Implementation of sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities

Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice.

An evidence-based program to improve analgesic practice and pain outcomes in residential aged care facilities

Pain is common in individuals living in residential aged care facilities (RACFs), and a number of obstacles have been identified as recurring barriers to adequate pain management. To address this, the Australian Pain Society developed 27 recommendations for comprehensive good practice in the identification, assessment, and management of pain. This study reviewed preexisting pain management practice at five Australian RACFs and identified changes needed to implement the recommendations and then implemented an evidence-based program that aimed to facilitate better pain management. The program involved staff training and education and revised in-house pain-management procedures. Reviews occurred before and after the program and included the assessment of 282 residents for analgesic use and pain status. Analgesic use improved after the program (P<.001), with a decrease in residents receiving no analgesics (from 15% to 6%) and an increase in residents receiving around-the-clock plus as-needed analgesics (from 24% to 43%). There were improvements in pain relief for residents with scores indicative of pain, with Abbey pain scale (P=.005), Pain Assessment in Advanced Dementia Scale (P=.001), and Non-communicative Patient's Pain Assessment Instrument scale (P<.001) scores all improving. Although physical function declined as expected, Medical Outcomes Study 36-item Short-Form Survey bodily pain scores also showed improvement (P=.001). Better evidence-based practice and outcomes in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce using this program improved analgesic practice and pain relief in participating sites. Further attention to the continued targeted pain management training of aged care staff is likely to improve pain-focused care for residents.

Victorian Public Libraries: Our Future, Our Skills. Research Report

This research study represents a key part of the program of Statewide Public Library Development Projects delivered by the State Library of Victoria between 2011 and 2014 in partnership with Public Libraries Victoria Network (PLVN), the peak body for Victoria’s 47 public library services. The overarching objectives of this project were: - to develop a framework to articulate the core competencies required by the public library workforce for the 21st century - to conduct a skills audit of Victorian public library staff in order to collect evidence of the current skills and to anticipate future skills requirements - to deliver a report that analyses the audit findings and makes recommendations on training needs and strategies to prepare for the future delivery of public library services in Victoria. The study built on the 2008 report Workforce sustainability and leadership: Survey, analysis and planning, developed for the State Library of Victoria and PLVN, in which three types of workplace skills were delineated: cognitive (or Foundation), technical (or Professional) and Behavioural skills. Following industry discussion and review, a framework comprising 59 skill-sets within the three distinct skills areas was finalised in October 2013. The skills audit, which comprised an Individual survey and a Management survey with questionnaires directly based on the skills framework, was undertaken between late November and December 2013. This report presents the analysis and interpretation of the data collected through the two surveys.

Regulating supply-chains to address the occupational health and safety problems associated with precarious employment: The case of home-based clothing workers in Australia

Over the past 20 years the labour market, workforce and work organisation of most if not all industrialised countries have been significantly refashioned by the increased use of more flexible work arrangements, variously labelled as precarious employment or contingent work. There is now a substantial and growing body of international evidence that many of these arrangements are associated with a significant deterioration in occupational health and safety (OHS), using a range of measures such as injury rates, disease, hazard exposures and work-related stress. Moreover, there is an emerging body of evidence that these arrangements pose particular problems for conventional regulatory regimes. Recognition of these problems has aroused the concern of policy makers - especially in Europe, North America and Australia - and a number of responses have been adopted in terms of modifying legislation, producing new guidance material and codes of practice and revised enforcement practices. This article describes one such in itiative in Australia with regard to home-based clothing workers. The regulatory strategy developed in one Australian jurisdiction (and now being ‘exported’ into others) seeks to counter this process via contractual tracking mechanisms to follow the work, tie in liability and shift overarching legal responsibility to the top of the supply chain. The process also entails the integration of minimum standards relating to wages, hours and working conditions; OHS and access to workers’ compensation. While home-based clothing manufacture represents a very old type of ‘flexible’ work arrangement, it is one that regulators have found especially difficult to address. Further, the elaborate multi-tiered subcont racting and diffuse work locations found in this industry are also characteristic of newer forms of contingent work in other industries (such as some telework) and the regulatory challenges they pose (such as the tendency of elaborate supply chains to attenuate and fracture statutory responsibilities, at least in terms of the attitudes and behaviour of those involved).

Social Justice Impacts of the Resources Boom

Until the 1970s mining leases were issued by state governments subject to conditions that companies build or substantially finance local community infrastructure, including housing, streets, transport, schools, hospitals and recreation facilities. Townships and communities went hand in hand with mining development. However, in the past thirty years mining companies have moved progressively to an expeditionary strategy for natural resources extraction - operating a continuous production cycle of 12 hour shifts - increasingly reliant on non-resident, fly-in, fly-out or drive-in, drive-out (FIFO/DIDO) workers who typically work block rosters, reside in work camps adjacent to existing communities and travel large distances from their homes. This paper presents the key findings of our survey into the social impacts of this kind of mining development in Qld. Based on the results we argue that the social license to develop new mining projects is strong for projects requiring a 25% or less non-resident workforce, diminishes significantly thereafter and is very weak for projects planning to recruit a non-resident workforce in excess of 75%. This finding is significant because there are at least 67 new mining projects undergoing social impact assessment in Queensland, and many it appears are planning to hire significant proportions of non-resident workers. The paper considers the policy implications of this growing social justice issue concluding there is a clear need for national leadership in formulating a national policy framework for guiding socially responsible and sustainable mining development into the next millennium.

Think Sociology

Contents: 1. SOCIOLOGY: An Introduction to the Sociological Imagination. John Carl, Sarah Baker 2. SOCIOLOGICAL THEORY: An Introduction to the Theoretical Foundations of Sociology. John Carl, Sarah Baker 3. SOCIAL CLASS IN AUSTRALIA: Stratification in a Modern Society. John Carl, John Scott 4. RACE AND ETHNIC STRATIFICATION: Is it a Question of Colour? John Carl, John Scott 5. SEX AND GENDER: The Social Side of Sex. John Carl, Wendy Hillman 6. AGE AND AGEING: The Greying of Society. John Carl, Sarah Baker 7. CRIME AND THE LEGAL SYSTEM: How Do Societies Respond to Crime and Deviance? John Carl, John Scott 8. EDUCATION AND EMPLOYMENT: From the Classroom to the Workforce. John Carl, Sarah Baker and Brady Robards 9: MARRIAGE AND FAMILY: How Do Societies Perpetuate Themselves? John Carl, Wendy Hillman 10. THE BODY, HEALTH AND ILLNESS: A Weight on Australia’s Shoulder. John Carl, John Scott 11. GLOBALISATION: The Economy and Society. John Carl, Geoffrey Lawrence 12. CULTURE: A Framework for the Individual. John Carl, Sarah Baker and Brady Robards 13. RELIGION: Is Society Losing Faith? John Carl, Sarah Baker and Brady Robards 14. ENVIRONMENTAL SUSTAINABILITY AND SOCIAL MOVEMENTS: How Do Societies Connect with Nature? John Carl, Geoffrey Lawrence 15. SOCIOLOGICAL RESEARCH: How Do We Learn about Society? John Carl, Wendy Hillman

Nursing casualisation and communication : a critical ethnography

Aim The aim was to explore the relationship between nursing casualization and the culture of communication for nurses in a healthcare facility. Background Casualization, or non-standard work, is the use of temporary, contract, part-time and casual labour. An increase in casual labour has been part of a global shift in work organization aimed at creating a more flexible and cheaper workforce. It has been argued that flexibility of labour has enabled nurses to manage both non-work related needs and an increasingly complex work environment. Yet no research has explored casualization and how it impacts on the communication culture for nurses in a healthcare facility. Design Critical ethnography. Methods Methods included observation, field notes, formal interviews and focus groups. Data collection was undertaken over the 2 years 2008–2009. Results The concepts of knowing and belonging were perceived as important to nursing teamwork and yet the traditional time/task work model, designed for a full-time workforce, marginalized non-standard workers. The combination of medical dominance and traditional stereotyping of the nurse and work as full-time shaped the behaviours of nurses and situated casual workers on the periphery. The overall finding was that entrenched systemic structures and processes shaped the physical and cultural dimensions of a contemporary work environment and contributed to an ineffective communication culture. Conclusion Flexible work is an important feature of contemporary nursing. Traditional work models and nurse attitudes and practices have not progressed and are discordant with a contemporary approach to nursing labour management.

Development of an online role-play assessment initiative for nursing students in their bioscience studies

Devising assessment tasks for large units that embrace academic goals of authenticity and assessment variety can be a challenge. We developed an online Role-Play Assessment Initiative for first year nursing students in bioscience. Students responded to a case study by preparing two role-play dialogues: as a nurse with the patient, and between two nurses. The aims were to assess whether the students could: 1) understand the underlying disease process (pathophysiology) and relate it to clinical practice; 2) use language appropriate for lay and medical conversation; and 3) apply information using active learning. We conducted a student survey using quantitative questions (Likert scale: 1=strongly disagree to 5=strongly agree), and qualitative questions. 65 completed surveys were received. 80% of respondents agreed (includes agree or strongly agree) that it was a useful way to learn and understand pathophysiology of the case study. 86% agreed that it was useful to apply pathophysiology from lectures to a clinical setting. Overall, students found it enjoyable, which is beneficial for enhanced student engagement, and agreed that it allowed them to work well in a group (74% and 85%, respectively). Most qualitative suggestions for improvement related to group work, despite the encouraging response to group work in quantitative questions. Most positive comments surrounded different communication with a nurse compared with a patient. These results demonstrate that students developed deeper understanding of pathophysiology through active learning and were able to expand their nursing career skills during the role-play. Learning using role-play to simulate the workforce has fostered active learning.

Out of the frying pan and into the fire – forging a career in a temporary workplace : a new perspective for HR?

Recent literature acknowledges the need for new career development models to support the way that careers evolve in the 21st century workplace (Bloch 2005). This is particularly so within temporary organisation forms, and for those pursuing a career in project management (Hölzle 2010). Our research, explores how project managers working on projects and within temporary organisation forms and those working on project-linked contracts access the development opportunities they require to remain employable in an era of project-by-project employment. Set in Australia where a project-based economy (Crawford, French and Lloyd-Walker 2013) and contract work have led to casualisation of the workforce (Connell & Burgess, 2006; McKeown & Hanley (2009) the results suggest new approaches to career development may be required.

The facilitator files : supporting the supporters of nursing students

Nurse education in Australia has undergone a substantial transformation in the course of its professional history. The use of experiential teaching and learning approaches in both pre and post registration courses has escalated dramatically and resulted in the extensive use of hospital based clinical experiences for student learning. The role of the clinical facilitator is used to provide stimulation to the affective and cognitive domains of student professional development and additionally is often used as a vehicle for student assessment. While most tertiary nursing schools utilise hospital clinical experiences widely, few studies have examined whether clinical facilitators have the necessary tools to effectively support and assess students in the clinical environment. Although employed for their clinical expertise and understanding of specific clinical contexts, facilitators are expected to have an understanding of experiential learning, how it informs the undergraduate curriculum and be able to support the development of neophyte nurses as they learn to apply theoretical concepts to the increasingly complex realm of patient care. Additionally, clinical facilitators are often employed on a casual basis and as a consequence of the casualisation of the facilitator workforce, universities are continually recruiting new clinical facilitators to these positions. This paper will explore a trial of facilitator education offered to clinical facilitators at the Queensland University of Technology, School of Nursing campus in Brisbane, Australia. It will report on the use of a series of student/facilitator “vignettes” created specifically for the purpose of facilitator education and how these interactions have been embedded within a wider educational package to support facilitators in their development as facilitators rather than teachers of nursing education. Finally, it will discuss the implications of facilitator preparedness on their ability to support and assess nursing students as they engage in the important transition from neophyte to registered nurse.

Impact of gender-focused human resource management on performance : the mediating effects of gender diversity

Gender-focused human resource policies and practices signal an organization’s perspective on gender diversity. The signal produces perceptions that the organization values gender diversity leading to a gender-diverse workforce. In turn, a gender-diverse workforce provides a firm with a competitive advantage which should result in higher performance. This paper tests the mediating effects of gender diversity (at non-management and management levels) in the relationship between gender-focused policies and practices and performance. The findings indicate that non-management gender diversity partially mediates the relationship between gender-focused policies and practices and productivity, and management gender diversity partially mediates the relationship between gender-focused policies and practices and perceived market performance. The results have several theoretical, research and practical implications.

Jet and flash imprint defectivity - Assessment and reduction for semiconductor applications

Defectivity has been historically identified as a leading technical roadblock to the implementation of nanoimprint lithography for semiconductor high volume manufacturing. The lack of confidence in nanoimprint's ability to meet defect requirements originates in part from the industry's past experiences with 1 × lithography and the shortage in enduser generated defect data. SEMATECH has therefore initiated a defect assessment aimed at addressing these concerns. The goal is to determine whether nanoimprint, specifically Jet and Flash Imprint Lithography from Molecular Imprints, is capable of meeting semiconductor industry defect requirements. At this time, several cycles of learning have been completed in SEMATECH's defect assessment, with promising results. J-FIL process random defectivity of < 0.1 def/cm2 has been demonstrated using a 120nm half-pitch template, providing proof of concept that a low defect nanoimprint process is possible. Template defectivity has also improved significantly as shown by a pre-production grade template at 80nm pitch. Cycles of learning continue on feature sizes down to 22nm. © 2011 SPIE.

The application of social network analysis in the construction industry of Hong Kong

The Hong Kong construction industry is currently facing ageing problem and labour shortage. There are opportunities for employing ethnic minority construction workers to join this hazardous industry. These ethnic minority workers are prone to accidents due to communication barriers. Safety communication is playing an important role for avoiding the accidents on construction sites. However, the ethnic minority workers are not very fluent in the local language and facing safety communication problems while working with local workers. Social network analysis (SNA), being an effective tool to identify the safety communication flow on the construction site, is used to attain the measures of safety communication like centrality, density and betweenness within the ethnic minorities and local workers, and to generate sociograms that visually represent communication pattern within the effective and ineffective safety networks. The aim of this paper is to present the application of SNA for improving the safety communication of ethnic minorities in the construction industry of Hong Kong. The paper provides the theoretical background of SNA approaches for the data collection and analysis using the software UCINET and NetDraw, to determine the predominant safety communication network structure and pattern of ethnic minorities on site.

Gen Y recruitment: Understanding graduate intentions to join an organisation using the Theory of Planned Behaviour

Purpose Using the Theory of Planned Behaviour (TPB) framework, this study explored whether the standard TPB constructs explained variance in Gen Y individuals’ intentions to join their ideal organisation. Design/methodology/approach A mixed methods approach was used featuring qualitative and quantitative methods. Findings The overall TPB model accounted for a significant 51.6% of the variance in intention to join one’s ideal organisation in the next six months with the significant predictors in the model being subjective norm and perceived behaviour control but not attitude. Research limitations/implications Using graduating students from a single Australian university sample may mean that the current findings may not extend to all Gen Y individuals. The current study has demonstrated the explanatory utility of the TPB in relation to graduate Gen Y’s intention to join their ideal organisation, providing further evidence of the robustness of the TPB framework in an organisational setting. Practical implications These findings have implications for enhancing understanding of the most effective recruitment processes for Gen Y students entering the workforce. The findings could inform recruitment policies and strategies to attract Gen Y applicants. Originality/value To our knowledge this study is the first application of the TPB to this topic. The current research extends the recruitment literature with a theoretically-based investigation. Identification of factors which inform organisational recruitment strategies, allow organisations to stand out from their competitors and potentially achieve a larger application pool from which to select the best human capital and sustain competitive advantage.

Energy Efficiency Resources for Undergraduate Engineering Education: Final Report

This report presents the findings of an investigation of energy efficiency resources for undergraduate engineering education, undertaken by web-based research, conversations with educators, and a university survey. The investigation draws on the results of a number of previous investigations undertaken by the research team for NFEE related to energy efficiency education and presents the following findings and recommendations, as explained in greater detail in the body of the report. The findings suggest that even though certain EE concepts and principles have been identified by lecturers as being important there is little to no coverage of a number of these concepts in some programs/courses. Similarly, many topics relating to the most important EE workforce skills and significant shortages as identified in industry research, do not rate highly in terms of both perceived importance by lecturers, or coverage within existing courses. Overall, these findings suggest that despite growing awareness of the importance of EE in both industry and academia, the current depth and breadth of EE content in courses does not reflect this. It confirms that efforts in these areas can be better supported.