Patient group directions : the application and integration of knowledge in advancing nursing practice

Background: The introduction of Patient Group Directions (PGD) has changed significantly the way in which nurses can now administer prescription only medicines as a one-off for patients requiring this level of service. PGD’s are a written authority to administer drugs to patients that are not identified at the time of treatment. Aim: The aim of this project was to develop a PGD for use within an Outreach team to administer colloid boluses to patients presenting with hypovolemia. Method: Using a case exemplar this paper will discuss the development of a PGD using aspects of transitional change theory to highlight the potential barriers that were encountered. Implications for Practice: The implications for this PGD are wide reaching. First it now enables members from the nursing Outreach team to administer colloid fluid boluses to a prescribed patient cohort without the need for prescription. Second, it ensures the deteriorating patient has interventions initiated in a timely and appropriate manner to reduce inadvertent admission to high care areas. Last, it will improve inter-professional team-working and communication so much so that collaborative patient care reduces health costs and identifies earlier those patients requiring substantially greater nursing and medical input. Conclusion: The experience of developing a working PGD for fluid administration has meant that the Outreach team is able to respond to patients in a more effective way. In addition, it is the experience of developing this PGD that has enabled the team to contemplate other PGD’s in the execution of Outreach work.

An investigation into challenges facing distributed teams: Case of South Australian construction projects

There is increasing momentum within the construction industry to deploy distributed teams on projects, yet the major challenges that companies face for managing teams in distributed arrangements have yet to be explored in the construction context. Driven by such need, this study is intended to present an account of the major challenges encountered throughout the life cycle of offshore outsourcing arrangements within the South Australian construction industry. To this end, the study describes the observations made within the natural contexts of one construction project in terms of the challenges to the success of deploying distributed teams for outsourcing of works. Discussions remain in dialogue with relevant theories and the pertinent literature to explain the interpretations and lessons learned and to underpin the conclusions made. It is contended that this study contributes to the field by providing an illuminating insight into potential challenges facing distributed teams being implemented in outsourcing tasks in construction projects. Discussions also offer practical guidelines for construction project managers and assist them in dealing with potential challenges of offshore outsourcing through the lenses of distributed team working principles.

A livelihoods study of farmers and fishers in Dang Tong Village Kampong Chhnang Province

This is the report of a livelihoods study team working together with villagers from Dang Tong Village in Kampong Chhnang Province, Cambodia. The study of the livelihoods of farmers and fishers is based on information provided by the villagers of Dang Tong, who shared their knowledge and raised real problems related to their livelihoods. [PDF contains 37 pages.]

A livelihoods study of farmers and fishers in Koh Chbar Village Kratie Province

This is the report of a livelihoods study team working together with villagers from Koh Chbar Village in Kratie Province, Cambodia, to find out about the livelihoods of farmers and fishers. It is based on information provided by the villagers who shared their knowledge and raised real issues related to their livelihoods. [PDF contains 37 pages.]

A livelihoods study of farmers and fishers in Trorbek Pork Village Kandal Province

This is the report of a livelihoods study team working together with villagers from Trorbek Pork in Kandal Province, Cambodia. The livelihoods study is based on the current population census (1998) and key informant interviews: 10 to 70 villagers (50% women) representing the 140 families of Trorbek Pork Village, Kampong Kong Commune, Koh Thom District, Kandal Province. (PDF contains 40 pages)

A livelihoods study of farmers and fishers in Saob Leu Village Kratie Province

This is the report of a livelihoods study team working together with villagers from Saob Leu Village in Kratie Province, Cambodia. The study is based on information provided by the villagers, who shared their knowledge and spoke about the real problems they face with their livelihoods. [PDF contains 40 pages]

A livelihoods study of fishers and farmers in Long An Province

This is the report of a livelihoods study team working together with people from two villages in Long An Province, Vietnam. The study is based on information provided by the villagers, who shared their knowledge and spoke about real problems they face with their livelihoods. This study was conducted from 11-20 October 2001. The team worked with key informants in two communes, Thuan Nghia Hoa and My Thanh Dong, who volunteered to participate and represented the 177 households in the village. (PDF contains 40 pages)

A livelihoods study of fishers and farmers in Quang Tri Province

This is the report of a livelihoods study team working together with villagers from two communes in Quang Tri Province, Vietnam: Ta Long Commune in Dakrong District and A Tuc Commune in Huong Hoa District. The study is based on information provided by members of the communes, who shared their knowledge and spoke about real problems they face with their livelihoods. This study was conducted from 10-22 October 2001. The team worked with key informants in two communes who volunteered to participate and represented the households in the village. (PDF contains 31 pages)

A livelihoods study of fishers and farmers in Thai Nguyen Province

This is the report of a livelihoods study team working together with members of two communes in Quang Tri Province, Vietnam. The study is based on information provided by the commune members, who shared their knowledge and spoke about real problems they face with their livelihoods. The study was conducted from 10-30 October 2001. The team worked with key informants in two communes, Dan Tien in Vo Nhia District and Phuong Tien in Dinh Hoa District, who participated in discussions and represented households in the commune. The livelihoods studies in Dan Tien and Phuong Tien communes explored existing human, labor and natural resources as well as other factors affecting people’s livelihoods. (PDF contains 32 pages)

国有企业管理者裁员决策特征及其对留岗者心理影响的研究

In China, orgnizational change and downsizing are the primary topics studied in I/O psychology and Human Resource Management. Due to the great need in reality, both theorists and practitioners raised the same questions: Does downsizing increase the organizational performance? What is the relationship between organizational downsizing strategies and survivors' psychological reations? Which factors influence managers' downsizing decision-making most? How can managers manage the process successfully? The purpose of this study is trying to answer these questions, and then to establish the downsizing decision-making model of China's SOE (State owned enterprise) managers. The hypothetical model of SOE managers' downsizing decision-making was put forward, based on a tremendous amount of literature on downsizing decision-making, especially on the downsizing decision-making model built by B. Shaw, and also based on the results of the interviews conducted to the SOE managers who have the downsizing decision-making experiences. In order to test and verify the model, 322 SOE managers were investigated by a questionnaire study. And the statistic results supported the hypothetical downsizing decision-making model. Further, 259 survivors (those who are still working in the SOEs) from 7 downsized SOEs and 1 non-downsizing SOE, were also investigated by a questionnaire study. The statistic results also supported the hypothetical downsizing decision-making model. A subsequent case study was performed upon one downsized SOE; and a deliberate focus group interview study within 6 SOE mangers from another downsized SOE was also conducted. Both fundings from the two studies surported the hypothetical model again. Thus, China's SOE managers' downsizing decision-making model was established. This China's SOE managers' downsizing decision-making model suggests the following: Firstly, the characteristics of managers'downsizing decision-making were the center of the model. Those characteristics displayed during the process of the downsizing decision planning, the participation of downsizing decision-making and the communication concerning downsizing events, were influenced by managers' sense of crisis, controlling factors out of the organization and the managing experience within it. Especially, the latter two factors were more important. Secondly, in downsizing decision-making problems, the perceived crisis of China's SOE managers was mainly influenced by the outer factors, esp. the controlling factors from the government or the high authorities, but not by the inner factors including manufacturing management, HRM skills and organizational competition strategies. Thirdly, survivors'psychological reactions (including job satisfaction, job motivation, team working cooperation, etc) were mainly influenced by the characteristics of the managers' downsizing decision-making, at the same time, also by the outer factors (including controlling and social security factors) and the inner factors (including competition strategy and HRM skills). Finally, according to the model and the results from this study, the conclusions were reached in the followings: The stronger the controlling effort upon the SOE managers, the worse the effect displayed during the downsizing process. And in order to improve the effect and quality of downsizing decision-making, SOE managers need a lot of training to ameliorate their competencies such as competition strategies and HRM skills.

North Wales Clinical Librarian project. Final project report

Urquhart, C., Durbin, J. & Turner, J. (2005). North Wales Clinical Librarian project. Final project report. Aberystwyth: Department of Information Studies. Summary report, plus individual site summary reports also available from http://users.aber.ac.uk/cju/ Sponsorship: NHS Trusts in North Wales

Training needs analysis of healthcare library staff, undertaken for South Yorkshire Workforce Development Confederation

Urquhart, C., Durbin, J. & Spink, S. (2004). Training needs analysis of healthcare library staff, undertaken for South Yorkshire Workforce Development Confederation. Aberystwyth: Department of Information Studies, University of Wales Aberystwyth. Sponsorship: South Yorkshire WDC (NHS)

Design-Build Experiences and Student Safety

Design-build experiences (DBEs) are an essential element of any programme based on the CDIO methodology. They enable students to develop practical hands-on skills, they enable the learning of theory by stealth and they provide a forum for developing professional skills such as team working and project management. The hands-on aspect of certain DBEs has significant risk associated with it, which must be addressed through the formal evaluation of risks and the development of a methodology for controlling them. This paper considers the aspects of design-build experiences that may impact on student safety. In particular, it examines the risk associated with each of the four stages of CDIO and gives examples of risks which may commonly apply across engineering disciplines. A system for assessing and controlling the risks in any particular DBE is presented and the paper finishes by discussing the significance of health and safety in the educational environment.

An interprofessional approach to improving paediatric medication safety.

BACKGROUND: Safe drug prescribing and administration are essential elements within undergraduate healthcare curricula, but medication errors, especially in paediatric practice, continue to compromise patient safety. In this area of clinical care, collective responsibility, team working and communication between health professionals have been identified as key elements in safe clinical practice. To date, there is limited research evidence as to how best to deliver teaching and learning of these competencies to practitioners of the future.

METHODS: An interprofessional workshop to facilitate learning of knowledge, core competencies, communication and team working skills in paediatric drug prescribing and administration at undergraduate level was developed and evaluated. The practical, ward-based workshop was delivered to 4th year medical and 3rd year nursing students and evaluated using a pre and post workshop questionnaire with open-ended response questions.

RESULTS: Following the workshop, students reported an increase in their knowledge and awareness of paediatric medication safety and the causes of medication errors (p < 0.001), with the greatest increase noted among medical students. Highly significant changes in students' attitudes to shared learning were observed, indicating that safe medication practice is learnt more effectively with students from other healthcare disciplines. Qualitative data revealed that students' participation in the workshop improved communication and teamworking skills, and led to greater awareness of the role of other healthcare professionals.

CONCLUSION: This study has helped bridge the knowledge-skills gap, demonstrating how an interprofessional approach to drug prescribing and administration has the potential to improve quality and safety within healthcare.

"They come with multiple morbidities":a qualitative assessment of pharmacist prescribing

This paper presents qualitative findings from a larger sequential mixed methods study which sought to provide an in-depth understanding of pharmacist prescribing from the perspective of pharmacist prescribers, medical colleagues and key stakeholders in Northern Ireland. Transcriptions were analyzed using thematic analysis as the interviews progressed and emergent themes were identified and coded (along with supporting quotes) independently and by consensus of the research team. Three major themes emerged in relation to pharmacist prescribing: the effect on patient care; challenges facing pharmacist prescribers and the importance of the interprofessional team (where two or more different professions with varied, yet complementary experience work together with a common purpose). Pharmacist prescribing may have the potential to reduce the medication burden for patients (as reported by pharmacists) as pharmacists tend to provide a more comprehensive medication review than doctors; the additional time for consultations made this possible. Further research is required on how interprofessional team working can be maximized in the context of pharmacist prescribing, particularly in relation to the management of multi-morbidity.