The Development of Weak Signal Concept

Tämän hetken trendit kuten globalisoituminen, ympäristömme turbulenttisuus, elintason nousu, turvallisuuden tarpeen kasvu ja teknologian kehitysnopeus korostavatmuutosten ennakoinnin tarpeellisuutta. Pysyäkseen kilpailukykyisenä yritysten tulee kerätä, analysoida ja hyödyntää liiketoimintatietoa, jokatukee niiden toimintaa viranomaisten, kilpailijoiden ja asiakkaiden toimenpiteiden ennakoinnissa. Innovoinnin ja uusien konseptien kehittäminen, kilpailijoiden toiminnan arviointi, asiakkaiden tarpeet muun muassa vaativatennakoivaa arviointia. Heikot signaalit ovat keskeisessä osassa organisaatioiden valmistautumisessa tulevaisuuden tapahtumiin. Opinnäytetyön tarkoitus on luoda ja kehittää heikkojen signaalien ymmärrystä ja hallintaa sekäkehittää konseptuaalinen ja käytännöllinen lähestymistapa ennakoivan toiminnan edistämiselle. Heikkojen signaalien tyyppien luokittelu perustuu ominaisuuksiin ajan, voimakkuuden ja liiketoimintaan integroinnin suhteen. Erityyppiset heikot signaalit piirteineen luovat reunaehdot laatutekijöiden keräämiselle ja siitä edelleen laatujärjestelmän ja matemaattiseen malliin perustuvan työvälineen kehittämiselle. Heikkojen signaalien laatutekijät on kerätty yhteen kaikista heikkojen signaalien konseptin alueista. Analysoidut ja kohdistetut laatumuuttujat antavat mahdollisuuden kehittää esianalyysiä ja ICT - työvälineitä perustuen matemaattisen mallin käyttöön. Opinnäytetyön tavoitteiden saavuttamiseksi tehtiin ensin Business Intelligence -kirjallisuustutkimus. Hiekkojen signaalien prosessi ja systeemi perustuvat koottuun Business Intelligence - systeemiin. Keskeisinä kehitysalueina tarkasteltiin liiketoiminnan integraatiota ja systemaattisen menetelmän kehitysaluetta. Heikkojen signaalien menetelmien ja määritelmien kerääminen sekä integrointi määriteltyyn prosessiin luovat uuden konseptin perustan, johon tyypitys ja laatutekijät kytkeytyvät. Käytännöllisen toiminnan tarkastelun ja käyttöönoton mahdollistamiseksi toteutettiin Business Intelligence markkinatutkimus (n=156) sekä yhteenveto muihin saatavilla oleviin markkinatutkimuksiin. Syvähaastatteluilla (n=21) varmennettiin laadullisen tarkastelun oikeellisuus. Lisäksi analysoitiin neljä käytännön projektia, joiden yhteenvedot kytkettiin uuden konseptin kehittämiseen. Prosessi voidaan jakaa kahteen luokkaan: yritysten markkinasignaalit vuoden ennakoinnilla ja julkisen sektorin verkostoprojektit kehittäen ennakoinnin struktuurin luonnin 7-15 vuoden ennakoivalle toiminnalle. Tutkimus rajattiin koskemaan pääasiassa ulkoisen tiedon aluetta. IT työvälineet ja lopullisen laatusysteemin kehittäminen jätettiin tutkimuksen ulkopuolelle. Opinnäytetyön tavoitteena ollut heikkojen signaalien konseptin kehittäminen toteutti sille asetetut odotusarvot. Heikkojen signaalien systemaattista tarkastelua ja kehittämistyötä on mahdollista edistää Business Intelligence - systematiikan hyödyntämisellä. Business Intelligence - systematiikkaa käytetään isojen yritysten liiketoiminnan suunnittelun tukena.Organisaatioiden toiminnassa ei ole kuitenkaan yleisesti hyödynnetty laadulliseen analyysiin tukeutuvaa ennakoinnin weak signals - toimintaa. Ulkoisenja sisäisen tiedon integroinnin ja systematiikan hyödyt PK -yritysten tukena vaativat merkittävää panostusta julkishallinnon rahoituksen ja kehitystoiminnan tukimuotoina. Ennakointi onkin tuottanut lukuisia julkishallinnon raportteja, mutta ei käytännön toteutuksia. Toisaalta analysoitujen case-tapausten tuloksena voidaan nähdä, ettei organisaatioissa välttämättä tarvita omaa projektipäällikköä liiketoiminnan tuen kehittämiseksi. Business vastuun ottamiseksi ja asiaan sitoutumiseen on kuitenkin löydyttävä oikea henkilö

Competence in intensive and critical care nursing - development of a basic assessment scale for graduating nursing students

Intensive and critical care nursing is a speciality in its own right and with its own nature within the nursing profession. This speciality poses its own demands for nursing competencies. Intensive and critical care nursing is focused on severely ill patients and their significant others. The patients are comprehensively cared for, constantly monitored and their vital functions are sustained artificially. The main goal is to win time to cure the cause of the patient’s situation or illness. The purpose of this empirical study was i) to describe and define competence and competence requirements in intensive and critical care nursing, ii) to develop a basic measurement scale for competence assessment in intensive and critical care nursing for graduating nursing students, and iii) to describe and evaluate graduating nursing students’ basic competence in intensive and critical care nursing by seeking the reference basis of self-evaluated basic competence in intensive and critical care nursing from ICU nurses. However, the main focus of this study was on the outcomes of nursing education in this nursing speciality. The study was carried out in different phases: basic exploration of competence (phase 1 and 2), instrumentation of competence (phase 3) and evaluation of competence (phase 4). Phase 1 (n=130) evaluated graduating nursing students’ basic biological and physiological knowledge and skills for working in intensive and critical care with Basic Knowledge Assessment Tool version 5 (BKAT-5, Toth 2012). Phase 2 focused on defining competence in intensive and critical care nursing with the help of literature review (n=45 empirical studies) as well as competence requirements in intensive and critical care nursing with the help of experts (n=45 experts) in a Delphi study. In phase 3 the scale Intensive and Critical Care Nursing Competence Scale (ICCN-CS) was developed and tested twice (pilot test 1: n=18 students and n=12 nurses; pilot test 2: n=56 students and n=54 nurses). Finally, in phase 4, graduating nursing students’ competence was evaluated with ICCN-CS and BKAT version 7 (Toth 2012). In order to develop a valid assessment scale of competence for graduating nursing students and to evaluate and establish the competence of graduating nursing students, empirical data were retrieved at the same time from both graduating nursing students (n=139) and ICU nurses (n=431). Competence can be divided into clinical and general professional competence. It can be defined as a specific knowledge base, skill base, attitude and value base and experience base of nursing and the personal base of an intensive and critical care nurse. Personal base was excluded in this self-evaluation based scale. The ICCN-CS-1 consists of 144 items (6 sum variables). Finally, it became evident that the experience base of competence is not a suitable sum variable in holistic intensive and critical care competence scale for graduating nursing students because of their minor experience in this special nursing area. ICCN-CS-1 is a reliable and tolerably valid scale for use among graduating nursing students and ICU nurses Among students, basic competence of intensive and critical care nursing was self-rated as good by 69%, as excellent by 25% and as moderate by 6%. However, graduating nursing students’ basic biological and physiological knowledge and skills for working in intensive and critical care were poor. The students rated their clinical and professional competence as good, and their knowledge base and skill base as moderate. They gave slightly higher ratings for their knowledge base than skill base. Differences in basic competence emerged between graduating nursing students and ICU nurses. The students’ self-ratings of both their basic competence and clinical and professional competence were significantly lower than the nurses’ ratings. The students’ self-ratings of their knowledge and skill base were also statistically significantly lower than nurses’ ratings. However, both groups reported the same attitude and value base, which was excellent. The strongest factor explaining students’ conception of their competence was their experience of autonomy in nursing. Conclusions: Competence in intensive and critical care nursing is a multidimensional concept. Basic competence in intensive and critical care nursing can be measured with self-evaluation based scale but alongside should be used an objective evaluation method. Graduating nursing students’ basic competence in intensive and critical care nursing is good but their knowledge and skill base are moderate. Especially the biological and physiological knowledge base is poor. Therefore in future in intensive and critical care nursing education should be focused on both strengthening students’ biological and physiological knowledge base and on strengthening their overall skill base. Practical implications are presented for nursing education, practice and administration. In future, research should focus on education methods and contents, mentoring of clinical practice and orientation programmes as well as further development of the scale.

Education export as a form of knowledge transfer : The potential of Finnish education export in Chile

Knowledge transfer is a complex process. Knowledge transfer in the form of exporting education products from one system of education to another is particularly complicated, because each system has been developed in a particular context to meet the requirements seen as relevant at each time. National innovation systems are often seen to form an essential framework within which the development of a country, its economy and level of knowledge are considered and promoted. These systems are orientated towards the future, and as such they also provide a framework for the knowledge transfer related to the development of education. In the best of circumstances they are able to facilitate and boost this transfer both from the viewpoint of the provider and the recipient. The leading thought and the idea of the study is that education export is a form of knowledge transfer, which is illustrated by the existing models included. The purpose of this study is to explore, analyze and describe the factors and phenomena related to education export, and more specifically, those related to the experiences and potential of Finnish education export to Chile. For better understanding, of the multiplicity of the issue involved, the current status of education export between Finland and Chile and he existing efforts within the Finnish innovation network will be outlined as well as new forms of co-operation between Finland and Chile in educational matters explored. Several countries have started to commercialize their education system in order to establish themselves as emerging education exporters. Moreover, the demand for education reform is accurate in many developing countries. This offers a good match between Finland and Chile to be the example countries of the research. The main research findings suggest that there are several business areas in education export. These include degrees in education, training services and education technologies for example The factors that influence education export can be divided into four groups, including academic, cultural, political and economic aspects. Challenges to overcome include the lack of product or services to be sold, lack of market and cultural knowledge of the buyer country, financing and lack of suitable pricing model. National innovation systems could be seen as enabling entities for successful education export. The extensive networks that national innovation systems aim to form, could operate as a basis for joining the forces in selling knowledge as well as receiving knowledge in a constructive way.

Foot Health In Older People - Development of a preventive, evaluative instrument for nurses

Foot health is a part of overall health in every age group and its importance increases during ageing. Health care professionals are in a vital position for preventing foot health problems, and identifying and caring them in older people. Despite the rather high number of studies conducted in the field of foot health in older people, reliable and valid nurse-administered foot health assessment instruments seem to be lacking. By identifying foot health in older people, it is possible to develop nursing interventions to enhance safe, independent living at home. The purpose of this three-phase study was to develop an instrument to assess the level of foot health in older people and evaluate foot care practices from the perspective of older people themselves and nurses in home care. The ultimate goal is to prevent foot health problems by increasing the attention paid to older people’s feet and recognizing those foot health problems which need further care; thus not focus on different foot health problems. The study was conducted in different phases and contexts. In phase 1, a descriptive design with a literature review from the Medline (R) and CINAHL databases to explore foot health in older people and nurses’ role in foot health care and pre-post design intervention study in nursing home with nursing staff (n=16) and older residents (n=43) were conducted. In phase 2, a descriptive and explorative study design was employed to develop an instrument for assessing foot health in older people (N=651, n=309, response rate 47%) and explore the psychometrics of the instrument. The data were collected from sheltered housing and home care settings. Finally, in phase 3, descriptive and explorative as well as cross-sectional correlational survey designs were used to assess foot health and evaluate the foot self-care activities of older people (N=651, n=309, response rate 47%) and to describe foot care knowledge and caring activities of nurses (N=651, n=322, response rate 50%) in home care in Finland. To achieve this, the Foot Health Assessment Instrument (FHAI) developed in phase 2 was used; at the same time, this large sample also was used for the psychometric evaluation of the FHAI. The data analysis methods used in this study were content analysis, descriptive and inferential statistics including factor and multivariate analysis. Many long-term diseases can manifest in feet. Therefore, the FHAI, developed in this study consisted of items relating to skin and nail health, foot structure and foot pain. The FHAI demonstrated acceptable preliminary psychometric properties. A great deal of different foot health problems in older people were found of which edema, dry skin, thickened and discoloured toenails and hallux valgus were the most prevalent foot health problems. Moreover, many older people had difficulties in performing foot self-care. Nurses’ knowledge of foot care was insufficient and revealed a need for more information and continuing education in matters relating to foot care in older people. Instead, nurses’ foot care activities were mainly adequate, though the findings indicate the need for updating foot care activities to correspond with the evidence found in the field of foot care. Practical implications are presented for nursing practice, education and administration. In future, research should focus on developing interventions for older people and nurses to promote foot health in older people and to prevent foot health problems, as well as for further development of the FHAI.

Quality of radiotherapy care by development of e-feedback knowledge

The aim of this three phase study was to develop quality of radiotherapy care by the e-Feedback knowledge of radiotherapy -intervention (e-Re-Know). In Phase I, the purpose was to describe the quality of radiotherapy care and its deficits experienced by cancer patients. Based on the deficits in patient education in Phase II, the purpose was to describe cancer patients’ e-knowledge expectations in radiotherapy. In Phase III, the purpose was to develop and evaluate the outcomes of the e-Re-Know among breast cancer patients. The ultimate aim was to develop radiotherapy care to support patients’ empowerment with patient e-education. In Phase I (2004-2005), the descriptive design was used, and 134 radiotherapy patients evaluated their experiences by Good Nursing Care Scale for Patients (GNCS-P) in the middle of RT period. In Phase II (2006-2008), the descriptive longitudinal design was used and 100 radiotherapy patients’ e-knowledge expectations of RT were evaluated using open-ended questionnaire developed for this study before commencing first RT, in the middle of the treatment, and concluding RT period. In Phase III, firstly (2009-2010), the e-Re-Know intervention, i.e. knowledge test and feedback, was developed in terms of empowering knowledge and implemented with e-feedback approach based on literature and expert reviews. Secondly (2011-2014), the randomized controlled study was used to evaluate the e-Re-Know. Breast cancer patients randomized to either the intervention group (n=65) receiving the e-Re-Know by e-mail before commencing first RT and standard education or the control group (n=63) receiving standard education. The data were collected before commencing first RT, concluding last RT and 3 months after last RT using RT Knowledge Test, Spielberger’s State Trait Inventory (STAI) and Functional Assessment of Cancer Therapy - Breast (FACT-B) –instruments. Data were analyzed using statistical methods and content analysis. The study showed radiotherapy patients experienced quality of care high. However, there were deficits in patient education. Furthermore, radiotherapy patients’ multidimensional e-knowledge expectations through Internet covered mainly bio-physiological and functional knowledge. Thus, the e-Re-Know was developed and evaluated. The study showed when breast cancer patients’ carried out the e-Re-Know their knowledge of side effects self-care was significantly increased and quality of life (QOL) significantly improved in line with decrease in anxiety from time before radiotherapy period to three months after. In addition, the e-Re-Know has potential to have positive effects on anxiety and QOL, regardless of patient characteristics or knowledge level. The results support the theory of empowering patient education suggesting that empowerment can be supported by confirming patients’ understanding of own knowledge level. In summary, the e-Feedback knowledge of radiotherapy (e-Re-Know) intervention can be recommended in development of quality of radiotherapy care experienced by breast cancer patients. Further research is needed to assess and develop patient-centred quality of care by patient education among cancer patients.