drive in their offices. In 2006, New Zealand changed from doing on-road driving tests with all older drivers from the age of 80, to a screening programme that uses medical assessment of fitness to drive only. Aim: This study set out to understand the experience of New Zealand GPs as they manage the process of medical assessment of fitness to drive assessments for older people. In particular, it aimed to establish how GPs understand the role of specialist driving assessment and rehabilitation carried out by occupational therapists. Design and setting: The study used an interpretive descriptive approach to analyze data from ten interviews with GPs in New Zealand. Results: The results indicated that GPs lack understanding about how occupational therapists can assist their patients, and tend to refer only when there is a disagreement with the patient. Conclusion: There are problems with the medical assessment of fitness to drive carried out by GPs, and there is a need for a more comprehensive community approach to driving cessation. Patients, families and the multidisciplinary team all have a role in deciding when driving cessation should occur. Occupational therapists have a particular responsibility for strategic leadership in this area of practice.

Keywords: assessment, driving, older people, occupational therapy

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1021 Introduction of Acute Paediatric Services in Primary Care: Evaluating the Impact on GP Education

Authors: Salman Imran, Chris Healey

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Traditionally, medical care of children in England and Wales starts from primary care with a referral to secondary care paediatricians who may not investigate further. Many primary care doctors do not undergo a paediatric rotation/exposure in training. As a result, there are many who have not acquired the necessary skills to manage children hence increasing hospital referral. With the current demand on hospitals in the National Health Service managing more problems in the community is needed. One way of handling this is to set up clinics, meetings and huddles in GP surgeries where professionals involved (general practitioner, paediatrician, health visitor, community nurse, dietician, school nurse) come together and share information which can help improve communication and care. The increased awareness and education that paediatricians can impart in this way will help boost confidence for primary care professionals to be able to be more self-sufficient. This has been tried successfully in other regions e.g., St. Mary’s Hospital in London but is crucial for a more rural setting like ours. The primary aim of this project would be to educate specifically GP’s and generally all other health professionals involved. Additional benefits would be providing care nearer home, increasing patient’s confidence in their local surgery, improving communication and reducing unnecessary patient flow to already stretched hospital resources. Methods: This was done as a plan do study act cycle (PDSA). Three clinics were delivered in different practices over six months where feedback from staff and patients was collected. Designated time for teaching/discussion was used which involved some cases from the actual clinics. Both new and follow up patients were included. Two clinics were conducted by a paediatrician and nurse whilst the 3rd involved paediatrician and local doctor. The distance from hospital to clinics varied from two miles to 22 miles approximately. All equipment used was provided by primary care. Results: A total of 30 patients were seen. All patients found the location convenient as it was nearer than the hospital. 70-90% clearly understood the reason for a change in venue. 95% agreed to the importance of their local doctor being involved in their care. 20% needed to be seen in the hospital for further investigations. Patients felt this to be a more personalised, in-depth, friendly and polite experience. Local physicians felt this to be a more relaxed, familiar and local experience for their patients and they managed to get immediate feedback regarding their own clinical management. 90% felt they gained important learning from the discussion time and the paediatrician also learned about their understanding and gaps in knowledge/focus areas. 80% felt this time was valuable for targeted learning. Equipment, information technology, and office space could be improved for the smooth running of any future clinics. Conclusion: The acute paediatric outpatient clinic can be successfully established in primary care facilities. Careful patient selection and adequate facilities are important. We have demonstrated a further step in the reduction of patient flow to hospitals and upskilling primary care health professionals. This service is expected to become more efficient with experience.

Keywords: clinics, education, paediatricians, primary care

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1020 Social Technology and Youth Justice: An Exploration of Ethical and Practical Challenges

Authors: Ravinder Barn, Balbir Barn

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This paper outlines ethical and practical challenges in the building of social technology for use with socially excluded and marginalised groups. The primary aim of this study was to design, deploy and evaluate social technology that may help to promote better engagement between case workers and young people to help prevent recidivism, and support young people’s transition towards social inclusion in society. A total of 107 practitioners/managers (n=64), and young people (n=43) contributed to the data collection via surveys, focus groups and 1-1 interviews. Through a process of co-design where end-users are involved as key contributors to social technological design, this paper seeks to make an important contribution to the area of participatory methodologies by arguing that whilst giving ‘voice’ to key stakeholders in the research process is crucial, there is a risk that competing voices may lead to tensions and unintended outcomes. The paper is contextualized within a Foucauldian perspective to examine significant concepts including power, authority and surveillance. Implications for youth justice policy and practice are considered. The authors conclude that marginalized youth and over-stretched practitioners are better served when such social technology is perceived and adopted as a tool of empowerment within a framework of child welfare and child rights.

Keywords: youth justice, social technology, marginalization, participatory research, power

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1019 Ethics in the Production of Chinese Reality TV

Authors: Tianyu Zhang

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China has become one of the markets with the biggest potential for UK exporters, but it remains difficult for outsiders to explore Chinese media’s inner workings due to a lack of access. Having worked in Chinese media, the author conducted six month’s participant-observation in China Central Television (CCTV) and three independent production companies. This paper mainly explores how TV production ethics were implemented in the casting process of three Chinese reality shows that are well-known within the country. The three production teams had issues in common: unorganised management, subjective casting standards and lack of production ethics. Casting directors, who were multitasking, could only rely on their professional experience and ad-hoc demands from the management. More concerning phenomena such as borderline corruption, passive-aggressiveness, and blame cultures were prevalent during the entire production, especially during casting. The casting process also often involved the celebrity status of the many ‘ordinary’ participants who were not that ‘ordinary’ as they claimed. Many of these participants were professional talents who were not famous enough but worked as many other well-known celebrities who had their own employees. On the other hand, as comprehensive production and ethics guidelines were missing, junior television practitioners struggled between their ideal professional standards and real-life events that fell into grey areas – telling white lies, bribery, shifting blame, and lack of employee training. Although facing challenges, many practitioners came up with self-management solutions and worked with positivity.

Keywords: production studies, ethics, television production, ethnography, reality TV, Chinese TV

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1018 Systematic Review of Sexual Assault Prevention Methods for Older Adults: Exploring the Hidden Needs of a Growing Population

Authors: Michelle Hand, Brieanne Beaujolais

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Rape stereotypes have long involved the assault of young females by strangers desiring sex. As such, older adult women and men have largely been excluded from research, policies, and awareness raising initiatives to address sexual violence. Moreover sexual assault accounts for the most underreported type of abuse experienced by older adults, highlighting a need to expand our knowledge base in this area. Thus a systematic review of peer-reviewed scholarly articles and reports was conducted to explore the ways sexual assault has been prevented among older adults in recent years and to identify implications for researchers and practitioners as they aim to meet the needs of this population. Articles and reports published during or after 2007 were eligible if their focus included methods to address sex abuse among older adults as well as practice or research implications. Forty-four articles met this criteria and were included in this systematic review. The findings from this review will provide an in-depth understanding of the under-researched issue of sexual violence among older adult women and men as well as current prevention strategies. In addition, implications and recommendations will be provided for practitioners, educators and researchers as they aim to meet the hidden needs of this growing yet under-researched population.

Keywords: elder, rape, sexual assault, sexual violence

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1017 Developing Telehealth-Focused Advanced Practice Nurse Educational Partnerships

Authors: Shelley Y. Hawkins

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Introduction/Background: As technology has grown exponentially in healthcare, nurse educators must prepare Advanced Practice Registered Nurse (APRN) graduates with the knowledge and skills in information systems/technology to support and improve patient care and health care systems. APRN’s are expected to lead in caring for populations who lack accessibility and availability through the use of technology, specifically telehealth. The capacity to effectively and efficiently use technology in patient care delivery is clearly delineated in the American Association of Colleges of Nursing (AACN) Doctor of Nursing Practice (DNP) and Master of Science in Nursing (MSN) Essentials. However, APRN’s have minimal, or no, exposure to formalized telehealth education and lack necessary technical skills needed to incorporate telehealth into their patient care. APRN’s must successfully master the technology using telehealth/telemedicine, electronic health records, health information technology, and clinical decision support systems to advance health. Furthermore, APRN’s must be prepared to lead the coordination and collaboration with other healthcare providers in their use and application. Aim/Goal/Purpose: The purpose of this presentation is to establish and operationalize telehealth-focused educational partnerships between one University School of Nursing and two health care systems in order to enhance the preparation of APRN NP students for practice, teaching, and/or scholarly endeavors. Methods: The proposed project was initially presented by the project director to selected multidisciplinary stakeholders including leadership, home telehealth personnel, primary care providers, and decision support systems within two major health care systems to garner their support for acceptance and implementation. Concurrently, backing was obtained from key university-affiliated colleagues including the Director of Simulation and Innovative Learning Lab and Coordinator of the Health Care Informatics Program. Technology experts skilled in design and production in web applications and electronic modules were secured from two local based technology companies. Results: Two telehealth-focused APRN Program academic/practice partnerships have been established. Students have opportunities to engage in clinically based telehealth experiences focused on: (1) providing patient care while incorporating various technology with a specific emphasis on telehealth; (2) conducting research and/or evidence-based practice projects in order to further develop the scientific foundation regarding incorporation of telehealth with patient care; and (3) participating in the production of patient-level educational materials related to specific topical areas. Conclusions: Evidence-based APRN student telehealth clinical experiences will assist in preparing graduates who can effectively incorporate telehealth into their clinical practice. Greater access for diverse populations will be available as a result of the telehealth service model as well as better care and better outcomes at lower costs. Furthermore, APRN’s will provide the necessary leadership and coordination through interprofessional practice by transforming health care through new innovative care models using information systems and technology.

Keywords: academic/practice partnerships, advanced practice nursing, nursing education, telehealth

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1016 Multimedia Design in Tactical Play Learning and Acquisition for Elite Gaelic Football Practitioners

Authors: Michael McMahon

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The use of media (video/animation/graphics) has long been used by athletes, coaches, and sports scientists to analyse and improve performance in technical skills and team tactics. Sports educators are increasingly open to the use of technology to support coach and learner development. However, an overreliance is a concern., This paper is part of a larger Ph.D. study looking into these new challenges for Sports Educators. Most notably, how to exploit the deep-learning potential of Digital Media among expert learners, how to instruct sports educators to create effective media content that fosters deep learning, and finally, how to make the process manageable and cost-effective. Central to the study is Richard Mayers Cognitive Theory of Multimedia Learning. Mayers Multimedia Learning Theory proposes twelve principles that shape the design and organization of multimedia presentations to improve learning and reduce cognitive load. For example, the Prior Knowledge principle suggests and highlights different learning outcomes for Novice and Non-Novice learners, respectively. Little research, however, is available to support this principle in modified domains (e.g., sports tactics and strategy). As a foundation for further research, this paper compares and contrasts a range of contemporary multimedia sports coaching content and assesses how they perform as learning tools for Strategic and Tactical Play Acquisition among elite sports practitioners. The stress tests applied are guided by Mayers's twelve Multimedia Learning Principles. The focus is on the elite athletes and whether current coaching digital media content does foster improved sports learning among this cohort. The sport of Gaelic Football was selected as it has high strategic and tactical play content, a wide range of Practitioner skill levels (Novice to Elite), and also a significant volume of Multimedia Coaching Content available for analysis. It is hoped the resulting data will help identify and inform the future instructional content design and delivery for Sports Practitioners and help promote best design practices optimal for different levels of expertise.

Keywords: multimedia learning, e-learning, design for learning, ICT

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1015 Predicting Stack Overflow Accepted Answers Using Features and Models with Varying Degrees of Complexity

Authors: Osayande Pascal Omondiagbe, Sherlock a Licorish

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Stack Overflow is a popular community question and answer portal which is used by practitioners to solve technology-related challenges during software development. Previous studies have shown that this forum is becoming a substitute for official software programming languages documentation. While tools have looked to aid developers by presenting interfaces to explore Stack Overflow, developers often face challenges searching through many possible answers to their questions, and this extends the development time. To this end, researchers have provided ways of predicting acceptable Stack Overflow answers by using various modeling techniques. However, less interest is dedicated to examining the performance and quality of typically used modeling methods, and especially in relation to models’ and features’ complexity. Such insights could be of practical significance to the many practitioners that use Stack Overflow. This study examines the performance and quality of various modeling methods that are used for predicting acceptable answers on Stack Overflow, drawn from 2014, 2015 and 2016. Our findings reveal significant differences in models’ performance and quality given the type of features and complexity of models used. Researchers examining classifiers’ performance and quality and features’ complexity may leverage these findings in selecting suitable techniques when developing prediction models.

Keywords: feature selection, modeling and prediction, neural network, random forest, stack overflow

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1014 Lean Construction Techniques in Construction Projects of Pakistan

Authors: Aftab Hameed Memon, Shadab Noor, Muhammad Akram Akhund

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Lean construction is a philosophy adopted in the construction industry to increase the value of a project by reducing waste and improving construction productivity. Lean emphasizes on maximizing the value of a project with less expenditure. Globally, lean philosophy has received wider popularity in construction sector. Lean construction has supported the practitioners with several tools and techniques to implement at various stages of a construction project. Following the global trends, this study has investigated the lean practice in Pakistan. The level of implementation of different lean tools and techniques altogether with potential benefits experienced by its implementation in construction projects of Pakistan is analyzed. To achieve the targets, the opinion was sought by the practitioners involved in handling construction projects representing four stakeholders that are a client, consultant, contractors and material suppliers through a structured questionnaire. A total of 34 completed questionnaires were collected and then statistically analyzed. The findings of the analysis have highlighted that pull approach, work standardization, just in time, increase visualization tools, integrated project delivery method and fail-safe for quality are common lean techniques implemented in the local construction industry. While reduction in waste, client’s satisfaction, improved communication, visual control and proper task management are major benefits of the lean construction application.

Keywords: lean construction, lean tools and techniques, lean benefits, waste reduction, Pakistan

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1013 Links between Moral Distress of Registered Nurses and Factors Related to Patient Care at the End of Their Life: A Cross Sectional Survey

Authors: L. Laurs, A. Blazeviciene, D. Milonas

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Introduction: Nursing as a profession is grounded in moral obligation. Nursing practice is grounded in ethical standards: to not harm, to promote justice, to be accountable, and to provide safe and competent care. The nature of the nurse-patient therapeutic relationship requires acting on the patient's behalf. Moral distress consists of negative stress symptoms that occur in situations that involve ethical situations that the nurse perceives as discordant with their professional values. Aim of the Study: The purpose of this study was to assess links between moral distress of registered nurses and factors related to patient care at the end of their life. Methods and Sample: A descriptive, cross-sectional, correlational design was applied in this study. Registered nurses were recruited from seven municipal multi-profile hospitals providing both general and specialized healthcare services in Lithuania (N=1055). Research instruments included two questionnaires: Obstacles and Facilitating at the End of Life Care and Moral Distress Scale (revised). Results: Spearman’s correlation analysis was performed to assess the relationship between nurses' attitudes towards patient care at the end of life and the experienced moral distress. A statistically significant correlation between moral distress and the following factors related to patient end-of-life care has been identified: conversations with physicians on patient end-of-life problems have a positive impact on job satisfaction; some patients may be excluded from decisions about their treatment and nursing because they are questioned about their ability to assess the situation. These situations increased moral distress. Patient consciousness should not be permanently suppressed by calming medications, and the patient should be provided with all nursing care services and moral distress. Conclusions: The moral distress of nurses is significantly related to the end-of-life care of patients and their determinants: moral distress increased due to lack of discussion with doctors about problem-solving and exclusion of patients from decision-making. And it diminished by refusing calming medications to permanently suppress a patient's consciousness and providing good care for patients.

Keywords: moral distress, registered nurses, end of life, care

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1012 Development of Peaceful Wellbeing in Executive Practitioners through Mindfulness-Based Practices

Authors: Narumon Jiwattanasuk, Phrakrupalad Pannavoravat, Pataraporn Sirikanchana

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Mindfulness has become a perspective addressing positive wellbeing these days. The aims of this paper are to analyze the problems of executive meditation practitioners at the Buddhamahametta Foundation in Thailand and to provide recommendations on the process to develop peaceful wellbeing in executive meditation practitioners by applying the principles of the four foundations of mindfulness. This study is particularly focused on executives because there is not much research focusing on the well-being development of executives, and the researcher recognizes that executives can be an example within their organizations. This would be a significant influence on their employees and their families to be interested in practicing mindfulness. This improvement will then grow from an individual to the surrounding community such as family, workplace, society, and the nation. This would lead to happiness at the national level, which is the expectation of this research. The paper highlights mindfulness practices that can be performed on a daily basis. This study is qualitative research, and there are 10 key participants who are executives from various sectors such as hospitality, healthcare, retail, power energy, and so on. Three mindfulness-based courses were conducted over a period of 8 months, and in-depth interviews were done before the first course as well as at the end of every course. In total, four in-depth interviews were conducted. The information collected from the interviews was analyzed in order to create the process to develop peaceful well-being. Focus group discussions with the mindfulness specialists were conducted to help develop the mindfulness program as well. As a result of this research, it is found that the executives faced the following problems: stress, negative thinking loops, losing temper, seeking acceptance, worry about uncontrollable external factors, unable to control their words, and weight gain. The cultivation of the four foundations of mindfulness can develop peaceful wellbeing. The results showed that after the key informant executives attended the mindfulness courses and practiced mindfulness regularly, they have developed peaceful well-being in all aspects such as physical, psychological, behavioral, and intellectual by applying 12 mindfulness-based activities. The development of wellbeing, in the conclusion of this study, also includes various tools to support the continuing practice, including the handout of guided mindfulness practice, VDO clips about mindfulness practice, the online dhamma channel, and mobile applications to support regular mindfulness-based practices.

Keywords: executive, mindfulness activities, stress, wellbeing

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1011 Impact of Organizational Citizenship Behavior on Employee Performance: Mediating Role of Counterproductive Work Behavior in Hotel Industry of Pakistan

Authors: Kashif Mahmood, Tehreem Fatima, Adeel Hassan

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Firms are always concerned with their performance which is directly linked to employees’ performance. In the thrive of this goal, number of researches have been conducted where Organizational Citizenship Behavior (OCB) and Counterproductive Work Behavior (CPWB) is among those studies. This study is aimed at investigating the role OCB by considering altruism and conscientiousness in an employee’s job performance with the mediating role of CPWB by considering sabotage and withdraw among the employees of hotel industry in Pakistan. A quantitative method was used by following deductive approach in positivist paradigm where survey was conducted through self-administered questionnaires and data was collected from the employees working in hotel industry of Pakistan. Top 10 hotels from the region of Lahore, Punjab was selected as population, and 500 questionnaires were distributed among their employees by using stratified random sampling technique. There is a positive impact of OCB is found on job performance of an employee whereas full mediation of CPWB is also found between OCB and job performance. The study is important for the practitioners in a way that hotel industry is growing at an enormous rate where employee behavior is always a concern specifically in emerging markets due to the exploitation of employees at the workplace, so the findings of the study can be helpful for practitioners and policy makers.

Keywords: organizational citizenship behavior, counterproductive work behavior, employee performance, altruism, conscientiousness, sabotage, withdraw, hotel industry

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1010 Challenges in Developing a World Class Sustainable Food Organization

Authors: Baskar Kotte

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Many organizations are constantly striving to implement numerous techniques for long-term sustainability, for food related organizations it is imperative to conceptualize the critical concepts which constitute food safety sustainability. This presentation provides three critical pillars to develop a sustainable organization. Financial sustainability, regulatory sustainability and excellence standards sustainability are the three components which practiced and implemented effectively with process performance metrics defined objectives and targets lead to sustainable and safe food organizations. The participants take away a well-developed concept diagram with all elements impacting sustainability. Proven disciplined path which worked to achieve desired results is presented for effective implementation. Effective implementation of this proven disciplined path positions organizations to achieve world class status with bottomline improvement. Additionally, this presentation highlights critical terms, principles and implementation difficulties related to using the proven disciplined path. This presentation is beneficial for business leaders, food safety compliance managers, food safety practitioners, financial managers, Lean & Six sigma continual improvement managers, BRC/SQF/ IFS / FSSC 22000 practitioners and food manufacturing personnel.

Keywords: food safety, sustainability, regulatory, lean, six sigma, bottom-line improvement disciplined path

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