Development of a learning resource manual for nurses new to thoracic surgery

Background: Patients with lung and esophageal cancer often have surgery as a means of treatment. In Newfoundland and Labrador, patients with lung and esophageal issues are cared for on Six East, the General/Thoracic Surgery unit at St. Clare’s Mercy Hospital. These patients frequently require chest tubes, which are managed and assessed by Registered Nurses (RNs) on the unit. For nurses new to thoracic surgery, fulfilling their new role and caring for chest tube systems can be daunting. Purpose: The purpose of this practicum project was to develop a learning resource manual for nurses who are new to thoracic surgery. Via self-directed learning, the manual can increase the knowledge and self-efficacy of nurses who are caring for thoracic surgery clients and assessing chest tube systems. Methods: An informal needs assessment, integrated literature review, and several consultations via in-person interviews were conducted. Results: Based on the findings from these methodologies, Knowles’ Adult Learning Theory, and Benner’s Novice to Expert Model, a learning resource manual was created. The manual was divided into chapters covering various aspects of patient and chest tube system care and assessment. Conclusion: For the purpose of this practicum project, no evaluation was conducted. However, a plan for future evaluation of the learning resource manual has been developed to determine if the manual assisted with increasing the knowledge and self-efficacy of nurses new to thoracic surgery. “Test Your Knowledge” questions were included at the end of each chapter in the manual as well as case study scenarios to allow for participant self-evaluation.

Caring for the autistic child: a resource manual for health care providers

Background: Autism Spectrum Disorder (ASD) is a neurodevelopmental disorder that affects approximately 1 in 68 children (CDC, 2014). Comorbid medical conditions and psychiatric disorders increase the likelihood that these children will require acute care services more often than their neurotypical peers (McDermott, Zhou, & Mann, 2008; Simonoff et al., 2008). The evidence suggests that most health care providers are unprepared for the complexity of the interactions with these children during an acute care episode (McGongile, Migyanka, et al., 2014; McGongile, Venkat, et al., 2014; Muskat et al., 2015). Currently, there are no formalized training programs for acute health care workers in Regina Qu’Appelle Health Region (RQHR). Purpose: The purpose of this practicum project was to use the best available evidence on the care needs of children with Autism Spectrum Disorder (ASD) and effective interaction strategies to guide development of a resource manual for acute care health workers, especially registered nurses (RNs), working in the RQHR. Methods: Initial steps involved planning for and conducting a needs assessment. The resulting database emerged from a critical review of relevant literature, an environmental scan of resources within RQHR, and informal consultations with parents and caregivers of children with ASD, acute care nurses and nurse managers and experts in the field of ASD. Following analysis and collation of all data into major themes, a draft blueprint guided development of a resource manual for health care providers interacting with and providing care to children with ASD. Results: The needs assessment data informed development of an educational resource manual appropriate for all health care providers who encounter children with ASD and their parents and/or caregivers within acute care environments. The Caring for the Autistic Child: A Guide for Health Care Providers in Acute Care provides insightful information on the disorder and associated comorbid conditions, as well as effective approaches to care delivery with this priority population. Implementation and evaluation plans will guide distribution of the resource manual within the RQHR. Conclusion: The sequential and interdependent steps taken in this practicum project led to the development of a resource manual comprised of simple, easy to implement strategies capable of assisting nurses and all healthcare providers in providing care tailored to the autistic child’s unique needs and challenges.

A supervisão e orientação pedagógica de educadores e professores em São Tomé e Princípe : proposta de um programa de desenvolvimento profissional

Dissertação apresentada à Escola Superior de Educação de Santarém para obtenção do grau de mestre em Ciências de Educação na especialização de Supervisão e Orientação Pedagógica

Spontaneity and international marketing performance

Purpose: The purpose of this paper is to ascertain how today’s international marketers can perform better on the global scene by harnessing spontaneity. Design/methodology/approach: The authors draw on contingency theory to develop a model of the spontaneity – international marketing performance relationship, and identify three potential moderators, namely, strategic planning, centralization, and market dynamism. The authors test the model via structural equation modeling with survey data from 197 UK exporters. Findings: The results indicate that spontaneity is beneficial to exporters in terms of enhancing profit performance. In addition, greater centralization and strategic planning strengthen the positive effects of spontaneity. However, market dynamism mitigates the positive effect of spontaneity on export performance (when customer needs are volatile, spontaneous decisions do not function as well in terms of ensuring success). Practical implications: Learning to be spontaneous when making export decisions appears to result in favorable outcomes for the export function. To harness spontaneity, export managers should look to develop company heuristics (increase centralization and strategic planning). Finally, if operating in dynamic export market environments, the role of spontaneity is weaker, so more conventional decision-making approaches should be adopted. Originality/value: The international marketing environment typically requires decisions to be flexible and fast. In this context, spontaneity could enable accelerated and responsive decision-making, allowing international marketers to realize superior performance. Yet, there is a lack of research on decision-making spontaneity and its potential for international marketing performance enhancement.

Konceptet mobilitet som tjänst : Viktiga kompetenser och möjliga utmaningar vid vidareutvecklingen av MaaS i Sverige.

Transport and travel is necessary for our society to function. Today, the privately owned car stands for more than half of all personal trips in Sweden. In the last couple of years researchers have highlighted the idea that personal transport is facing a paradigm shift, which means a reduction in the use and dependent of the privately owned car and an increased focus on individuals buying their Mobility as a Service (MaaS). MaaS is described as an integrated mix of different mobility services which are arranged in the form of customized mobility packages to the customer. These mobility packages can be compared to a mobile phone subscription, which includes various mobility services, such as train, bus, subway, taxi, carpool, etc. in various amounts depending on the individual's changing needs. The individual can take care of their own travel planning, booking and payment via an app in their smartphone. What distinguish MaaS from other mobility services is that the customer can travel from door-to-door instead of a predefine station to another. There have been various Maas projects around the world in order to increase understanding of the concept of MaaS, there is still a lot of unanswered questions and researchers would like to see more studies in the field, in order to find factors that are important and vital to the concept MaaS. The aim of the thesis is to: Discuss some competences that may be significant for the further development of the concept Maas in Sweden and discuss potential challenges that may arise at further development of the concept MaaS in Sweden. This study is based on previous research and experiences and thoughts on the concept MaaS from various stakeholders with knowledge and experience of the concept. This study has an abductive approach. Primary data were obtained through qualitative semistructured interviews with eight people who have knowledge and experience of the Maas. The main conclusions in this study is that the competences that are most important in the development of MaaS is collaborative skills and competences required to create an attractive mobility package based on customer needs. One challenge identified in this study is the challenge of creating individualized mobility package in which different types of mobility services are integrated. Another challenge can arise when public and private organizations collaborate and when new organizations enter the transport network and try to cooperate with the established organizations

Skapa förutsättningar för att implementera Lean production i en tillverkningsprocess som kännetecknas av HVLV : - En fallstudie på Tibrokök Sverige AB

Idag är det vanligt att företagen konkurrerar med produkter som innefattar en fysisk vara som har utvidgats med olika tjänster för att kunna tillfredsställa kundens behov. I takt med detta ökar produkternas komplexitet och högre krav ställs på leverantörerna. Denna utveckling har lett till att många företag som tillverkar produkter med hög variation måste arbeta helt kundorderstyrt för att kunna tillgodose kundernas ökande krav. Företagen som tillverkar dessa komplexa produkter har en tillverkning som karaktäriseras av hög variation och låg volym vilket benämns med förkortningen HVLV. Utmaningen för dessa HVLV-företag ligger i att ha en hög produktmixflexibilitet med så låg resursanvändning som möjligt. För att effektivisera verksamheten har många företag därför intresserat sig för Lean production som har visat sig vara ett framgångsrikt koncept för tillverkande företag runt om i världen som effektiviserat sin produktion. Ett flertal artiklar har uppmärksammat begränsningar vid implementeringen av Lean production i HVLV-miljöer. Artiklar pekar vidare på behovet av ytterligare forskning kring Lean productions applicerbarhet i HVLV-miljöer och detta var uppkomsten till examensarbetets bakgrund och syfte. En fallstudie har genomförts på Tibrokök som är ett företag med en helt kundorderstyrd produktion som kännetecknas av HVLV. Med hjälp av fallstudien syftar examensarbetet till att undersöka om verktygen processkartläggning inkl. tidsstudier och layoutflödesdiagram kan bidra till att skapa förutsättningar för implementering av Lean production i en enskild tillverkningsprocess i en HVLV-miljö. Trots att verktygen har behövt anpassas något så anses de ha varit användbara och bidragande till skapandet av förutsättningar för implementering av Lean production i denna HVLV-miljö. Detta eftersom vi kunde identifiera många orsaker till slöseri samt ta fram ett förslag som skapar effektiviseringar av Tibroköks ytbehandlingsprocess i det framtida läget.

Iowa state plan for substance abuse treatment, 2000

This report is the product of a statewide needs assessment/community input process. It is a follow up to the State Plan for Substance Abuse Prevention developed in 1998.

Commercial and Industrial Network Improvement and Programming Policy, Summary, 1991

The Commercial and Industrial Network improvement and programming policy reflected in this summary report was adopted for use in future highway programming by the Transportation Commission on November 5, 1991. The Iowa Department of Transportation, as directed by the Legislature, has established a 2,331-mile network of commercial and industrial highways and is directing a significant amount of primary construction funding resources toward improvements to this network. This summary outlines the technical needs assessment for improvements on the Commercial and Industrial Network for the next 20-year period. The portions of the network which require four-lane capacity, as well as major improvements to the two-lane sections, are graphically displayed. Detailed improvement needs and costs are listed in tabular form for the first two five-year periods (1992-1996 and 1997-2001). It is essential to note that these improvement needs are the result of a technical assessment and do not imply any funding commitment.

A influência do departamento de marketing: o caso OLI

Tem-se verificado alguma discussão na literatura sobre o decréscimo da importância do Marketing nas empresas. De acordo com alguns estudos, apenas 10% do tempo é dedicado ao departamento de Marketing nas suas reuniões gerais. O estudo de caso é dedicado a uma empresa portuguesa, Oliveira & Irmão, líder ibérica de produtos de instalação sanitária que atua no mercado há 60 anos. Esta empresa exporta 80% da sua produção e tornou-se reconhecida por ser uma das empresas mais inovadoras da sua àrea, contando atualmente com 40 patentes ativas. Neste estudo será analisada a influência do departamento de Marketing numa empresa com gestão familiar e onde a satisfação do cliente é o seu objetivo primário. Para compreender as alterações que se verificaram desde a implementação do Departamento de Marketing, foram realizadas quatro entrevistas aos diretores da empresa (Departamento Financeiro, Inovação, Comercial e Marketing) para compreender, através do seu ponto de vista, quais as implicações e modificações principais que sentiram. Verificou-se que apesar do departamento de Marketing ser recente na empresa este já realizou algumas alterações notórias a nível interno (comunicação interna) e a nível externo (posicionamento da marca no mercado). Contudo, um dos grandes entraves tem sido a dificuldade em participar no processo desenvolvimento de novos produtos, que até então é coordenado pelo departamento de Inovação e departamento Comercial. A autora do estudo propõe um processo em que o departamento de Marketing fornece os inputs para o desenvolvimento de novos produtos, de modo a satisfazer as necessidades dos clientes.

World class manufacturing: criando estabilidade nos 4M's: expedição

Atualmente, as empresas deparam-se com uma enorme competitividade dos mercados. Esta competitividade faz com que as empresas sejam obrigadas a reagir, através da redução de custos, maior qualidade, redução de desperdícios e processos produtivos mais aptos às necessidades dos clientes. De facto, o grande objetivo de qualquer empresa é a criação de valor para o cliente. É necessário disponibilizar o produto certo, na quantidade certa, no tempo certo e ao custo mínimo, contribuindo de forma eficiente para a melhoria do serviço ao cliente. Por forma a melhorar o serviço ao cliente, as empresas sentem cada vez mais necessidade de recorrer à estabilidade dos processos. O presente projeto tem como principal objetivo a criação de estabilidade nos processos da expedição de uma empresa de argamassas industriais, através do uso de ferramentas pertencentes ao programa World Class Manufacturing com base na filosofia Lean Thinking. Primeiramente, foi utilizado o Value Stream Mapping por forma a representar visualmente as etapas envolvidas nos fluxos de valor da expedição. Depois de calculados os indicadores referentes aos processos da expedição e identificação dos problemas, usaram-se as ferramentas “5 Porquês” e diagrama de Ishikawa para se identificarem as causas raiz dos mesmos. Como contramedida ao combate às causas raiz dos problemas, utilizou-se a ferramenta SMED, comparando o tempo de carga de um camião a um setup. Foram usadas como exemplo duas situações que retratam na íntegra os problemas que ocorrem na área da expedição da empresa. Como plano de ação, reorganizou-se o armazém de preparação de encomendas e utilizou-se a ferramenta Kanban como forma de auxílio no reabastecimento do armazém de preparação de encomendas. Após a implementação, foi feito o seguimento do plano de ações, do método de trabalho e dos indicadores Apesar de não terem sido atingidos todos os objetivos propostos no início do projeto, verificaram-se melhorias em todos os processos da expedição.

Asiakasarvon kehittäminen B2B-palveluyrityksessä

Yritysten välisen yhteistyön toimittajavalinta perustuu asiakasarvon määrittämiseen ja vertailuun. Tämä tutkimus tehtiin yritys A:lle asiakasarvon ymmärtämiseksi, kehittämiseksi ja asiakaspääoman kasvattamiseksi. Teoreettisesti keskeisiä käsiteltäviä teemoja ovat asiakasarvon luonti, toimittaminen ja kasvattaminen. Tutkimus on toteutettu pääasiassa kvalitatiivisesti teemahaastattelun kautta, jossa haastateltiin viittä yritys A:n asiakasyritystä. Tutkimus suunniteltiin yhdessä työn tilanneen yrityksen kanssa suhteessa aiempiin tutkimuksiin ja tavoitteisiin. Tutkimuksen tuloksissa havaittiin selviä vahvuuksia liittyen yritys A:n asiakasyritysten asiakasarvon teemoihin. Vahvuudet liittyivät muun muassa suoriin kustannuksiin, erillisiin lisäpalveluihin ja asiakaspalveluun. Kehitettävät teemat liittyivät pääasiassa työn suorittamiseen ja markkinointiin. Tulokset ovat käsitelty niin numeerisesti kuin tärkeimpinä teemoina. Asiakasarvoon ja –pääomaan liittyvistä teemoista esitetään lopuksi ratkaisuehdotus työn tilanneelle yritykselle, jota voidaan hyödyntää jatkossa ko. johtamisessa. Asiakasarvosta tulisi tehdä niin yrityskohtaisesti kuin tieteen kannalta lisää tutkimusta, sillä siinä on onnistuessaan merkittävä liiketoiminnallinen potentiaali.

A supervisão e orientação pedagógica de educadores e professores em São Tomé e Princípe : proposta de um programa de desenvolvimento profissional

Dissertação apresentada à Escola Superior de Educação de Santarém para obtenção do grau de mestre em Ciências de Educação na especialização de Supervisão e Orientação Pedagógica

Asiakkaan osallistuminen innovaatio- ja tuotekehitysprosessiin

Tässä tutkimuksessa tarkastellaan asiakkaan ja valmistajan osallistumista yhteistoiminnalliseen innovaatio- ja tuotekehitysprosessiin ja sen vaikutuksia yritysten kilpailukykyyn. Asiakaslähtöinen avoin innovaatio- ja tuotekehitystoiminta on yksi merkittävä kilpailuedun lähde, sillä se mahdollistaa tuotevariaatioiden nopeamman lanseerauksen ja asiakastarpeiden huomioimisen tuotekehitystoiminnassa. Tämän empiirisen tutkimuksen tavoitteena oli selvittää millä tavoin kulutustavaroihin kuuluvien muoti- ja sportvaatteiden suunnittelussa yhteistoiminnallinen innovaatio- ja tuotekehitystoiminta on mahdollista toteuttaa ja miten sitä voidaan hallita. Tutkimus toteutettiin kvalitatiivisena tapaustutkimuksena. Empiirinen aineisto kerättiin teemahaastatteluina tapausorganisaatiosta. Yhteistoiminnallisesta kehittämisestä ei ole olemassa yhtä kattavaa teoriaa, jota voitaisiin hyödyntää. Tämän vuoksi yritysten on luotava itse yhteistoiminnallisen innovaation ja tuotekehityksen viitekehys, joka parhaiten palvelee liiketoiminnan tarpeita. Viitekehys ja käytettävät menetelmät sekä yhteistoiminnallisuutta tukevat työvälineet ovat riippuvaisia mm. toimialasta ja sen markkinatilanteesta, liiketoimintamalleista, yrityksen toimintaympäristöstä, asiakkaista ja kehittämisen kohteeksi valitusta tuotealueesta. Empiirinen tutkimus osoittaa, että yhteistoiminnallinen innovaatio voi olla kilpailuedun lähde sekä valmistajille että asiakkaalle, mutta vaatii aina yrityskohtaista sopeuttamista. Tutkimuksen mukaan hyvin johdettu yhteistyömalli, oikeat tuotevalinnat ja asiakasinformaation monipuolinen hyödyntäminen vaikuttavat positiivisesti kehittämisprojektin tuloksiin.

Heurística de programação da produção para uma indústria cerâmica

Atualmente, uma organização industrial com vista a singrar no mercado global é fortemente influenciada por pressões que visam o aumento da eficiência global e consequente redução de custos operacionais. O desafio para as mesmas passa, portanto, por expurgar do produto tudo aquilo que não lhe acrescenta valor percetível pelo cliente e por maximizar a utilização dos vários recursos industriais instalados. No seguimento deste desafio, surge o Problema de Planeamento e Programação da Produção, ao qual é necessário dar uma resposta eficiente. Este projeto tem como objetivo estudar o problema da Programação da Produção numa indústria de pavimentos e revestimentos cerâmicos, desenvolvendo uma heurística construtiva capaz de traduzir com fiabilidade a realidade do processo produtivo da mesma e, se possível, auxiliar na sua resolução. O problema da programação da produção em estudo visa responder às questões: o quê, em que quantidade, quando e em que linha produzir, por forma a satisfazer as necessidades dos clientes num prazo previamente estipulado como admissível, garantindo o enchimento dos fornos ligados. Sem grandes constrangimentos ao normal lavor da Produção, pretende obter-se com a heurística planos de produção viáveis, que minimizem o tempo necessário para a conclusão do conjunto de referências com necessidades produtivas. O problema é também abordado através de um modelo exato como um problema de máquinas paralelas idênticas capacitado, com matriz de compatibilidades, setups de família e de subfamília e com lotes mínimos de produção. Quer a heurística quer o modelo de programação inteira mista desenvolvidos permitem obter planos de produção válidos, equivalentes aos obtidos atualmente pela empresa através dos meios de programação atuais, embora com um dispêndio de tempo muito inferior.

Digital Transformation of Municipal Services in Finland

Digitalization has been widely adopted by private organizations of all sizes. As customers we are starting to expect a certain level of digital services from businesses and these expectations are evolving to consider the public sector services as well. Moreover, the Finnish municipalities are under pressure to cut costs and make their operation more efficient. This research aims in exploring the field of municipal digitalization in Finland with three main questions to answer: what are the motivations for municipalities for digital service transformation, what the main benefits of this transformation are and what are the challenges for the transformation. The research starts with examining the characteristics of municipal operation and reviewing some of the relevant digital service opportunities. In the empirical part of the research, 11 professionals related to the municipal field were interviewed using a semi-structured interview design. These interviewees were chosen from three important groups for the change: the service provider, municipal administration and municipal employees. The data gained from the interviews was first summarized according to the main topics chosen from the literature and then reflected on the digital services opportunities presented in the research. The motivations discovered in both the service provider and the city of Porvoo interviews were: tightening resources combined with increasing expectations, transparent structuring of information, supporting the shift into mobile and providing new channels for customers to participate. The benefits discovered in all groups were: efficiency, customer experience, transparent structuring of information, reducing manual input and responding to customer needs in service development. The challenges perceived by multiple groups were: change resistance, innovating new with no best practices and defining the scope and new operation model. The results of this research suggest that even with some challenges along the way, digitalization is a likely future for the Finnish public sector. The business case for the transformation is becoming increasingly evident on both municipal- and governmental levels.