Everyone's problem but nobody's job : staff perceptions and explanations for poor nutritional intake in older medical patients

Aim: Up to 60% of older medical patients are malnourished with further decline during hospital stay. There is limited evidence for effective nutrition intervention. Staff focus groups were conducted to improve understanding of potential contextual and cultural barriers to feeding older adults in hospital. Methods: Three focus groups involved 22 staff working on the acute medical wards of a large tertiary teaching hospital. Staff disciplines were nursing, dietetics, speech pathology, occupational therapy, physiotherapy, pharmacy. A semistructured topic guide was used by the same facilitator to prompt discussions on hospital nutrition care including barriers. Focus groups were tape-recorded, transcribed and analysed thematically. Results: All staff recognised malnutrition to be an important problem in older patients during hospital stay and identified patient-level barriers to nutrition care such as non-compliance to feeding plans and hospital-level barriers including nursing staff shortages. Differences between disciplines revealed a lack of a coordinated approach, including poor knowledge of nutrition care processes, poor interdisciplinary communication, and a lack of a sense of shared responsibility/coordinated approach to nutrition care. All staff talked about competing activities at meal times and felt disempowered to prioritise nutrition in the acute medical setting. Staff agreed education and ‘extra hands’ would address most barriers but did not consider organisational change. Conclusions: Redesigning the model of care to reprioritise meal-time activities and redefine multidisciplinary roles and responsibilities would support coordinated nutrition care. However, effectiveness may also depend on hospitalwide leadership and support to empower staff and increase accountability within a team-led approach.

“We have to work within the system!”: Staff perceptions of organizational barriers to decision making for older adults with dementia in Australian aged care facilities

The current study explored the perceptions of direct care staff working in Australian residential aged care facilities (RACFs) regarding the organizational barriers that they believe prevent them from facilitating decision making for individuals with dementia. Normalization process theory (NPT) was used to interpret the findings to understand these barriers in a broader context. The qualitative study involved semi-structured interviews (N = 41) and focus groups (N = 8) with 80 direct care staff members of all levels working in Australian RACFs. Data collection and analysis were conducted in parallel and followed a systematic, inductive approach in line with grounded theory. The perceptions of participants regarding the organizational barriers to facilitating decision making for individuals with dementia can be described by the core category, Working Within the System, and three sub-themes: (a) finding time, (b) competing rights, and (c)not knowing. Examining the views of direct care staff through the lens of NPT allows possible areas for improvement to be identified at an organizational level and the perceived barriers to be understood in the context of promoting normalization of decision making for individuals with dementia.

Training teachers for further and technical education 1950-1982: staff perceptions of changing demands and policies

This paper aims to create a picture of aspects of the working lives of some trainers of technical and further education teachers in a specialist teacher training college in Bolton, Lancashire, from the 1950s to the 1980's. There is little reference to technical teacher training in the literature on teacher training in the second half of the twentieth century. With this gap in mind, this paper sets out to record some memories and impressions of staff involved during these years. Using data from a series of semi-structured interviews, the discussion centres upon their perceptions of their work: of their students, the working environment, the curriculum and their relationships with the technical colleges for whom they were training teachers. The paper has three sections. It begins with a brief discussion of the issues arising from the choice of research methods. The second section contextualises the study and traces the history of Bolton Technical Teachers' Training College from its establishment through to its merger with the Institute of Technology in 1982. This is followed by the presentation and discussion of the interview data.

Understanding Student and Staff Perceptions of Feedback in Architecture: Summary Report

This report presents the results of a collaborative project between Queens University, Belfast and the Robert Gordon University, Aberdeen, and builds on a dialogue initiated during Session 2009-10 through which course guidance and feedback received by students was identified as an area requiring deeper understanding in order to enhance current practice

Staff perceptions of the role of technology in experiential learning: a case study from an Australian university

This paper reports on a cross-disciplinary comparative study that examines the interplay between information and communications technologies (ICT) and experiential learning, in the context of seven fields of professional practice in undergraduate education. Our central claim is that academic teachers' framing of the meaning and nature of experiential learning shapes the actual and possible uses of ICT, in supporting the development of professional expertise in academic and workplace learning environments. Implicit in teaching conceptions and practices is an underlying view of the changing nature and conduct of the professions, and the requirements for effective entry level practice in relevant professional fields. The paper explores key indicators of ICT development and usage in supporting the creation of meaningful professional learning, and the design of integrated, coherent, professional learning environments.

Staff perceptions on the use of a sedation protocol in the intensive care setting

Sedation protocols are increasingly being investigated as a method of achieving improved patient outcomes whilst guiding the decision making of both nursing and medical practitioners. However, only a limited number of studies have investigated the perceptions of staff towards a sedation protocol during its implementation. This study was designed to survey the perceptions of staff regarding the implementation of a sedation protocol in an Australian intensive care unit (ICU). Questionnaires were distributed to all multidisciplinary team members who had used the sedation protocol. The response rate was 50% (n=70). The questionnaire combined the use of visual analogue scales plus a comments section to obtain qualitative data.

The results revealed that staff perceived sedation management to be enhanced with the use of a protocol and therefore should be incorporated into routine clinical practice. Staff perceived that providing clear guidelines that facilitated decision making and assisted beginner practitioners enhanced sedation management. In addition, there was a perceived improvement in the patient outcomes, including a decrease in the frequency of over-sedation resulting in a reduced ICU stay.

Positive perceptions may assist in the introduction of other interventional protocols. Other protocols may target areas where variability in clinical decision making exists, despite research evidence that supports specific therapeutic interventions. Further studies addressing protocol implementation for clinical interventions are warranted in other ICU settings.

Staff perceptions of the implementation of enterprise resource planning systems in three Australian universities

This chapter reports a study that examined the staff perceptions of the implementation of an Enterprise Resource Planning system (ERPs) in three Australian universities. The literature on issues impacting on effective Enterprise Resource Planning (ERP) implementations identified a number of issues that translate from the corporate sector to the higher education sector and included a number that require particular focus in this sector. Case study methodology is used to examine the staff perceptions of the management of ERP implementations in three Australian universities in the process of implementing ERP systems. The study was conducted in two phases. The first phase of the study obtained data through a series of focus groups at one university and, combined with an analysis of the relevant literature served as a framework for the development of the research process in the second phase of the study. This phase involved in depth interviews with staff that enabled the researcher to undertake a more detailed exploration of the staff perceptions of influences affecting ERP system implementations at three Australian universities. This chapter reports that staff perceptions of the process of ERP implementations are central to their efficacious implementations in Australian universities. Staff perceptions demonstrate that particular consideration of organisational influences related to their context and the perceptions of the users of the systems must be factored into the planning for ERP implementations in Universities.

Academic staff perceptions of the value of the elements of an online learning environment

Based on 276 responses from academic staff in an evaluation of an online learning environment (OLE), this paper identifies those elements of the OLE that were most used and valued by staff, those elements of the OLE that staff most wanted to see improved, and those factors that most contributed to staff perceptions that the use of the OLE enhanced their teaching. The most used and valued elements were core functions, including accessing unit information, accessing lecture/tutorial/lab notes, and reading online discussions. The elements identified as most needing attention related to online assessment: submitting assignments, managing assessment items, and receiving feedback on assignments. Staff felt that using the OLE enhanced their teaching when they were satisfied that their students were able to access and use their learning materials, and when they were satisfied with the professional development they received and were confident with their ability to teach with the OLE.

Student and staff perceptions of learning and teaching online, 2005 data

The dataset consists of data gathered from Deakin University staff and students.

Staff-derived data consists of qualitative data relating to advantages and disadvantages of teaching online; manifestation of cultural diversity in online learning environments; strategies to accommodate cultural diversity online; and using online environments to support cultural diversity

Student-derived data consists of quantitative and qualitative data relating to student perceptions of online learning; student demographics; student expectations of their university experience; students' approach to learning and online learning; perceptions of online learning and online team work; and perceptions of student and teacher roles at university.

Staff perceptions of risk of assault in psychiatric settings

This thesis examined current perceptions and experiences of staff relating to threatening and assaultive patient behaviours in mental health and forensic settings. The research uncovered the interrelated nature of staff experiences of assault and perceived vulnerability, with the view to optimising patient care and staff wellbeing in psychiatric settings.

Open-source vs proprietary VLE: An explanatory study of staff perceptions

This paper explores staff perceptions of two open-source Virtual learning environments (VLEs), Sakai 2.4.1 and Moodle 1.8, compared to Blackboard Vista 4. In general, staff felt that Sakai was simpler to use, but lacked some of the richer functionality available in Blackboard. A general dissatisfaction with both Sakai and Blackboard led to trialling of Moodle which was percieved more favourably than Blackboard

Students and staff perceptions of project/design based learning in an engineering curriculum

This paper focuses on the students and staff perceptions of project/design-based learning in an engineering curriculum. Engineering at Deakin University has used project/design based learning as one of its engineering learning principles for further development in learning and teaching. It is required to improve the learning and teaching process as a holistic approach from the perspective of students’ and staff over the entire degree program. Engaging students are an important aspect of the project/design based learning model which it helps students to be self-directed active learners. A project/design based learning environment helps a curriculum to practice career related skills for students, such as practical learning, problem solving, collaborative teamwork, innovative creative designs, active learning, and engagement with real-world assignments. The focus of this paper is to analyse the impact of project/design-based learning in an engineering curriculum. From the quantitative and qualitative analysis performed, the results are analysed and presented from a students’ and staff perspective about project/design based learning within the curriculum. This paper is also concerned with enhancing staff and students engagement through project/design based learning. The feedback was sought from students on project/design-based learning. Additional feedback is also needed from staff members who teach and perform research in engineering design. The survey results shows more than 50% of students and 75% of staff views on project/design based learning proven that the impact of project/design based learning is helps to enhance of student and staff interaction in the School of Engineering at Deakin University.

Global practice experience: A useful lens for understanding patient and staff perceptions of successful integration of health information technology in primary care

Making healthcare comprehensive and more efficient remains a complex challenge. Health Information Technology (HIT) is recognized as an important component of this transformation but few studies describe HIT adoption and it's effect on the bedside experience by physicians, staff and patients. This study applied descriptive statistics and correlation analysis to data from the Patient-Centered Medical Home National Demonstration Project (NDP) of the American Academy of Family Physicians. Thirty-six clinics were followed for 26 months by clinician/staff questionnaires and patient surveys. This study characterizes those clinics as well as staff and patient perspectives on HIT usefulness, the doctor-patient relationship, electronic medical record (EMR) implementation, and computer connections in the practice throughout the study. The Global Practice Experience factor, a composite score related to key components of primary care, was then correlated to clinician and patient perspectives. This study found wide adoption of HIT among NDP practices. Patient perspectives on HIT helpfulness on the doctor-patient showed a suggestive trend that approached statistical significance (p = 0.172). Clinicians and staff noted successful integration of EMR into clinic workflow and their perception of helpfulness to the doctor-patient relationship show a suggestive increase also approaching statistical significance (p=0.06). GPE was correlated with clinician/staff assessment of a helpful doctor-patient relationship midway through the study (R 0.460, p = 0.021) with the remaining time points nearing statistical significance. GPE was also correlated to both patient perspectives of EMR helpfulness in the doctor-patient relationship (R 0.601, p = 0.001) and computer connections (R 0.618, p = 0.0001) at the start of the study. ^