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.

Leveraging training outcomes on public construction projects

The paper explores the efficacy of public agencies using their contracting relationships with private firms to affect training outcomes in the construction industry. It develops a theoretical perspective on this issue by extending a framework that was originally developed by Hart, Schleifer and Vishny (1997) to study privatisation. This paper shows how their framework can also be applied to situations where the provision of public works is already privatised and the government is attempting to regulate training outcomes via a contracting arrangement. An empirical study of two training policies of the Western Australian government complements this theoretical discussion. We report the results of an analysis of data drawn from the government’s Tender Registration System between 1997 & 2006. As such we use a unique and comprehensive resource to examine the possible effects of new training policies on an important segment of the construction ‘market’.

Enhancing research and development: designing collaborative environments for innovation

Work environments have previously been studied to identify the strategies, structures and processes which increase the likelihood of creativity, innovation and collaboration for productive workplaces. A number of perspectives have emerged which identify social and cognitive factors known to contribute to or to restrict innovation and collaboration. Recently more attention has been given to designing physical environments to encourage processes relevant to innovation such as creativity (McCoy & Evans, 2002) knowledge sharing (Hemlin, Allwood & Martin, 2008) and collaboration (Bozeman & Corley, 2004). Some attention has been given specifically to research and development environments (Boutellier et al, 2008) but little integration of this research has occurred. In the context of the construction of new purpose-built premises which will bring together under one roof separate public sector agencies engaged in research and development in agriculture, natural resource systems and the environment, this paper examines the extant literature and develops initial propositions for research relevant to the transition, collaboration and performance of research and development in new organizational environments where traditional boundaries have been redrawn.

Managing knowledge in an outsourcing environment

What an organisation does versus what it out-sources to the market is a classic boundaries of the firm question that has previously been dominated by efficiency arguments. However, a knowledge-based view suggests these boundaries are integral to the ability of a firm to deploy existing knowledge stocks efficiently, as well as develop new knowledge through learning that will drive future competitiveness. Furthermore, the nature of these boundaries, in respect of their permeability is critical in understanding the likelihood of knowledge flowing into and out of the organisation. Using these concepts, we present a case study of Main Roads Western Australia to illustrate how these principles have allowed it to start rebuilding its internal capabilities through repositioning its operational boundaries and via ensuring their boundaries are highly porous as they move more major projects into alliance contracts.

Procurement selection in the public sector : a tale of two states.

The decision as to which procurement system to adopt is a complex and challenging task for clients of construction projects. Despite a plethora of tools and techniques available for selecting a procurement method, clients are still uncertain about what method to adopt for a given construction project to achieve success. This paper examines ‘how and why’ procurement methods are selected by public sector clients in Queensland (QLD) and Western Australia (WA). Findings from workshops with senior managers in procurement selection revealed that traditional lump sum methods (TLS) are preferred even though alternative forms could be better suited for a given project. Participants of the workshops agreed that alternative procurement forms should be considered for projects but an embedded culture of uncertainty avoidance meant the selection of TLS methods. It was perceived that only a limited number of contractors operating in the marketplace have the resources and experience to deliver projects using the non-traditional methods.

Driving and licensing experiences of learner drivers in two Australian states prior to major changes in the licensing laws

The learner licence is an important component of the graduated driver licensing system. This research describes the driving and licensing experiences of learner drivers in Queensland and New South Wales licensed prior to the changes made to the system in mid-2007. The sample consisted of 392 participants who completed a telephone interview just after they obtained their provisional licence. The results suggest that learner drivers in the two states had many similar experiences when they were obtaining a learner licence. However, once a learner licence was obtained, there were differences in the amount of practice, the supervisor learners practised with, the type of vehicle they used and the amount of unlicensed driving. This paper provides important baseline descriptive data that can be used to measure the impact of the changes that were introduced to the learner licence phase in mid-2007 in both of these states.