scholarly journals An aggression policy that works

2004 ◽  
Vol 28 (3) ◽  
pp. 357 ◽  
Author(s):  
Denby A Kitchener ◽  
Sharon R Sykes ◽  
Allan G McEwan
Keyword(s):  
Aggressive Behaviour ◽  
Action Plan ◽  
Working Party ◽  
Early Discharge ◽  
Fundamental Principle ◽  
Management Policy ◽  
Staff Members ◽  
Effective Strategies ◽  
Aggression Management

In 1999, a survey of the clinical staff in Royal Darwin Hospital showed that most instances of aggressive and abusive behaviour by patients or visitors occurring in the hospital went unreported because staff believed there would not be any follow-up investigation or action taken by management. In response, a hospital working party was formed to develop and implement an aggression management policy with practical effective strategies. The principal tool used was an Action Plan that delineated an immediate response to the aggression, as well as long-term strategies such as negotiated care and behaviour modification programs. An advocate is provided for the patient and debriefing for staff members. If the aggressive behaviour continues, early discharge of the patient could be initiated. The fundamental principle of the policy is to prevent fostering a culture of acceptance of aggressive behaviour through appropriate early intervention. In 2002, a follow-up survey showed that 82% of aggressive incidents were being reported and dealt with by management in a timely manner ? a significant improvement.

scholarly journals Process evaluation of appreciative inquiry to translate pain management evidence into pediatric nursing practice

2021 ◽  
Author(s):  
Tricia Kavanagh ◽  
Bonniue Stevens ◽  
Kate Seers ◽  
Souraya Sidani ◽  
Judy Watt-Watson
Keyword(s):  
Pain Management ◽  
Appreciative Inquiry ◽  
Action Plan ◽  
Implementation Process ◽  
Study Data ◽  
Pediatric Care ◽  
Clinical Issue ◽  
Staff Members

Background Appreciative inquiry (AI) is an innovative knowledge translation (KT) intervention that is compatible with the Promoting Action on Research in Health Services (PARiHS) framework. This study explored the innovative use of AI as a theoretically based KT intervention applied to a clinical issue in an inpatient pediatric care setting. The implementation of AI was explored in terms of its acceptability, fidelity, and feasibility as a KT intervention in pain management. Methods A mixed-methods case study design was used. The case was a surgical unit in a pediatric academic-affiliated hospital. The sample consisted of nurses in leadership positions and staff nurses interested in the study. Data on the AI intervention implementation were collected by digitally recording the AI sessions, maintaining logs, and conducting individual semistructured interviews. Data were analysed using qualitative and quantitative content analyses and descriptive statistics. Findings were triangulated in the discussion. Results Three nurse leaders and nine staff members participated in the study. Participants were generally satisfied with the intervention, which consisted of four 3-hour, interactive AI sessions delivered over two weeks to promote change based on positive examples of pain management in the unit and staff implementation of an action plan. The AI sessions were delivered with high fidelity and 11 of 12 participants attended all four sessions, where they developed an action plan to enhance evidence-based pain assessment documentation. Participants labeled AI a 'refreshing approach to change' because it was positive, democratic, and built on existing practices. Several barriers affected their implementation of the action plan, including a context of change overload, logistics, busyness, and a lack of organised follow-up. Conclusions Results of this case study supported the acceptability, fidelity, and feasibility of AI as a KT intervention in pain management. The AI intervention requires minor refinements (e.g., incorporating continued follow-up meetings) to enhance its clinical utility and sustainability. The implementation process and effectiveness of the modified AI intervention require evaluation in a larger multisite study.

scholarly journals Process evaluation of appreciative inquiry to translate pain management evidence into pediatric nursing practice

2021 ◽  
Author(s):  
Tricia Kavanagh ◽  
Bonniue Stevens ◽  
Kate Seers ◽  
Souraya Sidani ◽  
Judy Watt-Watson
Keyword(s):  
Pain Management ◽  
Appreciative Inquiry ◽  
Action Plan ◽  
Implementation Process ◽  
Study Data ◽  
Pediatric Care ◽  
Clinical Issue ◽  
Staff Members

Background Appreciative inquiry (AI) is an innovative knowledge translation (KT) intervention that is compatible with the Promoting Action on Research in Health Services (PARiHS) framework. This study explored the innovative use of AI as a theoretically based KT intervention applied to a clinical issue in an inpatient pediatric care setting. The implementation of AI was explored in terms of its acceptability, fidelity, and feasibility as a KT intervention in pain management. Methods A mixed-methods case study design was used. The case was a surgical unit in a pediatric academic-affiliated hospital. The sample consisted of nurses in leadership positions and staff nurses interested in the study. Data on the AI intervention implementation were collected by digitally recording the AI sessions, maintaining logs, and conducting individual semistructured interviews. Data were analysed using qualitative and quantitative content analyses and descriptive statistics. Findings were triangulated in the discussion. Results Three nurse leaders and nine staff members participated in the study. Participants were generally satisfied with the intervention, which consisted of four 3-hour, interactive AI sessions delivered over two weeks to promote change based on positive examples of pain management in the unit and staff implementation of an action plan. The AI sessions were delivered with high fidelity and 11 of 12 participants attended all four sessions, where they developed an action plan to enhance evidence-based pain assessment documentation. Participants labeled AI a 'refreshing approach to change' because it was positive, democratic, and built on existing practices. Several barriers affected their implementation of the action plan, including a context of change overload, logistics, busyness, and a lack of organised follow-up. Conclusions Results of this case study supported the acceptability, fidelity, and feasibility of AI as a KT intervention in pain management. The AI intervention requires minor refinements (e.g., incorporating continued follow-up meetings) to enhance its clinical utility and sustainability. The implementation process and effectiveness of the modified AI intervention require evaluation in a larger multisite study.

scholarly journals Analysis of risk scores and duration of hospital stay in prognosis of STEMI patients after pPCI

2021 ◽  
Vol 10 (Supplement_1) ◽  
Author(s):  
SR Thangasami ◽  
JS Prajapati ◽  
GL Dubey ◽  
VR Pandey ◽  
PM Shaniswara ◽  
...  
Keyword(s):  
Length Of Stay ◽  
Hospital Stay ◽  
Early Discharge ◽  
Risk Scores ◽  
Timi Score ◽  
Study Population ◽  
Event Rates ◽  
Grace Score

Abstract Funding Acknowledgements Type of funding sources: None. Introduction Advances in the immediate management of ST elevation myocardial infarction (STEMI) have led to a dramatic decline in mortality and reduction in hospital length of stay (LOS). We analysed the prognostic value of selected risk models in STEMI treated with primary percutaneous coronary intervention (PPCI) and to identify additional parameters to strengthen risk scores in categorizing patients for safe early discharge and to identify parameters prolonging hospital stay. Purpose To assess parameters and risk scores to categorize patients for safe early discharge following STEMI and to assess the composite of death, MI, unstable angina (UA), stroke, unplanned hospitalization at the end of 30 days, 6 months and at 1year follow up. Methods The study included 222 patients, who were diagnosed as STEMI, treated with successful pPCI. The risk scores like TIMI score, GRACE score, ZWOLLE score, CADILLAC score were calculated for all patients from the baseline clinical data collected on admission. Routine blood investigations along with Brain natri-uretic peptide (BNP) were done for all patients. The entire cohort was divided into three groups on the basis of length of stay: ≤3 days (n = 150), 4–5 days (n = 47), and >5 days (n = 25). All-cause mortality and major cardiovascular events (MACEs) were assessed up to 1 year. Results The mean age group (yrs) of the study population was 53.92 ± 12.9. Patients in LOS <3 days had a mean age (yrs) of 52.41 ± 11.74, patients in LOS 4-5 days group had 54.19 ±13.59 and patient with LOS >5 days had 62.52 ± 15.32. The most important parameters that predicted hospital stay in our study are BNP levels OR: 1.003, 95% CI: 1.002-1.004, P < 0.001, GRACE score OR: 1.02 ,95% CI: 1.01-1.03, P < 0.001, TIMI score OR: 1.35, 95% CI: 1.18-1.55, P = 0.007, ZWOLLE score OR: 1.26, 95% CI: 1.16-1.37, P < 0.001, CADILLAC score OR: 1.24, 95% CI; 1.15-1.3: P < 0.001. 32 (14.4%) patients expired in the study population. 36% patients of LOS >5 days expired in 1year follow up with maximum mortality in the first 6 months. 56% of the patients in LOS > 5 days had an adverse cardiac event in 1 year follow up. Patients in LOS >5 days had increased event rates in 30 days,6 months and in 1 year follow up. Patients with LOS 4-5 days (30%) had increased event rates than patients in LOS < 3 days (19%).Unadjusted Kaplan Meir survival curves for 1 year mortality among hospital survivors showed a significant increase in mortality at 6 months in length of stay> 5 days group. (P value < 0.001). CONCLUSION Long hospital stay after PCI among patients with STEMI was associated with increased long-term all-cause mortality. Addition of BNP to this risk scores can better predict the course of hospital stay and adverse clinical outcomes in follow up. Long hospital stay may be used as a marker to identify patients at higher risk for long-term mortality. Abstract Figure. Kaplan meir survival curve

scholarly journals Approaches to Anti-Ageism Interventions

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 672-672
Author(s):  
Tracey Gendron ◽  
Jennifer Inker
Keyword(s):  
Social Interactions ◽  
Self Esteem ◽  
Older Individuals ◽  
Staff Members ◽  
Self Development ◽  
And Behaviors ◽  
Aging Anxiety ◽  
Negative Impacts ◽  
Systemic Nature

Abstract Ageism, a multidimensional construct, is also understood as a relational process whereby perceptions and behaviors toward older individuals by younger individuals not only damage the self-esteem of elders, but also create a hostile environment for their own future social interactions and their own future self-development as elders. Anti-ageism interventions have the hefty task of improving attitudes and behaviors toward aging within all of these contexts. This presentation will discuss findings from two different anti-ageism interventions both designed to mitigate the negative impacts of ageism. Results from a study on an intergenerational arts-based program found that after participation students demonstrated a positive change in their attitudes toward older adults. Findings from a video-based ageism intervention among a sample of 265 staff members in 15 senior living communities demonstrated decreased internalized aging anxiety as well as decreased ageist behaviors directly after the training and at three month post follow-up. Given the complex and systemic nature of ageism, diversity is necessary in scope and type of intervention in order to reach the broadest audience.

CHALLENGES AND CONSTRAINTS TO ENHANCE THE ENTREPRENEURSHIP EDUCATION IN HIGHER EDUCATIONAL INSTITUTIONS OF A DEVELOPING COUNTRY: EVIDENCE FROM SRI LANKA

2020 ◽  
Vol 5 (12) ◽  
pp. 13-26
Author(s):  
T.M.A. Tennakoon ◽  
Kennedy Gunawardena ◽  
S.P. Premaratne
Keyword(s):  
Developing Countries ◽  
Sri Lanka ◽  
Education System ◽  
Action Plan ◽  
Secondary Data ◽  
Entrepreneurship Education ◽  
Sri Lankan ◽  
Study Approach ◽  
Effective Strategies ◽  
Developed Nations

This study through an exploratory approach review the challenges and constraints faced in enhancing entrepreneurship education in developing countries using Sri Lanka as a case study. Previous studies on the subject matter is very scarce and even in international journals only few papers appeared on entrepreneurship education in developing countries. The purpose of this paper is to study the current entrepreneurship education system in Sri Lankan state universities with reference to challenges and constraints and to propose an action plan to raise entrepreneurship education in Sri Lanka to be in par with that of developed nations so that these universities can act as the centerpieces of business innovations and entrepreneurship development. This paper employs an exploratory study approach by analyzing current entrepreneurship education system in Sri Lanka by reviewing secondary data such as various journals and government publications to build the arguments and recommendations outlined. Among constraints and challenges for the development of entrepreneurship education, lack of resources, lack of entrepreneurial skills in lecturers, poor stake-holder engagement, weak government policies and industry � university gap are common to most developing countries. In addition with its free education policy, Sri Lankan universities are faced with strict university entrance procedures and lack of selection of desired courses for majority of students. Findings of this study and salient suggestions will be an invaluable toolkit for policy makers to design effective strategies for entrepreneurship education in developing countries.

Perceptions of barriers to patient financial hardship screening differ by provider role within gynecologic oncology outpatient care.

2021 ◽  
Vol 39 (28_suppl) ◽  
pp. 317-317
Author(s):  
Jhalak Dholakia ◽  
Maria Pisu ◽  
Warner King Huh ◽  
Margaret Irene Liang
Keyword(s):  
Nurse Practitioners ◽  
Gynecologic Oncology ◽  
Financial Hardship ◽  
Comprehensive Cancer Center ◽  
Cancer Center ◽  
Patient Centered ◽  
Staff Members ◽  
Care Plans ◽  
Patient Barriers

317 Background: Although approximately half of patients with gynecologic malignancy experience financial hardship (FH) during treatment, best practices to identify and assist patients with FH are lacking. To develop such practices, we assessed oncology provider and staff perspectives about FH screening and provision of assistance. Methods: An anonymous survey was conducted electronically within the Gynecologic Oncology outpatient office at a Comprehensive Cancer Center. Potential barriers to patient FH screening and follow-up were assessed within 2 domains: 1) logistic barriers to incorporating FH screening and follow-up into outpatient workflow and 2) perceived patient barriers to FH screening. Responses were elicited on a 5-point Likert scale from ‘very’ to ‘not at all’ significant and dichotomized into significant and not significant barriers. Results: Of 43 providers approached, 37 responded (86% response rate) of which 14 were physicians (MD)/nurse practitioners (NP) and 23 were other staff members (i.e., clinical and research nurses, social workers, pharmacists, care coordinators, lay navigators, and financial counselors). Altogether, 38% worked in their current position for >5 years (n=14), 11% for 3-5 years (n=4), and 51% for <3 years (n=19). For logistic barriers to implementing FH screening and follow-up, the most frequently reported significant barriers included lack of personnel training (69%) and lack of available staff (62%), training regarding follow-up (72%), and case tracking infrastructure (67%). The most frequent significant perceived patient barriers were lack of knowledge of whom to contact (72%), concerns about impact on treatment if FH needs were identified (72%), and lack of patient readiness to discuss financial needs (62%.) Compared to MD/NP, staff members more often indicated the following as significant barriers: difficulty incorporating FH screening into initial visit workflow (31 % vs. 57%, p=0.03), overstretched personnel (29% vs 73%, p=0.005), and patient concerns about influence on treatment (62% vs 86%, p=0.01). Conclusions: Care team members identified barriers to patient FH screening across logistic and patient-centered domains, although MD/NP less so than other staff possibly reflecting different exposures to patient financial needs during clinical encounters or burden of workflow. Implementation of universal FH screening, dedicated personnel, convenient tracking mechanisms, and multi-disciplinary provider and staff training may improve recognition of patient FH and facilitate its integration into oncology care plans.

scholarly journals DEFCON 5: The Chris Hani Baragwanath Academic Hospital orthopaedic department's COVID-19 proactive action plan

2020 ◽  
Vol 19 (3) ◽  
Author(s):  
A Hirschmann ◽  
T Pillay ◽  
KW Fang ◽  
MT Ramokgopa ◽  
C Frey
Keyword(s):  
Orthopaedic Surgery ◽  
Action Plan ◽  
World Health ◽  
Global Public Health ◽  
Academic Hospital ◽  
Level Of Evidence ◽  
Staff Members ◽  
Level 3 ◽  
Health Organization ◽  
Multi Phase

ABSTRACT BACKGROUND: On 11 March 2020 the World Health Organization (WHO) declared COVID-19 a worldwide pandemic and a threat to global public health. In this paper we aim to describe the measures implemented to combat the COVID-19 pandemic in the Department of Orthopaedic Surgery at Chris Hani Baragwanath Academic Hospital (CHBAH), Soweto, Johannesburg, the largest hospital in Africa with approximately 3 200 beds and about 6 760 staff members. At the time of writing this report, we have transitioned from level 5 to level 3 lockdown METHODS: We performed a literature review and drew on the experiences of previous pandemic response plans worldwide. A working group comprising all relevant disciplines was created to develop standard operating procedures in line with governmental policy RESULTS: We found that by developing a multi-phase plan, we were able to maintain service delivery to all emergent patients while protecting medical staff and patients alike. This plan also allowed coordination with other disciplines and made provision for staff from within the Department of Orthopaedic Surgery to be made available to work within other departments as and when required. The implementation of this plan had to evolve constantly, adjusting to the changes in the national lockdown level and the demands of the developing situation CONCLUSION: We hope that by sharing our plan with our colleagues domestically and abroad, we can promote discussion and improve our ability to better prepare and deal with this unprecedented healthcare scenario. In order for us to win as individuals, we must fight as a team Level of evidence: Level 5 Keywords: COVID-19, orthopaedics, plan, response, Baragwanath

scholarly journals Practicability of Application of Re-Engineering the Administrative Processes at Colleges of Education in Universities in Arab-Majority Countries

2021 ◽  
Vol 14 (5) ◽  
pp. 87
Author(s):  
Bannaga Taha El-Zubair ◽  
El-Rusheed Habob Mohammed ◽  
Adil Mohammed Dafalla ◽  
Saad Saleh M. Alqarni
Keyword(s):  
Radical Change ◽  
Arab Countries ◽  
Colleges Of Education ◽  
Strategic Information ◽  
Staff Members ◽  
Strategic Process ◽  
Effective Training ◽  
Arab States ◽  
Teaching Learning

The study aims to highlight the importance of considering the implementation of process of re-engineering Reengineering Administrational Processes (RAP) in the Arab countries universities, particularly, colleges of education to attain good educational outputs. It seeks to highlight the requirements for this implementation and explore the problems associated to the implementation it and distinguish themselves from other organizations is. The Process of Re-Engineering (RAP) is defined as a rapid and drastic re-designing of managerial and strategic process of values at colleges of education in the Arab States Universities in order to attain good educational outputs. The managerial process includes planning, organization, control, follow-up, evaluation and decision taking. The significance of the study is that it can considerably help improve administrative processes applied in the domain of strategic planning at colleges of education in Arab States. The main objective of the study was to outline the main demands of colleges of education for using (RAP) and the obstacles that face its application. For that purpose, the descriptive/ analytic method was used. The study relied heavily on the analysis of the available literature, writings, and publications on the topic, for predicting the practicability of applying RAPRAP. The study came up with the following main results: RAP application, if used properly, can raise the level of job satisfaction among staff members of Arab States colleges of education in particular and the Arab States Universities in general. RAP application can affect total amendments on colleges of education administrative systems for better rendered services. The most demanding requirements of RAP are those that directly relate to the organization structure of the particular corporation, and all its activities for more flexibility, speed and accuracy of performance. The basic human requirements for RAP application include effective training for trainers for the sake of radical change in concepts and ideas. The main obstacles that face RAP application include the poor outcome at colleges of education regarding teaching/learning process, in addition to poor strategic information management on the part of colleges of education and universities. RAP is not fully made use of, despite large sums of money having been spent on for that exact purpose.

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