Knowledge and attitudes of paediatric nurses related to breastfeeding

Introduction: Almost 90% of Australian mothers are exclusively breastfeeding when they discharge from maternity hospitals but by six months of age breastfeeding infants have reduced to 32% nationally and 19% in Queensland, far below the national target of 80%. Many factors influence the choice to breastfeed, including health care provision, therefore the knowledge and attitudes of paediatric nurses have the potential to affect breastfeeding duration. Aims: To assess current breastfeeding knowledge and attitudes of paediatric nurses in metropolitan and regional Queensland settings. Method: The study used a cross-sectional survey design. The tool was developed from several documented health professional questionnaires about breastfeeding, with permission from authors. Survey items relating breastfeeding physiology, factors relating to breastfeeding success, and local, national and international policies were also included. Ethics approval was granted from the appropriate Ethics Committees to conduct the survey through tertiary metropolitan and regional hospital settings. Results: A total of 241 surveys were returned, achieving a response rate of 53%. Nurses acknowledged breastmilk as the best source of nutrition for infants (99%, n=238) and that mothers should be encouraged to breastfeed (92%, n=221). However, many respondents considered infant formula a nutritional equivalent (44%, n=105) and (47%, n=113) were unaware that supplemental formulas interfered with successful breastfeeding. Most nurses recognised that stress (e.g. infant hospitalisation) impacts on the success of breastfeeding (90%, n=216). Knowledge of breastfeeding anatomy and physiology was poor and a substantial number of nurses did not identify correct attachment in response to two diagrammatic representations (76%, n=183 and 45%, n=109). Survey results demonstrated deficiencies in knowledge that would impact on support provided to breastfeeding mothers. Knowledge deficits were also identified relating to local, national and international policies and protocols concerning breastfeeding and breastmilk substitutes. Conclusion: Breastfeeding knowledge and attitudes were exceptional in areas related to general breastfeeding knowledge. However, in areas directly related to nursing practice, considerable deficits in paediatric nurses' knowledge and attitudes were identified. Lack of appropriate skills, knowledge and varying attitudes amongst paediatric nurses has the potential to negatively impact on the education, advice and support provided to breastfeeding mothers and their families whilst their infant is in hospital. These study findings will guide future research and strategies to improve knowledge and policy statements to assist paediatric nurses in fulfilling their role.

Knowledge management for enterprise systems: observations from small, medium and large organizations

Anecdotal evidence suggests that the lifecycle-wide management of Enterprise System (ES) related knowledge is critical for ES health and longevity. At a time where many ES-vendors now offering solutions to Small and Medium size organizations, this paper investigates the ability of Small and Medium size organizations to maintain a lifecycle-wide knowledge management strategy. The paper explores the alleged differences in the knowledge management practices across 27 small, medium and large organizations that had implemented a market-leading ES. Results suggest that: (1) despite similar knowledge creation efforts in all three organizational sizes, small organizations struggle with retaining, transferring and applying the knowledge. The study also reveals that, (2) the overall goodness of the knowledge management process in larger organizations remains higher than their small and medium counterparts.

Developing a knowledge base for enterprise system success: the role of management and operational staff

Knowledge base is one of the emerging concepts in the Knowledge Management area. As there exists no agreed- upon standard definition of a knowledge base, this paper defines a knowledge base in terms of our research of Enterprise Systems (ES). The knowledge base is defined with reference to Learning Network Theory. Using this theoretical framework, we investigate the roles of management and operational staff in organisations and how their interactions can create a better ES-knowledge base to contribute to ES success. We focus on the post- implementation phase of ES as part of the ES lifecycle. Our findings will facilitate future research directions and contribute to better understandings of how the knowledge base can be integrated and how this integration leads to Enterprise System success.

Marginalised students and insider knowledge

One of the claims made for valuing the voices of marginalised students is that an insider perspective can be revealed on student issues and the ways in which education policies and systems impact on them. This chapter examines the ways in which participants in an Australian ‘students-as-researchers’ (SaR) project were able to raise knowledge of and address, to some extent, long-standing issues of racism in their schools. The SaR project has operated in more than thirty schools for periods of one to five years. Based on a participatory action research model, groups of secondary school students from schools serving socio-economically disadvantaged communities have worked with nominated teachers and university researchers to identify and research local issues relating to low academic outcomes and to develop and enact responses to the identified concerns. The voices of marginalised students quoted in this chapter illustrate that important insider knowledge can be revealed through the SaR process. Where student views have been acknowledged and acted on by the schools, significant change to student-teacher relationships and school culture has been achieved; the participants have been personally empowered and academic improvements across the schools have been noted. For such change to occur, however, a culture of mutual respect must be created in which teachers and school administrators value students’ views and are open to the possibility of unfavourable criticism.

The role of knowledge in the project management office

Both Knowledge Management (KM) and Project Management (PM) are known as crucial factors to develop competitive advantage(CA). PM Office (PMO) is recognized as a strong solution to institutionalize PM practices in organization. However, according to the literature there is a significant gap in addressing KM practices in the PMO. In other words, existing PMO maturity models has not been addressed from KM perceptive. This paper discusses undertaken investigations of both KM and PM as an initial part of PhD research on the role of knowledge in PMO

Using a knowledge-based approach : the way healthy communities make decisions

The planning for Knowledge Cities faces significant challenges due to the lack of effective information tools. These challenges are magnified while planning healthy communities. The Australian Health Information Council (AHIC) concluded in its last report that health information needs to be shared more effectively (AHIC, 2008). Some research justifies the use of Decision Support Systems (DSS) as an E-planning tool, particularly in the context of healthy communities. However, very limited research has been conducted in this area to date, especially in terms of evaluating the impact of these tools on decision-makers within the health planning practice. The paper presents the methodological instruments which were developed to measure the impact of the E-planning tool (i.e., Health Decision Support System [HDSS])) on a group of health planners, namely, the Logan Beaudesert Health Coalition (LBHC). The paper is focused on the culture in which decisions were made before and after the intervention of the HDSS. Subsequently, the paper presents the observed impact of the HDSS tool, to facilitate a knowledge-based decision-making approach. This study is an attempt to make some contribution to the Knowledge Cities literature in the context of planning healthy communities by adopting E-planning tools.

The HRM practices of innovative knowledge-intensive firms

There is little research on HRM practices in knowledge-intensive firms (KIFs), especially in comparison to that conducted in traditional production environments. Whether such HRM practices are appropriate for KIFs, particularly ones that differentiate themselves on their ability to innovate, is the basis of this research. The study investigates the HRM practices being used by four innovative firms: two KIFs and two traditional production companies. The findings suggest that there are some similarities between the HRM practices of the case firms, but there are also important differences. Specifically, the KIFs emphasise use of selection criteria and processes that secure a workforce with a desire for challenging work and the ability to work collaboratively. The KIFs are also more likely to provide a breadth of training and development opportunities for teams and individuals, to make extensive use of performance management systems, and to utilise a range of strategies to encourage and reward innovation.

A visual description of early-number counting, addition and subtraction knowledge

Early-number is a rich fabric of interconnected ideas that is often misunderstood and thus taught in ways that do not lead to rich understanding. In this presentation, a visual language is used to describe the organisation of this domain of knowledge. This visual language is based upon Piaget’s notion of reflective abstraction (Dubinsky, 1991; Piaget, 1977/2001), and thus captures the epistemological associations that link the problems, concepts and representations of the domain. The constructs of this visual language are introduced and then applied to the early-number domain. The introduction to this visual language may prompt reflection upon its suitability and significance to the description of other domains of knowledge. Through such a process of analysis and description, the visual language may serve as a scaffold for enhancing pedagogical content knowledge and thus ultimately improve learning outcomes.

A Popperian consilience : modelling mathematical knowledge and understanding

Goldin (2003) and McDonald, Yanchar, and Osguthorpe (2005) have called for mathematics learning theory that reconciles the chasm between ideologies, and which may advance mathematics teaching and learning practice. This paper discusses the theoretical underpinnings of a recently completed PhD study that draws upon Popper’s (1978) three-world model of knowledge as a lens through which to reconsider a variety of learning theories, including Piaget’s reflective abstraction. Based upon this consideration of theories, an alternative theoretical framework and complementary operational model was synthesised, the viability of which was demonstrated by its use to analyse the domain of early-number counting, addition and subtraction.

Nobody says no : student self-censorship in a collaborative knowledge building activity

This paper explores student self-censorship within an online learning environment. Self-censorship in group activity can be seen as a two-edged sword. While it can be advantageous that a student censor personal frustration and angst when working with others, if the self-censorship impacts on the cognitive contribution a student makes then this may significantly impact upon the overall quality of the group’s collective knowledge artefact. This paper reports on a study where it was found that students had self censored both their feelings and ideas as they collaboratively worked together.

Urban informatics for rural knowledge economies

This position paper provides an overview of a proposed study that seeks to design and develop tools, methods and applications of urban informatics to promote an innovation culture and knowledge economy in regional Queensland. The National Broadband Network has the potential to leapfrog regional Queensland to join the knowledge economy, but effective applications and content strategies are required. The Edge is the Queensland Government’s Digital Culture Centre to engage young people in the technology/culture nexus. This position paper provides an overview of a proposed study that will set up Living Labs at The Edge and in a new precinct in rural Queensland (Goondiwindi) as sites to trial strategies and applications that engage people in entrepreneurial thinking, sustainability initiatives, and new creative practices across the urban and rural boundaries.

High fidelity simulation; challenges encountered in developing and implementing student learning experiences, staff education and researching approaches to learning

High fidelity simulation as a teaching and learning approach is being embraced by many schools of nursing. Our school embarked on integrating high fidelity (HF) simulation into the undergraduate clinical education program in 2011. Low and medium fidelity simulation has been used for many years, but this did not simplify the integration of HF simulation. Alongside considerations of how and where HF simulation would be integrated, issues arose with: student consent and participation for observed activities; data management of video files; staff development, and conceptualising how methods for student learning could be researched. Simulation for undergraduate student nurses commenced as a formative learning activity, undertaken in groups of eight, where four students undertake the ‘doing’ role and four are structured observers, who then take a formal role in the simulation debrief. Challenges for integrating simulation into student learning included conceptualising and developing scenarios to trigger students’ decision making and application of skills, knowledge and attitudes explicit to solving clinical ‘problems’. Developing and planning scenarios for students to ‘try out’ skills and make decisions for problem solving lay beyond choosing pre-existing scenarios inbuilt with the software. The supplied scenarios were not concept based but rather knowledge, skills and technology (of the manikin) focussed. Challenges lay in using the technology for the purpose of building conceptual mastery rather than using technology simply because it was available. As we integrated use of HF simulation into the final year of the program, focus was on building skills, knowledge and attitudes that went beyond technical skill, and provided an opportunity to bridge the gap with theory-based knowledge that students often found difficult to link to clinical reality. We wished to provide opportunities to develop experiential knowledge based on application and clinical reasoning processes in team environments where problems are encountered, and to solve them, the nurse must show leadership and direction. Other challenges included students consenting for simulations to be videotaped and ethical considerations of this. For example if one student in a group of eight did not consent, did this mean they missed the opportunity to undertake simulation, or that others in the group may be disadvantaged by being unable to review their performance. This has implications for freely given consent but also for equity of access to learning opportunities for students who wished to be taped and those who did not. Alongside this issue were the details behind data management, storage and access. Developing staff with varying levels of computer skills to use software and undertake a different approach to being the ‘teacher’ required innovation where we took an experiential approach. Considering explicit learning approaches to be trialled for learning was not a difficult proposition, but considering how to enact this as research with issues of blinding, timetabling of blinded groups, and reducing bias for testing results of different learning approaches along with gaining ethical approval was problematic. This presentation presents examples of these challenges and how we overcame them.

Improving service innovation through structured process-oriented knowledge infrastructure design

Formalised service innovation is a central tenet of enterprise systems lifecycle phases. Event driven process models extended with knowledge objects are found to be not useful in early lifecycle phases. When an upgrade is required, a map of the knowledge infrastructure is needed to better design further service innovation because functional maps no longer adequately describe the context adequately. By looking at formal changes to business processes as service innovations, and recognising the knowledge infrastructure inherent in services generally, changes driven through technology such as ES can be better understood with the application of frameworks such as B-KIDE.

An integrated knowledge management framework for managing sustainability knowledge in the Australian infrastructure sector

In Australia, it has been increasingly accepted that sustainability needs to be at the top of the agenda when contemplating infrastructure development. In practice however, many companies struggle to find effective ways to embrace sustainable ideas and implement them in real projects beyond minimum compliance. One of the reasons is the lack of underpinning knowledge and evidence to demonstrate and measure the linkage between sustainability implementations and the relevant outcomes. This is compounded by the fact that very often there are no common understandings between the stakeholders on sustainability and there is a big divide between research advancement and real-life applications. Therefore it is both feasible and timely to develop and expand the body of sustainability knowledge on infrastructure development and investigate better ways of communicating with and managing it within the infrastructure sector. Although knowledge management (KM) is a relatively new and emerging discipline, it has shown its value and promise in existing applications in the construction industry. Considering the existing KM mechanisms and tools employed in practice, this research is aimed at establishing a specific KM approach to facilitate sustainability knowledge identification, acquisition, sharing, maintenance and application within the infrastructure sector, and promote integrated decision-making for sustainable infrastructure development. A triangulation of questionnaire survey, semi-structured interviews and case studies was employed in this research to collect required qualitative and quantitative data. The research studied the unique characteristics of the infrastructure sector, the nature of sustainability knowledge, and evaluated and validated the critical elements, key processes, and priority issues of KM for the Australian infrastructure sector. A holistic KM framework was developed to set the overall context for managing sustainability knowledge in the infrastructure sector by outlining (1) the main aims and outcomes of managing sustainability knowledge, (2) the key knowledge activities, (3) effective KM strategies and instruments, and (4) KM enablers. Because of the highly project-oriented nature of the infrastructure sector, knowledge can only add value when it is being used in real projects. Implementation guidelines were developed to help the industry practitioners and project teams to apply sustainability knowledge and implement KM in infrastructure project scenarios. This research provides the Australian infrastructure sector with tools to better understand KM, helps the industry practitioners to prioritize attention on relevant sustainability issues, and recommends effective practices to manage sustainability knowledge, especially in real life implementation of infrastructure projects.

Diversity in Knowledge Management : A Cultural Approach

This paper reviews diversity in knowledge management (KM) from a cultural perspective; it argues that culturally embedded theories and practices influence the practice of knowledge management. It further presents and analyses several case studies and in particular a case study of the Islamic culture focusing on its traditional approach to both Islamic knowledge and management. The analysis of this case reveals the cultural challenges that emerge in the process of applying essentially Western management theories within an Islamic culture with particular reference to knowledge management theories. The paper concludes that the concept of knowledge management must take into account the diversity of national culture in which the organization exists and that the concept of knowledge management will benefit from a diversity perspective rather than a universality perspective.