Management of sharps in ambulance care : a state-wide survey of paramedic knowledge and reported practice

Paramedics are at high risk of exposure to infectious diseases because they frequently undertake procedures such as the use and disposal of sharps as components of everyday practice. While the literature demonstrates that the management of sharps is problematic across all health disciplines, there is a paucity of research examining sharps management practices in the Australian pre-hospital paramedic context. This study examines knowledge and practices of sharps control among paramedics in Queensland, Australia. A mail survey focusing on infection control knowledge and practices was sent to all clinical personnel of the Queensland Ambulance Service (QAS) (N = 2274). A total of 1258 surveys were returned, a response rate of 55.3%. Participants responded to 12 true/false statements on the management of sharps and three questions about recapping practices. Most respondents were knowledgeable about the correct management of sharps, with a mean of 11.28 (out of 12, SD = 1.32). When gauging reported practices, more than half (59.1%, n = 736) of participants reported recapping a needle, and 38.5% (n = 479) reported never having done so. These results reflect good knowledge of general management of sharps among respondents, but suggest deficits regarding reported practices. The results suggest that a comprehensive ambulance in-service education programme focusing particularly on sharps management is required. The study highlights the need for further research on sharps management practices in the field, identification of barriers to safe sharps practices in pre-hospital settings, and 'best practice' for translating good sharps management knowledge into practice.

Levels of cardiac knowledge and cardiopulmonary resuscitation training among older people in Queensland

Objectives: The current study was conducted to determine levels of cardiac knowledge and cardiopulmonary resuscitation (CPR) training in older people in Queensland, Australia.---------- Methods: A telephone survey of 4490 Queensland adults examined respondents’ knowledge of coronary heart disease (CHD) risk factors, knowledge of heart attack symptoms, knowledge of the local emergency telephone number, as well as respondents’ rates and recency of training in CPR.---------- Results: Older participants, aged 60 years and over, were approximately one and a half times more likely than the 30–39 year-old reference group to have limited knowledge of heart disease risk factors (OR = 1.53), and low knowledge of heart attack symptoms (OR = 1.60). Knowledge of the local emergency telephone number also decreased with age. Older participants had significantly lower rates of training in CPR, with almost three quarters (71.7%) reporting that they had never been trained. Older people who had completed CPR training were significantly less likely to have done so recently.---------- Conclusions: Cardiac knowledge levels and CPR training rates in older Queensland persons were lower than those found in the younger population.

Human resource management and innovation: what are knowledge-intensive firms doing?

An undeniable shift in focus from traditional production companies to Knowledge-Intensive Firms (KIFs) poses challenges for academics and practioners alike. In particular, effective management of an organization's human resources has become a critical issue for ensuring sustained innovation capacity. The relationship between Human Resource Management (HRM) in KIFs is however still a largely unexplored arena. The objective of this paper is to explore this relationship in an effort to identify HRM practices that support innovation. To this end, the paper includes reviews of the literature relevant to HRM and innovation in KIFs and four case studies from companies in Denmark and Australia that have been recognized for excellence in innovation. On the basis of content analyses conducted on the case data, some preliminary conclusions are posited regarding the role of HRM in KIFs. More specifically, the findings from this study suggest that while there are commonalities between HRM practices in traditional manufacturing companies and KIFs, there are also important differences, especially in terms of staffing practices. The paper contributes by offering recommendations for management of HRM in innovative KIFs and potential avenues for research to further develop our understanding of how HRM can support innovation in KIFs.

Succession management as a knowledge management strategy

One of the most critical issues for building innovation capacity in organisations is the acquisition and maintenance of knowledge. As knowledge is the basis of human capital, then the ability to attract, retain and engage talent is argued to be an important element of innovation. By attracting and retaining good staff, the organisation is retaining organisational knowledge which is necessary particularly for exploitation of current capabilities, but will also contribute to capacity for exploration for future innovation. This paper addresses the importance of retaining and developing staff as a critical issue for knowledge management and addresses the issue of retaining talent through effective succession management practices. The findings from an exploratory study into current practices in the Australian rail sector, provides further insight into the potentially critical issues for the effective use of succession management as a knowledge management and employee retention tool for building innovation capacity.

Paramedic knowledge of infectious disease aetiology and transmission in an Australian Emergency Medical System

Introduction: Paramedics and other emergency health workers are exposed to infectious disease particularly when undertaking exposure-prone procedures as a component of their everyday practice. This study examined paramedic knowledge of infectious disease aetiology and transmission in the pre-hospital care environment.--------- Methods: A mail survey of paramedics from an Australian ambulance service (n=2274) was conducted.--------- Results: With a response rate of 55.3% (1258/2274), the study demonstrated that paramedic knowledge of infectious disease aetiology and modes of transmission was poor. Of the 25 infectious diseases included in the survey, only three aetiological agents were correctly identified by at least 80% of respondents. The most accurate responses for aetiology of individual infectious diseases were for HIV/AIDS (91.4%), influenza (87.4%), and hepatitis B (85.7%). Poorest results were observed for pertussis, infectious mononucleosis, leprosy, dengue fever, Japanese B encephalitis and vancomycin resistant enterococcus (VRE), all with less than half the sample providing a correct response. Modes of transmission of significant infectious diseases were also assessed. Most accurate responses were found for HIV/AIDS (85.8%), salmonella (81.9%) and influenza (80.1%). Poorest results were observed for infectious mononucleosis, diphtheria, shigella, Japanese B encephalitis, vancomycin resistant enterococcus, meningococcal meningitis, rubella and infectious mononucleosis, with less than a third of the sample providing a correct response.--------- Conclusions: Results suggest that knowledge of aetiology and transmission of infectious disease is generally poor amongst paramedics. A comprehensive in-service education infection control programs for paramedics with emphasis on infectious disease aetiology and transmission is recommended.

Systematising knowledge management in projects

Purpose – The purpose of this paper is to provide a practicable systems-based approach to knowledge management (KM) in a project environment, to encourage organisations to unlock the value in their review processes. It relies on knowledge capture and storage at decision review points, to enrich individual, team and organisational learning during the project life cycle. The project's phases are typically represented horizontally with deliverables (objectives) or project "promises" as the desirable outcomes. The purpose of this paper is to give expression through introducing a vertical dimension to facilitate the KM process. A model is proposed that conceptualises project-specific knowledge drawing on and feeding into the organisation's knowledge management system (KMS) at tactical and strategic levels. Design/methodology/approach – This conceptual paper links concepts from systems theory with KM, to produce a model to identify, collate, and optimise project-based knowledge and integrate it into the management process. Findings – The application of the system theory approach enriches the knowledge generated by a project, and feeds it into the next phase of that project. At the same time, it contributes to the individual's and project team's KM, specifies possible courses of action, together with risks, costs and benefits and thus it expands the organisation's higher level KMS. Research limitations/implications – The concept suggests that the knowledge capture, storage and sharing process may best be undertaken holistically, in view of the systems relationships between the tasks. Systems theory structures this process. Research opportunities include studying the interfaces between levels of KM, in relation to the project's progress. Practical implications – Reconceptualisation of the project as a knowledge creation process may improve the project's progress as well as add to the individual's, project team's, and wider organisation's knowledge base. An example is given. Originality/value – This paper illuminates the broader potential of under-utilised opportunities in well-known management approaches to add dimension to the business project, of knowledge creation, storage and sharing.

Managing knowledge in an outsourcing environment

What an organisation does versus what it out-sources to the market is a classic boundaries of the firm question that has previously been dominated by efficiency arguments. However, a knowledge-based view suggests these boundaries are integral to the ability of a firm to deploy existing knowledge stocks efficiently, as well as develop new knowledge through learning that will drive future competitiveness. Furthermore, the nature of these boundaries, in respect of their permeability is critical in understanding the likelihood of knowledge flowing into and out of the organisation. Using these concepts, we present a case study of Main Roads Western Australia to illustrate how these principles have allowed it to start rebuilding its internal capabilities through repositioning its operational boundaries and via ensuring their boundaries are highly porous as they move more major projects into alliance contracts.

Documenting reproduction and inequality : revisiting Jean Anyon’s “Social class and school knowledge”

Jean Anyon’s (1981) “Social class and school knowledge” was a landmark work in North American educational research. It provided a richly detailed qualitative description of differential, social-class-based constructions of knowledge and epistemological stance. This essay situates Anyon’s work in two parallel traditions of critical educational research: the sociology of the curriculum and classroom interaction and discourse analysis. It argues for the renewed importance of both quantitative and qualitative research on social reproduction and equity in the current policy context.

Extending knowledge management across the supply chains in the construction industry : knowledge sharing in construction supply chains

Supply chain management and knowledge management have emerged as two distinct business philosophies in the last decade. Both are making rapid inroads into the construction industry. The premise of this paper is that knowledge management would make it possible for all the trading partners in a supply chain to reap benefits. Current research in knowledge management in the construction industry is generally targeting those big organisations that are main contractors. This has restricted the scope of knowledge management, and limits the benefits to a few, rather than the whole industry. If the construction industry as a whole is to prosper and improve its productivity, strategies for knowledge management strategy at the industry level must be established. This paper argues the case for extending the scope of knowledge management across the full extent of the supply chain, and attempts to identify the benefits that may arise out of sharing knowledge across the supply chain.

Five case studies applying soft systems methodology to knowledge management

Construction projects are faced with a challenge that must not be underestimated. These projects are increasingly becoming highly competitive, more complex, and difficult to manage. They become problems that are difficult to solve using traditional approaches. Soft Systems Methodology (SSM) is a systems approach that is used for analysis and problem solving in such complex and messy situations. SSM uses “systems thinking” in a cycle of action research, learning and reflection to help understand the various perceptions that exist in the minds of the different people involved in the situation. This paper examines the benefits of applying SSM to problems of knowledge management in construction project management, especially those situations that are challenging to understand and difficult to act upon. It includes five case studies of its use in dealing with the confusing situations that incorporate human, organizational and technical aspects.

Knowledge channelization and innovation

This paper examines knowledge management and innovation in the Australian Construction Industry. A conceptual model is presented, based upon analysis of the literature and a series of preliminary construction industry interviews. Extensive knowledge management (KM) research has focused upon types of knowledge contained within specific organizational settings. However, we argue that a crucial missing link in KM research concerns the interface between flows of knowledge from external sources of innovations and its channelization in and out, and between organizations. This interface, regulating and facilitating knowledge from external sources of innovation into the organisation, operates under the influence of two main forces visualized as “pulling” and “pushing” forces in the model presented in this paper. The premise of the model lies in a hypothesis that as an organization changes itself into a more mature, learning organization (LO) over time, knowledge flows into it through “pull” rather than “push” forces. We conclude that a successful knowledge management initiative installs a learning and knowledge sharing culture, which is easily adaptable to new learning offering little resistance to new knowledge that flows into the organisation. The model bridges the gap between research and its application in construction practice.

Decolonising the concept of knowledge

Controlling the definition of what was essentially a subjugated culture, the colonisers reserve the power to distinguish authentic aspects of the living traditions of the colonised. If the colonised argue political demands by reference to their culture, the colonisers are quick to adjudicate what is genuine in such claims. (Fannon, 1967) Since colonial invasions, Australia’s Indigenous people have weathered rapid change. While the origins of Australia’s Indigenous peoples continues to be an archaeological interest for many, how Indigenous cultures have survived, transformed and retained a sense of ‘difference’ is fundamental to understanding the diversity of Aboriginal and Torres Strait Islander cultures within this continent as both contemporaneous and historical. It is important that teachers, students and researchers within Indigenous studies remind themselves that much of the literature on Aboriginal and Torres Strait Islanders can be ideologically traced back to the emergence of ‘knowledge’ about native peoples in the context of European imperialism and expansion from the fifteenth century. Care must therefore be taken in not conveying ‘scientific’ rational knowledge as perhaps the hidden agenda or notion of assumptions of European ‘superiority’ and non-European inferiority. The recognition by the High Court of Australia (1992) abandoned the legal myth of terra nullius which based the dispossession of Indigenous land on the basis of it being considered an empty land. It could also be argued that this decision recognised that distinct customs and traditions continue to exist within the social and cultural ‘knowledge’ of Indigenous peoples of Australia. General issues and concerns relating to research design, methodology and articulation within QUT are not just confined to this university and the research project presented as a case study but are important in dealing with how Aboriginal and Torres Strait Islander students and academics participate or are employed within the university. We feel that the design and methodology of research that either covertly or overtly focuses on Indigenous Australians can no longer presume that all research will naturally follow protocols that are culturally appropriate as this appropriateness is usually defined by the institution. By no means do we feel that research should be debilitated as a result of raising these issues, but that collaborative approaches within the ‘process’ of research will address Aboriginal and Torres Strait Islander people and communities as much as the intended outcomes of research itself.

Determinants of knowledge transfer and learning in hybrid public private alliances

This paper uses the case study of a hybrid public-private strategic alliance as data to complement and contrast with the traditional views on knowledge transfer and learning between alliance partners. In particular, the paper explores whether the concept of competitive collaboration conceptualized by Hamel (1991) in his seminal work holds true for all forms of strategic alliances. Conceptualizing the knowledge boundaries of organisations in alliances as a ‘collaborative membrane’, we focus attention on the permeability of these boundaries rather than the actual location of the boundaries. In this vein, we present a case study of a major public sector organization that illustrates how these principles have allowed it to start rebuilding its internal capabilities adopting a more collaborative stance and ensuring their knowledge boundaries are highly porous as they move more major projects into hybrid public private alliance contracts.

The BEE Undergraduate Model for Knowledge Development applied to the QUT Spatial Science Course : Diversity in Surveying Curriculum

This paper provides an overview of the current QUT Spatial Science undergraduate program based in Brisbane, Queensland, Australia. It discusses the development and implementation of a broad-based educational model for the faculty of built environment and engineering courses and specifically to the course structure of the new Bachelor of Urban Development (Spatial Science) study major. A brief historical background of surveying courses is discussed prior to the detailing of the three distinct and complementary learning themes of the new course structure with a graphical course matrix. Curriculum mapping of the spatial science major has been undertaken as the course approaches formal review in late 2010. Work-integrated learning opportunities have been embedded into the curriculum and a brief outline is presented. Some issues relevant to the tertiary surveying/ spatial sector are highlighted in the context of changing higher education environments in Australia.

Developing knowledge precincts in regional towns: opportunities and challenges

While extensive literature exists on knowledge-based urban development (KBUD) focusing on large metropolitan cities, there is a paucity of literature looking into similar developments in small regional towns. The major aim of the paper is to examine the nature and potential for building knowledge precincts in regional towns. Through a review of extant literature on knowledge precincts, five key value elements and principles for development are identified. These principles are then tested and applied to a case study of the small town of Cooroy in Noosa, Australia. The Cooroy Lower Mill Site and its surroundings are the designated location for what may be called a community-based creative knowledge precinct. The opportunities and challenges for setting up a creative knowledge precinct in Cooroy were examined. The study showed that there is a potential to develop Cooroy with the provision of cultural and learning facilities, partnerships with government, business and educational institutions, and networking with other creative and knowledge precincts in the region. However, there are also specific challenges relating to the development of a knowledge precinct within the regional town and these relate to critical mass, competition and governance.