Development and testing of an iPad application for teaching self-management to heart failure patients. (Nursing/Allied Health Professional Investigator Award)- Abstract

Purpose: Heart failure (HF) is the leading cause of hospitalization and significant burden to the health care system in Australia. To reduce hospitalizations, multidisciplinary approaches and enhance self-management programs have been strongly advocated for HF patients globally. HF patients who can effectively manage their symptoms and adhere to complex medicine regimes will experience fewer hospitalizations. Research indicates that information technologies (IT) have a significant role in providing support to promote patients' self-management skills. The iPad utilizes user-friendly interfaces and to date an application for HF patient education has not been developed. This project aimed to develop the HF iPad teaching application in the way that would be engaging, interactive and simple to follow and usable for patients' carers and health care workers within both the hospital and community setting. Methods: The design for the development and evaluation of the application consisted of two action research cycles. Each cycle included 3 phases of testing and feedback from three groups comprising IT team, HF experts and patients. All patient education materials of the application were derived from national and international evidence based practice guidelines and patient self-care recommendations. Results: The iPad application has animated anatomy and physiology that simply and clearly teaches the concepts of the normal heart and the heart in failure. Patient Avatars throughout the application can be changed to reflect the sex and culture of the patient. There is voice-over presenting a script developed by the heart failure expert panel. Additional engagement processes included points of interaction throughout the application with touch screen responses and the ability of the patient to enter their weight and this data is secured and transferred to the clinic nurse and/or research data set. The application has been used independently, for instance, at home or using headphones in a clinic waiting room or most commonly to aid a nurse-led HF consultation. Conclusion: This project utilized iPad as an educational tool to standardize HF education from nurses who are not always heart failure specialists. Furthermore, study is currently ongoing to evaluate of the effectiveness of this tool on patient outcomes and to develop several specifically designed cultural adaptations [Hispanic (USA), Aboriginal (Australia), and Maori (New Zealand)].

Do students and lecturers actively use collaboration tools in learning management systems?

In recent years there has been a large emphasis placed on the need to use Learning Management Systems (LMS) in the field of higher education, with many universities mandating their use. An important aspect of these systems is their ability to offer collaboration tools to build a community of learners. This paper reports on a study of the effectiveness of an LMS (Blackboard©) in a higher education setting and whether both lecturers and students voluntarily use collaborative tools for teaching and learning. Interviews were conducted with participants (N=67) from the faculties of Science and Technology, Business, Health and Law. Results from this study indicated that participants often use Blackboard© as an online repository of learning materials and that the collaboration tools of Blackboard© are often not utilised. The study also found that several factors have inhibited the use and uptake of the collaboration tools within Blackboard©. These have included structure and user experience, pedagogical practice, response time and a preference for other tools.

The promotion of sustainability agenda for facilities management through developing knowledge capabilities

The growing awareness of sustainability issues around the world has put extensive pressure on the construction industry to improve its sustainable practice. Sustainability principles need to be applied to not just during design and construction phase but the entire life cycle of a construction project. Compared to sustainability endeavours on earlier development phases, the pace to implement sustainability agenda during the operation and maintenance phase has not been as fast during past practices of facilities management (FM). Literature study suggests that sustainable practices in FM activities can bring substantial benefits such as reducing energy consumptions and waste, while increasing productivity, financial return and standing in the community. It also suggests several barriers which inhibit the implementation of sustainability in FM practices, including the lack of knowledge, discrepancy between capability and skills, and unwillingness of the FM personnel and organizations to adapt to new routines in order to implement sustainability in their business. The capabilities of FM personnel and organizations were regarded as the key enablers in managing sustainability knowledge. In a sustainable development context, capabilities are vital to the fostering of competency in an organization to innovate in a more sustainable way and support the agenda in an organization. Additionally, research which focused on people’s capabilities and skills is still lagging behind the efforts to develop guidelines, technical manuals and knowledge portals. Therefore, it is beneficial to explore the issues of capabilities in dealing with the implementation of sustainable practices in FM. This paper introduces a research project which is aimed at establishing a knowledge capabilities framework for promoting sustainability measures in FM practices. It will explore and highlight challenges to integrate sustainability as well as the personnel and organizational capabilities that are vital in dealing with knowledge issues in implementing sustainability agenda in FM practices. The expected outcome of this research has the potential to further sustainability endeavours in FM practices, while providing a useful source of knowledge to the FM personnel and organizations.

Management of delirium in medicine : experience of a close observation unit

Objective(s): A new model of care for the management of patients with delirium was developed and evaluated. Method: A 4-bedded Close Observation Unit (COU) was introduced. The model comprised an education strategy for assistants in nursing (AIN), environmental adaptations and AIN to patient ratio of 1:4. Outcomes in all patients with delirium before and after introduction of the new model of care were compared. Results: 105 patients were admitted to COU, of whom 100 (95%) were diagnosed with delirium. In-hospital mortality improved after introduction of the unit (15% versus 5%; p=0.002) without significant change in length of stay, discharge destination or falls frequency. Conclusion: A dedicated unit for delirium management within medicine achieved a reduction in mortality.

How fit is your organizational culture for business process management?

While business transformations often primarily focus on technological and methodological solutions, there is consensus that having the right organizational culture is critical for the successful change of business processes.

Application of Resilience concept for enhanced management of water supply systems

This paper presents an approach to developing indicators for expressing resilience of a generic water supply system. The system is contextualised as a meta-system consisting of three subsystems to represent the water catchment and reservoir, treatment plant and the distribution system supplying the end-users. The level of final service delivery to end-users is considered as a surrogate measure of systemic resilience. A set of modelled relationships are used to explore relationships between system components when placed under simulated stress. Conceptual system behaviour of specific types of simulated pressure is created for illustration of parameters for indicator development. The approach is based on the hypothesis that an in-depth knowledge of resilience would enable development of decision support system capability which in turn will contribute towards enhanced management of a water supply system. In contrast to conventional water supply system management approaches, a resilience approach facilitates improvement in system efficiency by emphasising awareness of points-of-intervention where system managers can adjust operational control measures across the meta-system (and within subsystems) rather than expansion of the system in entirety in the form of new infrastructure development.