Patient hand hygiene compliance in the hemodialysis environment

Hand hygiene compliance of patients receiving hemodialysis treatment is a contemporary discussion topic among health care professionals in the Nephrology Clinic of Helsinki University City Hospital. The purpose of the Final Thesis is to review patient hand hygiene in terms of risks its lack entails and based on the evidence based findings to design an end product as a poster. The poster can be utilised in the Nephrology Clinic's nursing environment to educate and motivate patients to pay specifid attention to the importance of hand hygiene. The method used was a systematic literature review. The most important evidence based findings were extracted from the chosen thirteen scientific articles. All articles were searched from the Cumulative Index to Nursing and Allied Health Literature electronic database. The gathered information was then used to build the content of a patient education tool that for this project was defined as a Poster. The findings in this study showed that transmission of bloodborne infections, like Hepatitis B or C virus can occur through a vascular access and that the consequences of this can be very fatal. Additionally, environmental surfaces such as furniture, door knobs and dialysis machine control knobs were all possible infection sources for the patient receiving hemodialysis treatment. Adherence to good hand hygiene behaviour lowered the risk for infections. The end product of this study is a poster that is targeted to patients undergoing hemodialysis treatment. Using a health promotion agenda in the Poster, it is hoped that patients will pay more attention to the importance of hand hygiene and that they will be more motivated to use aseptic methods such as alcohol based hand rubs in the hemodialysis setting.

The effect of oxygen delignification on fiber properties in kraft pulp production - a review

Fiber damages comprise fiber deformations, characterized as fiber curl, kink, dislocations and strength losses as well as some yet unidentified factors. This recently discovered phenomenon is especially evident in mill scale kraftpulps. Laboratory produced pulps tend to have less damages and superior strength properties compared to those produced in pulp mills. Generally fiber damages pose a problem in the production of reinforcement pulp because they tend to decrease the ability of fibers to transmit load. Previous studies on fiber damage have shown that most of the fiber damages occur during brown stock processing starting from cooking and discharging. This literature review gives an overall picture on fiber damages occurring during softwood kraft pulp production with an emphasis on the oxygen delignification stage. In addition the oxygen delignification stage itself is described in more detailed extent in order to understand the mechanisms behind the delignification and fiber damaging effect. The literature available on this subject is unfortunately quite contradictory and implicates a lotof different terms. Only a few studies have been published which help to understand the nature of fiber damages. For that reason the knowledge presented in this work is not only based on previous studies but also on research scientist and mill staff interviews.

KUMPPANUUKSIEN LAATUTEKIJÄT JA KUMPPANUUSKYVYKKYYS VERKOSTOSUHTEIDEN KRIITTISINÄ MENESTYSTEKIJÖINÄ

Pro gradu -tutkielman tavoitteena on selvittää, mitkä ovat kahden yrityksen läheisen verkostoyhteistyösuhteen menestystekijät ja kuinka yritys pystyy parantamaan onnistumistaan verkostosuhteissaan. Päämääränä on selvittää kirjallisuudesta löydettyjen menestystekijöiden avulla, mikä on case –yritysten yhteistyösuhteiden ja kumppanuuskyvykkyyden nykytila, pullonkaulatekijät ja kuinka niitä voidaan parantaa. Tutkielman tavoitteisiin on pyritty kvalitatiivisiin tutkimusmenetelmiin kuuluvalla case –tutkimuksella. Aineisto kerättiin teemahaastatteluin ja analysoitiin purkamalla ne sanallisiin, teema-alueiden mukaisiin kokonaisuuksiin. Analyysissä käytettiin osittain Atlas.Ti –ohjelmistoa. Tutkimuksen tulokset osoittavat, että läheisen verkostoyhteistyösuhteen menestystekijät ovat luottamus, sitoutuminen ja kommunikaatio sekä verkostoidentiteetti. Näistä luottamuksen tila oli tutkituissa suhteissa hyvä ja sitoutumisenkin kohtuullinen. Sen sijaan verkostoidentiteetti oli jossain määrin epäselvä ja kommunikaatiossa oli puutteita kasvaen sitä mukaan, kun organisaatiohierarkiassa edetään korkeammalle. Nämä mahdollisesti heikentävät läheisestä suhteesta saatavia hyötyjä. Tulokset osoittavat myös sen, että nostaakseen onnistumisen tason kaikissa yhteistyösuhteissaan, niiden tulee pyrkiä järjestelmällisesti hyödyntämään aikaisempaa yhteistyökokemustaan ja näin rakentamaan kumppanuuskyvykkyyttään. Kohdeyrityksissä oli tehty vielä vähän konkreettisia toimenpiteitä yritystason kumppanuuskyvykkyyden kohentamiseksi.

Laadullinen review -tutkimus metodina ja yhteiskuntatieteellisenä lähestymistapana

Abstract: Qualitative literature review as a method and a social scientific research approach

The Changing Face of Psychiatric Nursing –Care or Control?

This report has been written as part of the project “Toward improved quality – developing nurse’s continuing vocational training in hospitals and inpatient units”. Its overall goal is to ensure high quality, ethically appropriate and therapeutically effective interventions to enable nurses to manage distressed and disturbed patients in European psychiatric hospitals and inpatient units. In this large-scale, multinational projects there are all together six European countries involved: Finland, Ireland, England, Portugal, Italy and Lithuania. The project work plan were during autumn 2006 and spring 2007. The content of this publication was produced in the first stage of the project aiming to collect the preliminary source material for the project. The literature review was carried out in the project stage, providing the groundwork for the next steps for the project. This project aims to develop an interactive multinational portal with training material. Therefore, it is important to share an understanding of basic information, psychiatric nurse’s continuing vocational education, laws and ethical codes and patient restriction used in mental health care. In this publication, the purpose of the material produced here is to understand nurses’ educational need related to vocational continuing education and to be used in further project stages as an empirical data collection. The data were collected as a preliminary source material for latter phases where nurse’s perceptions of the current practice, nurse’s attitudes to mental illness, prevalence of use of seclusion room and existing and desired vocational training provision will be collected in six different European countries. The following organisations are involved in this project: University of Turku, Dublin City University, St. Vincent Hospital, National Council for the Professional Development of Nursing and Midwifery, University of Padova, Klaipeda College - Health Faculty, Klaipeda Psychiatric Hospital, Escola Superior de Enfermagem de Lisboa, Centro Hospitalar Psiquiátrico de Lisboa, Omnia Vocational Institution the Espoo Region, Kellokoski psychiatric hospital, Hyvinkää hospital area, Pirkanmaa Hospital District, Kingston University & St. George’s Medical School and South West London & St. George’s Mental Health NHS Trust. A wide variety of different countries, organisations and individuals in this project give us a strong confidence that theoretical, practical, ethical and political issues around the topic of interest will be taken account during this project lifetime. We are aware the content of this book will be partially outdated almost as soon as it has been published. We still hope that this publication will encourage nurses and different professions working in mental health care field to have a basic understanding of similarities and differences between different European countries related in mental health care. We also hope that this publication will inspirate and motivate nurses in maintaining and developing the quality of psychiatric care in Europe.

Competitive flexibility in systems supplier companies in mechanical engineering industry

Systems suppliers are focal actors in mechanical engineering supply chains, in between general contractors and component suppliers. This research concentrates on the systems suppliers’ competitive flexibility, as a competitive advantage that the systems supplier gains from independence from the competitive forces of the market. The aim is to study the roles that power, dependence relations, social capital, and interorganizational learning have on the competitive flexibility. Research on this particular theme is scarce thus far. The research method applied here is the inductive multiple case study. Interviews from four case companies were used as main source of the qualitative data. The literature review presents previous literature on subcontracting, supply chain flexibility, supply chain relationships, social capital and interorganizational learning. The result of this study are seven propositions and consequently a model on the effects that the dominance of sales of few customers, power of competitors, significance of the manufactured system in the end product, professionalism in procurement and the significance of brand products in the business have on the competitive flexibility. These relationships are moderated by either social capital or interorganizational learning. The main results obtained from this study revolve around social capital and interorganizational learning, which have beneficial effects on systems suppliers’ competitive flexibility, by moderating the effects of other constructs of the model. Further research on this topic should include quantitative research to provide the extent to which the results can be reliably generalized. Also each construct of the model gives possible focus for more thorough research.

Creating a customer profitability accounting model

Customer profitability accounting is a well-researched topic in the academic field, and it has been proved to posses rather undisputable benefits. However, the calculation of the customer profitabilities can be challenging, therefore the usage of the accounting is not self-explanatory in organizations. The aim of this study was to create a customer profitability accounting model for a wholesales unit in the case company to function as a sales management tool. The literature review of the study presents certain fundamental issues related to customer profitability accounting, in addition a theoretical framework for accounting model design is provided. The creation of the model was commenced by setting the requirements for it and examining the foundation of the model design, which consisted of for instance price setting and cost structure of products. This was followed by selecting approaches to the creation of the model. The result of the study was an accounting model, for which a determination of included revenues and costs was executed, along with the formulation of an allocation criteria of the costs. Lastly, the customer profitabilities were calculated in accordance with the accounting principles and the calculation logic of the model. The attained figures proved the model to provide an appropriate solution for obtaining the customer profitabilities and thus to use the accounting information as a sales management tool in for instance decision making and negotiation situations.

Utilization of Automatic Meter Reading in the Improvement of a District Heating System

A district heating system comprises production facilities, a distribution network, and heat consumers. The utilization of new energy metering and reading system (AMR) is increasing constantly in district heating systems. This heuristic study shows how the AMR system can be exploited in finding optimization opportunities in district heating system. In this study, the district heating system is mainly considered from the viewpoint of operational optimization. The focus is on the core processes, heat production and distribution. Three objectives were set to this study. The first one was to examine general optimization opportunities in district heating systems. Second, to figure out the benefits of AMR for general optimization opportunities. Finally, to define a methodology for process improvement endeavors. This study shows, through a case study, the usefulness of AMR in specifying current deficiencies in a district heating system. Based on a literature review, the methodology for the improvement of business processes is presented. Additionally, some issues related to future competitiveness of district heating are concerned. As a conclusion, some optimization objectives are considered more desirable than others. Study shows that AMR is useful in the specification of optimization targets in the district heating system. Further steps in optimization process were not examined in detail. That would seem to be interesting topic for further studies.

Future revenue models: Transformation from textbooks to digital solutions in the educational publishing industry, Case Sanoma Learning

This study was conducted in order to learn how companies’ revenue models will be transformed due to the digitalisation of its products and processes. Because there is still only a limited number of researches focusing solely on revenue models, and particularly on the revenue model change caused by the changes at the business environment, the topic was initially approached through the business model concept, which organises the different value creating operations and resources at a company in order to create profitable revenue streams. This was used as the base for constructing the theoretical framework for this study, used to collect and analyse the information. The empirical section is based on a qualitative study approach and multiple-case analysis of companies operating in learning materials publishing industry. Their operations are compared with companies operating in other industries, which have undergone comparable transformation, in order to recognise either similarities or contrasts between the cases. The sources of evidence are a literature review to find the essential dimensions researched earlier, and interviews 29 of managers and executives at 17 organisations representing six industries. Based onto the earlier literature and the empirical findings of this study, the change of the revenue model is linked with the change of the other dimen-sions of the business model. When one dimension will be altered, as well the other should be adjusted accordingly. At the case companies the transformation is observed as the utilisation of several revenue models simultaneously and the revenue creation processes becoming more complex.

Role of Capabilities in Purchasing and Supply Management Performance

The objective of this thesis was to study the role of capabilities in purchasing and supply management. For the pre-understanding of the research topic, purchasing and supply management development and the multidimensional, unstructured and complex nature of purchasing and supply management performance was studied in literature review. In addition, a capability-based purchasing and supply management performance framework were researched and structured for the empirical research. Due to the unstructured nature of the research topic, the empirical research is three-pronged in this study including three different research methods: the Delphi method, semi-structured interview, and case research. As a result, the purchasing and supply management capability assessment tool was structured to measure current level of capabilities and impact of capabilities on purchasing and supply management performance. The final results indicate that capabilities are enablers of purchasing and supply management performance, and therefore critical to purchasing and supply performance.

Enhancing Collaboration Between Marketing and Sales

Researchers’ interest toward cross-functional relationships has increased over the last decades, indicating the importance of collaboration of different functions. However, marketing-sales relationship has started to interest researchers only recently, even though collaboration between these functions is critical for companies’ success and customer satisfaction. The purpose of this study is to examine how collaboration between marketing and sales can be enhanced, and thus explore marketing-sales relationship and factors influencing on the collaboration between these functions. Literature review of this study draws together relevant literature and research concerning the topic. Empirical part explores marketing-sales relationships in a b-to-b company. The empirical research was conducted through six semi-structured interviews. Interviewees represented three different departments - each department’s marketing and sales manager were interviewed. All the interviewees considered that marketing-sales collaboration within the company should be improved. In the analysis certain factors impeding as well as facilitating the collaboration were recognized. Based on these, and lack of facilitating factors, the marketing-sales relationships within the company were defined as aligned relationships. Consequently, marketing-sales collaboration should be enhanced in all the departments by strengthening the facilitative elements. This study provides an overall view on marketing-sales collaboration, its elements and relationship types. Based on this study one can understand factors influencing on the marketing-sales collaboration and recognize the types of marketing-sales relationship.