Dissertations / Theses on the topic 'Safety precautions'

Problem: Nurses are potentially exposed to hazardous drugs (HDs) in their practice. HD exposure is associated with adverse outcomes (reproductive problems, learning disabilities in offspring of nurses exposed during pregnancy, and cancer occurrence). Safe handling precautions (safety equipment and personal protective equipment, [PPE]) minimize exposure to HDs and decrease the potential for adverse outcomes. Despite existing OSHA recommendations, adherence to precautions is below recommendations. The purpose of this study was to examine relationships among factors affecting nurses’ use of HD safe handling precautions, to identify factors that promote or interfere with HD precaution use, and to determine nurse managers’ perspectives on use of safe handling precautions. This study used a conceptual model which proposes that both individual and organizational factors influence precaution use. Methods: A cross-sectional, correlational design was used. Nurses (N = 165; 46% response rate) from oncology centers across the US who reported handling chemotherapy completed a mailed survey. Instruments measured HD precaution use, knowledge, self efficacy, barriers, perceived risk, conflict of interest, interpersonal influences and workplace safety climate. Hierarchical regression was used. Twenty managers of nurses handling chemotherapy were interviewed. Results: Nurses were experienced in oncology (M = 15.8 ± 7.6) yrs, well-educated (62.5% ≥BSN), certified in oncology nursing (85%), worked in outpatient settings (69%), and on average treated 6.8 ± 5.2 patients per day. Chemotherapy exposure knowledge was high (M = 10.9, ± 1, 0-12 scale); as was self efficacy for using PPE (M = 20.8 ± 3, 7-24 scale), and perceived risk (M = 3.14 ± .6, 0-4 scale). Total precaution use during HD administration and disposal was low (M = 1.9, SD = 1.1, 0= never to 5 = 100%). Nurse characteristics did not predict HD precaution use. In the final model (R2 = .29, F (2, 155) = 24.6, p < .000), fewer patients per day, fewer barriers and better workplace safety climate were independent predictors of higher precaution use. Conclusions: Results emphasize the importance of organizational influence on nurses’ HD safe handling precaution use and suggest fostering a positive workplace safety climate and reducing barriers as interventions.

Magister Public Health - MPH
Introduction: The Universal Safety Precautions (USP) are a set of principles including practices and protocols, which is meant to reduce or prevent occupational exposures to blood borne pathogens among health care workers (HCWs), during the course of their duties in health care settings. Globally and in Nigeria, significant number of HCWs are currently being exposed to blood and other body fluids while working in the hospital setting (Amoran, 2013; Samuel et al., 2008; Akinboro et al., 2012; Ajibola et al., 1994; Okechukwu et al., 2012). These exposures contribute annually to about 16,000 HCV infections and 66,000 HBV infections among HCWs worldwide (Prüss-Üstün et al., 2003) and about 1000 cases of HIV per annum in Nigeria since the first recorded case in 1984 (Okechukwu et al., 2012; Patricia et al., 2007). The objectives of the study were to describe the awareness of the USP among HCWs in Kogi State Specialist Hospital (KSSH), Lokoja and to describe the adherence to the USP among HCWs at KSSH. Methods: A descriptive cross-sectional study was conducted among HCWs working in departments where contacts with patients' blood and other body fluids are possible in KSSH. An anonymous self-administered questionnaire was used for data collection. Analysis of the data collected was with Software Package for Social Sciences (SPSS) V23.0.0 for Mac. Results: Of the 125 participants that returned their questionnaires, 37.6% were nurses, 17.6% were doctors and the remainder were laboratory staff, dentists and hospital attendants. Sixty four percent (64%) of them were females, 49.6% had tertiary education while their average age was 38.5 years. Awareness of and adherence to the USP were observed to be 5.6% and 2.4% respectively. Statistically, complete awareness of the USP was not significantly associated with complete adherence to the USP. More so, 3% and 2.2% of the participants with the number of years in services within the ranges of 5-9 years and 1-4 years respectively had complete adherence to the USP. Statistically significant association was only noted between participants' age and complete adherence to the USP. Post-exposure prophylaxis (PEP) and use of personal protective equipment (PPE) were the two USP principles with the lowest levels of awareness and adherence, with 46% and 47.6% on awareness respectively and, 43.8% and 44.6% on adherence respectively. Conclusion: The levels of awareness of and adherence to the USP among the HCWs in KSSH were observed to be very low. There is an urgent need for capacity building of the HCWs on the USP in the form of trainings, and in the long term, there is need to conduct a study to assess possible reasons for the observed outcome.

The aim of the present study was to examine both the individual and organizational level factors contributing to the safety related behaviours of nurses. Effects of the individual level factors on safety behaviour of nurses were analyzed within the theoretical framework of Ajzen&rsquo
s (1991) Theory of Planned Behaviour (TPB) and effects of the organizational level factors were analyzed through safety climate perceptions of the nurses. Data were collected from nurses (N=274) of two different private hospitals located in Ankara and their first line supervisors (N=34).Participants filled out the questionnaires including scales of TPB (i.e., subjective norm, attitude toward the behaviour, perceived behavioural control, and intention), safety climate perceptions and compliance to Standard Safety Precautions. The outcome variable was the compliance to the Standard Safety Precautions as rated by the first line supervisors of the nurses. Subjective norm was found to be the only significant predictor of the nurses&rsquo
intention to adhere to the Standard Safety Precautions. Contrary to the hypothesized relationships, intention and perceived behavioural control did not contribute significantly to the prediction of safety behaviour rated by the first line supervisors. Furthermore, teamwork dimension of safety climate perceptions was found to be the only significant predictor of compliance to the Standard Safety Precautions. The results are discussed with practical implications of the findings.Contributions of the study are presented followed by the limitations and some future research suggestions.

The study by Rehan et al. [1] was evaluated for support of the conclusion was by the data. The deviations from recommended practices were infrequent and not shown to be clinically significant. Although a strong study, the conclusion that world-wide education programs are needed is not warranted.

The purpose of this thesis is to explore if consumers evaluate CSR more into their purchase criterion compared to before the Covid-19 pandemic. CSR activities, consumer buying behavior, and CSR as a purchase criterion were combined in a conceptual framework. The consumer decision-making model was used as a framework in consumer buying behavior. In CSR as a purchase criterion, three factors were used to conclude if consumers started to evaluate CSR more as a purchase criterion. The empirical data was collected through two semi-structured focus groups. Group A was ensembled through a convenience sampling method but evolved to a snowball effect. Group B was ensembled through a purposive sampling method. The findings indicated that consumers did not start to evaluate CSR more as a purchase criterion. The main reason was the financial situation. However, consumers have started to buy more sustainable food, especially locally produced during the pandemic which indicated an increased awareness towards CSR as a purchase criterion. The findings also showed that the Covid-19 pandemic influenced consumers' awareness of CSR but the implemented safety precautions in grocery stores had a limited effect on consumers. The research field of consumer buying behavior in the context of CSR can be complemented with the findings in this study. This study contributed to a deeper understanding of consumer buying behavior and if they value CSR in their purchases during the Covid-19 pandemic.

This research project aims to investigate the level of risk/safety inherent in intermediate floors of buildings designed to the Compliance Document for the New Zealand Building Code, Fire Safety Clauses C1, C2, C3, C4 (C/AS1), and develop guidance for Fire Engineers on designing fire safety for firecells containing intermediate floors. The project also aims to develop a new set of prescriptive fire safety requirements for intermediate floors and proposes an outline of a verification method for designing fire safety for intermediate floors. This study includes a literature review of the fire safety requirements for intermediate floors (mezzanines) of prescriptive requirements in New Zealand and other countries such as USA, Canada, UK and Australia. The results of this literature review found that the intermediate floor size is limited and varies with country. An intermediate floor that has an area exceeding the limit set out by the prescriptive requirements is considered as a storey in all the countries prescriptive requirements reviewed including the New Zealand prescriptive requirements prior to 1991. Since 1991, in New Zealand Acceptable Solutions, the intermediate floor that has an area exceeding the limit will not be treated as a storey, however, a smoke control system is required. The level of risk was quantified using a factor of safety (FoS) - the ratio of Available Safe Egress Time (ASET) to Required Safe Egress Time (RSET). Two fire models; BRANZFIRE and FDS were used to calculate ASET and SIMULEX, an evacuation program, was used to calculate movement times of the occupants of the studied buildings. Unlike the traditional method in which RSET and FoS are assessed using single value, in this project the distribution of RSET and FoS were assessed using the @RISK software package. The analysis showed that the level of risk to the occupants of the firecells containing intermediate floors is always higher than that of the equivalent firecells without intermediate floors with the same occupant load and the differences in FoS range from 10% to 60%. The analysis also highlighted that the level of risk to the occupants of firecells having intermediate floors increases as the intermediate floor size increases, however, there are no clear cut-off points at which a higher level of fire safety precaution should be provided. The cut-off points in C/AS1 of 20% for a closed intermediate floor and 40% for an open intermediate floor, are not justified by this analysis. Occupant load has significant impact on the level of safety of the occupants of the firecells containing intermediate floors. The higher the occupant load the lower the level of safety is. The definitions for open and closed intermediate floors are proposed to which open and closed intermediate floors are clearly distinguished. The term “limited area intermediate floor” in the current C/AS1 is proposed be removed and all related clauses are proposed to be amended or deleted accordingly. A proposed new set of prescriptive fire safety requirements for intermediate floors has been developed based on the occupant load of intermediate floors and not the intermediate floor size in the form of a table similar to the current Table 4.1 of C/AS1. The occupant load and fire safety precautions (FSPs) of the intermediate floors are determined based on the occupant load and their required FSPs of the equivalent firecells without intermediate floors that have the same factor of safety with the firecells containing intermediate floors. With the proposed FSPs, a firecell with lower occupant load would require lesser fire safety requirements than a firecell with higher occupant load regardless of intermediate floor size. Moreover, with the proposed FSPs for intermediate floors, the level of safety of the occupants of the firecells having intermediate floors would be very similar to the level of safety of the equivalent firecells without intermediate floors. In addition to the proposed tables of FSPs, some clauses regarding the changes in the fire safety requirement and definitions for intermediate floors are proposed. Guidance for designers in designing fire safety for firecells containing intermediate floors in which the methods of modelling using BRANZFIRE and Fire Dynamics Simulator (FDS) are presented in detail, has been developed. The analysis has pointed out that the location of the exits is critical in designing fire safety for firecells containing intermediate floors and majority of exits from the lower floor should not be located under intermediate floors. Although one of the main objectives of this research project was to propose an outline of a verification method for designing fire safety for intermediate floors, the analysis showed that it is very difficult to develop a rational verification method for designing fire safety for firecells containing intermediate floors. Using the proposed FSPs for intermediate floors which are based on the occupant load of the intermediate floors in designing fire safety for firecells containing intermediate floors is recommended by this study. These recommendations do not preclude the use of specific fire engineering design for designing fire safety for firecells having intermediate floors.

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This is a qualitative study, descriptive and exploratory, documentary analysis type developed in order to analyze the methodological trends and education measures for the prevention and control of infections for patient safety in undergraduate courses in Nursing. Six higher education institutions that offer undergraduate course in Nursing in classroom mode participated. The data were collected from the six Political Pedagogical Project (PPP) and 273 discipline plans of the six courses, and allowed the overview of the curriculum and teaching methodologies adopted. In five courses, the curriculum matrices are organized by subject, and a course adopts integrated curriculum with units and themes. Despite efforts of undergraduate courses for the adoption of innovative and advanced methods of teaching, some points of the teaching-learning process require changes. The assessment of learning was predominantly punctual in most undergraduate courses, contradicting the adoption of critical-reflexive methods specified in PPP. In addition, inconsistencies were found in some discipline plans because the objectives and the menus had no connection between them. It was observed discipline plans identical to previous semesters and to the other courses offered in the educational institutions. Another finding refers to the large number of subjects taught by the same teacher, who in one of the courses, a teacher teaches up to nine subjects. It is assumed that the high number of courses taught by each teacher, results in insufficient time for planning the teaching process that includes all measures of standard precaution, necessary for learning and competent professional practice. The results for Patient Safety show that because it is a recent issue, this issue is addressed in a few disciplines of undergraduate programs in nursing. The contents such as communication, interpersonal relationships, teamwork, understanding the organizational complexity and the teaching of prevention and control of infections, should be strengthened, transversely during graduation so that the nursing student develops skills needed for safe care. The teaching of the measures of prevention and control of infection does not appear explicitly in the PPP, only some of which discipline plans. The using and the handling of Personal Protective Equipment was a measure that appeared more frequently (46,2%), followed by hand hygiene (38,5%), cleaning and disinfecting equipment and surfaces (30,8%), disposal of sharps (20,5%). The measure less addressed in the courses was the processing of health products (15,4%). The adoption of criticalreflective methodologies for the teaching of prevention and infection control measures requires encouragement of HEI (Higher Education Institution) for teaching qualification, curriculum revision, review of PPP and discipline plans and student effort, considering that any nursing activity involves patient safety.
Trata-se de um estudo qualitativo, descritivo exploratório, do tipo análise documental desenvolvido com o objetivo de caracterizar as tendências metodológicas e o ensino das medidas de prevenção e controle de infecções para a segurança do paciente em cursos de graduação em enfermagem. Participaram seis Instituições de Ensino Superior (IES) que oferecem Curso de Graduação em Enfermagem na modalidade presencial. Os dados foram coletados dos seis Projetos Pedagógicos dos Cursos (PPC) e de 273 planos de disciplina e permitiram a visualização geral da estrutura curricular e das metodologias de ensino adotadas. Em cinco cursos, as matrizes curriculares estão organizadas por disciplinas, e um curso adota matriz curricular integrada, com unidades e eixos temáticos. Apesar de esforços dos cursos de graduação para a adoção de metodologias inovadoras e avançadas de ensino, alguns pontos do processo de ensino-aprendizagem necessitam de mudanças. A avaliação da aprendizagem foi predominantemente pontual na maioria dos cursos de graduação, contradizendo a adoção de métodos crítico-reflexivos constantes nos PPC. Além disso, foram encontradas incoerências em alguns planos de disciplina, pois os objetivos e as ementas não apresentavam conexão entre eles. Observou-se planos de disciplina idênticos aos de semestres anteriores e aos de outros cursos oferecidos nas instituições de ensino. Outro achado refere-se ao número elevado de disciplinas ministradas pelos docentes que são responsáveis por disciplinas que abordam prevenção e controle de infecções. Em um dos cursos, um docente ministra até nove disciplinas. Presume-se que a elevada quantidade de disciplinas ministradas por um docente, culmina em tempo insuficiente, para o planejamento do processo de ensino que inclua todas as medidas de precaução padrão, necessárias para a aprendizagem e prática profissional competente. Os resultados referentes à Segurança do Paciente demonstraram que, essa temática é abordada em poucas disciplinas dos cursos de graduação em enfermagem. Os conteúdos como a comunicação, o relacionamento interpessoal, o trabalho em equipe, a compreensão da complexidade organizacional e o ensino das medidas de prevenção e controle de infecções devem ser reforçados, de forma transversal durante a graduação, para que o estudante de enfermagem desenvolva competências necessárias para a assistência segura. O ensino das medidas de prevenção e controle de infecções não aparece de forma explícita nos PPC, apenas em alguns planos de disciplina. O uso e manuseio de Equipamentos de Proteção Individual foi a medida que apareceu com maior frequência (46,2%), seguida de Higiene das Mãos (38,5%), limpeza e desinfecção de equipamentos e superfícies (30,8%), descarte de perfurocortantes (20,5%). A medida menos abordada nos cursos foi o processamento de produtos para a saúde (15,4%). A adoção de metodologias crítico-reflexivas para o ensino das medidas de prevenção e controle de infecções requer incentivo das IES para a qualificação docente, com revisão dos PPC e planos de disciplina e, esforço dos estudantes, considerando que toda e qualquer atividade de enfermagem envolve a segurança do paciente.

The topic of this Diploma's thesis is Road safety inspection in the Zlín region. To start off, I was given 14 dangerous locations in the region of Zlín by the Road Services of Kroměříž; 7 of them at crossroads and 7 outside of crossroads. Then I analysed accident risks and compared the locations among each other according to safety features. Based on the outcome of my analysis, then I chose 2 locations at crossroads and 2 outside of crossroads which I personally visited and conducted analysis on how safe they are. I uncovered potential risks which could lead to traffic accidents and suggested solutions that eliminate or minimise that risk.

Aujourd’hui, la valeur symbolique de la notion de « sécurité » atteint un point tel que seule l’idée de s’y opposer nous apparaît instinctivement absurde. De plus en plus, la poursuite de la sécurité sert de justification à une diversité impressionnante de pratiques et de domaines de la vie sociale. Cette expansion récente du « langage de la sécurité » fait de la sécurité une notion fondamentalement polysémique et par le fait même, un concept de plus en plus élastique et récupérable politiquement par ceux qui voudraient en profiter. Dans un contexte où le pouvoir symbolique du langage de la sécurité est tel que le simple fait de l’invoquer dans la promotion d’une mesure politique suscite à tout le moins une ouverture hors du commun chez l’électorat, il devient crucial d’élucider et de comprendre ce qui est entendu et sous-entendu par ce qu’est la sécurité pour les acteurs politiques qui à la fois la promeuvent et témoignent de leur désir de l’accroître. S’inspirant des préceptes de l’outil analytique de la gouvernementalité, notre étude vise à identifier les philosophies qui guident plus spécifiquement les discours politiques canadiens dans les discussions menant à la mise en place de législations en matière de sécurité publique. Pour ce faire, nous réalisons une analyse qualitative comparative en prenant comme sources de données les verbatim de discussions, débats politiques et textes législatifs menant à la mise en place de quatre projets de loi fédéraux distincts, projets de loi dont les textes sont également analysés. Si le dénominateur commun entre les projets de loi renvoie au fait que chacun vise à accroître la sécurité du public, deux d’entre eux — le projet de loi C-14 (2014) portant sur la non-responsabilité criminelle ainsi que le projet de loi C-36 (2001) portant sur le terrorisme — concernent de plus près la sphère de la politique criminelle alors que les deux autres — le projet de loi C-36 (2010) portant sur la sécurité des produits de consommation et projet de loi C-12 (2000) portant sur la santé et la sécurité au travail — touchent plutôt celle de la santé publique. En comparant les résultats des analyses individuelles de chaque cas, l’objectif ultime est d’identifier, s’il y a lieu, des philosophies qui les traversent tous. À ce chapitre, notre analyse montre entre autres en quoi deux philosophies, soit celle de la « gestion préventive des risques » et celle de la « précaution » orientent considérablement les discours politiques dans chacun des terrains d’enquête étudiés. Partant de là, nous avançons l’idée que de fournir de la sécurité de nos jours équivaut surtout à gouverner le futur, c’est-à-dire prévenir non seulement sur base des savoirs relativement sûrs du présent, mais aussi sur base des pires projections de notre fertile imagination. En conclusion, nous situons cette idée de gouvernance du futur dans le contexte plus large de l’expansion du langage de la sécurité pour ensuite en soulever les pièges, surtout lorsque ces tendances sont laissées à elles-mêmes. Partant de là, nous dégageons certaines pistes de solution afin justement d’éviter ces pièges.

A presente dissertação visa a analisar a cláusula de redução equitativa da indenização, introduzida no ordenamento jurídico brasileiro por meio do artigo 944, parágrafo único, do Código Civil de 2002. A aplicação da referida norma suscita intensos debates na doutrina e jurisprudência brasileiras, em especial no que tange à possibilidade de aplicação aos casos de responsabilidade objetiva. Nesse sentido, poder-se-ia argumentar que a redução da indenização impactaria na finalidade da norma expressa no artigo 927, parágrafo único, do Código Civil, inclusive no que tange aos incentivos para prevenção de danos. A partir de uma análise do contexto, evolução jurídica do conceito e seus elementos e funções, é realizada uma avaliação da possibilidade de aplicação e respectivos requisitos para a utilização do instituto de forma sistêmica e em consonância com o ordenamento jurídico vigente. Considerando que a Law and Economics permite ao intérprete antever os impactos da aplicação da norma na conduta dos agentes econômicos, em especial na internalização dos custos de prevenção, que são consequência direta de uma análise de custo e beneficio entre a prevenção e o pagamento da indenização pela causação de um dano, consiste em importante ferramenta à disposição da comunidade jurídica para a análise do terna proposto. Deste modo, o terna será analisado à luz da doutrina da Law and Economics, que traz importantes contribuições para a discussão do tema, que afeta de forma direta o comportamento dos agentes de mercado que desenvolvem atividades consideradas de risco.
The present dissertations aims at analyzing the equitable reduction o f indemnification, introduced in Brazilian legal system tbrough article 944, sole paragraph, o f the Civil Code of 2002. The application o f such rule raises intense debates in the Brazilian doctrine and case law, especially with regard to the possibility of application to cases of strict liability. In this sense, it could be argued that the reduction of indemnification would affect the purpose of the rule foreseen in article 927, sole paragraph, o f the Civil Code, including with regard to incentives to the prevention of damage. From an analysis ofthe context, legal evolution ofthe concept and its elements and functions, an evaluation is conducted to assess the applicability and respective requirements for the use of the institute in a systemic way and in accordance with the current legal system. Given that Law and Economics allows the interpreter to foresee the impacts that the application of the rule will have on the conduct of economic agents, especially regarding the internalization of prevention costs, which are a direct consequence of a cost and benefit analysis between prevention and payment of compensation due to a damage caused, it is an important tool available to the legal co=unity for the analysis of the proposed theme. Therefore, the subject will be analyzed in light ofthe Law and Economics doctrine that brings important contributions to the discussion, which directly affects the behavior of market agents who carry out activities considered risky.

À l'heure actuelle, deux formes de sanctions pénales s'opposent et se complètent : une forme classique et rétributive, la peine, et une forme plus moderne et essentiellement préventive, la mesure de sûreté. Ces deux sanctions pénales, si elles ne possèdent ni les mêmes fondements, ni les mêmes objectifs, sont pourtant parfois difficiles à différencier. La question des rapports qu'elles entretiennent est récurrente mais au regard de l'augmentation constante du nombre de mesures de sûreté dans la loi pénale depuis ces dernières années, elle mérite désormais une réponse. Cette dernière sera apportée à l'aune de la notion d'autonomie qui permettra d'une part d'identifier clairement les mesures de sûreté et d'autre part de dégager un ensemble de règles plus ou moins spécifiques destinées à clarifier leur régime juridique. De cette manière, la légitimité de l'existence des mesures de sûreté pourra être confirmée
At the moment, two forms of penalties oppose and complement each other: a classic shape and rétributive, the sentences, and a more modern and essentially preventive shape, the safety measures. These two criminal punishments, if they do not possess either the same foundations, or the same objectives, are nevertheless sometimes difficult to differentiate. The question of the relationships which they maintain is recurring but with regard to the constant increase of the number of safety measures in the penal law for these last years, it deserves from now on an answer. The latter will be brought in the form of the notion of autonomy which will on one hand allow to identify clearly safety measures and on the other hand to clear a set of more or less specific rules intended to clarify their legal regime. In this way, the legitimacy of the existence of safety measures can be confirmed

Problem: Nurses are potentially exposed to hazardous drugs (HDs) in their practice. HD exposure is associated with adverse outcomes (reproductive problems, learning disabilities in offspring of nurses exposed during pregnancy, and cancer occurrence). Safe handling precautions (safety equipment and personal protective equipment, [PPE]) minimize exposure to HDs and decrease the potential for adverse outcomes. Despite existing OSHA recommendations, adherence to precautions is below recommendations. The purpose of this study was to examine relationships among factors affecting nurses’ use of HD safe handling precautions, to identify factors that promote or interfere with HD precaution use, and to determine nurse managers’ perspectives on use of safe handling precautions. This study used a conceptual model which proposes that both individual and organizational factors influence precaution use. Methods: A cross-sectional, correlational design was used. Nurses (N = 165; 46% response rate) from oncology centers across the US who reported handling chemotherapy completed a mailed survey. Instruments measured HD precaution use, knowledge, self efficacy, barriers, perceived risk, conflict of interest, interpersonal influences and workplace safety climate. Hierarchical regression was used. Twenty managers of nurses handling chemotherapy were interviewed. Results: Nurses were experienced in oncology (M = 15.8 ± 7.6) yrs, well-educated (62.5% ≥BSN), certified in oncology nursing (85%), worked in outpatient settings (69%), and on average treated 6.8 ± 5.2 patients per day. Chemotherapy exposure knowledge was high (M = 10.9, ± 1, 0-12 scale); as was self efficacy for using PPE (M = 20.8 ± 3, 7-24 scale), and perceived risk (M = 3.14 ± .6, 0-4 scale). Total precaution use during HD administration and disposal was low (M = 1.9, SD = 1.1, 0= never to 5 = 100%). Nurse characteristics did not predict HD precaution use. In the final model (R2 = .29, F (2, 155) = 24.6, p < .000), fewer patients per day, fewer barriers and better workplace safety climate were independent predictors of higher precaution use. Conclusions: Results emphasize the importance of organizational influence on nurses’ HD safe handling precaution use and suggest fostering a positive workplace safety climate and reducing barriers as interventions.

The purpose of this study was to investigate how school principals understand HIV/AIDS and how their knowledge, attitude and interpretation filter in the implementation of the HIV policy in schools. The study comprises a literature review and empirical investigation. The results of this study can be used in planning and implementing HIV policy in schools. The data were collected by administering semi-structured interviews. Ten school principals from the Dennilton circuit in Southern Region of the Limpopo Province were interviewed. The results show that the majority of the principals involved in the study confirm that HIV/AIDS is an incurable disease caused by a virus and is mainly sexually transmitted. Some principals regard their school safe from HIV infection. Their assumption is based on the absence of HIV positive learners and educators in their schools. The principals are aware of the rights of HIV positive learners and educators. Significantly, the research findings indicate that the majority of schools lack educators with HIV/AIDS training, rules on safety precautions and first aid kits. It is recommended that ongoing HIV/AIDS training programmes be provided for educators to enable them to educate the youth on HIV/AIDS. Additionally, schools should focus on strategies to implement universal safety precautions against HIV transmission and to obtain first aid kits. Lastly, school principals should involve parents and other stakeholders in creating a positive school environment for HIV positive learners and educators.
Dissertation (MEd (Education Management))--University of Pretoria, 2005.
Education Management and Policy Studies
unrestricted

碩士
國立臺灣大學
法律學研究所
103
In recent years, Taiwan’s food market has been in a state of extreme instability. Various food safety incidents happened one after another. People are filled with suspicion and anxiety to the food provider and food market. This phenomenon is caused by illegal acts from the food businesses, or rather by unknown structured risks arising from environmental and industrial changes, technological developments as well as global trading. It shows that modern food safety issue has already extended from traditional idea of preventing danger to being precautious to the risk that would occur from food. Facing this change, the Taiwanese government only amended relevant food safety law in a fragmental and case-by-case faction when food safety incidents appear. Although this amendment made by Taiwanese government, had strengthened the food safety law, the frequency of occurrence of food safety incidents did not decrease significantly. This means that Taiwan’s food safety control system still remains in the idea of preventing danger and instead of being aware of risk precaution. Therefore, food safety system in Taiwan is subject to review and should be rebuilt. Food safety is not only a legal objective but also an important goal of our daily life; therefore, the aim of this thesis is to research how the government fulfills such a goal and how the rule of law principle in constitutional state will be affected. In addition, due to the characteristics of food safety risks, including such as complexity, high demand for professional knowledge, and uncertainty, risk precaution of food safety is a scientific mission that was not originally an legal issue. Therefore, the government needs to regulate the results of this mission and the executive power must enforce the regulation based on the guidance of the law in order to achieve the governmental obligation of risk precaution in food safety. Hence, government needs to establish risk-administrative law of food safety. On the other hand, after the regulation has been enforced, how the existing legal system will be changed and how basic human rights will be affected, is another issue that will require our attention. This thesis begins with the discussion of food safety issue. By understanding the significance of food safety, the production process of food, factors and characteristics of food problem, I explore legal elements associated with modern food safety mission and the difficulties we encounter during the mission. Secondly, the fact that food safety issue is closely connected to human’s basic daily demands is a universal fact; therefore, I refer to basic principles and traditional and new instruments of administrative regulation in the food law in the European Union law as well as Germany law. Moreover, I attempt to describe the fundamental legal structure of risk precaution in food safety field as a reference of reviewing Taiwan’s juridification of risk precaution of food safety. Furthermore, I analyze the theories, functions as well as limitations of traditional and new emerging of administrative regulatory instruments on the basic legal structure of food safety risk precaution. Next, I discuss the possibility of enforcing those instruments in risk precaution in the food safety field and how these instruments will affect the rule of law. Based on the context above, by observing Taiwan’s currently enforced risk precautionary measures in the food safety area, this thesis reviews rationalities and effectiveness of those administrative regulatory instruments and provide relevant amendatory suggestions. In this thesis, I intend to contribute to providing a rational legal structure of food safety risk precaution and direct Taiwan’s food safety control system to the precise direction that this thesis has concluded with.

碩士
國立臺北科技大學
建築與都市設計研究所
90
With the increase of mix-using constructions and repeated recurrences of natural disasters such as earthquakes, floods and man-made calamities such as fires in Taiwan in recent years, which have caused significant casualties and damages, it becomes more and more important for construction safety precautions. Children will be more seriously threatened while a disaster or calamity happens because they have less mobility and not enough knowledge. Furthermore, many schools were damaged during strong earthquakes on September 21, 1999, and Chia-Yu Child-Care Center, Taoyuan County, was set on fire in April of 2001. The safety of schoolchildren’s learning environment therefore has been questioned. The importance of safety precautions of kindergarten also becomes true. It is necessary to explore how to establish the safe and secure environment for kindergarten and provide our children a good place to learn. Every child’s mind and behavior is unique, so there should be a guiding criterion to standardize precaution for kindergarten constructions and safety and security inside and outside kindergarten. Although both existing Construction Law and Technical Rules of Construction stipulate the standards for school constructions, and the public safety check report has include kindergarten into items which should report at least every two years, there is not any special regulation, criterion or standard of precaution for kindergarten constructions and safety and security inside and outside kindergarten. This is the reason why so many kindergartens established and so many potential crises exist. Based on aforesaid background, the study of precaution and safety planning and design criterion for kindergarten constructions is an important subject at present. This study adopts the P.O.E theory and plans to go to various types of kindergartens in Taipei City to conduct a sampling questionnaire and field survey. Then the existing safety precaution problems of kindergarten will be analyzed, the evaluation standard and counter-policy designed to solve problems will be worked out and the criterion of precaution and safety planning and design for kindergarten will be drafted according to related materials, to set up the standard for safety precautions and general rule of environmental safety upon establishment of a kindergarten and to strengthen kindergarten’s precautions against fire, earthquake and ability to seek asylums once a disaster or calamity happen and management and maintenance to make sure the goal of precaution be reached. This study provides a criterion draft of precaution and safety design for newly established kindergartens and recommendations for amendments of related regulations for the central government reference and legislation. Also the study may be used as the basis of evaluation of kindergarten precaution and safety by education authorities. The study is divided into six chapters. The researcher believes that the study can provide positive contributions to the establishment of kindergarten and the safety and the security of schoolchildren. Chapter One Introduction Chapter Two Related Regulations and Their Frameworks in Home and Abroad Chapter Three The Study of Related Literature and Integration of Various Theories Chapter Four The Survey of Safety Evaluation of Kindergarten Constructions Chapter Five Integration of Subjects and Drafting of Regulations and Counter-Policy Chapter Six Conclusions and Recommendations Key words: Kindergarten, Evaluation of Precaution, Criterion, Technical Rules of Construction.

博士
國立臺灣大學
護理學研究所
107
Background. Research demonstrates that the nurses’ perceptions regarding workplace safety climate and perception to personal protective equipment use are common factors affecting their compliance with safety precautions. However, to date, no study has empirically examined a structural model to identify the factors related to nurses’ compliance with hazardous drug (HD) safe handling precautions. In this study, we aim to verify whether the ability of predict variables to explain and predict nurses’ compliance with HD safe handling precautions by using partial least squares structural equation modeling (PLS-SEM); the results provide recommendations for nursing clinical practice, education, research, and policy. Aims. This study aims to explore the relationship among nurses’ perception of the workplace safety climate, personal factors, the workplace background, and nurses’ behavior in complying with HD safe handling precautions during the intravenous administration and disconnection of HDs by PLS-SEM. Methods. This study included a cross-sectional survey of nurses recruited in the northern, northwestern, and south-central branches of a university medical system in Taiwan, in which 484 (of 506) self-administrated questionnaires were returned by respondents (response rate, 95.7%). Each participant was asked to complete the structured questionnaire developed by the author. It comprises the following four main parts: nurses’ perception of the workplace safety climate, personal factors, the workplace background, and nurses’ behavior regarding their compliance with HD safe handling precautions during the intravenous administration and disconnection of HDs. The data (N = 484) were randomly split into two groups, one group (N = 237) for exploratory factor analysis, and the other (N = 247) for confirmatory factor analysis. The exploratory factor analysis resulted in seven factors related to the workplace safety climate, and the result of the confirmatory factor analysis verified the acceptability of the model. The seven factors, with 31 items of the workplace safety climate, were “Clinical Care Situation,” “Colleagues Remind Each Other,” “Creation of a Safe Working Environment by the Head Nurse.,” “Creation of a Safe Working Environment by the Organization Manager,” “Ease of Use of Personal Protective Equipment,” “Perception of Comfortable Level of the Workplace,”and “Perception of Comfortable Level of Use of Personal Protective Equipment.” We used the samples (N = 247) for confirmatory factor analysis to verify the model by PLS-SEM 3.2.8. Result. The descriptive statistical results showed that nurses recorded the highest score for the “Creation of a Safe Working Environment by the Organization Manager” (Mean ± SD: 4.58 ± 0.52) of workplace safety climate and lowest for “Perception of Comfortable Level of Use of Personal Protective Equipment” (Mean ± SD: 3.24 ± 1.03). The mean frequency of the nurses’ compliance with HD safe handling precautions during intravenous administration (Mean ± SD: 4.25 ± 0.84) was higher than that during the disconnection of HDs (Mean ± SD: 2.92 ± 1.22). The PLS-SEM analyses revealed that workplace safety climate can explain 29.3% of the variance in nurses’ behavior regarding their compliance with HD safe handling precautions during intravenous administration and 30.5% of the variance during the disconnection of HDs. In addition, workplace safety climate can predict the outcome variable, and the results showed an acceptable model fit. Among the aforementioned variables, the “Clinical Care Situation,” “Colleagues Remind Each Other,” “Ease of Use of Personal Protective Equipment,” and “Perception of Comfortable Level of Use of Personal Protective Equipment” of workplace safety climate were significantly associated with nurses’ behavior regarding their compliance with HD safe handling precautions. We added nurses’ personal factors and the workplace background in the model; the result showed that nurses’ years of experience in administering chemotherapy, familiarity with the policy and procedure for the safe handling of HDs, and chemotherapy workload may significantly affect nurses’ behavior regarding their compliance with HD safe handling precautions during intravenous administration. Suggestions. We suggest that managers of hospitals and researchers should design interventions according to the “Clinical Care Situation,” “Colleagues Remind Each Other,” “Ease of Use of Personal Protective Equipment,” and “Perception of Comfortable Level of Use of Personal Protective Equipment” of workplace safety climate, such as enhancing nurses’ awareness of the importance of personal protective equipment use, creating opportunities for nurses to share with peers their opinions regarding the safe handling of HDs, and purchasing personal protective equipments that are easy to use and comfortable to wear and placing them at optimal locations for easy access. To increase nurses’ frequency of adherence to the HD safe handling precautions, we suggest that hospital managers should provide multifaceted learning resources, update the skills checklist, and invite nurses who are highly experienced in HD handling to conduct regular audits.

O presente relatório traduz todo um caminho percorrido no Mestrado em Enfermagem, Área de especialização: Enfermagem Médico-cirúrgica: A Pessoa em Situação Crítica bem como uma reflexão acerca da aquisição das competências comuns e especificas do Enfermeiro Especialista em EMCPSC, bem como as competências de Mestre em Enfermagem. O estágio final decorreu num serviço de urgência no qual desenvolvemos um Projeto de Intervenção em Serviço (PIS) na área da Prevenção e Controlo de Infeção. Este relatório retrata o desenvolvimento do PIS, em que recorremos à Metodologia de Projeto nas suas diferentes etapas, o qual intitulamos “Precauções de Isolamento no Serviço de Urgência. Um Projeto de Melhoria da Qualidade dos Cuidados de Enfermagem”. Neste âmbito foi elaborado um Manual de Boas Práticas visando a uniformização de procedimentos e a melhoria da qualidade e segurança dos cuidados de enfermagem
This report reflects a whole path taken in the Master's Degree in Nursing, Specialization area: Medical-surgical Nursing: The Person in Critical Situation as well as a reflection on the acquisition of the common and specific skills of the Specialist Nurse in EMCPSC, as well as the skills of Master in Nursing. The final stage took place in an emergency department in which we developed an In-Service Intervention Project (PIS) in the area of Infection Prevention and Control. This report portrays the development of the PIS, in which we resort to the Project Methodology in its diferente stages, which we call “Precautions for Isolation in the Emergency Department. A Project to Improve the Quality of Nursing Care ”. In this context, a Manual of Good Practices was developed to standardize procedures and improve the quality and safety of nursing care

碩士
中國醫藥大學
醫務管理學研究所碩士班
98
Abstract Purpose: The aim of this study is to clarify factors related to traditional Chinese doctors’ perception, attitude, and prevention methods of patient safety, so the results can be the reference of their future education and clinical practice guidelines. Method: The target subjects were all Taiwan traditional Chinese doctors who were evaluated through general survey. Total 5,099 copies of questionnaire were mailed to them with 1,424 valid copies, participation rate of 27.9%, retrieved. The cross-sectional analysis was applied through structured questionnaire. Other than descriptive and variant analyses, the multiple regression analysis was conducted to evaluate the possible factors influencing traditional Chinese doctors’ perception, attitude, and prevention activities of patient safety. Results: The average age of the enrolled traditional Chinese doctors was 48.7 years old. The ratio of male to female was three to one. Average 95.8% of the questions related to perception were answered correctly, which meant that almost 96% of traditional Chinese doctors had correct perception of patient safety. The mean score of their attitude was 4.72 (the total score was 5). Generally, the degree of preventing abnormal events was above average. The multiple regression analysis revealed that the factors affecting perception were “the way of being certified” and “the mean outpatient number per visit”. The factors influencing attitude included “age”, “seniority”, “professional title”, “personal experience of abnormal medical events”, “hours of attending patient safety education program” and “perception of patient safety”. The factors impacting prevention methods included “location of the institute” and “attitude toward patient safety”. Conclusion and recommendation: Generally, elder the traditional Chinese doctors were and more hours of education programs they attended, more positive attitude toward patient safety they had. Their perception positively affected their attitude that is positively related to the prevention methods of abnormal events. Therefore, appropriately arranging education programs of patient safety may improve their correct perception and positive attitude, and then flawless prevention methods can be established. As a result, patient safety can be maintained, quality of medical care can be improved, and legal problems can be reduced when performing acupuncture treatment. Key words: traditional Chinese medical doctors；patients’ safety； perception；attitude；precaution