873 resultados para Needs Assessment Program Development
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BACKGROUND: In this study, we aimed at assessing Inflammatory Bowel Disease patients' needs and current nursing practice to investigate to what extent consensus statements (European Crohn's and Colitis Organization) on the nursing roles in caring for patients with IBD concur with local practice. METHODS: We used a mixed-method convergent design to combine quantitative data prospectively collected in the Swiss IBD cohort study and qualitative data from structured interviews with IBD healthcare experts. Symptoms, quality of life, and anxiety and depression scores were retrieved from physician charts and patient self-reported questionnaires. Descriptive analyses were performed based on quantitative and qualitative data. RESULTS: 230 patients of a single center were included, 60% of patients were males, and median age was 40 (range 18-85). The prevalence of abdominal pain was 42%. Self-reported data were obtained from 75 out of 230 patients. General health was perceived significantly lower compared with the general population (p < 0.001). Prevalence of tiredness was 73%; sleep problems, 78%; issues related to work, 20%; sexual constraints, 35%; diarrhea, 67%; being afraid of not finding a bathroom, 42%; depression, 11%; and anxiety symptoms, 23%. According to experts' interviews, the consensus statements are found mostly relevant with many recommendations that are not yet realized in clinical practice. CONCLUSION: Identified prevalence may help clinicians in detecting patients at risk and improve patient management. 2015 S. Karger AG, Basel.
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The goal of the present study is to examine cross-sectional information on the growth of the humerus based on the analysis of four measurements, namely, diaphyseal length, transversal diameter of the proximal (metaphyseal) end of the shaft, epicondylar breadth and vertical diameter of the head. This analysis was performed in 181 individuals (90 and 91 ) ranging from birth to 25 years of age and belonging to three documented Western European skeletal collections (Coimbra, Lisbon and St. Bride). After testing the homogeneity of the sample, the existence of sexual differences (Student"s t- and Mann-Whitney U-test) and the growth of the variables (polynomial regression) were evaluated. The results showed the presence of sexual differences in epicondylar breadth above 20 years of age and vertical diameter of the head from 15 years of age, thus indicating that these two variables may be of use in determining sex from that age onward. The growth pattern of the variables showed a continuous increase and followed first- and second-degree polynomials. However, growth of the transversal diameter of the proximal end of the shaft followed a fourth-degree polynomial. Strong correlation coefficients were identified between humeral size and age for each of the four metric variables. These results indicate that any of the humeral measurements studied herein is likely to serve as a useful means of estimating sub-adult age in forensic samples.
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Kansainvlisen kaupan kiristyess yrityksien kyky tytt asiakasketjunsa lailliset, sosiaaliset ja toiminnalliset asiakastarpeet tulee punnituksi. Globaalisuuden lisntyess asiakasketju voi sislt toimintoja samanaikaisesti yli sadassa maassa. Jotta asiakasketjun tarpeet voidaan sisllytt tuotteeseen tehokkaasti yh useammat yritykset ovat siirtyneet kyttmn Quality Function Deployment nimist projektijohto- ja laatutykalua. Quality Function Deployment tykalu auttaa yrityst muuntamaan sisisten ja ulkoisten asiakkaittensa tarpeet, tuotefunktioiksi ja tuotespesifikaatioiksi. Nin tehdess voidaan uuden tuotteen kehitysaikaa ja hintaa alentaa merkittvsti suunnittelmalla tuote alunalkaen paremmin. QFD:t on kytetty useissa yrityksiss Aasiassa, Pohjois-Amerikassa ja Euroopassa, sen kehittmisen jlkeen Japanissa 1960 luvulla. Tm diplomity antaa teoreettisen ja kytnnn kuvauksen siit miten QFD:t kannatta kytt ja mit sen avulla voidaan saavuttaa vastaten kysymykseen "miten min, ja yritykseni hytyy jos kytn QFD:t".
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Diplomity on tehty Lappeenrannan teknillisen korkeakoulun tuotantotalouden osastolla. Ty on osa Asiakastarpeiden kustannus- ja aikatehokas selvittminen kansainvlisilt markkinoilta (Kannasta) -projektia. Tyn tarkoituksena oli tutkia Interneti asiakastarvekartoituksessa. Tyn tavoitteena oli kar-toittaa Internetin avulla kytettvi asiakastarvetiedon lhteit tuotekehitykselle ja esitell Internetin avulla tapahtuvan asiakastarvetiedon keryksen toimintatapa sek tiedon keryksen apuvlineet. Internetin avulla voidaan yrityksen liiketoimintaympristst kert asiakastarvetietoja. Tietojen kerys voidaan tehd kirjoituspyttutkimuksena tai kvantitatiivis-kvalitatiivisena tutkimuksena. Internetin avulla tehtvss kirjoituspyttutkimuksessa tietoa asiakkaista, asiakkaiden tarpeista ja kilpailijoista voidaan kert World Wide Web -sivuilta tai tietopankeista. Kvantitatiivis-kvalitatiivisessa tutkimuksessa tietoja asiakkaiden tarpeista ja vaatimuksista kertn Internet-tykaluilla yrityksen asiakkailta ja muilta sen sidosryhmilt. Tyss on esitelty kolme eri asiakastarvekartoituksen Internet-tykalua. Internetin avulla saadaan parannettua yrityksen ja sen asiakkaiden vlist viestint sek tehostettua asiakastarvetiedon keryst.
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Diplomityn tavoitteena oli arvioida uutta sellu-, paperi- ja kartonkiteollisuuden Paper Profile -ympristtuoteselostetta. Paper Profilen tarkoituksena on tarjota paperiteollisuuden asiakkaille ja muille kiinnostuneilla sidosryhmille yhtenist ympristinformaatiota koskien paperituotteiden koostumusta ja tuotteiden trkeimpi ympristparametrej. Tyn trkein tavoite oli arvioida kriittisesti Paper Profilea ja verrata konseptia ISO:n, Kansainvlisen stardardisoimisliiton tuoteselosteeseen sek lyt konseptien yhtlisyydet ja erot. Trkein tehtv oli tunnistaa ne avaintekijt, joiden avulla Paper Profile -tuoteselostetta voitaisiin pit yhtenevn ISO/TR 14025 teknisen raportin kanssa. Lisksi Paper Profile -tuoteselosteen mahdolliset kehittmistarpeet arvioitiin ISO-tuoteselosteen nkkulmasta. Tyn toinen tavoite oli kert ja analysoida uuteen tuoteselosteeseen liittyv asiakaspalaute ja verrata sit Stora Enson tehtaiden ympristpllikiden antamiin Paper Profilea koskeviin kommentteihin. Tyn tuloksena huomattiin, ett Paper Profile -konsepti sellaisenaan ei ole kovin informatiivinen vaan tuoteseloste jtt monia ympristkysymyksi avoimeksi. Siit huolimatta Paper Profile tarjoaa riittvn taustan eri paperituotteiden ympristkuormitusten keskiniselle vertailuille. Konseptin viestinnllinen nkkulma paranisi huomattavasti, jos tuoteselosteeseen listtisiin kolmannen osapuolen verifiointi. Lisksi referenssiarvot kertoisivat asiakkaille paremmin esitettyjen parametrien taustoista. Stora Enson tehtaiden ympristpllikiden, samoin kuin asiakkaidenkin mielest Paper Profile on yleisesti ottaen potentiaalinen ympristviestinnn tykalu, mutta silti konseptiin ehdotettiin joitakin pieni muutoksia. Avoinna olevat metssertifiointikysymykset ja niiden puutteellinen tiedottaminen tuoteselosteessa puhututtivat sek tehtaiden henkilst ett yritysasiakkaita.
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Atherosclerosis is a chronic cardiovascular disease that involves the thickening of the artery walls as well as the formation of plaques (lesions) causing the narrowing of the lumens, in vessels such as the aorta, the coronary and the carotid arteries. Magnetic resonance imaging (MRI) is a promising modality for the assessment of atherosclerosis, as it is a non-invasive and patient-friendly procedure that does not use ionizing radiation. MRI offers high soft tissue contrast already without the need of intravenous contrast media; while modification of the MR pulse sequences allows for further adjustment of the contrast for specific diagnostic needs. As such, MRI can create angiographic images of the vessel lumens to assess stenoses at the late stage of the disease, as well as blood flow-suppressed images for the early investigation of the vessel wall and the characterization of the atherosclerotic plaques. However, despite the great technical progress that occurred over the past two decades, MRI is intrinsically a low sensitive technique and some limitations still exist in terms of accuracy and performance. A major challenge for coronary artery imaging is respiratory motion. State- of-the-art diaphragmatic navigators rely on an indirect measure of motion, perform a ID correction, and have long and unpredictable scan time. In response, self-navigation (SM) strategies have recently been introduced that offer 100% scan efficiency and increased ease of use. SN detects respiratory motion directly from the image data obtained at the level of the heart, and retrospectively corrects the same data before final image reconstruction. Thus, SN holds po-tential for multi-dimensional motion compensation. To this regard, this thesis presents novel SN methods that estimate 2D and 3D motion parameters from aliased sub-images that are obtained from the same raw data composing the final image. Combination of all corrected sub-images produces a final image with reduced motion artifacts for the visualization of the coronaries. The first study (section 2.2, 2D Self-Navigation with Compressed Sensing) consists of a method for 2D translational motion compensation. Here, the use of com- pressed sensing (CS) reconstruction is proposed and investigated to support motion detection by reducing aliasing artifacts. In healthy human subjects, CS demonstrated an improvement in motion detection accuracy with simulations on in vivo data, while improved coronary artery visualization was demonstrated on in vivo free-breathing acquisitions. However, the motion of the heart induced by respiration has been shown to occur in three dimensions and to be more complex than a simple translation. Therefore, the second study (section 2.3,3D Self-Navigation) consists of a method for 3D affine motion correction rather than 2D only. Here, different techniques were adopted to reduce background signal contribution in respiratory motion tracking, as this can be adversely affected by the static tissue that surrounds the heart. The proposed method demonstrated to improve conspicuity and visualization of coronary arteries in healthy and cardiovascular disease patient cohorts in comparison to a conventional ID SN method. In the third study (section 2.4, 3D Self-Navigation with Compressed Sensing), the same tracking methods were used to obtain sub-images sorted according to the respiratory position. Then, instead of motion correction, a compressed sensing reconstruction was performed on all sorted sub-image data. This process exploits the consistency of the sorted data to reduce aliasing artifacts such that the sub-image corresponding to the end-expiratory phase can directly be used to visualize the coronaries. In a healthy volunteer cohort, this strategy improved conspicuity and visualization of the coronary arteries when compared to a conventional ID SN method. For the visualization of the vessel wall and atherosclerotic plaques, the state- of-the-art dual inversion recovery (DIR) technique is able to suppress the signal coming from flowing blood and provide positive wall-lumen contrast. However, optimal contrast may be difficult to obtain and is subject to RR variability. Furthermore, DIR imaging is time-inefficient and multislice acquisitions may lead to prolonged scanning times. In response and as a fourth study of this thesis (chapter 3, Vessel Wall MRI of the Carotid Arteries), a phase-sensitive DIR method has been implemented and tested in the carotid arteries of a healthy volunteer cohort. By exploiting the phase information of images acquired after DIR, the proposed phase-sensitive method enhances wall-lumen contrast while widens the window of opportunity for image acquisition. As a result, a 3-fold increase in volumetric coverage is obtained at no extra cost in scanning time, while image quality is improved. In conclusion, this thesis presented novel methods to address some of the main challenges for MRI of atherosclerosis: the suppression of motion and flow artifacts for improved visualization of vessel lumens, walls and plaques. Such methods showed to significantly improve image quality in human healthy subjects, as well as scan efficiency and ease-of-use of MRI. Extensive validation is now warranted in patient populations to ascertain their diagnostic performance. Eventually, these methods may bring the use of atherosclerosis MRI closer to the clinical practice. Rsum L'athrosclrose est une maladie cardiovasculaire chronique qui implique le paississement de la paroi des artres, ainsi que la formation de plaques (lsions) provoquant le rtrcissement des lumires, dans des vaisseaux tels que l'aorte, les coronaires et les artres carotides. L'imagerie par rsonance magntique (IRM) est une modalit prometteuse pour l'valuation de l'athrosclrose, car il s'agit d'une procdure non-invasive et conviviale pour les patients, qui n'utilise pas des rayonnements ionisants. L'IRM offre un contraste des tissus mous trs lev sans avoir besoin de mdias de contraste intraveineux, tandis que la modification des squences d'impulsions de RM permet en outre le rglage du contraste pour des besoins diagnostiques spcifiques. ce titre, l'IRM peut crer des images angiographiques des lumires des vaisseaux pour valuer les stnoses la fin du stade de la maladie, ainsi que des images avec suppression du flux sanguin pour une premire enqute des parois des vaisseaux et une caractrisation des plaques d'athrosclrose. Cependant, malgr les grands progrs techniques qui ont eu lieu au cours des deux dernires dcennies, l'IRM est une technique peu sensible et certaines limitations existent encore en termes de prcision et de performance. Un des principaux dfis pour l'imagerie de l'artre coronaire est le mouvement respiratoire. Les navigateurs diaphragmatiques de pointe comptent sur une mesure indirecte de mouvement, effectuent une correction 1D, et ont un temps d'acquisition long et imprvisible. En rponse, les stratgies d'auto- navigation (self-navigation: SN) ont t introduites rcemment et offrent 100% d'efficacit d'acquisition et une meilleure facilit d'utilisation. Les SN dtectent le mouvement respiratoire directement partir des donnes brutes de l'image obtenue au niveau du coeur, et rtrospectivement corrigent ces mmes donnes avant la reconstruction finale de l'image. Ainsi, les SN dtiennent un potentiel pour une compensation multidimensionnelle du mouvement. A cet gard, cette thse prsente de nouvelles mthodes SN qui estiment les paramtres de mouvement 2D et 3D partir de sous-images qui sont obtenues partir des mmes donnes brutes qui composent l'image finale. La combinaison de toutes les sous-images corriges produit une image finale pour la visualisation des coronaires ou les artefacts du mouvement sont rduits. La premire tude (section 2.2,2D Self-Navigation with Compressed Sensing) traite d'une mthode pour une compensation 2D de mouvement de translation. Ici, on tudie l'utilisation de la reconstruction d'acquisition comprime (compressed sensing: CS) pour soutenir la dtection de mouvement en rduisant les artefacts de sous-chantillonnage. Chez des sujets humains sains, CS a dmontr une amlioration de la prcision de la dtection de mouvement avec des simulations sur des donnes in vivo, tandis que la visualisation de l'artre coronaire sur des acquisitions de respiration libre in vivo a aussi t amliore. Pourtant, le mouvement du coeur induite par la respiration se produit en trois dimensions et il est plus complexe qu'un simple dplacement. Par consquent, la deuxime tude (section 2.3, 3D Self-Navigation) traite d'une mthode de correction du mouvement 3D plutt que 2D uniquement. Ici, diffrentes techniques ont t adoptes pour rduire la contribution du signal du fond dans le suivi de mouvement respiratoire, qui peut tre influenc ngativement par le tissu statique qui entoure le coeur. La mthode propose a dmontr une amlioration, par rapport la procdure classique SN de correction 1D, de la visualisation des artres coronaires dans le groupe de sujets sains et des patients avec maladies cardio-vasculaires. Dans la troisime tude (section 2.4,3D Self-Navigation with Compressed Sensing), les mmes mthodes de suivi ont t utilises pour obtenir des sous-images tries selon la position respiratoire. Au lieu de la correction du mouvement, une reconstruction de CS a t ralise sur toutes les sous-images tries. Cette procdure exploite la cohrence des donnes pour rduire les artefacts de sous- chantillonnage de telle sorte que la sous-image correspondant la phase de fin d'expiration peut directement tre utilise pour visualiser les coronaires. Dans un chantillon de volontaires en bonne sant, cette stratgie a amlior la nettet et la visualisation des artres coronaires par rapport une mthode classique SN ID. Pour la visualisation des parois des vaisseaux et de plaques d'athrosclrose, la technique de pointe avec double rcupration d'inversion (DIR) est capable de supprimer le signal provenant du sang et de fournir un contraste positif entre la paroi et la lumire. Pourtant, il est difficile d'obtenir un contraste optimal car cela est soumis la variabilit du rythme cardiaque. Par ailleurs, l'imagerie DIR est inefficace du point de vue du temps et les acquisitions "mul- tislice" peuvent conduire des temps de scan prolongs. En rponse ce problme et comme quatrime tude de cette thse (chapitre 3, Vessel Wall MRI of the Carotid Arteries), une mthode de DIR phase-sensitive a t implment et test
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Business process improvement is a common approach in increasing the effectiveness of an organization. It can be seen as an effort to increase coordination between units. Process improvement has proved to be challenging, and most management consultation firms facilitate organizations in this kind of initiatives. Cross-functional improvement is one of the main areas for internal consultants as well. However, the needs, challenges and means of cross-functional help have been rarely discussed in the literature. The objective of this thesis is on one hand to present a conceptual and descriptive framework to help understand the challenges of facilitating coordination improvement efforts in cross-functional improvement programs, and on the other hand to develop and test feasible solutions for some facilitation situations. The research questions are: 1. Why and in what kind of situations do organizations need help in developing coordination in cross-functional processes? 2. How can a facilitator help organizations in improving coordination to develop cross-functional processes? The study consists of two parts. The first part is an overview of the dissertation, and the second part comprises six research publications. The theoretical background for the study are the differentiation causing challenges in cross-functional settings, the coordination needed to improve processes, change management principles, methods and tools, and consultation practises. Three of the publications introduce tools for helping in developing prerequisites, planning responsibilities and supporting learning during the cross-functional program. The three other papers present frameworks to help understand and analyse the improvement situation. The main methodological approaches used in this study are design science research, action research and case research. The research data has been collected from ten cases representing different kinds of organizations, processes and developing situations. The data has been collected mainly by observation, semi-structured interviews and questionnaires. The research contributes to the rare literature combining coordination theories and process improvement practises. It also provides additional understanding of a holistic point of view in process improvement situations. The most important contribution is the addition to the theories of facilitating change in process improvement situations. From the managerial point of view, this study gives advice to managers and consultants in planning and executing cross-functional programs. The main factors increasing the need for facilitation are the challenges for differentiation, challenges of organizational change in general, and the novelty of initiatives and improvement practices concerning process development. Organizations need help in creating the prerequisites to change, in planning initiatives, easing conflict management and collaboration between groups, as well as supporting the learning of cross-functional improvement. The main challenges of facilitation are combining the different roles as a consultant, maintaining the ownership for the improvement project with the client, and supporting learning in the client organization.
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AIM: To develop and test the Parental PELICAN Questionnaire, an instrument to retrospectively assess parental experiences and needs during their child's end-of-life care. BACKGROUND: To offer appropriate care for dying children, healthcare professionals need to understand the illness experience from the family perspective. A questionnaire specific to the end-of-life experiences and needs of parents losing a child is needed to evaluate the perceived quality of paediatric end-of-life care. DESIGN: This is an instrument development study applying mixed methods based on recommendations for questionnaire design and validation. METHOD: The Parental PELICAN Questionnaire was developed in four phases between August 2012-March 2014: phase 1: item generation; phase 2: validity testing; phase 3: translation; phase 4: pilot testing. Psychometric properties were assessed after applying the Parental PELICAN Questionnaire in a sample of 224 bereaved parents in April 2014. Validity testing covered the evidence based on tests of content, internal structure and relations to other variables. RESULTS: The Parental PELICAN Questionnaire consists of approximately 90 items in four slightly different versions accounting for particularities of the four diagnostic groups. The questionnaire's items were structured according to six quality domains described in the literature. Evidence of initial validity and reliability could be demonstrated with the involvement of healthcare professionals and bereaved parents. CONCLUSION: The Parental PELICAN Questionnaire holds promise as a measure to assess parental experiences and needs and is applicable to a broad range of paediatric specialties and settings. Future validation is needed to evaluate its suitability in different cultures.
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Objectives: The efficacy of drug-based treatments and psychological interventions on the primary negative symptoms of schizophrenia remains limited. Recent literature has distinguished negative symptoms associated with a diminished capacity to experience, from those associated with a limited capacity for expression. The positive emotions program for schizophrenia (PEPS) is a new method that specifically aims to reduce the syndrome of a diminished capacity to experience. Methods: The intervention's vital ingredients were identified through a literature review of emotion in schizophrenia and positive psychology. The program has been beta-tested on various groups of health-care professionals. Results: A detailed description of the final version of PEPS is presented here. The French version of the program is freely downloadable. Conclusion: PEPS is a specific, short, easy to use, group-based intervention to improve pleasure, and motivation in schizophrenia. It was built considering a recovery-oriented approach to schizophrenia.
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Through indisputable evidence of climate change and its link to the greenhouse gas emissions comes the necessity for change in energy production infrastructure during the coming decades. Through political conventions and restrictions energy industry is pushed toward using bigger share of renewable energy sources as energy supply. In addition to climate change, sustainable energy supply is another major issue for future development plans, but neither of these should come with unbearable price. All the power production types have environmental effects as well as strengths and weaknesses. Although each change comes with a price, right track in minimising the environmental impacts and energy supply security can be found by combining all possible low-carbon technologies and by improving energy efficiency in all sectors, for creating a new power production infrastructure of tolerable energy price and of minor environmental effects. GEMIS-Global Emission Model for Integrated Systems is a life-cycle analysis program which was used in this thesis to make indicative energy models for Finlands future energy supply. Results indicate that the energy supply must comprise both high capacity nuclear power as well as large variation of renewable energy sources for minimization of all environmental effects and keeping energy price reasonable.
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The aim of this Thesis is to study how to manage the front-end of the offering planning process. This includes actual process development and methods to gather and analyze information to achieve the best outcome in customer oriented product offering. Study is carried out in two parts: theoretical part and company related part. Theoretical framework is created introducing different types of approaches to manage product planning processes. Products are seen as platforms and they are broken down to subsystems to show different parts of the development. With the help of the matrix-based approaches product platform related information is gathered and analyzed. In this kind of analysis business/market drivers and cus-tomer/competitor information are connected with product subsystems. This gives possibilities to study product gaps/needs and possible future ideas/scenarios in different customer segments. Company related part consists of offering planning process development in real company environment. Process formation includes documents and tools that guide planning from the information gathering to the prioritization and decision making.
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The front end of innovation is regarded as one of the most important steps in building new software products or services, and the most significant benefits in software development can be achieved through improvements in the front end activities. Problems in the front end phase have an impact on customer dissatisfaction with delivered software, and on the effectiveness of the entire software development process. When these processes are improved, the likelihood of delivering high quality software and business success increases. This thesis highlights the challenges and problems related to the early phases of software development, and provides new methods and tools for improving performance in the front end activities of software development. The theoretical framework of this study comprises two fields of research. The first section belongs to the field of innovation management, and especially to the management of the early phases of the innovation process, i.e. the front end of innovation. The second section of the framework is closely linked to the processes of software engineering, especially to the early phases of the software development process, i.e. the practice of requirements engineering. Thus, this study extends the theoretical knowledge and discloses the differences and similarities in these two fields of research. In addition, this study opens up a new strand for academic discussion by connecting these research directions. Several qualitative business research methodologies have been utilized in the individual publications to solve the research questions. The theoretical and managerial contribution of the study can be divided into three areas: 1) processes and concepts, 2) challenges and development needs, and 3) means and methods for the front end activities of software development. First, the study discloses the difference and similarities between the concepts of the front end of innovation and requirements engineering, and proposes a new framework for managing the front end of the software innovation process, bringing business and innovation perspectives into software development. Furthermore, the study discloses managerial perceptions of the similarities and differences in the concept of the front end of innovation between the software industry and the traditional industrial sector. Second, the study highlights the challenges and development needs in the front end phase of software development, especially challenges in communication, such as linguistic problems, ineffective communication channels, a communication gap between users/customers and software developers, and participation of multiple persons in software development. Third, the study proposes new group methods for improving the front end activities of software development, especially customer need assessment, and the elicitation of software requirements.
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Intensive and critical care nursing is a speciality in its own right and with its own nature within the nursing profession. This speciality poses its own demands for nursing competencies. Intensive and critical care nursing is focused on severely ill patients and their significant others. The patients are comprehensively cared for, constantly monitored and their vital functions are sustained artificially. The main goal is to win time to cure the cause of the patients situation or illness. The purpose of this empirical study was i) to describe and define competence and competence requirements in intensive and critical care nursing, ii) to develop a basic measurement scale for competence assessment in intensive and critical care nursing for graduating nursing students, and iii) to describe and evaluate graduating nursing students basic competence in intensive and critical care nursing by seeking the reference basis of self-evaluated basic competence in intensive and critical care nursing from ICU nurses. However, the main focus of this study was on the outcomes of nursing education in this nursing speciality. The study was carried out in different phases: basic exploration of competence (phase 1 and 2), instrumentation of competence (phase 3) and evaluation of competence (phase 4). Phase 1 (n=130) evaluated graduating nursing students basic biological and physiological knowledge and skills for working in intensive and critical care with Basic Knowledge Assessment Tool version 5 (BKAT-5, Toth 2012). Phase 2 focused on defining competence in intensive and critical care nursing with the help of literature review (n=45 empirical studies) as well as competence requirements in intensive and critical care nursing with the help of experts (n=45 experts) in a Delphi study. In phase 3 the scale Intensive and Critical Care Nursing Competence Scale (ICCN-CS) was developed and tested twice (pilot test 1: n=18 students and n=12 nurses; pilot test 2: n=56 students and n=54 nurses). Finally, in phase 4, graduating nursing students competence was evaluated with ICCN-CS and BKAT version 7 (Toth 2012). In order to develop a valid assessment scale of competence for graduating nursing students and to evaluate and establish the competence of graduating nursing students, empirical data were retrieved at the same time from both graduating nursing students (n=139) and ICU nurses (n=431). Competence can be divided into clinical and general professional competence. It can be defined as a specific knowledge base, skill base, attitude and value base and experience base of nursing and the personal base of an intensive and critical care nurse. Personal base was excluded in this self-evaluation based scale. The ICCN-CS-1 consists of 144 items (6 sum variables). Finally, it became evident that the experience base of competence is not a suitable sum variable in holistic intensive and critical care competence scale for graduating nursing students because of their minor experience in this special nursing area. ICCN-CS-1 is a reliable and tolerably valid scale for use among graduating nursing students and ICU nurses Among students, basic competence of intensive and critical care nursing was self-rated as good by 69%, as excellent by 25% and as moderate by 6%. However, graduating nursing students basic biological and physiological knowledge and skills for working in intensive and critical care were poor. The students rated their clinical and professional competence as good, and their knowledge base and skill base as moderate. They gave slightly higher ratings for their knowledge base than skill base. Differences in basic competence emerged between graduating nursing students and ICU nurses. The students self-ratings of both their basic competence and clinical and professional competence were significantly lower than the nurses ratings. The students self-ratings of their knowledge and skill base were also statistically significantly lower than nurses ratings. However, both groups reported the same attitude and value base, which was excellent. The strongest factor explaining students conception of their competence was their experience of autonomy in nursing. Conclusions: Competence in intensive and critical care nursing is a multidimensional concept. Basic competence in intensive and critical care nursing can be measured with self-evaluation based scale but alongside should be used an objective evaluation method. Graduating nursing students basic competence in intensive and critical care nursing is good but their knowledge and skill base are moderate. Especially the biological and physiological knowledge base is poor. Therefore in future in intensive and critical care nursing education should be focused on both strengthening students biological and physiological knowledge base and on strengthening their overall skill base. Practical implications are presented for nursing education, practice and administration. In future, research should focus on education methods and contents, mentoring of clinical practice and orientation programmes as well as further development of the scale.
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After decades of mergers and acquisitions and successive technology trends such as CRM, ERP and DW, the data in enterprise systems is scattered and inconsistent. Global organizations face the challenge of addressing local uses of shared business entities, such as customer and material, and at the same time have a consistent, unique, and consolidate view of financial indicators. In addition, current enterprise systems do not accommodate the pace of organizational changes and immense efforts are required to maintain data. When it comes to systems integration, ERPs are considered closed and expensive. Data structures are complex and the out-of-the-box integration options offered are not based on industry standards. Therefore expensive and time-consuming projects are undertaken in order to have required data flowing according to business processes needs. Master Data Management (MDM) emerges as one discipline focused on ensuring long-term data consistency. Presented as a technology-enabled business discipline, it emphasizes business process and governance to model and maintain the data related to key business entities. There are immense technical and organizational challenges to accomplish the single version of the truth MDM mantra. Adding one central repository of master data might prove unfeasible in a few scenarios, thus an incremental approach is recommended, starting from areas most critically affected by data issues. This research aims at understanding the current literature on MDM and contrasting it with views from professionals. The data collected from interviews revealed details on the complexities of data structures and data management practices in global organizations, reinforcing the call for more in-depth research on organizational aspects of MDM. The most difficult piece of master data to manage is the local part, the attributes related to the sourcing and storing of materials in one particular warehouse in The Netherlands or a complex set of pricing rules for a subsidiary of a customer in Brazil. From a practical perspective, this research evaluates one MDM solution under development at a Finnish IT solution-provider. By means of applying an existing assessment method, the research attempts at providing the company with one possible tool to evaluate its product from a vendor-agnostics perspective.
