969 resultados para nursing process


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Desalination processes to remove dissolved salts from seawater or brackish water includes common industrial scale processes such as reverse osmosis, thermal processes (i.e. multi-stage flash, multiple-effect distillation) and mechanical vapour compression. These processes are very energy intensive. The Institute for Future Environments (IFE) has evaluated various alternative processes to accomplish desalination using renewable or sustainable energy sources. A new process - a solar, thermally driven distillation system . based on the principles of a solar still – has been examined. This work presents an initial evaluation of the process.

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A solar thermal membrane distillation pilot plant was operated for over 70 days in field conditions. The pilot plant incorporated a single spiral wound permeate gap membrane distillation style of module. All energy used to operate the unit was supplied by solar hot water collectors and photovoltaic panels. The process was able to produce a distillate stream of product water with a conductivity less than 10 µS/cm. Feed water concentration varied from 2,400 µS/cm to 106,000 µS/cm. The process is expected to find application in the production of drinking water for remote island and arid regions without the consumption of electrical energy.

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Background: Postoperative nausea and vomiting is one of the most common adverse reactions to surgery and all types of anaesthesia and despite the wide variety of available antiemetic and anti-nausea treatments, 20-30% of all patients still suffer moderate to severe nausea and vomiting following general anaesthesia. While aromatherapy is well-known and is used personally by nurses, it is less well utilised in the healthcare setting. If aromatherapy is to become an accepted adjunct treatment for postoperative nausea and vomiting, it is imperative that there is both an evidence base to support the use of aromatherapy, and a nursing workforce prepared to utilise it. Methods: This involved a Cochrane Systematic Review, a Delphi process to modify an existing tool to assess beliefs about aromatherapy to make it more relevant to nursing and midwifery practice, and a survey to test the modified tool in a population of nurses and midwives. Findings: The systematic review found that aromatherapy with isopropyl alcohol was more effective than placebo for reducing the number of doses of rescue antiemetics required but not more effective than standard antiemetic drugs. The Delphi panel process showed that the original Beliefs About Aromatherapy Scale was not completely relevant to nursing and midwifery practice. The modified Nurses' Beliefs About Aromatherapy Scale was found to be valid and reliable to measure nurses' and midwives' beliefs about aromatherapy. Factor analysis supported the construct validity of the scale by finding two sub-scales measuring beliefs about the 'usefulness of aromatherapy' and the 'scientific basis of aromatherapy'. Survey respondents were found to have generally positive beliefs about aromatherapy, with more strongly positive beliefs on the 'usefulness of aromatherapy' sub-scale. Conclusions: From the evidence of the systematic review, the use of isopropyl alcohol vapour inhalation as an adjunct therapy for postoperative nausea and vomiting is unlikely to be harmful and may reduce nausea for some adult patients. It may provide a useful therapeutic option, particularly when the alternative is no treatment at all. Given the moderately positive beliefs expressed by nurses and midwives particularly about the usefulness of aromatherapy there is potential for this therapy to be implemented and used to improve patient care.

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AR process modelling movie presented at Gartner BPM Summit in Sydney, August, 2011.

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Video presented as part of BPM2011 demonstration(France). In this video we show a prototype BPMN process modelling tool which uses Augmented Reality techniques to increase the sense of immersion when editing a process model. The avatar represents a remotely logged in user, and facilitates greater insight into the editing actions of the collaborator than present 2D web-based approaches in collaborative process modelling. We modified the Second Life client to integrate the ARToolkit in order to support pattern-based AR.

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Video presented as part of APCCM 2010 conference in Brisbane Australia. Video illustrating the main components of an Open Simulator BPMN Editor we have developed.

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Video presented as part of Smart Services CRC Participants meeting. A short demonstration video of our ideas for using Business Process Software in Virtual Worlds for Process Education.

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Situated on Youtube, and shown in various locations. A video showing members of the QUT BPM research group using a Mimio pen-based tabletop system for collaborative process modelling.

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Aim: The movement from a medical model of disability to a more social model implies an imperative to include the views of people with ID in research regarding their care. Contemporary quality processes in improving care require consumer involvement at many levels and in doing so have shown better outcomes. A New Zealand research study is being undertaken utilizing focus groups with people with ID to understand their experiences during a psychiatric inpatient admission. The primary focus of this presentation will concern the literature review, undertaken as part of the study, of research in which people with ID have participated. Method: The literature review was conducted using a variety of electronic databases and search terms to identify studies with people with ID as active participants. Results: Only a few studies have been undertaken with people with ID as participants. While these studies demonstrate numerous benefits in including the voice of the person with ID this still remains absent from much of the research discourse. Conclusion: It is accepted and indeed advocated that people with ID have the same rights as others in regard to choosing whether or not they wish to participate in research. High response rates in the few identified studies indicated that people with ID are eager to be consulted. It is recommended that the unique needs of people with ID be taken into account in the research evidence base for future services.

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Existing compliance management frameworks (CMFs) offer a multitude of compliance management capabilities that makes difficult for enterprises to decide on the suitability of a framework. Making a decision on the suitability requires a deep understanding of the functionalities of a framework. Gaining such an understanding is a difficult task which, in turn, requires specialised tools and methodologies for evaluation. Current compliance research lacks such tools and methodologies for evaluating CMFs. This paper reports a methodological evaluation of existing CMFs based on a pre-defined evaluation criteria. Our evaluation highlights what existing CMFs offer, and what they cannot. Also, it underpins various open questions and discusses the challenges in this direction.

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This research develops a new framework to be used as a tool for analysing and designing walkable communities. The literature review recognises the work of other researchers combining their findings with the theory of activity nodes and considers how a framework may be used on a more global basis. The methodology develops a set of criteria through the analysis of noted successful case studies and this is then tested against an area with very low walking rates in Brisbane, Australia. Results of the study suggest that as well as the accepted criteria of connectivity, accessibility, safety, security, and path quality further criteria in the form or planning hierarchy, activity nodes and climate mitigation could be added to allow the framework to cover a broader context. Of particular note is the development of the nodal approach, which allows simple and effective analysis of existing conditions, and may also prove effective as a tool for planning and design of walkable communities.

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This article describes the architecture of a monitoring component for the YAWL system. The architecture proposed is based on sensors and it is realized as a YAWL service to have perfect integration with the YAWL systems. The architecture proposed is generic and applicable in different contexts of business process monitoring. Finally, it was tested and evaluated in the context of risk monitoring for business processes.

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Background The largest proportion of cancer patients are aged 65 years and over. Increasing age is also associated with nutritional risk and multi-morbidities—factors which complicate the cancer treatment decision-making process in older patients. Objectives To determine whether malnutrition risk and Body Mass Index (BMI) are associated with key oncogeriatric variables as potential predictors of chemotherapy outcomes in geriatric oncology patients with solid tumours. Methods In this longitudinal study, geriatric oncology patients (aged ≥65 years) received a Comprehensive Geriatric Assessment (CGA) for baseline data collection prior to the commencement of chemotherapy treatment. Malnutrition risk was assessed using the Malnutrition Screening Tool (MST) and BMI was calculated using anthropometric data. Nutritional risk was compared with other variables collected as part of standard CGA. Associations were determined by chi-square tests and correlations. Results Over half of the 175 geriatric oncology patients were at risk of malnutrition (53.1%) according to MST. BMI ranged from 15.5–50.9kg/m2, with 35.4% of the cohort overweight when compared to geriatric cutoffs. Malnutrition risk was more prevalent in those who were underweight (70%) although many overweight participants presented as at risk (34%). Malnutrition risk was associated with a diagnosis of colorectal or lung cancer (p=0.001), dependence in activities of daily living (p=0.015) and impaired cognition (p=0.049). Malnutrition risk was positively associated with vulnerability to intensive cancer therapy (rho=0.16, p=0.038). Larger BMI was associated with a greater number of multi-morbidities (rho =.27, p=0.001. Conclusions Malnutrition risk is prevalent among geriatric patients undergoing chemotherapy, is more common in colorectal and lung cancer diagnoses, is associated with impaired functionality and cognition and negatively influences ability to complete planned intensive chemotherapy.

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Background: Malnutrition before and during chemotherapy is associated with poor treatment outcomes. The risk of cancer-related malnutrition is exacerbated by common nutrition impact symptoms during chemotherapy, such as nausea, diarrhoea and mucositis. Aim of presentation: To describe the prevalence of malnutrition/ malnutrition risk in two samples of patients treated in a quaternary-level chemotherapy unit. Research design: Cross sectional survey. Sample 1: Patients ≥ 65 years prior to chemotherapy treatment (n=175). Instrument: Nurse-administered Malnutrition Screening Tool to screen for malnutrition risk and body mass index (BMI). Sample 2: Patients ≥ 18 years receiving chemotherapy (n=121). Instrument: Dietitian-administered Patient Generated Subjective Global Assessment to assess malnutrition, malnutrition risk and BMI. Findings Sample 1: 93/175 (53%) of older patients were at risk of malnutrition prior to chemotherapy. 27 (15%) were underweight (BMI <21.9); 84 (48%) were overweight (BMI >27). Findings Sample 2: 31/121 patients (26%) were malnourished; 12 (10%) had intake-limiting nausea or vomiting; 22 (20%) reported significant weight loss; and 20 (18%) required improved nutritional symptom management during treatment. 13 participants with malnutrition/nutrition impact symptoms (35%) had no dietitian contact; the majority of these participants were overweight. Implications for nursing: Patients with, or at risk of, malnutrition before and during chemotherapy can be overlooked, particularly if they are overweight. Older patients seem particularly at risk. Nurses can easily and quickly identify risk with the regular use of the Malnutrition Screening Tool, and refer patients to expert dietetic support, to ensure optimal treatment outcomes.

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Background There is growing consensus that a multidisciplinary, comprehensive and standardised process for assessing the fitness of older patients for chemotherapy should be undertaken to determine appropriate cancer treatment. Aim This study tested a model of cancer care for the older patient incorporating Comprehensive Geriatric Assessment (CGA), which aimed to ensure that 'fit' individuals amenable to active treatment were accurately identified; 'vulnerable' patients more suitable for modified or supportive regimens were determined; and 'frail 'individuals who would benefit most from palliative regimens were also identified and offered the appropriate level of care. Methods A consecutive-series n=178 sample of patients >65 years was recruited from a major Australian cancer centre. The following instruments were administered by an oncogeriatric nurse prior to treatment: Vulnerable Elders Survey-13; Cumulative Illness Rating Scale (Geriatric); Malnutrition Screening Tool; Mini-mental State Examination; Geriatric Depression Scale; Barthel Index; and Lawton Instrumental Activities of Daily Living Scale. Scores from these instruments were aggregated to predict patient fitness, vulnerability or frailty for chemotherapy. Physicians provided a concurrent (blinded) prediction of patient fitness, vulnerability or frailty based on their clinical assessment. Data were also collected on actual patient outcomes (eg treatment completed as predicted, treatment reduced) during monthly audits of patient trajectories. Data analysis Data analysis is underway. A sample of 178 is adequate to detect, with 90% power, kappa coefficients of agreement between CGA and physician assessments of K>0.90 ("almost perfect agreement"). Primary endpoints comprise a) whether the nurse-led CGA determination of fit, vulnerable or frail agrees with the oncologist's assessments of fit, vulnerable or frail and b) whether the CGA and physician assessments accurately predict actual patient outcomes. Conclusion An oncogeriatric nurse-led model of care is currently being developed from the results. We conclude with a discussion of the pivotal role of nurses in CGA-based models of care.