Educational administration and social justice

This paper argues that social justice is central to the pursuit of education and therefore should also be central to the practice of educational administration. Social justice in education, as elsewhere, demands both distributive justice (which remedies undeserved inequalities) and recognitional justice (which treats cultural differences with understanding and respect). But, given that cultures are always in the process of change, education is a key agency for negotiating cultural change through the exploration and negotiation of difference. Educational administration as a field can no longer escape the consideration of such issues as they are brought to the fore by the recognition of the failure of schools and school systems to ameliorate injustice in the distribution of resources and to recognise and celebrate difference as a means to social and cultural progress. We still need a model of educational administration centered around the problem of the justice and fairness of social and educational arrangements. Given the renewed interest in such issues, perhaps what was impossible twenty five years ago might now be achieved.<br />

Nursing administration of medication via enteral tubes in adults : a systematic review

<b>Background </b>Enteral tubes are frequently inserted as part of medical treatment in a wide range of patient situations. Patients with an enteral tube are cared for by nurses in a variety of settings, including general and specialised acute care areas, aged care facilities and at home. Regardless of the setting, nurses have the primary responsibility for administering medication through enteral tubes. Medication administration via an enteral tube is a reasonably common nursing intervention that entails a number of skills, including preparing the medication, verifying the tube position, flushing the tube and assessing for potential complications. If medications are not given effectively through an enteral tube, harmful consequences may result leading to increased morbidity, for example, tube occlusion, diarrhoea and aspiration pneumonia. There are resultant costs for the health-care system related to possible increased length of stay and increased use of equipment. Presently what is considered to be best practice to give medications through enteral tubes is unknown.<br /><br /><b>Objectives </b>The objective of this systematic review was to determine the best available evidence on which nursing interventions are effective in minimising the complications associated with the administration of medications via enteral tubes in adults. Nursing interventions and considerations related to medication administration included form of medication, verifying tube placement before administration, methods used to give medication, methods used to flush tubes, maintenance of tube patency and specific practices to prevent possible complications related to the administration of enteral medications.<br /><br /><b>Search strategy </b>The following databases were searched for literature reported in English only: CINAHL, MEDLINE, The Cochrane Library, Current Contents/All Editions, EMBASE, Australasian Medical Index and PsychINFO. There was no date restriction applied. In addition, the reference lists of all included studies were scrutinised for other potentially relevant studies.<br /><br /><b>Selection criteria</b> Systematic reviews of randomised controlled trials (RCTs) and RCTs that compared the effectiveness of nursing interventions and considerations used in the administration of medications via enteral tubes. Other research methods, such as non-randomised controlled trials, longitudinal studies, cohort and case control studies, were also included. Exclusion criteria included studies investigating drug&ndash;nutrient interactions or the bioavailability of specific medications.<br /><br /><b>Data collection and analysis</b> Initial consideration of potential relevance to the review was carried out by the primary author (NP). Two reviewers independently assessed study eligibility for inclusion. A meta-analysis could not be undertaken, as there were no comparable RCTs identified. All data were presented in a narrative summary.<br /><br /><b>Results </b>There is very limited evidence regarding the effectiveness of nursing interventions in minimising the complications associated with enteral tube medication administration in adults. The review highlights a lack of high quality research on many important nursing issues relating to enteral medication administration. There is huge scope for further research. Some of the evidence that was identified included that nurses should consider the use of liquid form medications as there may be fewer tube occlusions than with solid forms in nasoenteral tubes and silicone percutaneous endoscopic gastronomy tubes. Nurses may need to consider the sorbitol content of some liquid medications, for example, elixirs, as diarrhoea has been attributed to the sorbitol content of the elixir, not the drug itself. In addition, the use of 30 mL of water for irrigation when administering medications or flushing small-diameter nasoenteral tubes may reduce the number of tube occlusions.<br />

A systematic review of nursing administration of medication via enteral tubes in adults

<b>Aim</b>. This systematic review aimed to determine the best available evidence regarding the effectiveness of nursing interventions in minimising the complications associated with administering medication via enteral tubes in adults.<br /><b>Background</b>. Giving enteral medication is a fairly common nursing intervention entailing several skills: verifying tube position, preparing medication, flushing the tube and assessing for potential complications. If not carried out effectively harmful consequences may result leading to increased morbidity and even mortality. Until now, what was considered to be best practice in this area was unknown.<br /><b>Design</b>. Systematic review.<br /><b>Methods</b>. CINAHL, MEDLINE, The Cochrane Library, Current Contents/All Editions, EMBASE, Australasian Medical Index and PsychINFO databases were searched up to September 2005. Reference lists of included studies were appraised. Two reviewers independently assessed study eligibility for inclusion. There were no comparable randomised-controlled trials; data<br />were presented in a narrative summary.<br /><b>Results</b>. Identified evidence included using 30 ml of water for irrigation when giving medication or flushing small-diameter nasoenteral tubes may reduce tube occlusion. Using liquid medication should be considered as there may be less tube occlusions than with solid forms in nasoenteral tubes and silicone percutaneous endoscopic gastrostomy tubes. In addition, nurses may need to consider the sorbitol content of some liquid medications, for example elixirs, as diarrhoea has been attributed to the sorbitol content of the elixir, not the drug itself.<br /><b>Conclusion</b>. The evidence was limited. There was a lack of high-quality research on many important issues relating to giving enteral medication.<br /><b>Relevance to clinical practice</b>. Nurses have the primary responsibility for giving medication through enteral tubes and need knowledge of the best available evidence. Some of the nursing considerations and interventions relating to this skill have been researched in the clinical area and have implications for practice. There is a need for further studies to strengthen these findings.<br />

Australia local government and e-governance : from administration to citizen participation

This chapter analyses local government&rsquo;s response to the pressure to modernise its structures through its use of Information Communication Technologies (ICT) to execute its broad range of tasks. The chapter begins by discussing Chadwick and May&rsquo;s (2003) three basic models of e-government; managerial, consultative and participatory. Using data collected from an analysis of 658 local government websites in Australia together with existing survey research the chapter then analyses the extent to which local government sites fit into the three models. The chapter concludes with a discussion of the issues and problems faced by local government in its attempt to develop e-governance as both an extension of administrative as well as democratic functions.<br />

Teaching educational leadership and administration in Australia

Despite the ubiquity of programmes in educational administration and leadership little is known about the resources used to teach them. This article reviews the sources currently employed in such programmes in Australia by examining the textbooks, book chapters and journal articles specified for 53 separate units (papers) offered at 15 of the key institutions that responded to requests for copies of their reading lists. Surprisingly, few of the units prescribed textbooks (35), relying instead on book chapters (243) and journal articles (362). While there was a very eclectic spread of sources across institutions, 10 major themes emerged. However, there appeared to be little emphasis on Australian research on educational leadership and little reference to major Australian authors of the previous decades. This may be because the field has become global. The second part of the article therefore examines an audit of the contributions made by Australian authors to the global literature represented by leading journals in the field. The audit shows that during the period 1977-2007 an average of 12-13% of papers in key journals were contributed by Australian authors, perhaps more than might be expected given the comparative size of the Australian community. <br />

Identifying the "right patient" : nurse and patient perspectives on how to verify patient identity during medication administration

In this paper, we report on a research project funded by the Australian College of Mental Health Nurses&rsquo; and Bristol Myers Squibb Research Grant in 2007. We examined ways in which Mental Health Nurses could correctly identify patients during medication administration that promote medication safety and that are acceptable to both consumers and nurses. Central to the safe practice of medication administration are the &ldquo;five rights&rdquo; &ndash; giving the right drug, in the right dose, to the right patient, via the right route, at the right time. In non-psychiatric settings, such as medical and surgical inpatient units, the use of identification aids, such as wristbands, are common. In most Victorian psychiatric inpatient units, however, standardised identification aids are not used. Anecdotally, consumers dislike some methods of patient identification, such as wearing wrist bands, and some nurses perceive consumers&rsquo; rights are infringed through wearing personal identifiers. In focus groups, mental health consumers and Mental Health Nurses were invited to discuss their experiences of patient identification during routine psychiatric inpatient medication administration. They were also asked their opinions of, and preferences for, different ways of verifying &ldquo;right patient&rdquo; during routine medication administration. In our paper, we will present the findings of a qualitative research project in which we explored the experiences, opinions, and preferences of mental health consumers and Mental Health Nurses towards methods of correctly identifying patients during medication administration.<br />

Identifying the "right patient" : nurse and patient perspectives on how to verify patient identity during medication administration

In this paper, we report on a research project funded by the Australian College Mental Health Nurses&rsquo; and Bristol Myers Squibb Research Grant in 2007. We examined ways in which mental health nurses could correctly identify patients during medication administration that promote medication safety and that are acceptable to both consumers and nurses.<br /><br />Central to the safe practice of medication administration are the &ldquo;five rights&rdquo;- giving the right drug, in the right dose, to the right patient, via the right route, at the right time. In non-psychiatric settings, such as medical and surgical inpatient units, the use of identification aids, such as wristbands, are common. In most Victorian psychiatric inpatient units, however, standardised identification aids are not used. Anecdotally, consumers dislike some methods of patient identification, such as wearing wrist bands, and some nurses perceive consumers' rights are infringed through wearing personal identifiers.<br /><br />In focus groups, mental health consumers and mental health nurses were invited to discuss their experiences of patient identification during routine psychiatric inpatient medication administration. They were also asked their opinions of, and preferences for, different ways of verifying &ldquo;right patient&rdquo; during routine medication administration. In our paper, we will present the findings of a qualitative research project in which we explored the experiences, opinions, and preferences of mental health consumers and mental health nurses towards methods of correctly identifying patients during medication administration.<br />

ß2-Agonist administration increases sarcoplasmic reticulum Ca2+-ATPase activity in aged rat skeletal muscle

Aging is associated with a slowing of skeletal muscle contractile properties, including a decreased rate of relaxation. In rats, the age-related decrease in the maximal rate of relaxation is reversed after 4-wk administration with the &beta;2-adrenoceptor agonist (&beta;2-agonist) fenoterol. Given the critical role of the sarcoplasmic reticulum (SR) in regulating intracellular Ca2+ transients and ultimately the time course of muscle contraction and relaxation, we tested the hypothesis that the mechanisms of action of fenoterol are mediated by alterations in SR proteins. Sarcoendoplasmic reticulum Ca2+-ATPase (SERCA) kinetic properties were assessed in muscle homogenates and enriched SR membranes isolated from the red (RG) and white (WG) portions of the gastrocnemius muscle in adult (16 mo) and aged (28 mo) F344 rats that had been administered fenoterol for 4 wk (1.4 mg/kg/day ip, in saline) or vehicle only. Aging was associated with a 29% decrease in the maximal activity (Vmax) of SERCA in the RG but not in the WG muscles. Fenoterol treatment increased the Vmax of SERCA and SERCA1 protein levels in RG and WG. In the RG, fenoterol administration reversed an age-related selective nitration of the SERCA2a isoform. Our findings demonstrate that the mechanisms underlying age-related changes in contractile properties are fiber type dependent, whereas the effects of fenoterol administration are independent of age and fiber type. <br />