A Time-Motion Study of Registered Nurses’ Workflow in Intensive Care Unit Remote Monitoring

Utilizing advanced information technology, Intensive Care Unit (ICU) remote monitoring allows highly trained specialists to oversee a large number of patients at multiple sites on a continuous basis. In the current research, we conducted a time-motion study of registered nurses’ work in an ICU remote monitoring facility. Data were collected on seven nurses through 40 hours of observation. The results showed that nurses’ essential tasks were centered on three themes: monitoring patients, maintaining patients’ health records, and managing technology use. In monitoring patients, nurses spent 52% of the time assimilating information embedded in a clinical information system and 15% on monitoring live vitals. System-generated alerts frequently interrupted nurses in their task performance and redirected them to manage suddenly appearing events. These findings provide insight into nurses’ workflow in a new, technology-driven critical care setting and have important implications for system design, work engineering, and personnel selection and training.

Factors determining the use of universal precautions by emergency department nurses

The Health Belief Model (HBM) provided the theoretical framework for examining Universal Precautions (UP) compliance factors by Emergency Department nurses. A random sample of Emergency Nurses Association (ENA) clinical nurses (n = 900) from five states (New York, New Jersey, California, Texas, and Florida), were surveyed to explore the factors related to their decision to comply with UP. Five-hundred-ninety-eight (598) useable questionnaires were analyzed. The responders were primarily female (84.9%), hospital based (94.6%), staff nurses (66.6%) who had a mean 8.5 years of emergency nursing experience. The nurses represented all levels of hospitals from rural (4.5%) to urban trauma centers (23.7%). The mean UP training hours was 3.0 (range 0-38 hours). Linear regression was used to analyze the four hypotheses. The first hypothesis evaluating perceived susceptibility and seriousness with reported UP use was not significant (p = $>$.05). Hypothesis 2 tested perceived benefits with internal and external barriers. Both perceived benefits and internal barriers as well as the overall regression were significant (F = 26.03, p = $<$0.001). Hypothesis 3 which tested modifying factors, cues to action, select demographic variables, and the main effects of the HBM with self reported UP compliance, was also significant (F = 12.39, p = $<$0.001). The additive effects were tested by use of a stepwise regression that assessed the contribution of each of the significant variables. The regression was significant (F = 12.39, p = $<$0.001) and explained 18% of the total variance. In descending order of contribution, the significant variables related to compliance were: internal barriers (t = $-$6.267; p = $<$0.001) such as the perception that because of the nature of the emergency care environment there is sometimes inadequate time to put on UP; cues to action (t = 3.195; p = 0.001) such as posted reminder signs or verbal reminders from peers; the number of Universal Precautions training hours (t = 3.667; p = $<$0.001) meaning that as the number of training hours increase so does compliance; perceived benefits (t = 3.466; p = 0.001) such as believing that UP will provide adequate barrier protection; and perceived susceptibility (t = 2.880; p = 0.004) such as feeling that they are at risk of exposure. ^

Applying prospect theory to predict new venture creation

Although prior research on new venture creation has identified several antecedents that differentiate entrepreneurs from non-entrepreneurs, scholars still have an incomplete understanding of the factors and decision processes that lead an individual to become an entrepreneur. By applying prospect theory, we introduce the reference point as an important antecedent of new venture creation. Testing our research model and hypotheses with entrepreneurs and employees, results show that entrepreneurs set more aspiring reference points and therefore find themselves more often in a perceived loss situation. Results are also robust when testing for entrepreneurial intention of business graduate students. According to prospect theory, the perceived loss triggers more risk-seeking behavior. Summing up, the reference point has a positive effect on new venture creation and differentiates entrepreneurs from nonentrepreneurs. We discuss theoretical and managerial implications of the findings and develop avenues for future research.

Barriers and facilitators to nurses' acceptance of and implications for injury rates of an IV catheter safety device

This study has the purpose of determining the barriers and facilitators to nurses' acceptance of the Johnson and Johnson Protectiv®* Plus IV catheter safety needle device and implications for needlestick injuries at St. Luke's Episcopal Hospital, Houston, Texas. A one-time cross-sectional survey of 620 responding nurses was conducted by this researcher during December, 2000. The study objectives were to: (1) describe the perceived (a) organizational and individual barriers and facilitators and (b) acceptance of implementation of the IV catheter device; (2) examine the relative importance of these predictors; (3) describe (a) perceived changes in needlestick injuries after implementation of the device; (b) the reported incidence of injuries; and (c) the extent of underreporting by nurses; and (4) examine the relative importance of (a) the preceding predictors and (b) acceptance of the device in predicting perceived changes in needlestick injuries. Safety climate and training were evaluated as organizational factors. Individual factors evaluated were experience with the device, including time using it and frequency of use, and background information, including nursing unit, and length of time as a nurse in this hospital and in total nursing career. The conceptual framework was based upon the safety climate model. Descriptive statistics and multiple and logistic regression were utilized to address the study objectives. ^ The findings showed widespread acceptance of the device and a strong perception that it reduced the number of needlesticks. Acceptance was notably predicted by adequate training, appropriate time between training and device use, solid safety climate, and short length of service, in that order. A barrier to acceptance was nurses' longtime of use of previous needle technologies. Over four-fifths of nurses were compliant in always using the device. Compliance had two facilitators: length of time using device and, to a lesser extent, safety climate. Rates of compliance tended to be lower among nurses in units in which the device was frequently used. ^ High quality training and an atmosphere of caring about nurse safety stand out as primary facilitators that other institutions would need to adopt in order to achieve maximum success in implementing safety programs involving utilization of new safety devices. ^

Vocation in the insertion of the university student and the graduate

The work plan aims at deepening the analysis of the theoretic assumptions which support the practice in Vocational Guidance: analyzing the incidence of endogenous and exogenous factors both in the election and studying of a particular course of study and in the occupational resolution of the graduate. This analysis enables the revision and the new theoretic conceptualization which is afterwards transferred to the course, and to different groups and provincial institutions where the practice of Vocational Guidance occurs, as well as to other schools in the Northwest provinces of Argentina. Semiotic analysis, statistical elaboration and the research-action approach which, while surveying data renders a service to the milieu, provide the base for the project. Said project focuses on the following individuals: 1) freshmen, who offer us the following aspects to be considered: a) factors which either favor or hinder the insertion of the students attending the first years of the course; b) the conditions making up the learning situation in each subject, from the teaching point of view; c) the influence of institutional dimension in the insertion process; 2) graduands: the characteristics of the situation following graduation from University, those of the labor field and the different ways of gaining access to it are investigated. This analysis is carried out in the courses of study of Psychology and English (education of Professionals in English and English for Professionals).

Vocation in the insertion of the university student and the graduate

The work plan aims at deepening the analysis of the theoretic assumptions which support the practice in Vocational Guidance: analyzing the incidence of endogenous and exogenous factors both in the election and studying of a particular course of study and in the occupational resolution of the graduate. This analysis enables the revision and the new theoretic conceptualization which is afterwards transferred to the course, and to different groups and provincial institutions where the practice of Vocational Guidance occurs, as well as to other schools in the Northwest provinces of Argentina. Semiotic analysis, statistical elaboration and the research-action approach which, while surveying data renders a service to the milieu, provide the base for the project. Said project focuses on the following individuals: 1) freshmen, who offer us the following aspects to be considered: a) factors which either favor or hinder the insertion of the students attending the first years of the course; b) the conditions making up the learning situation in each subject, from the teaching point of view; c) the influence of institutional dimension in the insertion process; 2) graduands: the characteristics of the situation following graduation from University, those of the labor field and the different ways of gaining access to it are investigated. This analysis is carried out in the courses of study of Psychology and English (education of Professionals in English and English for Professionals).

Vocation in the insertion of the university student and the graduate

The work plan aims at deepening the analysis of the theoretic assumptions which support the practice in Vocational Guidance: analyzing the incidence of endogenous and exogenous factors both in the election and studying of a particular course of study and in the occupational resolution of the graduate. This analysis enables the revision and the new theoretic conceptualization which is afterwards transferred to the course, and to different groups and provincial institutions where the practice of Vocational Guidance occurs, as well as to other schools in the Northwest provinces of Argentina. Semiotic analysis, statistical elaboration and the research-action approach which, while surveying data renders a service to the milieu, provide the base for the project. Said project focuses on the following individuals: 1) freshmen, who offer us the following aspects to be considered: a) factors which either favor or hinder the insertion of the students attending the first years of the course; b) the conditions making up the learning situation in each subject, from the teaching point of view; c) the influence of institutional dimension in the insertion process; 2) graduands: the characteristics of the situation following graduation from University, those of the labor field and the different ways of gaining access to it are investigated. This analysis is carried out in the courses of study of Psychology and English (education of Professionals in English and English for Professionals).

The use of computers for graduate education in Project Management. Improving the integration to the industry.

This paper presents an initiative for monitoring the competence acquisition by a team of students with different backgrounds facing the experience of being working by projects and in a project. These students are graduated bachelor engineering are inexperienced in the project management field and they play this course on a time-shared manner along with other activities. The goal of this experience is to increase the competence levels acquired by using an structured web based portfolio tool helping to reinforce how relevant different project management approaches can result for final products and how important it becomes to maintain the integration along the project. Monitoring is carried out by means of have a look on how the work is being done and measuring different technical parameters per participant. The use of this information could make possible to bring additional information to the students involved in terms of their individual competencies and the identification of new opportunities of personal improvement. These capabilities are strongly requested by companies in their daily work as well as they can be very convenient too for students when they try to organize their PhD work.