Current Care Guidelines for Cardiopulmonary Resuscitation : Implementation, skills and attitudes

Background: The national resuscitation guidelines were published in Finland in 2002 and are based on international guidelines published in 2000. The main goal of the national guidelines, available on the Internet free of charge, is early defibrillation by nurses in an institutional setting. Aim: To study possible changes in cardiopulmonary resuscitation (CPR) practices, especially concerning early defibrillation, nurses and students attitudes of guideline implementation and nurses and students ability to implement the guideline recommendations in clinical practices after publication of the Current Care (CC) guidelines for CPR 2002. Material and methods: CPR practices in Finnish health centres; especially concerning rapid defibrillation programmes, as well as the implementation of CC guidelines for CPR was studied in a mail survey to chief physicians of every health centre in Finland (Study I). The CPR skills using an automated external defibrillator (AED) were compared in a study including Objective stuctured clinical examination (OSCE) of resuscitation skills of nurses and nursing students in Finnish and Swedish hospital and institution (Studies II, III). Attitudes towards CPR-D and CPR guidelines among medical and nursing students and secondary hospital nurses were studied in surveys (Studies IV, V). The nurses receiving different CPR training were compared in a randomized trial including OSCE of CPR skills of nurses in Finnish Hospital (Study VI). Results: Two years after the publication, 40.7% of Finnish health centres used national resuscitation guidelines. The proportion of health centres having at least one AED (66%) and principle of nurse-performed defibrillation without the presence of a physician (42%) had increased. The CPR-D training was estimated to be insufficient regarding basic life support and advanced life support in the majority of health centres (Study I). CPR-D skills of nurses and nursing students in two specific Swedish and Finnish hospitals and institutions (Study II and III) were generally inadequate. The nurses performed better than the students and the Swedish nurses surpassed the Finnish ones. Geriatric nurses receiving traditional CPR-D training performed better than those receiving an Internet-based course but both groups failed to defibrillate within 60 s. Thus, the performance was not satisfactory even two weeks after traditional training (Study VI). Unlike the medical students, the nursing students did not feel competent to perform procedures recommended in the cardiopulmonary resuscitation guidelines including the defibrillation. However, the majority of nursing students felt confident about their ability to perform basic life support. The perceived ability to defibrillate correlated significantly with a positive attitude towards nurse-performed defibrillation and negatively with fear of damaging the patient s heart by defibrillation (Study IV). After the educational intervention, the nurses found their level of CPR-D capability more sufficient than before and felt more confident about their ability to perform defibrillation themselves. A negative attitude toward defibrillation correlated with perceived negative organisational attitudes toward cardiopulmonary resuscitation guidelines. After CPR-D education in the hospital, the majority (64%) of nurses hesitated to perform defibrillation because of anxiety and 27 % hesitated because of fear of injuring the patient. Also a negative personal attitude towards guidelines increased markedly after education (Study V). Conclusions: Although a significant change had occurred in resuscitation practices in primary health care after publication of national cardiopulmonary resuscitation guidelines the participants CPR-D skills were not adequate according to the CPR guidelines. The current way of teaching is unlikely to result in participants being able to perform adequate and rapid CPR-D. More information and more frequent training are needed to diminish anxiety concerning defibrillation. Negative beliefs and attitudes toward defibrillation affect the nursing students and nurses attitudes toward cardiopulmonary resuscitation guidelines. CPR-D education increased the participants self-confidence concerning CPR-D skills but it did not reduce their anxiety. AEDs have replaced the manual defibrillators in most institutions, but in spite of the modern devices the anxiety still exists. Basic education does not provide nursing students with adequate CPR-D skills. Thus, frequent training in the workplace has vital importance. This multi-professional program supported by the administration might provide better CPR-D skills. Distance learning alone cannot substitute for traditional small-group learning, tutored hands-on training is needed to learn practical CPR-D skills. Standardized testing would probably help controlling the quality of learning. Training of group-working skills might improve CPR performance.

HALLINNONTASOJEN VÄLINEN DIALOGI JA ERITYISOPETUKSEN MUUTOS BYROKRAATTISENA INSTITUUTIONA : - Kymppikuntien loppuraportin ja Erityisopetuksen strategian sisällönanalyyttinen vertailu

The rise of Special education numbers in Finland has caused a situation where Finland s ten largest LEA s so called kymppikunnat (ten communes) have expressed their growing concern of organizing the special education in the current institutional settings. The LEA s started the conversation of redefining special education system in 2004. Their aim was to target the governments attention to the problematics of special education. By the request of the Ministry of Education the LEA s prepared a final report concerning the central questions in the Finnish special education system. On the basis of the LEA s survey it became even clearer that the legislation, funding system and curriculum are tightly linked together. The following LEA s took part into the writing process Espoo, Helsinki, Jyväskylä, Kuopio, Lahti, Lappeenranta, Tampere, Turku and Vantaa. The report was hand over to the Ministry of Education at 18.8.2006. After the delivery the Ministry organized special education development group meetings 17 times in the year 2007. The result of the LEA s report and the development meetings was a new Special Education Strategy 2007. I am observing the dialogue between administrational levels in governmental institutions change process. The research is a content analysis where I compare the Erityistä tukea tarvitsevan oppilaan opetuksen järjestämisen uudistaminen osana yhtenäistä perusopetusta- kohti laatua ja joustavuutta (The renewal of the organization of teaching for student with special educational needs as part of unified education for all - towards quality and flexibility) document to Erityisopetuksen strategia (Special education strategy) document. My aim was to find out how much of their own interests have the LEA s been able to integrate into the official governmental documentation. The data has been organized and analyzed quantitatively with Macros created as additional parts in Microsoft Excel software. The document material has also been arranged manually on sentence based categorization into an Excel matrix. The results have been theoretically viewed from the special education reform dialogue perspective, and from the angle of the change process of a bureaucratic institution. My target has been to provide a new viewpoint to the change of special education system as a bureaucratic institution. The education system has traditionally been understood as a machine bureaucracy. By the review provided in my pro gradu analysis it seems however that the administrational system in special education is more of a postmodern network bureaucracy than machine bureaucracy. The system appears to be constructed by overlapping, crossing and complex networks where things are been decided. These kinds of networks are called "governance networks . It seems that the governmental administrational - and politic levels, the third sector actors and other society s operators are mixed in decision making.

Ihmisoikeuskasvatus lukiossa — outoa ja itsestään selvää

Human Rights Education in a Finnish Upper Secondary School: Alien Yet Obvious This study focused on conceptions of human rights and human rights education (HRE) among students and teachers. I examined how human rights and HRE are understood by the students and teachers in one general upper secondary school located in southern Finland. I also examined teacher and student discourses about foreigners and immigrants. In the theoretical part of the study I dealt with the history of human rights, the different emphases in HRE and how HRE is handled within the curriculum of upper secondary schools in Finland. In the empirical part of the study I examined HRE in one particular general upper secondary school located in southern Finland where I carried out 28 student interviews and 18 teacher interviews. The study is based on qualitative theme interviews, which I analysed using qualitative content analysis. The aims of HRE as specified in UN documents on education seem not to have been achieved in the Finnish context. The students' knowledge of human rights seemed weak and very limited. Few teachers were familiar with the concept of human rights education. The concept of human rights was also unclear to many of the students. Freedom of speech was the most well-known and the most often-cited human right mentioned in the interviews. Students were not well acquainted with the different human rights instruments or the organisations dealing with human rights. In a way, human rights were both familiar and strange to the students. Materials related to HRE were used very little in the school or not at all. Yet human rights seemed to be very well implemented in the institution. The upper secondary school studied here does not seem to have substantial problems with equality among either the teachers or the students. In the interviews human rights problems were often considered someone else's problem in some other country. The teachers and students connected HRE especially with religious education, history and social studies. Human dignity is mostly dealt with in religious education, while matters concerning the history of human rights are mostly dealt with in history classes. Teachers appear to be human rights educators in the sense that they try to follow human rights principles in their daily work and respect the human dignity of everyone. The special role of a human rights educator was usually assigned to someone else — a teacher or an expert outside the school. HRE was not an intentional or conscious part of teachers´ educational work and was not seen either as belonging to the curriculum or as an obligation prescribed by international documents. There is a need to strengthen the presence of HRE in teacher education. HRE plays an important role in creating a culture of human rights. It is important to implement HRE so that the international aims for HRE will be fulfilled.

Developement of DSP based educational kit for power electronics and drives

The educational kit was developed for power electronics and drives. The need and purpose of this kit is to train engineers with current technology of digital control in power electronics. The DSP is the natural choice as it is able to perform high speed calculations required in power electronics. The educational kit consists of a DSP platform using TI DSP TMS320C50 starter kit, an inverter and an induction machine-dc machine set. A set of experiments have been prepared so that DSP programming can be learned easily in a smooth fashion. Here the application presented is open loop V/F control of three phase induction using sine pulse width modulation technique.

Quality Assurance and Assessment in Technical Education System: A Web Based Approach

Engineering education quality embraces the activities through which a technical institution satisfies itself that the quality of education it provides and standards it has set are appropriate and are being maintained. There is a need to develop a standardised approach to most aspects of quality assurance for engineering programmes which is sufficiently well defined to be accepted for all assessments.We have designed a Technical Educational Quality Assurance and Assessment (TEQ-AA) System, which makes use of the information on the web and analyzes the standards of the institution. With the standards as anchors for definition, the institution is clearer about its present in order to plan better for its future and enhancing the level of educational quality.The system has been tested and implemented on the technical educational Institutions in the Karnataka State which usually host their web pages for commercially advertising their technical education programs and their Institution objectives, policies, etc., for commercialization and for better reach-out to the students and faculty. This helps in assisting the students in selecting an institution for study and to assist in employment.

Factors Facilitating Successful Educational Innovation with ICT in Schools

[EN]This paper proposes an approach to the concept of ICT-based innovation in schools, from the perspective of the factors that facilitate the innovative use of ICT. To this end, a scale has been developed and validated to identify these factors through the participation of 195 teachers from 16 schools considered by the Basque educational authorities as innovators in ICT. The results obtained attest to the validity and reliability of both the scale and the 5 key factors that influence innovation in technology-based teaching. This factor-based structure enables a holistic view of ICT innovation in schools across 3 key areas: school context, teachers and the education authorities.

The development of the South Carolina Coastal Information Network and portal site: Bringing training opportunities and educational resources to coastal community officials and the public

The South Carolina Coastal Information Network (SCCIN) emerged as a result of a number of coastal outreach institutions working in partnership to enhance coordination of the coastal community outreach efforts in South Carolina. This organized effort, led by the S.C. Sea Grant Consortium and its Extension Program, includes partners from federal and state agencies, regional government agencies, and private organizations seeking to coordinate and/or jointly deliver outreach programs that target coastal community constituents. The Network was officially formed in 2006 with the original intention of fostering intra-and inter- agency communication, coordination, and cooperation. Network partners include the S.C. Sea Grant Consortium, S.C. Department of Health and Environmental Control – Office of Ocean and Coastal Resource Management and Bureau of Water, S.C. Department of Natural Resources – ACE Basin National Estuarine Research Reserve, North Inlet-Winyah Bay National Estuarine Research Reserve, Clemson University Cooperative Extension Service and Carolina Clear, Berkeley-Charleston-Dorchester Council of Governments, Waccamaw Regional Council of Governments, Urban Land Institute of South Carolina, S.C. Department of Archives and History, the National Oceanic and Atmospheric Administration – Coastal Services Center and Hollings Marine Laboratory, Michaux Conservancy, Ashley-Cooper Stormwater Education Consortium, the Coastal Waccamaw Stormwater Education Consortium, the S.C. Chapter of the U.S. Green Building Council, and the Lowcountry Council of Governments. (PDF contains 3 pages)