scholarly journals Nurses and physicians’ viewpoints about decision making of do not attempt resuscitation (DNAR)

2018 ◽  
Vol 13 ◽  
Author(s):  
Masoud Fallahi ◽  
Somaye Mahdavikian ◽  
Alireza Abdi ◽  
Fariba Borhani ◽  
Parvin Taghizadeh ◽  
...  
Keyword(s):  
Decision Making ◽  
Data Gathering ◽  
Implementation Process ◽  
Decision Making Process ◽  
Attitude Score ◽  
Team Members ◽  
Medical Guideline ◽  
Nurses And Physicians ◽  
Quota Sampling ◽  
Nurses Attitude

Background: Despite advances with regard to “do not attempt resuscitation order”, physicians are still reluctant to implement it. In fact, while the nurses could be of great help in making decision about “do not attempt resuscitation order,” they are mostly neglected in this process. The current study was conducted to determine the nurses and physicians’ viewpoints about decision making process of “do not attempt resuscitation order”. Methods: A descriptive analytical study was carried out with participation of 152 physicians and 152 nurses. The participants were selected through stratified quota sampling from three educational hospitals affiliated with Kermanshah University of Medical Sciences. Data gathering tools were a demographics checklist and a researcher-designed questionnaire with 20 statements for measuring the attitudes of the respondents about the decision-making process and implementation of “do not attempt resuscitation order” of incurable patients. Results: Totally, 304 respondents (152 nurses and 152 physicians) participated in the study. The nurses’ attitude score about the consent of the competent patients to “do not attempt resuscitation” was significantly lower in comparison with the physicians, (p < 0.001). However, the nurses’ attitude was more positive than the physicians attitude about the belief that “taking the patient’s consent is the physician’s responsibility” (p < 0.001). Moreover, the nurses’ attitude was more negative compared with the physicians’ attitude about the idea that “obtaining the patient’s consent is the nurse’s responsibility” (p < 0.001). Both groups believed that the nurses cannot recommend “do not attempt resuscitation order” (p < 0.770). Both groups of the respondents believed that the nurses were not qualified to issue the “do not attempt resuscitation order” (physicians’ mean score = 2.85, nurses’ mean score = 2.89). The physicians’ believe in “necessity to negotiate with the nurses about the order” was less deep than that of the nurses (p = 0.035). Conclusions: Given the different attitudes of the nurses and the physicians about the decision-making process of “do not attempt resuscitation,” it is necessary to codify a medical guideline and clarify the decision making and implementation process. The guideline needs to clearly state physician's, nurse's, patient's, and other medical team members’ responsibilities and roles, respectively.

scholarly journals Decision-making process for introduction of maternal vaccines in Kenya, 2017–2018

2021 ◽  
Vol 16 (1) ◽  
Author(s):  
Nancy A. Otieno ◽  
Fauzia A. Malik ◽  
Stacy W. Nganga ◽  
Winnie N. Wairimu ◽  
Dominic O. Ouma ◽  
...  
Keyword(s):  
Decision Making ◽  
Policy Development ◽  
Implementation Process ◽  
Policy Formulation ◽  
Advisory Group ◽  
Decision Making Process ◽  
Middle Income ◽  
Maternal Immunization ◽  
Negative Impacts ◽  
High Level

Abstract Background Maternal immunization is a key strategy for reducing morbidity and mortality associated with infectious diseases in mothers and their newborns. Recent developments in the science and safety of maternal vaccinations have made possible development of new maternal vaccines ready for introduction in low- and middle-income countries. Decisions at the policy level remain the entry point for maternal immunization programs. We describe the policy and decision-making process in Kenya for the introduction of new vaccines, with particular emphasis on maternal vaccines, and identify opportunities to improve vaccine policy formulation and implementation process. Methods We conducted 29 formal interviews with government officials and policy makers, including high-level officials at the Kenya National Immunization Technical Advisory Group, and Ministry of Health officials at national and county levels. All interviews were recorded and transcribed. We analyzed the qualitative data using NVivo 11.0 software. Results All key informants understood the vaccine policy formulation and implementation processes, although national officials appeared more informed compared to county officials. County officials reported feeling left out of policy development. The recent health system decentralization had both positive and negative impacts on the policy process; however, the negative impacts outweighed the positive impacts. Other factors outside vaccine policy environment such as rumours, sociocultural practices, and anti-vaccine campaigns influenced the policy development and implementation process. Conclusions Public policy development process is complex and multifaceted by its nature. As Kenya prepares for introduction of other maternal vaccines, it is important that the identified policy gaps and challenges are addressed.

Ripensare gli indicatori per le politiche per l’innovazione attraverso il Design-thinking

2021 ◽  
pp. 149-161
Author(s):  
Mauro Lombardi
Keyword(s):  
Decision Making ◽  
Design Thinking ◽  
Implementation Process ◽  
Decision Making Process ◽  
Global Order ◽  
Multi Level ◽  
Multi Stakeholder ◽  
Different Levels ◽  
Systemic View

The final chapter contains the proposal to rethink the policies for innovation based on the approach defined Design thinking. Particularly important is the introduction of concepts such as global order parameters, referring to a systemic view of the techno-economic dynamics, and of a complementary methodology, called Agile. Based on the proposed framework, the decision-making space of different actors (private, public) in pursuing objectives at different levels is then analyzed. In this way a multi-level and multi-stakeholder decision making process can be enriched through a multiplicity of indicators in order to timely verify the efficiency of implementation process.

scholarly journals Nevyriausybinių organizacijų ir savivaldybių sąveika Lietuvoje: teoriniai sprendimų priėmimo ir įgyvendinimo proceso aspektai

2015 ◽  
Vol 14 (2) ◽  
pp. 221
Author(s):  
Aušra Šilinskytė
Keyword(s):  
Decision Making ◽  
Interest Groups ◽  
Local Governance ◽  
Implementation Process ◽  
Decision Making Process ◽  
The Public ◽  
Implementation Processes ◽  
Governmental Organizations ◽  
Non Governmental Organizations

The paper is focused on the discussion about the role of non-governmental organizations during the decision-making process in local governance and what factors influence it. To achieve this, the following steps have been made: first, the concept of non-governmental organizations and their relationship with civil society was analyzed, then possible variations of relationship between non-governmental organizations and their impact to the public sector was described. In the last part of the paper, the stages of the decision–making and implementation process in the municipality were analyzed and theoretical aspects of enabling NGOs were discussed. The analyses showed that the decision-making and implementation processes depend on the understanding of the need to cooperate, the ability of both subjects to work together, their relationship with citizens and other interest groups.

scholarly journals A Study on the Democratic Style of Leadership

2013 ◽  
Vol 3 (2) ◽  
pp. 54-57
Author(s):  
Dr. L. Jibon Kumar Sharma ◽  
Dr. S. Keshorjit Singh
Keyword(s):  
Decision Making ◽  
Leadership Style ◽  
The State ◽  
Primary Data ◽  
Decision Making Process ◽  
Team Members ◽  
Top Executives ◽  
Interview Techniques ◽  
Questionnaire Method

The paper studies democratic style of leadership and how the style influences the practices of leadership. Leadership can be categorized based on the level of involving team members and participating in the decision making process. The study is exploratory in nature and attempts to explore and analyze the democratic aspects of leadership style and its influence in the practices of leadership. The study adopts survey and interview techniques and 25 leaders of the state Manipur, India are considered as sample. The primary data are collected using interview cum questionnaire method from the top executives of the selected 25 organizations and also from two immediate subordinates of the sampled executives of the selected organizations and from two immediate subordinates of the sampled executives. The responses of the followers become essential to crosscheck the practices of the leaders. The study highlights how the democratic style influences the practice of leadership.

Roles and functions of stakeholders in implementing energy retrofits in the hotel sector

2020 ◽  
Vol 38 (5) ◽  
pp. 737-751
Author(s):  
M.F.F. Fasna ◽  
Sachie Gunatilake
Keyword(s):  
Decision Making ◽  
Implementation Process ◽  
Decision Making Process ◽  
Structured Interviews ◽  
Content Type ◽  
Face To Face ◽  
Key Stakeholders ◽  
Energy Service ◽  
Hotel Sector ◽  
The Right

PurposeThe success of energy retrofits (ER) projects is highly dependent on the involvement of right stakeholders at the right stage. So far, little insight is available from previous literature on the involvement of different stakeholders during various stages of the ER decision-making process, and their roles and functions in the respective stages. This is specifically true in the context of Energy Service Company (ESCO) led ER projects, which is an emerging trend in the current context. Hence, this paper aims to investigate the roles and functions of stakeholders during different stages of an ESCO-led ER project in the hotel sector.Design/methodology/approachAn in-depth case study was conducted in a selected hotel building to gain insights into the roles and functions of stakeholders throughout the project stages. To collect the required data, face-to-face semi-structured interviews were conducted with seven selected respondents within the case.FindingsThe study identified nine key stakeholders that were involved during five different project stages along with their functions. Based on these identified functions, four main roles (i.e. decision-maker, performer, monitor/observer, and supporter) emerged that were reflective of the nature of the stakeholders' involvement in different stages of the decision-making process. Owner/client, facilities manager (FM), ESCO and architect attached to ESCO emerged as the key “decision-makers” during project implementation process.Originality/valueThe outcomes of this research would be useful in ensuring the proactive involvement of all the identified stakeholders in respective project stages of ESCO led ER projects in the hotel sector.

scholarly journals Physical Restraint Use in Intensive Care Units: Exploring the Decision-Making Process and New Proposals. A Multimethod Study

2021 ◽  
Vol 18 (22) ◽  
pp. 11826
Author(s):  
María Acevedo-Nuevo ◽  
María Teresa González-Gil ◽  
María Concepción Martin-Arribas
Keyword(s):  
Decision Making ◽  
Intensive Care ◽  
Qualitative Methodology ◽  
Descriptive Analysis ◽  
Physical Restraint ◽  
Public Hospitals ◽  
Decision Making Process ◽  
Team Members ◽  
Restraint Use ◽  
Phenomenological Perspective

Aim: The general aim of this study was to explore the decision-making process followed by Intensive Care Unit (ICU) health professionals with respect to physical restraint (PR) administration and management, along with the factors that influence it. Method: A qual-quant multimethod design was sequenced in two stages: an initial stage following a qualitative methodology; and second, quantitative with a predominant descriptive approach. The multicenter study was undertaken at 17 ICUs belonging to 11 public hospitals in the Madrid region (Spain) across the period 2015 through 2019. The qualitative stage was performed from an interpretative phenomenological perspective. A total of eight discussion groups (DG) were held, with the participation of 23 nurses, 12 patient care nursing assistants, and seven physicians. Intentional purposive sampling was carried out. DG were tape-recorded and transcribed. A thematic analysis of the latent content was performed. In the quantitative stage, we maintained a 96-h observation period at each ICU. Variables pertaining to general descriptive elements of each ICU, institutional pain-agitation/sedation-delirium (PAD) monitoring policies and elements linked to quality of PR use were recorded. A descriptive analysis was performed, and the relationship between the variables was analyzed. The level of significance was set at p ≤ 0.05. Findings: A total of 1070 patients were observed, amounting to a median prevalence of PR use of 19.11% (min: 0%–max: 44.44%). The differences observed between ICUs could be explained by a difference in restraint conceptualization. The various actors involved jointly build up a health care culture and a conceptualization of the terms “safety-risk”, which determine decision-making about the use of restraints at each ICU. These shared meanings are the germ of beliefs, values, and rituals which, in this case, determine the greater or lesser use of restraints. There were different profiles of PR use among the units studied: preventive restraints versus “Zero” restraints. The differences corresponded to aspects such as: systematic use of tools for assessment of PAD; interpretation of patient behavior; the decision-making process, the significance attributed to patient safety and restraints; and the feelings generated by PR use. The restraint–free model requires an approach to safety from a holistic perspective, with the involvement of all team members and the family.

scholarly journals MULTIATTRIBUTE DECISION MAKING PENENTUAN AKREDITASI SMA MENGGUNAKAN METODE ECKENRODE DAN DIA

2020 ◽  
Vol 7 (3) ◽  
pp. 271
Author(s):  
Yeffriansjah Salim
Keyword(s):  
High School ◽  
Decision Making ◽  
National Level ◽  
Implementation Process ◽  
Education Institution ◽  
High School Education ◽  
Decision Making Process ◽  
Average Value ◽  
Multi Attribute Decision Making ◽  
Decision Making Model

<p><em>The accreditation of a high school education institution (SMA) has been carried out by BAN-SM of South Kalimantan Province in stages starting from the provincial level as a recommendation provided to the national level as the decision-maker for determining accreditation. The accreditation implementation process is carried out manually. This process is carried out by both assessors and secretariat staff in charge of receiving and checking accreditation documents and reporting document inspection results and real conditions in the field that often experience fatigue and missing data. These constraints can cause the accreditation process's objectivity and even the possibility of "wrong value" to overcome these problems. We need a tool used for the decision-making process. This study made a multi-attribute decision-making model in determining the accreditation of SMA using the Eckenrode and DIA methods. The Eckenrode method is used to calculate the weight value; DIA is used to rank alternative decisions. This research is a multi-attribute decision-making model in determining high school accreditation by testing 50 data samples, producing an average value of 95% accuracy, and a sensitivity value of 93%. And specificity of 91%.</em></p><p><em><strong>Keywords</strong></em><em>: </em><em>accreditation of SMA, Eckenrode, DIA</em></p><p><em>Akreditasi suatu lembaga pendidikan sekolah menengah atas (SMA) selama ini dilaksanakan oleh BAN-SM Provinsi Kalimantan Selatan secara bertahap dimulai dari tingkat provinsi sebagai pemberi rekomendasi hinga ke tingkat nasional selaku pengambil keputusan penentuan akreditasi. proses pelaksanaan akreditasi dilaksanakan secara manual. Proses ini dilaksanakan oleh asesor maupun staf sekretariat yang bertugas menerima dan memeriksa dokumen akreditasi serta melaporkan hasil pemeriksaan dokumen dan kondisi riil di lapangan sering mengalami kendala seperti lelah, data yang hilang. Kendala-kendala tersebut dapat menjadi penyebab ketidakobjektifan proses akreditasi bahkan kemungkinan “salah nilai”, untuk mengatasi permasalahan tersebut maka diperlukan suatu alat bantu yang digunakan untuk proses pengambilan keputusan. Penelitian ini membuat model multiatribute decision making dalam menentukan akredtasi SMA menggunakan metode Eckenrode dan DIA. Metode Eckenrode digunakan untuk menghitung nilai bobot, DIA digunakan untuk perangkingan alternatif keputusan. Hasil dari penelitian ini adalah model multiatribute decision making dalam menentukan akredtasi SMA dengan pengujian menggunakan 50 sampel data dan menghasilkan nilai nilai rata-rata accuracy 95%, nilai sensitivitas sebesar 93%. dan spesifisitas 91%.</em></p><p><em><strong>Kata kunci</strong></em><em>: Akreditasi SMA, Eckenrode, DIA</em></p>

Corporate performance management: process of organizational-tailored flow chart

2018 ◽  
Vol 90 (9) ◽  
pp. 1394-1402 ◽  
Author(s):  
Ayşe Kucuk Yilmaz ◽  
Ebru Yazgan
Keyword(s):  
Decision Making ◽  
Performance Management ◽  
Corporate Performance ◽  
Implementation Process ◽  
Considerable Effect ◽  
Flow Chart ◽  
Decision Making Process ◽  
Corporate Value ◽  
Content Type ◽  
Depth And Complexity

Purpose Main issue in management and strategy is corporate performance. Managers seek effective and strategic way to improve their performance. Authorization, which includes reputational and strategic indicators, is one of these ways. The applying authorization and using this authorization are decision-making process for managers. These processes have potential to make considerable effect on corporate performance. As a considerable result of this research that need of resource dependency type certified aircraft technicians in Anadolu University are decreased owing to this research and, also the purpose of this study is that technicians have got opportunity to creating own human resource in view of both sustainability, and competition in training field. Design/methodology/approach In this study, both specified and organizational-tailored flowchart as the problem solving techniques in decision-making process of maintenance training organization have been developed, compiled after taking the opinions of experts, for the effective implementation of type rating training, following approval, that cover the types of fleet at Anadolu University. This flowchart may guide to the relevant aircraft maintenance training organizations in their type trainings implementation process. Findings Human factor is both vital and necessary element to achieve high corporate performance. By following the flow chart, the implementation process is shortened by eliminating the difficulties in complying with the depth and complexity of the required regulation. Originality/value The development of the necessary skills and competencies of the workforce is one of the critical points for the creation, preservation and improvement of corporate value. This research has been carried out with the aim of effective utilization of institutional resources, development of personnel and hence corporate value creation. Anadolu University, which is aware of the importance of core competence, is trying to make it one of its strengths institutionally. The Anadolu University Faculty of Aeronautics and Astronautics, as an organization that has completed the necessary steps to become authorized to give type rating training, may guide other aviation organizations using the organization-specified tailored flow chart developed with the help of expert opinion.

An Aggregated Value Model for Collaborative Engineering Decisions

2000 ◽  
Author(s):  
Mohammad Reza Danesh ◽  
Yan Jin
Keyword(s):  
Decision Making ◽  
Product Development ◽  
Product Development Process ◽  
Engineering Practice ◽  
Decision Making Process ◽  
Collaborative Engineering ◽  
Team Members ◽  
Advantages And Disadvantages ◽  
Engineering Collaboration ◽  
Value Model

Abstract In recent years, considerable attentions have been given to collaboration and teamwork for product development in engineering communities. Engineering collaboration involves sharing and exchanging design objectives and information with other team members, detecting and resolving design conflicts, and integrating results of sub-tasks into overall solution. Our research views the collaborative product development process as a distributed decision-making process executed by an engineering team with members from different disciplines. Distribution of design activities among team members, on the one hand, reduces knowledge requirement for designers to carry out their sub-tasks, and, on the other hand, poses demand for smooth coordination among team members to deal with dependencies between the sub-tasks. We argue that to achieve efficient engineering collaboration, team members should share their objectives and values from the early stages of the product development. Our aggregated value model is an attempt to formalize collaborative engineering process. In this paper, we introduce three modes of collaboration, namely total distribution, partial aggregation, and total aggregation as different collaboration schemes and compared their advantages and disadvantages. After that, we present a formal aggregated value model of engineering decision-making process. Finally, an example is discussed to illustrate some of the interesting features of the proposed model in engineering practice.

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