The organisational context of nursing care in stroke units: A case study approach

Background Internationally the stroke unit is recognised as the evidence-based model for patient management, although clarity about the effective components of stroke units is lacking. Whilst skilled nursing care has been proposed as one component, the theoretical and empirical basis for stroke nursing is limited. We attempted to explore the organisational context of stroke unit nursing, to determine those features that staff perceived to be important in facilitating high quality care. Design A case study approach was used, that included interviews with nurses and members of the multidisciplinary teams in two Canadian acute stroke units. A total of 20 interviews were completed, transcribed and analysed thematically using the Framework Approach. Trustworthiness was established through the review of themes and their interpretation by members of the stroke units. Findings Nine themes that comprised an organisational context that supported the delivery of high quality nursing care in acute stroke units were identified, and provide a framework for organisational development. The study highlighted the importance of an overarching service model to guide the organisation of care and the development of specialist and advanced nursing roles. Whilst multidisciplinary working appears to be a key component of stroke unit nursing, various organisational challenges to its successful implementation were highlighted. In particular the consequence of differences in the therapeutic approach of nurses and therapy staff needs to be explored in greater depth. Successful teamwork appears to depend on opportunities for the development of relationships between team members as much as the use of formal communication systems and structures. A co-ordinated approach to education and training, clinical leadership, a commitment to research, and opportunities for role and practice development also appear to be key organisational features of stroke unit nursing. Recommendations for the development of stroke nursing leadership and future research into teamwork in stroke settings are made.

Building a "brain attack" team to administer thrombolytic therapy for acute ischemic stroke

Before tissue plasminogen activator (tPA) was licensed for use in Canada, in February 1999, the Calgary Regional Stroke Program spearheaded the development and organization of local resources to use thrombolytic therapy in patients who had experienced acute ischemic stroke. In 1996 special permission was obtained from the Calgary Regional Health Authority to use intravenously administered tPA for acute ischemic stroke, and ethical and scientific review boards approved the protocols. After 3 years our efforts have resulted in improved patient outcomes, shorter times from symptom onset to treatment and acceptable adverse event rates. Areas for continued improvement include the door-to-needle time and broader education of the public about the symptoms of acute ischemic stroke.

IdeaWall: Bridging the digital and non-digital worlds to facilitate distant collaboration

Creative and ad-hoc work often involves non-digital artifacts, such as whiteboards and post-it notes. The preferred method of brainstorming and idea development, while facilitating work among collocated participants, makes it particularly tricky to involve remote participants, not even mentioning cases where live social involvement is required and the number and location of remote participants can be vast. Our work has originally focused on large distributed teams in business entities. Vast majority of teams in large organizations are distributed teams. Our team of corporate researchers decided to identify state of the art technologies that could facilitate the scenarios mentioned above. This paper is an account of a research project in the area of enterprise collaboration, with a strong focus on the aspects of human computer interaction in mixed mode environments, especially in areas of collaboration where computers still play a secondary role. It is describing a currently running corporate research project. In this paper we signal the potential use of the technology in situation, where community involvement is either required or desirable. The goal of the paper is to initiate a discussion on the use of technologies, initially designed as supporting enterprise collaboration, in situation requiring community engagement. In other words, it is a contribution of technically focused research exploring the uses of the technology in areas such as social engagement and community involvement. © 2012 IEEE.

Origins of Australian Football: Victoria's Early History. Volume 3: Covert 'Professionalism': The Power of the Wealthy Clubs 1886 to 1890

This volume continues the story of football in Marvellous Melbourne during the 1880s. At this time the VFA continued to expand as Melbourne’s boom continued apace. In 1886 Port Melbourne, Prahran, St Kilda, Footscray and South Williamstown joined the competition, and the Ballarat clubs Ballarat, Ballarat Imperial and South Ballarat were also contending for the VFA premiership. In 1886 matches were divided into four quarters, goal umpires waved two flags to announce a goal, and time clocks and bells were employed to mark the end of quarters. Victoria also played inter-colonial matches against New South Wales, Tasmania and South Australia. VFA secretary T.S. Marshall was at the forefront of fighting the game’s turn towards professionalism, but although it was illegal to pay players, the practice continued. The period 1886 to 1890 also set the stage for the eventual formation of the Victorian Football League, for by the end of the 1880s the Victorian Football Association had become in effect a two-tier competition. The most popular clubs in the VFA, South Melbourne, Geelong, Carlton and Essendon collected the lion’s share of the gate money, which they used to build their wealth and entrench their position as the dominant Victorian teams. The lower tier clubs had to make do with paltry gate money and season fixtures that advantaged the strong clubs. In these fixtures the strong clubs elected to play each other first to increase their gate money, and only deemed to play the poorer clubs at the start of the season. This led to an increasing divide between the VFA’s rich and poor, and by 1890 South Williamstown and Prahran merged with Williamstown and St Kilda respectively, University dropped out of senior ranks, and the Ballarat clubs were excluded from competing for the VFA premiership, which left 12 senior clubs until Collingwood’s emergence in 1892. At this time, no team was as powerful as South Melbourne, which experienced the greatest success in the club’s VFA and VFL history when it collected triple premiership crowns in 1888, 1889, and 1890. South Melbourne was a most ambitious club and spearheaded the move towards professionalism, although this could not be made public. The fine teams it produced at this time contained some of the greatest players of the era, such as Peter Burns, “Sonny” Elms and “Dinny” McKay, and it looked after players with health insurance, jobs, inter-colonial trips, and other incentives. Geelong’s premiership in 1886 was perhaps its greatest triumph, but this success was followed by a premiership drought that would last for 39 years. Carlton remained one of Victorian football’s power clubs, and after securing the premiership in 1887 continued to compete for top honours. As always, the game became ever more popular and world record crowds of over 30,000 attended matches between South Melbourne, Carlton, Geelong and Essendon.

Creative work environments and employee engagement: Exploring potential links and possibilities

Companies that perform well are often identified as either possessing creative work environments and (or) having high levels of employee engagement. Creative work environments are largely not well defined, although research alludes to contributing factors. On the other hand employee engagement is defined as the multiple emotional, rational and behavioural dimensions of an employee's consistent level of effort, commitment and connection to their job. Some authors including Saks (2006) and Shuck and Wollard (2010) call for more scholarly research to increase our understanding of the drivers of employee engagement and the actions that organisations can take to improve engagement. There are references made in the literature to the existence of a relationship between a creative work environment and engaged employees (Isaksen & Ekvall 2010), but there is a lack of empirical evidence providing support for the direct relationship between the two. This study aims to explore the relationship, addressing the question of how a creative work environment impacts on employee engagement. Exploratory research to investigate this relationship will use a qualitative methodology with semi-structured interviews, field observations and document analysis. Key themes will be analysed at both the individual and team level reflecting the multi-level nature of the constructs.

Team building activities in dance and discoveries from reflective essays

The purpose of this study was to determine if using team building activities within a university Latin dance course enhances cohesion. Students (N=30) completed the Group Environment Questionnaire (GEQ; Carron, Widmeyer, & Brawley, 1985), which measures group integration (individuals’ perceptions of the closeness, similarity, and bonding within the group as a whole) and individual attractions to the group in terms of both task and social cohesion. Students also completed an evaluation of the team building activities and wrote reflective essays about their experiences in the course. The course consisted of twenty 90-minute classes. In the third class students were provided an information sheet describing the research. In the fourth class the students completed a demographics questionnaire and the GEQ. The students completed the GEQ again during the ninth class. In classes 10 to 14 team building activities took up roughly the first third of each class. The students completed the GEQ again in classes 15 and 20. In class 16 the students completed the evaluation. The reflective essays were submitted two weeks after the last class. There were no significant differences across time in social cohesion. Group integration task, however, was significantly higher at times 3 and 4 compared to time 1. Students agreed that the team-building activities helped to bond class members, and felt it was valuable for these activities to be included in the unit in the future. The reflective essays indicated the students felt the team building activities improved social factors, and interpersonal, dance, and personal mental skills.

Integration of Geospatial and Built Environment - National Data Policy

Digital technology offers enormous benefits (economic, quality of design and efficiency in use) if adopted to implement integrated ways of representing the physical world in a digital form. When applied across the full extent of the built and natural world, it is referred to as the Digital Built Environment (DBE) and encompasses a wide range of approaches and technology initiatives, all aimed at the same end goal: the development of a virtual world that sufficiently mirrors the real world to form the basis for the smart cities of the present and future, enable efficient infrastructure design and programmed maintenance, and create a new foundation for economic growth and social well-being through evidence-based analysis. The creation of a National Data Policy for the DBE will facilitate the creation of additional high technology industries in Australia; provide Governments, industries and citizens with greater knowledge of the environments they occupy and plan; and offer citizen-driven innovations for the future. Australia has slipped behind other nations in the adoption and execution of Building Information Modelling (BIM) and the principal concern is that the gap is widening. Data driven innovation added $67 billion to the Australian economy in 20131. Strong open data policy equates to $16 billion in new value2. Australian Government initiatives such as the Digital Earth inspired “National Map” offer a platform and pathway to embrace the concept of a “BIM Globe”, while also leveraging unprecedented growth in open source / open data collaboration. Australia must address the challenges by learning from international experiences—most notably the UK and NZ—and mandate the use of BIM across Government, extending the Framework for Spatial Data Foundation to include the Built Environment as a theme and engaging collaboration through a “BIM globe” metaphor. This proposed DBE strategy will modernise the Australian urban planning and the construction industry. It will change the way we develop our cities by fundamentally altering the dynamics and behaviours of the supply chains and unlocking new and more efficient ways of collaborating at all stages of the project life-cycle. There are currently two major modelling approaches that contribute to the challenge of delivering the DBE. Though these collectively encompass many (often competing) approaches or proprietary software systems, all can be categorised as either: a spatial modelling approach, where the focus is generally on representing the elements that make up the world within their geographic context; and a construction modelling approach, where the focus is on models that support the life cycle management of the built environment. These two approaches have tended to evolve independently, addressing two broad industry sectors: the one concerned with understanding and managing global and regional aspects of the world that we inhabit, including disciplines concerned with climate, earth sciences, land ownership, urban and regional planning and infrastructure management; the other is concerned with planning, design, construction and operation of built facilities and includes architectural and engineering design, product manufacturing, construction, facility management and related disciplines (a process/technology commonly known as Building Information Modelling, BIM). The spatial industries have a strong voice in the development of public policy in Australia, while the construction sector, which in 2014 accounted for around 8.5% of Australia’s GDP3, has no single voice and because of its diversity, is struggling to adapt to and take advantage of the opportunity presented by these digital technologies. The experience in the UK over the past few years has demonstrated that government leadership is very effective in stimulating industry adoption of digital technologies by, on the one hand, mandating the use of BIM on public procurement projects while at the same time, providing comparatively modest funding to address the common issues that confront the industry in adopting that way of working across the supply chain. The reported result has been savings of £840m in construction costs in 2013/14 according to UK Cabinet Office figures4. There is worldwide recognition of the value of bringing these two modelling technologies together. Australia has the expertise to exercise leadership in this work, but it requires a commitment by government to recognise the importance of BIM as a companion methodology to the spatial technologies so that these two disciplinary domains can cooperate in the development of data policies and information exchange standards to smooth out common workflows. buildingSMART Australasia, SIBA and their academic partners have initiated this dialogue in Australia and wish to work collaboratively, with government support and leadership, to explore the opportunities open to us as we develop an Australasian Digital Built Environment. As part of that programme, we must develop and implement a strategy to accelerate the adoption of BIM processes across the Australian construction sector while at the same time, developing an integrated approach in concert with the spatial sector that will position Australia at the forefront of international best practice in this area. Australia and New Zealand cannot afford to be on the back foot as we face the challenges of rapid urbanisation and change in the global environment. Although we can identify some exemplary initiatives in this area, particularly in New Zealand in response to the need for more resilient urban development in the face of earthquake threats, there is still much that needs to be done. We are well situated in the Asian region to take a lead in this challenge, but we are at imminent risk of losing the initiative if we do not take action now. Strategic collaboration between Governments, Industry and Academia will create new jobs and wealth, with the potential, for example, to save around 20% on the delivery costs of new built assets, based on recent UK estimates.

Time, place and space – student group collaboration using Google Drive

Virtual working environments are intrinsic to the contemporary workplace and collaborative skills are a vital graduate capability. To develop students’ collaborative skills, first year medical laboratory science students undertake a group poster project, based on a blended learning model. Learning is scaffolded in lectures, workshops in collaborative learning spaces, practitioner mentoring sessions, and online resources. Google Drive provides an online collaborative space for students to realise tangible outcomes from this learning. A Google Drive document is created for each group and shared with members. In this space, students assign tasks and plan workflow, share research, progressively develop poster content, reflect and comment on peer contributions and use the messaging functions to ‘talk’ to group members. This provides a readily accessible, transparent record of group work, crucial in peer assessment, and a communication channel for group members and the lecturer, who can support groups if required. This knowledge creation space also augments productivity and effectiveness of face-to-face collaboration. As members are randomly allocated to groups and are often of diverse backgrounds and unknown to each other, resilience is built as students navigate the uncertainties and complexities of group dynamics, learning to focus on the goal of the team task as they constructively and professionally engage in team dialogue. Students are responsible and accountable for individual and group work. The use of Google Drive was evaluated in a survey including Likert scale and open ended qualitative questions. Statistical analysis was carried out. Results show students (79%) valued the inclusion of online space in collaborative work and highly appreciated (78%) the flexibility provided by Google Drive, while recognising the need for improved notification functionality. Teaching staff recognised the advantages in monitoring and moderating collaborative group work, and the transformational progression in student collaborative as well as technological skill acquisition, including professional dialogue.

Collaborative learning from distributed places and spaces: Exploring the use of virtual collaborative tools for local and global student teamwork projects

Educating responsive graduates. Graduate competencies include reliability, communication skills and ability to work in teams. Students using Collaborative technologies adapt to a new working environment, working in teams and using collaborative technologies for learning. Collaborative Technologies were used not simply for delivery of learning but innovatively to supplement and enrich research-based learning, providing a space for active engagement and interaction with resources and team. This promotes the development of responsive ‘intellectual producers’, able to effectively communicate, collaborate and negotiate in complex work environments. Exploiting technologies. Students use ‘new’ technologies to work collaboratively, allowing them to experience the reality of distributed workplaces incorporating both flexibility and ‘real’ time responsiveness. Students are responsible and accountable for individual and group work contributions in a highly transparent and readily accessible workspace. This experience provides a model of an effective learning tool. Navigating uncertainty and complexity. Collaborative technologies allows students to develop critical thinking and reflective skills as they develop a group product. In this forum students build resilience by taking ownership and managing group work, and navigating the uncertainties and complexities of group dynamics as they constructively and professionally engage in team dialogue and learn to focus on the goal of the team task.

QUT’s research data storage solutions: A launchpad for research journeys

This poster presents key features of how QUT’s integrated research data storage and management services work with researchers through their own individual or team research life cycle. By understanding the characteristics of research data, and the long-term need to store this data, QUT has provided resources and tools that support QUT’s goal of being a research intensive institute. Key to successful delivery and operation has been the focus upon researchers’ individual needs and the collaboration between providers, in particular, Information Technology Services, High Performance Computing and Research Support, and QUT Library. QUT’s Research Data Storage service provides all QUT researchers (staff and Higher Degree Research students (HDRs)) with a secure data repository throughout the research data lifecycle. Three distinct storage areas provide for raw research data to be acquired, project data to be worked on, and published data to be archived. Since the service was launched in late 2014, it has provided research project teams from all QUT faculties with acquisition, working or archival data space. Feedback indicates that the storage suits the unique needs of researchers and their data. As part of the workflow to establish storage space for researchers, Research Support Specialists and Research Data Librarians consult with researchers and HDRs to identify data storage requirements for projects and individual researchers, and to select and implement the most suitable data storage services and facilities. While research can be a journey into the unknown[1], a plan can help navigate through the uncertainty. Intertwined in the storage provision is QUT’s Research Data Management Planning tool. Launched in March 2015, it has already attracted 273 QUT staff and 352 HDR student registrations, and over 620 plans have been created (2/10/2015). Developed in collaboration with Office of Research Ethics and Integrity (OREI), uptake of the plan has exceeded expectations.

Constructing abstract maps from spatial descriptions for goal-directed exploration

This paper describes ongoing work on a system using spatial descriptions to construct abstract maps that can be used for goal-directed exploration in an unfamiliar office environment. Abstract maps contain membership, connectivity, and spatial layout information extracted from symbolic spatial information. In goal-directed exploration, the robot would then link this information with observed symbolic information and its grounded world representation. We demonstrate the ability of the system to extract and represent membership, connectivity, and spatial layout information from spatial descriptions of an office environment. In the planned study, the robot will navigate to the goal location using the abstract map to inform the best direction to explore in.

Pathophysiology team teaching: Bioscientist contribution to knowledge integration in a nursing subject

Bioscience content within undergraduate nursing degrees provides foundational knowledge of pathophysiology, anatomy, physiology, microbiology and pharmacology. However, nursing students often find studying the bioscience components of undergraduate nursing program daunting (Friedel & Treagust 2005, Craft et al. 2013). This is related to factors such as the volume of content, degree of difficulty and insufficient linkage between bioscience concepts and nurses' clinical practice. Students who are unable to conceptualise the relevance of bioscience with nursing subjects and subsequent nursing practice may not appreciate the broader importance of bioscience, and hence may adopt a surface approach to learning (Craft et al. 2013). The aim of this study was to develop a model within Nursing Practice in the Context theory subject, to include a bioscientist lecturing to complement the nursing lecturer, in order to explicitly demonstrate links between physiology, pathophysiology and nursing practice.

It's all in the Team: Collaborations driving success in learning – a first year case

First year medical laboratory science students (up to 120) undertake a group e-poster project, based in a blended learning model Google Drive, encompassing Google’s cloud computing software, provides a readily accessible, transparent online space for students to collaborate with each other and realise tangible outcomes from their learning The Cube provides an inspiring digital learning display space for student ‘conference style’ presentations

Up close and personal with those experiencing homelessness: Pharmacist involvement in a multidisciplinary healthcare team

Introduction. The Brisbane City Council holds a biannual Homeless Connect event which brings together business and community groups on one day to provide free services to people experiencing or at risk of homelessness. Pharmacists were involved in this initiative and provided health services in a multidisciplinary healthcare environment building on the lessons of previous Homeless Connect events (Chan et al, 2015) Aims. To explore pharmacists reflections on their role in a multidisciplinary healthcare team providing services at a community outreach event for those experiencing homelessness. Methods. The pharmacists (n=2) documented the types of services provided during the Homeless Connect event. A semi-structured interview was conducted post-event to investigate barriers, facilitators and changes that would be recommended for future events. Their perceptions of their role in the multidisciplinary healthcare team were also explored. Results. Primarily, the services provided included delivery of primary healthcare, advice on accessing cost effective pharmacy services and addressing medication enquiries. The pharmacists also provided moisturiser samples and health information leaflets. Interdisciplinary referrals were primarily between the pharmacists and podiatrists; no pharmacist-medical practitioner referrals occurred. The pharmacists did believe they had a positive role in this health initiative but improvements could be implemented to improve the delivery of these services in future events. Discussion. Pharmacists can play an important role in providing services to people experiencing or at risk of homelessness and the overall experience was positive for the pharmacists. They were able to integrate into a multidisciplinary healthcare team in this setting but strategies for further collaboration were identified. The possibility of involving pharmacy students in future events was identified.

The impacts of policy change on collaborative governance networks

For many complex natural resources problems, planning and management efforts involve groups of organizations working collaboratively through networks (Agranoff, 2007; Booher & Innes, 2010). These networks sometimes involve formal roles and relationships, but often include informal elements (Edelenbos & Klijn, 2007). All of these roles and relationships undergo change in response to changes in personnel, priorities and policy. There has been considerable focus in the planning and public policy literature on describing and characterizing these networks (Mandell & Keast, 2008; Provan & Kenis, 2007). However, there has been far less research assessing how networks change and adjust in response to policy and political change. In the Australian state of Queensland, Natural Resource Management (NRM) organizations were created as lead organizations to address land and water management issues on a regional basis with Commonwealth funding and state support. In 2012, a change in state government signaled a dramatic change in policy that resulted in a significant reduction of state support and commitment. In response to this change, NRM organizations have had to adapt their networks and relationships. In this study, we examine the issues of network relationships, capacity and changing relationships over time using written surveys and focus groups with NRM CEOs, managers and planners (note: data collection events scheduled for March and April 2015). The research team will meet with each of these three groups separately, conduct an in-person survey followed by a facilitated focus group discussion. The NRM participant focus groups will also be subdivided by region, which correlates with capacity (inland/low capacity; coastal/high capacity). The findings focus on how changes in state government commitment have affected NRM networks and their relationships with state agencies. We also examine how these changes vary according to the level within the organization and the capacity of the organization. We hypothesize that: (1) NRM organizations have struggled to maintain capacity in the wake of state agency withdrawal of support; (2) NRM organizations with the lowest capacity have been most adversely affected, while some high capacity NRM organizations may have become more resilient as they have sought out other partners; (3) Network relationships at the highest levels of the organization have been affected the most by state policy change; (4) NRM relationships at the lowest levels of the organizations have changed the least, as formal relationships are replaced by informal networks and relationships.