The impact of a closed-loop electronic prescribing and administration system on prescribing errors, administration errors and staff time: a before-and-after study

Objectives: To assess the impact of a closed-loop electronic prescribing, automated dispensing, barcode patient identification and electronic medication administration record (EMAR) system on prescribing and administration errors, confirmation of patient identity before administration, and staff time. Design, setting and participants: Before-and-after study in a surgical ward of a teaching hospital, involving patients and staff of that ward. Intervention: Closed-loop electronic prescribing, automated dispensing, barcode patient identification and EMAR system. Main outcome measures: Percentage of new medication orders with a prescribing error, percentage of doses with medication administration errors (MAEs) and percentage given without checking patient identity. Time spent prescribing and providing a ward pharmacy service. Nursing time on medication tasks. Results: Prescribing errors were identified in 3.8% of 2450 medication orders pre-intervention and 2.0% of 2353 orders afterwards (p<0.001; χ2 test). MAEs occurred in 7.0% of 1473 non-intravenous doses pre-intervention and 4.3% of 1139 afterwards (p = 0.005; χ2 test). Patient identity was not checked for 82.6% of 1344 doses pre-intervention and 18.9% of 1291 afterwards (p<0.001; χ2 test). Medical staff required 15 s to prescribe a regular inpatient drug pre-intervention and 39 s afterwards (p = 0.03; t test). Time spent providing a ward pharmacy service increased from 68 min to 98 min each weekday (p = 0.001; t test); 22% of drug charts were unavailable pre-intervention. Time per drug administration round decreased from 50 min to 40 min (p = 0.006; t test); nursing time on medication tasks outside of drug rounds increased from 21.1% to 28.7% (p = 0.006; χ2 test). Conclusions: A closed-loop electronic prescribing, dispensing and barcode patient identification system reduced prescribing errors and MAEs, and increased confirmation of patient identity before administration. Time spent on medication-related tasks increased.

The use of computer-based learning tools for teaching and clinical purposes: Interactive computing strategy for Iraq

Medical universities and teaching hospitals in Iraq are facing a lack of professional staff due to the ongoing violence that forces them to flee the country. The professionals are now distributed outside the country which reduces the chances for the staff and students to be physically in one place to continue the teaching and limits the efficiency of the consultations in hospitals. A survey was done among students and professional staff in Iraq to find the problems in the learning and clinical systems and how Information and Communication Technology could improve it. The survey has shown that 86% of the participants use the Internet as a learning resource and 25% for clinical purposes while less than 11% of them uses it for collaboration between different institutions. A web-based collaborative tool is proposed to improve the teaching and clinical system. The tool helps the users to collaborate remotely to increase the quality of the learning system as well as it can be used for remote medical consultation in hospitals.

The impact of a closed-loop electronic prescribing and automated dispensing system on the ward pharmacist’s time and activities

Objective To assess the impact of a closed-loop electronic prescribing and automated dispensing system on the time spent providing a ward pharmacy service and the activities carried out. Setting Surgical ward, London teaching hospital. Method All data were collected two months pre- and one year post-intervention. First, the ward pharmacist recorded the time taken each day for four weeks. Second, an observational study was conducted over 10 weekdays, using two-dimensional work sampling, to identify the ward pharmacist's activities. Finally, medication orders were examined to identify pharmacists' endorsements that should have been, and were actually, made. Key findings Mean time to provide a weekday ward pharmacy service increased from 1 h 8 min to 1 h 38 min per day (P = 0.001; unpaired t-test). There were significant increases in time spent prescription monitoring, recommending changes in therapy/monitoring, giving advice or information, and non-productive time. There were decreases for supply, looking for charts and checking patients' own drugs. There was an increase in the amount of time spent with medical and pharmacy staff, and with 'self'. Seventy-eight per cent of patients' medication records could be assessed for endorsements pre- and 100% post-intervention. Endorsements were required for 390 (50%) of 787 medication orders pre-intervention and 190 (21%) of 897 afterwards (P < 0.0001; chi-square test). Endorsements were made for 214 (55%) of endorsement opportunities pre-intervention and 57 (30%) afterwards (P < 0.0001; chi-square test). Conclusion The intervention increased the overall time required to provide a ward pharmacy service and changed the types of activity undertaken. Contact time with medical and pharmacy staff increased. There was no significant change in time spent with patients. Fewer pharmacy endorsements were required post-intervention, but a lower percentage were actually made. The findings have important implications for the design, introduction and use of similar systems.

In-service and pre-service teachers' opinion on the use of models in teaching chemistry

The presented study examined the opinion of in-service and prospective chemistry teachers about the importance of usage of molecular and crystal models in secondary-level school practice, and investigated some of the reasons for their (non-) usage. The majority of participants stated that the use of models plays an important role in chemistry education and that they would use them more often if the circumstances were more favourable. Many teachers claimed that three-dimensional (3d) models are still not available in sufficient number at their schools; they also pointed to the lack of available computer facilities during chemistry lessons. The research revealed that, besides the inadequate material circumstances, less than one third of participants are able to use simple (freeware) computer programs for drawing molecular structures and their presentation in virtual space; however both groups of teachers expressed the willingness to improve their knowledge in the subject area. The investigation points to several actions which could be undertaken to improve the current situation.

Electronic voting systems in undergraduate teaching

One of the major differences undergraduates experience during the transition to university is the style of teaching. In schools and colleges most students study key stage 5 subjects in relatively small informal groups where teacher–pupil interaction is encouraged and two-way feedback occurs through question and answer type delivery. On starting in HE students are amazed by the sizes of the classes. For even a relatively small chemistry department with an intake of 60-70 students, biologists, pharmacists, and other first year undergraduates requiring chemistry can boost numbers in the lecture hall to around 200 or higher. In many universities class sizes of 400 are not unusual for first year groups where efficiency is crucial. Clearly the personalised classroom-style delivery is not practical and it is a brave student who shows his ignorance by venturing to ask a question in front of such an audience. In these environments learning can be a very passive process, the lecture acts as a vehicle for the conveyance of information and our students are expected to reinforce their understanding by ‘self-study’, a term, the meaning of which, many struggle to understand. The use of electronic voting systems (EVS) in such situations can vastly change the students’ learning experience from a passive to a highly interactive process. This principle has already been demonstrated in Physics, most notably in the work of Bates and colleagues at Edinburgh.1 These small hand-held devices, similar to those which have become familiar through programmes such as ‘Who Wants to be a Millionaire’ can be used to provide instant feedback to students and teachers alike. Advances in technology now allow them to be used in a range of more sophisticated settings and comprehensive guides on use have been developed for even the most techno-phobic staff.

Managing non-standard international experience: evidence from a Finnish company

Purpose – This paper extends the increasing debates about the role of international experience through mechanisms other than standard expatriation packages, in particular through the use of short-term assignments. It explores the different forms of short-term assignments (project work, commuter assignments, virtual international working and development assignments) and the different sets of positive and negative implications these can have for the company and the individuals concerned. The integration-differentiation debate is reflected here as elsewhere in IHRM, with the company moving towards greater centralization and control of its use of these assignments. Design/methodology/approach – Since the research is exploratory, we adopted a qualitative approach to get a more in-depth understanding on the realities the corporations and the assignees are facing. The study was implemented through a single case study setting in which the data were collected by interviewing (n=20) line managers, human resource management (HRM) staff and assignees themselves. In addition corporate documentation and other materials were reviewed. Findings – The present case study provides evidence about the characteristics of short-term assignments as well as the on the management of such assignments. The paper identifies various benefits and challenges involved in the use of short-term assignments both from the perspectives of the company and assignees. Furthermore, the findings support the view that a recent increase in the popularity of short-term assignments has not been matched by the development of HRM policies for such assignments. Research limitations/implications – As a single case study, limitations in the generalizability of the findings should be kept in mind. More large-scale research evidence is needed around different forms of international assignments beyond standard expatriation in order to fully capture the realities faced by international HRM specialists Practical implications – The paper identifies many challenges but also benefits of using short-term assignments. The paper reports in-depth findings on HR development needs that organizations face when expanding the use of such assignments. Social implications – The paper identifies many challenges but also benefits of using short-term assignments. The paper reports in-depth findings on HR development needs that organizations face when expanding the use of such assignments. Originality/value – Empirical research on short-term assignments is still very limited. In that way the paper provides much needed in-depth evidence on why such assignments are used, what challenges are involved in the use of such assignments and what kinds of HR-development needs are involved.

Creating and implementing a biodiversity recording app for teaching and research in environmental studies

This case study reports on the development of a bespoke mobile recording app for collating records of biodiversity sightings on a University campus. This innovative project was achieved through a multi-disciplinary partnership of staff and students. It is hoped that the app itself will benefit lecturers by streamlining data collection during teaching and learning activities, whilst engaging students and highlighting the wealth of diversity available on campus

(How) Do research and administrative duties affect university professors’ teaching?

We analyze the interaction between university professors’ teaching quality and their research and administrative activities. Our sample is a high-quality individual panel data set from a medium size public Spanish university that allows us to avoid several types of biases frequently encountered in the literature. Although researchers teach roughly 20% more than non-researchers, their teaching quality is also 20% higher. Instructors with no research are 5 times more likely than the rest to be among the worst teachers. Over much of the relevant range, we find a nonlinear and positive relationship between research output and teaching quantity on teaching quality. Our conclusions may be useful for decision makers in universities and governments.

Disambiguating with Bourdieu: unravelling policy from practice in the teaching of children with English as an additional language

This article explores the use of Bourdieusian analysis for examining how policy and practice interact in the teaching of English and therefore in the development of children’s language and literacy; in particular how Bourdieusian analysis uncovers the ways in which teachers’ practice has been influenced unconsciously by centralised shaping of the curriculum for English in England while the pupil demographic in schools has become more linguistically diverse. Data were collected from interviews with both newly qualified and very experienced primary school (pupil ages 5 – 11) teachers, whose pedagogical norms for the teaching of English were challenged by the arrival of non-English speakers in their classrooms. The discussion highlights how the use of Bourdieusian constructs of field, habitus and capital can disambiguate teachers’ practical classroom decisions from the influences of policy expectations.

Teachers' habitus for teaching English

In this examination of monolingual and multilingual pedagogies I draw on literature that explores the position of English globally and in the curriculum for English. I amplify the discussion with data from a project exploring how teachers responded to the arrival of Polish children in their English classrooms following Poland’s entry to the European Union in 2004. While both Poland and England are a long way from Australia, the sudden arrival of non-native speaking children from families who have the right to work and settle in the UK is interesting of itself as a development in the migration agenda affecting many nations of teachers in the 21st century. Indeed, this view of migration adds to the overview of migration in an Australian context and recent Australian immigration settlement policies often mirror this with new arrivals moving to rural areas resulting in an EAL presence in schools which may be new. Until recently it was most commonly the case that teachers in schools in inner city and other urban parts of the UK might expect to teach in multilingual classrooms, but teachers in smaller towns and in areas identified as rural were unlikely to confront either linguistic or ethnic differences in their pupils. I use the theories of Bourdieu to analyse the status of the curriculum for English expressed in research literature, and the teachers’ interview data. This supports a level of interpretation that allows us to see how teachers’ practice and the teaching of English are formed by schools’ and teachers’ histories and beliefs as much as they are by the wishes of politicians in creating educational policy. It adds to the view presented in the first article in this issue that provision for EAL/D learners sits within a monolingual assessment structure which may militate against the attainment of non-native English speakers. I present a wide-ranging discussion intentionally, in order that the many complexities of policy impact and teacher habitus on teachers’ practice are made apparent.

Turning a Bourdieuian lens on English teaching in primary schools: linguistic field, linguistic habitus and linguistic capital

The research project used to frame discussion in this chapter was a doctoral study of the experiences of English primary school teachers teaching pupils whose home language was not English in their previously monolingual classrooms. They taught in a region in the south of England which experienced a significant rise in the population of non-native English speakers following Eastern European member states’ accession to the EU in 2004 and 2007. The study focussed principally on the teachers’ responses to their newly arrived Polish children because Polish families were arriving in far greater numbers than those from other countries. The research aims focussed on exploring and analysing the pedagogical experiences of teachers managing the acquisition of English language for their Polish children. Critical engagement with their experiences and the ways in which they did or did not adapt their pedagogy for teaching English was channelled through Bourdieuian constructs of linguistic field, capital and habitus. The following sections explore my reasons for adopting Bourdieu’s work as a theoretical lens, the practicalities and challenges of incorporating Bourdieu’s tools for thinking in data analysis, and the subsequent impact on my research activity.