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.

Compliance of crane electrics with electrical safety standards and codes

Master’s thesis focuses on the questions of crane electrics compliance with electrical safety standards. Overview and short comparison of the world’s effective standards in the field is made in order to understand their demands. Basic concepts of a proper electrical circuit design are presented. Characteristics, construction and operation principles of overcurrent protective devices are studied in details. Electrics of the basic crane is designed according to the assumed customer’s demands, compliance with the requirements of the standards is checked. Solutions to achieve better compliance in some issues are proposed. Accent is made on the National Electrical Code (NEC) and standards by Underwriters Laboratories (UL) latests demands. Requirements of the International Electrotechnical Commission (IEC) are also taken into account.

Military crisis management in the next decade (2020-2030) : inducing consent or relying on compliance?

The most outstanding conceptual challenge of modern crisis management is the principle of consent. It is not a problem only at the operational level - it challenges the entire decision-making structures of crisis management operations. In post-cold war times and especially in the 21st century, there has been a transition from peacekeeping with limited size and scope towards large and complex peace operations. This shift has presented peace operations with a dilemma. How to balance between maintaining consent for peace operations, whilst being able to use military force to coerce those attempting to wreck peace processes? To address such a dilemma, this research aims to promote understanding, on what can be achieved by military crisis management operations (peace support operations) in the next decade. The research concentrates on the focal research question: Should military components induce consent or rely on the compliance of conflicting parties in crisis management operations of the next decade (2020 – 2030)? The focus is on military – political strategic level considerations, and especially on the time before political decisions to commit to a crisis management operation. This study does not focus on which actor or organisation should intervene. The framework of this thesis derives from the so called ‘peacebuilding space’, the scope of peace operations and spoiler theory. Feasibility of both peace enforcement and peacekeeping in countering future risk conditions are analysed in this framework. This future-orientated qualitative research uses the Delphi-method with a panel of national and international experts. Citation analysis supports identification of relevant reference material, which consists of contemporary literature, the Delphi-questionnaires and interviews. The research process followed three main stages. In the first stage, plausible future scenarios and risk conditions were identified with the Delphi-panel. In the second stage, operating environments for peace support operations were described and consequent hypotheses formulated. In the third stage, these hypotheses were tested on the Delphi-panel. The Delphi-panel is sufficiently wide and diverse to produce plausible yet different insights. The research design utilised specifically military crisis management and peace operations theories. This produced various and relevant normative considerations. Therefore, one may argue that this research; which is based on accepted contemporary theory, hypotheses derived thereof and utilising an expert panel, contributes to the realm of peace support operations. This research finds that some degree of peace enforcement will be feasible and necessary in at least the following risk conditions: failed governance; potential spillover of ethnic, religious, ideological conflict; vulnerability of strategic chokepoints and infrastructures in ungoverned spaces; as well as in territorial and extra-territorial border disputes. In addition, some form of peace enforcement is probably necessary in risk conditions pertaining to: extremism of marginalised groups; potential disputes over previously uninhabited and resource-rich territories; and interstate rivalry. Furthermore, this research finds that peacekeeping measures will be feasible and necessary in at least risk conditions pertaining to: potential spillover of ethnic, religious, ideological conflict; uncontrolled migration; consequences from environmental catastrophes or changes; territorial and extra-territorial border disputes; and potential disputes over previously uninhabited and resource-rich territories. These findings are all subject to both generic and case specific preconditions that must exist for a peace support operation. Some deductions could be derived from the research findings. Although some risk conditions may appear illogical, understanding the underlying logic of a conflict is fundamental to understanding transition in crisis management. Practitioners of crisis management should possess cognizance of such transition. They must understand how transition should occur from threat to safety, from conflict to stability – and so forth. Understanding transition is imperative for managing the dynamic evolution of preconditions, which begins at the outset of a peace support operation. Furthermore, it is pertinent that spoilers are defined from a peace process point of view. If spoilers are defined otherwise, it changes the nature of an operation towards war, where the logic is breaking the will of an enemy - and surrender. In peace support operations, the logic is different: actions towards spoilers are intended to cause transition towards consent - not defeat. Notwithstanding future developments, history continues to provide strategic education. However, the distinction is that the risk conditions occur in novel futures. Hence, lessons learned from the past should be fitted to the case at hand. This research shows compelling evidence that swaying between intervention optimism and pessimism is not substantiated. Both peace enforcement and peacekeeping are sine qua non for successful military crisis management in the next decade.