Littérature scientifique sur le sujet « Supervision after training »

Background. Supervision is an activity of assisting, guidance, teaching, supporting someone in completing their work under policies and procedures, how to develop new skills and a broader understanding of their work so they can do it better. Aims: This study aims to determine the effect of supervising head clinic training on the competence of implementing nurses in documenting nursing care at Hospital X North Sulawesi. Methods: involving 178 respondents divided by 134 respondents in the intervention group and 44 respondents in the control group by purposive sampling technique. Result: The results of the structural model match test showed that there was a significant influence of head nurse clinic supervision training on the level of headroom clinic supervision ability significantly with a value of t = 49.12; there is a significant influence of the ability of head nurse clinical supervision to the interpersonal headroom relationship significantly with t value = 2.75; there is an influence of the level of education and length of work on the competence of implementing nurses in documenting nursing care significantly with a value of t => 2; Simultaneously there was the contribution of the head nurse clinic supervision training, the level of headroom clinical supervision ability to the interpersonal relationship of the room head with a value of R2 = 16%; Simultaneously there are contributions of the chief room clinical supervision training, the level of head nurse clinical supervision ability, the interpersonal relationship of the head nurse with the implementing nurse, age, education level, length of work to nurse competence in documenting nursing care values ​​with R2 = 61%. Conclusion: The nursing care documentation program through IT is one of the techniques to improve the quality of nursing care services.

Background: Nursing is an activity of providing care to individuals, families, groups or communities both sick and healthy as a form of professional service where the nursing practice is a service organized by nurses in the form of nursing care. One of the tasks of the nursing manager is to coordinate through supervision/supervision. Aims: This study aims to analyze, explore the effect of training and implementation of clinical supervision on nurse-patient therapeutic communication. Methods: This study used quasi-experimental design research before and after post control group. The number of samples in this study was 100 respondent nurses and patients who were divided into 75 intervention groups who were given training and implementation of supervision and control groups of 25 respondents. Results: The study showed that the improvement in the supervision capability of the headroom clinics increased significantly (p = 0,000) after training and implementation of clinical supervision. Patient satisfaction with therapeutic communication has increased with a value (p = 0,000). Conclusion: Implementation of clinical supervision contributed to patient satisfaction and therapeutic communication of patient nurses by 17.6%, while 82.4% was influenced by other variables (quality of service, hospital products). This study further recommends the implementation of clinical supervision to be one of the models in developing the quality of nursing services.

Training in psychotherapy for junior registrars is often piecemeal and relegated to an after hours out-patient and supervision. We are fortunate in having had the opportunity for a whole-time psychotherapy placement at the Cassel Hospital, Ham Common, Richmond, itself an internationally renowned clinical and training centre devoted to psychotherapeutic treatment of in-patients and out-patients.

A training program to improve clinical supervision behavior, knowledge, self-efficacy, and working alliance among state vocational rehabilitation supervisors (SVRS) was studied. SVRS ( n = 180) were randomly assigned to either the control or experimental group. To further validate training effectiveness, counselors ( n = 350) who were assigned to both groups of supervisors also completed parallel outcome measures evaluating their supervisors’ performance. Results indicate differential impact when comparing changes across baseline, Posttest 1 (approximately 6 weeks after baseline), and Posttest 2 data collection (approximately 6 months after baseline) between both supervisory groups. Specifically, in comparison with the control group, supervisors who received the training reported greater changes at Posttest 1 regarding time spent in individual supervision, frequency, and time devoted to group supervision as well as perceived value in providing clinical supervision. Posttest 2 evaluation between groups noted differences in clinical supervision knowledge and behavior, frequency of individual supervision sessions, and time spent in group supervision. In contrast, counselors assigned to one of the supervisory groups reported few differences in parallel outcome measures. Although the intervention provided some support for its effectiveness for supervisors, further modifications are needed before a valid training model exists for rehabilitation counseling.

Objectives: Anatomical student tutors have to provide high skills for teaching students in dissection courses. To increase the quality of these student tutors, peer teaching concepts need be introduced. Materials and Methods: Student tutors received peer teaching by an experienced board-certified anatomist. The training included live dissections of the dissection program of two modules (Locomotion and topographical anatomy) in an open quorum. The training lasted for two to three hours per session. Additionally, the tutors could view video instructions. In the dissection hall, a special hierarchical supervising system was used. Official online student´s evaluation (Likert scale 1-5 [1 good-5 poor]) before and after implementation of this training system were compared to assess the result of the peer teaching method (supervision, support, interest in learning success, support in learning behaviour). Results: The assessment of tutor´s significantly increased in all statements (Locomotion: supervision [before: 2.25; after: 1,45]; interest in learning behaviour [before: 2.33; after: 1,45]; interest in learning success [before: 2.61; after: 1,45]; support [before: 2.03; after: 1,6]; positive personal comments [before: 25 comments; after: 150 comments]; Topographical anatomy: supervision [before: 1,89; after: 1,6]; interest in learning behaviour [before: 1,93; after: 1,4]; interest in learning success [before: 2,1; after: 1,78]; support [before: 1,88; after: 1,68]; positive personal comments [before: -; after: 120 comments]). Conclusions: The implemented teaching method seems to increase the quality of the student tutors successfully. Objetivos: Los tutores estudiantiles de anatomía tienen que poseer grandes habilidades para poder guiar a otros estudiantes durante los cursos de disecciones. Para mejorar la calidad de los tutores estudiantiles es necesario establecer conceptos de aprendizaje entre pares. Métodos: Los tutores estudiantiles recibieron una formación bajo el concepto de aprendizaje entre pares por parte de un médico anatomista certificado con mucha experiencia en el ámbito. El entrenamiento incluyó disseciones en vivo del programa de disecciones de dos módulos (aparato locomotor y anatomía topográfica) en un quórum abierto. El entrenamiento duró dos a tres horas por cada sesión. Adicionalmente, los tutores pudieron observar instrucciones de disecciones en videos. En la sala de disecciones, se aplicó un sistema jerárquico de supervision. El resultado del aprendizaje entre pares (supervision, apoyo en general, interés en el éxito de aprendizaje, apoyo en la conducta de aprendizaje) fue comparado por medio de un sistema de evaluación oficial para los estudiantes (escala de Likert 1-5 [1 buena – 5 mala]) previamente y posteriormente a la aplicación de este sistema de entrenamiento. Resultados: La valoración de los tutores aumentó significativamente en todos los parámetros comparados (aparato locomotor: supervisión [previamente: 2.25; posteriormente: 1,45]; interés en la conducta de aprendizaje [previamente: 2.33; posteriormente: 1,45]; interés en el éxito de aprendizaje [previamente: 2,61; posteriormente: 1,45]; apoyo en general [previamente: 2,03; posteriormente: 1,6]; observaciones personales positivas [previamente: 25 commentarios; posteriormente: 150 commentarios]; anatomía topográfica: supervisión [previamente: 1,89; posteriormente: 1,6]; interés en la conducta de aprendizaje [previamente: 1,93; posteriormente: 1,4]; interés en el éxito de aprendizaje [previamente: 2,1; posteriormente: 1,78]; apoyo en general [previamente: 1,88; posteriormente: 1,68]; observaciones personales positivas: [previamente -; posteriormente: 120 commentarios]). Conclusión: El método de aprendizaje entre pares aplicado para la docencia de tutores estudiantiles en la anatomía mejora significativamente la calidad y la satisfacción de los tutores.

The principles of amputee rehabilitation, from preamputation to reintegration into the work force and community, are reviewed. The authors discuss exercise techniques, training programs, and environmental modifications that have been found to be helpful in the rehabilitation of the amputee. The exercise programs presented here are divided into four main components: flexibility, muscle strength, cardiovascular training, and balance and gait. The programs include interventions by the physical, occupational, and recreational therapist under the supervision and guidance of a physician. (J Am Podiatr Med Assoc 91(1): 13-22, 2001)

Abstract Objective Practicum experiences are critical to internship readiness. While established guidelines for practicum training in clinical neuropsychology exist, the application of such guidelines across training sites has received little attention. The objective of this study is to compare practicum training models across different sites. Methods We surveyed training supervisors regarding the cost and benefit of training practicum students in their setting. Results Despite wide variability across settings, results indicated that on average, practicum sites spent around 6 hours per week in direct active training and onboarding during the first 1–3 months of the training year. After 3–4 months, the hours spent on supervision decreased to about 1–2 hours of individual supervision and 1–2 hours of group supervision per week. By the 8th month, each practicum student provided the clinic with approximately 36 hours of direct service (considered an administrative benefit to the clinic). Conclusion Training practicum students is a labor of love, with overall net administrative benefits to the clinic. An advantage was seen in settings with multiple trainees, trainees at multiple levels, and tiered supervision models with access to diverse didactic experiences.

This article describes both formal and informal aspects of doctoral training of psychology students in the United States. We first describe admission procedures and the financial support of doctoral students and then discuss the various milestones in a typical doctoral program. There follows an overview of what is expected of doctoral students and a description of the working environment (e.g., faculty and fellow students) in doctoral programs. Finally, we provide a brief analysis of the doctoral training system in the United States. One question of particular importance is whether the close supervision associated with many doctoral programs prepares the student adequately for supervising researchers and developing a research program of his/her own after graduation.

Aims and MethodPrevious studies have suggested that despite the cost of attendance at postgraduate cognitive–behavioural therapy (CBT) courses, psychiatrists are unable to engage in CBT after qualification. A postal survey of psychiatrists with postgraduate CBT training currently practising in Scotland was performed to assess the levels of training and supervision that they provide, therapeutic CBT activity, and supervision and continued professional development that they receive.ResultsOf the 58 psychiatrists, 51 replied to the survey (88%). Less than half of the respondents supervised other staff. Although 43 (84%) engaged in some therapeutic CBT activity, only 25 (49%) received supervision for their own practice. The main reasons given for not engaging in CBT therapeutic activity were that there was inadequate ‘protected time’ and that CBT had not been included in ‘job plans'.Clinical ImplicationsPsychiatrists can help to disseminate CBT skills. To do this, they require personal supervision, and time for the development and maintenance of therapeutic skills as well as for the training and supervision of others. This survey builds on the results of others and indicates that these requirements are currently being inadequately met.

Thesis (Ph. D.)--University of Tennessee, Knoxville, 2003.
Title from title page screen (viewed Apr. 25, 2004). Thesis advisor: Susan Benner. Document formatted into pages (xi, 115 p. : ill. (some col.)). Vita. Includes bibliographical references (p. 83-89).

The purpose of this study was to investigate the relationship between attitudes towards supervisory support after training and work performance of employees at the Department of Education’s Nkangala District in Mpumalanga during 2008. The sample comprised a complete sampling frame of HR and finance personnel. A five-point Likert scale was used to evaluate the attitudes of respondents towards supervisory support, and their work performance scores were correlated with the ratings of the attitudes towards supervisory support after training. Pearson’s product- moment correlation coefficient (PPM) was used to assess the relationship between the two variables. The results showed no significant relationship between attitudes towards supervisory support and work performance. The ANOVA test found that a significant (p= .016) difference only existed between attitudes towards supervisory support and educational level. The hypothesis stated in this study was therefore rejected.
Human Resource Management
M. Tech. (Human Resource Development)

Chapter 7 narrates Foundation activities beyond Encinitas and after Sedlock. Sonia Jones rebranded the Jois Foundation as the Sonima Foundation (Sonima Health and Wellness Foundation) in 2014 and as Pure Edge in 2016, and provided funding, curriculum, training, and support to schools in Nairobi, Kenya; San Diego, California; New York City, New York; Houston, Texas; East Palo Alto, California, and Louisville, Kentucky. Seeking to avoid future lawsuits, the Foundation subtracted linguistic references to Ashtanga, but continued to teach core Ashtanga practices—including Sun Salutations, Lotus, and Rest—increasingly coupled with mindfulness meditation. Once the threat of litigation seemed safely past, Foundation leaders reintroduced references to Jois, Ashtanga, Hinduism, Buddhism, and spiritual goals through a visually distinct website, Sonima.com. This gave the Foundation perceptual distance to become more involved with funded schools by requiring use of a proprietary curriculum, mandatory training and supervision, and formal evaluation of results. The chapter argues that having won a victory for yoga in Encinitas, the Foundation accelerated its missional work of bringing the philosophy, teachings, and values of Pattabhi Jois to youth in underserved communities across the country and around the world.

According to the World Health Organization’s No Health Without a Workforce report, the global shortage of community health workers (CHWs) is expected to reach 12.9 million by 2035. This shortfall raises pressing questions about how CHWs are recruited, trained, and supported as front-line care providers. Lay people become CHWs in a variety of ways; they might be chosen by a non-governmental organization or a government programme, elected by community members, or simply volunteer themselves at the right time and place. After recruitment, CHWs typically undergo training, and the scope and quality of this training can vary enormously. Often, limited funds are stretched to conduct trainings in person at facilities that may or may not be readily accessible for health workers, and refresher trainings are often cut in times of budget shortfall. While there may be no simple solution to these challenges, many now look to the use of digital technologies as a promising opportunity. Digital health interventions have come to play a growing role in healthcare in the last decade, yet the uses of technology for training, ongoing education, and supportive supervision remain understudied in lower-income settings. In this chapter, we examine a case study of digital health interventions in Nepal. We examine matters of baseline literacy and access to technology, the interweaving of technology and health system design issues, and prospects for integrating digital and face-to-face education and support. While the role of technology is easily overstated, we nonetheless argue that new digital workflows can address real implementation challenges if designed in a human-centred manner.

A number of studies have found that the skills and practices of probation and parole officers, and others who supervise offenders in the community, have an impact on the recidivism rates of offenders under supervision. There is evidence to suggest, however, that evidence based practice skills are not used routinely in probation and parole supervision. The limited amount of research in this area suggests that while some probation officers may have a natural pre-disposition towards the use of effective practice skills, training and coaching may increase the level of skills of most probation officers. The studies which have been undertaken to date, however, have been done with relatively small samples rather than across whole organisations. This chapter reports on a study undertaken in Queensland Youth Justice which aimed to increase the skill levels of probation officers. It was found that the use of pro-social modelling and relationships skills increased following training and coaching, however, the use of problem solving and cognitive behavioural techniques remained low both before and after training and coaching.

Implementation of guidelines in the health system is a complex and considerable undertaking. After the health administration has developed guidelines, a dissemination strategy needs to be put in place. Dissemination involves distribution of printed guidelines booklets, training of health care providers, provision of the equipment needed for implementing the guidelines, improvements to facilities, and supervision and monitoring by managers. This chapter reports on the Basic Antenatal Care Information System (Bacis) study in South Africa which pertains to an e-health decision support systems that is intended as an aid for nurses and managers at primary health care. The Bacis program study is important because there are few published studies from developing countries on implementation of e-health decision support systems at primary health care and their effectiveness in improving care.

Physical disability due to any neurological disorder such as Traumatic Brain Injury (TBI), Spinal Cord Injury (SCI) or Cerebrovascular Accident (CVA) leads to motor deficit which will result in loss of control over whole body or one side of the body depending on which part of the brain is affected. In this case, physical rehabilitation is required to perform for restoration of lost functions to promote the patient's quality of life. However, traditional rehabilitation therapy requires one-to-one attention between patient and therapist. Furthermore, patients feel mundane after long term training with traditional exercises in repetitive manners. Therefore, this chapter presents the Effective Physical Rehabilitation System (EPRS) for upper limb rehabilitation by combination of augmented reality based rehabilitation exercises and biofeedback for fast recovery of motor deficit with motivational approach over traditional upper limb rehabilitation therapy which requires minimum supervision of physiotherapist. The main objective of EPRs is to restore the range of motions of upper limb and to prevent from muscle spasticity, muscle atrophy and osteoporosis in effective and motivated way. To meet this objective, augmented reality based pick and place rehabilitation exercises are developed for reaching movements. The effectiveness of the proposed system is evaluated by the experiments and questionnaires results.

To support the U.S. war effort in April 1917, Camp begins and actively promotes around the country a “Senior Service Corps”—local groups of executives who jointly exercise one hour a day, three days a week, to improve fitness and relieve stress from war-induced overwork. In Washington, DC, he obtains some cabinet-level participation. He advocates his exercise ideas for naval service personnel and is appointed to the Navy Commission on Training Camp activities as director of athletics. Besides supervising football and other sports contests, he develops an exercise program he calls the “Daily Dozen,” consisting of twelve different exercises that can be done in a few minutes without exhausting the exerciser. After the war, Camp writes magazine articles and books to promote nationwide civilian physical fitness, including promoting the Daily Dozen to wide use. He also promotes playground development as well as golf for adults, including advocating more municipal golf courses for the general population.

This chapter deals with the application of Higher Order Neural Networks (HONN) on the modeling and simulation of two processes commonly used to produce gas with energy potential: anaerobic digestion and gasification. Two control strategies for anaerobic digestion are proposed in order to obtain high biomethane flow rate from degradation of organic wastes such as wastewater. A neurofuzzy scheme which is composed by a neural observer, a fuzzy supervisor, and two control actions is presented first. After that, a speed-gradient inverse optimal neural control for trajectory tracking is designed and applied to an anaerobic digestion model. The control law calculates dilution rate and bicarbonate in order to track a methane production reference trajectory under controlled conditions and avoid washout. A nonlinear discrete-time neural observer (RHONO) for unknown nonlinear systems in presence of external disturbances and parameter uncertainties is used to estimate the biomass concentration, substrate degradation, and inorganic carbon. On the other side, a high order neural network structure is developed for the process identification in a gasification reactor; the gas, composed mainly of hydrogen and carbon monoxide (synthesis gas or syngas), is produced from thermo chemical transformation of solid organic wastes. The identifier is developed in order to reproduce a kinetic model of a biomass gasifier. In both cases (biological and thermo chemical processes), the Extended Kalman Filter (EKF) is used as a training algorithm. The proposed methodologies application is illustrated via numerical simulations.

Semi-Supervised Learning (SSL) is able to build reliable classifier with very scarce labeled examples by properly utilizing the abundant unlabeled examples. However, existing SSL algorithms often yield unsatisfactory performance due to the lack of supervision information. To address this issue, this paper formulates SSL as a Generalized Distillation (GD) problem, which treats existing SSL algorithm as a learner and introduces a teacher to guide the learner?s training process. Specifically, the intelligent teacher holds the privileged knowledge that ?explains? the training data but remains unknown to the learner, and the teacher should convey its rich knowledge to the imperfect learner through a specific teaching function. After that, the learner gains knowledge by ?imitating? the output of the teaching function under an optimization framework. Therefore, the learner in our algorithm learns from both the teacher and the training data, so its output can be substantially distilled and enhanced. By deriving the Rademacher complexity and error bounds of the proposed algorithm, the usefulness of the introduced teacher is theoretically demonstrated. The superiority of our algorithm to the related state-of-the-art methods has also been empirically demonstrated by the experiments on different datasets with various sources of privileged knowledge.

In the United States, recent legislation has dictated that by October 2002, all personnel that perform tasks that can affect the safety and integrity of pipeline operations (“covered tasks”) must have demonstrated that they are “qualified” to perform those tasks. Around the world, governments are considering passing equivalent legislation to require control room staff (and other operations personnel) to demonstrate their proficiency. The U.S. Department of Transportation has instituted the “Operator Qualification” rule in 49CFR Part 192 Subpart N (natural gas), and Part 195 Subpart G (hazardous liquids). After October 27th 2002, it will be unlawful for anyone performing a covered task not to have demonstrated proficiency in that task, unless they are under the direct supervision of a “qualified” person. While the rule applies to anyone performing a covered task, this paper concentrates simply on pipeline controllers. One specific focus of the law is the demonstration that staff are qualified to perform covered tasks under both normal and abnormal conditions. For control room staff, abnormal conditions occur only rarely, and the likelihood that any one individual is in the control room when a pipeline incident occurs is slim, at best. Simulation is uniquely situated to help train and qualify control room staff. Not only can pipeline controllers, as part of their training, be repeatedly exposed to abnormal conditions in a safe environment, but structured testing involving simulated abnormal conditions can also demonstrate qualification to react appropriately. This paper summarizes key points of the U.S. legislation, and introduces pipeline controller training simulators in outline. The experiences of three operating companies in their use of simulators to comply with legislated proficiency testing are recounted.

Purpose: Breast cancer patients are at increased risk of developing comorbidities such as lymphedema, sarcopenia, osteoporosis and cardiovascular disease after breast cancer treatment. These complications contribute to a decrease in quality of life, cardiorespiratory fitness and muscle strength. Regular and long-term physical activity is an effective non-pharmacological strategy that can improve physical, psychological and social outcomes. The aim of our research was to evaluate the effect of various modes of an exercise intervention on physical performance, body composition, depression and autonomic nervous system in breast cancer survivors. Methods: 16 women after surgery with hormonal treatment enter the research. Thirteen of them completed the controlled, quasi-experimental study (54 ± 9 yrs, 164cm ± 6cm, 72 ± 12kg) and were divided into 3 groups according to their place of living: trained under supervision (n=5) (SUPERV), trained at home without supervision by videos (n=7) (HOME) and with no prescribed physical activity (n=4) (CON). Exercise intervention lasted 3 months and comprised of 60 min training units 3 × week (aerobic with resistant exercise in a 2 : 1 mode combined with regular weekly yoga and breathing exercises). The exercise intensity was set individually at 65–75% of HRR based on spiroergometry and was continuously controlled by heart rate monitors. The same principles applied to the HOME group, which, in addition to heart rate monitors, recorded frequency, length, HRmax, HRavg, and Borg scale of intensity perception. VO2max, BMI, fat mass, depression level (Beck’s depression inventory) and the power of the autonomic nervous system (total power and sympatho-vagal balance) were analyzed. For data evaluation we used descriptive statistics and Cohens d effect size. Results: 3 women dropped out of research because of medical reason. In all groups VO2max values increased. The largest increase in VO2max values was in SUPERV group by 36%, in HOME group by 20% and in CON group by 2%. Body weight decreased for groups SUPERV (˗1.2 kg) and CON (-0.1kg), for HOME group there was an increase (+0.2 kg). Body mass index decreased for SUPERV group (-0.4), for HOME and CON it increased (both +0.1). Total power decreased in SUPERV (-0.6) and HOME group (-0.2), in CON has not changed. The same results were achieved by the sympatho-vagal balance, only the CON group increased. Values from Beck’s depression inventory decreased for all groups, most for CON group. Conclusion: A 3-months of supervised and controlled exercise had a significant effect on physical fitness and body composition in comparison with non-supervised home-based physical intervention. Our results indicate that it is strongly advisable to apply a supervised exercise program to induce positive physiological changes in breast cancer survivors as part of aftercare.

This study aimed to examine a research tendency through Master's and Doctoral dissertation in South Korea related to school counselors. In this study, school counselors were used in terms that included full-time and contractual counselors. School counselors are teachers who specialize in understanding students' daily psychological counseling, problem behavior and maladaptive counseling and establishing a prevention support system of fundamental reason of problem behavior for students. This is because their tasks required in school are similar. They were deployed to unit schools after Wee Project implemented in 2007 to ensure that students and all students experiencing poor learning and school maladaptation for having a happy school life. This study aimed to lay the foundation for improving and developing policies for improving the welfare and professionalism of school counselors, focusing on the subject of the degree thesis related to school counselors. This study conducted an exploratory study based on the year of publication and topics of the dissertation based on key words extracted from the data. The dissertations were published from 2010 to 2021 and were collected through Riss, a domestic database website in South Korea. This study focused on the frequency of emergence and Word Cloud which shows research tendency based on the year of publication analyzed by the frequency of emergency, title of the dissertation, and key words in abstract of the dissertation extracted from a file in MS Excel from the domestic database homepage. The analysis results of this study are as follows. First, the role and awareness of professional counseling teachers and Wee classes are required. Second, research was conducted to develop the capabilities of school counselors teachers working in the Wee class.it will serve as a foundation for improving professionalism, leading to the protection of ethics as a counselor working in the Wee class and ensuring the rights and welfare of counselors. In order to improve counseling capabilities, supervision and a certain amount of counseling practice are required in the process of training school counselors.

Five years after the introduction of gas turbine propulsion in major U. S. Navy combatants, the engineering training pipeline, populated with cross-rates primarily from the existing machinist, engineman, and electrical ratings, consisted of a series of contractor developed block courses operationally centered around the propulsion and electrical control consoles. The rapid introduction of new ships in the late seventies and eighties required an accelerated training pipeline and the use of mostly apprentice candidates directly from recruitment. This increased need, the recognition in the fleet that existing training was not providing system knowledge, and the construction of a gas turbine training hot plant precipitated the development of a new training curriculum. Course development was derived from documentation which dictates plant operation: the equipment/system design; the Preventive Maintenance System (PMS); the Engineering Operating Sequencing System (EOSS); Fleet commander engineering management programs; and the Ships’ Manning Document (SMD). Using a disciplined approach, essential student performance objectives were defined and necessary learning objectives developed from the above documentation. The scope of the course encompassed the “cradle to grave” concept from apprentice training through journeyman and supervisor, and necessitated incremental and refresher training throughout the career of the gas turbine mechanic and electrician.

Attention to safety and health are of ever-increasing priority to industrial organizations. Good Safety is demanded by stockholders, employees, and the community while increasing injury costs provide additional motivation for safety and health excellence. Safety has always been a strong corporate value of DuPont and a vital part of its culture. As a result, DuPont has become a benchmark in safety and health performance. Since 1990, DuPont has re-engineered itself to meet global competition and address future vision. In the new re-engineered organizational structures, DuPont has also had to re-engineer its safety management systems. A special Discovery Team was chartered by DuPont senior management to determine the “best practices’ for safety and health being used in DuPont best-performing sites. A summary of the findings is presented, and five of the practices are discussed. Excellence in safety and health management is more important today than ever. Public awareness, federal and state regulations, and enlightened management have resulted in a widespread conviction that all employees have the right to work in an environment that will not adversely affect their safety and health. In DuPont, we believe that excellence in safety and health is necessary to achieve global competitiveness, maintain employee loyalty, and be an accepted member of the communities in which we make, handle, use, and transport products. Safety can also be the “catalyst” to achieving excellence in other important business parameters. The organizational and communication skills developed by management, individuals, and teams in safety can be directly applied to other company initiatives. As we look into the 21st Century, we must also recognize that new organizational structures (flatter with empowered teams) will require new safety management techniques and systems in order to maintain continuous improvement in safety performance. Injury costs, which have risen dramatically in the past twenty years, provide another incentive for safety and health excellence. Shown in the Figure 1, injury costs have increased even after correcting for inflation. Many companies have found these costs to be an “invisible drain” on earnings and profitability. In some organizations, significant initiatives have been launched to better manage the workers’ compensation systems. We have found that the ultimate solution is to prevent injuries and incidents before they occur. A globally-respected company, DuPont is regarded as a well-managed, extremely ethical firm that is the benchmark in industrial safety performance. Like many other companies, DuPont has re-engineered itself and downsized its operations since 1985. Through these changes, we have maintained dedication to our principles and developed new techniques to manage in these organizational environments. As a diversified company, our operations involve chemical process facilities, production line operations, field activities, and sales and distribution of materials. Our customer base is almost entirely industrial and yet we still maintain a high level of consumer awareness and positive perception. The DuPont concern for safety dates back to the early 1800s and the first days of the company. In 1802 E.I. DuPont, a Frenchman, began manufacturing quality grade explosives to fill America’s growing need to build roads, clear fields, increase mining output, and protect its recently won independence. Because explosives production is such a hazardous industry, DuPont recognized and accepted the need for an effective safety effort. The building walls of the first powder mill near Wilmington, Delaware, were built three stones thick on three sides. The back remained open to the Brandywine River to direct any explosive forces away from other buildings and employees. To set the safety example, DuPont also built his home and the homes of his managers next to the powder yard. An effective safety program was a necessity. It represented the first defense against instant corporate liquidation. Safety needs more than a well-designed plant, however. In 1811, work rules were posted in the mill to guide employee work habits. Though not nearly as sophisticated as the safety standards of today, they did introduce an important basic concept — that safety must be a line management responsibility. Later, DuPont introduced an employee health program and hired a company doctor. An early step taken in 1912 was the keeping of safety statistics, approximately 60 years before the federal requirement to do so. We had a visible measure of our safety performance and were determined that we were going to improve it. When the nation entered World War I, the DuPont Company supplied 40 percent of the explosives used by the Allied Forces, more than 1.5 billion pounds. To accomplish this task, over 30,000 new employees were hired and trained to build and operate many plants. Among these facilities was the largest smokeless powder plant the world had ever seen. The new plant was producing granulated powder in a record 116 days after ground breaking. The trends on the safety performance chart reflect the problems that a large new work force can pose until the employees fully accept the company’s safety philosophy. The first arrow reflects the World War I scale-up, and the second arrow represents rapid diversification into new businesses during the 1920s. These instances of significant deterioration in safety performance reinforced DuPont’s commitment to reduce the unsafe acts that were causing 96 percent of our injuries. Only 4 percent of injuries result from unsafe conditions or equipment — the remainder result from the unsafe acts of people. This is an important concept if we are to focus our attention on reducing injuries and incidents within the work environment. World War II brought on a similar set of demands. The story was similar to World War I but the numbers were even more astonishing: one billion dollars in capital expenditures, 54 new plants, 75,000 additional employees, and 4.5 billion pounds of explosives produced — 20 percent of the volume used by the Allied Forces. Yet, the performance during the war years showed no significant deviation from the pre-war years. In 1941, the DuPont Company was 10 times safer than all industry and 9 times safer than the Chemical Industry. Management and the line organization were finally working as they should to control the real causes of injuries. Today, DuPont is about 50 times safer than US industrial safety performance averages. Comparing performance to other industries, it is interesting to note that seemingly “hazard-free” industries seem to have extraordinarily high injury rates. This is because, as DuPont has found out, performance is a function of injury prevention and safety management systems, not hazard exposure. Our success in safety results from a sound safety management philosophy. Each of the 125 DuPont facilities is responsible for its own safety program, progress, and performance. However, management at each of these facilities approaches safety from the same fundamental and sound philosophy. This philosophy can be expressed in eleven straightforward principles. The first principle is that all injuries can be prevented. That statement may seem a bit optimistic. In fact, we believe that this is a realistic goal and not just a theoretical objective. Our safety performance proves that the objective is achievable. We have plants with over 2,000 employees that have operated for over 10 years without a lost time injury. As injuries and incidents are investigated, we can always identify actions that could have prevented that incident. If we manage safety in a proactive — rather than reactive — manner, we will eliminate injuries by reducing the acts and conditions that cause them. The second principle is that management, which includes all levels through first-line supervisors, is responsible and accountable for preventing injuries. Only when senior management exerts sustained and consistent leadership in establishing safety goals, demanding accountability for safety performance and providing the necessary resources, can a safety program be effective in an industrial environment. The third principle states that, while recognizing management responsibility, it takes the combined energy of the entire organization to reach sustained, continuous improvement in safety and health performance. Creating an environment in which employees feel ownership for the safety effort and make significant contributions is an essential task for management, and one that needs deliberate and ongoing attention. The fourth principle is a corollary to the first principle that all injuries are preventable. It holds that all operating exposures that may result in injuries or illnesses can be controlled. No matter what the exposure, an effective safeguard can be provided. It is preferable, of course, to eliminate sources of danger, but when this is not reasonable or practical, supervision must specify measures such as special training, safety devices, and protective clothing. Our fifth safety principle states that safety is a condition of employment. Conscientious assumption of safety responsibility is required from all employees from their first day on the job. Each employee must be convinced that he or she has a responsibility for working safely. The sixth safety principle: Employees must be trained to work safely. We have found that an awareness for safety does not come naturally and that people have to be trained to work safely. With effective training programs to teach, motivate, and sustain safety knowledge, all injuries and illnesses can be eliminated. Our seventh principle holds that management must audit performance on the workplace to assess safety program success. Comprehensive inspections of both facilities and programs not only confirm their effectiveness in achieving the desired performance, but also detect specific problems and help to identify weaknesses in the safety effort. The Company’s eighth principle states that all deficiencies must be corrected promptly. Without prompt action, risk of injuries will increase and, even more important, the credibility of management’s safety efforts will suffer. Our ninth principle is a statement that off-the-job safety is an important part of the overall safety effort. We do not expect nor want employees to “turn safety on” as they come to work and “turn it off” when they go home. The company safety culture truly becomes of the individual employee’s way of thinking. The tenth principle recognizes that it’s good business to prevent injuries. Injuries cost money. However, hidden or indirect costs usually exceed the direct cost. Our last principle is the most important. Safety must be integrated as core business and personal value. There are two reasons for this. First, we’ve learned from almost 200 years of experience that 96 percent of safety incidents are directly caused by the action of people, not by faulty equipment or inadequate safety standards. But conversely, it is our people who provide the solutions to our safety problems. They are the one essential ingredient in the recipe for a safe workplace. Intelligent, trained, and motivated employees are any company’s greatest resource. Our success in safety depends upon the men and women in our plants following procedures, participating actively in training, and identifying and alerting each other and management to potential hazards. By demonstrating a real concern for each employee, management helps establish a mutual respect, and the foundation is laid for a solid safety program. This, of course, is also the foundation for good employee relations. An important lesson learned in DuPont is that the majority of injuries are caused by unsafe acts and at-risk behaviors rather than unsafe equipment or conditions. In fact, in several DuPont studies it was estimated that 96 percent of injuries are caused by unsafe acts. This was particularly revealing when considering safety audits — if audits were only focused on conditions, at best we could only prevent four percent of our injuries. By establishing management systems for safety auditing that focus on people, including audit training, techniques, and plans, all incidents are preventable. Of course, employee contribution and involvement in auditing leads to sustainability through stakeholdership in the system. Management safety audits help to make manage the “behavioral balance.” Every job and task performed at a site can do be done at-risk or safely. The essence of a good safety system ensures that safe behavior is the accepted norm amongst employees, and that it is the expected and respected way of doing things. Shifting employees norms contributes mightily to changing culture. The management safety audit provides a way to quantify these norms. DuPont safety performance has continued to improve since we began keeping records in 1911 until about 1990. In the 1990–1994 time frame, performance deteriorated as shown in the chart that follows: This increase in injuries caused great concern to senior DuPont management as well as employees. It occurred while the corporation was undergoing changes in organization. In order to sustain our technological, competitive, and business leadership positions, DuPont began re-engineering itself beginning in about 1990. New streamlined organizational structures and collaborative work processes eliminated many positions and levels of management and supervision. The total employment of the company was reduced about 25 percent during these four years. In our traditional hierarchical organization structures, every level of supervision and management knew exactly what they were expected to do with safety, and all had important roles. As many of these levels were eliminated, new systems needed to be identified for these new organizations. In early 1995, Edgar S. Woolard, DuPont Chairman, chartered a Corporate Discovery Team to look for processes that will put DuPont on a consistent path toward a goal of zero injuries and occupational illnesses. The cross-functional team used a mode of “discovery through learning” from as many DuPont employees and sites around the world. The Discovery Team fostered the rapid sharing and leveraging of “best practices” and innovative approaches being pursued at DuPont’s plants, field sites, laboratories, and office locations. In short, the team examined the company’s current state, described the future state, identified barriers between the two, and recommended key ways to overcome these barriers. After reporting back to executive management in April, 1995, the Discovery Team was realigned to help organizations implement their recommendations. The Discovery Team reconfirmed key values in DuPont — in short, that all injuries, incidents, and occupational illnesses are preventable and that safety is a source of competitive advantage. As such, the steps taken to improve safety performance also improve overall competitiveness. Senior management made this belief clear: “We will strengthen our business by making safety excellence an integral part of all business activities.” One of the key findings of the Discovery Team was the identification of the best practices used within the company, which are listed below: ▪ Felt Leadership – Management Commitment ▪ Business Integration ▪ Responsibility and Accountability ▪ Individual/Team Involvement and Influence ▪ Contractor Safety ▪ Metrics and Measurements ▪ Communications ▪ Rewards and Recognition ▪ Caring Interdependent Culture; Team-Based Work Process and Systems ▪ Performance Standards and Operating Discipline ▪ Training/Capability ▪ Technology ▪ Safety and Health Resources ▪ Management and Team Audits ▪ Deviation Investigation ▪ Risk Management and Emergency Response ▪ Process Safety ▪ Off-the-Job Safety and Health Education Attention to each of these best practices is essential to achieve sustained improvements in safety and health. The Discovery Implementation in conjunction with DuPont Safety and Environmental Management Services has developed a Safety Self-Assessment around these systems. In this presentation, we will discuss a few of these practices and learn what they mean. Paper published with permission.

ABSTRACT Background: After families, school plays an important role in taking account of children’s health at elementary school. This is because students spend a lot of time at schools and often encountered various health problems. Studies have shown that School Health Based Centre are particularly suited to meet the children needs for proper health services. This study aimed to evaluate the implementation of trias of school health center program (UKS) at Giwangan elementary school, Yogyakarta. Subjects and Method: This was a qualitative study with case study approach. The study was conducted at Giwangan elementary school, Yogyakarta, Indonesia, in May 2018. The key informants were supervisor and head of UKS. The informants were selected by purposive sampling. The data were collected by in-depth interview, observation, and study document. Results: Input evaluation showed that facilities and infrastructure in the school health center were not optimally available. Evaluation process found that there were some obstacles faced by school health center in providing health education in students. Output evaluation showed that there was lack of personnel to implement school health center service. There has never been a little doctor training for students. Conclusion: There is a need to improve facilities and number of personnel in school health center. Keywords: school health center program, evaluation Correspondence: Lina Eta Safitri. Masters Program in Public Health, Universitas Sebelas Maret. Jl. Ir. Sutami 36A, Surakarta 57126, Central Java. Email:linaetasafitri_96@student.uns.ac.id DOI: https://doi.org/10.26911/the7thicph.04.52