Advanced nursing practice : a global perspective

Aim: To review the titles, roles and scope of practice of Advanced Practice Nurses internationally.----- Background: There is a worldwide shortage of nurses but there is also an increased demand for nurses with enhanced skills who can manage a more diverse, complex and acutely ill patient population than ever before. As a result, a variety of nurses in advanced practice positions has evolved around the world. The differences in nomenclature have led to confusion over the roles, scope of practice and professional boundaries of nurses in an international context.----- Method: CINAHL, Medline, and the Cochrane database of Systematic Reviews were searched from 1987 to 2008. Information was also obtained through government health and professional organisation websites. All information in the literature regarding current and past status, and nomenclature of advanced practice nursing was considered relevant.----- Findings: There are many names for Advanced Practice Nurses, and although many of these roles are similar in their function, they can often have different titles.----- Conclusion: Advanced Practice Nurses are critical for the future, provide cost-effective care and are highly regarded by patients/clients. They will be a constant and permanent feature of future health care provision. However, clarification regarding their classification and regulation is necessary in some countries.

Combining ganglion cell topology and data of patients with glaucoma to determine a structure-function map

PURPOSE: To introduce techniques for deriving a map that relates visual field locations to optic nerve head (ONH) sectors and to use the techniques to derive a map relating Medmont perimetric data to data from the Heidelberg Retinal Tomograph. METHODS: Spearman correlation coefficients were calculated relating each visual field location (Medmont M700) to rim area and volume measures for 10 degrees ONH sectors (HRT III software) for 57 participants: 34 with glaucoma, 18 with suspected glaucoma, and 5 with ocular hypertension. Correlations were constrained to be anatomically plausible with a computational model of the axon growth of retinal ganglion cells (Algorithm GROW). GROW generated a map relating field locations to sectors of the ONH. The sector with the maximum statistically significant (P < 0.05) correlation coefficient within 40 degrees of the angle predicted by GROW for each location was computed. Before correlation, both functional and structural data were normalized by either normative data or the fellow eye in each participant. RESULTS: The model of axon growth produced a 24-2 map that is qualitatively similar to existing maps derived from empiric data. When GROW was used in conjunction with normative data, 31% of field locations exhibited a statistically significant relationship. This significance increased to 67% (z-test, z = 4.84; P < 0.001) when both field and rim area data were normalized with the fellow eye. CONCLUSIONS: A computational model of axon growth and normalizing data by the fellow eye can assist in constructing an anatomically plausible map connecting visual field data and sectoral ONH data.

Sydney Opera House – FM exemplar project

The Sydney Opera House Facilities Management Exemplar Project (SOH FM Exemplar Project) aims to develop innovative research on facility management (FM) with the focus on asset maintenance. The project utilises the Sydney Opera House (SOH), one of most unique buildings in Australia, to research and create innovative FM strategies and models that will have a direct beneficial role for the Australian facilities management industry as well as the economy as a whole. The procurement, benchmarking and digitisation are crucial in improving the performance of FM. The procurement develops strategic plan and deployment framework enabling products, services, etc. meet objectives of performance, economic, environment, etc. Benchmarking is a technology used to compare practice and assess performance against the competitors recognised as industry leaders who achieve most successful activities in the field. Digitisation develops digitized FM modelling that facilitates the integration and automation of facility management. The project carries out the research on all the three areas as well as the relationship between them. It aims to develop an integrated approach for the improvement of FM performance.

Open Specification for BIM : Sydney Opera House Case Study

Executive Summary The objective of this report was to use the Sydney Opera House as a case study of the application of Building Information Modelling (BIM). The Sydney opera House is a complex, large building with very irregular building configuration, that makes it a challenging test. A number of key concerns are evident at SOH: • the building structure is complex, and building service systems - already the major cost of ongoing maintenance - are undergoing technology change, with new computer based services becoming increasingly important. • the current “documentation” of the facility is comprised of several independent systems, some overlapping and is inadequate to service current and future services required • the building has reached a milestone age in terms of the condition and maintainability of key public areas and service systems, functionality of spaces and longer term strategic management. • many business functions such as space or event management require up-to-date information of the facility that are currently inadequately delivered, expensive and time consuming to update and deliver to customers. • major building upgrades are being planned that will put considerable strain on existing Facilities Portfolio services, and their capacity to manage them effectively While some of these concerns are unique to the House, many will be common to larger commercial and institutional portfolios. The work described here supported a complementary task which sought to identify if a building information model – an integrated building database – could be created, that would support asset & facility management functions (see Sydney Opera House – FM Exemplar Project, Report Number: 2005-001-C-4 Building Information Modelling for FM at Sydney Opera House), a business strategy that has been well demonstrated. The development of the BIMSS - Open Specification for BIM has been surprisingly straightforward. The lack of technical difficulties in converting the House’s existing conventions and standards to the new model based environment can be related to three key factors: • SOH Facilities Portfolio – the internal group responsible for asset and facility management - have already well established building and documentation policies in place. The setting and adherence to well thought out operational standards has been based on the need to create an environment that is understood by all users and that addresses the major business needs of the House. • The second factor is the nature of the IFC Model Specification used to define the BIM protocol. The IFC standard is based on building practice and nomenclature, widely used in the construction industries across the globe. For example the nomenclature of building parts – eg ifcWall, corresponds to our normal terminology, but extends the traditional drawing environment currently used for design and documentation. This demonstrates that the international IFC model accurately represents local practice for building data representation and management. • a BIM environment sets up opportunities for innovative processes that can exploit the rich data in the model and improve services and functions for the House: for example several high-level processes have been identified that could benefit from standardized Building Information Models such as maintenance processes using engineering data, business processes using scheduling, venue access, security data and benchmarking processes using building performance data. The new technology matches business needs for current and new services. The adoption of IFC compliant applications opens the way forward for shared building model collaboration and new processes, a significant new focus of the BIM standards. In summary, SOH current building standards have been successfully drafted for a BIM environment and are confidently expected to be fully developed when BIM is adopted operationally by SOH. These BIM standards and their application to the Opera House are intended as a template for other organisations to adopt for the own procurement and facility management activities. Appendices provide an overview of the IFC Integrated Object Model and an understanding IFC Model Data.

Building Information Modelling for FM at Sydney Opera House

“SOH see significant benefit in digitising its drawings and operation and maintenance manuals. Since SOH do not currently have digital models of the Opera House structure or other components, there is an opportunity for this national case study to promote the application of Digital Facility Modelling using standardized Building Information Models (BIM)”. The digital modelling element of this project examined the potential of building information models for Facility Management focusing on the following areas: • The re-usability of building information for FM purposes • BIM as an Integrated information model for facility management • Extendibility of the BIM to cope with business specific requirements • Commercial facility management software using standardised building information models • The ability to add (organisation specific) intelligence to the model • A roadmap for SOH to adopt BIM for FM The project has established that BIM – building information modelling - is an appropriate and potentially beneficial technology for the storage of integrated building, maintenance and management data for SOH. Based on the attributes of a BIM, several advantages can be envisioned: consistency in the data, intelligence in the model, multiple representations, source of information for intelligent programs and intelligent queries. The IFC – open building exchange standard – specification provides comprehensive support for asset and facility management functions, and offers new management, collaboration and procurement relationships based on sharing of intelligent building data. The major advantages of using an open standard are: information can be read and manipulated by any compliant software, reduced user “lock in” to proprietary solutions, third party software can be the “best of breed” to suit the process and scope at hand, standardised BIM solutions consider the wider implications of information exchange outside the scope of any particular vendor, information can be archived as ASCII files for archival purposes, and data quality can be enhanced as the now single source of users’ information has improved accuracy, correctness, currency, completeness and relevance. SOH current building standards have been successfully drafted for a BIM environment and are confidently expected to be fully developed when BIM is adopted operationally by SOH. There have been remarkably few technical difficulties in converting the House’s existing conventions and standards to the new model based environment. This demonstrates that the IFC model represents world practice for building data representation and management (see Sydney Opera House – FM Exemplar Project Report Number 2005-001-C-3, Open Specification for BIM: Sydney Opera House Case Study). Availability of FM applications based on BIM is in its infancy but focussed systems are already in operation internationally and show excellent prospects for implementation systems at SOH. In addition to the generic benefits of standardised BIM described above, the following FM specific advantages can be expected from this new integrated facilities management environment: faster and more effective processes, controlled whole life costs and environmental data, better customer service, common operational picture for current and strategic planning, visual decision-making and a total ownership cost model. Tests with partial BIM data – provided by several of SOH’s current consultants – show that the creation of a SOH complete model is realistic, but subject to resolution of compliance and detailed functional support by participating software applications. The showcase has demonstrated successfully that IFC based exchange is possible with several common BIM based applications through the creation of a new partial model of the building. Data exchanged has been geometrically accurate (the SOH building structure represents some of the most complex building elements) and supports rich information describing the types of objects, with their properties and relationships.

Procurement Case Study and Decision-making Strategies

Objectives The procurement research of Sydney Opera House FM Exemplar Project aims to develop innovative methods and guidelines for the procurement of FM services, applicable to iconic and / or performing arts centre facilities, or facilities with similar FM functions. The initial procurement report in June 2005 analysed the strategic objectives and operational requirements that provide ‘demand statements’ as evaluation criteria in the service procurement process. The subsequent interim procurement report in September 2005 discussed the elements contributing to the criteria for decision-making in the service procurement process. This procurement report concentrates on the research on procurement strategies and innovative methods using a case study approach. The objectives of this report are: • to investigate service procurement methods and process in iconic and/or performing arts centre facilities; • to showcase FM innovation in Sydney Opera House through a case study; • to establish a preliminary decision-making framework and guidelines for selection of appropriate FM procurement routes to provide a useful model for FM community. Findings Findings from this procurement research are presented as follows. • FM innovation and experience of Sydney Opera House • Innovative procurement methods and processes, drawn from a case study of Sydney Opera House as exemplar • An integrated performance framework to link maintenance service functions to high level organisational objective and strategies • Procurement methods and contract outcomes, focusing on building maintenance and cleaning services of Sydney Opera House • Multi-dimensional assessment of Service Providers • General decision-making strategies and guidelines for selection of appropriate FM procurement routes Further Research Whilst the Sydney Opera House case study emphasises the experience of Sydney Opera House, a study of procurement strategies and methods from published research and FM good practice will supply facilities managers with alternative procurement routes. Further research on the procurement theme will develop a final decision-making model for the procurement of FM services, drawn from the evaluation of the case study outcomes, as well as FM good practice and findings from current published research.

Benchmarking Research Report

This benchmarking research report builds on the previous benchmarking review (Report 2005-001-C-1) and presents the benchmarking data collection and framework developments thus far. The objective is to deliver a benchmarking framework and recommendations on implementation of best practice on asset maintenance. The FM Exemplar Project using the Sydney Opera House has conducted a two (2) stage survey of iconic facilities. The benchmarking team has been led by Rider Hunt Terotech with researchers from the CSIRO and The University of Sydney.

Digital Modelling

This Digital Modelling Report incorporates the previous research completed for the FM Exemplar Project utilising the Sydney Opera House as a case study. The research has demonstrated significant benefits in digitising design documentation and operational and maintenance manuals. Since Sydney Opera House do not have digital models of its structure, there is an opportunity to investigate the application of Digital Facility Modelling using standardised Building Information Models (BIM). The digital modelling research project has examined the potential of standardised building information models to develop a digital facility model supporting facilities management (FM). The focus of this investigation was on the following areas: • The re-usability of standardised building information models (BIM) for FM purposes. • The potential of BIM as an information framework acting as integrator for various FM data sources. • The extendibility and flexibility of the BIM to cope with business specific data and requirements. • Commercial FM software using standardised building information models. • The ability to add (organisation-specific) intelligence to the model. • A roadmap for Sydney Opera House to adopt BIM for FM.

Services Procurement

This Services Procurement Report incorporates the previous benchmarking research and aims to develop innovative methods and guidelines for the procurement of FM services, applicable to iconic and / or performing arts centre facilities, or facilities with similar FM functions. The FM Exemplar Project utilising the Sydney Opera House produced its initial procurement report in June 2005 which analysed the strategic objectives and operational requirements that provide ‘demand statements’ as evaluation criteria in the service procurement process. The subsequent interim procurement report in September 2005 discussed the elements contributing to the criteria for decision-making in the service procurement process. This procurement report concentrates on the research on procurement strategies and innovative methods using a case study approach. The objectives of this report are to: Investigate service procurement methods and process in iconic and/or performing arts centre facilities; Showcase FM innovation in Sydney Opera House through a case study; Establish a preliminary decision-making framework and guidelines for selection of appropriate FM procurement routes to provide a useful model for FM community

Investment decision framework for infrastructure asset management: a probability-based approach

Australia’s civil infrastructure assets of roads, bridges, railways, buildings and other structures are worth billions of dollars. Road assets alone are valued at around A$ 140 billion. As the condition of assets deteriorate over time, close to A$10 billion is spent annually in asset maintenance on Australia's roads, or the equivalent of A$27 million per day. To effectively manage road infrastructures, firstly, road agencies need to optimise the expenditure for asset data collection, but at the same time, not jeopardise the reliability in using the optimised data to predict maintenance and rehabilitation costs. Secondly, road agencies need to accurately predict the deterioration rates of infrastructures to reflect local conditions so that the budget estimates could be accurately estimated. And finally, the prediction of budgets for maintenance and rehabilitation must provide a certain degree of reliability. A procedure for assessing investment decision for road asset management has been developed. The procedure includes: • A methodology for optimising asset data collection; • A methodology for calibrating deterioration prediction models; • A methodology for assessing risk-adjusted estimates for life-cycle cost estimates. • A decision framework in the form of risk map

Facilities management action agenda : the Australian government and industry working together for improvement

This paper provides an overview of the Australian Government’s Facilities Management (FM) Action Agenda as announced in 2004 as a key policy plank designed to facilitate growth of the FM industry. The resulting consultation with industry leaders has seen the criterion and release in April 2005 of the FM Action Agenda’s strategic plan entitled ‘Managing the Built Environment’. This framework, representing a collaboration between the Australian Government, public and private sector stakeholders and Facility Management Association of Australia (FMA Australia) and other allied bodies, sets out to achieve the vision of a more “…productive and sustainable built environment…” through improved innovation, education and standards. The 36 month implementation phase is now underway and will take a multi-pronged approach to enhancing the recognition of the FM industry and removing impediments to its growth with a 20 point action plan across the following platforms: • Innovation – Improved appreciation of facility life cycles, and greater understanding of the key drivers of workplace productivity, and the improved application of information technology. • Education and Training – Improved access to dedicated FM education and training opportunities and creation clear career pathways into the profession. • Regulatory Reform – Explore opportunities to harmonise cross jurisdictional regulatory compliance requirements that have an efficiency impact on FM. • Sustainability – Improved utilization of existing knowledge and the development of tools and opportunities to improve the environmental performance of facilities. Additional information is available at www.fma.com.au

Sydney Opera House : facilities management exemplar project

The paper presents an interim summary of research and case studies being undertaken in the Sydney Opera House FM Exemplar Project covering procurement, benchmarking and building information models. The final outcomes of the FM Exemplar Project will be presented through various forums open to all FM practitioners and published in Australia and elsewhere through relevant journals. Sydney Opera House is an Australian icon, attracting some 4.5 million visitors per year who admire its built form and enjoy an evening of theatre. The building is the attraction, part of the experience. Therefore, facilities management is critical to the success of the Sydney Opera House enterprise and an ideal subject for the study of facilities management. Significantly the three research themes are heavily intertwined – effective risk sharing in procurement requires historic information and benchmarks for future performance, benchmarking gathers vast quantities of data that can only be exploited if properly related to one another and a building information model provides the means to manage such data. The case studies are emerging as real-life examples of how one organisation is addressing FM issues common to many, and will provide useful lessons for practitioners pursing similar strategies in their own organisations.

Building information modelling for FM using IFC

Facility managers have to acquire, integrate, edit and update diverse facility information ranging from building elements & fabric data, operational costs, contract types, room allocation, logistics, maintenance, etc. With the advent of standardized Building Information Models (BIM) such as the Industry Foundation Classes (IFC) new opportunities are available for Facility Managers to manage their FM data. The usage of IFC supports data interoperability between different software systems including the use of operational data for facility management systems. Besides the re-use of building data, the Building Information Model can be used as an information framework for storing and retrieving FM related data. Currently several BIM driven FM systems are available including IFC compliant ones. These systems have the potential to not only manage primary data more effectively but also to offer practical systems for detailed monitoring, and analysis of facility performance that can underpin innovative and more cost effective management of complex facilities.

How can preservice teachers be measured against advocated professional teaching standards?

Australia has had many inquiries into teaching and teacher education over the last decade. Standards for teaching have been produced by national education systems with many state systems following suit. The Queensland College of Teachers (QCT) advocates ten professional teaching standards for teachers and preservice teachers. How can preservice teachers be measured against advocated professional standards? This study investigated 106 second-year preservice teachers’ perceptions of their development against the QCT standards. A pretest-posttest survey instrument was developed based on the QCT standards and administered to these preservice teachers before and after their science education coursework. Percentages, ANOVAs and t-tests were generated to analyse the results. Findings indicated that 22 of the 24 paired pretest-posttest items were highly significant (p<.001). Percentage increases ranged from as low as 27% in the pretest to as high as 97% in the posttest, yet, there were two items with lower significance (i.e., working in professional science education teams and supporting students’ participation in society). Understanding preservice teachers’ perceptions of their abilities to implement these standards may be a step towards the process of determining the achievement of teaching standards; however, more rigorous measurements will need to be developed for both teachers and preservice teachers. University coursework and related assessments can provide an indication of achieving these standards, especially authentic assessment of preservice teachers’ practices.