GSTF Digital Library (GSTF-DL): Open Journal Systems (Global Science and Technology Forum)
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Electrocardiographic Alarms in the Acute Care Setting
Full text linkElectrocardiographic [ECG] alarms are used in acute care settings to continuously monitor patients’ cardiac status, and to alert clinicians to potentially life-threatening changes in a patient’s condition. However, the numbers of alarms in the acute care setting have increased exponentially in the past 20 years. This was to ensure patient safety, and to avoid adverse events that could end in litigations [1]. Cardiac alarms represent the second most frequent alarm in the acute care setting at 37% [2]. Although ECG alarms may help save lives, proper alarm management has been problematic and ECG alarms that were designed to enhance patient safety have become a top national safety hazard. Registered Nurses [RNs] must respond to a variety of alarms in acute care settings; however many of these alarms require no action because they may not be triggered by an actual health need. Responding to non-actionable alarms can interrupt nursing workflow, increase the likelihood of clinical errors, and can lead to alarm fatigue and nurse burnout, as well as serious financial consequences for the organizations. This paper discusses problems with ECG alarm management as experienced by RN’s, and provides suggestions to improve alarm management in acute care settings
Health-related quality of life and psychological distress in implantable cardioverter defibrillator patients with and without heart failure
Full text linkHeart failure (HF) is one of the major health concerns worldwide due to high incidence and mortality. HF patients experience high level of psychological distress, particularly anxiety and depression. To increase survival rate, implantable cardioverter defibrillator (ICD) acts as a life-savor to deliver immediate shock to correct life-threatening arrhythmias as HF patients are the high-risk population for sudden cardiac arrest. It was attributed to unpredictable ICD shock. Moreover, some studies reported that ICD can improve health-related quality of life (HRQoL) among HF patients. However, ICD was evidenced to increase anxiety and depression. Psychological distress can also impair HRQoL of ICD patients. Due to different health conditions and health needs, ICD patients with and without HF can perceive different degrees of heightened psychological distress and declined HRQoL. Although the number of HF patients receiving ICD implantation has been increasing, inadequate knowledge is reported about their psychological status and HRQoL. To improve current ICD care to patients with and without HF, this study aimed to compare psychological status (anxiety and depression) and HRQoL and identify the relationships of personal and clinical characteristics with psychological status and HRQoL between ICD patients with and without HF. A total of 139 ICD patients were recruited, including 68 patients with HF. Those with HF perceived relatively higher depression and poorer physical HRQoL. Patients without HF who were married perceived better physical and mental health. Patients with HF who were more dependent have heightened anxiety and depression. The results shed light on the differences from the level of anxiety and depression among ICD patients with and without HF as well as their HRQoL so that ICD care for these two specific ICD patient groups can be directed. Family involvement is more significant for patients with and without HF
E-Mail Overload and Instant Messaging: Different Investigative Dimensions
Full text linkWhile there have been extensive investigations on email overload, the main source of this business and management problem has received less attention so far. There are claims that using Instant Messaging (IM) reduces email overload, however, this has not been validated by academic research findings. This paper investigates how email overload is generated, and why IM is claimed to reduce it. Data collection was through the use of a quantitative mono-method, via an anonymous Survey Monkey online questionnaire. Respondents are members of an international professional body – The International Institute of Risk & Safety Management (IIRSM) – and work in different countries, industries and organizations. A cross-sectional Case Study, with an inductive approach is used. Results provide evidence that email overload is not externally-generated and that using IM does help reduce this internally-generated overload. A potential link between email overload, IM use and industry is observed. This study helps develop a more comprehensive understanding of email overload and contributes unique findings focused on establishing the main source of this universal workplace problem. Claims that IM reduces overload come from marketing material and newspaper articles lacking empirical evidence. This research is the first to establish whether or not these claims are true
Board Scheme Concept: Prospect of Providing Tenure Security Solutions to Squatter Settlements in Jamaica
No full textInadequate supply of affordable housing for persons of lower economic status has plagued many countries. This inadequacy is exacerbated by the expense of tenure legitimization through formal channels. The end result is a constant increase in squatter communities. This paper, through the use of surveys and interviews, explores one concept (Board Scheme Concept) that has been utilized by lower income families in western Jamaica to arrive at de facto legitimate housing solutions. It is then applied to squatting to determine the potential for implementation and a review of similar such tenure security initiatives in alignment with the concept. The results suggest that a burdened formal titling system can be simplified, thereby reducing fear of loss of tenure, by creating a bridge between private and government owned land ownership processes utilizing other simplistic land lease approaches to tenure, which in turn may create the potential for permanent homeownershi
A study of the Causes of Schedule overrun in Indian High-rise construction using Relative Importance Index
No full textConstruction projects across the world are plagued with time and schedule overruns. Schedule overruns are caused due to a wide range of factors associated to site-related issues to the issues related to payment. Although the principal reasons for construction delays are comparable across different locations within a country, several factors pertaining to local industry, socio-economic issues, cultural effects and project characteristics also contribute to construction delays. Through a series of studies performed across the past few decades, it has been seen that the causes and extent of schedule overruns varies across different countries and no universal causes of delay have been identified. On these grounds, it can also be hypothesised that in a country as diverse as India, the causes of delay may vary across different states and regions. This research tries to ascertain the causes of schedule overrun associated to the various construction project locations in India, identified through a questionnaire survey and analysed using statistical methods. The findings of this study suggest that though there are certain similarities in the delay causes, but there is a difference between their relative importances. There are certain unique causes specific to some locations
Nurse Involvement in End of Life Decision Making in the Intensive Care Unit: A Literature Review
Full text linkThis article reviews the evidence related to nurse involvement in the end of life (EOL) decision making in the Intensive Care Unit (ICU). This study was conducted by analyzing 53 scholarly papers which met the inclusion criteria. Data were searched through CINAHL, Science Direct, ProQuest, Wiley Online Library, and PubMed. The keywords used were “ICU Nurseâ€, combined with “end of lifeâ€, “decision making†and “end of life decision makingâ€. The databases of PubMed, ProQuest, CINAHL, Wiley Online, Ovid, and Science Direct were used to search for the relevant articles. The results of the analysis present the definition of end of life decision making, type of end of life decision making, persons involved in end of life decision making in the ICU, process of end of life decision making in the ICU, a nurse’s role in end of life decision making, and factors influencing end of life decision making in the ICU. The results of this study are important to develop an understanding regarding nurse involvement in end of life decision making in the ICU
Longitudinal study on factors affecting assertiveness among preceptors of novice nurses
Full text linkPurpose: This study aims to understand the assertiveness of preceptors of novice nurses and factors affecting the assertiveness through a longitudinal perspective. Methods: Anonymous self-rating questionnaire surveys were administered to 1292 preceptors working in participating city and university hospitals across Japan (August, 2013 (baseline) and March, 2014 (second survey)). The surveys had question items from the Japanese version of the Rathus Assertiveness Schedule (J-RAS, 30 items), demographic details of the participants, evaluation of novice nurses by preceptors, instruction framework, selfevaluation of preceptors, working environment, and a burnout inventory (Japanese version of the Maslach Burnout InventoryHuman Services Survey, 22 items). Bivariate analyses (T-tests and one-way analysis of variance) were conducted using assertiveness of the second survey as the objective variable, and other items of the baseline survey as explanatory variables. Selecting variables with p values smaller than 0.2 obtained in the bivariate analysis as explanatory variables, a multiple linear regression analysis (Stepwise method) was conducted. For the analyses, we used a statistics analysis software, SPSS Statistic 22. Results: Choosing 836 valid respondents of the baseline survey as a cohort group, we repeated the survey 8 months after the baseline survey to identify the factors affecting the assertiveness of preceptors of novice nurses. Excluding 62 who had missing values in the question items for assertiveness, 472 participants who were followed were included in analyses. As the results, following factors were found to affect the assertiveness: thinking that ‘they make rapid decisions’, and that ‘they are valuable as others’. Further, participants who have higher total burnout scores had lower assertiveness. Adjusted coefficient of determination was 0.153. Discussion: It can be inferred that the assertiveness of preceptors is higher than that of novice nurses measured by the J-RAS used in this study, and lower than that of administrative nurses. The assertiveness of preceptors was higher among participants who evaluated themselves positively, thinking that ‘they make rapid decisions’, and that ‘they are valuable as others’. It was also found that higher ‘total burnout scores’ was a factor that lowers the assertiveness. These findings suggest that a positive self-evaluation improves assertiveness and helps to prevent burnou
Public health implications of metals concentrations from prescribed burns: A study adjacent to the Perth metropolitan area.
Full text linkAsh is not a homogenous product. It is the solid residue of combustion and contains a complex mixture of chemical products. The ash residue resulting from fires varies and is dependent on its source, and burn characteristics such as the temperature of the fire. Ash comprises particles of carbon, soot and trace elements. Ash presents public health risk to people and communities, through direct and indirect ingestion and inhalation. The health effects of ash exposure are not limited to symptoms affecting the eyes, throat and lungs. They can contribute to chronic disease and increase the risk of cancer. The purpose of this study was to evaluate the public health implications of controlled burns in the Darling Escarpment, adjacent to Perth’s metropolitan area in Western Australia. Concentrations of metals in unburnt vegetative litter and ash (post burn), stratified by size fraction, were determined to assess the potential mobilisation of metals caused by prescribed burns and the potential public health implications associated with burns. These data can also be used in predictive modelling to ascertain the amount of metals likely to be released per hectare when authorities plan future burns in the area.  Ash samples were collected immediately following the fire to capture fine material before it was blown away. The ash samples were separated into size fractions to investigate whether there are differences within each sub sample. Australia’s National Environmental Protection Measures were used to establish whether the metal concentrations were above designated thresholds for health and environmental investigation, these being the recognised levels above which metals are deemed to pose a risk to public (or environmental) health.  Vegetation and ash samples were collected from three sites immediately after the prescribed burn. Samples were analysed for thirteen (13) metals with nine (9) showing statistically significant increases in concentrations in vegetation as compared to ash. The percentages of metals are higher in ash than in vegetative ground litter. The metals identified are Manganese - Vegetation (158.3 ± 89.3 mg/kg), Ash (442.2 ± 462.6 mg/kg); Barium - Vegetation (19.4 ± 25.3 mg/kg); Ash (41.8 ± 62.7 mg/kg); Zinc - Vegetation (15.3 ± 9.7 mg/kg), Ash (25.6 ± 29.7 mg/kg); Vanadium - Vegetation (31.0 mg/kg ± 76.3 mg/kg), Ash (32.2 mg/kg ± 51.0 mg/kg); Copper - Vegetation (4.2 ± 1.5 mg/kg), Ash (10.9 ± 9.8 mg/kg); Chromium (Total) - Vegetation (8.3 ± 15.6 mg/kg), Ash (9.6 ± 12.4 mg/kg); Lead - Vegetation (6.1 ± 8.3 mg/kg), Ash (12.2 ± 8.5 mg/kg); Nickel - Vegetation (2.2 ± 2.2 mg/kg), Ash (4.7 ± 4.4mg/kg) and Cadmium - Vegetation (0.6 ± 0.9 mg/kg), Ash (0.6 ± 0.9 mg/kg). The ash samples were sieved through three aperture’s (2-4 mm, 1-2 mm, <1 mm) to stratify the samples by size fraction and concentrations in all but three of the metals increased as the ash size decreased.It was demonstrated that the level of metal present within the ash samples did not exceed health investigation levels and, with the exception of Manganese, and did not exceed environmental investigations levels. Metals were unlikely to pose a risk if left insitu. However, modelling estimated the volume of metal released and it was determined that metals can pose a subsequent risk if mobilised by wind or water. The likelihood of such mobilisation is high and this finding therefore has public health implications for surrounding communities that are subjected to increases in their exposure to metals, associated with bushfires.The findings from this study contribute to the management of prescribed burns by providing a better understanding of the composition of ash and the effects of potential distribution via aerial deposition or runoff. Data from this study can be used to do predictive modelling of heavy metal mobilisation that may result from burns of similar vegetation environments. This becomes particularly significant where burns are conducted in water catchment areas Â
SUNDOWNING: EFFECTIVENESS OF TEACHING AMONG NURSING STUDENTS
Full text linkAlzheimer’s disease is a major public health issue that will increasingly affect the health and well-being of the population. Memory disorders will become conventional, and there is an increased need for excellent health care services for the aged population. Developing positive attitudes towards people with Alzheimer’s disease is necessary yet challenging. Nursing care plays crucial role in providing care for geriatric patients at hospital, community and at home because of the effects of aging and multiple co-morbid medical conditions. In general, nursing students spend significant periods of time on clinical placements. Also evidence suggests that the health services in developing countries were not adequately prepared to provide better services for people with Alzheimer’s disease related dementiaObjective. The study evaluated the nursing students’ knowledge toward individuals with Alzheimer’s disease.  Methodology. The research design used for the study was a preexperimental one group pre-test post-test carried out with a randomly selected group of nursing students (N = 120) from Chennai, India. The study used the Alzheimer’s disease Knowledge scale (30 questions). Results. The analysis of the study findings revealed that there is a significant difference in the level of knowledge scores between the master degree and post basic, bachelor degree students. The mean knowledge score was 75.5 ± 8.4 slightly higher compared to the students from post basic and bachelor degree studentsConclusion. The study concluded that the students had inadequate knowledge of Alzheimer’s disease during the pre-test. However, they have some knowledge towards the same patients, giving way to improve their knowledge related to the disease after providing essential knowledge on the same. Thus, there is vital necessity to augment the nursing students study plan with respect to the content of the study and strengthen their knowledge of comprehensive care to individuals with Alzheimer’s disease. Â
Coping Behaviors and Collaboration among Staff of Multiple Occupation Classifications during Norovirus
Full text linkIn December 2012 a norovirus infection outbreak occurred in the Orthopedic Surgery Ward of Hospital A in Japan. This study aims to establish details of coping behaviors used by nurses, physicians, physiotherapists, and pharmacists of the facility, and examine the issues involved in infection control by team collaboration as well as the ways employed to deal with the infections. Participants in this study were thirty-seven medical professionals who were working in the Orthopedic Surgery Ward of Hospital A at the time the infection outbreak occurred, and who were still working there when the interviews were conducted. Interviews were conducted from January to April 2015, and the data from the interviews were analyzed using the “Trend Search 2008†text mining software. As a result of the analysis it was found that the nurses primarily communicated information by passing messages to the nurses who took over the duty at shift changes, but did not pass on the information to staff in other occupations or to the ward as a whole. The nurses clearly remembered that the ward was closed and it was a difficult experience, but did not remember details of the patients they were in charge of. The physicians clearly remembered individual patients they were in charge of, but they were not aware of the situation and state throughout the ward. The findings suggest that this difference is due to the differences in the occupational nature and sense of values of the staff involved. It is also found that physiotherapists did not feel a sense of crisis about the norovirus outbreak because they felt the patients in the ward appeared to be in better condition than patients in other wards, and that pharmacists lacked communication with staff in other occupations because they usually have heavy workloads. In concept mappings of physicians, physiotherapists, and pharmacists, the keyword places in the center of the maps, and is linked to and . Because the nurse plays a central role to report information among the four occupations, nurses should be aware of and assigned to play the role to coordinate team collaboration