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Oxtoby, Catherine. "Patient safety in veterinary practice." Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/42281/.
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Patient safety is an active field of research in medicine and the driving force behind healthcare policy and practices to ensure the delivery of safe, quality patient care. However, it is a concept in its infancy in the veterinary profession. Veterinary medical error is under reported, poorly understood and inadequately managed with consequences for patients, owners and clinicians. The aim of this thesis is to explore the causes and types of error in veterinary practice and develop solutions to improve patient safety, and by extension quality of care for veterinary patients. A mixed methodology was employed in the investigation of this aim, with data gathered by focus groups, insurance claim review and questionnaires. The findings of the study suggest that the causes of error in veterinary practice mirror those in other safety critical industries, namely individual errors and system failures. These findings led to the development of a reliable, validated safety culture survey for veterinary practice, to assess and understand the attitudes which drive safety critical behaviours of veterinary staff. This survey was then used as a pre and post training measure to assess the effectiveness of a teamwork training programme, VetTeams, as an intervention to improve safety culture, and by extension patient outcomes in veterinary practice. The outcomes of this study are a framework to inform the understanding and analysis of veterinary error, a measurement tool of veterinary safety culture and a training programme for veterinary teams which addresses the non technical skills identified as critical to preventing mistakes. The findings suggest that changing attitudes to error through an understanding of the causative factors and education in non technical skills, is essential to drive behaviour change in clinicians and enable improved delivery of clinical care.
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Lyndon, Audrey. "Agency for safety in perinatal nursing practice." Diss., Search in ProQuest Dissertations & Theses. UC Only, 2007. http://gateway.proquest.com/openurl?url_ver=Z39.88-2004&rft_val_fmt=info:ofi/fmt:kev:mtx:dissertation&res_dat=xri:pqdiss&rft_dat=xri:pqdiss:3261236.
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Jebb, Sarah E. "Reducing workplace safety incidents : bridging the gap between safety culture theory and practice." Thesis, Queensland University of Technology, 2015. https://eprints.qut.edu.au/81626/1/Sarah_Jebb_Thesis.pdf.
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This thesis explored safety culture in a large Australasian construction and mining organisation, with a view to understanding how theory and practice can be integrated to improve safety culture and related outcomes within the industry. The research comprised three studies that investigated the relationship between safety culture, safety motivation, leadership and safety behaviour, and examined differences in perceptions of safety culture across the organisation. Research methodologies and samples included a modified Delphi method with safety leaders (n=41), a quantitative survey with a cross-section of the organisation (n=2,957), and group interviews with frontline supervisors and workers (n=29).
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Al-Haji, Ghazwan. "Road Safety Development Index : Theory, Philosophy and Practice." Doctoral thesis, Linköpings universitet, Institutionen för teknik och naturvetenskap, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-8812.
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This dissertation develops, presents and tests a new international tool, the so-called Road Safety Development Index (RSDI), which indicates in a comprehensive and easy way the severity of the road safety situation in a specific country and/or in comparison with other countries. There are three pillars of outcomes involved in the framework of RSDI. One pillar is the People focus (road user behaviour). The second is the System focus (safer vehicles, safer roads, enforcement, management, etc). The third is the Product focus in terms of accident death rates. This thesis analyses each of these pillars. In addition, RSDI links the key national practices of road safety to each other and to the end-results (accident death rates). The study suggests a master-list of performance indicators to be implemented for assessing road safety level in a country and for RSDI building. Based on the “master-list”, a short key list of performance indicators is chosen and classified into two primary categories that correspond to two groups of countries: LMCs “Less Motorised Countries” and HMCs “Highly Motorised Countries”. RSDI aggregates the key performance indicators into one single quantitative value (composite index). Four main objective and subjective approaches are used to calculate RSDI and determine which one is the best. One approach uses equal weights for all indicators and countries, whereas the other approaches give different weights depending on the importance of indicators. Two empirical studies were carried out, in different parts of the world, to determine the applicability of this tool in real world applications. The first empirical study comes from eight European countries (HMCs). The second empirical study comes from five Southeast Asian countries (LMCs). The RSDI results from this study indicate a remarkable difference between the selected countries even at the same level of motorisation and/or with close accident death rates. The unavailability of comparable and useful data are problems for deeper analysis of RSDI, especially the index should be as relevant as possible for different parts of the world. The empirical and theoretical assessments prove that RSDI can give a broader picture of the whole road safety situation in a country compared to the traditional models and can offer a simple and easily understandable tool to national policy makers and public.<br>Denna avhandling utvecklar, presenterar och testar ett nytt internationellt verktyg, det så kallade Road Safety Development Index (RSDI), vilket på ett begripligt och lättillgängligt sätt beskriver trafiksäkerhetsläget i ett visst land jämfört med andra länder. Resultatet av RSDI utgörs av tre grundpelare. Den första pelaren är Fokus på människor (vägtrafikbeteende). Den andra är Fokus på systemet (säkrare fordon, säkrare vägar, beivrande, management, osv). Den tredje pelaren är Fokus på produkten med avseende på antal döda per fordon och per invånare. Arbetet analyserar var och en av dessa tre pelare. RSDI kopplar dessutom samman de viktigaste nationella praxisarna och erfarenheterna med varandra och till slutresultaten (antal dödsfall). Studien föreslår en lista med de viktigaste indikatorerna på hur olika länder vidtar åtgärder för trafiksäkerheten. Grundat på denna “master-lista” kan en kort lista med de viktigaste indikatorerna skapas och klassificeras i två huvudkategorier för två typer av länder: LMC “länder med låg andel fordon” och HMC “länder med hög andel fordon”. RSDI aggregerar de viktigaste performance-indikatorerna till ett enda kvantitativt mått (ett sammansatt index). Fyra olika objektiva och subjektiva huvudangreppssätt används för att beräkna RSDI och bestämma vilket av dem som är det bästa. En metod använder sig av lika stora vikter för alla indikatorer och länder, medan en annan metod ger olika vikter beroende på indikatorernas betydelse. Två empiriska studier genomfördes i olika delar av världen för att bestämma tillämpligheten av detta verktyg i verkliga situationer. Den första empiriska studien kommer från åtta länder i Europa (HMC-länder). Den andra empiriska studien har gjorts i fem länder i Sydostasien (LMC-länder). Resultaten från detta RSDI tyder på en anmärkningsvärd skillnad mellan de valda länderna, också om andelen bilägare och/eller andra variabler för trafiksäkerhet hålls konstanta. Bristen på jämförbara och användbara data medför problem vid en djupare analys av RSDI för olika delar av världen. De empiriska och teoretiska skattningarna visar att RSDI kan ge en bredare bild av hela trafiksäkerhetssituationen i ett land jämfört med traditionella modeller och kan erbjuda ett enkelt och lättförståeligt verktyg för de nationella beslutsfattarna liksom för allmänheten.
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Lundy, Shaun James. "Professional ethics in occupational health & safety practice." Thesis, Middlesex University, 2013. http://eprints.mdx.ac.uk/13712/.
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This thesis provides a critical evaluation of a real world project involving the researcher as leader of a review and subsequent development of a new Code of Conduct for the world’s largest health and safety body, the Institution of Occupational Safety Health (IOSH, 2011). The health and safety profession in the UK has seen many changes over the last 10-years, in particular a stronger focus on degree education, continual professional development (CPD) and Chartered Practitioner status. In addition to these progressive changes the profession has also seen a rise in the negative media coverage regarding reported risk aversion in decision-making processes. In response to the negative media and at the request of the conservative party, then in opposition, Lord Young led a complete review of health and safety in Great Britain(Young, 2010). More recently, the Government requested a further independent review into health and safety legislation (Löfstedt, 2011). Since the publication of these reports there have been calls for more rigorous competence standards for consultants and a move towards more industry led self-regulation. This has seen IOSH placed in a strong influencing position, albeit with added scrutiny of its own regulation of members. The researcher led a critical review of the existing Code as part of an IOSH standing Committee, the Profession Committee (PC) that has the responsibility among other things for examining allegations of misconduct. The project was conducted as action research and was divided into 4 cycles or stages. Stage 1 involved the critical review and benchmarking of the existing Code against other Codes using an adaptation of the PARN criteria. Stage 2 involved the consultation process for the development of a new Code. This included the researcher’s role as leader of the project and an evaluation of misconduct cases reviewed by the PC. Stage 3 involved semi-structured interviews of practitioners to explore experiential accounts of ethical issues from practice to inform the guidance on the Code. Finally, Stage 4 involved the concluding consultation and consolidation of all the stages for presentation of the revised Code to IOSH Council for approval. The project reinforced the benefits of applying a systematic approach for the development of professional body documentation. It also revealed the value of applying a flexible iterative methodology in the real world environment to prevent the project from diverging from its real world objectives. The outcome of the project has been positively received by IOSH. A new Code was produced with guidance and a revised disciplinary procedure that is fit for purpose and adaptable to change through the use of robust development and broad consultation processes. It is anticipated that these changes will make a significant contribution to the wider profession and practice. An ethical decision making model was developed from the findings and includes a dissemination strategy for the profession.
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McHenry, Kristen L. "Safe Practice." Digital Commons @ East Tennessee State University, 2018. https://dc.etsu.edu/etsu-works/2535.
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Jeyaretnam, Joseph S. "Occupational hazards and radiation safety in veterinary practice including zoo veterinary practice in Australia." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2003. https://ro.ecu.edu.au/theses/1306.
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This thesis contains reviews and research on the occupational hazards of zoo veterinary practitioners in Australia. Although occupational hazards have long been recognised in the veterinary profession, little information is available on the number and magnitude of injuries to veterinarians in Australia, the United Kingdom or the United States. Apart from anecdotal accounts and some limited data, most of the available information is on occupational zoonoses, generally well recognized by veterinarians. Other occupational hazards to which veterinarians are exposed have received scant attention. The veterinary practitioner in a zoo environment has to treat a range of captive wild species which are much more unpredictable and dangerous than domesticated animals. A comprehensive study on occupational hazards sustained by veterinarians in zoological gardens has not been undertaken in Australia. Only one study had been undertaken in the US amongst zoo veterinarians, while comprehensive may not be able to be transposed to zoos in Australia as the species held in Australian zoos differ from those in the US. Personal communication with some senior veterinarians in the zoological gardens in Australia, have elicited further information on the prevalence of occupational hazards sustained by the zoo and wildlife park veterinarians. The prevalence of physical hazards including radiation, chemical and biological hazards reported by veterinary practitioners and the author's own experience as a veterinary practitioner, chairman of the safety committee, member of the animal ethics committee and manager, research In the zoological gardens in Perth, Western Australia have demonstrated a need for a comprehensive study on occupational hazards prevalent among zoo veterinarians. To investigate the occupational hazards including radiological hazards amongst zoo veterinarians in Australia, a self-administered 14-page comprehensive questionnaire comprising 58 questions was mailed to 27 practising zoo veterinarians in Australia. The questionnaire focused on physical injuries, chemical exposures, allergic and irritant reactions, biological exposures, radiological hazards including problems encountered with x-ray machines, use of protective gear and ancillary equipment for radiography, personnel involved in x-ray procedures and in restraining animals, compliance with the Australian National Health and Medical Research Council (NHMRC) Code of Practice (1982), Radiation Safety Regulations (1988) and National Standard for Limiting Occupational Exposure to Ionising Radiation (1995) The result of the study revealed that 60% of the participants sustained physical injuries such as crushes, bites and scratches inflicted by a range of species with some Injuries requiring medical treatment. Also, 50% of the participants suffered from back injuries while 15% reported fractures, kicks, bites necessitating hospitalization. Ninety percent of the participants sustained needlestick injuries ranging from one to 16+ times. Other significant findings include: necropsy injuries, animal allergies, formaldehyde exposure, musculoskeletal Injuries and zoonotic infections. The survey also identified that veterinary practitioners and their staff were exposed to radiation by not complying with the National Health and Medical Research Council (NHMRC) Australian Code of Practice for the Safe Use of Ionising Radiation (1982) which has been framed to minimize exposure to ionising radiation. The majority of the veterinarians in the study group indicated that radiation exposure Is a major occupational hazard to the veterinary profession. Subsequent to the review and research, discussions were held with few senior zoo veterinarians, the Registrar of the Veterinary Surgeons Board and a number of practising senior veterinarians In Australia to collect information on occupational hazards. Additional information was obtained on occupational injuries sustained by the zoo veterinarians through formal discussions with the Director and the two senior veterinarians In the zoological gardens in Sri Lanka. The discussions with the veterinary practitioners in government and private practice revealed that veterinarians experienced a range of occupational hazards including exposure to rabies. Discussions with the dean and the professor of the animal science department focused on the nature of injuries and preventive strategies. In order to obtain information on occupational hazards in the health care industry, the professor of anatomy of the faculty of medicine and a senior surgeon in Sri Lanka were interviewed. This study identified that the zoo veterinarians are routinely exposed to a wide range of occupational hazards. The literature review among veterinary practitioners In US, UK, Australia and Canada have also identified numerous occupational hazards sustained by the veterinarians. The discussions held in Sri Lanka with the professionals in veterinary and health care industry showed that occupational injuries have been common amongst them and they do not have appropriate preventive guidelines in place. This thesis has incorporated recommendations in the form of preventive strategies for minimizing occupational hazards among veterinary practitioners both in zoological gardens and veterinary practices In Australia and in the developed and developing countries.
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Al, Haji Ghazwan. "Road safety development index (RSDI) : theory, philosophy and practice /." Norrköping : Department of Science and technology, Linköping University, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-8812.
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Parlour, Stephen. "Paternalistic legislation : political theory and practice in road safety." Thesis, University of Sussex, 2002. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.270331.
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Kaya, Gulsum Kubra. "Good risk assessment practice in hospitals." Thesis, University of Cambridge, 2018. https://www.repository.cam.ac.uk/handle/1810/273747.
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Risk assessment is essential to ensure safety in hospitals. However, hospitals have paid little attention to risk assessment. Several problems have already been identified in the literature about current risk assessment practice, such as inadequate risk assessment guidance and bias in risk scoring. This research aimed to improve current risk assessment practice in hospitals in the National Health Service (NHS) in England. To address this aim, the research investigated current risk assessment practice and designed a new risk assessment approach by the use of mixed methods. One hundred hospitals’ risk assessment documents were reviewed to examine the current recommended risk assessment practice. Seventeen interviews and sixty-one questionnaires were conducted, a risk management system from a single hospital was reviewed, and strategic risks from thirty-four hospitals were reviewed, in order to examine how risks are assessed in actual practice. Following that, the proposed approach was designed by conducting requirements analysis and then evaluated by interviews and questionnaires with ten healthcare staff. The findings of this research reveal that hospitals conduct risk assessments in different ways (i.e. with a focus on individual patient-based, operational and strategic risks). There are also many problems involved in current risk assessment practice regarding both the foundations and use of risk assessment. For example, organisation-wide risk assessments predominantly rely on risk matrices which might lead to wrong risk prioritisation and resource allocation; and risks tend to reflect existing or past problems rather than being proactive. All these reveal a need to improve current risk assessment practice. This research makes an important contribution to the current understanding of risk assessment practice in hospitals by providing extensive evidence on both recommended and actual practice, and proposes a new risk assessment framework. The framework guides healthcare staff on how to conduct risk assessment in a more comprehensive way by encouraging its potential users to consider good risk assessment practice.
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Möller, Niklas. "Thick Concepts in Practice : Normative Aspects of Risk and Safety." Doctoral thesis, KTH, Filosofi och teknikhistoria, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-10421.
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The thesis aims at analyzing the concepts of risk and safety as well as the class of concepts to which they belong, thick concepts, focusing in particular on the normative aspects involved. Essay I analyzes thick concepts, i.e. concepts such as cruelty and kindness that seem to combine descriptive and evaluative features. The traditional account, in which thick concepts are analyzed as the conjunction of a factual description and an evaluation, is criticized. Instead, it is argued that the descriptive and evaluative aspects must be understood as a whole. Furthermore, it is argued that the two main worries evoked against non-naturalism – that non-naturalism cannot account for disagreement and that it is not genuinely explanatory – can be met. Essay II investigates the utilization of the Kripke/Putnam causal theory of reference in relation to the Open Question Argument. It is argued that the Open Question Argument suitably interpreted provides prima facie evidence against the claim that moral kinds are natural kinds, and that the causal theory, as interpreted by leading naturalist defenders, actually underscores this conclusion. Essay III utilizes the interpretation of the Open Question Argument argued for in the previous essay in order to argue against naturalistic reduction of risk, i.e. reduction of risk into natural concepts such as probability and harm. Three different normative aspects of risk and safety are put forward – epistemic uncertainty, distributive normativity and border normativity – and it is argued that these normative aspects cannot be reduced to a natural measure. Essay IV provides a conceptual analysis of safety in the context of societal decision-making, and argues for a notion that explicitly includes epistemic uncertainty, the degree to which we are uncertain of our knowledge of the situation at hand. Some formal versions of a comparative safety concept are also proposed. Essay V puts forward a normative critique against a common argument, viz. the claim that the public should follow the experts’ advice in recommending an activity whenever the experts have the best knowledge of the risk involved. The importance of safety in risk acceptance together with considerations from epistemic uncertainty makes the claim incorrect even after including plausible limitations to exclude ‘external’ considerations. Furthermore, it is shown that the scope of the objection covers risk assessment as well as risk management. Essay VI provides a systematized account of safety engineering practices that clarifies their relation to the goal of safety engineering, namely to increase safety. A list of 24 principles referred to in the literature of safety engineering is provided, divided into four major categories. It is argued that important aspects of these methods can be better understood with the help of the distinction between risk and uncertainty, in addition to the common distinction between risk and probability.<br>QC 20100803
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Carson-Stevens, Andrew. "Generating learning from patient safety incident reports from general practice." Thesis, Cardiff University, 2017. http://orca.cf.ac.uk/104070/.
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Internationally, there is an emerging interest in the inadvertent harm caused to patients by the provision of healthcare services. Since the publication of the Institute of Medicine’s report, To Err is Human, in 1999, research and policy directives have predominantly focused on patient safety in hospital settings. More recently, the World Health Organization has highlighted 2-3% of primary care encounters result in a patient safety incident. Given around 330 million general practice consultations occur in the UK each year, unsafe primary care is a poorly understood, major threat to public health. In 2003, a major investment was made in the National Reporting and Learning System to better understand patient safety incidents occurring in England and Wales. Over 40,000 incident reports have arisen from general practice. These have never been systematically analysed, and a key challenge to exploiting these data has been to generate learning from the largely unstructured, free-text descriptions of incidents. My thesis describes the empirical development and application of methods to classify (structure) incident report data. This includes the development of coding frameworks specific to primary care, aligned to the WHO International Classification for Patient Safety, to describe the incident, contributory factors and incident outcomes. I have developed a mixed-methods approach which combines a structured process for coding reports and an exploratory data analysis with subsequent thematic analysis. Analyses of reports can generate hypotheses about priorities for systems improvement in primary care at a local and national level. Existing interventions or initiatives to minimise or mitigate patient safety risks can be identified through scoping reviews. Future research and quality improvement activities should deepen understanding about the risks to patients, and generate knowledge about how interventions made in practice can improve safety.
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Möller, Niklas. "Thick concepts in practice normative aspects of risk and safety /." Stockholm : KTH Architecture and the Built Environment, 2009. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-10421.
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Caccia, Lewis E. "Risk communication in the workplace an analysis of communication toolkits as rhetorical practice /." [Kent, Ohio] : Kent State University, 2009. http://rave.ohiolink.edu/etdc/view?acc%5Fnum=kent1239226189.
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Thesis (Ph.D.)--Kent State University, 2009.<br>Title from PDF t.p. (viewed Nov. 13, 2009). Advisor: Sara J. Newman. Keywords: labor relations, workplace, risk communication, occupational safety, safety communication, enthymemes, literacy, rhetoric, Communications Toolkits, Toolkits, topoi. Includes bibliographical references (p. 196-206).
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Provan, David John. "What is the role of a safety professional? The identity, practice and future of the profession." Thesis, Griffith University, 2018. http://hdl.handle.net/10072/382671.
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The role of a safety professional is central to the way organisations understand and manage safety since it is these expert roles that provide their organisations with their safety narrative. Yet despite the importance of this role, we understand very little about safety professional identity and safety professional practice – who are they and what do they do? This thesis asks the fundamental question for the existence of the safety profession – What is the role of a safety professional?
The primary research design involved a 6-month longitudinal ethnographic case-study of professional identity and safety professional practice within a large Australian energy company. 12 mid-level and senior-level safety professionals were interviewed monthly regarding their work, and this data was supplemented by continuous work observations by an embedded researcher throughout the study period. Through the research design, the results of this study provide a deeper and broader perspective of safety professional practice, than the existing descriptive research into the role of safety professionals.
Safety Professional identify is rife with tensions and contradictions that reveal the complex social and organisational challenges associated with the role. Safety Professionals are both friend and enemy of line management and the frontline workforce. Safety professionals through the practice of their role: align themselves and their work with management objectives, develop safety specific processes and practices, satisfy organisational needs at the expense of worker safety risk reduction, and lack a working connection between safety science knowledge and their safety professional work, decisions and advice.
Contemporary safety theory describes new ways for achieving safety in organisations that are largely at odds with current organisational safety approaches and existing safety professional practice. This thesis provides the first practical description of the role of a safety professional thorough a resilience engineering, safety-II, and safety differently theoretical lens. The conclusion from this research, is that organisations expect safety professionals to perform their existing role, and that the contemporary safety science literature demands them to work vastly differently. This thesis makes a significant scientific contribution to the understanding of safety professional identity, safety professional practice, and the future design of the role of a safety professional which will narrow the gap between safety professional work and the safety of work.<br>Thesis (PhD Doctorate)<br>Doctor of Philosophy (PhD)<br>School of Hum, Lang & Soc Sc<br>Arts, Education and Law<br>Full Text
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Theron, Margot Cecile. "Nursing care practice related to patient safety in the operating room." Thesis, Nelson Mandela Metropolitan University, 2013. http://hdl.handle.net/10948/d1017197.
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Patient safety is a primary concern of members of the surgical team. Professional nurses working in the operating room play a vital role in the safety of the patients from the moment the patient enters the operating room to the discharge of the patient to the unit. Quality nursing care is of the utmost importance and therefore it is the responsibility of a professional nurse to ensure patient safety during the peri-operative period. Team work and good communication in the operating room are essential in order to ensure patient safety. Nursing care practices related to patient safety should be a key aspect to consider in rendering care to the surgical patient and professional nurses should perform their duties to the best of their ability despite lack of resources and shortage of staff. The main purpose of the study was to explore and describe nursing care practice related to patient safety in the operating room at hospitals in the Nelson Mandela Metropolitan area. Once this was established recommendations on how to enhance nursing care practice related to patient safety in the operating room were made. This study is based on a quantitative, explorative, descriptive and contextual design. Convenient sampling was used in this study. Data were collected by means of a self-administered questionnaire. Descriptive and inferential statistics were used to analyse the data. Ethical considerations were adhered to and the findings of the research will be disseminated appropriately. Recommendations based on the findings that emerge from the data, as well as the literature review, will be offered to enhance nursing care practice related to patient safety in the operating room.
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Azzi, Manal Maroun. "Occupational Safety and Health Implementation: Between Policy and Practice in Lebanon." Thesis, University of Surrey, 2009. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.510374.
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Makeham, Meredith Anne Blatt. "The Measurement of Threats to Patient Safety in Australian General Practice." Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/3899.
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The importance of better understanding error and safety in the community setting is widely accepted, with recent calls to promote efforts and improve resources in this area of research (Jacobson, Elwyn et al. 2003). The measurement of patient safety events in primary care is a relatively under-researched area and it is well recognized that there are large gaps in the research describing patient safety in ambulatory settings (Hammons, Piland et al. 2003). Attitudes towards embracing safety event measurement have improved in recent years, however there remains a substantial amount of work to be done before common standards can be recommended, despite recent calls in the scientific literature for national and international systems (Runciman, Williamson et al. 2006). This thesis describes the Threats to Australian Patient Safety (TAPS) study, which aimed to create a secure anonymous web-based error reporting system suited to the Australian general practice setting, and then describe and quantify the errors reported by a representative random sample of Australian general practitioners. The study was made possible with the support of funding from a National Health and Medical Research Council project grant, and also gained support from NSW Health and the Commonwealth Department of Health and Aging in the form of granting qualified privilege and providing essential Medicare data under legal instrument. The study methodology involved the development of a database management system which created an electronic method for managing and analysing a wide variety of vii features related to large numbers of anonymously reported errors from Australian general practice. A representative random sample of 84 general practitioners (GPs) from New South Wales (NSW) participated in the study, with over 400 errors reported in a 12 month period. The key messages arising from the TAPS study were: • GPs embraced anonymous patient safety event reporting using a secure website, with the majority of study participants making reports • New findings from this study on the incidence of reported error in general practice were published in the scientific literature, which will help guide the design of future error reporting systems • A new taxonomy to describe reported error from GPs was developed as part of this study and published in the scientific literature, with the view of allowing future self-coding of reported patient safety events by GPs The TAPS study presented the first calculations known worldwide of the incidence of reported error in a general practice setting using a representative random sample of general practitioners. It was found that if an anonymous, secure, web-based reporting system was provided, approximately 2 errors were reported by general practitioners per 1000 patients seen per year (Makeham, Kidd et al. 2006). In addition, the study created a simple descriptive general practice based error taxonomy, entitled the TAPS taxonomy (see Appendix 10) (Makeham, Stromer et al. 2007), and was the first study to test the reproducibility of the application of such a viii tool using a group of general practitioners. The TAPS taxonomy developed as part of this study was found to have a good level of inter-coder agreement. With respect to the underlying causes of errors, the TAPS study found that the majority of reported patient safety events were errors related to the processes of health care (70%), rather than errors related to the knowledge and skills of health professionals (30%). Most errors reported in the TAPS study had the direct involvement of a patient (93% of error reports). Overall the reporting general practitioners were very familiar with these patients, who were on average 52 years old, and more often female (56%). Around one quarter of the errors reported was associated with patients being harmed. Reports containing events related to processes of health care were associated less with harm than those containing events related to the knowledge and skills of health professionals. The patients in errors associated with patient harm reported in the TAPS study were on average older than patients in reports where no harm was known to have occurred (58 years versus 50 years respectively). There was no statistically significant difference found between these groups with respect to gender or ethnicity, including people from Non-English speaking backgrounds or Aboriginal and Torres Strait Islander (ATSI) peoples, although the association with the latter group approached statistical significance. ix Cases of patient death were reported in 8 of 415 errors reported in the TAPS study (2%), and more often involved events relating to the knowledge and skills of health professionals than events relating to the processes of health care compared to reports not involving a known patient death. In support of suggestions in the scientific literature about the importance of anonymity as a feature of an error reporting system, a feedback interview found that an anonymous reporting system was a factor which made participants more likely to report error events, with two thirds of participants agreeing that anonymity made them more likely to participate in reporting. The majority of participants found the reporting process easy to undertake, and took approximately 6 minutes to send a report. The study provided a self directed learning educational activity for participating general practitioners that was approved for 30 group 1 Quality Assurance and Continuing Education points by the Royal Australian College of General Practitioners (RACGP). An important practical outcome of the TAPS study was that it highlighted a systematic error relating to immunisation failures with meningococcal vaccines which was reported to relevant organisations including NSW Health, the RACGP and the manufacturer involved, which was addressed with educational materials for GPs being distributed and communication in Australian Family Physician. x There are further analyses that could be undertaken using the TAPS data to improve our understanding of the errors reported, such as further statistical analyses using techniques such as building a model with multiple regression to determine significant factors that contribute to different error types. This work was beyond the scope of the TAPS study aims, but is part of further research recommendations. In addition, future studies should address aspects of patient safety and reported error that it would not be possible to capture from the perspective of the reporting GP. Rather than one taxonomy which describes the reported errors from the GP’s perspective in the way that the TAPS taxonomy does, it may be useful to develop a series of interlinked taxonomies that are directed to the needs of differing constituencies, such as the organisation providing health funds or the health insurer, the health regulators and legislators, and the patients or their significant others. The assessment of potential and actual harms sustained by patients involved in reported errors is a further area of patient safety research that is difficult to comprehensively assess, and existing reporting systems in the literature, whilst addressing this from the reporter’s perspective, require further work to improve the accuracy by which harm is measured and correlated with other data sets such as those managed by health insurers, and the experiences of people who are the subject of the reports. The TAPS study presents a number of new findings about the nature of error and threats to patient safety that arise in the Australian health care environment, reported by a representative sample of general practitioners, and it is hoped that these will be xi useful to all stakeholders in the health care setting, from clinicians, through to policy makers, and most importantly the patients who are the subject of the potentially preventable harms and near misses that are highlighted in this thesis
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Makeham, Meredith Anne Blatt. "The Measurement of Threats to Patient Safety in Australian General Practice." University of Sydney, 2008. http://hdl.handle.net/2123/3899.
Full textAbstract:
Doctor of Philosophy(PhD)<br>The importance of better understanding error and safety in the community setting is widely accepted, with recent calls to promote efforts and improve resources in this area of research (Jacobson, Elwyn et al. 2003). The measurement of patient safety events in primary care is a relatively under-researched area and it is well recognized that there are large gaps in the research describing patient safety in ambulatory settings (Hammons, Piland et al. 2003). Attitudes towards embracing safety event measurement have improved in recent years, however there remains a substantial amount of work to be done before common standards can be recommended, despite recent calls in the scientific literature for national and international systems (Runciman, Williamson et al. 2006). This thesis describes the Threats to Australian Patient Safety (TAPS) study, which aimed to create a secure anonymous web-based error reporting system suited to the Australian general practice setting, and then describe and quantify the errors reported by a representative random sample of Australian general practitioners. The study was made possible with the support of funding from a National Health and Medical Research Council project grant, and also gained support from NSW Health and the Commonwealth Department of Health and Aging in the form of granting qualified privilege and providing essential Medicare data under legal instrument. The study methodology involved the development of a database management system which created an electronic method for managing and analysing a wide variety of vii features related to large numbers of anonymously reported errors from Australian general practice. A representative random sample of 84 general practitioners (GPs) from New South Wales (NSW) participated in the study, with over 400 errors reported in a 12 month period. The key messages arising from the TAPS study were: • GPs embraced anonymous patient safety event reporting using a secure website, with the majority of study participants making reports • New findings from this study on the incidence of reported error in general practice were published in the scientific literature, which will help guide the design of future error reporting systems • A new taxonomy to describe reported error from GPs was developed as part of this study and published in the scientific literature, with the view of allowing future self-coding of reported patient safety events by GPs The TAPS study presented the first calculations known worldwide of the incidence of reported error in a general practice setting using a representative random sample of general practitioners. It was found that if an anonymous, secure, web-based reporting system was provided, approximately 2 errors were reported by general practitioners per 1000 patients seen per year (Makeham, Kidd et al. 2006). In addition, the study created a simple descriptive general practice based error taxonomy, entitled the TAPS taxonomy (see Appendix 10) (Makeham, Stromer et al. 2007), and was the first study to test the reproducibility of the application of such a viii tool using a group of general practitioners. The TAPS taxonomy developed as part of this study was found to have a good level of inter-coder agreement. With respect to the underlying causes of errors, the TAPS study found that the majority of reported patient safety events were errors related to the processes of health care (70%), rather than errors related to the knowledge and skills of health professionals (30%). Most errors reported in the TAPS study had the direct involvement of a patient (93% of error reports). Overall the reporting general practitioners were very familiar with these patients, who were on average 52 years old, and more often female (56%). Around one quarter of the errors reported was associated with patients being harmed. Reports containing events related to processes of health care were associated less with harm than those containing events related to the knowledge and skills of health professionals. The patients in errors associated with patient harm reported in the TAPS study were on average older than patients in reports where no harm was known to have occurred (58 years versus 50 years respectively). There was no statistically significant difference found between these groups with respect to gender or ethnicity, including people from Non-English speaking backgrounds or Aboriginal and Torres Strait Islander (ATSI) peoples, although the association with the latter group approached statistical significance. ix Cases of patient death were reported in 8 of 415 errors reported in the TAPS study (2%), and more often involved events relating to the knowledge and skills of health professionals than events relating to the processes of health care compared to reports not involving a known patient death. In support of suggestions in the scientific literature about the importance of anonymity as a feature of an error reporting system, a feedback interview found that an anonymous reporting system was a factor which made participants more likely to report error events, with two thirds of participants agreeing that anonymity made them more likely to participate in reporting. The majority of participants found the reporting process easy to undertake, and took approximately 6 minutes to send a report. The study provided a self directed learning educational activity for participating general practitioners that was approved for 30 group 1 Quality Assurance and Continuing Education points by the Royal Australian College of General Practitioners (RACGP). An important practical outcome of the TAPS study was that it highlighted a systematic error relating to immunisation failures with meningococcal vaccines which was reported to relevant organisations including NSW Health, the RACGP and the manufacturer involved, which was addressed with educational materials for GPs being distributed and communication in Australian Family Physician. x There are further analyses that could be undertaken using the TAPS data to improve our understanding of the errors reported, such as further statistical analyses using techniques such as building a model with multiple regression to determine significant factors that contribute to different error types. This work was beyond the scope of the TAPS study aims, but is part of further research recommendations. In addition, future studies should address aspects of patient safety and reported error that it would not be possible to capture from the perspective of the reporting GP. Rather than one taxonomy which describes the reported errors from the GP’s perspective in the way that the TAPS taxonomy does, it may be useful to develop a series of interlinked taxonomies that are directed to the needs of differing constituencies, such as the organisation providing health funds or the health insurer, the health regulators and legislators, and the patients or their significant others. The assessment of potential and actual harms sustained by patients involved in reported errors is a further area of patient safety research that is difficult to comprehensively assess, and existing reporting systems in the literature, whilst addressing this from the reporter’s perspective, require further work to improve the accuracy by which harm is measured and correlated with other data sets such as those managed by health insurers, and the experiences of people who are the subject of the reports. The TAPS study presents a number of new findings about the nature of error and threats to patient safety that arise in the Australian health care environment, reported by a representative sample of general practitioners, and it is hoped that these will be xi useful to all stakeholders in the health care setting, from clinicians, through to policy makers, and most importantly the patients who are the subject of the potentially preventable harms and near misses that are highlighted in this thesis
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D'Esmond, Lynn Berggren Knapp. "Distracted Practice and Patient Safety: The Healthcare Team Experience: A Dissertation." eScholarship@UMMS, 2016. https://escholarship.umassmed.edu/gsn_diss/41.
Full textAbstract:
Purpose: The purpose of this study was to explore the experiences of distracted practice across the healthcare team.
Definition: Distracted practice is the diversion of a portion of available cognitive resources that may be needed to effectively perform/carry out the current activity.
Background: Distracted practice is the result of individuals interacting with the healthcare team, the environment and technology in the performance of their jobs. The resultant behaviors can lead to error and affect patient safety.
Methods: A qualitative descriptive (QD) approach was used that integrated observations with semi-structured interviews. The conceptual framework was based on the distracted driving model and a completed concept analysis.
Results: There were 22 observation sessions and 32 interviews (12 RNs, 11 MDs, and 9 Pharmacists) completed between December, 2014 and July 2015. Results suggested that distracted practice is based on the main theme of cognitive resources which varies by the subthemes of individual differences; environmental disruptions; team awareness; and “rush mode”/time pressure.
Conclusions and Implications: Distracted practice is an individual human experience that occurs when there are not enough cognitive resources available to effectively complete the task at hand. In that moment an individual shifts from thinking critically, being able to complete their current task without error, to not thinking critically and working in an automatic mode. This is when errors occur. Additional research is needed to evaluate intervention strategies to reduce and prevent distracted practice.
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Green, Trevor David. "Food Safety Practice and Food Safety Knowledge in Australia's Retail Food Businesses: Levels, Gaps and Directions for Reform." Thesis, Griffith University, 2009. http://hdl.handle.net/10072/365584.
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Food safety is one of the World Health Organisation’s (WHO) top ten priorities (WHO 2008). The WHO (1999a) estimates that the incidence of diarrhoeal diseases alone is 4000 million cases per year worldwide indicating serious underlying food safety problems. WHO (1999a) also advises that contaminated food contributes to 1.5 billion cases of diarrhoea in children each year, resulting in more than three million premature deaths. These food-borne deaths and illnesses are shared by both developed and developing nations (Centre for Science in the Public Interest 2005). Food poisoning remains a significant public health issue for Australia (Australia New Zealand Food Authority (ANZFA) 1996), with an estimated 4.2 million individual cases of food-borne illness in Australia per year, resulting in a total annual cost to Australia of approximately $2.7 billion per year (Queensland Health 1999; ANZFA 1999b). Unofficial estimates of the number of food-borne illness cases in Queensland in 2002 are between 1.6 million and 1.9 million cases per year. Internationally the WHO has called for more systematic and aggressive steps to be taken to significantly reduce the risk of food-borne diseases (WHO 2008). Nationally the federal government states that the most important reason for introducing food safety reform in Australia is the need to reduce the national incidence of food-borne illness (Roche 2002). The Queensland government has adviseded that it is committed to food safety in the food supply chain from source to consumption (Queensland Health 2000). Australia’s food hygiene regulatory system costs government $18.6 million (net) to enforce and small business $337 million in compliance costs per year, and yet 11,500 consumers contract food-borne disease every day (ANZFA 1999b). Federal, state and territory governments throughout Australia have all acknowledged that this is unacceptable. A reduction in food-borne illness of just 20% would result in an annual saving to the Australian community of over $500 million (ANZFA 1999a), as well as reducing human mortality, morbidity and suffering. To improve the safety of our food, reduce food-borne illness and to assist Australia develop a thriving food industry, the federal, state and territory governments agreed on a series of national food safety reforms (Queensland Health 2000; ANZFA 1999a). But this is not an easy task. The food industry is one of Australia’s major employers with an estimated 131,500 food businesses throughout the country and an annual retail turnover in 1996-1997 of $41 billion (Queensland Health May 1999). In Queensland there are approximately 30,000 registered food businesses (Queensland Health 2004). The majority of these are small food businesses. Owners of small food businesses face considerable challenges to be successful. To improve food safety levels, a number of challenges must be faced and overcome by the both the food industry and government at all levels...<br>Thesis (Masters)<br>Master of Philosophy (MPhil)<br>Griffith School of Environment<br>Science, Environment, Engineering and Technology<br>Full Text
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Pengelly, Jon. "Environmentally sensitive printmaking : a framework for safe practice." Thesis, Robert Gordon University, 1997. http://hdl.handle.net/10059/605.
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This research is concerned with establishing a rationale which will link safe printmaking practices with artists' individual and sustainable creative practices, by investigating the preconception that printmaking practices may be limited by adopting such an environmentally sensitive approach. This has been investigated through a practice-led approach, which implicitly involves the researchers' professional practice as a visual artist printmaker. The cross disciplinary nature of this practice-led research has established that diverse and non-text based sources be included in the literature review. The resulting contextual review established the evolutionary nature of printmaking practices, the role played by individual artists perceptions of risk, and the limited ability of available literature to adequately link evolving and didactic creative practices to emergent boundaries established by environmental and occupational health and safety legislative criteria. There was evidently no theoretical framework for linking these apparently divergent criteria. The multi-disciplinary and practice-led context i. e. the research was generated by practice and carried out through practice, determined the range of methods employed: questionnaire, quantitative tests of materials; participation in, and initiation of collaborative case studies; documenting workshop practice and visual development of printed art works; and exhibition for peer review. These multiple methods and their complex interrelationships were visualised as a system of consequential actions, in order to externalise possible alternative actions and choices made by the researcher in response to this research. Analysis of these methods revealed that: the collaborative case studies and the researcher's own visual and practical response, established that a systematic revaluation of practice could link the idiosyncratic and individual creative practices to the use and selection of nonhazardous practices, which did respond to objective occupational health and safety rationale. This revealed the extent to which a systematic re-evaluation of 'established practices' may be synthesised into the working practice of the researcher and lead to the diversification of that practice - visually and practically. This process has resulted in the generation of a body of printed art works which implicitly embodied the hypothesis developed in this research; the development of a electronic database or 'morphological framework', which initiates a sequential examination of process at a structural level, collating, comparing and promoting previously un-considered alternatives based on a heterarchical model of risk. This process has offered tangible means of visualising the generative processes involved in making prints. The 'morphological framework' has implicitly linked the researcher's printmaking to a sustainable and environmentally sensitive creative practice, which is methodologically transparent and procedurally transferable.
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Hassan, Aymane. "Handling river floating debris for dam safety – the state of the practice." Thesis, KTH, Betongbyggnad, 2020. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-289387.
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This study reviews the current knowledge and state of the practice for handling floating debris for dam safety. This report is a guidance to improve the understanding of risks of floating debris for dam safety and of countermeasures for risk reduction. The strengths and limitations of current approaches related to dam vulnerability assessment and handling strategies are discussed and recommendations are provided. Several countries experienced issues with floating debris which often led to severe damages to dam spillways. High and extreme flood events could be responsible for similar incidents in Sweden which requires to systematically assess dam vulnerability to floating debris and examine suitable countermeasures. A vulnerability assessment involves investigating the potential for debris production, for debris transport to the dam facility and for blockage and drawdown at spillways. Various concepts for reducing the vulnerability of dam spillways to floating debris were presented in the technical literature. Countermeasures for floating debris management based on a river perspective approach involve controlling the debris yield produced in a catchment, the interception of floating debris in tributaries and reservoirs and measures taken at dam spillways to facilitate floating debris passage. Floating debris management often requires opting for a combination of suitable and cost-efficient measures rather than a single line of defense.
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Dash, Shirlana Norene. "Effectiveness of Practice Change From Risk Model to Safety Model at DHS." ScholarWorks, 2018. https://scholarworks.waldenu.edu/dissertations/5067.
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In 2012, the U.S. Department of Health and Human Services reported an estimated 686,000 victims of child abuse and neglect. Forty-nine states reported a total of 1,593 fatalities. This quantitative research study examined the relationship between the variables: age of child, gender of child, age of parent/caregiver, prior substantiated reports of abuse, and incidents of abuse in Philadelphia at the Department of Human Services using risk practice model (RPM) and safety practice model (SPM). Although child welfare practitioners have examined the relationship between family and societal factors that affect child abuse; few researchers have examined the correlation between service delivery practice models and incidents of abuse. The findings of this quantitative study examined 34,761 components of variable data from the Department of Human Services revealed that the age of the child, age of the caregiver, and incidents of abuse are statistically significant predictors of abuse, whereas the gender of child had minimal effect on incidents of abuse. The most accurate predictor of child abuse is prior substantiated reports of abuse. The study shows that reports received in 2007 using the RPM were 9.6% more likely to have a valid report; likewise, every report received during the years 2007 and 2012 increases the probability of a valid report by 94.2%. Development of a comprehensive assessment tool that combines the principle tenets of both RPM and SPM is recommended. The implications for social change include developing a practice model that can increase safety probabilities while diminishing incidents of abuse by using a more comprehensive assessment tool.
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Pandiani-Vlachos, Teresa. "Air navigation safety over prohibited and danger areas : international regulation and state's practice." Thesis, McGill University, 1989. http://digitool.Library.McGill.CA:80/R/?func=dbin-jump-full&object_id=61753.
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Wright, Frank Beverley. "The enforcement policy and practice of the Health and Safety Executive, 1974-1990." Thesis, University of Leicester, 1995. http://hdl.handle.net/2381/34907.
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Murray, Melanie Anne. "Linking patient safety to clinical practice: The insight of new graduate registered nurses." Thesis, Murray, Melanie Anne (2019) Linking patient safety to clinical practice: The insight of new graduate registered nurses. PhD thesis, Murdoch University, 2019. https://researchrepository.murdoch.edu.au/id/eprint/50613/.
Full textAbstract:
New graduate registered nurses’ (NGRNs) transition to practice with limited clinical experiences and skills. The related anxiety and stress predispose new graduate nurses to increased risk of contributing to preventable errors or adverse events. This risk, together with the new graduate’s fledgling ability to manage clinical deterioration, potentially compromises quality and safety of patient outcomes.
A longitudinal mixed methods design was used to develop an understanding of new graduate registered nurses’ patient safety knowledge and actions within the first year of nursing registration and offer important insights into NGRNs’ transition with a patient safety focus. New graduate registered nurses employed in graduate nurse programs at two Australian metropolitan hospitals were invited to participate. Data collection activities took place from August 2016 to February 2018.
A closed-ended questionnaire, a modified version of the “Medical students’ questionnaire of knowledge, skills, and attitudes regarding patient safety”, was delivered at three time points during the graduate program to monitor the evolution of the NGRNs’ knowledge, feelings and attitudes regarding medical errors and patient safety over time. Qualitative data was collected by semi-structured one-on-one interviews to gain a deeper appreciation of the NGRNs knowledge of patient safety and challenges of integrating this knowledge into their clinical practice.
Quantitative data were analysed using ANOVA One-way analysis of variance, or General Linear Model for repeated measures to measure vi difference, if any, between the time points. Qualitative data analysis was guided by Braun and Clark’s six steps of thematic analysis.
Quantitative results were categorised into the four subcategories of knowledge of medical error; knowledge of actions regarding medical error; attitudes to compromised patient safety; and intentions regarding patient safety prior to analysis. Thematic analysis revealed five main themes: patient safety and insights; time management; making a mistake; experiential learning; and transition.
Although confidence was low, participants intend to communicate, support, and intervene, when faced with compromised patient safety situations. However, self-reported knowledge of medical error and knowledge of actions regarding medical error decreased over the three time points. Medical errors and time management persist as stressors to the NGRNs early months of transition to the registered nurse role. New graduates reported moderate knowledge of safety and quality issues, however, their questioning of their own abilities overshadowed growth in their involvement in patient safety.
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Murray, Melanie. "Linking patient safety to clinical practice: The insight of new graduate registered nurses." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2019. https://ro.ecu.edu.au/theses/2237.
Full textAbstract:
New graduate registered nurses’ (NGRNs) transition to practice with limited clinical experiences and skills. The related anxiety and stress predispose new graduate nurses to increased risk of contributing to preventable errors or adverse events. This risk, together with the new graduate’s fledgling ability to manage clinical deterioration, potentially compromises quality and safety of patient outcomes.
A longitudinal mixed methods design was used to develop an understanding of new graduate registered nurses’ patient safety knowledge and actions within the first year of nursing registration and offer important insights into NGRNs’ transition with a patient safety focus. New graduate registered nurses employed in graduate nurse programs at two Australian metropolitan hospitals were invited to participate. Data collection activities took place from August 2016 to February 2018.
A closed-ended questionnaire, a modified version of the “Medical students’ questionnaire of knowledge, skills, and attitudes regarding patient safety”, was delivered at three time points during the graduate program to monitor the evolution of the NGRNs’ knowledge, feelings and attitudes regarding medical errors and patient safety over time. Qualitative data was collected by semi-structured one-on-one interviews to gain a deeper appreciation of the NGRNs knowledge of patient safety and challenges of integrating this knowledge into their clinical practice.
Quantitative data were analysed using ANOVA One-way analysis of variance, or General Linear Model for repeated measures to measure vi difference, if any, between the time points. Qualitative data analysis was guided by Braun and Clark’s six steps of thematic analysis.
Quantitative results were categorised into the four subcategories of knowledge of medical error; knowledge of actions regarding medical error; attitudes to compromised patient safety; and intentions regarding patient safety prior to analysis. Thematic analysis revealed five main themes: patient safety and insights; time management; making a mistake; experiential learning; and transition.
Although confidence was low, participants intend to communicate, support, and intervene, when faced with compromised patient safety situations. However, self-reported knowledge of medical error and knowledge of actions regarding medical error decreased over the three time points. Medical errors and time management persist as stressors to the NGRNs early months of transition to the registered nurse role. New graduates reported moderate knowledge of safety and quality issues, however, their questioning of their own abilities overshadowed growth in their involvement in patient safety.
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Watson, Margaret C. "The development, implementation and evaluation of prescribing guidelines in general practice." Thesis, University of Bristol, 1998. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.265364.
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Desmond, Martin, and Henrik Hansson. "The safety manager as a boundary spanner between communities of practice : The employment of a safety manager in a Swedish construction company." Thesis, KTH, Fastigheter och byggande, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-212069.
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Safety is an important concern within the construction industry. Many different management strategies exist in the literature, but despite ambitious efforts to improve the safety and prevent accidents, the accident incidence is still unacceptably high. This paper examines the employment of a safety manager in the Swedish construction industry as a strategy to foster a better safety culture, and discusses how the safety manager should approach the project based organisation (PBO). The study uses an abductive approach with an iteration of interviews, observations and a literature study to gain deeper knowledge of the subject. The research comprises a cross sectional interview study of semi-structured interviews to narrate the role of the safety manager accompanied with a short survey. The study is limited to three projects of one Swedish construction company, and a new role not yet established in the company. Furthermore, the study uses a human resource management approach with focus on communities of practice and boundary spanning. The findings report that the safety managers take on a role as a boundary spanning link between well-established but unsynchronized communities of practice. The identified communities are the HR department and the PBOs. Furthermore, the safety manager functions as a “double-sided” boundary spanner, to broke knowledge and support employees to achieve a satisfactory safety culture. However, the narratives express a present ambiguity and a need to clarify the role and its responsibilities regarding safety in the PBO. The thesis contributes with insights of the safety manager’s practice and discusses how safety knowledge should be transferred between communities of practice in the fragmented PBO and its high level of tacit knowledge.<br>Arbetsmiljö och säkerhet är ett viktigt ämne inom byggbranschen. Många olika strategier och metoder för att förbättra arbetsmiljön finns också tillgängliga. Trots detta inträffar alltför många olycksfall. Denna studie undersöker strategin att anställa en safety manager i den svenska byggbranschen för att främja en bättre säkerhetskultur samt diskuterar hur en safety manager bör utöva sin profession. Ett kvalitativt abduktivt arbetssätt har tillämpats där intervjuer och observationer har växlats med litteraturstudier för att erhålla förståelse av ämnet. Studien är en multipel tvärsnittsfallstudie med semistrukturerade intervjuer samt en mindre enkätundersökning. Studien omfattar tre projekt i ett svenskt företag. Det teoretiska perspektivet utgår från, samt begränsas av koncepten human resource management (HRM), communities of practice och boundary spanning. Resultatet visar att safety managern kan fungera som en boundary role som länkar ihop olika osynkroniserade communities. Det identifieras att effektiv boundary spanning kan ske mellan HR-avdelningen och projektorganisationerna samt mellan produktionsledningen och yrkesarbetarna inom projektorganisationerna. Safety managern blir en double-sided boundary spanner som knowledge broker samt en support för anställda för att främja en god säkerhetskultur. Resultatet visar samtidigt att det råder oklarheter kring rollen och att bland annat ansvarsområden behöver förtydligas för att nå full potential. Studien bidrar med insikter i hur safety manager-rollen uppfattas och hur den fungerar, samt hur den kan förbättras. Vidare bidrar studien med förståelse för hur rollen kan främja kunskapsöverföring avseende arbetsmiljö mellan communities där hög grad av tyst kunskap råder.
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Caccia, Lewis E. Jr. "Risk Communication in the Workplace: An Analysis of Communication Toolkits as Rhetorical Practice." Kent State University / OhioLINK, 2009. http://rave.ohiolink.edu/etdc/view?acc_num=kent1239226189.
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Garvin, Theresa Dawn. "Evidence, policy and practice in environmental health : an international case study of sun safety /." Thesis, National Library of Canada = Bibliothèque nationale du Canada, 1999. http://www.collectionscanada.ca/obj/s4/f2/dsk1/tape8/PQDD_0033/NQ66209.pdf.
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Lewis-Smith, Alison. "A community of practice : a case study exploring safety and quality through professional leadership." Thesis, University of Southampton, 2013. https://eprints.soton.ac.uk/354123/.
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This research reports an emerging Community of Practice (CoP), informing how knowledge, understanding and learning were shared through professional leaders using stories to influence change and improve the safety and quality of services. The research focused on generating knowledge and dramatising leadership experiences in integrated community health and social care services. A case study design and multiple qualitative data collection methods were used. The analysis of all data sources revealed rich descriptions with several emerging features including: a) Constructing and sharing a meaning for professional leadership through partnership working to foster cross organisational learning. b) Creating an entrepreneurial identity through contextualising new knowledge and skills c) Developing skills and confidence to be instrumental in progressing the safety and quality agenda d) Using storytelling, sharing anecdotes to dramatise experiences and encourage debate creating shared meanings within the Community of Practice e) The Community of Practice created a forum for learning through generating professional capital by sharing experiential knowledge. The theory practice gap has been closed through professional practice and leadership discourse, developing new knowledge to lead and empower practitioners. In doing so it has widened the debate regarding the professional leadership structure in operation and questioned the need to reshape the context in which professional leaders act and are able to influence the safety and quality of services. Professional leaders should have continual investment as a resource to impact on safety and quality improvements, service developments and managing change. Communities of Practice should be acknowledged and established as an opportunity to generate collective knowledge and influence organisational development and change. Storytelling and narrative can be used as a recognised methodology for sharing specific experiences in order to reflect, contextualise and provide the language required to influence the wider organisational strategic direction. A recognised programme of further research should be considered.
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Popplewell, Ainslie. "Occupational health and safety in the workplace reform environment : striving for best practice occupational health and safety in the Email Washing Products divisions." Thesis, Federation University Australia, 1993. http://researchonline.federation.edu.au/vital/access/HandleResolver/1959.17/164910.
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Matias, Erica Oliveira. "Nursing practice assessment in the process of pediatrics intravenous drug administration." Universidade Federal do CearÃ, 2015. http://www.teses.ufc.br/tde_busca/arquivo.php?codArquivo=13393.
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The delivery process of the intravenous (IV) medication, one of the activities of greater responsibility of the nursing team, has a high incidence in child care in urgent and emergency situation. This process is considered highly complex and when not planned, controlled and monitored through indicators is exposed to unpredictable results affecting the quality of care. The objective was to evaluate the nursing practice in drug administration in child trough IV. Exploratory, descriptive, observational, quantitative study. It was developed in the urgency and emergency department in a pediatric referral hospital of the municipal sphere of Fortaleza. The study population consisted of 69 nurses whom participated in the drug administration via IV process that was in work schedules during the study period in the investigated unit. The sample of professionals was composed by 36 licensed practice nurses and 2 nurses. For the number of observations, it was considered the calculation for finite population with a total of 327 observations of intravenous medication delivery process. Interviews were carried out for data collection with the nursing staff and systematic observation of drug delivery process in children via IV. For data collection interviews were performed with the nursing staff and systematic observation by IV drug delivery process in children, considering seven stages, namely: medical prescription reading, hand hygiene, preparation of material and medication , guidance on the procedure, puncture technique and administration of the drug. Such steps have the total 47 shares. The data was stored in a database produced on the Windows Excel 2010 and analyzed according to the literature. The study was approved by the Ethics Committee under CAAE protocol 34651314.7.0000.5054. It was found that in 15% of the observations nursing professionals did not understand the prescription due to illegible handwriting professional. In 78.0% of the time there was no hand hygiene. It was found that all professionals used personal protective equipment (cap and mask), but none used gloves. Among the 327 observations included: peripheral intravenous device most commonly used was the scalp 21 (63.3%); selection of dorsal hand veins arc (83.9%); success on the first attempt of venipuncture (82.6%); explains the procedure for child and /or guardian (5.5%); calms the child (82.6%); performs antisepsis of the skin at the site to be punctured with a swab with 70% alcohol (100%); awaits antiseptic evaporation to then continue the procedure (45.6%); proper disposal of the materials used during the procedure (89.3%); checks the prescription immediately after drug administration (86.8%). It was found unsatisfactory performance in 23 actions by IV drug administration process. Therefore, we suggest the development of training for nursing professionals about medication delivery process.<br>O processo de administraÃÃo de medicamento por via intravenosa (IV), uma das atividades mais importante da equipe de Enfermagem, possui alta incidÃncia na assistÃncia à crianÃa em situaÃÃo de urgÃncia e emergÃncia. Tal processo à considerado de alta complexidade e, quando nÃo planejado, controlado e monitorado por meio de indicadores, fica exposto à imprevisibilidade de seus resultados, interferindo na qualidade da assistÃncia. Objetivou-se avaliar a prÃtica de enfermagem no processo de administraÃÃo de medicamento por via IV na crianÃa. Trata-se de um estudo exploratÃrio, descritivo, observacional, de natureza quantitativa, desenvolvido no setor de urgÃncia e emergÃncia de um hospital pediÃtrico de referÃncia da esfera municipal de Fortaleza-CE. A populaÃÃo do estudo foi constituÃda por 69 profissionais de enfermagem que participaram do processo de administraÃÃo de medicamento pela via IV e que estavam nas escalas de trabalho durante o perÃodo do estudo na unidade investigada. A amostra dos profissionais foi composta por 36 tÃcnicos de enfermagem e 2 enfermeiros. Para o nÃmero de observaÃÃes, considerou-se o cÃlculo para populaÃÃo finita, com um total de 327 observaÃÃes do processo de administraÃÃo de medicamento por via IV. Para a coleta de dados realizou-se entrevista com a equipe de enfermagem e observaÃÃo sistemÃtica do processo de administraÃÃo de medicamento por via IV na crianÃa, considerando sete etapas, quais sejam: leitura da prescriÃÃo mÃdica, higienizaÃÃo das mÃos, preparo do material e medicaÃÃo, orientaÃÃo acerca do procedimento, tÃcnica de punÃÃo e administraÃÃo do medicamento. Tais etapas possuem ao total 47 aÃÃes. Os dados foram armazenados em um banco de dados produzidos no Excel do Windows 2010, analisados estatisticamente e de acordo com a literatura pertinente. O estudo foi aprovado pelo Comità de Ãtica sob parecer N0 805.953. Constatou-se que em 15% das observaÃÃes o profissional de enfermagem nÃo compreendeu a prescriÃÃo mÃdica devido à letra ilegÃvel do profissional. Em 78,0% das observaÃÃes nÃo houve a higienizaÃÃo das mÃos. Identificou-se que todos os profissionais utilizaram equipamento de proteÃÃo individual (gorro e mÃscara), entretanto nenhum utilizou luvas. Dentre as 327 observaÃÃes destacaram-se como dispositivo intravenoso perifÃrico mais utilizado o scalp n 21 (63,3%); escolha das veias do arco dorsal da mÃo (83,9%); Ãxito na primeira tentativa da punÃÃo venosa (82,6%); orientaÃÃo sobre o procedimento para crianÃa e/ou responsÃvel (5,5%); acalma a crianÃa (82,6%); realizaÃÃo de antissepsia da pele no local a ser puncionado com algodÃo embebido com Ãlcool a 70% (100%); aguarda a evaporaÃÃo do antissÃptico para em seguida dar prosseguimento ao procedimento (45,6%); descarte adequado dos materiais utilizados durante o procedimento (89,3%); checou a prescriÃÃo imediatamente apÃs a administraÃÃo do medicamento (86,8%). Concluiu-se desempenho insatisfatÃrio em 23 aÃÃes do processo de administraÃÃo de medicamento por via IV. Portanto, sugere-se o desenvolvimento de capacitaÃÃo para os profissionais de enfermagem acerca do processo de administraÃÃo de medicamento.
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Yap, Yong Hwee Kristine. "Learning safety in the workplace: A case study of petrochemical workers in Singapore." Thesis, Griffith University, 2017. http://hdl.handle.net/10072/375773.
Full textAbstract:
The ability to work effectively, including being able to identify changing circumstances and respond to them efficaciously, is an enduring goal for workers, workplaces, and governments. One key element of the ability to work effectively is working safely. The oil and petrochemical industries are amongst the most hazardous and risky environments where failure to understand and maintain safe practices can lead to potentially disastrous consequences. Hence, workers must engage in continuing learning at work to maintain high standards of safe and effective work practice.
In workplaces, individuals constantly influence and adjust to each other’s emerging behaviours, ideas, and intentions, including artefacts and objects through a myriad of complex interactions and fluctuations. Unlike most classroom-based learning which transpires in predefined context, all these social processes in a workplace can have profound impact in shaping learning and practices within the organizational members. In line with such considerations, the primary contribution of this research is to understand how safety is learnt in the context of everyday work circumstances.
This thesis addresses the conundrum faced by high-risk organizations to maintain high levels of safety and avoid workplace accidents. The main research question guiding this study is: How can workplace learning be optimized to develop and sustain occupational competencies for workplace safety and health? This will be explored through three sub-questions:
1. What are the current provisions of learning for safety and health in a process plant?
2. How do workers engage and participate in workplace learning for safety? and
3. How can their workplace learning be optimised?
A case-study approach was adopted for this inquiry to explore how site operators learn to work safely during everyday work at a petrochemical plant in Singapore. The inquiry entailed in-depth interviews with 20 site operators working in various technical roles at the work site, across an 8-week period. The aim was to identify exemplary practices that contributed to and enhanced their learning and performing tasks safely.
Findings from the interviews provided rich insights into an array of institutional, social, and personal contributions and imperatives that serve as important bases for appraising the pedagogical and invitational qualities of the workplace in supporting learning and practice. These salient contributions exemplified how workers mediate their learning through participation in different practice arrangements, utilisation of artefacts and materials, as well as seeking guidance from intermediaries and social agents who provided pedagogically rich learning. Furthering these, the study posits that learning to work safely in a perilous workplace and trade will need to be contextual, interactional, relational and, more importantly, supported with legitimate and quality guidance.
Drawing on these findings, the study highlights four distinct qualities that characterise how learning for safe work practices is supported and developed during work circumstances. These include:
1. Considerations for circumstantial and practice requirements
2. Legitimate and appropriate guidance
3. Interactive and informative pedagogies
4. Relational and purposeful alignment with personal and organisational goals.
A learning framework is developed to facilitate these considerations through the intertwined relationship of workplace, agency and safety as a situated form of knowledge. Ways to enhance workplace learning and advance safety practice are proposed. These include advocating the need to leverage the workplace as a learning space to re-contextualise knowledge that will enhance congruency between theory and practice; effective utilisation of those social-cultural imperatives for reaffirming procedures and refine practices; and creating spaces for dialogic exploration ( Freire et.al, 1997) and strengthening relational agency (Edwards, 2011) to deepen workers’ thinking skill for occupational efficacies and achieve intersubjectivity (Alterman, 2007) consensus for safe working.
Overall, this study enriches understandings of how workers situated in perilous work settings learn to work safely in specific or situational work circumstances. The findings suggest effective interventions to enhance occupational efficacies and organizational performance in safety practice. At a national level, the study contributes to refinement of the continuing education and training (CET) framework, curriculum design and reinforcement of practices that augment individual and organisational learning. Further research is recommended to investigate how the proposed interventions and pedagogical strategies effect learning and practice outcomes in similar high-risk workplaces to draw more conclusive generalisations on ways to enhance workplace learning for safety practice.<br>Thesis (Professional Doctorate)<br>Doctor of Education (EdD)<br>School Educ & Professional St<br>Arts, Education and Law<br>Full Text
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Harmon, debran L. "Anesthesia Safety: Filter Needle Use With Glass Ampules." UNF Digital Commons, 2014. http://digitalcommons.unf.edu/etd/538.
Full textAbstract:
Glass particle contamination of medication occurs when opening ampules which may cause patient harm. The use of filter needles reduces this risk. Many anesthesia providers use ampules daily, but do not use filter needles when aspirating medications from ampules. In addition, filter needles may not be readily available at the anesthesia medication preparation site. Not using filter needles or having them available for use can increase the risk of patient harm by glass particle contamination. The purpose of this project was to increase anesthesia provider’s knowledge thereby improving compliance with evidence-based standards when preparing medications from ampules. The goal is to increase filter needle use when medication is aspirated from an ampule in order to decrease the risk of glass particle contamination to the patient. This project consisted of a one-group pre/post intervention design using a piloted self-developed survey, an education intervention, and tracking of filter needle use. The convenience sample of eighty-three recruited anesthesia providers included anesthesiologists, nurse anesthetists, and anesthesiologist assistants that consented to participate. The filter needle inventory was tracked via an existing software program to determine filter needle use three months prior and three months after the intervention. Data were collected and analyzed using descriptive statistics. The results of this project found greater awareness among participants of standards and organizations regarding filter needle use with ampules, greater awareness of availability of filter needles on anesthesia carts, and a five-fold increase in filter needle usage by participants three months following the intervention as compared to three months prior to the intervention.
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Gauthereau, Vincent. "Work practice, safety and heedfulness : studies of organizational reliability in hospitals and nuclear power plants /." Linköping : Univ, 2003. http://www.bibl.liu.se/liupubl/disp/disp2003/tek842s.pdf.
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Ernawati, Desak Ketut. "Medication safety in Indonesia: Expanding pharmacists’ role through Interprofessional Education (IPE) and Interprofessional Practice (IPP)." Thesis, Curtin University, 2015. http://hdl.handle.net/20.500.11937/2047.
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This study undertaken in Indonesia, examined how the pharmacist's role could be expanded into medication safety. It explored the feasibility of implementing interprofessional education as a means of fostering interprofessional practice. While also looking at pharmacy students' readiness to engage in interprofessional learning and graduates' perceptions of their preparedness to deliver patient care, a clinical pharmacy service pilot was also conducted to document need. Facilitators and barriers to education and practice change were also explored.
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Lundvall, Lise-Lott. "Radiographers’ professional practice : a Swedish perspective." Licentiate thesis, Linköpings universitet, Avdelningen för radiologiska vetenskaper, 2014. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-111722.
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The general aim of this thesis was to empirically describe the radiographers’ professional scope in diagnostic imaging from the viewpoint of the practitioners and investigate how technical development affects the relations and actions in this practice. Data was collected by interviews and observations to both studies at the same time with two different aims. Eight radiographers (n=8) were interviewed. The interviews were open in character, were recorded with a digital voice recorder, and transcribed verbatim by the interviewer. The interview guide consisted of four interview questions. The observations of radiographers during their work with Computer Tomography (CT) and Magnetic Resonance Imaging (MRI) were conducted in a middle-sized radiology department in the southern part of Sweden. The observations were ten (n=10) in total. Two different theoretical perspectives were used: phenomenology (Study I) and practice theory perspective (Study II). Data was analysed with a phenomenological method in Study I. In Study II data was firstly analysed inductively, which resulted in seven codes. Secondly, abduction was made by interpretation of these codes from a practice theory perspective. This led to four themes. The findings in Study I display the main aspect of the radiographers’ work with image production. Their general tasks and responsibilities can be viewed as a process with the goal of producing images that can be used for diagnosis purposes. The process has three different phases: planning the examination, production of images, and evaluation of the image quality. The radiographers experience the production of images as their autonomous professional area. The findings in Study II report how technology development affects the relations between different actors and their actions in the practice of Computer Tomography. Four themes were identified; 1) Changed materiality makes the practical action easier. Radiographers’ practica work with image production has become easier when working with CT compared to conventional techniques because the CT usually performs the image production in one scan. 2) Changed machines cause conflict between the arrangements of the work and the patients` needs. It is difficult to plan the examination individually for each patient because of the arrangements of the CT practice, i.e. they have little information about the patient before the examination. 3) Changing materiality prefigures learning. The radiographers describe a need for constant learning activities because of the changing procedures for image production and new modalities for image production. If not achieved it may affect their relations with the patients. 4) How the connections between different practices lead to times when practical reasoning is required in the radiography process with CT. The connections between the different professions in CT practice mainly occur through material arrangements because physically they work in different areas. The external arrangements in CT practice pre-figure actions for securing accurate radiation level and image quality. But the radiographers, who meet the patients, have to critically judge the intended actions in relation to clinical observed data to ensure patient safety.
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Othman, Fatmah. "Epidemiology of proton pump inhibitors therapy : an examination of the use and safety in general practice." Thesis, University of Nottingham, 2017. http://eprints.nottingham.ac.uk/42399/.
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Background: Proton pump inhibitors (PPIs) have become the cornerstone of medical treatment for acid-related gastrointestinal disorders. To date, there is a distinct lack of understanding about the recent UK trends in PPI use and evidence about the association between the increased risk of these drugs and the potential adverse effects, in particular the risk of infection, remains questionable. The publication of contradictory findings in several research studies further compounds this situation. Aim and Objectives: This thesis aimed to examine the epidemiology of PPI use in general practices in the UK, and the side effects of PPI, mainly their proposed infective complications. The specific objectives were: • To determine the prevalence and pattern of PPI prescription, and to identify the practices employed to reduce PPI use in the UK general population. • To examine the risk of community-acquired pneumonia before and after the administration of PPI and to assess whether unmeasured confounding explains this association. • To determine whether the mechanism by which PPIs induce an increased risk of infection is supported by the same mechanism acting in another cause of achlorhydria, pernicious anaemia. Methods: This thesis describes work conducted using the UK’s Clinical Practice Research Database (CPRD) and, for some studies in this project, a subset of the CPRD linked to the hospital records from the Hospital Episodes Statistics (HES) database. Firstly, the CPRD was used to estimate the annual prevalence of PPI use during the period 1990-2013. In this study, new users of PPI therapy who had five years of follow-up data were identified to describe patterns of cessation and duration of PPI use. Secondly, cohort (analysed using Cox regression and prior event rate ratio) and self-controlled case series studies were conducted to examine the risk of community-acquired pneumonia and PPI exposure. Thirdly, a cohort of pernicious anaemia patients was used to estimate the risk of infections (community-acquired pneumonia and Clostridium difficile infection) compared to controls to examine whether a reduction in gastric acidity might be the underlying mechanism of the increased risk of these infections. Findings: 1) There was a considerable increase in the administration of PPI prescriptions in UK general practice such that both the period and point prevalence of PPI use increased between 1990 and 2012 (period prevalence increased from 0.2% to 14.8% and point prevalence from 0.03 % to 7.7%). Of new users of PPI therapy, 27% used PPI therapy over a long-term basis (≥1 year continuously), while 4% remained on PPI therapy for five years. Clear attempts to step down the dosage were identified in 41% of long-term users. 2) Among 320, 000 patients, including 160 ,000 new PPI users, the risk of community-acquired pneumonia was 1.67 (95% confidence interval (95%CI) 1.55 to 1.79) times higher for patients exposed to PPIs than it was for the controls. Among the 48,451 PPI-exposed patients with a record of community-acquired pneumonia, the relative incidence rate ratio was 1.19 (95%CI 1.14 to 1.25) in the 30 days after a PPI prescription but was higher in the 30 days before a PPI prescription (1.92, 95%CI 1.84 to 2.00). This reduction in the increased risk in PPI users after prescription was also reflected in the prior event rate of 0.91 (95%CI 0.83 to 0.99). 3) A total of 45,467 pernicious anaemia patients were identified and matched to 449,635 controls. Patients with a pernicious anaemia diagnosis had a higher risk of developing community-acquired pneumonia than the control group (adjusted hazard ratio(HR)1.24, 95%CI 1.21 to 1.26); however, this risk decreased when a stricter definition of pernicious anaemia was applied, and the data was further restricted to incident diagnosis. The findings also suggest that pernicious anaemia patients have a 57% increased risk of Clostridium difficile infection (adjusted HR 1.57, 95% CI 1.40 -1.76) and this association persisted when we limited the analysis to a subgroup with a more restrictive definition of pernicious anaemia diagnosis, or to incident cases. Conclusions: This research revealed that there was a high prevalence of PPI prescribing in the primary care setting and that there are considerable opportunities available to reduce the cost and side effects of PPI use through improving adherence to recommended withdrawal strategies. In addition, the studies investigating the proposed infective complications of PPI use on which we focussed in this thesis add important data to the development of a safety profile of PPI use.
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Tsang, Carmen. "Patient safety in English general practice : the role of routinely collected data in detecting adverse events." Thesis, Imperial College London, 2013. http://hdl.handle.net/10044/1/14712.
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The use of routinely collected, or administrative, data for measuring and monitoring patient safety in primary care is a relatively new phenomenon. With increasing availability of data from different sources and care settings, their application for adverse event surveillance needs evaluation. In this thesis, I demonstrated that data routinely collected from primary care and secondary care can be applied for internal monitoring of adverse events at the general practice-level in England, but these data currently have limited use for safety benchmarking in primary care. To support this statement, multiple approaches were adopted. In the first part of the thesis, the nature and scope of patient safety issues in general practice were defined by evidence from a literature review and informal consultations with general practitioners (GPs). Secondly, using these two methods, measures of adverse events based on routinely collected healthcare data were identified. Thirdly, clinical consensus guided the selection of three candidate patient safety indicators for investigation; the safety issues explored in this thesis were recorded incidents with designated adverse event diagnostic codes and complications associated with two common diseases, emergency admissions for diabetic hyperglycaemic emergencies (diabetic ketoacidosis, DKA and hyperglycaemic hyperosmolar state, HHS) and cancer. In the second part of the thesis, the contributions of routinely collected data to new knowledge about potentially preventable adverse events in England were considered. Data from a primary care trust (NHS Brent), national primary care data (from the General Practice Research Database, GPRD) and secondary care data (Hospital Episode Statistics, HES) were used to explore the epidemiology of, and patient characteristics associated with, coded adverse events and emergency admissions for diabetic hyperglycaemic emergencies and cancer. Low rates of adverse events were found, with variation by individual patient factors. Finally, recommendations were made on extending the uses of routinely collected data for patient safety monitoring in general practice.
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Sarac, Cakil. "The Association Between Organizational Culture And Individual Factors On Medical Practice." Master's thesis, METU, 2007. http://etd.lib.metu.edu.tr/upload/12608501/index.pdf.
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The aim of the present research was to investigate the relationships between patient safety culture within hospitals and individual factors on medical practice among physicians. A total of 240 physicians from ten different hospitals completed the Medical Practice Questionnaire, Hospital Survey on Patient Safety Culture, Maslach Burnout Inventory and Eysenck Personality Questionnaire Revised- Abbreviated Form. In order to assess frequency and types of medical errors, Medical Practice Questionnaire was developed by the author. Factor analysis of this Questionnaire demonstrated the existence of four subscales named as Patient Management/Information Delivery Errors, Execution Errors, Procedure Related errors and One Source Errors. ANOVA results revealed that males conduct more Procedure Related Errors than females. In support of the hypothesis, a number of differences observed on patient safety culture between types of institutions that public hospitals received lower scores on most of the safety dimensions. Regression analysis results revealed that personality dimensions and burnout levels were significantly related to types and frequency of errors. Considering significant predictors, while the extravert participants were found to report more Patient Management/Information Delivery, Execution and Procedure Related errors,
Neurotics were found to report lower levels of errors on these three dimensions.
Regression analysis of burnout levels showed that depersonalization were also associated with these three error dimensions.The level of depersonalization were found to increase the frequency of Patient Management/Information Delivery, Execution and Procedure Related Errors. The research findings however, did not support the assertion in a manner that safety culture dimensions were not found to have main effects on types of errors. The limitations of the current research and implications for further research were discussed.
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Hittle, Beverly M. "Elusive Sleep: Healthcare Workers, Shift Work, and Implications for Worker Health and Patient Safety." University of Cincinnati / OhioLINK, 2019. http://rave.ohiolink.edu/etdc/view?acc_num=ucin1562059911010694.
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Schamel, Craig R. "Idealism and Actualization. Saint-Just in Theory, Practice, and Exigency." Scholarship @ Claremont, 2012. http://scholarship.claremont.edu/cgu_etd/82.
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Louis-Antoine Léon de Saint-Just (1767-1794) was a revolutionary, a statesman, and a political philosopher, yet it is largely only as a revolutionary that he is remembered. As a political person who occupied these three different but overlapping roles, Saint-Just is ideal as the subject and center of a study of actualization, the taking of political ideals into reality. Saint-Just’s political philosophy was that of an idealist, and yet he, by force of circumstance, ability, and audacity, had the opportunity in his short life to attempt to establish and put into practice his political ideals. In his work as a political person Saint-Just created templates for the understanding of the relationship between political theory and political action. Saint-Just’s political theory is examined in relation to his political action, using the concepts of ‘the natural’, ‘the civil’, ‘the social’ and ‘the political’, concepts which are central in Saint-Just’s political philosophy. Saint-Just’s formulations of these concepts, concepts which have also been central to the history of political philosophy, and his understanding of the relations between these concepts, helps to establish him as a political philosopher of some importance, as does the theory and practice approach to politics which his attempts demanded and which his political life demonstrated. In Saint-Just’s function as political philosopher the thesis finds the theoretical element of politics, which becomes redefined in its interaction with Saint-Just’s other functions as statesman and revolutionary, the latter two of which correspond roughly to practice and exigency. As a theorist who is also a statesman in a context of exigency, or revolution, Saint-Just’s political life is a constantly rearranged juxtaposition of theory, practice, and revolution, albeit one which never loses it essential ties to its philosophical base, even in the hours of greatest emergency. Such dedication to a philosophical base, one which refuses to dispense with political philosophy, demonstrates a new conception of political philosophy for the modern world, fills in elements of a theory of revolution as a phenomenon of both theory and action, and provides a contained case for examination of political philosophy and political action, questioning their disunity.
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Chesson, Barry. "In pursuit of best practice : Benchmarking tools and processes for the management of hazardous substances in the workplace." Thesis, Edith Cowan University, Research Online, Perth, Western Australia, 2003. https://ro.ecu.edu.au/theses/1300.
Full textAbstract:
Many organisations now strive to achieve excellence in various aspects of occupational health and safety. Benchmarking of the techniques and approaches of other organisations is becoming a popular way of bridging gaps and seeking to achieve high levels of performance. There exist many sources of guidance in the form of external and internal standards, regulations, codes of practice, publications by professional institutions and similar. However, there are clear shortfalls in terms of tools and processes needed to identify areas of opportunity and to overcome barriers to the efficient transfer of ideas and techniques from one enterprise to another. This is true for all organisations, but particularly so for small/medium sized facilities with limited resources and expertise. This study has sought to develop and test new tools and processes to make benchmarking activity and the transfer of technology, ideas and approaches more efficient and meaningful. It has drawn heavily from state-of-the-art management theory and has sought to establish the linkage between the people factor, the workplace environment factor and the organisation of work factor as they contribute to workplace health and safety performance. It has used qualitative inquiry methodologies and an approach based on personal contact and insight, as expressed by Patton (1990, p. 46), to generate data. The fieldwork component of the study was conducted at eight mining, mineral processing and related industry sites within Western Australia. The subject of the study was the facility's processes and practices in regard to the management of hazardous materials. This was chosen partly because chemical-induced injury and disease remain a significant problem for workers in industry (Winder, 1999b, p. 168) and partly because of its complexity and degree of difficulty. Data collection was based on the three qualitative inquiry methods, namely in-depth, open-ended interviews with the Site Manager and the Site Occupational Health and Safety (OHS) Professional, direct observation and review of written documents. Also tested was the assumption that if the materials developed during the study can be applied successfully in the area of hazardous materials, then other less complex areas under the OHS umbrella could be approached with confidence. There is potential for the tools and processes developed and evaluated in this work to be used widely in the transfer of best practice, that is, to be deployed beyond the hazardous substances focus of this study and beyond the Mining Industry of Western Australia. Study outcomes and the new materials that have been generated will assist with the selection of benchmarking partners and will help to identify "pockets of excellence" for focused attention. This will encourage and assist organisations to take steps towards identifying and implementing Industry best practice in the element of interest. There is potential for study outcomes to impact positively on OHS practices within many organisations - and thereby to reduce the personal and societal cost of injury and illness outcomes associated with the use of hazardous materials at work.
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Kahindi, Bright Barestus. "Food Safety Management Practices of Small and Medium Sized Food Industry Enterprizes in Tanzania." TopSCHOLAR®, 2016. http://digitalcommons.wku.edu/theses/1562.
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The study aimed to investigate the food safety practices of HACCP and ISO2200 in food establishments in Tanzania, focused on knowledge (awareness) and management practices of food safety systems. The research randomly surveyed 200 food establishments from three regions in the country; only 113 managers completed the survey. Research conducted face-to-face by questioning knowledge (employees and managers), management practices (ISO 22000, HACCP and prerequisites programs, GMP and SSOP), and demographic information. Employees indicated to have more knowledge on the use of GMP (64.3 %) than HACCP (22.9%) and ISO22000 (15.4%) and training of employees was GMP (73.9 %), ISO22000 (19.2 %) and HACCP (27.1%). This knowledge was also measured by frequency of training results, which indicated inadequacy of twice per year almost 31.4 % for manager, and every 3 months (29.1%) employees.
Management practices of food safety systems indicated HACCP practices were inadequately done by only 26.6 % of food establishments by validating quality assurance and monitoring systems. This also included the management pratices of barriers and benefits of food safety systems (ISO 22000 and HACCP). Barriers indicated poor confidence in suppliers to provide appropriate raw material (25.7 %), lack of government support (17.3 %) and the least 4% volume of paperwork. While, benefits indicated 68.6 % benefits as the highest with the lowest (22.7%) increase in product price. The improperbarrier implemenatation resulted into inadequate control of hazards under the HACCP program, only 40 % of the food establishments asserted all food in storage was protected from contamination.
Prerequisite programs in food establishments were fairly managed, over 80 % had well-designed draining systems within their food establishments.The least (35.5%) had written sanitation standard operation procedure for cleaning and disinfectants.
It is suggested that through job training, class training on food safety, and availability of resources, knowledge as well as management practices could be improved within food establishments. Further studies should focus on customer awareness, food vendors as well as single groups within the food industries.
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Henry, Alistair. "Partnerships and communities of practice : a social learning perspective on crime prevention and community safety in Scotland." Thesis, University of Edinburgh, 2009. http://hdl.handle.net/1842/3278.
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This social learning analysis of Community Safety Partnerships in Scotland will develop two sets of arguments – one empirical and one epistemological. The empirical argument is that the well-documented difficulties in partnership working (largely a result of the very different occupational cultures, structures, roles and functions of the agencies generally brought on board) are not only very much in evidence but that current ways of organising and structuring partnership working in Scotland are also very often not conducive to overcoming them. It will be argued that viewing partnership working through the lens of a relational social learning perspective (Etienne Wenger’s theory of communities of practice) provides a clear set of recommendations for resolving these problems. These empirical arguments shall form the main focus of the thesis but, given the theoretical perspective employed, a related epistemological argument also emerged and shall be developed. It is generally accepted in theoretical criminology (and elsewhere in the social sciences) that the ideas and mentalities of the discipline have been shaped by the institutional contexts in which actors were doing criminology or criminal justice work (whether as practitioners or as scholars). Therefore, it will be argued that Community Safety Partnerships are important not only as sites of criminal justice practice but also as new institutional spaces in which ways of thinking about crime and community safety have the potential to be transformed. The empirical and epistemological arguments are interrelated because it will only be where the problems of conflict and communication within partnerships can be positively resolved that their potential to become sites of thinking that transcend traditional criminal justice mentalities will be fulfilled.
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Peet, Jacqueline Stephanie. "Strengthening nursing surveillance in general wards: A practice development approach." Thesis, Queensland University of Technology, 2020. https://eprints.qut.edu.au/205383/1/Jacqueline_Peet_Thesis.pdf.
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This thesis evaluated an emancipatory practice development (ePD) approach to strengthening nursing surveillance on a single medical-surgical ward. A relationship was established, and a researcher embedded on a ward around a shared interest of strengthening nursing surveillance and patient safety. Ward engagement with ePD methods of critical reflection, holistic facilitation and active learning were supported through workplace workshops and the formation of an action learning set with a group of ward RNs. The ward travelled through a transformative and at time turbulent process of resistance and retreat towards a new learning culture where nursing surveillance is visible and valued.
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LaFave, Lea R. Ayers. "Nursing Practice as Knowledge Work Within a Clinical Microsystem: A Dissertation." eScholarship@UMMS, 2008. https://escholarship.umassmed.edu/gsn_diss/9.
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Nurses have a key role in keeping patients safe from medical errors because they work at the point of care where most errors occur. Nursing work at the intersection of patients and health care systems requires high levels of cognitive activity to anticipate potential problems and effectively respond to rapidly evolving and potentially harmful situations. The literature describes nursing work at the intersection of patient and health care system as well as barriers to providing safe patient care. However, little is known about the systems knowledge nurses use to negotiate the health care system on their patients’ behalf, or how this systems information is exchanged between nurses.
Using the clinical microsystem as the conceptual framework, this qualitative descriptive investigation identified and described: 1) the components of systems knowledge needed by nurses, 2) how systems information is exchanged between nurses, and 3) systems information exchanged between staff nurses and travel nurses. Data were collected from a stratified maximum variation sample of 18 nurse leaders, staff nurses, and travel nurses working within a high-functioning neonatal intensive care nursery within a large academic medical center in New England. Data collection methods included participant observation, document review, individual interviews, and a focus group session. Data were analyzed through constant comparison for emerging themes and patterns. Findings were compared for commonalities and differences within and across groups.
Three components of systems knowledge emerged: structural, operational, and relational. Systems information exchange occurred through direct and indirect means. Direct means included formal and informal mechanisms. The formal mechanism of orientation was identified by each participant. Informal mechanisms such as peer teaching, problem solving, and modeling behaviors were identified by participants from each of the three nurse groups. Travel nurses’ descriptions of the common themes focused on individual efficacy. Staff nurses focused on fostering smooth unit functioning. Nurse leaders described common themes from a perspective of unit development. Four overarching domains of systems information were exchanged between staff nurses and travel nurses: practice patterns; staffing patterns and roles; tips, tricks, tidbits, and techniques; and environmental elements. Communication emerged as a common theme across nurse groups and domains of systems information exchanged. These findings have implications for nursing orientation and staff development, continuous improvement at the local level, and curriculum development.