Verenpaineen mittaamisen opettaminen sairaanhoitaja- ja terveydenhoitajaopiskelijoille

Teaching the measurement of blood pressure for both nursing and public health nursing students The purpose of this two-phase study was to develop the teaching of blood pressure measurement within the nursing degree programmes of the Universities of Applied Sciences. The first survey phase described what and how blood pressure measurement was taught within nursing degree programmes. The second intervention phase (2004-2005) evaluated first academic year nursing and public health nursing students’ knowledge and skills results for blood pressure measurement. Additionally, the effect on the Taitoviikko experimental group students’ blood pressure measurement knowledge and skills level. A further objective was to construct models for an instrument (RRmittTest) to evaluate nursing students measurement of blood pressure (2003-2009). The research data for the survey phase were collected from teachers (total sampling, N=107, response rate 77%) using a specially developed RRmittopetus-questionnaire. Quasi-experimental study data on the RRmittTest-instrument was collected from students (purposive sampling, experimental group, n=29, control group, n=44). The RRmittTest consisted of a test of knowledge (Tietotesti) and simulation-based test (TaitoSimkäsi and Taitovideo) of skills. Measurements were made immediately after the teaching and in clinical practice. Statistical methods were used to analyse the results and responses to open-ended questions were organised and classified. Due to the small amount of materials involved and the results of distribution tests of the variables, non-parametric analytic methods were mainly used. Experimental group and control group similar knowledge and skills teaching was based on the results of the national survey phase (RRmittopetus) questionnaire results. Experimental group teaching includes the supervised Taitoviikko teaching method. During Taitoviikko students studied blood pressure measurement at the municipal hospital in a real nursing environment, guided by a teacher and a clinical nursing professional. In order to evaluate both learning and teaching the processes and components of blood pressure measurement were clearly defined as follows: the reliability of measurement instruments, activities preceding blood pressure measurement, technical execution of the measurement, recording, lifestyle guidance and measurement at home (self-monitoring). According to the survey study, blood pressure measurement is most often taught at Universities of Applied Sciences, separately, as knowledge (teaching of theory, 2 hours) and skills (classroom practice, 4 hours). The teaching was implemented largely in a classroom and was based mainly on a textbook. In the intervention phase the students had good knowledge of blood pressure measurement. However, their blood pressure measurement skills were deficient and the control group students, in particular, were highly deficient. Following in clinical practice the experimental group and control group students’ blood pressure measurement recording knowledge improve and experimental groups declined lifestyle guidance. Skills did not improve within any of the components analysed. The control groups` skills on the whole, declined statistically.There was a significant decline amongst the experimental group although only in one component measured. The results describe the learning results for first academic year students and no parallel conclusions should be drawn when considering any learning results for graduating students. The results support the use and further development of the Taitoviiko teaching method. The RRmittTest developed for the study should be assessed and the results seen from a negative perspective. This evaluation tool needs to be developed and retested.

Comparing service contract prices of outsourcing partner

The main objective of this Master’s thesis is to find out which one of the two pricing models is the most cost-effective. In this thesis there are two companies that have made an outsourcing contract, in which they have a possibility to choose between two different pricing models. The first model is so called FTE (Full Time Employee) -based. The total cost will be based on the amount of outsourced person-workyears. The second pricing model is the transaction-based, in which the price will be formed according to the amount of transactions. Changing the pricing model from FTE-based to the transaction-based will also incur other costs. It is very important that these other costs are also taken into consideration, so that it is possible to determine the total costs of the pricing models. These other costs are direct costs, indirect costs and performance related costs of outsourcing. Activity based-costing (ABC) was used in order to find out the trues indirect costs of the outsourced processes. Performance related costs are related to quality, so Pareto-analysis was used to analyse the costs. Based on all of that, a framework for service related cost analysis was developed. Quality costs were almost impossible to quantify, so quality had to be taken into consideration in a qualitative way. Furthermore, considering only the indirect and direct costs in a quantitative way and quality costs in a qualitative way, it was possible to find a conditional solution for the research question.

Nimihistoria muutosten peili

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Pohjoisen hiippakunnan perusteellinen historia

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Book review

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Perusoikeuksien paradoksit

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Paikallinen uusi hallintatapa : haaste tutkijoille ja käytännön toimijoille

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