Emergency department nurses' understanding and experiences of implementing discharge planning

Aim: This paper is a report of a study conducted to describe emergency department nurses' understanding and experiences of implementing discharge planning. ---------- Background: Discharge planning in the emergency department is an important issue because of increased healthcare costs and greater emphasis on continuity of care. When executed as a collaborative process involving a multi-disciplinary team with the patient and family, discharge planning provides continuity of care for patients, less demand on hospitals, improvement in community services and in the services of other healthcare organizations. ---------- Method: The qualitative approach of phenomenography was used in this study. Thirty-two emergency department nurses were recruited between July and September 2005. Semi-structured interviews were conducted. ---------- Findings: From interviewees' descriptions of implementing discharge planning, six categories were established: implementing discharge planning as 'getting rid of my patients', completing routines, being involved in patient education, professionally accountable practice, autonomous practice and demonstrating professional emergency department nursing care. The referential meaning of implementing discharge planning 'in the outcome space' was the professional commitment to emergency department provision of effective discharge services. ---------- Conclusion: The results of this research contribute to knowledge of emergency department nurses' experience in the implementation of the discharge planning process. Key requirements for the provision of manageable discharge services both in Taiwan and worldwide highlighted by this study include adequate workloads, sufficient time, clear policies and standards of discharge planning and enhancement of professional commitment.

Discharge planning in the emergency department : a comprehensive approach

Discharge planning has become increasingly important, with current trends toward shorter hospital stays, increased health care costs, and more community-based health services. Effective discharge planning ensures the safety and ongoing care for patients,1 and it also benefits health care providers and organizations. It results in shorter hospital stays, fewer readmissions, higher access rates to post-hospitalization services, greater patient satisfaction with the discharge, and improved quality of life and continuity of care.[2] and [3] All acute care patients and their caregivers require some degree of preparation for discharge home—education about their health status, risks, and treatment; help setting health goals and maintaining a good level of self-care; information about community resources; and follow-up appointments and referrals to appropriate community health providers. Inadequate preparation exposes the patient to unnecessary risks of recurrence or complications of the acute complaint, neglect of nonacute comorbidities, mismanagement and side effects of medication, disruption of family and social life, emotional distress, and financial loss.[2], [3] and [4] The result may be re-presentation to the emergency department. It is noteworthy that up to 18% of ED presentations are revisits within 72 hours of the original visit5; many of these are considered preventable.6 It is a primary responsibility of nurses to ensure that patients return to the community adequately prepared and with appropriate support in place. Up to 65% of ED patients are discharged home from the emergency department,7 and the characteristics of the emergency department and its patient population make the provision of a high standard of discharge planning uniquely difficult. In addition, discharge planning is neglected in contemporary emergency nursing—there are no monographs devoted to the subject, and there is little published research. In this article 3 issues are explored: the importance of emergency nurses’ participation in the discharge-planning process, impediments to their participation; and strategies to improve discharge planning in the emergency department.

Trailblazers

A recent study in the United Kingdom (Ofsted Report 2008) provides strong evidence that well-organized activities outside the classroom contribute significantly to the quality and depth of children's learning, including their personal, social, and emotional development. Outdoor math trails supply further evidence of such enhanced learning: They are meaningful, stimulating, challenging, and exciting for children. Most important, these trails invite all students, irrespective of their classroom achievement level, to participate successfully in the problem activities and gain a sense of pride in the mathematics they create. Additionally, Math trails empower lifelong learning. Integrating "outside" mathematics with "inside" classroom mathematics can sow the seeds to develop flexible, creative, future-oriented mathematical thinkers and problem solvers. Here, English et al discuss how to design and implement math trails to promote active, meaningful, real-world mathematical learning beyond the classroom walls.

Curriculum in postcolonial contexts

This entry uses postcolonial perspectives to interrogate relations of power in the curriculum that are deeply influenced by the aftermath of European colonialism. The insights gained help to analyze continuing inequity in material, cultural, ideological and social aspects of the curriculum. This is a starting point for working out strategies of change and identifying the complexities and contestations which accompany change. The entry provides an introduction to key aspects of postcolonial theory, examines various aspects of the curriculum which are problematized by postcolonial perspectives, and explores ways in which curriculum decolonization is advocated in terms of social equity, race, cultural and gender identity, language and knowledge paradigms.

Will the Australian national curriculum up the intellectual ante in classrooms?

A critical review of the current and potential impacts of the Australian National Curriculum on the enacted curriculum in primary schools, with specific attention to issues of equity and social justice.

Towards compatible and integrated airport and regional land use planning in Australia

Over the past decade privatised capital city airports in Australia have planned developed a range of non aviation commercial and retail land uses on airport land. Many surrounding municipalities consider this development in conflict with existing regional land use planning. Conversely airport operators are alarmed at continued urban consolidation and encroachment of incompatible regional development. Land use planning within and surrounding Australian capital city airports does not support compatible and integrated land use. It is currently a fragmented process due to: 1) current legislative and policy frameworks; 2) competing stakeholder priorities and interests; and 3) inadequate coordination and disjointed decision-making. This paper will examine privatised Australian airport development and consider three case studies to detail the context of airport and regional land use planning. A series of stakeholder workshops have served to inform the procedural dynamics and relationships between airport and regional decision-making. This exploratory research will assist in informing the knowledge gaps between aviation, airport development and broader urban land use policy. This paper will provide recommendations to enhance approaches to land use planning for airports and adjacent metropolitan regions in Australia and overseas.

Planning for survival

When the global financial crisis has its own acronym (the “GFC”), you know its going to be around for a while. This article looks at some of the risk/opportunity assessments you should take into consideration if you are planning for your property development business to still be around when the GFC is a thing of the past.

Mildura, Victoria : Aboriginal health promotion short course

The Victorian Aboriginal Community Controlled Health Organisation’s (VACCHO) Public Health and Research Unit delivered an Aboriginal Health Promotion Short Course in Mildura in 2009. ----- The VACCHO delivered Aboriginal Health Promotion Short Course included current health promotion theory and practice as it specifically relates to Aboriginal people within Victoria. As Aboriginal people have a higher risk of cardiovascular disease and type 2 diabetes, the course specifically addressed risk factors for chronic disease including smoking, physical activity, nutrition and mental health and well-being. Hence, a key part of the course involved participants working in groups to plan a health promotion program for one of the key health issues- smoking, physical activity and nutrition, or spiritual health and wellbeing. The aim is for participants to use these programs in their daily work with Aboriginal clients.

Guided chaos : path planning and control for a UAV-forced landing

In recent years, unmanned aerial vehicles (UAVs) have been widely used in combat, and their potential applications in civil and commercial roles are also receiving considerable attention by industry and the research community. There are numerous published reports of UAVs used in Earth science missions [1], fire-fighting [2], and border security [3] trials, with other speculative deployments, including applications in agriculture, communications, and traffic monitoring. However, none of these UAVs can demonstrate an equivalent level of safety to manned aircraft, particularly in the case of an engine failure, which would require an emergency or forced landing. This may be arguably the main factor that has prevented these UAV trials from becoming full-scale commercial operations, as well as restricted operations of civilian UAVs to only within segregated airspace.

Probabilistic world modeling for distributed team planning

This paper describes an application of decoupled probabilistic world modeling to achieve team planning. The research is based on the principle that the action selection mechanism of a member in a robot team can select an effective action if a global world model is available to all team members. In the real world, the sensors are imprecise, and are individual to each robot, hence providing each robot a partial and unique view about the environment. We address this problem by creating a probabilistic global view on each agent by combining the perceptual information from each robot. This probabilistic view forms the basis for selecting actions to achieve the team goal in a dynamic environment. Experiments have been carried out to investigate the effectiveness of this principle using custom-built robots for real world performance, in addition, to extensive simulation results. The results show an improvement in team effectiveness when using probabilistic world modeling based on perception sharing for team planning.

Cultivating teachers’ beliefs, knowledge and skills for leading change in schools

Australian policy initiatives and state curriculum reform efforts affirm a commitment to address student disengagement through the development of inclusive school environments, curriculum, and pedagogy. This paper, drawing on critical social theory, describes three Australian projects that support the cultivation of teachers’ beliefs, knowledge and skills for critical reflection and leading change in schools. The first project reports on the valued ethics that emerged in pre-service teacher reflections about a Service-learning Program at a university in Queensland. The second project reports on a school-based collaborative inquiry approach to professional development with a focus on literacy practices. The final project reports on an initiative in another university in Victoria, to operationalise pedagogical change and curriculum renewal in Victoria, through the Principles of Learning and Teaching (PoLT). These case studies illustrate how critical reflection and development of beliefs, knowledge and skills can be acquired to better meet the needs of schools.

Contesting ‘sustainability’ in infrastructure planning : The debate of the public interest in Brisbane’s Boggo Road Busway development

Sustainable infrastructure demands that declared principles of sustainability are enacted in the processes of its implementation. However, a problem arises if the concept of sustainability is not thoroughly scrutinised in the planning process. The public interest could be undermined when the rhetoric of sustainability is used to substantiate a proposed plan. This chapter analyses the manifestation of sustainable development in the Boggo Road Busway Plan in Brisbane, Australia against the sustainability agenda set in the South East Queensland Regional and Transport Plans. Although the construction of the Busway was intended to improve public transport access in the region, its implementation drew significant environmental concerns. Local community groups contested the ‘sustainability’ concept deployed in Queensland’s infrastructure planning. Their challenges resulted in important concessions in the delivery of the Busway plan. This case demonstrates that principles of sustainable infrastructure should be measurable and that local communities be better informed in order to fulfil the public interest in regional planning.

Water sensitive urban design : landscape planning and design to improve water quality in Shijiazhaung and Yueyang

Water quality issues are heavily dependent on land development and management decisions within river and lake catchments or watersheds. Economic benefits of urbanisation may be short‐ lived without cleaner environmental outcomes. However, whole‐of‐catchment thinking is not, as yet, as frequent a consideration in urban planning and development in China as it is in many other countries. Water is predominantly seen as a resource to be ‘owned’ by different jurisdictions and allocated to numerous users, both within a catchment and between catchments. An alternative to this approach is to think of water in the same way as other commodities that must be kept moving through a complex transport system. Water must ultimately arrive at particular destinations in the biosphere, although it travels across a broad landscape and may be held up temporarily at certain places along the way. While water extraction can be heavily controlled, water pollution is far more difficult to regulate. Both have significant impacts on water availability and flows both now and in the future. As Chinese cities strive to improve economic conditions for their citizens, new centres are being rebuilt and environmental valued

UAS mission path planning system (MPPS) using hybrid-game coupled to multi-objective optimiser

This paper presents the application of advanced optimization techniques to unmanned aerial system mission path planning system (MPPS) using multi-objective evolutionary algorithms (MOEAs). Two types of multi-objective optimizers are compared; the MOEA nondominated sorting genetic algorithm II and a hybrid-game strategy are implemented to produce a set of optimal collision-free trajectories in a three-dimensional environment. The resulting trajectories on a three-dimensional terrain are collision-free and are represented by using Bézier spline curves from start position to target and then target to start position or different positions with altitude constraints. The efficiency of the two optimization methods is compared in terms of computational cost and design quality. Numerical results show the benefits of adding a hybrid-game strategy to a MOEA and for a MPPS.