Assessing performance in critical care nursing practice using the Benner Novice to expert model: A pilot study

Background It is often believed that by ensuring the ongoing completion of competency documents and life-long learning in nursing practice guarantees quality patient care. This is probably true in most cases where it provides reassurances that the nursing team is maintaining a safe “generalised” level of practice. However, competency does not always promise quality performance. There are a number of studies that have reported differences in what practitioners know and what they actually do despite being deemed competent. Aim The aim of this study was to assess whether our current competency documentation is fit for purpose and to ascertain whether performance assessment needs to be a key component in determining competence. Method 15 nurses within a General ICU who had been on the unit <4 years agreed to participate in this project. Using participant observation and assessing performance against key indicators of the Benner Novice to Expert5 model the participants were supported and assessed over the course of a ‘normal’ nursing shift. Results The results were surprising both positively and negatively. First, the nurses felt more empowered in their clinical decision making skills; second, it identified individual learning needs and milestones in educational development. There were some key challenges identified which included 5 nurses over estimating their level of competence, practice was still very much focused on task acquisition and skill and surprisingly some nurses still felt dominated by the other health professionals within the unit. Conclusion We found that the capacity and capabilities of our nursing workforce needs continual ongoing support especially if we want to move our staff from capable task-doer to competent performers. Using the key novice to expert indicators identified the way forward for us in how we assess performance and competence in practice particularly where promotion to higher grades is based on existing documentation.

Performance evaluation of a distributed concurrency control algorithm

Concurrency control (CC) algorithms are important in distributed database systems to ensure consistency of the database. A number of such algorithms are available in the literature. The issue of performance evaluation of these algorithms has been recognized to be important. However, only a few studies have been carried out towards this. This paper deals with the performance evaluation of a CC algorithm proposed by Rosenkrantz et al. through a detailed simulation study. In doing so, the algorithm has been modified so that it can, within itself, take care of the redundancy in the database. The influences of various system parameters and the transaction profile on the response time and on the degree of conflict are considered. The entire study has been carried out using the programming language SIMULA on a DEC-1090 system.

Construction, installation, and performance of two repacked weighing lysimeters

Weighing lysimeters are the standard method for directly measuring evapotranspiration (ET). This paper discusses the construction, installation, and performance of two (1.52 m × 1.52 m × 2.13-m deep) repacked weighing lysimeters for measuring ET of corn and soybean in West Central Nebraska. The cost of constructing and installing each lysimeter was approximately US $12,500, which could vary depending on the availability and cost of equipment and labor. The resolution of the lysimeters was 0.0001 mV V-1, which was limited by the data processing and storage resolution of the datalogger. This resolution was equivalent to 0.064 and 0.078 mm of ET for the north and south lysimeters, respectively. Since the percent measurement error decreases with the magnitude of the ET measured, this resolution is adequate for measuring ET for daily and longer periods, but not for shorter time steps. This resolution would result in measurement errors of less than 5% for measuring ET values of ≥3 mm, but the percent error rapidly increases for lower ET values. The resolution of the lysimeters could potentially be improved by choosing a datalogger that could process and store data with a higher resolution than the one used in this study.

Performance of seven hardwood species underplanted to Pinus elliottii in south-east Queensland

Seven hardwood species were tested as underplants under Pinus elliottii plantations on the coastal lowlands of south-east Queensland. The species tested were: Flindersia brayleyana (F. Muell) (Queensland maple), F. australis (R. Br.), (crow's ash), Swietenia macrophylla (King) (American mahogany), Grevillea robusta (A. cunn) (southern silky oak), Elaeocarpus grandis (F. Muell) (silver quandong), F. ifflaiana (F. Meull) (Cairns hickory) and Ceratopetalum apetalum (D. Don) (coachwood). Most species (except E. grandis) established successfully but slowly. Underplants suffered 9-16% mortality during thinning of the overstorey. By 2004 when aged c. 38 years, four underplanted species; F. brayleyana, S. macrophylla, F. ifflaiana and E. grandis, had attained predominant heights of 20 m and mean diameter at breast height of 25 cm or better. The presence of underplants increased total site productivity by up to 23% and did not have any detrimental effect on the development of the overwood.This experiment has demonstrated that some rainforest species will survive and grow healthily as underplants in exotic pine plantations plus produce small merchantable logs within a 38 year rotation. The results also indicated the importance of correct species selection if an underplanting option is to be pursued as some species have been a complete failure (notably G. robusta).

The effect of light on cognitive performance of partially sleep-deprived young drivers

Sleepiness remains a primary cause of road crashes, the major cause of death in young adults. Light is known to produce a direct alerting effect, but little is known about its effects on sleepy drivers. This study aimed to compare the effect of blue-green light and caffeine on young drivers’ cognitive performance after chronic-partial sleep loss.

Business process performance mining with staged process flows

Existing process mining techniques provide summary views of the overall process performance over a period of time, allowing analysts to identify bottlenecks and associated performance issues. However, these tools are not de- signed to help analysts understand how bottlenecks form and dissolve over time nor how the formation and dissolution of bottlenecks – and associated fluctua- tions in demand and capacity – affect the overall process performance. This paper presents an approach to analyze the evolution of process performance via a notion of Staged Process Flow (SPF). An SPF abstracts a business process as a series of queues corresponding to stages. The paper defines a number of stage character- istics and visualizations that collectively allow process performance evolution to be analyzed from multiple perspectives. The approach has been implemented in the ProM process mining framework. The paper demonstrates the advantages of the SPF approach over state-of-the-art process performance mining tools using two real-life event logs publicly available.

Dietary composition manipulation to enhance the performance of juvenile barramundi (Lates calcarifer Bloch) reared in cool water

Barramundi Lates calcarifer reared in cool water (20-22 degrees C) grow slowly and feed is used poorly compared with fish in warm water (28-32 degrees C). Two comparative slaughter growth assays were carried out with juvenile barramundi to see if increasing the digestible energy (DE) and/or the n-3 highly unsaturated fatty acid (n-3 HUFA) content of the feed would improve growth of fish raised in cool water. Increasing the DE content of the feed from 15 to 17 or 19 MJ kg(-1) while maintaining a constant protein to energy ratio in Experiment 1 brought about significant improvements in feed conversion ratio (FCR) (from 2.01 to 1.19) and daily growth coefficient (DGC; from 0.69 to 1.08%/day) for fish at 20 degrees C. For fish at 29 degrees C, improvements, while significant, were of a lesser magnitude: from 1.32 to 0.97 for FCR and from 3.24 to 3.65%/day for DGC. Increasing the absolute amount of dietary n-3 HUFA, expressed as the sum of eicosapentaenoic and docosahexaenoic fatty acids, from 0.5% to 2.0% in Experiment 2 improved DGC linearly and FCR curvilinearly for fish at 29 degrees C whereas at 20 degrees C, DGC was not affected while FCR improved slightly (from 1.83 to 1.68). Feed conversion ratio was optimized with a dietary n-3 HUFA of about 1.5%. Providing barramundi with a feed that is high in DE (viz 19 MJ kg(-1)) and a digestible protein to DE ratio of 22.5 g MJ(-1) is a practical strategy for improving the productivity of barramundi cultured in cool water whereas increasing dietary n-3 HUFA conferred very little additional benefit.

The effect of endophyte on the performance of irrigated perennial ryegrasses in subtropical Australia

The effect of fungal endophyte (Neotyphodium lolii) infection on the performance of perennial ryegrass (Lolium perenne) growing under irrigation in a subtropical environment was investigated. Seed of 4 cultivars, infected with standard (common toxic or wild-type) endophyte or the novel endophyte AR1, or free of endophyte (Nil), was sown in pure swards, which were fertilised with 50 kg N/ha.month. Seasonal and total yield, persistence, and rust susceptibility were assessed over 3 years, along with details of the presence of endophyte and alkaloids in plant shoots. Endophyte occurrence in tillers in both the standard and AR1 treatments was above 95% for Bronsyn and Impact throughout and rose to that level in Samson by the end of the second year. Meridian AR1 only reached 93% while, in the standard treatment, the endophyte had mostly died before sowing. Nil Zendophyte treatments carried an average of ?0.6% infection throughout. Infection of the standard endophyte was associated with increased dry matter (DM) yields in all 3 years compared with no endophyte. AR1 also significantly increased yields in the second and third years. Over the full 3 years, standard and AR1 increased yields by 18% and 11%, respectively. Infection with both endophytes was associated with increased yields in all 4 seasons, the effects increasing in intensity over time. There was 27% better persistence in standard infected plants compared with Nil at the end of the first year, increasing to 198% by the end of the experiment, while for AR1 the improvements were 20 and 134%, respectively. The effect of endophyte on crown rust (Puccinia coronata) infection was inconsistent, with endophyte increasing rust damage on one occasion and reducing it on another. Cultivar differences in rust infection were greater than endophyte effects. Plants infected with the AR1 endophyte had no detectable ergovaline or lolitrem B in leaf, pseudostem, or dead tissue. In standard infected plants, ergovaline and lolitrem B were highest in pseudostem and considerably lower in leaf. Dead tissue had very low or no detectable ergovaline but high lolitrem B concentrations. Peramine concentration was high and at similar levels in leaf and pseudostem, but not detectable in dead material. Concentration was similar in both AR1 and standard infected plants. Endophyte presence appeared to have a similar effect in the subtropics as has been demonstrated in temperate areas, in terms of improving yields and persistence and increasing tolerance of plants to stress factors.