Management of sharps in ambulance care : a state-wide survey of paramedic knowledge and reported practice

Paramedics are at high risk of exposure to infectious diseases because they frequently undertake procedures such as the use and disposal of sharps as components of everyday practice. While the literature demonstrates that the management of sharps is problematic across all health disciplines, there is a paucity of research examining sharps management practices in the Australian pre-hospital paramedic context. This study examines knowledge and practices of sharps control among paramedics in Queensland, Australia. A mail survey focusing on infection control knowledge and practices was sent to all clinical personnel of the Queensland Ambulance Service (QAS) (N = 2274). A total of 1258 surveys were returned, a response rate of 55.3%. Participants responded to 12 true/false statements on the management of sharps and three questions about recapping practices. Most respondents were knowledgeable about the correct management of sharps, with a mean of 11.28 (out of 12, SD = 1.32). When gauging reported practices, more than half (59.1%, n = 736) of participants reported recapping a needle, and 38.5% (n = 479) reported never having done so. These results reflect good knowledge of general management of sharps among respondents, but suggest deficits regarding reported practices. The results suggest that a comprehensive ambulance in-service education programme focusing particularly on sharps management is required. The study highlights the need for further research on sharps management practices in the field, identification of barriers to safe sharps practices in pre-hospital settings, and 'best practice' for translating good sharps management knowledge into practice.

Research productivity levels of Chinese TEFL academics

Since China’s Economic Reform and its Open Door Policy, China has entered a new era of education (Adamson, 2002; Hu, 2005a). English has gained status as a language for international relations (Graddol, 1997) and international trade (Qu, 2007). Hence, in 2001, China’s Ministry of Education (MOE) required universities to offer 5-10% of their course units in English, particularly in the fields of information technology, biotechnology, finance and law (Jen, 2001; MOE, 2001). However, “the upgrading of national English proficiency, then, is predicted largely on the professional competence of the teaching force” (Hu, 2005b, p. 655). For TEFL academics, one component of this competence is the capacity to conduct research (Day, 1991; Shu, 2002). Indeed, research productivity has become essential for university success, and academics’ employment and promotional prospects. This study aims to investigate 182 Chinese TEFL academics’ research outputs across three Chinese higher education institutions through the research question: What are the research productivity levels of Chinese TEFL academics? A survey instrument was devised to gather TEFL academics’ calculations of research productivity and, in particular, the quality and quantity of research outputs over a five-year period (2004-2008). Descriptive statistics through SPSS were used to analyse data across research output fields (e.g., journal articles, conference papers). Academic status varied (n=182; teaching assistants 23.6%, lecturers 47.3%, associate professors 22.5%, and professors 6.6%) as did years of teaching (1-5 years 27.4%, 6-10 years 24.7%, 11-15 18.1%, 16-20 years 13.7%, > 21 years 15.9%). Results (n=182, male=27%, females=73%) indicated 18% had not produced any research in the five-year period. Indeed, more than 70% had produced no research in all categories except non-core journal articles and provincial projects. An overwhelming majority of TEFL academics had zero productivity in 10 of the 12 categories. Nevertheless, there were highly-productive TEFL academics, who had produced five or more pieces of research across the 12 categories. In addition, there was not much difference between sole and co-authored research outputs, except non-core journal articles where sole authored work was 20% higher than co-authored work. China’s desire for international competitiveness in education will require measures that facilitate higher levels of research productivity. These measures must include professional development, support and mentoring programs, and employment of personnel who can guide these processes. Research performance is an outcome, hence there is a need to understand Chinese TEFL academics’ perceptions about research, and experiences that may hinder and facilitate higher research productivity.

Senior management teams in schools : understanding their dynamics, enhancing their effectiveness

Increasingly it has been argued that senior management teams (SMTs), comprising principals, deputy heads and other personnel, play a critical role in the governance of schools. In recent years, many researchers have drawn upon the tools of micropolitics to illuminate the relationships, dynamics and power plays between and amongst members of SMTs. The paper has two foci. Firstly, it overviews some of the seminal literature in the field of SMTs and micropolitics in an attempt to identify the working practices of and challenges facing members of SMTs. Secondly, it discusses an instrument, the TEAM Development Questionnaire, that emerged from a synthesis of this writing and research. The questionnaire presented here was especially devised to use with members of SMTs to help them (i) identify the dynamics amongst team members; and (ii) identify areas for the team to improve. A set of procedures for implementing the TEAM Development Questionnaire is provided to demonstrate its application to the field.

Dancing between diversity and consistency : refining assessment in postgraduate degrees in dance

This publication is the culmination of a 2 year Australian Learning and Teaching Council's Project Priority Programs Research Grant which investigates key issues and challenges in developing flexible guidelines lines for best practice in Australian Doctoral and Masters by Research Examination, encompassing the two modes of investigation, written and multi-modal (practice-led/based) theses, their distinctiveness and their potential interplay. The aims of the project were to address issues of assessment legitimacy raised by the entry of practice-orientated dance studies into Australian higher degrees; examine literal embodiment and presence, as opposed to cultural studies about states of embodiment; foreground the validity of questions around subjectivity and corporeal intelligence/s and the reliability of artistic/aesthetic communications, and finally to celebrate ‘performance mastery’(Melrose 2003) as a rigorous and legitimate mode of higher research. The project began with questions which centred around: the functions of higher degree dance research; concepts of 'master-ness’ and ‘doctorateness’; the kinds of languages, structures and processes which may guide candidates, supervisors, examiners and research personnel; the purpose of evaluation/examination; addressing positive and negative attributes of examination. Finally the study examined ways in which academic/professional, writing/dancing, tradition/creation and diversity/consistency relationships might be fostered to embrace change. Over two years, the authors undertook a qualitative national study encompassing a triangulation of semi-structured face to face interviews and industry forums to gather views from the profession, together with an analysis of existing guidelines, and recent literature in the field. The most significant primary data emerged from 74 qualitative interviews with supervisors, examiners, research deans and administrators, and candidates in dance and more broadly across the creative arts. Qualitative data gathered from the two primary sources, was coded and analysed using the NVivo software program. Further perspectives were drawn from international consultant and dance researcher Susan Melrose, as well as publications in the field, and initial feedback from a draft document circulated at the World Dance Alliance Global Summit in July 2008 in Brisbane. Refinement of data occurred in a continual sifting process until the final publication was produced. This process resulted in a set of guidelines in the form of a complex dynamic system for both product and process oriented outcomes of multi-modal theses, along with short position papers on issues which arose from the research such as contested definitions, embodiment and ephemerality, ‘liveness’ in performance research higher degrees, dissolving theory/practice binaries, the relationship between academe and industry, documenting practices and a re-consideration of the viva voce.

Maintaining centralised application systems : a cross-country, cross-sector, cross-platform comparison

Past studies of software maintenance issues have largely concentrated on the average North American firm. While they have made a substantial contribution to good information system management practice, it is believed that further segmentation of sample data and cross-country comparisons will help to identify patterns of behaviour more akin to many less average organizations in North America and elsewhere. This paper compares the Singapore maintenance scene with the reported North American experience. Comparisons are also made between: Government organizations, Singapore corporations and multinational corporations (MNCs); mainframe and minicomputer installations; and fourth-generation language (4GL) and non-4GL computer installations. Study findings, while in many cases were similar to earlier US studies, do show the importance of Singapore's young application portfolio, the widespread usage of 4GLs and the severe maintenance personnel problems.

Achieving effective supervision

Supervision probably does have benefits both for the maintenance and improvement of clinical skills and for job satisfaction, but the data are very thin and almost non-existent in the area of alcohol and other drugs ser vices. Because of the potential complexity of objectives and roles in super vision, a structured agreement appears to be an important part of the effective supervision relationship. Because sessions can degenerate easily into unstructured socialization, agendas and session objectives may also be important. While a working alliance based on mutual respect and trust is an essential base for the supervision relationship, procedures for direct observation of clinical skills, demonstration of new procedures and skills practice with detailed feedback appear critical to super vision’s impact on practice. To ensure effective supervision, there needs not only to be a minimum of personnel and resources, but also a compatibility with the values and procedures of management and staff, access to supervision training and consultation and sufficient incentives to ensure it continues.

Exploring the impact of context-specific job stressors on employee work outcomes

A path model was developed to examine the impact of context-specific job stressors on the work outcomes of 132 customer service employees. Respondents who reported a moderate and high level of context-specific stressors report a higher level of job demand and work family conflict. Respondents who reported a higher level of job control tend to receive more work-related support and are more satisfied with their job. Surprisingly, respondents who experienced a higher level of work family conflict tend to receive less work-related support. We found that respondents who obtained more work-related support tend to report a higher level of job satisfaction. There was also a positive relationship between positive job satisfaction and a lower level of intention to quit.

Identification of barriers to and facilitators for the implementation of occupational road safety initiatives

To explore potential barriers to and facilitators for implementing occupational road safety initiatives, in-depth interviews were conducted with personnel from four major Australian organizations. Twenty-four participants were involved in the interviews comprising 16 front line employees and eight managers. The interviews identified that employees perceived six organizational characteristics as potential barriers to implementing occupational road safety initiatives. These included: prioritisation of production over safety; complacency towards occupational road risks; insufficient resources; diversity; limited employee input in safety decisions; and a perception that road safety initiatives were an unnecessary burden. Of these organizational characteristics, prioritisation of production over safety and complacency were the most frequently cited barriers. In regards to facilitators, participants perceived three organizational characteristics as potential facilitators to implementing occupational road safety initiatives. These included: management commitment; the presence of existing systems that could support the implementation of initiatives; and supportive relationships. Of these organizational characteristics, management commitment was the most frequently cited facilitator.

Managing hostile environments : journalists and media workers : learning to survive the world's difficult, remote and hostile environments

The aim of this research is to examine the changing nature of risks that face journalists and media workers in the world's difficult, remote and hostile environments, and consider the 'adequacy' of managing hostile environment safety courses that some media organizations require prior to foreign assignments. The study utilizes several creative works and contributions to this area of analysis, which includes a documentary film production, course contributions, an emergency reference handbook, security and incident management reviews and a template for evacuation and contingency planning. The research acknowledges that employers have a 'duty of care' to personnel working in these environments, identifies the necessity for pre-deployment training and support, and provides a solution for organizations that wish to initiate a comprehensive framework to advise, monitor, protect and respond to incidents. Finally, it explores the possible development of a unique and holistic service to facilitate proactive and responsive support, in the form of a new profession of 'Editorial Logistics Officer' or 'Editorial Safety Officer' within media organizations. This area of research is vitally important to the profession, and the intended contribution is to introduce a simple and cost-efficient framework for media organizations that desire to implement pre-deployment training and field-support – as these programs save lives. The complete proactive and responsive services may be several years from implementation. However, this study demonstrates that the facilitation of Managing Hostile Environment (MHE) courses should be the minimum professional standard. These courses have saved lives in the past and they provide journalists with the tools to "cover the story, and not become the story."

A practical approach for reliability prediction of pipeline systems

Pipelines play an important role in the modern society. Failures of pipelines can have great impacts on economy, environment and community. Preventive maintenance (PM) is often conducted to improve the reliability of pipelines. Modern asset management practice requires accurate predictability of the reliability of pipelines with multiple PM actions, especially when these PM actions involve imperfect repairs. To address this issue, a split system approach (SSA) based model is developed in this paper through an industrial case study. This new model enables maintenance personnel to predict the reliability of pipelines with different PM strategies and hence effectively assists them in making optimal PM decisions.

A summary view of government cost recovery policies in Australia and New Zealand relating to the supply of public sector information

Researching administrative history is problematical. A trail of authoritative documents is often hard to find; and useful summaries can be difficult to organise, especially if source material is in paper formats in geographically dispersed locations. In the absence of documents, the reasons for particular decisions and the rationale underpinning particular policies can be confounded as key personnel advance in their professions and retire. The rationale for past decisions may be lost for practical purposes; and if an organisation’s memory of events is diminished, its learning through experience is also diminished. Publishing this document tries to avoid unnecessary duplication of effort by other researchers that need to venture into how policies of charging for public sector information have been justified. The author compiled this work within a somewhat limited time period and the work does not pretend to be a complete or comprehensive analysis of the issues.----- A significant part of the role of government is to provide a framework of legally-enforceable rights and obligations that can support individuals and non-government organisations in their lawful activities. Accordingly, claims that governments should be more ‘business-like’ need careful scrutiny. A significant supply of goods and services occurs as non-market activity where neither benefits nor costs are quantified within conventional accounting systems or in terms of money. Where a government decides to provide information as a service; and information from land registries is archetypical, the transactions occur as a political decision made under a direct or a clearly delegated authority of a parliament with the requisite constitutional powers. This is not a market transaction and the language of the market confuses attempts to describe a number of aspects of how governments allocate resources.----- Cost recovery can be construed as an aspect of taxation that is a sole prerogative of a parliament. The issues are fundamental to political constitutions; but they become more complicated where states cede some taxing powers to a central government as part of a federal system. Nor should the absence of markets be construed necessarily as ‘market failure’ or even ‘government failure’. The absence is often attributable to particular technical, economic and political constraints that preclude the operation of markets. Arguably, greater care is needed in distinguishing between the polity and markets in raising revenues and allocating resources; and that needs to start by removing unhelpful references to ‘business’ in the context of government decision-making.

Air evacuation in war : the role of RAAF nurses undertaking air evacuation of casualties between 1943-1953

Air transportation of Australian casualties in World War II was initially carried out in air ambulances with an accompanying male medical orderly. By late 1943 with the war effort concentrated in the Pacific, Allied military authorities realised that air transport was needed to move the increasing numbers of casualties over longer distances. The Royal Australian Air Force (RAAF) became responsible for air evacuation of Australian casualties and established a formal medical air evacuation system with trained flight teams early in 1944. Specialised Medical Air Evacuation Transport Units (MAETUs) were established whose sole responsibility was undertaking air evacuations of Australian casualties from the forward operational areas back to definitive medical care. Flight teams consisting of a RAAF nursing sister (registered nurse) and a medical orderly carried out the escort duties. These personnel had been specially trained in Australia for their role. Post-WWII, the RAAF Nursing Service was demobilised with a limited number of nurses being retained for the Interim Air Force. Subsequently, those nurses were offered commissions in the Permanent Air Force. Some of the nurses who remained were air evacuation trained and carried out air evacuations both in Australia and as part of the British Commonwealth Occupation Force in Japan. With the outbreak of the Korean War in June 1950, Australia became responsible for the air evacuation of British Commonwealth casualties from Korea to Japan. With a re-organisation of the Australian forces as part of the British Commonwealth forces, RAAF nurses were posted to undertake air evacuation from Korea and back to Australia from Iwakuni, Japan. By 1952, a specialised casualty staging section was established in Seoul and staffed by RAAF nurses from Iwakuni on a rotation basis. The development of the Australian air evacuation system and the role of the flight nurses are not well documented for the period 1943-1953. The aims of this research are three fold and include documenting the origins and development of the air evacuation system from 1943-1953; analysing and documenting the RAAF nurse’s role and exploring whether any influences or lessons remain valid today. A traditional historical methodology of narrative and then analysis was used to inform the flight nurse’s role within the totality of the social system. Evidence was based on primary data sources mainly held in Defence files, the Australian War Memorial or the National Archives of Australia. Interviews with 12 ex-RAAF nurses from both WWII and the Korean War were conducted to provide information where there were gaps in the primary data and to enable exploration of the flight nurses’ role and their contributions in war of the air evacuation of casualties. Finally, this thesis highlights two lessons that remain valid today. The first is that interoperability of air evacuation systems with other nations is a force multiplier when resources are scarce or limited. Second, the pre-flight assessment of patients was essential and ensured that there were no deaths in-flight.

Sir Neville Howse (VC), Private John Simpson Kirkpatrick and Private Martin O’Meara (VC) and their contributions to Australian military medicine

Medical personnel serving with the Defence Forces have contributed to the evolution of trauma treatment and the advancement of prehospital care within the military environment. This paper investigates the stories of an Australian Medical Officer, Sir Neville Howse, and two stretcher bearers, Private John Simpson (Kirkpatrick) and Private Martin O’Meara, In particular it describes the gruelling conditions under which they performed their roles, and reflects on the legacy that they have left behind in Australian society. While it is widely acknowledged that conflicts such as World War One should never have happened, as civilian and defence force paramedics, we should never forget the service and sacrifice of defence force medical personnel and their contribution to the body of knowledge on the treatment of trauma. These men and women bravely provided emergency care in the most harrowing conditions possible. However, men like Martin O’Meara may not have been given the same status in society today as Sir Neville Howse or Simpson and his donkey, due to the public’s lack of awareness and acceptance of war neurosis and conditions such as post traumatic stress disorder, reactive psychosis and somatoform disorders which were suffered by many soldiers during their wartime service and on their return home after fighting in war.

Testing a tri-partite contingent model of engineering cultures : a pilot study

For some time there has been a growing awareness of organizational culture and its impact on the functioning of engineering and maintenance departments. Those wishing to implement contemporary maintenance regimes (e.g. condition based maintenance) are often encouraged to develop “appropriate cultures” to support a new method’s introduction. Unfortunately these same publications often fail to specifically articulate the cultural values required to support those efforts. In the broader literature, only a limited number of case examples document the cultural values held by engineering asset intensive firms and how they contribute to their success (or failure). Consequently a gap exists in our knowledge of what engineering cultures currently might look like, or what might constitute a best practice engineering asset culture. The findings of a pilot study investigating the perceived ideal characteristics of engineering asset cultures are reported. Engineering managers, consultants and academics (n=47), were surveyed as to what they saw were essential attributes of both engineering cultures and engineering asset personnel. Valued cultural elements included those orientated around continuous improvement, safety and quality. Valued individual attributes included openness to change, interpersonal skills and conscientiousness. The paper concludes with a discussion regarding the development of a best practice cultural framework for practitioners and engineering managers.

Where have all the workers gone? Exploring public sector workforce planning

Governments undertake extensive planning of many services and functions, but tend to neglect planning of public service workforces. Disruptions to public service delivery, such as shortages of nurses and doctors, have rejuvenated interest in workforce planning, but many organisations struggle to do it effectively. This historical study examines the capacity of central personnel agencies to predict workforce risks and support workforce planning, using a study of the Queensland public service. It identifies lack of workforce data as a barrier to effective workforce planning, as a result of factors such as changes in the direction of the central personnel agency, lack of appreciation for the value of comprehensive central workforce data, and limited agency human resource (HR) skills or capacity.