Nurse retention in a correctional facility: a study of the relationship between the nurses' perceived barriers and benefits.

PubMed

Chafin, W Sue; Biddle, Wendy L

2013-04-01

Retention of nursing staff is more complex in a correctional facility. After a period of 3 years, only 20% of the staff remained employed at this study facility. Without retention of qualified correctional nurses, there are decreases in access to care, gaps in continuity of care, and less time for mentorship. Trained correctional nurses improve patient and staff safety, provide more education, and are more team-oriented. The purpose of this study was to identify barriers and benefits to nursing staff satisfaction with their job and the likelihood that they will continue to work in correctional settings. Practice and patient care will be favorably impacted if correctional nurses are provided with services such as new hire orientation, clinical ladder programs to recruit and retain nursing staff, and teambuilding.

Inspired Planning

ERIC Educational Resources Information Center

Erickson, Paul W.

2009-01-01

Long-range facility planning is a comprehensive process for preparing education institutions for the future and confirm that facilities meet current needs. A long-range facilities plan (LRFP) evaluates how facilities support programs and the educational needs of students, staff and the community. Each school district or college has unique needs…

PLANNERS AND PLANNING, A REPORT FROM THE COMMUNITY COLLEGE PLANNING CENTER ON COMMUNITY COLLEGE FACILITIES.

ERIC Educational Resources Information Center

MAYHEW, LEWIS B.

GROWTH OF STUDENT POPULATIONS AND THE KNOWLEDGE EXPANSION NECESSITATE CAREFUL PLANNING IN THE COMMUNITY COLLEGE. PLANT PLANNING DEPENDS ON INSTRUCTIONAL PROGRAM PLANNING, STAFF EMPLOYMENT AND ORGANIZATION, STUDENT PLANNING, FUNDING AND COMMUNITY RELATIONSHIPS. PLANNING SHOULD INVOLVE THE ADMINISTRATIVE STAFF, LIBRARIAN, FACULTY, OTHER STAFF,…

Implementation of an Initial Training Program for New Employees in a Profoundly Mentally and Physically Handicapped Children and Adult Residential Facility.

ERIC Educational Resources Information Center

Hoeft, Linda A.

A project was designed to reduce the turnover of direct care staff in a community-based residential facility that provides a home and educational or adult day training services for 54 severely or profoundly mentally and physically handicapped children and adults. The project sought to reduce total staff turnover by 40%, reduce employee…

Managing patients with behavioral health problems in acute care: balancing safety and financial viability.

PubMed

Rape, Cyndy; Mann, Tammy; Schooley, John; Ramey, Jana

2015-01-01

With a recent decrease in community resources for the mental health population, acute care facilities must seek creative, cost-effective ways to protect and care for these vulnerable individuals. This article describes 1 facility's journey to maintaining patient and staff safety while reducing cost. Success factors of this program include staff engagement, environmental modifications, and a nurse-driven, sitter-reduction process.

Getting Started in the Child Care Business.

ERIC Educational Resources Information Center

Kimery, Sharon

This pamphlet discusses questions to consider when planning a child care facility. Topics discussed include licensing, financial management, written policies on facility operation, recordkeeping, insurance, the physical nature of the facility, program planning, scheduling of daily activities, personnel selection, staff development, parent…

Ohio School Design Manual.

ERIC Educational Resources Information Center

Ohio School Facilities Commission, Columbus.

This manual presents guidance to facility designers, school administrators, staff, and students for the development of school facilities being constructed under Ohio's Classroom Facilities Assistance Program. It provides critical analysis of individual spaces and material/system components necessary for the construction of elementary and secondary…

[Patterns of utilization of external employee assistance program--analysis of employees who have their psychiatrists].

PubMed

Ito, H; Fujii, K; Sasaki, Y

1998-01-01

The purpose of this paper is to clarify some patterns of utilization of an external employee assistance program (EAP) we have conducted for other public and private facilities in the Tokyo Kenbikyoin Foundation between April, 1986 and December, 1996. The subjects were 26 men and 12 women in 7 facilities under the following conditions: (1) Employees who have already had their own psychiatrists at the first interview of the external EAP; (2) Facilities utilize the EAP for two or more employees who met the first criterion. As a result, utilization patterns differed depending on medical staff's attitude toward the external EAP. There was a significant difference according to sex. The rate for men was 54% in worksites where medical staff understood this external program (worksite A1) and 93% in worksites where they did not (worksite A2-3, B). As to expectations for the program, there were more consultations for organizational measurements (63%) in worksite A1, while less organizational matters (27%) and more personal complains about their psychiatrists in the worksite A2-3, and B. These results suggest that the involvement of medical staff is the key to utilizing the external EAP effectively.

Seeing Results in Flooring for Schools

ERIC Educational Resources Information Center

Simmons, Brian

2011-01-01

Operations staffs at education facilities of all sizes are tasked with selecting a hard floor cleaning program that is cost-effective, efficient and highly productive. With an increased focus on the sustainability of an environment, facility managers also must select a program that meets sustainability goals while maintaining a healthful, safe…

Handbook of Policies and Procedures for Before-and-After-School Child Care Staff.

ERIC Educational Resources Information Center

1991

This handbook, which is provided by the Adel-Desoto Community School District for new staff members, covers all aspects of the before-and-after-school child care program, including: (1) the school itself (facilities and equipment); (2) the staff (employment qualifications, requirements, and classifications; policies regarding conduct, appearance,…

Training and certification program of the operating staff for a 90-day test of a regenerative life support system

NASA Technical Reports Server (NTRS)

1972-01-01

Prior to beginning a 90-day test of a regenerative life support system, a need was identified for a training and certification program to qualify an operating staff for conducting the test. The staff was responsible for operating and maintaining the test facility, monitoring and ensuring crew safety, and implementing procedures to ensure effective mission performance with good data collection and analysis. The training program was designed to ensure that each operating staff member was capable of performing his assigned function and was sufficiently cross-trained to serve at certain other positions on a contingency basis. Complicating the training program were budget and schedule limitations, and the high level of sophistication of test systems.

Applied Workplace Literacy for the Facilities Maintenance Industry. Performance Report and Third Party Evaluation Report.

ERIC Educational Resources Information Center

Texas State Technical Coll., Waco.

A project was conducted to determine if interactive video programs could produce positive results in literacy programs. During the project, staff from a technical college developed a task analysis, curriculum, and evaluation measures for the training of facilities maintenance workers in mathematical concepts. From this activity, an instructional…

Agents of Nursing Home Quality of Care: Ombudsmen and Staff Ratios Revisited.

ERIC Educational Resources Information Center

Cherry, Ralph L.

1991-01-01

Compared effects of ombudsman programs on quality of nursing home care on random sample of 134 Medicare/Medicaid-certified long-term care facilities in Missouri. Found that presence of ombudsman program was most important factor associated with quality for intermediate-care facilities, and was significantly associated with quality for skilled…

Programs for Infants and Young Children. Part IV: Facilities and Equipment.

ERIC Educational Resources Information Center

Sale, June

This manual is designed to facilitate planning for day care center facilities. Goals and principles of day care are discussed in relation to programs for infants, toddlers, and preschoolers with special attention to staff, parents, and community. Suggestions are presented for indoor and outdoor planning for such topics as equipment, supplies,…

Results of a field test and follow-up study of a restorative care training program.

PubMed

Walker, Bonnie L; Harrington, Susan S

2013-09-01

To implement restorative care in assisted living facilities, staff and administrators need to understand the philosophy and learn methods to help residents maintain optimal function. In this study, researchers investigated the use of a Web-based training program to improve the restorative care knowledge, attitudes, and practices of assisted living administrators and staff. The study design was one group repeated measure to consider the impact of the training program on participant's knowledge of restorative care and restorative care techniques, attitudes toward restorative care, and self-reported practices. Participants included 266 administrators and 203 direct care staff from assisted living facilities in eight states. Measurements were done at baseline (pretest), following the instruction (posttest), and one month later (follow-up). Researchers found that participants (n=469) significantly improved their scores from pre- to posttest. In a follow-up study (n=244), over half of participants reported making changes at their facility as a result of the restorative care training. Most of the changes are related to care practices, such as an emphasis on encouraging, motivating, and offering positive feedback to residents. Researchers concluded that there is a need for restorative care training for both administrators and staff of assisted living facilities. The study also demonstrates that a brief training session (2h or less) can bring about significant change in the learner's knowledge of facts, attitudes, and practices. It demonstrates that much of that change continues for at least 1 month after the training. It also demonstrates the loss of knowledge and points out the need for training to be followed up with continuing education and administrator encouragement. Furthermore, this study demonstrates that the Web is a feasible method of delivering restorative care training to assisted living facility administrators and staff. Copyright © 2012 Elsevier Ltd. All rights reserved.

42 CFR 483.430 - Condition of participation: Facility staffing.

Code of Federal Regulations, 2014 CFR

2014-10-01

... have at least a master's degree in psychology from an accredited school. (vi) To be designated as a... psychology). (xi) If the client's individual program plan is being successfully implemented by facility staff...

42 CFR 483.430 - Condition of participation: Facility staffing.

Code of Federal Regulations, 2013 CFR

2013-10-01

... have at least a master's degree in psychology from an accredited school. (vi) To be designated as a... psychology). (xi) If the client's individual program plan is being successfully implemented by facility staff...

42 CFR 483.430 - Condition of participation: Facility staffing.

Code of Federal Regulations, 2012 CFR

2012-10-01

... have at least a master's degree in psychology from an accredited school. (vi) To be designated as a... psychology). (xi) If the client's individual program plan is being successfully implemented by facility staff...

Staff members' perceptions of an animal-assisted activity.

PubMed

Bibbo, Jessica

2013-07-01

To examine the perceptions of staff members toward the implementation of an animal-assisted activity (AAA) in an outpatient regional cancer center. Quasi-experimental, post-test design. An adult outpatient regional cancer center in northern California. 34 facility staff members. Self-report questionnaire following four weeks of AAA visitation. Visits took place three times a week for a total of 12 visits. Perceptions of the AAA. Previous perceptions toward AAA influenced the perceptions of the visitation's efficacy. Direct and indirect interaction with the visiting AAA teams was positively associated with perceptions of the AAA. A disagreement occurred that the AAA had caused extra stress or work for staff. Enjoyment of interacting with the dog handler was not significantly different from interacting with the dog; however, it was more positively correlated to acceptance of the AAA. The study provided evidence that the AAA was generally accepted by staff members. Individual staff members' perceptions of dogs and AAAs can influence their receptivity to AAA interventions. Interaction with AAA teams should be voluntary and available for patients and staff members. AAA may be introduced into facilities without creating the perception of extra stress or work for staff members. Providing staff the opportunity to interact with visiting AAA teams may be beneficial for the success of such programs. The human handler in AAA teams may play a vital role in the staff acceptance of such programs.

Texas certified volunteer Long-Term Care Ombudsmen: perspectives of role and effectiveness.

PubMed

Ostwald, Sharon K; Runge, Anke; Lees, Emily J; Patterson, Gina D

2003-01-01

Under the federally mandated Long-Term Care Ombudsman Program (LTCOP), certified volunteer ombudsmen (CVO) advocate for the welfare and rights of residents in nursing facilities. In Texas, the Department on Aging contracts with 28 agencies to deliver the LTCOP in respective regions. Regional ombudsman staff in charge of a group of CVOs administers each local program. The volunteer ombudsman role is threefold: advocate, mediator, and friendly visitor. This descriptive study used a 75-item mail survey designed to gain a better understanding of CVOs' perspectives of their role and effectiveness. A total of 361 active, certified volunteers participated, representing all of the 28 regional Texas ombudsman programs. A series of focus groups was used to amplify survey data. Findings indicate overall role satisfaction, although perception of satisfaction varied with volunteers' age, length of service, level of education, and work experience. Volunteers felt most effective in promoting residents' rights and welfare, and least effective in dealing with financial exploitation, nutrition, and hydration issues. Although not always able to achieve desired changes, most volunteers believed that the ombudsman presence was a positive force. A need for improved understanding and support of the ombudsman role among facility staff and regulatory agents was exposed. CVOs' potentially favorable impact on the institutional setting in general, and facility personnel in particular, is dependent on the support from state personnel and regional ombudsman staff as well as the willingness of nursing facility staff to cooperate. Volunteers' sense of performance effectiveness is essential to the success of the LTCOP. Specific recommendations based on study findings are intended to assist in assuring continuous program quality improvement purposed to ensure residents' quality of life.

Implementation of sustainable evidence-based practice for the assessment and management of pain in residential aged care facilities.

PubMed

Savvas, Steven; Toye, Christine; Beattie, Elizabeth; Gibson, Stephen J

2014-12-01

Pain is common in residential aged care facilities (RACFs). In 2005, the Australian Pain Society developed 27 recommendations for good practice in the identification, assessment, and management of pain in these settings. This study aimed to address implementation of the standards and evaluate outcomes. Five facilities in Australia participated in a comprehensive evaluation of RACF pain practice and outcomes. Pre-existing pain management practices were compared with the 27 recommendations, before an evidence-based pain management program was introduced that included training and education for staff and revised in-house pain-management procedures. Post-implementation audits evaluated the program's success. Aged care staff teams also were assessed on their reports of self-efficacy in pain management. The results show that before the implementation program, the RACFs demonstrated full compliance on 6 to 12 standards. By the project's completion, RACFs demonstrated full compliance with 10 to 23 standards and major improvements toward compliance in the remaining standards. After implementation, the staff also reported better understanding of the standards (p < .001) or of facility pain management guidelines (p < .001), increased confidence in therapies for pain management (p < .001), and increased confidence in their training to assess pain (p < .001) and recognize pain in residents with dementia who are nonverbal (p = .003). The results show that improved evidence-based practice in RACFs can be achieved with appropriate training and education. Investing resources in the aged care workforce via this implementation program has shown improvements in staff self-efficacy and practice. Copyright © 2014 American Society for Pain Management Nursing. Published by Elsevier Inc. All rights reserved.

Implementation of Best Practices in Obesity Prevention in Child Care Facilities: The Arizona Empower Program, 2013–2015

PubMed Central

Papa, Jillian; Rodriguez, Gertrudes; Robinson, Deborah

2017-01-01

Introduction Obesity is a major health concern in every US age group. Approximately one in 4 children in Arizona’s Special Supplemental Nutrition Program for Women, Infants, and Children is overweight or obese. The Arizona Department of Health Services developed the Empower program to promote healthy environments in licensed child care facilities. The program consists of 10 standards, including one standard for each of these 5 areas: physical activity and screen time, breastfeeding, fruit juice and water, family-style meals, and staff training. The objective of this evaluation was to determine the level of implementation of these 5 Empower standards. Methods A self-assessment survey was completed from July 2013 through June 2015 by 1,850 facilities to evaluate the level of implementation of 5 Empower standards. We calculated the percentage of facilities that reported the degree to which they implemented each standard and identified common themes in comments recorded in the survey. Results All facilities reported either full or partial implementation of the 5 standards. Of 1,678 facilities, 21.7% (n = 364) reported full implementation of all standards, and 78.3% (n = 1,314) reported at least partial implementation. Staff training, which has only one component, had the highest level of implementation: 77.4% (n = 1,299) reported full implementation. Only 44.0% (n = 738) reported full implementation of the standard on a breastfeeding-friendly environment. Conclusion Arizona child care facilities have begun to implement the Empower program, but facilities will need more education, technical assistance, and support in some areas to fully implement the program. PMID:28880840

Implementation of Best Practices in Obesity Prevention in Child Care Facilities: The Arizona Empower Program, 2013-2015.

PubMed

Papa, Jillian; Agostinelli, Joan; Rodriguez, Gertrudes; Robinson, Deborah

2017-09-07

Obesity is a major health concern in every US age group. Approximately one in 4 children in Arizona's Special Supplemental Nutrition Program for Women, Infants, and Children is overweight or obese. The Arizona Department of Health Services developed the Empower program to promote healthy environments in licensed child care facilities. The program consists of 10 standards, including one standard for each of these 5 areas: physical activity and screen time, breastfeeding, fruit juice and water, family-style meals, and staff training. The objective of this evaluation was to determine the level of implementation of these 5 Empower standards. A self-assessment survey was completed from July 2013 through June 2015 by 1,850 facilities to evaluate the level of implementation of 5 Empower standards. We calculated the percentage of facilities that reported the degree to which they implemented each standard and identified common themes in comments recorded in the survey. All facilities reported either full or partial implementation of the 5 standards. Of 1,678 facilities, 21.7% (n = 364) reported full implementation of all standards, and 78.3% (n = 1,314) reported at least partial implementation. Staff training, which has only one component, had the highest level of implementation: 77.4% (n = 1,299) reported full implementation. Only 44.0% (n = 738) reported full implementation of the standard on a breastfeeding-friendly environment. Arizona child care facilities have begun to implement the Empower program, but facilities will need more education, technical assistance, and support in some areas to fully implement the program.

A Wellness Program for Your Staff Sets a Healthy Example for Students.

ERIC Educational Resources Information Center

Wolform, Cynthia A.; And Others

1988-01-01

Employee health promotion through wellness programs can be set up at schools using existing facilities. Describes how Greenwood Area Schools in Millertown, Pennsylvania, set up a program and lists who does what in the program. (MLF)

Continuing education for staff in long-term care facilities: corporate philosophies and approaches.

PubMed

Ross, M M; Carswell, A; Dalziel, W B; Aminzadeh, F

2001-01-01

The purpose of this study was to determine corporate philosophies of continuing education and approaches to meeting the learning needs of staff who strive to provide for the increasingly challenging care requirements of seniors who reside in long-term care facilities. In-depth interviews lasting approximately 1 hour were conducted with key informants at the administrative level from nine long-term care facilities. Content analysis revealed a commitment to continuing education for staff. While recognizing the importance of organizational responsibility for continuing education, administrators placed emphasis on the individual responsibility of staff. Learning needs were identified as affective, managerial, and physical in nature. Challenges to providing continuing education programs were derived from a general lack of fiscal and human resources. A variety of measures was suggested as important to supporting the continuing learning of staff. Implications of this study point to the need for long-term care facilities to incorporate into their strategic plans measures of ensuring continuing education as a basis for the ongoing competence and development of staff. In addition, there is a need for collaboration between long-term care facilities and other institutions of a long-term care, acute care, and educational nature in the development of strategies to operationalize a philosophy of continuing learning as a basis for the provision of optimal care to residents.

Predictors of organizational commitment among staff in assisted living.

PubMed

Sikorska-Simmons, Elzbieta

2005-04-01

This study examines the role of organizational culture, job satisfaction, and sociodemographic characteristics as predictors of organizational commitment among staff in assisted living. It is particularly important to examine organizational commitment, because of its close links to staff turnover. Data were collected from 317 staff members in 61 facilities, using self-administered questionnaires. The facilities were selected from licensed assisted living programs and were stratified into small, traditional, and new-model homes. Staff questionnaires were distributed by a researcher during 1-day visits to each facility. Organizational commitment was measured by the extent of staff identification, involvement, and loyalty to the organization. Organizational culture, job satisfaction, and education were strong predictors of commitment, together explaining 58% of the total variance in the dependent variable. Higher levels of organizational commitment were associated with more favorable staff perceptions of organizational culture and greater job satisfaction. In addition, more educated staff members tended to report higher levels of organizational commitment. Other than education, sociodemographic characteristics failed to account for a significant amount of variance in organizational commitment. Because job satisfaction and organizational culture were strong predictors of commitment, interventions aimed at increasing job satisfaction and creating an organizational culture that values and respects staff members could be most effective in producing higher levels of organizational commitment.

The Effects of Staff Training on the Types of Interactions Observed at Two Group Homes for Foster Care Children

ERIC Educational Resources Information Center

Crosland, Kimberly A.; Dunlap, Glen; Sager, Wayne; Neff, Bryon; Wilcox, Catherine; Blanco, Alfredo; Giddings, Tamela

2008-01-01

Objectives: An extensive literature base exists for behavioral parent training; however, few studies have focused on training direct care staff at group home and residential facilities for children. This study was conducted to determine whether a behavioral staff training program consisting of classroom training and in-home feedback would improve…

EVALUATION OF THE ADULT LEARNING CENTER OF ELIZABETHPORT BY STAFF AND PARTICIPANTS, OPERATIONS FROM 2/26/68 - 4/30/68.

ERIC Educational Resources Information Center

TATUM, WILLIAM; CHASNOFF, ROBERT

ACTIVITIES, FACILITIES, AND PROGRAMED READING MATERIALS AT THE ADULT LEARNING CENTER OF ELIZABETHPORT (ELIZABETH, NEW JERSEY) WERE EVALUATED IN 1968 BY STAFF MEMBERS AND PARTICIPANTS. STAFF OPINIONS DIFFERED AS TO THE MOST SUCCESSFUL MATERIALS, AND REASONS GIVEN FOR SUCCESS VARIED BETWEEN INTEREST LEVEL, SIZE OF PRINT AND LENGTH OF STORIES, THE…

Impact of the raising immunizations safely and effectively (RISE) program on healthcare worker influenza immunization rates in long term care settings.

PubMed

Nace, David A; Handler, Steven M; Hoffman, Erika L; Perera, Subashan

2012-11-01

National influenza immunization rates for healthcare workers (HCW) in long-term care (LTC) remain unacceptably low. This poses a serious public health threat to residents. Prior work has suggested high staff turnover rates as a contributing factor to low immunization rates. There is a critical need to identify and deploy successful models of HCW influenza immunization programs to LTC facilities. This report describes one potential model that has been successfully initiated in a network of LTC facilities. All facilities served by a single regional LTC pharmacy were invited to participate in a HCW influenza immunization program. This voluntary immunization program began in 2005 and continues to the present. As part of the program, the pharmacy promoted organizational change by assuming oversight and control of HCW immunization policies and processes for all facilities. Primary and secondary outcomes are the number of facilities reaching HCW influenza immunization rates of 60% and 80%. Fourteen of the 16 LTC facilities participated. Facilities were diverse and included both nursing and assisted living facilities; unionized and nonunionized facilities; and urban, suburban, and rural facilities. The pharmacy provided educational and communication materials, centralized data collection using a standardized definition for HCW immunization rates, and facility feedback. All 14 LTC facilities achieved the primary goal of 60% and nearly two thirds reached the secondary goal of 80%. Twenty percent reached the new Healthy People 2020 goal of 90%. It is possible for LTC facilities to improve HCW immunization rates using a pharmacy based, voluntary HCW influenza immunization approach. Such an approach may help attenuate the negative influence of staff turnover on HCW immunizations. Attainment of the new Health People 2020 goals still remains a challenge and may require mandatory programs. Copyright © 2012 American Medical Directors Association, Inc. Published by Elsevier Inc. All rights reserved.

An evaluation of substance misuse treatment providers used by an employee assistance program.

PubMed

Miller, N A

1992-05-01

Structural measures of access, continuity, and quality of substance misuse treatment services were compared in 30 fee-for-service (FFS) facilities and nine health maintenance organizations (HMOs). Probit models related effects of the provider system (FFS or HMO) and the system's structural characteristics to 243 employees' access to and outcomes from treatment. Access was decreased in Independent Practice Association (IPA)/network HMOs and in all facilities which did not employ an addictionologist or provide coordinated treatment services. When bivariate correlations were examined, both use of copayments and imposing limits to the levels of treatment covered were negatively related to access, while a facility's provision of ongoing professional development was positively associated with access. These correlations did not remain significant in the multivariate probits. Receiving treatment in a staff model HMO and facing limits to the levels of treatment covered were negatively associated with attaining sufficient progress, while receiving treatment in a facility which provided ongoing professional development was positively related to progress: these effects did not remain significant in multivariate analyses. Implications for employee assistance program (EAP) staff in their role as case managers and for EAP staff and employers in their shared role as purchasers of treatment are discussed.

Off We Go Cybernetting--Staff Development Makes the Difference.

ERIC Educational Resources Information Center

Joseph, Linda

1995-01-01

Describes how to create a school or district model for an Internet staff development training program for integrating information access skills into the school curriculum. Highlights include instructional design; facility development, including computer workstations; hands-on workshops that include electronic mail, gopher, and downloading;…

Fire Safety in Nursing Facilities: Participant's Coursebook.

ERIC Educational Resources Information Center

Walker (Bonnie) and Associates, Inc., Crofton, MD.

Fewer people die in nursing facility fires than in fires occurring in other places where older people live. Fire remains, however, a significant threat in nursing facilities. This book is centered around six "modules" that present a fire safety training program for managers and staff in nursing homes. These modules present the following…

The Role of the Environmental Health Specialist in the Penal and Correctional System

ERIC Educational Resources Information Center

Walker, Bailus, Jr.; Gordon, Theodore J.

1976-01-01

Implementing a health and hygiene program in penal systems necessitates coordinating the entire staff. Health specialists could participate in facility planning and management, policy formation, and evaluation of medical care, housekeeping, and food services. They could also serve as liaisons between correctional staff and governmental or…

Strategies to Mitigate a Mycobacterium marinum Outbreak in a Zebrafish Research Facility

PubMed Central

Snell, Kathy; Mittge, Erika; Melancon, Ellie; Montgomery, Rebecca; McFadden, Marcie; Camoriano, Javier; Kent, Michael L.; Whipps, Christopher M.; Peirce, Judy

2016-01-01

Abstract In 2011, the zebrafish research facility at the University of Oregon experienced an outbreak of Mycobacterium marinum that affected both research fish and facility staff. A thorough review of risks to personnel, the zebrafish veterinary care program, and zebrafish husbandry procedures at the research facility followed. In the years since 2011, changes have been implemented throughout the research facility to protect the personnel, the fish colony, and ultimately the continued success of the zebrafish model research program. In this study, we present the history of the outbreak, the changes we implemented, and recommendations to mitigate pathogen outbreaks in zebrafish research facilities. PMID:27351618

Impact of an educational program on knowledge and practice of health care staff toward pharmaceutical waste management in Gaza, Palestine.

PubMed

Tabash, Mohammed I; Hussein, Rim A; Mahmoud, Aleya H; El-Borgy, Mohamed D; Abu-Hamad, Bassam A

2016-04-01

In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. Poor knowledge about their potential downstream impacts may be a primary factor for improper disposal behavior. The objective of this study was to determine the impact of an intervention program on knowledge and practice of health care staff regarding pharmaceutical waste management. The study was designed as a pre/posttest intervention study. Total sample size was 530 in the pre-intervention phase, and then a subsample of 69 individuals was selected for the intervention and the post-intervention phases. Paired-sample t test was used to assess the difference between pretest and follow-up test results. A statistically significant improvement in knowledge and practice was achieved (P<0.001). Poor knowledge and poor practice levels (scores<50%) were found to improve to satisfactory levels (scores≥75%). Therefore, educational programs could be considered as an effective tool for changing health care staff practice in pharmaceutical waste management. In health care facilities, pharmaceutical waste is generally discharged down the drain or sent to landfill. A lack of knowledge about the potential impacts of this type of waste may be a leading factor in improper disposal behavior. Following an educational program, statistically significant improvement in knowledge and practice of health care staff as regards to pharmaceutical waste management (PWM) was achieved. It is thus recommended that authorities implement training-of-trainers (TOT) programs to educate health care staff on PWM and organize refreshment workshops regularly.

Innovating team-based outpatient mental health care in the Veterans Health Administration: Staff-perceived benefits and challenges to pilot implementation of the Behavioral Health Interdisciplinary Program (BHIP).

PubMed

Barry, Catherine N; Abraham, Kristen M; Weaver, Kendra R; Bowersox, Nicholas W

2016-05-01

In the past decade, the demand for Veterans Health Administration (VHA) mental health care has increased rapidly. In response to the increased demand, the VHA developed the Behavioral Health Interdisciplinary Program (BHIP) team model as an innovative approach to transform VHA general outpatient mental health delivery. The present formative evaluation gathered information about pilot implementation of BHIP to understand the struggles and successes that staff experienced during facility transitions to the BHIP model. Using a purposive, nonrandom sampling approach, we conducted 1-on-1, semistructured interviews with 37 licensed and nonlicensed clinical providers and 13 clerical support staff assigned to BHIP teams in 21 facilities across the VHA. Interviews revealed that having actively involved facility mental health leaders, obtaining adequate staffing for teams to meet the requirements of the BHIP model, creating clear descriptions and expectations for team member roles within the BHIP framework, and allocating designated time for BHIP team meetings challenged many VHA sites but are crucial for successful BHIP implementation. Despite the challenges, staff reported that the transition to BHIP improved team work and improved patient care. Staff specifically highlighted the potential for the BHIP model to improve staff working relationships and enhance communication, collaboration, morale, and veteran treatment consistency. Future evaluations of the BHIP implementation process and BHIP team functioning focusing on patient outcomes, organizational outcomes, and staff functioning are recommended for fully understanding effects of transitioning to the BHIP model within VHA general mental health clinics and to identify best practices and areas for improvement. (PsycINFO Database Record (c) 2016 APA, all rights reserved).

Program to Combat Stereotyping in Career Choice.

ERIC Educational Resources Information Center

Harrison, Laurie R.

Divided into three sections which deal with sex, race, and handicap stereotyping in career choice, the twenty-eight programs described here attempt to combat stereotypes among students and/or staff (K-12). Most descriptions list the goals of the program, target population, staffing and management, facilities and activities, program effectiveness…

International Affairs Programs: The Air Force Versus the Army

DTIC Science & Technology

2015-10-01

individual tutoring programs . Additionally RAS personnel are offered regional enhancement studies opportunities at several facilities.48 RAS personnel...AU/ACSC/2015 AIR COMMAND AND STAFF COLLEGE AIR UNIVERSITY INTERNATIONAL AFFAIRS PROGRAMS : THE AIR FORCE VERSUS THE ARMY by Robin L...5 COMPARISON: INTERNATIONAL AFFAIRS PROGRAMS AIR FORCE VERSUS ARMY 8

Cross-Training Laboratory Animal Care Personnel in Physically Separate Animal Facilities at a Land-Grant Institution.

PubMed

Henze, Tonja M; Allison, Sarah O; Criley, Jennifer M; Myers, Sara J; Goodly, Lyndon J

2016-01-01

The University of Illinois at Urbana-Champaign maintains physically separated animal care facilities under centralized management by the Division of Animal Resources. As part of a land-grant institution, the animal care and use program operates several animal units in key locations for specific disciplines within the campus, all of which have the core mission to teach, conduct research, and engage in public service. Populations of research animals vary with the levels of research funding, the number of research investigators on staff, research direction, and animal availability. Accordingly, the requirement for animal care staffing in each unit may vary widely also. To best use the existing animal care staff and remain fiscally responsible, cross-training of staff was implemented to allow staff to travel from units with small animal populations to units with larger populations or short-term staffing shortages. Here we detail and describe the system we used to assess the needs for cross-training, identify the staff to train, and implement the training plan. We believe this information will assist other programs, particularly those with large or complex organization (for example, land-grant institutions) that experience similar fluctuations in animal use.

Dialectical Behavior Therapy Training and Desired Resources for Implementation: Results From a National Program Evaluation in the Veterans Health Administration.

PubMed

Landes, Sara J; Matthieu, Monica M; Smith, Brandy N; Trent, Lindsay R; Rodriguez, Allison L; Kemp, Janet; Thompson, Caitlin

2016-08-01

Little is known about nonresearch training experiences of providers who implement evidence-based psychotherapies for suicidal behaviors among veterans. This national program evaluation identified the history of training, training needs, and desired resources of clinicians who work with at-risk veterans in a national health care system. This sequential mixed methods national program evaluation used a post-only survey design to obtain needs assessment data from clinical sites (N = 59) within Veterans Health Administration (VHA) facilities that implemented dialectical behavior therapy (DBT). Data were also collected on resources preferred to support ongoing use of DBT. While only 33% of clinical sites within VHA facilities reported that staff attended a formal DBT intensive training workshop, nearly 97% of participating sites reported having staff who completed self-study using DBT manuals. Mobile apps for therapists and clients and templates for documentation in the electronic health records to support measurement-based care were desired clinical resources. Results indicate that less-intensive training models can aid staff in implementing DBT in real-world health care settings. While more training is requested, a number of VHA facilities have successfully implemented DBT into the continuum of care for veterans at risk for suicide. Reprint & Copyright © 2016 Association of Military Surgeons of the U.S.

Bullying in Senior Living Facilities: Perspectives of Long-Term Care Staff.

PubMed

Andresen, Felicia J; Buchanan, Jeffrey A

2017-07-01

Resident-to-resident bullying has attracted attention in the media, but little empirical literature exists related to the topic of senior bullying. The aim of the current study was to better understand resident-to-resident bullying from the perspective of staff who work with older adults. Forty-five long-term care staff members were interviewed regarding their observations of bullying. Results indicate that most staff members have observed bullying. Verbal bullying was the most observed type of bullying, but social bullying was also prevalent. Victims and perpetrators were reported to commonly have cognitive and physical disabilities. More than one half of participants had not received formal training and only 21% reported their facility had a formal policy to address bullying. The implications of these results support the need for detailed policies and training programs for staff to effectively intervene when bullying occurs. [Journal of Gerontological Nursing, 43(7), 34-41.]. Copyright 2017, SLACK Incorporated.

Resident aggression toward staff at a center for the developmentally disabled.

PubMed

West, Christine A; Galloway, Ellen; Niemeier, Maureen T

2014-01-01

Few studies have examined factors contributing to nonfatal assaults to staff working in residential care facilities. The authors evaluated resident assaults toward direct care/nursing staff at an intermediate Care Facility for Individuals with Mental Retardation (ICF/MR), which included observations of work areas, employee interviews, calculation of injury and assault rates for 2004 to 2007 from Occupational Safety and Health Administration Logs, and review of state ICP/MR guidelines. Most staff interviewed reported having been injured during physical restraint of a resident and the average rate of injury from assault at the center evaluated was higher than the average national rates for the health care and social assistance sector for the same time period. The center lacked policies and developing a post-incident response and evaluation program to assist staff in coping with the consequences of assault and/or occupational injury.

Challenges in conducting research in pediatric long-term care facilities.

PubMed

Larson, Elaine L; Cohen, Bevin; Murray, Meghan; Saiman, Lisa

2014-10-01

Children residing in long-term care facilities (LTCFs) have complex medical problems and unique care needs, yet research in this setting is rare. As part of an intervention study to improve patient safety (Keep It Clean for Kids [KICK]), we describe the challenges encountered and recommend approaches to build a successful and sustained collaborative relationship between pediatric LTCFs and the research team. We implemented a program with 5 components: leadership commitment, active staff participation by the creation of KICK teams, workflow assessments, staff training in the World Health Organization's "5 Moments for Hand Hygiene," and electronic monitoring and feedback to staff regarding hand hygiene practices. Major challenges encountered were establishing trust, building research teams, enhancing staff participation, and engaging families and visitors. Approaches to deal with these challenges are discussed. Conducting research in pediatric LTCFs requires sustained commitment to dealing with challenges and establishing collaborative relationships with administrative and frontline staff. © The Author(s) 2014.

Effect of Promoting High-Quality Staff Interactions on Fall Prevention in Nursing Homes: A Cluster-Randomized Trial.

PubMed

Colón-Emeric, Cathleen S; Corazzini, Kirsten; McConnell, Eleanor S; Pan, Wei; Toles, Mark; Hall, Rasheeda; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Anderson, Amber L; Burd, Andrew; Amarasekara, Sathya; Anderson, Ruth A

2017-11-01

New approaches are needed to enhance implementation of complex interventions for geriatric syndromes such as falls. To test whether a complexity science-based staff training intervention (CONNECT) promoting high-quality staff interactions improves the impact of an evidence-based falls quality improvement program (FALLS). Cluster-randomized trial in 24 nursing homes receiving either CONNECT followed by FALLS (intervention), or FALLS alone (control). Nursing home staff in all positions were asked to complete surveys at baseline, 3, 6, and 9 months. Medical records of residents with at least 1 fall in the 6-month pre- and postintervention windows (n = 1794) were abstracted for fall risk reduction measures, falls, and injurious falls. CONNECT taught staff to improve their connections with coworkers, increase information flow, and use cognitive diversity in problem solving. Intervention components included 2 classroom sessions, relationship mapping, and self-monitoring. FALLS provided instruction in the Agency for Healthcare Research and Quality's Falls Management Program. Primary outcomes were (1) mean number of fall risk reduction activities documented within 30 days of falls and (2) median fall rates among residents with at least 1 fall during the study period. In addition, validated scales measured staff communication quality, frequency, timeliness, and safety climate. Surveys were completed by 1545 staff members, representing 734 (37%) and 811 (44%) of eligible staff in intervention and control facilities, respectively; 511 (33%) respondents were hands-on care workers. Neither the CONNECT nor the FALLS-only facilities improved the mean count of fall risk reduction activities following FALLS (3.3 [1.6] vs 3.2 [1.5] of 10); furthermore, adjusted median recurrent fall rates did not differ between the groups (4.06 [interquartile range {IQR}, 2.03-8.11] vs 4.06 [IQR, 2.04-8.11] falls/resident/y). A modest improvement in staff communication measures was observed overall (mean, 0.03 [SE, 0.01] points on a 5-point scale; P = .03) and for communication timeliness (mean, 0.8 [SE, 0.03] points on a 5-point scale; P = .02). There was wide variation across facilities in intervention penetration. An intervention targeting gaps in staff communication and coordination did not improve the impact of a falls quality improvement program. New approaches to implementing evidence-based care for complex conditions in the nursing home are urgently needed. clinicaltrials.gov Identifier: NCT00636675.

Safety climate and workplace violence prevention in state-run residential addiction treatment centers.

PubMed

Lipscomb, Jane A; London, M; Chen, Y M; Flannery, K; Watt, M; Geiger-Brown, J; Johnson, J V; McPhaul, K

2012-01-01

To examine the association between violence prevention safety climate measures and self reported violence toward staff in state-run residential addiction treatment centers. In mid-2006, 409 staff from an Eastern United States state agency that oversees a system of thirteen residential addiction treatment centers (ATCs) completed a self-administered survey as part of a comprehensive risk assessment. The survey was undertaken to identify and measure facility-level risk factors for violence, including staff perceptions of the quality of existing US Occupational Safety and Health Administration (OSHA) program elements, and ultimately to guide violence prevention programming. Key informant interviews and staff focus groups provided researchers with qualitative data with which to understand safety climate and violence prevention efforts within these work settings. The frequency with which staff reported experiencing violent behavior ranged from 37% for "clients raised their voices in a threatening way to you" to 1% for "clients pushed, hit, kicked, or struck you". Findings from the staff survey included the following significant predictors of violence: "client actively resisting program" (OR=2.34, 95% CI=1.35, 4.05), "working with clients for whom the history of violence is unknown" (OR=1.91, 95% CI=1.18, 3.09) and "management commitment to violence prevention" reported as "never/hardly ever" and "seldom or sometimes" (OR=4.30 and OR=2.31 respectively), while controlling for other covariates. We utilized a combination of qualitative and quantitative research methods to begin to describe the risk and potential for violence prevention in this setting. The prevalence of staff physical violence within the agency's treatment facilities was lower than would be predicted. Possible explanations include the voluntary nature of treatment programs; strong policies and consequences for resident behavior and ongoing quality improvement efforts. Quantitative data identified low management commitment to violence prevention as a significant predictor of staff reported violence.

Motorcycle Safety Education. A Curriculum Guide.

ERIC Educational Resources Information Center

Ohio State Board of Education, Columbus.

This curriculum guide was produced to assist instructors of educational programs for novice motorcycle operators, automobile drivers, and all highway users. An introductory section discusses program implementation concerns, such as public relations, legal considerations, scheduling, staff, students, facilities, motorcycles, insurance, financial…

Army Corrosion Prevention and Control (CPC) Program for Facilities and Infrastructure

DTIC Science & Technology

2010-02-01

FY2009 - 2011 • Benefits: Reduced corrosion due to elimination of metallic rebar , reduced weight equates to reduced dead load and increased dynamic...Decks as Replacement for Steel Reinforced Concrete Decks F09AR04: Corrosion Resistant Roofs with Integrated Sustainable PV Power Systems • Where...Army Corrosion Prevention and Control (CPC) Program for Facilities and Infrastructure Dr. Craig E. College Deputy Assistant Chief of Staff for

Prescription for Health Care Costs. Wellness Programs on Campus.

ERIC Educational Resources Information Center

Dunlavey, Christopher S.

1992-01-01

The wellness program is applied within the higher education setting as one means to control health care costs. Discussed are the program's design, objectives, content, facilities, structure and staff, financing, and evaluation. It is noted that wellness programs are not only cost effective but can help to improve morale and increase productivity.…

College Union Facilities and Their Perceived Influence on Institutional Retention

ERIC Educational Resources Information Center

Tierno, Scott A.

2013-01-01

The College Union is a campus facility that is part of the campus ecology. It provides a place where all can feel a sense of inclusion, safety, involvement, and community. Through a comparative research approach I will present how both students and professional staff perceive the College Union, the programs that are part of the facility, and how…

Social and Economic Impacts of Selected Potential Dredged Material Containment Facilities in Long Island Sound.

DTIC Science & Technology

1981-09-01

GRANT NuMBER(s) CENTER FOR THE ENVIRONMENT AND MAN, INC. DACW 33-8U-~e--’-e/ Work Order No. 8 I.~3 PERFORMING ORGANIZATION NAME AND ADDRESS 10. PROGRAM ...08-735 Program Manager Lynn E. Johnson Principal Investigator Gaylord M. Northrop Project Staff John Ball Kenneth Bober Kayla Costenoble Brian...determination of the merits of continuing the program . This is a Stage 2 report. While six potential dredged material containment facilities are

Perceptions of staff attributes in substance abuse treatment.

PubMed

Grosenick, J K; Hatmaker, C M

2000-10-01

Qualified professional staff contribute significantly to successful health-care service delivery. Organizations view six categories of staff attributes as valued qualities of competent personnel: knowledge and experience, organizational citizenship, interpersonal skills, service orientation, personal attributes, and leadership skills. This study presents the perceptions regarding these and other staff attributes held by female clients and staff from a substance abuse treatment facility. Results indicated that four attributes were perceived as particularly influential in assisting women to reach treatment goals. These included knowledge and experience, supportiveness, nonthreatening behaviors, and availability. Attention to these variables may prove useful as treatment programs strive to improve client outcomes.

An annual employee education calendar as the capstone of educational assessment, planning, and delivery.

PubMed

Morton, Paula G

2005-01-01

Staff development educators can better control their workload and provide a more comprehensive employee education program when the organization adopts a formal five-step process that culminates in the publication of an annual employee education calendar. This article describes the five steps of organization-wide learning needs assessment, resource allocation, priority setting, documentation of the educational plan, and calendar development, including elements and timelines. The annual calendar reflects involvement of staff throughout the facility in the identification, planning, and delivery of education programs. Its publication enhances staff and supervisors' awareness of learning opportunities. Its longer-range perspective assists managers and employees to better plan to meet learning needs and improves participation in staff development activities.

Aeropropulsion facilities configuration control: Procedures manual

NASA Technical Reports Server (NTRS)

Lavelle, James J.

1990-01-01

Lewis Research Center senior management directed that the aeropropulsion facilities be put under configuration control. A Configuration Management (CM) program was established by the Facilities Management Branch of the Aeropropulsion Facilities and Experiments Division. Under the CM program, a support service contractor was engaged to staff and implement the program. The Aeronautics Directorate has over 30 facilities at Lewis of various sizes and complexities. Under the program, a Facility Baseline List (FBL) was established for each facility, listing which systems and their documents were to be placed under configuration control. A Change Control System (CCS) was established requiring that any proposed changes to FBL systems or their documents were to be processed as per the CCS. Limited access control of the FBL master drawings was implemented and an audit system established to ensure all facility changes are properly processed. This procedures manual sets forth the policy and responsibilities to ensure all key documents constituting a facilities configuration are kept current, modified as needed, and verified to reflect any proposed change. This is the essence of the CM program.

Client-centered design of residential addiction and mental health care facilities: staff perceptions of their work environment.

PubMed

Novotná, Gabriela; Urbanoski, Karen A; Rush, Brian R

2011-11-01

In this article we discuss the findings from a series of focus groups conducted as part of a 3-year, mixed-method evaluation of clinical programs in a large mental health and substance use treatment facility in Canada. We examined the perceptions of clinical personnel on the physical design of new treatment units and the impact on service delivery and the work environment. The new physical design appeared to support client recovery and reduce stigma; however, it brought certain challenges. Participants reported a compromised ability to monitor clients, a lack of designated therapeutic spaces, and insufficient workspace for staff. They also thought that physical design positively facilitated communication and therapeutic relationships among clinicians and clients, and increased team cohesion. We suggest that, from these findings, new avenues for research on achieving the important balance between client and staff needs in health facility design can be explored.

Preschool Guidelines: Suburban Model (Ontario Local School District).

ERIC Educational Resources Information Center

Ohio State Dept. of Education, Columbus. Div. of Educational Services.

The Ontario Local Schools District, serving the village of Ontario and Springfield Township, offers this manual of operation which program staff developed to reflect the first year of implementation of a preschool program. Contents concern: (1) needs assessment; (2) program development; (3) facilities, equipment, and supplies; (4) staffing and…

7 CFR 91.6 - Availability of services.

Code of Federal Regulations, 2011 CFR

2011-01-01

..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... furnished whenever a Science and Technology staff is available and the facilities and conditions are...

7 CFR 91.6 - Availability of services.

Code of Federal Regulations, 2014 CFR

2014-01-01

..., Inspections, Marketing Practices), DEPARTMENT OF AGRICULTURE (CONTINUED) COMMODITY LABORATORY TESTING PROGRAMS... furnished whenever a Science and Technology staff is available and the facilities and conditions are...

Chemical Safety Programs.

ERIC Educational Resources Information Center

Shaw, Richard

2000-01-01

Discusses the need to enhance understanding of chemical safety in educational facilities that includes adequate staff training and drilling requirements. The question of what is considered proper training is addressed. (GR)

Culturally Competent Palliative and Hospice Care Training for Ethnically Diverse Staff in Long-Term Care Facilities.

PubMed

Kataoka-Yahiro, Merle R; McFarlane, Sandra; Koijane, Jeannette; Li, Dongmei

2017-05-01

Between 2013 and 2030, older adults 65 years and older of racial/ethnic populations in the U.S. is projected to increase by 123% in comparison to the Whites (Non-Hispanics). To meet this demand, training of ethnically diverse health staff in long-term care facilities in palliative and hospice care is imperative. The purpose of this study was to evaluate a palliative and hospice care training of staff in two nursing homes in Hawaii - (a) to evaluate knowledge and confidence over three time periods, and (b) to compare staff and family caregiver satisfaction at end of program. The educational frameworks were based on cultural and communication theories. Fifty-two ethnically diverse staff, a majority being Asian (89%), participated in a 10-week module training and one 4 hour communication skills workshop. Staff evaluation included knowledge and confidence surveys, pre- and post-test knowledge tests, and FAMCARE-2 satisfaction instrument. There were nine Asian (89%) and Pacific Islander (11%) family caregivers who completed the FAMCARE-2 satisfaction instrument. The overall staff knowledge and confidence results were promising. The staff rated overall satisfaction of palliative care services lower than the family caregivers. Implications for future research, practice, and education with palliative and hospice care training of ethnically diverse nursing home staff is to include patient and family caregiver satisfaction of palliative and hospice care services, evaluation of effectiveness of cross-cultural communication theories in palliative and hospice care staff training, and support from administration for mentorship and development of these services in long term care facilities.

The MICA Case Conference Program at Tewksbury Hospital, Mass.: an integrated treatment model.

PubMed

Clodfelter, Reynolds C; Albanese, Mark J; Baker, Gregg; Domoto, Katherine; Gui, Amy L; Khantzian, Edward J

2003-01-01

This report describes the MICA (Mentally Ill Chemically Abusing) Program at the Tewksbury Hospital campus in Tewksbury, Massachusetts. Several campus facilities collaborate in the MICA Program. Through Expert Case Conferences, principles of integrated psychosocial treatment with dual diagnosis patients are demonstrated. An expert clinician focuses on the interplay between psychological pain, characterological traits, defenses, and the patient's drug of choice. Patients who have participated in the program have reported positive experiences. The staff reported that the program has resulted in facility improvement in assessment and treatment of complex dual diagnosis patients.

Implementation of personalized music listening for assisted living residents with dementia.

PubMed

Murphy, Kelly; Liu, Winston W; Goltz, Daniel; Fixsen, Emma; Kirchner, Stephen; Hu, Janice; White, Heidi

2018-05-03

Personalized music listening (PML) has been touted as a safe and inexpensive means of improving the quality of life, mood, and behavior of persons with dementia. A PML program was implemented in an assisted living facility and evaluated across the five dimensions of the RE-AIM framework: reach, effectiveness, adoption, implementation, and maintenance. The first 17 residents invited to participate were enrolled and followed over eight months. Effectiveness was evident in staff-reported mood improvement in 62% of encounters. Adoption was evident in qualitative feedback collected from medication technicians. Implementation was facilitated by low costs, engagement of external volunteers, highlighting outcomes that are relevant to staff, and attention to playlists over time. Maintenance required continued engagement of volunteers, ongoing fundraising, attention to facility staff engagement, and iterative adjustments to the program framework as staffing changes occurred. PML was found to be a meaningful intervention that is possible at a reasonable cost. Copyright © 2018 Elsevier Inc. All rights reserved.

Implementing a Cardiac Skills Orientation and Simulation Program.

PubMed

Hemingway, Maureen W; Osgood, Patrice; Mannion, Mildred

2018-02-01

Patients with cardiac morbidities admitted for cardiac surgical procedures require perioperative nurses with a high level of complex nursing skills. Orienting new cardiac team members takes commitment and perseverance in light of variable staffing levels, high-acuity patient populations, an active cardiac surgical schedule, and the unpredictability of scheduling patients undergoing cardiac transplantation. At an academic medical center in Boston, these issues presented opportunities to orient new staff members to the scrub person role, but hampered efforts to provide active learning opportunities in a safe environment. As a result, facility personnel created a program to increase new staff members' skills, confidence, and proficiency, while also increasing the number of staff members who were proficient at scrubbing complex cardiac procedures. To address the safe learning requirement, personnel designed a simulation program to provide scrubbing experience, decrease orientees' supervision time, and increase staff members' confidence in performing the scrub person role. © AORN, Inc, 2018.

Clean Air Markets - Facility Attributes and Contacts Query Wizard

EPA Pesticide Factsheets

The Facility Attributes and Contacts Query Wizard is part of a suite of Clean Air Markets-related tools that are accessible at http://camddataandmaps.epa.gov/gdm/index.cfm. The Facility Attributes and Contact module gives the user access to current and historical facility, owner, and representative data using custom queries, via the Facility Attributes Query Wizard, or Quick Reports. In addition, data regarding EPA, State, and local agency staff are also available. The Query Wizard can be used to search for data about a facility or facilities by identifying characteristics such as associated programs, owners, representatives, locations, and unit characteristics, facility inventories, and classifications.EPA's Clean Air Markets Division (CAMD) includes several market-based regulatory programs designed to improve air quality and ecosystems. The most well-known of these programs are EPA's Acid Rain Program and the NOx Programs, which reduce emissions of sulfur dioxide (SO2) and nitrogen oxides (NOx)-compounds that adversely affect air quality, the environment, and public health. CAMD also plays an integral role in the development and implementation of the Clean Air Interstate Rule (CAIR).

Energy management system optimization for on-site facility staff - a case history of the New York State Office of Mental Health

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bagdon, M.J.; Martin, P.J.

1997-06-01

In 1994, Novus Engineering and EME Group began a project for the New York State Office of Mental Health (OMH) to maximize the use and benefit of energy management systems (EMS) installed at various large psychiatric hospitals throughout New York State. The project, which was funded and managed by the Dormitory Authority of the State of New York (DASNY), had three major objectives: (1) Maximize Energy Savings - Novus staff quickly learned that EMS systems as set up by contractors are far from optimal for generating energy savings. This part of the program revealed numerous opportunities for increased energy savings,more » such as: fine tuning proportional/integral/derivative (PID) loops to eliminate valve and damper hunting; adjusting temperature reset schedules to reduce energy consumption and provide more uniform temperature conditions throughout the facilities; and modifying equipment schedules. (2) Develop Monitoring Protocols - Large EMS systems are so complex that they require a systematic approach to daily, monthly and seasonal monitoring of building system conditions in order to locate system problems before they turn into trouble calls or equipment failures. In order to assist local facility staff in their monitoring efforts, Novus prepared user-friendly handbooks on each EMS. These included monitoring protocols tailored to each facility. (3) Provide Staff Training - When a new EMS is installed at a facility, it is frequently the maintenance staffs first exposure to a complex computerized system. Without proper training in what to look for, staff use of the EMS is generally very limited. With proper training, staff can be taught to take a pro-active approach to identify and solve problems before they get out of hand. The staff then realize that the EMS is a powerful preventative maintenance tool that can be used to make their work more effective and efficient. Case histories are presented.« less

Developing an Effective Intervention for Incarcerated Teen Fathers: The Baby Elmo Program

ERIC Educational Resources Information Center

Brito, Natalie; Barr, Rachel; Rodriguez, Jennifer; Shauffer, Carole

2012-01-01

The absence of a father figure has been linked to very poor developmental outcomes. The Baby Elmo Program, a parenting and structured visitation program, aims to form and maintain bonds between children and their incarcerated teen fathers. The program is taught and supervised by probation staff in juvenile detention facilities. This intervention…

Optimizing care of residents with Parkinsonism in supervised facilities.

PubMed

Makoutonina, Margarita; Iansek, Robert; Simpson, Pam

2010-06-01

People with Parkinsonism (PWP) in residential facilities are usually elderly, cognitively impaired, physically disabled with poor quality of life and a high mortality rate. This paper aims to determine if the care of PWP in residential facilities could be improved by addressing staff knowledge on Parkinson related issues. A curriculum based on the Victorian Comprehensive Parkinson Program (VCPP) was developed and delivered to 118 staff members in 9 facilities across Melbourne. Measures of staff knowledge were undertaken at baseline, 1, 3 and 12 months. Data from a total of 49 residents were used in the analysis. Measures were taken at baseline, 1, 3 and 12 months included dementia screen (MMSE), geriatric depression scale (GDS), quality of life (PDQ39), fatigue (PDFS16), monthly falls diary, Unified Parkinson Disease Rating Scale (I,II,III) Hoehn & Yahr scale (H&Y) and resident/family questionnaire (RFQ) which focused on quality of care provision. It was found that the staff knowledge assessment scores (max = 37) significantly improved post education (P < 0.01) from baseline mean (11.1) and were maintained to 12 months mean (29.0). The residents group improved significantly for all measures at 1 month and these improvements were maintained up to 12 months (except for UPDRS III). This study demonstrated how a simple intervention, resulting in improved staff knowledge, produced a significant and clinically meaningful improvement in the care of PWP.

A brief, standardized tool for measuring HIV-related stigma among health facility staff: results of field testing in China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis.

PubMed

Nyblade, Laura; Jain, Aparna; Benkirane, Manal; Li, Li; Lohiniva, Anna-Leena; McLean, Roger; Turan, Janet M; Varas-Díaz, Nelson; Cintrón-Bou, Francheska; Guan, Jihui; Kwena, Zachary; Thomas, Wendell

2013-11-13

Within healthcare settings, HIV-related stigma is a recognized barrier to access of HIV prevention and treatment services and yet, few efforts have been made to scale-up stigma reduction programs in service delivery. This is in part due to the lack of a brief, simple, standardized tool for measuring stigma among all levels of health facility staff that works across diverse HIV prevalence, language and healthcare settings. In response, an international consortium led by the Health Policy Project, has developed and field tested a stigma measurement tool for use with health facility staff. Experts participated in a content-development workshop to review an item pool of existing measures, identify gaps and prioritize questions. The resulting questionnaire was field tested in six diverse sites (China, Dominica, Egypt, Kenya, Puerto Rico and St. Christopher & Nevis). Respondents included clinical and non-clinical staff. Questionnaires were self- or interviewer-administered. Analysis of item performance across sites examined both psychometric properties and contextual issues. The key outcome of the process was a substantially reduced questionnaire. Eighteen core questions measure three programmatically actionable drivers of stigma within health facilities (worry about HIV transmission, attitudes towards people living with HIV (PLHIV), and health facility environment, including policies), and enacted stigma. The questionnaire also includes one short scale for attitudes towards PLHIV (5-item scale, α=0.78). Stigma-reduction programmes in healthcare facilities are urgently needed to improve the quality of care provided, uphold the human right to healthcare, increase access to health services, and maximize investments in HIV prevention and treatment. This brief, standardized tool will facilitate inclusion of stigma measurement in research studies and in routine facility data collection, allowing for the monitoring of stigma within healthcare facilities and evaluation of stigma-reduction programmes. There is potential for wide use of the tool either as a stand-alone survey or integrated within other studies of health facility staff.

Analysis of Qualitative Interviews about the Impact of Information Technology on Pressure Ulcer Prevention Programs: Implications for the Wound Ostomy Continence Nurse

PubMed Central

Shepherd, Marilyn Murphy; Wipke-Tevis, Deidre D.; Alexander, Gregory L.

2015-01-01

Purpose The purpose of this study was to compare pressure ulcer prevention programs in 2 long term care facilities (LTC) with diverse Information Technology Sophistication (ITS), one with high sophistication and one with low sophistication, and to identify implications for the Wound Ostomy Continence Nurse (WOC Nurse) Design Secondary analysis of narrative data obtained from a mixed methods study. Subjects and Setting The study setting was 2 LTC facilities in the Midwestern United States. The sample comprised 39 staff from 2 facilities, including 26 from a high ITS facility and 13 from the low ITS facility. Respondents included Certified Nurse Assistants,, Certified Medical Technicians, Restorative Medical Technicians, Social Workers, Registered Nurses, Licensed Practical Nurses, Information Technology staff, Administrators, and Directors. Methods This study is a secondary analysis of interviews regarding communication and education strategies in two longterm care agencies. This analysis focused on focus group interviews, which included both direct and non-direct care providers. Results Eight themes (codes) were identified in the analysis. Three themes are presented individually with exemplars of communication and education strategies. The analysis revealed specific differences between the high ITS and low ITS facility in regards to education and communication involving pressure ulcer prevention. These differences have direct implications for WOC nurses consulting in the LTC setting. Conclusions Findings from this study suggest that effective strategies for staff education and communication regarding PU prevention differ based on the level of ITS within a given facility. Specific strategies for education and communication are suggested for agencies with high ITS and agencies with low ITS sophistication. PMID:25945822

Resident Aggression Toward Staff at a Center for the Developmentally Disabled

PubMed Central

West, Christine A.; Galloway, Ellen; Niemeier, Maureen T.

2015-01-01

Few studies have examined factors contributing to nonfatal assaults to staff working in residential care facilities. The authors evaluated resident assaults toward direct care/nursing staff at an Intermediate Care Facility for Individuals with Mental Retardation (ICF/MR), which included observations of work areas, employee interviews, calculation of injury and assault rates for 2004 to 2007 from Occupational Safety and Health Administration Logs, and review of state ICF/MR guidelines. Most staff interviewed reported having been injured during physical restraint of a resident and the average rate of injury from assault at the center evaluated was higher than the average national rates for the health care and social assistance sector for the same time period. The center lacked policies for a safe workplace. The authors recommended review and maintenance of workplace violence prevention policies and developing a post-incident response and evaluation program to assist staff in coping with the consequences of assault and/or occupational injury. PMID:24571051

Study protocol for the translating research in elder care (TREC): building context – an organizational monitoring program in long-term care project (project one)

PubMed Central

Estabrooks, Carole A; Squires, Janet E; Cummings, Greta G; Teare, Gary F; Norton, Peter G

2009-01-01

Background While there is a growing awareness of the importance of organizational context (or the work environment/setting) to successful knowledge translation, and successful knowledge translation to better patient, provider (staff), and system outcomes, little empirical evidence supports these assumptions. Further, little is known about the factors that enhance knowledge translation and better outcomes in residential long-term care facilities, where care has been shown to be suboptimal. The project described in this protocol is one of the two main projects of the larger five-year Translating Research in Elder Care (TREC) program. Aims The purpose of this project is to establish the magnitude of the effect of organizational context on knowledge translation, and subsequently on resident, staff (unregulated, regulated, and managerial) and system outcomes in long-term care facilities in the three Canadian Prairie Provinces (Alberta, Saskatchewan, Manitoba). Methods/Design This study protocol describes the details of a multi-level – including provinces, regions, facilities, units within facilities, and individuals who receive care (residents) or work (staff) in facilities – and longitudinal (five-year) research project. A stratified random sample of 36 residential long-term care facilities (30 urban and 6 rural) from the Canadian Prairie Provinces will comprise the sample. Caregivers and care managers within these facilities will be asked to complete the TREC survey – a suite of survey instruments designed to assess organizational context and related factors hypothesized to be important to successful knowledge translation and to achieving better resident, staff, and system outcomes. Facility and unit level data will be collected using standardized data collection forms, and resident outcomes using the Resident Assessment Instrument-Minimum Data Set version 2.0 instrument. A variety of analytic techniques will be employed including descriptive analyses, psychometric analyses, multi-level modeling, and mixed-method analyses. Discussion Three key challenging areas associated with conducting this project are discussed: sampling, participant recruitment, and sample retention; survey administration (with unregulated caregivers); and the provision of a stable set of study definitions to guide the project. PMID:19671166

Attitudes of Nursing Facilities' Staff Toward Pharmacy Students' Interaction with its Residents.

PubMed

Adkins, Donna; Gavaza, Paul; Deel, Sharon

2017-06-01

All Appalachian College of Pharmacy second-year students undertake the longitudinal geriatric early pharmacy practice experiences (EPPE) 2 course, which involves interacting with geriatric residents in two nursing facilities over two semesters. The study investigated the nursing staff's perceptions about the rotation and the pharmacy students' interaction with nursing facility residents. Cross-sectional study. Academic setting. 63 nursing facility staff. A 10-item attitude survey administered to nursing staff. Nursing staff attitude toward pharmacy students' interaction with geriatric residents during the course. Sixty-three responses were received (84% response rate). Most respondents were female (95.2%), who occasionally interacted with pharmacy students (54.8%) and had worked at the facilities for an average of 6.8 years (standard deviation [SD] = 6.7) years. Staff reported that pharmacy students practiced interacting with geriatric residents and nursing facility staff, learned about different medications taken by residents as well as their life as a nursing facility resident. In addition, the student visits improved the mood of residents and staff's understanding of medicines, among others. Staff suggested that students spend more time with their residents in the facility as well as ask more questions of staff. The nursing facility staff generally had favorable attitudes about pharmacy students' visits in their nursing facility. Nursing facility staff noted that the geriatric rotation was a great learning experience for the pharmacy students.

European Quality--Adding to the Debate?

ERIC Educational Resources Information Center

Birtwistle, Tim

1996-01-01

Two pilot programs designed to improve and maintain quality in European higher education are described and compared: an audit of universities' procedures for quality assurance; and an assessment of programs of study, including teaching and learning, student characteristics, staff, facilities, and quality management. Both include institutional…

78 FR 19711 - Center for Devices and Radiological Health: Experiential Learning Program

Federal Register 2010, 2011, 2012, 2013, 2014

2013-04-02

... Program (ELP). The ELP provides a formal training mechanism for regulatory review staff to visit research... medical device establishments, including, research, manufacturing, academia, and health care facilities.... Clinical use of orthopedic bone void Observation of surgical filler devices. procedures (posterolateral...

24 CFR 578.59 - Project administrative costs.

Code of Federal Regulations, 2014 CFR

2014-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES CONTINUUM OF CARE PROGRAM Program Components and Eligible Costs... 10 percent of any grant awarded under this part, excluding the amount for Continuum of Care Planning... execution of Continuum of Care activities. This does not include staff and overhead costs directly related...

24 CFR 578.59 - Project administrative costs.

Code of Federal Regulations, 2013 CFR

2013-04-01

... URBAN DEVELOPMENT COMMUNITY FACILITIES CONTINUUM OF CARE PROGRAM Program Components and Eligible Costs... 10 percent of any grant awarded under this part, excluding the amount for Continuum of Care Planning... execution of Continuum of Care activities. This does not include staff and overhead costs directly related...

Participatory Programming of a Campus Child Development Facility.

ERIC Educational Resources Information Center

Sanoff, Henry; Sanoff, Joan

The process of designing Wake Technical College's campus child development center involved a team of college administrators, early childhood program staff, and an architectural consultant. The design process included a needs assessment, an interest survey, center visitations, team formation, goal refinement and clarification in brainstorming…

No Place for Kids: The Case for Reducing Juvenile Incarceration

ERIC Educational Resources Information Center

Mendel, Richard A.

2011-01-01

States confine juvenile offenders in many types of facilities, including group homes, residential treatment centers, boot camps, wilderness programs, or country-run youth facilities (some of them locked, others secured only through staff supervision). But the largest share of committed youth--about 40 percent of the total--are held in locked…

Making the Case for Sustainable K-12 School Environmental Health Programs

ERIC Educational Resources Information Center

Belle, Kara; Utebay, Kudret; McArthur, Ashley

2012-01-01

The U.S. Environmental Protection Agency (EPA) offers resources to help a school or school district improve the environmental health and energy performance of its facilities, and in many cases, apply the savings generated through improved energy efficiency toward facility improvements, for the betterment of students, faculty, and staff. As an…

Effect of a Novel Interdisciplinary Teaching Program in the Care-continuum on Medical Student Knowledge and Self-Efficacy.

PubMed

Lathia, Amanda; Rothberg, Michael; Heflin, Mitchell; Nottingham, Kelly; Messinger-Rapport, Barbara

2015-10-01

Medical students report that they receive inadequate training in different levels of care, including care transitions to and from post-acute (PA) and long-term care (LTC). The authors implemented the Medical Students as Teachers in Extended Care (MedTEC) program as an educational innovation at the Cleveland Clinic to address training in the care-continuum, as well as the new medical student and physician competencies in PA/LTC. MedTEC is a 7-hour interactive program that supplements standard geriatric didactics during the medical student primary care rotation. This study evaluated the performance of the program in improving medical student knowledge and attitudes on levels and transitions of care. The program occurs in a community facility that includes subacute/skilled nursing, assisted living, and nursing home care. Five to 8 students completing their primary care rotation at the Cleveland Clinic are required to participate in the MedTEC program each month. The program includes up to 3 hours of interactive discussion and opportunities to meet facility staff, residents, and patients. The highlight of the program is a student-led in-service for facility staff. With institutional review board approval as an exempt educational research project, pre- and postactivity surveys assessed self-efficacy and knowledge regarding levels of care for students who participated in the program and a student comparison group. The post-program knowledge test also was administered to hospital medicine staff, and test performance was compared with medical students who participated in the MedTEC program. Between October 2011 and December 2013, approximately 100 students participated in 20 sessions of MedTEC. All students reported improved self-efficacy and attitudes regarding care of older adults and care transition management. Mean percentage correct on the knowledge test increased significantly from 59.8% to 71.2% (P = .004) for the MedTEC participants but not for the comparison group students (63.1%-58.3%, P = .47). There was no significant difference in mean percentage correct on the post-program knowledge test between MedTEC medical students and hospitalists (71.0% versus 70.3%, P = .86). Students led 8 in-service sessions for facility staff on various topics relating to the care of older adults in PA/LTC. The MedTEC program appears to be a successful innovation in medical student education on levels of care. It could serve as a model for building competency of health professionals on managing care transitions and determining appropriate levels of care for older adults. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

Treatment for Youth in Short-Term Care Facilities: The Impact of a Comprehensive Behavior Management Intervention

ERIC Educational Resources Information Center

Hurley, Kristin Duppong; Ingram, Stephanie; Czyz, J. Douglas; Juliano, Nicholas; Wilson, Evelyn

2006-01-01

We describe a comprehensive program to train emergency shelter staff in effective methods for dealing with youth who have behavioral and emotional problems; assess the degree to which staff implemented the treatment approach; measure the impact of the intervention on shelter-wide incidents such as out-of-control behavior, runaways, and violence…

The utilization of intravenous therapy programs in community long-term care nursing facilities.

PubMed

Weinberg, A D; Pals, J K; Wei, J Y

1997-01-01

To determine if non-federal Boston-area long-term care nursing facilities are actively using intravenous (IV) therapy as a form of treatment, the specific design of such programs and to assess the availability of central line IVs, percutaneous endoscopic gastrostomy (PEG) tubes and hypodermoclysis for hydration in this setting. DESIGN/SETTINGS: A prospective telephone survey of 100 Boston-area skilled nursing facilities, each with a minimum of 50 beds and representing a total of 12,763 beds, certified to provide both Medicaid (Title-19) and Medicare services, to ascertain their ability to provide IV and other modes of hydration for their residents. A series of questions were asked of a member of the staff knowledgeable in the operations of the nursing facility. Questions included whether an IV program was in existence, duration of the program, provider of IV training for nurses, presence of a subacute unit, whether IVs were administered in non-subacute areas, frequency of IV usage, the ability to manage central lines and the use of PEG tubes or hypodermoclysis for hydration. A total of 100 nursing facilities were surveyed between September and October of 1996. A total of 79 nursing facilities had active IV programs (79%) and 54 of those (68%) also managed central lines. However, in those facilities with active IV programs, 73% (N = 58) reported administering a total of less than five IVs per month. Training for 82% of the nursing facilities (N = 65) was by an outside vendor pharmacy and initial training ranged from one to three days in duration. Of the 19 nursing facilities with IV programs available only in subacute or equivalent units, only 26% (N = 5) did not allow direct transfer of residents from other wards into these units. Of the 79 nursing facilities having IV capability, a total of 91% (N = 72) have also used PEG tubes for hydration and nutritional needs although only 6% (N = 5) have ever used hypodermoclysis for hydration. The majority of nursing facilities in the Boston area provide IV programs for their residents, although in limited numbers on a monthly basis. Residents with central lines are admitted in the majority of these nursing facilities although total staff training time is only one to three days. The use of PEG tubes for hydration is quite frequent, although the use of hypodermoclysis was extremely low. Further work is necessary to fully elucidate the clinical implications of whether these programs decrease the need for acute hospitalization or are used mainly in the post-hospitalization (Medicare A-covered) period.

Study of Programs To Meet the Developmental Needs of Young Children. Report to the Legislature.

ERIC Educational Resources Information Center

Minnesota State Dept. of Education, St. Paul. Div. of Development and Partnership.

Committees discussed six educational program options for 4- and 5-year-old children, in terms of curriculum, staff and licensure, cost and school facilities, coordination with existing resources, public opinion, and school-age day care. The curriculum committee developed a set of goals, outlined a program design, and considered the possible…

Trust Territory of the Pacific Islands Adult Basic Education Program. Evaluation Report, Fiscal Year 1979.

ERIC Educational Resources Information Center

McCune, Donald A.

The Adult Basic Education (ABE) program conducted by the Trust Territory of the Pacific Islands was evaluated. Data were collected via staff interviews and record reviews during site visits at ABE facilities located in five of six district comprising the Trust Territory. Focus of the evaluation activities was on program administration,…

It is possible: availability of lymphedema case management in each health facility in Togo. Program description, evaluation, and lessons learned.

PubMed

Mathieu, Els; Dorkenoo, Ameyo M; Datagni, Michael; Cantey, Paul T; Morgah, Kodjo; Harvey, Kira; Ziperstein, Joshua; Drexler, Naomi; Chapleau, Gina; Sodahlon, Yao

2013-07-01

Lymphatic filariasis (LF) is a vector-borne parasitic disease that can clinically manifest as disabling lymphedema. Although the LF elimination program aims to reduce disability and to interrupt transmission, there has been a scarcity of disease morbidity management programs, particularly on a national scale. This report describes the implementation of the first nationwide LF lymphedema management program. The program, which was initiated in Togo in 2007, focuses on patient behavioral change. Its goal is two-fold: to achieve a sustainable program on a national-scale, and to serve as a model for other countries. The program has five major components: 1) train at least one health staff in lymphedema care in each health facility in Togo; 2) inform people with a swollen leg that care is available at their dispensary; 3) train patients on self-care; 4) provide a support system to motivate patients to continue self-care by training community health workers or family members and providing in home follow-up; and 5) integrate lymphedema management into the curriculum for medical staff. The program achieved the inclusion of lymphedema management in the routine healthcare package. The evaluation after three years estimated that 79% of persons with a swollen leg in Togo were enrolled in the program. The adherence rate to the proposed World Health Organization treatment of washing, exercise, and leg elevation was more than 70% after three years of the program, resulting in a stabilization of the lymphedema stage and a slight decrease in reported acute attacks among program participants. Health staff and patients consider the program successful in reaching and educating the patients. After the external funding ended, the morbidity management program is maintained through routine Ministry of Health activities.

It is Possible: Availability of Lymphedema Case Management in each Health Facility in Togo. Program Description, Evaluation, and Lessons Learned

PubMed Central

Mathieu, Els; Dorkenoo, Ameyo M.; Datagni, Michael; Cantey, Paul T.; Morgah, Kodjo; Harvey, Kira; Ziperstein, Joshua; Drexler, Naomi; Chapleau, Gina; Sodahlon, Yao

2013-01-01

Lymphatic filariasis (LF) is a vector-borne parasitic disease that can clinically manifest as disabling lymphedema. Although the LF elimination program aims to reduce disability and to interrupt transmission, there has been a scarcity of disease morbidity management programs, particularly on a national scale. This report describes the implementation of the first nationwide LF lymphedema management program. The program, which was initiated in Togo in 2007, focuses on patient behavioral change. Its goal is two-fold: to achieve a sustainable program on a national-scale, and to serve as a model for other countries. The program has five major components: 1) train at least one health staff in lymphedema care in each health facility in Togo; 2) inform people with a swollen leg that care is available at their dispensary; 3) train patients on self-care; 4) provide a support system to motivate patients to continue self-care by training community health workers or family members and providing in home follow-up; and 5) integrate lymphedema management into the curriculum for medical staff. The program achieved the inclusion of lymphedema management in the routine healthcare package. The evaluation after three years estimated that 79% of persons with a swollen leg in Togo were enrolled in the program. The adherence rate to the proposed World Health Organization treatment of washing, exercise, and leg elevation was more than 70% after three years of the program, resulting in a stabilization of the lymphedema stage and a slight decrease in reported acute attacks among program participants. Health staff and patients consider the program successful in reaching and educating the patients. After the external funding ended, the morbidity management program is maintained through routine Ministry of Health activities. PMID:23690550

Glossary of Health Care Terminology

DTIC Science & Technology

1989-03-01

surgery, readmission rate following discharge, nosocomial infection rate, and wound evisceration or dehiscence rate. OUTLIERS. Atypical cases which have an...center. INFECTION CONTROL PROGRAM. Policies and procedures followed by a medical or dental treatment facility to minimize the risk of infection to...patients and staff. INFECTION CONTROL COMMITTEE. Medical treatment facility committee composed of medical, dental, nursing, laboratory, and

Day Care for Persons with Dementia: The Impact of the Physical Environment on Staff Stress and Quality of Care.

ERIC Educational Resources Information Center

Lyman, Karen A.

1989-01-01

Considered impact of physical environment on work-related stress and quality of care in day care center integrating demented people and other frail elderly. Examined positive and negative differences before and after move to new facility. Discusses implications for facility design and other program characteristics. (Author/CM)

Barriers and enablers to changing organizational culture in nursing homes.

PubMed

Scalzi, Cynthia C; Evans, Lois K; Barstow, Alan; Hostvedt, Kathryn

2006-01-01

To discuss the barriers and enablers of changing organizational culture in 3 nursing homes undergoing a culture change initiative, and suggest actions for program enhancement. Interview data with staff (n = 64) and families (n = 14) from 3 culture-change facilities in a larger mixed-methods pilot study were used to identify barriers and enablers. The 3 sites ranged from 120 to 139 beds and did not differ in staff characteristics. Barriers included exclusion of nurses from culture-change activities, perceived corporate emphasis on regulatory compliance and the "bottom line," and high turnover of administrators and caregivers. Enablers included a critical mass of "change champions," shared values and goals, resident/family participation, and empowerment at the facility level. Involve all levels of staff, residents, and community in culture-change activities. Align incentives and rewards with the new values. Empower individual homes to make decisions at the facility level. Work with corporate partners to enable rapid translation and implementation of recommendations based on the findings.

12 CFR 268.701 - Purpose and application.

Code of Federal Regulations, 2010 CFR

2010-01-01

... conducted by the Board. Such programs and activities include: (i) Holding open meetings of the Board or... library facilities; and (iv) Any other lawful interaction with the Board or its staff in any official...

12 CFR 268.701 - Purpose and application.

Code of Federal Regulations, 2011 CFR

2011-01-01

... conducted by the Board. Such programs and activities include: (i) Holding open meetings of the Board or... library facilities; and (iv) Any other lawful interaction with the Board or its staff in any official...

Stakeholder Perspectives on the Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) Project.

PubMed

Ersek, Mary; Hickman, Susan E; Thomas, Anne C; Bernard, Brittany; Unroe, Kathleen T

2017-10-17

The need to reduce burdensome and costly hospitalizations of frail nursing home residents is well documented. The Optimizing Patient Transfers, Impacting Medical Quality, and Improving Symptoms: Transforming Institutional Care (OPTIMISTIC) project achieved this reduction through a multicomponent collaborative care model. We conducted an implementation-focused project evaluation to describe stakeholders' perspectives on (a) the most and least effective components of the intervention; (b) barriers to implementation; and (c) program features that promoted its adoption. Nineteen nursing homes participated in OPTIMISTIC. We conducted semistructured, qualitative interviews with 63 stakeholders: 23 nursing home staff and leaders, 4 primary care providers, 10 family members, and 26 OPTIMISTIC clinical staff. We used directed content analysis to analyze the data. We found universal endorsement of the value of in-depth advance care planning (ACP) discussions in reducing hospitalizations and improving care. Similarly, all stakeholder groups emphasized that nursing home access to specially trained, project registered nurses (RNs) and nurse practitioners (NPs) with time to focus on ACP, comprehensive resident assessment, and staff education was particularly valuable in identifying residents' goals for care. Challenges to implementation included inadequately trained facility staff and resistance to changing practice. In addition, the program sometimes failed to communicate its goals and activities clearly, leaving facilities uncertain about the OPTIMISTIC clinical staff's roles in the facilities. These findings are important for dissemination efforts related to the OPTIMISTIC care model and may be applicable to other innovations in nursing homes. Published by Oxford University Press on behalf of The Gerontological Society of America 2017. This work is written by (a) US Government employee(s) and is in the public domain in the US.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Putnam, T.M.

This report presents the objectives, organization, policies, and essential rules and procedures that have been adopted by MP Division and that form the basis of the Health and Safety Program of the Clinton P. Anderson Meson Physics Facility (LAMPF). The facility includes the beam-delivery systems for the Los Alamos Neutron Scattering Center and the Weapons Neutron Research Facility (LANSCE/WNR). The program is designed not only to assure the health and safety of all personnel, including users, in their work at LAMPF, and of MP-Division staff in their work on the LANSCE/WNR beam lines, but also to protect the facility (buildingsmore » and equipment) and the environment. 33 refs., 18 figs., 2 tabs.« less

Use of a dementia training designed for nurse aides to train other staff.

PubMed

Irvine, A Blair; Beaty, Jeff A; Seeley, John R; Bourgeois, Michelle

2013-12-01

Problematic resident behaviors may escalate in long-term care facilities (LTCs). If nurse aides (NAs) are not nearby, the nearest staff to intervene may be non-direct care workers (NDCWs), who have little or no dementia training. This pilot research tested Internet dementia-training program, designed for NAs, on NDCWs in a LTC setting. Sixty-eight NDCWs participated, filling out two baseline surveys at 1-month intervals and a posttest survey after training. The surveys included video-situation testing, items addressing psychosocial constructs associated with behavior change, and measures training-acceptance. Paired t tests showed significant positive effects on measures of knowledge, attitudes, self-efficacy, and behavioral intentions, with small-moderate effect sizes. Nursing staff as well as non-health care workers showed improved scores, and the web-site training program was well received by all participants. These results suggest that Internet training may allow staff development coordinators to conserve limited resources by cross-training of different job categories with the same program.

Practical Approaches for Assessment of Daily and Post-discharge Room Disinfection in Healthcare Facilities.

PubMed

Deshpande, Abhishek; Donskey, Curtis J

2017-09-01

Cleaning and disinfection in healthcare facilities is essential to ensure patient safety. This review examines practical strategies used to assess and improve the effectiveness of daily and post-discharge manual cleaning in healthcare facilities. Effective implementation of cleaning interventions requires objective monitoring of staff performance with regular feedback on performance. Use of fluorescent markers to assess thoroughness of cleaning and measurement of residual ATP can provide rapid and objective feedback to personnel and have been associated with improved cleaning. Direct observation of cleaning and interviews with front-line staff are useful to identify variations and deficiencies in practice that may not be detected by other methods. Although not recommended for routine monitoring, cultures can be helpful for outbreak investigations. Monitoring and feedback can be effective in improving cleaning and disinfection in healthcare facilities. Ongoing commitment within institutions is needed to sustain successful cleaning and disinfection programs.

Peer coaching and mentoring: a new model of educational intervention for safe patient handling in health care.

PubMed

Alamgir, Hasanat; Drebit, Sharla; Li, Helen Guiyun; Kidd, Catherine; Tam, Helen; Fast, Catherine

2011-08-01

To reduce the risk of patient handling-related musculoskeletal injury, overhead ceiling lifts have been installed in health care facilities. To increase ceiling lift usage for a variety of patient handling tasks, a peer coaching and mentoring program was implemented among the direct care staff in the long-term care subsector in British Columbia, Canada. They received a 4-day training program on body mechanics, ergonomics, patient-handling techniques, ceiling lift usage, in addition to coaching skills. A questionnaire was administered among staff before and after the intervention to evaluate the program's effectiveness. There were 403 and 200 respondents to the pre-intervention and post-intervention questionnaires. In general, staff perceived the peer-coaching program to be effective. The number of staff who reported to be using ceiling lifts "often and always" went higher from 64.5% to 80.5% (<0.001) after coaching program implementation. Furthermore, staff reported that they were using the ceiling lifts for more types of tasks post-intervention. Staff reported that the peer coaching program has increased their safety awareness at work and confidence in using the ceiling lifts. The findings suggest that this educational model can increase the uptake of mechanical interventions for occupational health and safety initiatives. It appears that the training led to a greater awareness of the availability of or increased perceptions of the number of ceiling lifts, presumably through coaches advocating their use. Copyright © 2011 Wiley-Liss, Inc.

Effects of using nursing home residents to serve as group activity leaders: lessons learned from the RAP project.

PubMed

Skrajner, Michael J; Haberman, Jessica L; Camp, Cameron J; Tusick, Melanie; Frentiu, Cristina; Gorzelle, Gregg

2014-03-01

Previous research has demonstrated that persons with early to moderate stage dementia are capable of leading small group activities for persons with more advanced dementia. In this study, we built upon this previous work by training residents in long-term care facilities to fill the role of group activity leaders using a Resident-Assisted Programming (RAP) training regimen. There were two stages to the program. In the first stage, RAP training was provided by researchers. In the second stage, RAP training was provided to residents by activities staff members of long-term care facilities who had been trained by researchers. We examine the effects of RAP implemented by researchers and by activities staff member on long-term care resident with dementia who took part in these RAP activities. We also examined effects produced by two types of small group activities: two Montessori-based activities and an activity which focuses on persons with more advanced dementia, based on the work of Jitka Zgola. Results demonstrate that levels of positive engagement seen in players during RAP (resident-led activities) were typically higher than those observed during standard activities programming led by site staff. In general, Montessori-Based Dementia Programming® produced more constructive engagement than Zgola-based programming (ZBP), though ZBP did increase a positive form of engagement involving observing activities with interest. In addition, RAP implemented by activities staff members produced effects that were, on the whole, similar to those produced when RAP was implemented by researchers. Implications of these findings for providing meaningful social roles for persons with dementia residing in long-term care, and suggestions for further research in this area, are discussed.

Adverse event reporting in Czech long-term care facilities.

PubMed

Hěib, Zdenřk; Vychytil, Pavel; Marx, David

2013-04-01

To describe adverse event reporting processes in long-term care facilities in the Czech Republic. Prospective cohort study involving a written questionnaire followed by in-person structured interviews with selected respondents. Long-term care facilities located in the Czech Republic. Staff of 111 long-term care facilities (87% of long-term care facilities in the Czech Republic). None. Sixty-three percent of long-term health-care facilities in the Czech Republic have adverse event-reporting processes already established, but these were frequently very immature programs sometimes consisting only of paper recording of incidents. Compared to questionnaire responses, in-person interview responses only partially tended to confirm the results of the written survey. Twenty-one facilities (33%) had at most 1 unconfirmed response, 31 facilities (49%) had 2 or 3 unconfirmed responses and the remaining 11 facilities (17%) had 4 or more unconfirmed responses. In-person interviews suggest that use of a written questionnaire to assess the adverse event-reporting process may have limited validity. Staff of the facilities we studied expressed an understanding of the importance of adverse event reporting and prevention, but interviews also suggested a lack of knowledge necessary for establishing a good institutional reporting system in long-term care.

L'Anse Warden Inspection April 2012

EPA Pesticide Factsheets

EPA Water enforcement program staff inspected both the L'Anse Warden Fuel Aggregation Facility and Plant on April 26-27, 2012. EPA issued an administrative order. L'Anse Warden submitted a revised stormwater pollution prevention plan.

Western Illinois University Shares Facilities and Staff with Inner City Youngsters

ERIC Educational Resources Information Center

Leach, John

1970-01-01

Physical education--as well as other academic areas such as agriculture, language arts, business, music, home economics, art, and commercial skills--made up the curriculum for this 4-week program. (SW)

Results of a Veterans Affairs employee education program on antimicrobial stewardship for older adults.

PubMed

Heath, Barbara; Bernhardt, Jaime; Michalski, Thomas J; Crnich, Christopher J; Moehring, Rebekah; Schmader, Kenneth E; Olds, Danielle; Higgins, Patricia A; Jump, Robin L P

2016-03-01

We describe a course in the Veterans Affairs (VA) Employee Education System designed to engage nursing staff working in VA long-term care facilities as partners in antimicrobial stewardship. We found that the course addressed an important knowledge gap. Our outcomes suggest opportunities to engage nursing staff in advancing antimicrobial stewardship, particularly in the long-term care setting. Published by Elsevier Inc.

Military Medical Care: Questions and Answers

DTIC Science & Technology

2013-07-24

services through either Department of Defense (DOD) medical facilities, known as “military treatment facilities” or “MTFs” as space is available, or...Chiefs of Staff, CAE /PEO =Component Acquisition Executive/Program Executive Officer, DHA OGC = Defense Health Agency Office of General Counsel, NCR...funding for all fixed medical treatment facilities/activities, including such costs as real property maintenance, environmental compliance, minor

Residents' self-reported quality of life in long-term care facilities in Canada.

PubMed

Kehyayan, Vahe; Hirdes, John P; Tyas, Suzanne L; Stolee, Paul

2015-06-01

Quality of life (QoL) of long-term care (LTC) facility residents is an important outcome of care. This cross-sectional, descriptive study examined the self-reported QoL of LTC facility residents in Canada using the interRAI Self-Report Nursing Home Quality of Life Survey instrument. A secondary purpose was to test the instrument's psychometric properties. Psychometric testing of the instrument supported its reliability and its convergent and content validity for assessing the residents' QoL. Findings showed that residents rated positively several aspects of their life, such as having privacy during visits (76.9%) and staff's being honest with them (73.6%). Residents gave lower ratings to other aspects such as autonomy, staff-resident bonding, and personal relationships. The findings point to gaps between facility philosophies of care and their translation into a care environment where care is truly resident-directed. Moreover, the findings have potential implications for resident care planning, facility programming, social policy development, and future research.

Syllabus for a Course of Instruction, Preparing the Nurse's Assistant.

ERIC Educational Resources Information Center

New York State Education Dept., Albany. Bureau of Secondary Curriculum Development.

The rapidly increasing need for persons trained to assist the nursing staff of health facilities presents occupational education programs with both an opportunity and a duty. This course syllabus is designed for the instruction of nurse's assistants and is the minimum course content acceptable for State credit. A program of supervised experience…

Identifying weaknesses in undergraduate programs within the context input process product model framework in view of faculty and library staff in 2014.

PubMed

Neyazi, Narges; Arab, Mohammad; Farzianpour, Freshteh; Mahmoudi, Mahmood

2016-06-01

Objective of this research is to find out weaknesses of undergraduate programs in terms of personnel and financial, organizational management and facilities in view of faculty and library staff, and determining factors that may facilitate program quality-improvement. This is a descriptive analytical survey research and from purpose aspect is an application evaluation study that undergraduate groups of selected faculties (Public Health, Nursing and Midwifery, Allied Medical Sciences and Rehabilitation) at Tehran University of Medical Sciences (TUMS) have been surveyed using context input process product model in 2014. Statistical population were consist of three subgroups including department head (n=10), faculty members (n=61), and library staff (n=10) with total population of 81 people. Data collected through three researcher-made questionnaires which were based on Likert scale. The data were then analyzed using descriptive and inferential statistics. Results showed desirable and relatively desirable situation for factors in context, input, process, and product fields except for factors of administration and financial; and research and educational spaces and equipment which were in undesirable situation. Based on results, researcher highlighted weaknesses in the undergraduate programs of TUMS in terms of research and educational spaces and facilities, educational curriculum, administration and financial; and recommended some steps in terms of financial, organizational management and communication with graduates in order to improve the quality of this system.

Prevention and management of "do not return" notices: a quality improvement process for supplemental staffing nursing agencies.

PubMed

Ade-Oshifogun, Jochebed Bosede; Dufelmeier, Thaddeus

2012-01-01

This article describes a quality improvement process for "do not return" (DNR) notices for healthcare supplemental staffing agencies and healthcare facilities that use them. It is imperative that supplemental staffing agencies partner with healthcare facilities in assuring the quality of supplemental staff. Although supplemental staffing agencies attempt to ensure quality staffing, supplemental staff are sometimes subjectively evaluated by healthcare facilities as "DNR." The objective of this article is to describe a quality improvement process to prevent and manage "DNR" within healthcare organizations. We developed a curriculum and accompanying evaluation tool by adapting Rampersad's problem-solving discipline approach: (a) definition of area(s) for improvement; (b) identification of all possible causes; (c) development of an action plan; (d) implementation of the action plan; (e) evaluation for program improvement; and (f) standardization of the process. Face and content validity of the evaluation tool was ascertained by input from a panel of experienced supplemental staff and nursing faculty. This curriculum and its evaluation tool will have practical implications for supplemental staffing agencies and healthcare facilities in reducing "DNR" rates and in meeting certification/accreditation requirements. Further work is needed to translate this process into future research. © 2012 Wiley Periodicals, Inc.

Francis bitter national magnet laboratory annual report, July 1991 through June 1992

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1992-06-01

;Contents: Reports on Laboratory Research Programs--Magneto-Optics and Semiconductor Physics, Superconductivity and Magnetism, Solid State Nuclear Magnetic Resonance, Condensed Matter Chemistry, Biomagnetism, Magnet Technology, Instrumentation, Molecular Biophysics, Carbon Filters and Fullerenes; Reports of Visiting Scientists--Reports of Users of the High Magnetic Field Facility, Reports of the Users of the Pulsed Field Facility, Reports of the Users of the High Field NMR Facility; Appendices--Publications and Meeting Speeches, Organization, Summary of High Magnetic Field Facility Use--January 1, 1984 through June 30, 1992, Geographic Distribution of High Magnetic Field Facility Users (Excluding FBNML Staff), Summary of Educational Activities.

The Horace Mann Planning Project; A Design for a Comprehensive Center and Educational Program for Communicative Disorders.

ERIC Educational Resources Information Center

Pronovost, Wilbert L.; And Others

The purpose of this project was to develop recommendations and plans for program, personnel, and facilities for a new Horace Mann Center for the Deaf as a replacement for and an expansion of the present school. The project staff's initial proposal took into account the existing background, programs, and needs of the deaf in Massachusetts. The…

Do Safety Culture Scores in Nursing Homes Depend on Job Role and Ownership? Results from a National Survey.

PubMed

Banaszak-Holl, Jane; Reichert, Heidi; Todd Greene, M; Mody, Lona; Wald, Heidi L; Crnich, Christopher; McNamara, Sara E; Meddings, Jennifer

2017-10-01

To identify facility- and individual-level predictors of nursing home safety culture. Cross-sectional survey of individuals within facilities. Nursing homes participating in the national Agency for Healthcare Research and Quality Safety Program for Long-Term Care: Healthcare-Associated Infections/Catheter-Associated Urinary Tract Infections Project. Responding nursing home staff (N = 14,177) from 170 (81%) of 210 participating facilities. Staff responses to the Nursing Home Survey on Patient Safety Culture (NHSOPS), focused on five domains (teamwork, training and skills, communication openness, supervisor expectations, organizational learning) and individual respondent characteristics (occupation, tenure, hours worked), were merged with data on facility characteristics (from the Certification and Survey Provider Enhanced Reporting): ownership, chain membership, percentage residents on Medicare, bed size. Data were analyzed using multivariate hierarchical models. Nursing assistants rated all domains worse than administrators did (P < .001), with the largest differences for communication openness (24.3 points), teamwork (17.4 points), and supervisor expectations (16.1 points). Clinical staff rated all domains worse than administrators. Nonprofit ownership was associated with worse training and skills (by 6.0 points, P =.04) and communication openness (7.3 points, P =.004), and nonprofit and chain ownership were associated with worse supervisor expectations (5.2 points, P =.001 and 3.2 points, P =.03, respectively) and organizational learning (5.6 points, P =.009 and 4.2 points, P = .03). The percentage of variation in safety culture attributable to facility characteristics was less than 22%, with ownership having the strongest effect. Perceptions of safety culture vary widely among nursing home staff, with administrators consistently perceiving better safety culture than clinical staff who spend more time with residents. Reporting safety culture scores according to occupation may be more important than facility-level scores alone to describe and assess barriers, facilitators, and changes in safety culture. © 2017, Copyright the Authors Journal compilation © 2017, The American Geriatrics Society.

MIT Laboratory for Computer Science Progress Report, July 1984-June 1985

DTIC Science & Technology

1985-06-01

larger (up to several thousand machines) multiprocessor systems. This facility, funded by the newly formed Strategic Computing Program of the Defense...Szolovits, Group Leader R. Patil Collaborating Investigators M. Criscitiello, M.D., Tufts-New England Medical Center Hospital J. Dzierzanowski, Ph.D., Dept...COMPUTATION STRUCTURES Academic Staff J. B. Dennis, Group Leader Research Staff W. B. Ackerman G. A. Boughton W. Y-P. Lim Graduate Students T-A. Chu S

A Videotape-Based Training Method for Improving the Detection of Depression in Residents of Long-Term Care Facilities

ERIC Educational Resources Information Center

Wood, Stacey; Cummings, Jeffrey L.; Schnelle, Betha; Stephens, Mary

2002-01-01

Purpose: This article reviews the effectiveness of a new training program for improving nursing staffs' detection of depression within long-term care facilities. The course was designed to increase recognition of the Minimal Data Set (MDS) Mood Trigger items, to be brief, and to rely on images rather than didactics. Design and Methods: This study…

Investing in organisational culture: nursing students' experience of organisational learning culture in aged care settings following a program of cultural development.

PubMed

Grealish, Laurie; Henderson, Amanda

2016-10-01

Concerns around organisational learning culture limit nursing student placements in aged care settings to first year experiences. Determine the impact of an extended staff capacity building program on students' experiences of the organisational learning culture in the aged care setting. Pre and post-test design. A convenience sample of first, second and third year Bachelor of Nursing students attending placements at three residential aged care facilities completed the Clinical Learning Organisational Culture Survey. Responses between the group that attended placement before the program (n = 17/44; RR 38%) and the group that attended following the program (n = 33/72; RR 45%) were compared. Improvements were noted in the areas of recognition, accomplishment, and influence, with decreases in dissatisfaction. Organisational investment in building staff capacity can produce a positive learning culture. The aged care sector offers a rich learning experience for students when staff capacity to support learning is developed.

44 CFR 312.5 - Personnel.

Code of Federal Regulations, 2013 CFR

2013-10-01

....5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER... of specific programs, through payment of salaries and benefits of State and local civil defense staff...

44 CFR 312.5 - Personnel.

Code of Federal Regulations, 2011 CFR

2011-10-01

....5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER... of specific programs, through payment of salaries and benefits of State and local civil defense staff...

44 CFR 312.5 - Personnel.

Code of Federal Regulations, 2014 CFR

2014-10-01

....5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER... of specific programs, through payment of salaries and benefits of State and local civil defense staff...

44 CFR 312.5 - Personnel.

Code of Federal Regulations, 2010 CFR

2010-10-01

....5 Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER... of specific programs, through payment of salaries and benefits of State and local civil defense staff...

Guidance on Radon Resistant Construction and Radon Mitigation

EPA Pesticide Factsheets

This Unnumbered Letter regarding radon gas mitigation applies to all housing and community facilities, low-rise buildings and dwellings for the mentioned programs. Its intention is to guide staff to best serve our borrowers and protect their health.

Continent or incontinent? That is the question.

PubMed

Taunton, Roma Lee; Swagerty, Daniel L; Lasseter, Joyce A; Lee, Robert H

2005-09-01

A qualitative, emergent, case study design guided the description of care provided to nursing home residents with urinary incontinence in three Midwestern nursing facilities. Participants included 17 residents and 16 family members or friends of the respective residents. Staff and managers involved in the planning and delivery of care to the participating residents also were included. The three facilities represented variation in size, location, ownership, and Medicare certification. Data were collected via observation, resident record audit, and semi-structured interview. Definitions of incontinence varied among staff. A collectively held expectation that residents would be toileted every 2 hours was not met. Maintaining skin integrity was the primary motivation for keeping residents clean and dry. Medical directors viewed incontinence as a nursing problem. Staff described situations in which incontinence was improved for specific residents, but there was little evidence of formal programs to maintain continence or improve incontinence.

A study protocol to investigate the management of depression and challenging behaviors associated with dementia in aged care settings.

PubMed

McCabe, Marita P; Mellor, David; Davison, Tanya E; Karantzas, Gery; von Treuer, Kathryn; O'Connor, Daniel W

2013-09-19

The high occurrence and under-treatment of clinical depression and behavioral and psychological symptoms of dementia (BPSD) within aged care settings is concerning, yet training programs aimed at improving the detection and management of these problems have generally been ineffective. This article presents a study protocol to evaluate a training intervention for facility managers/registered nurses working in aged care facilities that focuses on organisational processes and culture as well as knowledge, skills and self-efficacy. A Randomised Control Trial (RCT) will be implemented across 18 aged care facilities (divided into three conditions). Participants will be senior registered nurses and personal care attendants employed in the aged care facility. The first condition will receive the training program (Staff as Change Agents - Enhancing and Sustaining Mental Health in Aged Care), the second condition will receive the training program and clinical support, and the third condition will receive no intervention. Pre-, post-, 6-month and 12-month follow-up measures of staff and residents will be used to demonstrate how upskilling clinical leaders using our transformational training approach, as well as the use of a structured screening, referral and monitoring protocol, can address the mental health needs of older people in residential care. The expected outcome of this study is the validation of an evidence-based training program to improve the management of depression and BPSD among older people in residential care settings by establishing routine practices related to mental health. This relatively brief but highly focussed training package will be readily rolled out to a larger number of residential care facilities at a relatively low cost. Australia and New Zealand Clinical Trials Register (ANZCTR): The Universal Trial Number (UTN) is U1111-1141-0109.

INFECTION CONTROL IN ALTERNATIVE HEALTHCARE SETTINGS

PubMed Central

Flanagan, Elaine; Chopra, Teena; Mody, Lona

2011-01-01

SYNOPSIS With the changing healthcare delivery, patients receive care at various settings including acute care hospitals, skilled nursing facilities, outpatient primary care and specialty clinics, as well as at home, exposing them to pathogens in various settings. Various healthcare settings face unique challenges requiring individualized infection control programs. Infection control programs in skilled nursing facilities should address: surveillance for infections and antimicrobial resistance, outbreak investigation and control plan for epidemics, isolation precautions, hand hygiene, staff education, and employee and resident health programs. Infection control programs in ambulatory clinics should address: Triage and standard – transmission based precautions, cleaning, disinfection and sterilization principles, surveillance in surgical clinics, safe injection practices, and bioterrorism and disaster planning for ambulatory clinics. PMID:21316005

Report of the Survey of Howard University: The Graduate School and Selected Ph.D. Programs.

ERIC Educational Resources Information Center

Office of Education (DHEW), Washington, DC.

Results of the Office of Education's Bureau of Higher and Continuing Education's inspection of Howard University's Graduate School and the Ph.D. program are presented. The inspection was performed by conducting a survey of the administrative staff, the faculty, and student body, and by examining relevant facilities, laboratories, equipment,…

Strategies for Community Rehabilitation Programs to Serve Consumers Who Are Deaf, Hard of Hearing, Late Deafened or Deafblind

ERIC Educational Resources Information Center

Faulkner, Gail; Harmon, Marguerite; Johnson, Lynnette; Knopf, Elise; Latz, Rubin; Parnes, Alan; Currie-Richardson, Diane; Sligar, Steven

2004-01-01

This book provides guidance for administrators and service delivery staff of Community Rehabilitation Programs to serve consumers who are deaf, hard of hearing, late deafened or deafblind. This publication follows an outline based on standards from CARF (Commission on Accreditation of Rehabilitation Facilities), the national accrediting agency for…

Key role of staff competencies for patient and donor safety in a bone marrow transplantation unit: design and implementation of an accredited training and self-assessment program.

PubMed

Lamanna, C; Baroni, M; Bisin, S; Gianassi, S; Bambi, F; Caselli, D; Aricò, M

2010-01-01

Human resources represent at the moment the most critical factor in an hospital setting characterized by a high rate of staff turnover. It is important to ensure a consistent level of expertise and knowledge of professionals who work in health care facilities to provide quality services and simultaneously support the implementation of strategies for patient safety. Unfortunately, the development of effective interventions for training newly added staff and self-evaluation of skills possessed by trained staff are closely related to understanding critical aspects of the organization. At the new Center for Bone Marrow Transplantation and Blood Transfusion Service in Meyer Hospital, during the last year, a group of professional nurses and technicians completed a specific plan to train new staff and, at the same time, a program of self-assessment of skills for experienced staff. The main purpose of this project was to promote skills development by newly added as well as experienced staff, to identify areas of weaknesses, and to correct them with training (organized by the hospital, departmental, or individual) designed to improve performance. Copyright 2010 Elsevier Inc. All rights reserved.

Ministerial Decision No. G2a/ik. 4108 laying down regulations on the operation of State facilities for children and State facilities for young children, 1 August 1988.

PubMed

1989-01-01

This Greek decision repeals all contrary provisions. Sec. 1 lays down that state facilities for children and state facilities for young children have as their objective to ensure, on a day-to-day basis, that young children who cannot obtain the necessary care because their parents work, or for other social reasons, obtain food, education, and recreation. Sec. 15 lays down that the children accepted in such facilities are to have their health monitored by a physician under contract to the facility, unless the facility can obtain the services of the National Health System. The physician is to draw up a detailed record for each child dealing with the various aspects of its health. The staff of the facility are also to be responsible for safeguarding the health of the child, within the various areas of responsibility of the individual staff members; such staff are to take all steps necessary for health and safety and to be responsible for any errors or omissions liable to produce an adverse affect on children's health. Under Sec. 24, the contractual physician is to discharge the following duties: provide health services and visit the facility once every 15 days; carry out a medical examination of every child, monitor its physical and intellectual development, and verify that the compulsory vaccinations have been carried out; keep the health records of the children up to date and indicate to the director and the parents appropriate measures to be taken; propose hygiene measures to be taken concerning children's health and the health conditions in the facility; ensure that the pharmacy of the facility has the necessary first-aid medicaments available; indicate the measures appropriate to the protection of the children against infectious diseases and the measures necessary for the prevention and control of such diseases and carry out surveillance of the implementation of these measures; and devise a program and activities concerning health education for children, staff, and parents.

Library-Information Education in Algeria.

ERIC Educational Resources Information Center

Boumarafi, B. B.; Haythornthwaite, J.

1988-01-01

Reviews the development of educational programs for library technicians, librarians, and information professionals in Algeria and describes the current educational structure. Topics discussed include the need for improvements in curriculum development, teaching staff development, library facilities, and the use of information technologies. (CLB)

An Evidence-Based Cue-Selection Guide and Logic Model to Improve Pressure Ulcer Prevention in Long-term Care.

PubMed

Yap, Tracey L; Kennerly, Susan M; Bergstrom, Nancy; Hudak, Sandra L; Horn, Susan D

2016-01-01

Pressure ulcers have consistently resisted prevention efforts in long-term care facilities nationwide. Recent research has described cueing innovations that-when selected according to the assumptions and resources of particular facilities-support best practices of pressure ulcer prevention. This article synthesizes that research into a unified, dynamic logic model to facilitate effective staff implementation of a pressure ulcer prevention program.

Can formalizing links among community health workers, accredited drug dispensing outlet dispensers, and health facility staff increase their collaboration to improve prompt access to maternal and child care? A qualitative study in Tanzania.

PubMed

Dillip, Angel; Kimatta, Suleiman; Embrey, Martha; Chalker, John C; Valimba, Richard; Malliwah, Mariam; Meena, John; Lieber, Rachel; Johnson, Keith

2017-06-19

In Tanzania, progress toward achieving the 2015 Millennium Development Goals for maternal and newborn health was slow. An intervention brought together community health workers, health facility staff, and accredited drug dispensing outlet (ADDO) dispensers to improve maternal and newborn health through a mechanism of collaboration and referral. This study explored barriers, successes, and promising approaches to increasing timely access to care by linking the three levels of health care provision. The study was conducted in the Kibaha district, where we applied qualitative approaches with in-depth interviews and focus group discussions. In-depth interview participants included retail drug shop dispensers (36), community health workers (45), and health facility staff members (15). We conducted one focus group discussion with district officials and four with mothers of newborns and children under 5 years old. Relationships among the three levels of care improved after the linkage intervention, especially for ADDO dispensers and health facility staff who previously had no formal communication pathway. The study participants perceptions of success included improved knowledge of case management and relationships among the three levels of care, more timely access to care, increased numbers of patients/customers, more meetings between community health workers and health facility staff, and a decrease in child and maternal mortality. Reported challenges included stock-outs of medicines at the health facility, participating ADDO dispensers who left to work in other regions, documentation of referrals, and lack of treatment available at health facilities on the weekend. The primary issue that threatens the sustainability of the intervention is that local council health management team members, who are responsible for facilitating the linkage, had not made any supervision visits and were therefore unaware of how the program was running. The study highlights the benefits of approaches that link different levels of care providers to improve access to maternal and child health care. To strengthen this collaboration further, health campaign platforms should include retail drug dispensers as a type of community health care provider. To increase linkage sustainability, the council health management team needs to develop feasible supervision plans.

Social skills training of Prader-Willi staff.

PubMed

Mitchell, W; Cook, K V

1987-12-01

Over the past 30 years, research interest in PWS has focused on questions related to the identification of syndrome features, determination of etiology and incidence, and effectiveness of both medical and nutritional management strategies. Residential and day treatment facilities have emphasized control of food and of inappropriate behaviors. The present training program developed techniques and materials to encourage positive behaviors and minimize inappropriate behaviors, supplementing earlier techniques. Activities from social skills training curricula were adapted to the needs of PWS persons. Training sessions were held with staff in residential settings to field test the techniques. This paper summarizes the training program and describes effective techniques and materials.

Management of suicidal and self-harming behaviors in prisons: systematic literature review of evidence-based activities.

PubMed

Barker, Emma; Kõlves, Kairi; De Leo, Diego

2014-01-01

The purpose of this study was to systematically analyze existing literature testing the effectiveness of programs involving the management of suicidal and self-harming behaviors in prisons. For the study, 545 English-language articles published in peer reviewed journals were retrieved using the terms "suicid*," "prevent*," "prison," or "correctional facility" in SCOPUS, MEDLINE, PROQUEST, and Web of Knowledge. In total, 12 articles were relevant, with 6 involving multi-factored suicide prevention programs, and 2 involving peer focused programs. Others included changes to the referral and care of suicidal inmates, staff training, legislation changes, and a suicide prevention program for inmates with Borderline Personality Disorder. Multi-factored suicide prevention programs appear most effective in the prison environment. Using trained inmates to provide social support to suicidal inmates is promising. Staff attitudes toward training programs were generally positive.

Nurse turnover in substance abuse treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network.

PubMed

Knudsen, Hannah K; Abraham, Amanda J; Roman, Paul M; Studts, Jamie L

2011-04-01

Voluntary nurse turnover, which is costly and disrupts patient care, has not been studied as an organizational phenomenon within substance abuse treatment organizations. In this exploratory study, we examined the frequency and correlates of nurse turnover within treatment programs affiliated with the National Drug Abuse Treatment Clinical Trials Network. During face-to-face interviews conducted in 2005-2006, 215 program administrators reported the number of nurses currently employed. Leaders of programs with nursing staff then described the number of nurses who had voluntarily quit in the past year, the degree to which filling vacant nursing positions was difficult, and the average number of days to fill a vacant position. About two thirds of these programs had at least one nurse on staff. In programs with nurses, the average rate of voluntary turnover was 15.0%. Turnover was significantly lower in hospital-based programs and programs offering adolescent treatment but higher in facilities offering residential treatment. Most of the administrators indicated that filling vacant nurse positions was difficult and took more than 2 months to complete. These findings suggest that nurse turnover is a significant issue facing many substance abuse treatment facilities. Efforts to improve retention of the addiction treatment workforce should be expanded to include nursing professionals. Copyright © 2011 Elsevier Inc. All rights reserved.

43 CFR 26.7 - Application format and instructions.

Code of Federal Regulations, 2011 CFR

2011-10-01

..., if residential project (types of facilities, age, condition, tents, cabins, dormitories, food service). (11) Project staff (number and position titles). (12) Work-learning program. (Describe major projects... environmental learning will be integrated into projects.) (13) Complete calculation for daily rate of enrollee...

44 CFR 312.5 - Personnel.

Code of Federal Regulations, 2012 CFR

2012-10-01

... Emergency Management and Assistance FEDERAL EMERGENCY MANAGEMENT AGENCY, DEPARTMENT OF HOMELAND SECURITY PREPAREDNESS USE OF CIVIL DEFENSE PERSONNEL, MATERIALS, AND FACILITIES FOR NATURAL DISASTER PURPOSES § 312.5... programs, through payment of salaries and benefits of State and local civil defense staff, and the payment...

7 CFR 2003.10 - Rural Development State Offices.

Code of Federal Regulations, 2010 CFR

2010-01-01

... BUSINESS-COOPERATIVE SERVICE, RURAL UTILITIES SERVICE, AND FARM SERVICE AGENCY, DEPARTMENT OF AGRICULTURE... to program plans approved for the State by the Under Secretary, and rendering staff advisory and... Multi-Family Housing loans and grants, Community Facility, Water and Waste Disposal, Business and...

Breathing In

ERIC Educational Resources Information Center

Mahoney, Daniel P.

2008-01-01

Healthful indoor air quality (IAQ) in education facilities can improve the learning environment for students, enhance teacher job satisfaction, and reduce staff complaints. A proactive indoor air quality program helps identify and eliminate conditions that could lead to IAQ complaints, building-related illnesses, and workers' compensation claims.…

Using Simulation to Implement an OR Cardiac Arrest Crisis Checklist.

PubMed

Dagey, Darleen

2017-01-01

Crisis checklists are cognitive aids used to coordinate care during critical events. Simulation training is a method to validate process improvement initiatives such as checklist implementation. In response to concerns staff members expressed regarding their comfort level when responding to infrequent occurrences such as cardiac arrest and other OR emergencies, the OR Comprehensive Unit-based Safety Program team at our facility decided to institute the use of crisis checklists in the OR during critical events. We provided 90-minute education sessions, simulation opportunities, and debriefings to help staff members become more comfortable using these checklists. Based on program evaluations, 80% of staff members who participated in the training expressed an increased comfort level when caring for a patient in cardiac arrest. Copyright © 2017 AORN, Inc. Published by Elsevier Inc. All rights reserved.

Efficacy of an Exercise and Nutritional Supplement Program on Physical Performance and Nutritional Status in Older Adults With Mobility Limitations Residing at Senior Living Facilities.

PubMed

Corcoran, Michael P; Nelson, Miriam E; Sacheck, Jennifer M; Reid, Kieran F; Kirn, Dylan; Fielding, Roger A; Chui, Kenneth K H; Folta, Sara C

2017-07-01

This cluster-randomized trial was designed to determine the efficacy of a 6-month exercise-nutritional supplement program (ENP) on physical function and nutritional status for older adults and the feasibility of implementing this program in a senior living setting. Twenty senior-living facilities were randomized to either a 3 day per week group-based ENP led by a trained facility staff member or a health education program (SAP). Participants (N = 121) completed a short physical performance battery, 400-m walk, handgrip strength test, and mini-nutrition assessment. 25-hydroxyvitamin D [25(OH)D], insulin-like growth-factor 1 (IGF-1), and activity level were also measured. The ENP did not significantly improve physical function or nutritional status compared with the SAP. Compared with baseline, participants in the ENP engaged in 39 min less physical activity per week at 6 months. Several facility characteristics hindered implementation of the ENP. This study highlights the complexity of implementing an evidence-based program in a field setting.

Residential care workers and residents: the New Zealand story.

PubMed

Kiata, Liz; Kerse, Ngaire; Dixon, Robyn

2005-05-06

To describe the nature and size of long-term residential care homes in New Zealand; funding of facilities; and the ethnic and gender composition of residents and residential care workers nationwide. A postal, fax, and email survey of all long-term residential care homes in New Zealand. Completed surveys were received from an eligible 845 facilities (response rate: 55%). The majority of these (54%) facilities housed less than 30 residents. Of the 438 (94%) facilities completing the questions about residents' ethnicity, 432 (99%) housed residents from New Zealand European (Pakeha) descent, 156 (33%) housed at least 1 Maori resident, 71 (15%) at least 1 Pacific (Islands) resident, and 61 (13%) housed at least 1 Asian resident. Facilities employed a range of ethnically diverse staff, with 66% reporting Maori staff. Less than half of all facilities employed Pacific staff (43%) and Asian staff (33%). Registered nursing staff were mainly between 46 and 60 years (47%), and healthcare assistant staff were mostly between 25 and 45 years old (52%). Wide regional variation in the ethnic make up of staff was reported. About half of all staff were reported to have moved within the previous 2 years. The age and turnover of the residential care workforce suggests the industry continues to be under threat from staffing shortages. While few ethnic minority residents live in long-term care facilities, staff come from diverse backgrounds, especially in certain regions.

Microgravity

NASA Image and Video Library

2001-04-26

The first NASA Dropping In a Microgravity Environment (DIME) student competition pilot project came to a conclusion at the Glenn Research Center in April 2001. The competition involved high-school student teams who developed the concept for a microgravity experiment and prepared an experiment proposal. The two student teams - COSI Academy, sponsored by the Columbus Center of Science and Industry, and another team from Cincinnati, Ohio's Sycamore High School, designed a microgravity experiment, fabricated the experimental apparatus, and visited NASA Glenn to operate their experiment in the 2.2 Second Drop Tower. NASA and contractor personnel who conducted the DIME activity with the students. Shown (L-R) are: Eric Baumann (NASA, 2.2-second Drop Tower Facility manager), Daniel Dietrich (NASA) mentor for Sycamore High School team), Carol Hodanbosi (National Center for Microgravity Research; DIME staff), Richard DeLombard (NASA; DIME staff), Jose Carrion (GRC Akima, drop tower technician), Dennis Stocker (NASA; DIME staff), Peter Sunderland (NCMR, mentor for COSI Academy student team), Sandi Thompson (NSMR sabbatical teacher; DIME staff), Dan Woodard (MASA Microgravity Outreach Program Manager), Adam Malcolm (NASA co-op student; DIME staff), Carla Rosenberg (NCMR; DIME staff), and Twila Schneider (Infinity Technology; NASA Microgravity Research program contractor). This image is from a digital still camera; higher resolution is not available.

Hip protector compliance: a 13-month study on factors and cost in a long-term care facility.

PubMed

Burl, Jeffrey B; Centola, James; Bonner, Alice; Burque, Colleen

2003-01-01

To determine if a high compliance rate for wearing external hip protectors could be achieved and sustained in a long-term care population. A 13-month prospective study of daytime use of external hip protectors in an at-risk long-term care population. One hundred-bed not-for-profit long-term care facility. Thirty-eight ambulatory residents having at least 1 of 4 risk factors (osteoporosis, recent fall, positive fall screen, previous fracture). The rehabilitation department coordinated an implementation program. Members of the rehabilitation team met with eligible participants, primary caregivers, families, and other support staff for educational instruction and a description of the program. The rehabilitation team assumed overall responsibility for measuring and ordering hip protectors and monitoring compliance. By the end of the third month, hip protector compliance averaged greater than 90% daily wear. The average number of falls per month in the hip protector group was 3.9 versus 1.3 in nonparticipants. Estimated total indirect staff time was 7.75 hours. The total cost of the study (hip protectors and indirect staff time) was 6,300 US dollars. High hip protector compliance is both feasible and sustainable in an at-risk long-term care population. Achieving high compliance requires an interdisciplinary approach with one department acting as a champion. The cost of protectors could be a barrier to widespread use. Facilities might be unable to cover the cost until the product is paid for by third-party payers.

A controlled investigation of continuing pain education for long-term care staff.

PubMed

Ghandehari, Omeed O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P; Dal Bello-Haas, Vanina; Malloy, David C; Martin, Ronald R; Rahaman, Omar; Zwakhalen, Sandra M G; Carleton, R N; Hunter, Paulette V; Lix, Lisa M

2013-01-01

The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors. To investigate the effectiveness of an expert-based continuing education program in pain assessment⁄management for LTC staff. Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes⁄beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies. Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants. Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers.

Process evaluation of the RaDIANT community study: a dialysis facility-level intervention to increase referral for kidney transplantation.

PubMed

Hamoda, Reem E; Gander, Jennifer C; McPherson, Laura J; Arriola, Kimberly J; Cobb, Loren; Pastan, Stephen O; Plantinga, Laura; Browne, Teri; Hartmann, Erica; Mulloy, Laura; Zayas, Carlos; Krisher, Jenna; Patzer, Rachel E

2018-01-15

The Reducing Disparities in Access to kidNey Transplantation Community Study (RaDIANT) was an End-Stage Renal Disease (ESRD) Network 6-developed, dialysis facility-level randomized trial testing the effectiveness of a 1-year multicomponent education and quality improvement intervention in increasing referral for kidney transplant evaluation among selected Georgia dialysis facilities. To assess implementation of the RaDIANT intervention, we conducted a process evaluation at the conclusion of the intervention period (January-December 2014). We administered a 20-item survey to the staff involved with transplant education in 67 dialysis facilities randomized to participate in intervention activities. Survey items assessed facility participation in the intervention (fidelity and reach), helpfulness and willingness to continue intervention activities (sustainability), suggestions for improving intervention components (sustainability), and factors that may have influenced participation and study outcomes (context). We defined high fidelity to the intervention as completing 11 or more activities, and high participation in an activity as having at least 75% participation across intervention facilities. Staff from 65 of the 67 dialysis facilities completed the questionnaire, and more than half (50.8%) reported high adherence (fidelity) to RaDIANT intervention requirements. Nearly two-thirds (63.1%) of facilities reported that RaDIANT intervention activities were helpful or very helpful, with 90.8% of facilities willing to continue at least one intervention component beyond the study period. Intervention components with high participation emphasized staff and patient-level education, including in-service staff orientations, patient and family education programs, and patient educational materials. Suggested improvements for intervention activities emphasized addressing financial barriers to transplantation, with financial education materials perceived as most helpful among RaDIANT educational materials. Variation in facility-level fidelity of the RADIANT intervention did not significantly influence the mean difference in proportion of patients referred pre- (2013) and post-intervention (2014). We found high fidelity to the RaDIANT multicomponent intervention at the majority of intervention facilities, with sustainability of select intervention components at intervention facilities and feasibility for dissemination across ESRD Networks. Future modification of the intervention should emphasize financial education regarding kidney transplantation and amend intervention components that facilities perceive as time-intensive or non-sustainable. Clinicaltrials.gov number NCT02092727 . Registered 13 Mar 2014 (retrospectively registered).

USAWC (United States Army War College) Military Studies Program. The Chaplain as Personal/Special Staff Officer.

DTIC Science & Technology

1984-04-13

Army, however, the placing of the chaplain and the surgeon/ dental sur- geon would be nonstandard since at Department of Army (DA) level the 13 ’ Chief of... Dental Surgeons, Provost Marshal, and the Chief of Staff does not improve effectiveness or efficiency. If anything the danger is the opposite may occur...medical and dental treatment facilities and to chaplains. 7. On HSC installations, the implementation of the proposed concept as regards the chaplain would

Impact of Contextual Factors on Interventions to Reduce Acute Care Transfers II Implementation and Hospital Readmission Rates.

PubMed

Rask, Kimberly J; Hodge, Jennifer; Kluge, Linda

2017-11-01

Identify contextual and implementation factors impacting the effectiveness of an organizational-level intervention to reduce preventable hospital readmissions from affiliated skilled nursing facilities (SNFs). Observational study of the implementation of Interventions to Reduce Acute Care Transfers tools in 3 different cohorts. SNFs. SNFs belonging to 1 of 2 corporate entities and a group of independent SNFs that volunteered to participate in a Quality Improvement Organization (QIO) training program. Two groups of SNFs received INTERACT II training and technical assistance from corporate staff, and 1 group of SNFs received training from QIO staff. Thirty-day acute care hospital readmissions from Medicare fee-for-service claims, contextual factors using the Model for Understanding Success in Quality framework. All 3 cohorts were able to deliver the INTERACT training program to their constituent facilities through regional events as well as onsite technical assistance, but the impact on readmission rates varied. Facilities supported by the QIO and corporation A were able to achieve statistically significant reductions in 30-day readmission rates. A review of contextual factors found that although all cohorts were challenged by staff turnover and workload, corporation B facilities struggled with a less mature quality improvement (QI) culture and infrastructure. Both corporations demonstrated a strong corporate commitment to implementing INTERACT II, but differences in training strategies, QI culture, capacity, and competing pressures may have impacted the effectiveness of the training. Proactively addressing these factors may help long-term care organizations interested in reducing acute care readmission rates increase the likelihood of QI success. Copyright © 2017 AMDA – The Society for Post-Acute and Long-Term Care Medicine. All rights reserved.

An early stage evaluation of the Supporting Program for Obstetric Care Underserved Areas in Korea.

PubMed

Na, Baeg Ju; Kim, Hyun Joo; Lee, Jin Yong

2014-06-01

"The Supporting Program for Obstetric Care Underserved Areas (SPOU)" provides financial aids to rural community (or district) hospitals to reopen prenatal care and delivery services for regions without obstetrics and gynecology clinics or hospitals. The purpose of this study was to evaluate the early stage effect of the SPOU program. The proportion of the number of birth through SPOU was calculated by each region. Also survey was conducted to investigate the extent of overall satisfaction, elements of dissatisfaction, and suggestions for improvement of the program; 209 subjects participated from 7 to 12 December, 2012. Overall, 20% of pregnant women in Youngdong (71 cases) and Gangjin (106 cases) used their community (or district) hospitals through the SPOU whereas Yecheon (23 cases) was 8%; their satisfaction rates were high. Short distance and easy accessibility was the main reason among women choosing community (or district) hospital whereas the reasons of not selecting the community (or district) hospital were favor of the outside hospital's facility, system, and trust in the medical staffs. The SPOU seems to be currently effective at an early stage. However, to successfully implement this program, the government should make continuous efforts to recruit highly qualified medical staffs and improve medical facility and equipment.

The role and working conditions of Movement Science students employed in sport and recreational facilities: An Italian multicenter study.

PubMed

Gallè, Francesca; Di Onofrio, Valeria; Arpesella, Marisa; Bacci, Silvia; Bianco, Antonino; Brandi, Giorgio; Bruno, Stefania; Anastasi, Daniela; Carraro, Elisabetta; Flacco, Maria Elena; Giampaoli, Saverio; Izzotti, Alberto; Leoni, Erica; Bertoncello, Chiara; Minelli, Liliana; Napoli, Christian; Nobile, Carmelo; Pasquarella, Cesira; Liguori, Giorgio; Romano Spica, Vincenzo

2015-01-01

In Italy, students from Movement Science (MS) Degree Courses often work in sport and recreational facilities before graduation. The employment conditions of Movement Science students working in sport/recreational facilities were investigated, and the management and structural features of the facilities were evaluated, including safety policies. Regional differences were also considered. Questionnaires were administered to undergraduate and graduate students (N = 4,217) in 17 Universities. Students' perceptions of the quality of the facilities where they had been employed was evaluated using multivariate analysis. A latent class model with covariates was used to evaluate how variables relating to participants, employment facilities or regions influence their opinions. A high proportion of MS students were employed in sporting facilities (undergraduate level: 33% ; graduate level: 55%), in most cases without any formal employment contracts. Both the structural and hygienic features, as well as the professional knowledge of the staff, were considered good to excellent by the majority of participants (about 70%). Communication of the basic behavioral rules was considered adequate by 61-63% of undergraduate students and 71-75% of graduate students, while nearly half of the participants were dissatisfied with the staff safety training. Correlations between the perceived good structural/hygienic conditions, the presence of regulations and training programs for the staff were investigated. Differences regarding occupational level and safety training among different regions of Italy were also observed. Italian students in Movement Science were easily employed in sport/recreational facilities, but frequently without a formal contract. This is a consequence of the lack of specific regulations in the field of recreational/leisure employment and could have negative implications, especially in terms of safety.

Challenges and Consequences of Reduced Skilled Nursing Facility Lengths of Stay.

PubMed

Tyler, Denise A; McHugh, John P; Shield, Renée R; Winblad, Ulrika; Gadbois, Emily A; Mor, Vincent

2018-06-05

To identify the challenges that reductions in length of stay (LOS) pose for skilled nursing facilities (SNFs) and their postacute care (PAC) patients. Seventy interviews with staff in 25 SNFs in eight U.S. cities, LOS data for patients in those SNFs. Data were qualitatively analyzed, and key themes were identified. Interview data from SNFs with and without reductions in median risk-adjusted LOS were compared and contrasted. We conducted 70 semistructured interviews. LOS data were derived from minimum dataset (MDS) admission records available for all patients in all U.S. SNFs from 2012 to 2014. Challenges reported regardless of reductions in LOS included frequent and more complicated re-authorization processes, patients becoming responsible for costs, and discharging patients whom staff felt were unsafe at home. Challenges related to reduced LOS included SNFs being pressured to discharge patients within certain time limits. Some SNFs reported instituting programs and processes for following up with patients after discharge. These programs helped alleviate concerns about patients, but they resulted in nonreimbursable costs for facilities. The push for shorter LOS has resulted in unexpected challenges and costs for SNFs and possible unintended consequences for PAC patients. © Health Research and Educational Trust.

Los Medanos College Fact Book.

ERIC Educational Resources Information Center

MacDonald, Ross; And Others

Prepared to support the self-study and strategic planning processes at Los Medanos College (LMC), in Pittsburgh, California, this fact book offers information about LMC's students, staff, programs, services, facilities, and expenditures. The first section focuses on the student population, including a trend analysis and longitudinal data on…

Evaluating High School Libraries: Service Is Top Priority.

ERIC Educational Resources Information Center

Baldwin, Margaret

1988-01-01

Discusses the need for ongoing evaluation within high school libraries to ensure adequate library services, which, in turn, enhance the total educational program. The evaluation of library facilities, collections, and staff is discussed, and an annotated bibliography of evaluation tools is provided. (6 references) (CLB)

Management of radioactive material safety programs at medical facilities. Final report

DOE Office of Scientific and Technical Information (OSTI.GOV)

Camper, L.W.; Schlueter, J.; Woods, S.

A Task Force, comprising eight US Nuclear Regulatory Commission and two Agreement State program staff members, developed the guidance contained in this report. This report describes a systematic approach for effectively managing radiation safety programs at medical facilities. This is accomplished by defining and emphasizing the roles of an institution`s executive management, radiation safety committee, and radiation safety officer. Various aspects of program management are discussed and guidance is offered on selecting the radiation safety officer, determining adequate resources for the program, using such contractual services as consultants and service companies, conducting audits, and establishing the roles of authorized usersmore » and supervised individuals; NRC`s reporting and notification requirements are discussed, and a general description is given of how NRC`s licensing, inspection and enforcement programs work.« less

State “Technical Assistance Programs” for nursing home quality improvement: variations and potential implications

PubMed Central

Li, Yue; Spector, Williams D.; Glance, Laurent G.; Mukamel, Dana B.

2013-01-01

Context To improve nursing home quality, many states developed “Technical Assistance Programs” that provide on-site consultation and training for nursing facility staff. Methods We conducted a national survey on these state programs to collect data on program design, operations, financing, and perceived effectiveness. Results As of 2010, 17 states have developed such programs. Compared to existing state nursing home quality regulations, these programs represent a collaborative, rather than enforcement-oriented, approach to quality. However, existing programs vary substantially in key structural features such as staffing patterns, funding levels, and relationship with state survey and certification agencies. Perceived effectiveness by program officials on quality was high, although few states have performed formal evaluations. Perceived barriers to program effectiveness included lack of appropriate staff and funding, among others. Conclusion State “Technical Assistance Programs” for nursing homes varies in program design and perceived effectiveness. Future comparative evaluations are needed to inform evidence-based quality initiatives. PMID:23216345

Jobs and Opportunity: The Power and Potential of Maine's Community Colleges--Report of the Governor's Community College Advisory Council

ERIC Educational Resources Information Center

Pelletier, Helen

2007-01-01

In 2006, it was determined that Maine's new community college system--off to a remarkably promising start--was already at a critical juncture: nearing or exceeding capacity in many of their most popular programs, straining facilities and the ability of staff to deliver high quality programs and services, and struggling to meet the demand of many…

The contractor`s role in low-level waste disposal facility application review and licensing

DOE Office of Scientific and Technical Information (OSTI.GOV)

Serie, P.J.; Dressen, A.L.

1991-12-31

The California Department of Health Services will soon reach a licensing decision on the proposed Ward Valley low-level radioactive waste disposal facility. As the first regulatory agency in the country to address the 10 CFR Part 61 requirements for a new disposal facility, California`s program has broken new ground in its approach. Throughout the review process, the Department has relied on contractor support to augment its technical and administrative staff. A team consisting of Roy F. Weston, Inc., supported by ERM-Program Management Corp., Environmental Issues Management, Inc., and Rogers and Associates Engineering Corporation, has worked closely with the Department inmore » a staff extension role. The authors have been involved with the project in contractor project management roles since 1987, and continue to support the Department`s program as it proceeds to finalize its licensing process. This paper describes the selection process used to identify a contractor team with the needed skills and experience, and the makeup of team capabilities. It outlines the management, communication, and technical approaches used to assure a smooth agency-contractor function and relationship. It describes the techniques used to ensure that decisions and documents represented the Department credibly in its role as the regulatory and licensing agency under the Nuclear Regulatory Commission (NRC) Agreement State program. The paper outlines the license application review process and activities, through preparation of licensing documentation and responses to public comments. Lessons learned in coordination of an agency-contractor team effort to review and license a low-level waste disposal facility are reviewed and suggestions made for approaching a similar license application review and licensing situation.« less

Joint Assessment of Renewable Energy and Water Desalination Research Center (REWDC) Program Capabilities and Facilities In Radioactive Waste Management

DOE Office of Scientific and Technical Information (OSTI.GOV)

Bissani, M; Fischer, R; Kidd, S

2006-04-03

The primary goal of this visit was to perform a joint assessment of the Renewable Energy and Water Desalination Center's (REWDC) program in radioactive waste management. The visit represented the fourth technical and scientific interaction with Libya under the DOE/NNSA Sister Laboratory Arrangement. Specific topics addressed during the visit focused on Action Sheet P-05-5, ''Radioactive Waste Management''. The Team, comprised of Mo Bissani (Team Lead), Robert Fischer, Scott Kidd, and Jim Merrigan, consulted with REWDC management and staff. The team collected information, discussed particulars of the technical collaboration and toured the Tajura facility. The tour included the waste treatment facility,more » waste storage/disposal facility, research reactor facility, hot cells and analytical labs. The assessment team conducted the first phase of Task A for Action Sheet 5, which involved a joint assessment of the Radioactive Waste Management Program. The assessment included review of the facilities dedicated to the management of radioactive waste at the Tourja site, the waste management practices, proposed projects for the facility and potential impacts on waste generation and management.« less

The value of mentoring: a strategic approach to retention and recruitment.

PubMed

Greene, Maureen T; Puetzer, Mary

2002-10-01

The issues of recruitment, training, and retention of experienced nursing staff remains an ongoing business strategy of nursing service in many health care facilities. The implementation of a structured mentoring program recognizes the need to develop and maintain relationships between the new and the experienced nurses. The terms of mentor and mentee are defined within a structured orientation program, highlighting specific roles and responsibilities of each. The use of other staff as preceptors and resources is discussed as a mechanism to enhance diversity in skill and knowledge development. The value of clinical tracking forms, planning calendars, and feedback mechanisms are stressed to ensure success in monitoring this program in a longitudinal way. Problems associated with the assignment of mentors are addressed as an area for future investigation in different care settings.

Use of Quality Indicators in Nursing Homes in Victoria, Australia: A Cross-Sectional Descriptive Survey.

PubMed

Ibrahim, Joseph E; Chadwick, Liam; MacPhail, Aleece; McAuliffe, Linda; Koch, Susan; Wells, Yvonne

2014-08-01

This study aimed to characterize the use of mandated quality indicators (QIs) in public sector nursing homes by describing their adherence to established principles of measurement and whether nursing homes respond to QI data to improve care. Data were collected from a descriptive cross-sectional quantitative study using a confidential survey questionnaire distributed electronically to senior staff in all public sector nursing homes in Victoria, Australia. Staff from 113 of 196 facilities completed the survey (58%). Adherence to principles of measurement was suboptimal, with variation in applying QI definitions and infrequent random audits of data (n = 54, 48%). QI data triggered reviews of individual residents (62%-79%), staff practice (44%-65%), and systems of care (45%-55%). Most facilities (58%-75%) reported that beneficial changes in care occurred as a result of using QIs. QI performance data are positively received and used to improve care. Standardization of data collection, analysis, and reporting should strengthen the program's utility. © The Author(s) 2014.

Towards 90-90-90 Target: Factors Influencing Availability, Access, and Utilization of HIV Services—A Qualitative Study in 19 Ugandan Districts

PubMed Central

Tumwebaze, Flora; Akakimpa, Denis; Kityo, Cissy; Mugyenyi, Peter; Abongomera, George

2018-01-01

Background UNAIDS has set a new target 90-90-90 by 2020. To achieve this target, current programs need to address challenges that limit access, availability, and utilization of HIV testing and treatment services. Therefore, the aim of this study was to identify the barriers that influence access, availability, and utilization of HIV services in rural Uganda within the setting of a large donor funded program. Methods We conducted key informant interviews with stakeholders at the district level, staff of existing HIV/AIDS projects, and health facilities in 19 districts. Data were also collected from focus group discussions comprised of clients presenting for HIV care and treatment. Data were transcribed and analyzed using content analysis. Results. Barriers identified were as follows: (1) drug shortages including antiretroviral drugs at health facilities. Some patients were afraid to start ART because of worrying about shortages; (2) distance and (3) staffing shortages; (4) stigma persistence; (5) lack of social and economic support initiatives that enhance retention in treatment. Conclusions In conclusion, our study has identified several factors that influence access, availability, and utilization of HIV services. Programs need to address drug and staff shortages, HIV stigma, and long distances to health facilities to broaden access and utilization in order to realize the UNAIDS target. PMID:29750175

Mental Illness Training for Licensed Staff in Long-Term Care

PubMed Central

Irvine, A. Blair; Billow, Molly B.; Eberhage, Mark G.; Seeley, John R.; McMahon, Edward; Bourgeois, Michelle

2013-01-01

Licensed care staff working in long-term care facilities may be poorly prepared to work with residents with mental illness. This research reports on the program evaluation of Caring Skills: Working with Mental Illness, a training program delivered on the Internet. It was tested with a randomized treatment-control design, with an eight-week follow-up. The training provided video-based behavioral skills and knowledge training. Measures included video situations testing and assessment of psycho-social constructs including empathy and stigmatization. ANCOVA analysis at 4-weeks posttest showed significant positive effects with medium-large effect sizes, which were largely maintained at the 8-week follow-up. The training was well-received by the users. PMID:22364430

Peer exchange May 3-5, 2016 : Alaska Department of Transportation and Public Facilities : research development & technology transfer.

DOT National Transportation Integrated Search

2016-01-01

Members of the Peer Exchange Team identified actions Alaska should consider to : improve effectiveness of the research program: : 1. Conduct Research Strategic Visioning Workshop with Staff and Research : Advisory Board in Fall, 2016 : 2. Develop a T...

ANNUAL REPORT

DOE Office of Scientific and Technical Information (OSTI.GOV)

None

1959-07-01

The national laboratory concept, laboratory objectives, the staff, research facilities. research activities, and administration are discussed in general terms and a financial statement is given. Fairly detailed accounts are given for the research programs in the fields of physics, accelerator development, instrumentation, applied mathematics, chemistry, nuclear engineering, biology, and medicine. (W.D.M.)

30 CFR 585.706 - How do I nominate a CVA for BOEM approval?

Code of Federal Regulations, 2014 CFR

2014-07-01

... technology (including computer programs, hardware, and testing materials and equipment); (5) Ability to perform the CVA functions for the specific project considering current commitments; (6) Previous... facilities; (2) Technical capabilities of the individual or the primary staff for the specific project; (3...

30 CFR 585.706 - How do I nominate a CVA for BOEM approval?

Code of Federal Regulations, 2013 CFR

2013-07-01

... technology (including computer programs, hardware, and testing materials and equipment); (5) Ability to perform the CVA functions for the specific project considering current commitments; (6) Previous... facilities; (2) Technical capabilities of the individual or the primary staff for the specific project; (3...

30 CFR 585.706 - How do I nominate a CVA for BOEM approval?

Code of Federal Regulations, 2012 CFR

2012-07-01

... technology (including computer programs, hardware, and testing materials and equipment); (5) Ability to perform the CVA functions for the specific project considering current commitments; (6) Previous... facilities; (2) Technical capabilities of the individual or the primary staff for the specific project; (3...

Francis Bitter National Magnet Laboratory annual report, July 1988 through June 1989

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1989-01-01

Contents include: reports on laboratory research programs--magneto-optics and semiconductor physics, magnetism, superconductivity, solid-state nuclear magnetic resonance, condensed-matter chemistry, biomagnetism, magnet technology, instrumentation for high-magnetic-field research, molecular biophysics; reports of visiting scientists--reports of users of the High Magnetic Field Facility, reports of users of the Pulsed Field Facility, reports of users of the SQUID Magnetometer and Moessbauer Facility, reports of users of the High-Field NMR Facility; Appendices--publications and meeting speeches, organization, summary of High-Field Magnet Facility use January 1, 1981 through December 31, 1988; geographic distribution of High-Field Magnet users (excluding laboratory staff); and summary of educational activities.

Who let the dogs out? Infection control did: utility of dogs in health care settings and infection control aspects.

PubMed

DiSalvo, Heidi; Haiduven, Donna; Johnson, Nancy; Reyes, Valentine V; Hench, Carmen P; Shaw, Rosemary; Stevens, David A

2006-06-01

Research has substantiated that animals improve human health, both psychologically and physiologically. Therefore, healthcare facilities have begun to implement programs, such as the "Furry Friends Foundation," that bring animals into the facility to improve the quality of life of patients. When implementing these programs, consideration must be given to potential adverse events such as phobias, allergies, and particularly the possibility of zoonotic disease transmission. Santa Clara Valley Medical Centre (SCVMC), a 600-bed county teaching hospital with specialized units (e.g., for burns, rehabilitation, and pediatric care), has implemented programs that incorporate animals into the healthcare setting. This facility allows three categories of dogs to interact with their patients: service dogs, therapy dogs, and pet visitation dogs by the "Furry Friends Foundation." A blurring of the roles of the three categories of dogs occurred when these programs were put into place at SCVMC. The American with Disabilities Act (ADA) states that service animals cannot be prohibited from any area. For example, a "no pet allowed" policy could not apply to these animals. Proof of a person's disability or proof of the service animal's health or training cannot be required. The purpose of this project was to maintain these programs by clarifying the policies regarding animals, specifically dogs, in the healthcare setting. This had to take place to provide a safe and enjoyable environment for the patients and the staff. A comprehensive table was developed to delineate the three categories of dogs and the corresponding policies. Therapy dogs and the visitation animals are more restricted than service dogs. Both therapy dogs and visitation dogs require identification and certification of health and are excluded from certain areas of the facility, including intensive care units and isolation rooms. By complying with the current policies and regulations, the risks from these programs can be minimized. Staff should be educated on the proper terminology and procedures to prevent a blurring of the categories and roles of these animals.

PLANNING, PROGRAMMING, DESIGNING THE COMMUNITY COLLEGE, PROCEEDINGS OF A CONFERENCE SPONSORED BY THE COLLEGE OF ARCHITECTURE AND URBAN PLANNING AND THE CENTER FOR THE DEVELOPMENT OF COMMUNITY COLLEGE EDUCATION (UNIVERSITY OF WASHINGTON, APRIL 24-25, 1967).

ERIC Educational Resources Information Center

SONDALLE, MARVIN P.

PARTICIPANTS AT THIS CONFERENCE DEFINED THE ESSENTIAL MAJOR STEPS IN FACILITY PLANNING FOR A NEW CAMPUS AS SITE SELECTION, FINANCIAL PROGRAMMING, CAMPUS PLANNING, AND CONSTRUCTION. THEY ALSO AGREED THAT THE COLLEGE ADMINISTRATION AND THE ARCHITECTURAL STAFF MUST WORK TOGETHER AT EVERY STAGE OF THE PROGRAM. PRESENT TECHNIQUES OF ENROLLMENT…

University multi-user facility survey-2010.

PubMed

Riley, Melissa B

2011-12-01

Multi-user facilities serve as a resource for many universities. In 2010, a survey was conducted investigating possible changes and successful characteristics of multi-user facilities, as well as identifying problems in facilities. Over 300 surveys were e-mailed to persons identified from university websites as being involved with multi-user facilities. Complete responses were received from 36 facilities with an average of 20 years of operation. Facilities were associated with specific departments (22%), colleges (22%), and university research centers (8.3%) or were not affiliated with any department or college within the university (47%). The five most important factors to succeed as a multi-user facility were: 1) maintaining an experienced, professional staff in an open atmosphere; 2) university-level support providing partial funding; 3) broad client base; 4) instrument training programs; and 5) an effective leader and engaged strategic advisory group. The most significant problems were: 1) inadequate university financial support and commitment; 2) problems recovering full service costs from university subsidies and user fees; 3) availability of funds to repair and upgrade equipment; 4) inability to retain highly qualified staff; and 5) unqualified users dirtying/damaging equipment. Further information related to these issues and to fee structure was solicited. Overall, there appeared to be a decline in university support for facilities and more emphasis on securing income by serving clients outside of the institution and by obtaining grants from entities outside of the university.

Integrated approach to oral health in aged care facilities using oral health practitioners and teledentistry in rural Queensland.

PubMed

Tynan, Anna; Deeth, Lisa; McKenzie, Debra; Bourke, Carolyn; Stenhouse, Shayne; Pitt, Jacinta; Linneman, Helen

2018-04-16

Residents of residential aged care facilities are at very high risk of developing complex oral diseases and dental problems. Key barriers exist in delivering oral health services to residential aged care facilities, particularly in regional and rural areas. A quality improvement study incorporating pre- and post chart audits and pre- and post consultation with key stakeholders, including staff and residents, expert opinion on cost estimates and field notes were used. One regional and three rural residential aged care facilities situated in a non-metropolitan hospital and health service in Queensland. Number of appointments avoided at an oral health facility Feedback on program experience by staff and residents Compliance with oral health care plan implementation Observations of costs involved to deliver new service. The model developed incorporated a visit by an oral health therapist for screening, education, simple intervention and referral for a teledentistry session if required. Results showed an improvement in implementation of oral health care plans and a minimisation of need for residents to attend an oral health care facility. Potential financial and social cost savings for residents and the facilities were also noted. Screening via the oral health therapist and teledentistry appointment minimises the need for a visit to an oral health facility and subsequent disruption to residents in residential aged care facilities. © 2018 National Rural Health Alliance Ltd.

Staffing levels in not-for-profit and for-profit long-term care facilities: Does type of ownership matter?

PubMed Central

McGregor, Margaret J.; Cohen, Marcy; McGrail, Kimberlyn; Broemeling, Anne Marie; Adler, Reva N.; Schulzer, Michael; Ronald, Lisa; Cvitkovich, Yuri; Beck, Mary

2005-01-01

Background Currently there is a lot of debate about the advantages and disadvantages of for-profit health care delivery. We examined staffing ratios for direct-care and support staff in publicly funded not-for-profit and for-profit nursing homes in British Columbia. Methods We obtained staffing data for 167 long-term care facilities and linked these to the type of facility and ownership of the facility. All staff were members of the same bargaining association and received identical wages in both not-for-profit and for-profit facilities. Similar public funding is provided to both types of facilities, although the amounts vary by the level of functional dependence of the residents. We compared the mean number of hours per resident-day provided by direct-care staff (registered nurses, licensed practical nurses and resident care aides) and support staff (housekeeping, dietary and laundry staff) in not-for-profit versus for-profit facilities, after adjusting for facility size (number of beds) and level of care. Results The nursing homes included in our study comprised 76% of all such facilities in the province. Of the 167 nursing homes examined, 109 (65%) were not-for-profit and 58 (35%) were for-profit; 24% of the for-profit homes were part of a chain, and the remaining homes were owned by a single operator. The mean number of hours per resident-day was higher in the not-for-profit facilities than in the for-profit facilities for both direct-care and support staff and for all facility levels of care. Compared with for-profit ownership, not-for-profit status was associated with an estimated 0.34 more hours per resident-day (95% confidence interval [CI] 0.18–0.49, p < 0.001) provided by direct-care staff and 0.23 more hours per resident-day (95% CI 0.15–0.30, p < 0.001) provided by support staff. Interpretation Not-for-profit facility ownership is associated with higher staffing levels. This finding suggests that public money used to provide care to frail eldery people purchases significantly fewer direct-care and support staff hours per resident-day in for-profit long-term care facilities than in not-for-profit facilities. PMID:15738489

Development of an Enhanced Payback Function for the Superior Energy Performance Program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Therkelsen, Peter; Rao, Prakash; McKane, Aimee

2015-08-03

The U.S. DOE Superior Energy Performance (SEP) program provides recognition to industrial and commercial facilities that achieve certification to the ISO 50001 energy management system standard and third party verification of energy performance improvements. Over 50 industrial facilities are participating and 28 facilities have been certified in the SEP program. These facilities find value in the robust, data driven energy performance improvement result that the SEP program delivers. Previous analysis of SEP certified facility data demonstrated the cost effectiveness of SEP and identified internal staff time to be the largest cost component related to SEP implementation and certification. This papermore » analyzes previously reported and newly collected data of costs and benefits associated with the implementation of an ISO 50001 and SEP certification. By disaggregating “sunk energy management system (EnMS) labor costs”, this analysis results in a more accurate and detailed understanding of the costs and benefits of SEP participation. SEP is shown to significantly improve and sustain energy performance and energy cost savings, resulting in a highly attractive return on investment. To illustrate these results, a payback function has been developed and is presented. On average facilities with annual energy spend greater than $2M can expect to implement SEP with a payback of less than 1.5 years. Finally, this paper also observes and details decreasing facility costs associated with implementing ISO 50001 and certifying to the SEP program, as the program has improved from pilot, to demonstration, to full launch.« less

Haimei Zheng

Science.gov Websites

Investigators Division Staff Facilities and Centers Staff Jobs Safety Personnel Resources Committees In Case of ; Finance Templates Travel One-Stop Investigators Division Staff Facilities and Centers Staff Jobs Haimei Zheng Staff Scientist hmzheng@lbl.gov 510-486-4110 Research profile » A U.S. Department of Energy

An Evidence-Based Cue-Selection Guide and Logic Model to Improve Pressure Ulcer Prevention in Long Term Care

PubMed Central

Yap, Tracey L.; Kennerly, Susan M.; Bergstrom, Nancy; Hudak, Sandra L.; Horn, Susan D.

2015-01-01

Pressure ulcers (PrUs) have consistently resisted prevention efforts in long term care (LTC) facilities nationwide. Recent research has described cueing innovations that – when selected according to the assumptions and resources of particular facilities – support best practices of PrU prevention. This paper synthesizes that research into a unified, dynamic logic model to facilitate effective staff implementation of a PrU prevention program. PMID:26066791

The 1985 National Aeronautics and Space Administration's Summer High School Apprenticeship Research Program (SHARP)

NASA Technical Reports Server (NTRS)

1985-01-01

In 1985, a total of 126 talented high school students gained first hand knowledge about science and engineering careers by working directly with a NASA scientist or engineer during the summer. This marked the sixth year of operation for NASA's Summer High School Apprenticeship Research Program (SHARP). The major priority of maintaining the high standards and success of prior years was satisfied. The following eight sites participated in the Program: Ames Research Center, Ames' Dryden Flight Research Facility, Goddard Space Flight Center, Goddard's Wallop Flight Facility, Kennedy Space Center, Langley Research Center, Lewis Research Center, and Marshall Space Flight Center. Tresp Associates served as the SHARP contractor and worked closely with NASA staff at headquarters and the sites just mentioned to plan, implement, and evaluate the program.

Summer High School Apprenticeship Research Program (SHARP) of the National Aeronautics and Space Administration

NASA Technical Reports Server (NTRS)

1984-01-01

A total of 125 talented high school students had the opportunity to gain first hand experience about science and engineering careers by working directly with a NASA scientist or engineer during the summer. This marked the fifth year of operation for NASA's Summer High School Apprenticehsip Research Program (SHARP). Ferguson Bryan served as the SHARP contractor and worked closely with NASA staff at Headquarters and the eight participating sites to plan, implement, and evaluate the Program. The main objectives were to strengthen SHARP and expand the number of students in the Program. These eight sites participated in the Program: Ames Research Center North, Ames' Dryden Flight Research Facility, Goddard Space Flight Center, Goddard's Wallops Flight Facility, Kennedy Space Center, Langley Research Center, Lewis Research Center, and Marshall Space Flight Center.

Idaho State University Statistical Portrait, Academic Year 1998-1999.

ERIC Educational Resources Information Center

Idaho State Univ., Pocatello. Office of Institutional Research.

This report provides basic statistical data for Idaho State University, and includes both point-of-time data as well as trend data. The information is divided into sections emphasizing students, programs, faculty and staff, finances, and physical facilities. Student data includes enrollment, geographical distribution, student/faculty ratios,…

78 FR 17633 - Notice of Request for Extension of a Currently Approved Information Collection

Federal Register 2010, 2011, 2012, 2013, 2014

2013-03-22

... DEPARTMENT OF AGRICULTURE Rural Housing Service Notice of Request for Extension of a Currently... Support Staff, Housing and Community Facilities Programs, U.S. Department of Agriculture, Stop 0761, 1400... on the quality of the human environment during agency planning and decision-making processes. For...

[Problems of X-ray mammology manpower training and management].

PubMed

Rozhkova, N I

2014-01-01

The paper considers the issues of manpower training in X-ray mammology. It mentions staff shortage and no special training, which reduces the efficient activities of X-ray mammographic rooms, as well as shortage of training facilities and no unified educational programs within interdisciplinary integration, inadequate technical equipment in the training facilities, the lack of an accounting system for training higher- and mid-level health workers, as well as engineers. Emphasis is placed on that the educational programs must comply with the organizational forms of testing the specialists to be employed. The introduction of a continuous education system should be accelerated to rule out the decay period of specialists' competence.

Alessandra Lanzara

Science.gov Websites

Berkeley Lab Berkeley Lab A-Z Index Phone Book Jobs Search DOE Search MSD Go MSD - Materials Investigators Division Staff Facilities and Centers Staff Jobs Safety Personnel Resources Committees In Case of ; Finance Templates Travel One-Stop Investigators Division Staff Facilities and Centers Staff Jobs

Sustaining complex interventions in long-term care: a qualitative study of direct care staff and managers.

PubMed

Colón-Emeric, Cathleen; Toles, Mark; Cary, Michael P; Batchelor-Murphy, Melissa; Yap, Tracey; Song, Yuting; Hall, Rasheeda; Anderson, Amber; Burd, Andrew; Anderson, Ruth A

2016-07-16

Little is known about the sustainability of behavioral change interventions in long-term care (LTC). Following a cluster randomized trial of an intervention to improve staff communication (CONNECT), we conducted focus groups of direct care staff and managers to elicit their perceptions of factors that enhance or reduce sustainability in the LTC setting. The overall aim was to generate hypotheses about how to sustain complex interventions in LTC. In eight facilities, we conducted 15 focus groups with 83 staff who had participated in at least one intervention session. Where possible, separate groups were conducted with direct care staff and managers. An interview guide probed for staff perceptions of intervention salience and sustainability. Framework analysis of coded transcripts was used to distill insights about sustainability related to intervention features, organizational context, and external supports. Staff described important factors for intervention sustainability that are particularly challenging in LTC. Because of the tremendous diversity in staff roles and education level, interventions should balance complexity and simplicity, use a variety of delivery methods and venues (e.g., group and individual sessions, role-play/storytelling), and be inclusive of many work positions. Intervention customizability and flexibility was particularly prized in this unpredictable and resource-strapped environment. Contextual features noted to be important include addressing the frequent lack of trust between direct care staff and managers and ensuring that direct care staff directly observe manager participation and support for the program. External supports suggested to be useful for sustainability include formalization of changes into facility routines, using "train the trainer" approaches and refresher sessions. High staff turnover is common in LTC, and providing materials for new staff orientation was reported to be important for sustainability. When designing or implementing complex behavior change interventions in LTC, consideration of these particularly salient intervention features, contextual factors, and external supports identified by staff may enhance sustainability. ClinicalTrial.gov, NCT00636675.

The Dryden Flight Research Center at Edwards Air Force Base is NASA's premier center for atmospheric flight research to validate high-risk aerospace technology.

NASA Image and Video Library

2001-07-25

Since the 1940s the Dryden Flight Research Center, Edwards, California, has developed a unique and highly specialized capability for conducting flight research programs. The organization, made up of pilots, scientists, engineers, technicians, and mechanics, has been and will continue to be leaders in the field of advanced aeronautics. Located on the northwest "shore" of Rogers Dry Lake, the complex was built around the original administrative-hangar building constructed in 1954. Since then many additional support and operational facilities have been built including a number of unique test facilities such as the Thermalstructures Research Facility, Flow Visualization Facility, and the Integrated Test Facility. One of the most prominent structures is the space shuttle program's Mate-Demate Device and hangar in Area A to the north of the main complex. On the lakebed surface is a Compass Rose that gives pilots an instant compass heading. The Dryden complex originated at Edwards Air Force Base in support of the X-1 supersonic flight program. As other high-speed aircraft entered research programs, the facility became permanent and grew from a staff of five engineers in 1947 to a population in 2006 of nearly 1100 full-time government and contractor employees.

NASA's Dryden Flight Research Center is situated immediately adjacent to the compass rose on the bed of Rogers Dry Lake at Edwards Air Force Base, Calif.

NASA Image and Video Library

2001-07-25

Since the 1940s the Dryden Flight Research Center, Edwards, California, has developed a unique and highly specialized capability for conducting flight research programs. The organization, made up of pilots, scientists, engineers, technicians, and mechanics, has been and will continue to be leaders in the field of advanced aeronautics. Located on the northwest "shore" of Rogers Dry Lake, the complex was built around the original administrative-hangar building constructed in 1954. Since then many additional support and operational facilities have been built including a number of unique test facilities such as the Thermalstructures Research Facility, Flow Visualization Facility, and the Integrated Test Facility. One of the most prominent structures is the space shuttle program's Mate-Demate Device and hangar in Area A to the north of the main complex. On the lakebed surface is a Compass Rose that gives pilots an instant compass heading. The Dryden complex originated at Edwards Air Force Base in support of the X-1 supersonic flight program. As other high-speed aircraft entered research programs, the facility became permanent and grew from a staff of five engineers in 1947 to a population in 2006 of nearly 1100 full-time government and contractor employees.

Medicare program; prospective payment system and consolidated billing for skilled nursing facilities for FY 2010; minimum data set, version 3.0 for skilled nursing facilities and Medicaid nursing facilities. Final rule.

PubMed

2009-08-11

This final rule updates the payment rates used under the prospective payment system (PPS) for skilled nursing facilities (SNFs), for fiscal year (FY) 2010. In addition, it recalibrates the case-mix indexes so that they more accurately reflect parity in expenditures related to the implementation of case-mix refinements in January 2006. It also discusses the results of our ongoing analysis of nursing home staff time measurement data collected in the Staff Time and Resource Intensity Verification project, as well as a new Resource Utilization Groups, version 4 case-mix classification model for FY 2011 that will use the updated Minimum Data Set 3.0 resident assessment for case-mix classification. In addition, this final rule discusses the public comments that we have received on these and other issues, including a possible requirement for the quarterly reporting of nursing home staffing data, as well as on applying the quality monitoring mechanism in place for all other SNF PPS facilities to rural swing-bed hospitals. Finally, this final rule revises the regulations to incorporate certain technical corrections.

An analysis of restructuring orientation to enhance nurse retention.

PubMed

Kiel, Joan M

2012-01-01

The nursing shortage has received much media attention; however, something that contributes to it-nurse turnover-has not received the same attention. Facilities spend time and money to train new employees only to have them leave within a few months. Staff morale, money, time, and quality of care are all affected by nurse turnover. The fact that it often occurs so soon after one takes a position makes it pertinent to look at the process of transition into the new position, namely, the orientation program. This article examines the turnover statistics, costs, rationale, and orientation programs that have proven positive results. It is hoped that the findings can assist health care facilities to replicate successful orientation programs and reduce nurse turnover.

APSIC Guidelines for environmental cleaning and decontamination.

PubMed

Ling, Moi Lin; Apisarnthanarak, Anucha; Thu, Le Thi Anh; Villanueva, Victoria; Pandjaitan, Costy; Yusof, Mohamad Yasim

2015-01-01

This document is an executive summary of APSIC Guidelines for Environmental Cleaning and Decontamination. It describes best practices in routine cleaning and decontamination in healthcare facilities as well as in specific settings e.g. management of patients with isolation precautions, food preparation areas, construction and renovation, and following a flood. It recommends the implementation of environmental hygiene program to keep the environment safe for patients, staff and visitors visiting a healthcare facility. Objective assessment of cleanliness and quality is an essential component of this program as a method for identifying quality improvement opportunities. Recommendations for safe handling of linen and bedding; as well as occupational health and safety issues are included in the guidelines. A training program is vital to ensure consistent adherence to best practices.

University education and nuclear criticality safety professionals

DOE Office of Scientific and Technical Information (OSTI.GOV)

Wilson, R.E.; Stachowiak, R.V.; Knief, R.A.

1996-12-31

The problem of developing a productive criticality safety specialist at a nuclear fuel facility has long been with us. The normal practice is to hire a recent undergraduate or graduate degree recipient and invest at least a decade in on-the-job training. In the early 1980s, the U.S. Department of Energy (DOE) developed a model intern program in an attempt to speed up the process. The program involved working at assigned projects for extended periods at a working critical mass laboratory, a methods development group, and a fuel cycle facility. This never gained support as it involved extended time away frommore » the job. At the Rocky Flats Environmental Technology Site, the training method is currently the traditional one involving extensive experience. The flaw is that the criticality safety staff turnover has been such that few individuals continue for the decade some consider necessary for maturity in the discipline. To maintain quality evaluations and controls as well as interpretation decisions, extensive group review is used. This has proved costly to the site and professionally unsatisfying to the current staff. The site contractor has proposed a training program to remedy the basic problem.« less

A controlled investigation of continuing pain education for long-term care staff

PubMed Central

Ghandehari, Omeed O; Hadjistavropoulos, Thomas; Williams, Jaime; Thorpe, Lilian; Alfano, Dennis P; Bello-Haas, Vanina Dal; Malloy, David C; Martin, Ronald R; Rahaman, Omar; Zwakhalen, Sandra MG; Carleton, R Nicholas; Hunter, Paulette V; Lix, Lisa M

2013-01-01

BACKGROUND: The underassessment and undertreatment of pain in residents of long-term care (LTC) facilities has been well documented. Gaps in staff knowledge and inaccurate beliefs have been identified as contributors. OBJECTIVES: To investigate the effectiveness of an expert-based continuing education program in pain assessment/management for LTC staff. METHODS: Participants included 131 LTC staff members who were randomly assigned to either an interactive pain education (PE) program, which addressed gaps in knowledge such as medication management, or an interactive control program consisting of general dementia education without a specific clinical focus. Participants attended three sessions, each lasting 3 h, and completed measures of pain-related knowledge and attitudes/beliefs before, immediately after and two weeks following the program. Focus groups were conducted with a subset of participants to gauge perception of the training program and barriers to implementing pain-related strategies. RESULTS: Analysis using ANOVA revealed that PE participants demonstrated larger gains compared with control participants with regard to pain knowledge and pain beliefs. Barriers to implementing pain-related strategies certainly exist. Nonetheless, qualitative analyses demonstrated that PE participants reported that they overcame many of these barriers and used pain management strategies four times more frequently than control participants. CONCLUSIONS: Contrary to previous research, the present study found that the interactive PE program was effective in changing pain beliefs and improving knowledge. Continuing PE in LTC has the potential to address knowledge gaps among front-line LTC providers. PMID:23457681

A proposed emergency management program for acute care facilities in response to a highly virulent infectious disease.

PubMed

Petinaux, Bruno; Ferguson, Brandy; Walker, Milena; Lee, Yeo-Jin; Little, Gary; Parenti, David; Simon, Gary

2016-01-01

To address the organizational complexities associated with a highly virulent infectious disease (HVID) hazard, such as Ebola Virus Disease (EVD), an acute care facility should institute an emergency management program rooted in the fundamentals of mitigation, preparedness, response, and recovery. This program must address all known facets of the care of a patient with HVID, from unannounced arrival to discharge. The implementation of such a program not only serves to mitigate the risks from an unrecognized exposure but also serves to prepare the organization and its staff to provide for a safe response, and ensure a full recovery. Much of this program is based on education, training, and infection control measures along with resourcing for appropriate personal protective equipment which is instrumental in ensuring an organized and safe response of the acute care facility in the service to the community. This emergency management program approach can serve as a model in the care of not only current HVIDs such as EVD but also future presentations in our healthcare setting.

Providing culturally competent services for American Indian and Alaska Native veterans to reduce health care disparities.

PubMed

Noe, Timothy D; Kaufman, Carol E; Kaufmann, L Jeanne; Brooks, Elizabeth; Shore, Jay H

2014-09-01

We conducted an exploratory study to determine what organizational characteristics predict the provision of culturally competent services for American Indian and Alaska Native (AI/AN) veterans in Department of Veterans Affairs (VA) health facilities. In 2011 to 2012, we adapted the Organizational Readiness to Change Assessment (ORCA) for a survey of 27 VA facilities in the Western Region to assess organizational readiness and capacity to adopt and implement native-specific services and to profile the availability of AI/AN veteran programs and interest in and resources for such programs. Several ORCA subscales (Program Needs, Leader's Practices, and Communication) statistically significantly predicted whether VA staff perceived that their facilities were meeting the needs of AI/AN veterans. However, none predicted greater implementation of native-specific services. Our findings may aid in developing strategies for adopting and implementing promising native-specific programs and services for AI/AN veterans, and may be generalizable for other veteran groups.

Providing Culturally Competent Services for American Indian and Alaska Native Veterans to Reduce Health Care Disparities

PubMed Central

Kaufman, Carol E.; Kaufmann, L. Jeanne; Brooks, Elizabeth; Shore, Jay H.

2014-01-01

Objectives. We conducted an exploratory study to determine what organizational characteristics predict the provision of culturally competent services for American Indian and Alaska Native (AI/AN) veterans in Department of Veterans Affairs (VA) health facilities. Methods. In 2011 to 2012, we adapted the Organizational Readiness to Change Assessment (ORCA) for a survey of 27 VA facilities in the Western Region to assess organizational readiness and capacity to adopt and implement native-specific services and to profile the availability of AI/AN veteran programs and interest in and resources for such programs. Results. Several ORCA subscales (Program Needs, Leader’s Practices, and Communication) statistically significantly predicted whether VA staff perceived that their facilities were meeting the needs of AI/AN veterans. However, none predicted greater implementation of native-specific services. Conclusions. Our findings may aid in developing strategies for adopting and implementing promising native-specific programs and services for AI/AN veterans, and may be generalizable for other veteran groups. PMID:25100420

Dropping In a Microgravity Environment (DIME) contest

NASA Technical Reports Server (NTRS)

2001-01-01

The first NASA Dropping In a Microgravity Environment (DIME) student competition pilot project came to a conclusion at the Glenn Research Center in April 2001. The competition involved high-school student teams who developed the concept for a microgravity experiment and prepared an experiment proposal. The two student teams - COSI Academy, sponsored by the Columbus Center of Science and Industry, and another team from Cincinnati, Ohio's Sycamore High School, designed a microgravity experiment, fabricated the experimental apparatus, and visited NASA Glenn to operate their experiment in the 2.2 Second Drop Tower. NASA and contractor personnel who conducted the DIME activity with the students. Shown (L-R) are: Eric Baumann (NASA, 2.2-second Drop Tower Facility manager), Daniel Dietrich (NASA) mentor for Sycamore High School team), Carol Hodanbosi (National Center for Microgravity Research; DIME staff), Richard DeLombard (NASA; DIME staff), Jose Carrion (GRC Akima, drop tower technician), Dennis Stocker (NASA; DIME staff), Peter Sunderland (NCMR, mentor for COSI Academy student team), Sandi Thompson (NSMR sabbatical teacher; DIME staff), Dan Woodard (MASA Microgravity Outreach Program Manager), Adam Malcolm (NASA co-op student; DIME staff), Carla Rosenberg (NCMR; DIME staff), and Twila Schneider (Infinity Technology; NASA Microgravity Research program contractor). This image is from a digital still camera; higher resolution is not available.

Development and evaluation of a multifaceted ergonomics program to prevent injuries associated with patient handling tasks.

PubMed

Nelson, Audrey; Matz, Mary; Chen, Fangfei; Siddharthan, Kris; Lloyd, John; Fragala, Guy

2006-08-01

Nurses have one of the highest rates of work-related musculoskeletal injury of any profession. Over the past 30 years, efforts to reduce work-related musculoskeletal disorders in nurses have been largely unsuccessful. The primary goal of this program was to create safer working environments for nursing staff who provide direct patient care. Our first objective was to design and implement a multifaceted program that successfully integrated evidence-based practice, technology, and safety improvement. The second objective was to evaluate the impact of the program on injury rate, lost and modified work days, job satisfaction, self-reported unsafe patient handling acts, level of support for program, staff and patient acceptance, program effectiveness, costs, and return on investment. The intervention included six program elements: (1) Ergonomic Assessment Protocol, (2) Patient Handling Assessment Criteria and Decision Algorithms, (3) Peer Leader role, "Back Injury Resource Nurses", (4) State-of-the-art Equipment, (5) After Action Reviews, and (6) No Lift Policy. A pre-/post design without a control group was used to evaluate the effectiveness of a patient care ergonomics program on 23 high risk units (19 nursing home care units and 4 spinal cord injury units) in 7 facilities. Injury rates, lost work days, modified work days, job satisfaction, staff , and patient acceptance, program effectiveness, and program costs/savings were compared over two nine month periods: pre-intervention (May 2001-January 2002) and post-intervention (March 2002-November 2002). Data were collected prospectively through surveys, weekly process logs, injury logs, and cost logs. The program elements resulted in a statistically significant decrease in the rate of musculoskeletal injuries as well as the number of modified duty days taken per injury. While the total number of lost workdays decreased by 18% post-intervention, this difference was not statistically significant. There were statistically significant increases in two subscales of job satisfaction: professional status and tasks requirements. Self-reports by nursing staff revealed a statistically significant decrease in the number of 'unsafe' patient handling practices performed daily. Nurses ranked program elements they deemed to be "extremely effective": equipment was rated as most effective (96%), followed by No Lift Policy (68%), peer leader education program (66%), ergonomic assessment protocol (59%), patient handling assessment criteria and decision algorithms (55%), and lastly after action reviews (41%). Perceived support and interest for the program started at a high level for managers and nursing staff and remained very high throughout the program implementation. Patient acceptance was moderate when the program started but increased to very high by the end of the program. Although the ease and success of program implementation initially varied between and within the facilities, after six months there was strong evidence of support at all levels. The initial capital investment for patient handling equipment was recovered in approximately 3.75 years based on annual post-intervention savings of over $200,000/year in workers' compensation expenses and cost savings associated with reduced lost and modified work days and worker compensation. This multi-faceted program resulted in an overall lower injury rate, fewer modified duty days taken per injury, and significant cost savings. The program was well accepted by patients, nursing staff, and administrators. Given the significant increases in two job satisfaction subscales (professional status and task requirements), it is possible that nurse recruitment and retention could be positively impacted.

The Role of Organizational Culture in Retaining Nursing Workforce

PubMed Central

Banaszak-Holl, Jane; Castle, Nicholas G.; Lin, Michael K.; Shrivastwa, Nijika; Spreitzer, Gretchen

2015-01-01

Purpose of the Study: We examined how organizational culture in nursing homes affects staff turnover, because culture is a first step to creating satisfactory work environments. Design and Methods: Nursing home administrators were asked in 2009 to report on facility culture and staff turnover. We received responses from 419 of 1,056 administrators contacted. Respondents reported the strength of cultural values using scales from a Competing Values Framework and percent of staff leaving annually for Registered Nurse (RN), Licensed Practice Nurse (LPN), and nursing aide (NA) staff. We estimated negative binomial models predicting turnover.  Results: Turnover rates are lower than found in past but remain significantly higher among NAs than among RNs or LPNs. Facilities with stronger market values had increased turnover among RNs and LPNs, and among NAs when turnover was adjusted for facilities with few staff. Facilities emphasizing hierarchical internal processes had lower RN turnover. Group and developmental values focusing on staff and innovation only lowered LPN turnover. Finally, effects on NA turnover become insignificant when turnover was adjusted if voluntary turnover was reported. Implications: Organizational culture had differential effects on the turnover of RN, LPN, and NA staff that should be addressed in developing culture-change strategies. More flexible organizational culture values were important for LPN staff only, whereas unexpectedly, greater emphasis on rigid internal rules helped facilities retain RNs. Facilities with a stronger focus on customer needs had higher turnover among all staff. PMID:24218146

DOE Office of Scientific and Technical Information (OSTI.GOV)

SLAC,

The Department of Energy (DOE) and the SLAC National Accelerator Laboratory (SLAC) encourage innovation, creativity, originality and quality to maintain the Laboratory’s research activities and staff at the forefront of science and technology. To further advance its scientific research capabilities, the Laboratory allocates a portion of its funds for the Laboratory Directed Research and Development (LDRD) program. With DOE guidance, the LDRD program enables SLAC scientists to make rapid and significant contributions that seed new strategies for solving important national science and technology problems. The LDRD program is conducted using existing research facilities.

Initial experiences and innovations in supervising community health workers for maternal, newborn, and child health in Morogoro region, Tanzania.

PubMed

Roberton, Timothy; Applegate, Jennifer; Lefevre, Amnesty E; Mosha, Idda; Cooper, Chelsea M; Silverman, Marissa; Feldhaus, Isabelle; Chebet, Joy J; Mpembeni, Rose; Semu, Helen; Killewo, Japhet; Winch, Peter; Baqui, Abdullah H; George, Asha S

2015-04-09

Supervision is meant to improve the performance and motivation of community health workers (CHWs). However, most evidence on supervision relates to facility health workers. The Integrated Maternal, Newborn, and Child Health (MNCH) Program in Morogoro region, Tanzania, implemented a CHW pilot with a cascade supervision model where facility health workers were trained in supportive supervision for volunteer CHWs, supported by regional and district staff, and with village leaders to further support CHWs. We examine the initial experiences of CHWs, their supervisors, and village leaders to understand the strengths and challenges of such a supervision model for CHWs. Quantitative and qualitative data were collected concurrently from CHWs, supervisors, and village leaders. A survey was administered to 228 (96%) of the CHWs in the Integrated MNCH Program and semi-structured interviews were conducted with 15 CHWs, 8 supervisors, and 15 village leaders purposefully sampled to represent different actor perspectives from health centre catchment villages in Morogoro region. Descriptive statistics analysed the frequency and content of CHW supervision, while thematic content analysis explored CHW, supervisor, and village leader experiences with CHW supervision. CHWs meet with their facility-based supervisors an average of 1.2 times per month. CHWs value supervision and appreciate the sense of legitimacy that arises when supervisors visit them in their village. Village leaders and district staff are engaged and committed to supporting CHWs. Despite these successes, facility-based supervisors visit CHWs in their village an average of only once every 2.8 months, CHWs and supervisors still see supervision primarily as an opportunity to check reports, and meetings with district staff are infrequent and not well scheduled. Supervision of CHWs could be strengthened by streamlining supervision protocols to focus less on report checking and more on problem solving and skills development. Facility health workers, while important for technical oversight, may not be the best mentors for certain tasks such as community relationship-building. We suggest further exploring CHW supervision innovations, such as an enhanced role for community actors, who may be more suitable to support CHWs engaged primarily in health promotion than scarce and over-worked facility health workers.

A Framework for Measuring Student and Staff Satisfaction with University Campus Facilities

ERIC Educational Resources Information Center

Kärnä, Sami; Julin, Päivi

2015-01-01

Purpose: The purpose of the study is to evaluate and discuss the extent of the satisfaction as perceived by the students and staff towards university facilities and services in two campuses in Finland. The aim is to analyse which facility-related factors have the greatest impacts on students' and staff's overall satisfaction.…

Development of a Space Flight Prototype Doppler Asymmetric Spatial Heterodyne (DASH) Spectrometer for the Measurement of Upper Atmospheric Winds

DTIC Science & Technology

2011-10-31

required for space flight. Dr. John Hughes and Dr. Abas Sivjee of Embry-Riddle Aeronautical University in Daytona FL and all the staff at the HAARP ...Laboratory, was conducted at the High Frequency Active Auroral Research Program ( HAARP ) facility in Alaska. ARROW was shipped to Anchorage AK from...the Naval Research Laboratory in Washington DC and was delivered, installed, and run at the HAARP facility by ARTEP Inc. personnel. The field

Implementing solutions to barriers to on-site HIV testing in substance abuse treatment: a tale of three facilities.

PubMed

Hood, Kristina B; Robertson, Angela A; Baird-Thomas, Connie

2015-04-01

Due to the scarcity of resources for implementing rapid on-site HIV testing, many substance abuse treatment programs do not offer these services. This study sought to determine whether addressing previously identified implementation barriers to integrating on-site rapid HIV testing into the treatment admissions process would increase offer and acceptance rates. Results indicate that it is feasible to integrate rapid HIV testing into existing treatment programs for substance abusers when resources are provided. Addressing barriers such as providing start-up costs for HIV testing, staff training, addressing staffing needs to reduce competing job responsibilities, and helping treatment staff members overcome their concerns about clients' reactions to positive test results is paramount for the integration and maintenance of such programs. Copyright © 2014 Elsevier Ltd. All rights reserved.

Cultural Awareness Among Nursing Staff at an Academic Medical Center.

PubMed

McElroy, Jennifer; Smith-Miller, Cheryl A; Madigan, Catherine K; Li, Yin

2016-03-01

The goal is to identify areas for targeted improvement in regard to cultural awareness and competence among nursing staff and in the work environment. Many facilities have initiated programs to facilitate cultural competence development among nursing staff; however, there has been little examination of the effect of these initiatives, assessment of experienced nurses' cultural awareness, or investigation of nurse leader's role in promoting cultural competence in the literature. In this cross-sectional descriptive study, a cultural awareness survey was modified and electronically distributed to all registered nurses and assistive personnel at an academic medical center. The modified survey instrument showed good reliability and validity among the study population. Most nursing staff exhibited a moderate to high level of cultural awareness and held positive opinions about nursing leadership and the work environment with regard to cultural issues. In increasingly diverse work environments, assessing the cultural awareness of nursing staff enables nurse leaders to evaluate efforts in promoting cultural competence and to identify specific areas in which to target staff development efforts and leadership training.

Annual Report To Congress. Department of Energy Activities Relating to the Defense Nuclear Facilities Safety Board, Calendar Year 2003

DOE Office of Scientific and Technical Information (OSTI.GOV)

None, None

2004-02-28

The Department of Energy (Department) submits an Annual Report to Congress each year detailing the Department’s activities relating to the Defense Nuclear Facilities Safety Board (Board), which provides advice and recommendations to the Secretary of Energy (Secretary) regarding public health and safety issues at the Department’s defense nuclear facilities. In 2003, the Department continued ongoing activities to resolve issues identified by the Board in formal recommendations and correspondence, staff issue reports pertaining to Department facilities, and public meetings and briefings. Additionally, the Department is implementing several key safety initiatives to address and prevent safety issues: safety culture and review ofmore » the Columbia accident investigation; risk reduction through stabilization of excess nuclear materials; the Facility Representative Program; independent oversight and performance assurance; the Federal Technical Capability Program (FTCP); executive safety initiatives; and quality assurance activities. The following summarizes the key activities addressed in this Annual Report.« less

CONNECT for better fall prevention in nursing homes: results from a pilot intervention study.

PubMed

Colon-Emeric, Cathleen S; McConnell, Eleanor; Pinheiro, Sandro O; Corazzini, Kirsten; Porter, Kristie; Earp, Kelly M; Landerman, Lawrence; Beales, Julie; Lipscomb, Jeffrey; Hancock, Kathryn; Anderson, Ruth A

2013-12-01

To determine whether an intervention that improves nursing home (NH) staff connections, communication, and problem solving (CONNECT) would improve implementation of a falls reduction education program (FALLS). Cluster randomized trial. Community (n=4) and Veterans Affairs (VA) NHs (n=4). Staff in any role with resident contact (n=497). NHs received FALLS alone (control) or CONNECT followed by FALLS (intervention), each delivered over 3 months. CONNECT used storytelling, relationship mapping, mentoring, self-monitoring, and feedback to help staff identify communication gaps and practice interaction strategies. FALLS included group training, modules, teleconferences, academic detailing, and audit and feedback. NH staff completed surveys about interactions at baseline, 3 months (immediately after CONNECT or control period), and 6 months (immediately after FALLS). A random sample of resident charts was abstracted for fall risk reduction documentation (n=651). Change in facility fall rates was an exploratory outcome. Focus groups were conducted to explore changes in organizational learning. Significant improvements in staff perceptions of communication quality, participation in decision-making, safety climate, caregiving quality, and use of local interaction strategies were observed in intervention community NHs (treatment-by-time effect P=.01) but not in VA NHs, where a ceiling effect was observed. Fall risk reduction documentation did not change significantly, and the direction of change in individual facilities did not relate to observed direction of change in fall rates. Fall rates did not change in control facilities (falls/bed per year: baseline, 2.61; after intervention, 2.64) but decreased by 12% in intervention facilities (falls/bed per year: baseline, 2.34; after intervention, 2.06); the effect of treatment on rate of change was 0.81 (95% confidence interval=0.55-1.20). CONNECT has the potential to improve care delivery in NHs, but the trend toward improving fall rates requires confirmation in a larger ongoing study. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Functional behavioral analysis and social scripting for the older patient with schizophrenia: a staff development program.

PubMed

Markwick, Laura; Smith, Charlene; Mick, Diane

2014-11-01

Executive functioning is the ability to plan, strategize, organize, and focus on details. Impaired executive functioning plays a significant role in behavior disturbances. Lack of inhibition, impaired abstract reasoning, thought perseverance, rigidity in routine, and lack of insight disrupt social skills and daily life. Autism and schizophrenia present some similar behaviors, including impaired executive functioning, often resulting in pharmacological management as many healthcare professionals receive limited training in executive functioning. Non-pharmacological tools used in autism for behavior management include functional behavioral analysis and social scripting, which help to identify causes of behavior and teach more appropriate behavioral responses. Described here is an educational program for healthcare workers in a long-term care skilled nursing facility, to help them understand the basis for behaviors in individuals with impaired executive function, to use these same tools for behavioral modification techniques, and to help patients learn more appropriate social skills. Program evaluation suggested the educational program was successful in increasing the staff's knowledge and comfort level in addressing the behavioral issues that arise with this population and staff also reported less use of medication as first-line treatment for behavioral issues.

The Poster Visits Nottingham Castle in England | Poster

Cancer.gov

By Nancy Parrish, Staff Writer Last September, Nadya Tarasova, Ph.D., head, Synthetic Biologics and Drug Discovery Facility, Cancer and Inflammation Program, traveled to Nottingham, England, where she was an invited speaker and chaired a session on JAK/STAT signaling in cancer at the second special meeting of the Federation of European Biochemical Societies (FEBS).

BDP Is Unified at the ATRF | Poster

Cancer.gov

By Ken Michaels, Staff Writer The Biopharmaceutical Development Program (BDP) at the Frederick National Laboratory is, for the first time ever, in a single building at the Advanced Technology Research Facility (ATRF). At Fort Detrick, BDP operations were spread out in about a dozen buildings, resulting in redundancies in maintaining various utilities (air handlers, clean

Chemicals in Schools: Solutions for Healthy School Environments. K-12 Schools

ERIC Educational Resources Information Center

US Environmental Protection Agency, 2006

2006-01-01

School leaders play a pivotal role in keeping schools safe from chemical accidents. Readers of this brochure can help schools develop a chemical cleanout and prevention program and assemble a team of teachers, facilities staff, and administrators with technical expertise to assess chemical safety issues and set policy. Some important team roles…

Voices from the Chalkface: Tutor Perceptions in Adult Education.

ERIC Educational Resources Information Center

Wilkinson, Graham

1996-01-01

A survey of 66 part-time tutors in Suffolk College's Community and Leisure Learning Program revealed that they spend considerable time in travel and preparation; more than one-third feel isolated and many coped with poor facilities and inadequate resources; and almost half indicated a need for subject-related staff development and subject-based…

Evaluation of Components of Residential Treatment by Medicaid ICF-MR Surveys: A Validity Assessment.

ERIC Educational Resources Information Center

Reid, Dennis H.; And Others

1991-01-01

Four studies found serious problems with components of the federal Medicaid program's survey process for evaluating intermediate care facilities for the mentally retarded--surveys did not discriminate between certified and noncertified units, direct-care staff behavior was very reactive to the survey's presence, and service providers had divergent…

2 CFR Appendix A to Part 225 - General Principles for Determining Allowable Costs

Code of Federal Regulations, 2013 CFR

2013-01-01

... in the financing of a particular program or project. The principles are designed to provide that... its own unique combination of staff, facilities, and experience, will have the primary responsibility... services may be allocated or billed to users. 5. “Claim” means a written demand or written assertion by the...

A Matter of Facts: The North Carolina Community College System Fact Book.

ERIC Educational Resources Information Center

North Carolina Community Coll. System, Raleigh.

Designed as a reference tool for administrators and policymakers, this handbook provides data on the entire North Carolina Community College System (NCCS). The five sections of this edition contain an introduction, program briefs, finance/facilities/equipment data, student data, and staff/faculty data. Section I covers the purpose, history,…

13 CFR 120.853 - Inspector General audits of CDCs.

Code of Federal Regulations, 2014 CFR

2014-01-01

... 13 Business Credit and Assistance 1 2014-01-01 2014-01-01 false Inspector General audits of CDCs... Development Company Loan Program (504) Other Cdc Requirements § 120.853 Inspector General audits of CDCs. The... Inspector General Act. The CDC must cooperate and make its staff, records, and facilities available. [68 FR...

13 CFR 120.853 - Inspector General audits of CDCs.

Code of Federal Regulations, 2011 CFR

2011-01-01

... 13 Business Credit and Assistance 1 2011-01-01 2011-01-01 false Inspector General audits of CDCs... Development Company Loan Program (504) Other Cdc Requirements § 120.853 Inspector General audits of CDCs. The... Inspector General Act. The CDC must cooperate and make its staff, records, and facilities available. [68 FR...

13 CFR 120.853 - Inspector General audits of CDCs.

Code of Federal Regulations, 2013 CFR

2013-01-01

... 13 Business Credit and Assistance 1 2013-01-01 2013-01-01 false Inspector General audits of CDCs... Development Company Loan Program (504) Other Cdc Requirements § 120.853 Inspector General audits of CDCs. The... Inspector General Act. The CDC must cooperate and make its staff, records, and facilities available. [68 FR...

13 CFR 120.853 - Inspector General audits of CDCs.

Code of Federal Regulations, 2010 CFR

2010-01-01

... 13 Business Credit and Assistance 1 2010-01-01 2010-01-01 false Inspector General audits of CDCs... Development Company Loan Program (504) Other Cdc Requirements § 120.853 Inspector General audits of CDCs. The... Inspector General Act. The CDC must cooperate and make its staff, records, and facilities available. [68 FR...

13 CFR 120.853 - Inspector General audits of CDCs.

Code of Federal Regulations, 2012 CFR

2012-01-01

... 13 Business Credit and Assistance 1 2012-01-01 2012-01-01 false Inspector General audits of CDCs... Development Company Loan Program (504) Other Cdc Requirements § 120.853 Inspector General audits of CDCs. The... Inspector General Act. The CDC must cooperate and make its staff, records, and facilities available. [68 FR...

Administrative Procedures for the Fort Lincoln Schools. Fort Lincoln New Town Education System.

ERIC Educational Resources Information Center

General Learning Corp., Washington, DC.

This is an operating manual for administration of the educational program to be used by the staff of the Fort Lincoln First Facility. It details specifications regarding information flow, storage, output, time cycles, staffing provisions, authority and responsibility provisions. An effort has been made to include those elements critical to…

Use of Assessment: A Collective Case Study of Museum Educators' Experiences

ERIC Educational Resources Information Center

Bonnell, Francoise Barnes

2013-01-01

Museums have been transformed from facilities once preoccupied with collecting and displaying artifacts to institutions now mostly focused on education. Museum educators have been added to museums' staff, and large amounts of money have been dedicated to adult and K-12 educational programming. Stakeholders have asked to see the impact of their…

Graduates | Argonne National Laboratory

Science.gov Websites

Staff Directory Argonne National Laboratory Educational Programs Connecting today's world-class research , Argonne is the place to be if you are a graduate student. With access to world-class facilities and world -reknowned researchers, graduate students at Argonne can taste the best of the research and development world

The Incident: It's 2pm on a Friday Afternoon...

ERIC Educational Resources Information Center

Grant, Frank

2002-01-01

A false allegation of sexual abuse at a residential outdoor education facility demonstrates why programs should have written policies and procedures directing staff how to respond to infatuations and "come-on" traps of young people; how to avoid bodily contact, being alone with a group, or dealing emotionally and physically with…

76 FR 72006 - Draft Interim Staff Guidance: Evaluations of Uranium Recovery Facility Surveys of Radon and Radon...

Federal Register 2010, 2011, 2012, 2013, 2014

2011-11-21

.... Discussion Uranium recovery facility licensees, including in-situ recovery facilities and conventional... Recovery Facility Surveys of Radon and Radon Progeny in Air and Demonstrations of Compliance AGENCY... Staff Guidance, ``Evaluations of Uranium Recovery Facility Surveys of Radon and Radon Progeny in Air and...

A cluster-randomised trial of staff education to improve the quality of life of people with dementia living in residential care: the DIRECT study.

PubMed

Beer, Christopher; Horner, Barbara; Flicker, Leon; Scherer, Samuel; Lautenschlager, Nicola T; Bretland, Nick; Flett, Penelope; Schaper, Frank; Almeida, Osvaldo P

2011-01-01

The Dementia In Residential care: EduCation intervention Trial (DIRECT) was conducted to determine if delivery of education designed to meet the perceived need of GPs and care staff improves the quality of life of participants with dementia living in residential care. This cluster-randomised controlled trial was conducted in 39 residential aged care facilities in the metropolitan area of Perth, Western Australia. 351 care facility residents aged 65 years and older with Mini-Mental State Examination ≤ 24, their GPs and facility staff participated. Flexible education designed to meet the perceived needs of learners was delivered to GPs and care facility staff in intervention groups. The primary outcome of the study was self-rated quality of life of participants with dementia, measured using the QOL-Alzheimer's Disease Scale (QOL-AD) at 4 weeks and 6 months after the conclusion of the intervention. Analysis accounted for the effect of clustering by using multi-level regression analysis. Education of GPs or care facility staff did not affect the primary outcome at either 4 weeks or 6 months. In a post hoc analysis excluding facilities in which fewer than 50% of staff attended an education session, self-rated QOL-AD scores were 6.14 points (adjusted 95%CI 1.14, 11.15) higher at four-week follow-up among residents in facilities randomly assigned to the education intervention. The education intervention directed at care facilities or GPs did not improve the quality of life ratings of participants with dementia as a group. This may be explained by the poor adherence to the intervention programme, as participants with dementia living in facilities where staff participated at least minimally seemed to benefit. ANZCTR.org.au ACTRN12607000417482.

The role of organizational culture in retaining nursing workforce.

PubMed

Banaszak-Holl, Jane; Castle, Nicholas G; Lin, Michael K; Shrivastwa, Nijika; Spreitzer, Gretchen

2015-06-01

We examined how organizational culture in nursing homes affects staff turnover, because culture is a first step to creating satisfactory work environments. Nursing home administrators were asked in 2009 to report on facility culture and staff turnover. We received responses from 419 of 1,056 administrators contacted. Respondents reported the strength of cultural values using scales from a Competing Values Framework and percent of staff leaving annually for Registered Nurse (RN), Licensed Practice Nurse (LPN), and nursing aide (NA) staff. We estimated negative binomial models predicting turnover.  Turnover rates are lower than found in past but remain significantly higher among NAs than among RNs or LPNs. Facilities with stronger market values had increased turnover among RNs and LPNs, and among NAs when turnover was adjusted for facilities with few staff. Facilities emphasizing hierarchical internal processes had lower RN turnover. Group and developmental values focusing on staff and innovation only lowered LPN turnover. Finally, effects on NA turnover become insignificant when turnover was adjusted if voluntary turnover was reported. Organizational culture had differential effects on the turnover of RN, LPN, and NA staff that should be addressed in developing culture-change strategies. More flexible organizational culture values were important for LPN staff only, whereas unexpectedly, greater emphasis on rigid internal rules helped facilities retain RNs. Facilities with a stronger focus on customer needs had higher turnover among all staff. © The Author 2013. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Working in small-scale, homelike dementia care: effects on staff burnout symptoms and job characteristics. A quasi-experimental, longitudinal study.

PubMed

Zwakhalen, Sandra Mg; Hamers, Jan Ph; van Rossum, Erik; Ambergen, Ton; Kempen, Gertrudis Ijm; Verbeek, Hilde

2018-05-01

This paper reports on a quasi-experimental, longitudinal study on the effects of working in a new type of dementia care facility (i.e. small-scale living facilities) on staff burnout symptoms and job characteristics (job autonomy, social support, physical demands and workload). It is hypothesised that nursing staff working in small-scale facilities experience fewer burnout symptoms, more autonomy and social support, and fewer symptoms of physical demands and workload compared with staff in regular wards. Two types of long-term institutional nursing care settings were included: 28 houses in small-scale living facilities and 21 regular psychogeriatric wards in nursing homes. At baseline and at follow-ups after 6 and 12 months nursing staff were assessed by means of self-report questionnaires. In total, 305 nursing staff members were included in the study, 114 working in small-scale living facilities (intervention group) and 191 in regular wards (control group). No overall effects on burnout symptoms were detected. Significantly fewer physical demands and lower workload were experienced by staff working in small-scale living facilities compared with staff in regular wards. They also experienced more job autonomy. No significant effect was found for overall social support in the total group. This study suggests positive effects of the work environment on several work characteristics. Organisational climate differs in the two conditions, which might account for our results. This may influence nursing staff well-being and has important implications for nursing home managers and policy makers. Future studies should enhance our understanding of the influence of job characteristics on outcomes.

Managing behavioural symptoms of dementia: effectiveness of staff education and peer support.

PubMed

Visser, S M; McCabe, M P; Hudgson, C; Buchanan, G; Davison, T E; George, K

2008-01-01

This study was designed to investigate the impact of staff education on the behaviour and quality of life of residents with dementia and on staff members' attitudes about working with people with dementia and level of burnout. Staff from three aged care facilities participated in the study (n=52). These facilities were randomly assigned to one of two intervention groups or a control group. Staff assigned to the intervention groups received an eight-week behaviourally-based programme. Staff from one aged care facility also participated in a peer support group designed to reinforce educational material and facilitate positive changes among staff members. Behavioural symptoms displayed by residents (n=76) in each of the facilities were also assessed. Assessments were conducted at pre-intervention, post-intervention, three- and six-month follow-up. The results of this study indicated that education or peer support was not associated with an improvement in resident behaviour or quality of life. Education or peer support also did not impact on staff members' level of burnout. There was, however, a change in staff members' attitudes about working with people with dementia. Possible explanations for these findings and implication for further research are considered.

ASC FY17 Implementation Plan, Rev. 1

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hamilton, P. G.

The Stockpile Stewardship Program (SSP) is an integrated technical program for maintaining the safety, surety, and reliability of the U.S. nuclear stockpile. The SSP uses nuclear test data, computational modeling and simulation, and experimental facilities to advance understanding of nuclear weapons. It includes stockpile surveillance, experimental research, development and engineering programs, and an appropriately scaled production capability to support stockpile requirements. This integrated national program requires the continued use of experimental facilities and programs, and the computational capabilities to support these programs. The Advanced Simulation and Computing Program (ASC) is a cornerstone of the SSP, providing simulation capabilities and computationalmore » resources that support annual stockpile assessment and certification, study advanced nuclear weapons design and manufacturing processes, analyze accident scenarios and weapons aging, and provide the tools to enable stockpile Life Extension Programs (LEPs) and the resolution of Significant Finding Investigations (SFIs). This requires a balance of resources, including technical staff, hardware, simulation software, and computer science solutions.« less

Mental Illness Training on the Internet for Nurse Aides: A Replication Study

PubMed Central

Irvine, A. Blair; Billow, Molly B.; McMahon, Edward; Eberhage, Mark G.; Seeley, John R.; Bourgeois, Michelle

2013-01-01

Internet training courses for Nurse Aides (NA) in long term care facilities (LTCs) have been shown to be effective., Little is known, however, about Internet training effects on NAs in a non-research context, or about continued utilization of an available training program. In this research, a replication study was conducted with the Internet training program Caring Skills: Working with Mental Illness. Three LTCs provided the training to all NAs, each within a one-month interval scheduled during consecutive months. Supervisors were interviewed subsequently about their experiences organizing and supervising the training. Participants in all three LTCs showed positive pre-posttests effects with large effect sizes on situational knowledge and self-efficacy, and knowledge about mental illness. Users rated the program highly, and they indicated that it would improve quality of their resident care. Supervisors praised the training, and they said NAs were using recommended training behaviors. Although available to all staff, nursing and other staff made little use of the training in subsequent months. Training for NAs on the internet thus appears feasible, and it is perceived to be beneficial for resident care. Plans for continued utilization and dissemination of best practices to other staff, however, should be integrated when planning for staff training on the Internet. PMID:23379724

Implementing a tobacco-free hospital campus in Ireland: lessons learned.

PubMed

McArdle, D; Kabir, Z

2018-05-01

The Irish Health Service Executive (HSE) had set a target that all HSE facilities should implement the HSE Tobacco Free Campus (TFC) policy by 2015. The aims of this study are to examine hospital staff awareness and to assess the progress of selected HSE health care facilities towards a TFC policy. Three health care facilities that were conveniently located were self-selected in County Cork, namely, an acute hospital, a mental health service and an older person's facility. Three different types of quantitative data were collected between May and September 2016 drawn on Standards 3, 4 and 5 of the European Network for Tobacco Free Health Care Services (ENSH-Global) tools: (1) face-to-face consultation with health care facility managers on their progress towards the HSE TFC policy, (2) self-administered questionnaire to a purposive sample of 153 staff members across three health care facilities and (3) physical observation of signs of smoking and smoking-related information across each health care facility for objective verification of compliance. Of the 153 staff who completed the questionnaire, 64% were females, 39% were nurses, 20% were smokers and 76% agreed with the TFC policy. However, only 26% of the 153 staff had received training on motivational and tobacco cessation techniques. Seventy-seven percent of the 153 staff stated that the campus was not tobacco-free. Physical observation suggested signs of smoking within the campus across all three health care facilities surveyed. Staff awareness of the HSE TFC policy across selected health care facilities in Ireland is positive but is not sufficient. There are gaps in the implementation process of the HSE TFC policy in the health care facilities. Therefore, proper communication on the importance of the ENSH-Global standards and cessation training to all staff is necessary to help reduce smoking rates across the health care facilities and also to move towards a Tobacco Free Campus in Ireland.

VA residential substance use disorder treatment program providers' perceptions of facilitators and barriers to performance on pre-admission processes.

PubMed

Ellerbe, Laura S; Manfredi, Luisa; Gupta, Shalini; Phelps, Tyler E; Bowe, Thomas R; Rubinsky, Anna D; Burden, Jennifer L; Harris, Alex H S

2017-04-04

In the U.S. Department of Veterans Affairs (VA), residential treatment programs are an important part of the continuum of care for patients with a substance use disorder (SUD). However, a limited number of program-specific measures to identify quality gaps in SUD residential programs exist. This study aimed to: (1) Develop metrics for two pre-admission processes: Wait Time and Engagement While Waiting, and (2) Interview program management and staff about program structures and processes that may contribute to performance on these metrics. The first aim sought to supplement the VA's existing facility-level performance metrics with SUD program-level metrics in order to identify high-value targets for quality improvement. The second aim recognized that not all key processes are reflected in the administrative data, and even when they are, new insight may be gained from viewing these data in the context of day-to-day clinical practice. VA administrative data from fiscal year 2012 were used to calculate pre-admission metrics for 97 programs (63 SUD Residential Rehabilitation Treatment Programs (SUD RRTPs); 34 Mental Health Residential Rehabilitation Treatment Programs (MH RRTPs) with a SUD track). Interviews were then conducted with management and front-line staff to learn what factors may have contributed to high or low performance, relative to the national average for their program type. We hypothesized that speaking directly to residential program staff may reveal innovative practices, areas for improvement, and factors that may explain system-wide variability in performance. Average wait time for admission was 16 days (SUD RRTPs: 17 days; MH RRTPs with a SUD track: 11 days), with 60% of Veterans waiting longer than 7 days. For these Veterans, engagement while waiting occurred in an average of 54% of the waiting weeks (range 3-100% across programs). Fifty-nine interviews representing 44 programs revealed factors perceived to potentially impact performance in these domains. Efficient screening processes, effective patient flow, and available beds were perceived to facilitate shorter wait times, while lack of beds, poor staffing levels, and lengths of stay of existing patients were thought to lengthen wait times. Accessible outpatient services, strong patient outreach, and strong encouragement of pre-admission outpatient treatment emerged as facilitators of engagement while waiting; poor staffing levels, socioeconomic barriers, and low patient motivation were viewed as barriers. Metrics for pre-admission processes can be helpful for monitoring residential SUD treatment programs. Interviewing program management and staff about drivers of performance metrics can play a complementary role by identifying innovative and other strong practices, as well as high-value targets for quality improvement. Key facilitators of high-performing facilities may offer programs with lower performance useful strategies to improve specific pre-admission processes.

Multidimensional team-based intervention using musical cues to reduce odds of facility-acquired pressure ulcers in long-term care: a paired randomized intervention study.

PubMed

Yap, Tracey L; Kennerly, Susan M; Simmons, Mark R; Buncher, Charles R; Miller, Elaine; Kim, Jay; Yap, Winston Y

2013-09-01

To test the effectiveness of a pressure ulcer (PU) prevention intervention featuring musical cues to remind all long-term care (LTC) staff (nursing and ancillary) to help every resident move or reposition every 2 hours. Twelve-month paired-facility two-arm (with one-arm crossover) randomized intervention trial. Ten midwestern U.S. LTC facilities. Four treatment facilities received intervention during Months 1 to 12, four comparison facilities received intervention during Months 7 to 12, and two pseudo-control facilities received no intervention. LTC facility residents (N = 1,928). All facility staff received in-person education, video, and handouts, and visiting family members received informational pamphlets on PU prevention and an intervention featuring musical cues. Nurse-led multidisciplinary staff teams presented the cues as prompts for staff and family to reposition residents or remind them to move. Musical selections (with and without lyrics) customized to facility preferences were played daily over the facility intercom or public address system every 2 hours for the 12-hour daytime period. Primary outcome measure was the frequency of new facility-acquired PUs divided by the total number of facility Minimum Data Set (MDS) resident assessments conducted during the study period. Odds of a new PU were lower in intervention facilities (P = .08) for MDS 2.0 assessments and were significantly lower (P = .05) for MDS 3.0. Mean odds ratios suggested intervention facility residents were 45% less likely than comparison facility residents to develop a new PU. Customized musical cues that prompt multidisciplinary staff teams to encourage or enable movement of all residents hold promise for reducing facility-acquired PUs in LTC settings. © 2013, Copyright the Authors Journal compilation © 2013, The American Geriatrics Society.

Long-term care survey reveals challenges. Facilities grapple with five broad issues, including changes in leadership and AIDS.

PubMed

Westhoff, L J; Schaefer, J C

1993-05-01

The Catholic Health Association's 1992 survey of Catholic long-term care (LTC) facilities identified five broad issues LTC facilities face in the 1990s: leadership, system affiliation, community programs, resident issues, and care of persons with AIDS. The transition to lay leadership presents new challenges to the relationship between LTC facilities and their sponsors. Despite the dominance of religious sponsors, an increasing number of laypersons are serving as healthcare administrators both in long-term and acute care. Thirty percent of respondents reported being affiliated with a multi-institutional system. This percentage has changed little in the past few years, although the number of facilities that are system members continues to increase at the fastest rate of any type of LTC facility. Only 27 percent of survey respondents said they provide educational or informational programs for persons in their communities. Thirty-nine percent of system-affiliated LTC facilities reported offering such programs. One encouraging finding shows that 80 percent of facilities have written policies for living wills, 64 percent for designated proxy, and 86 percent for durable power of attorney for healthcare. LTC providers are struggling to determine their role in caring for persons with HIV and AIDS. Only 3.6 percent of respondents care for residents with AIDS. A major problem LTC administrators face is a fear of potential infection of staff or residents.

Peer education programs in corrections: curriculum, implementation, and nursing interventions.

PubMed

Dubik-Unruh, S

1999-01-01

Despite the prevalence of HIV and other infectious diseases in U.S. prisons, and the mix of infected and high-risk prisoners in crowded and volatile living conditions, federal and state prisons have reduced or eliminated prevention education programs addressing HIV and other infectious diseases for incarcerated populations. Nurses' knowledge, education, and licensure place them in a position to influence prison policy in developing and implementing educational programs for inmates and staff. Their role as advocates for patients in prison and their separation from the more punitive aspects of corrections also enable nurses to earn the trust of inmate populations. These factors identify nurses as the staff best suited within corrections to implement inmate prevention education. Training inmate educators to provide peer prevention and strategies for risk reduction have potential to modify inmate behaviors both within the facility and following release. Selection criteria for peer educator recruitment, prison-sensitive issues, and suggested training activities are discussed.

Accounting for variations in ART program sustainability outcomes in health facilities in Uganda: a comparative case study analysis.

PubMed

Zakumumpa, Henry; Bennett, Sara; Ssengooba, Freddie

2016-10-18

Uganda implemented a national ART scale-up program at public and private health facilities between 2004 and 2009. Little is known about how and why some health facilities have sustained ART programs and why others have not sustained these interventions. The objective of the study was to identify facilitators and barriers to the long-term sustainability of ART programs at six health facilities in Uganda which received donor support to commence ART between 2004 and 2009. A case-study approach was adopted. Six health facilities were purposively selected for in-depth study from a national sample of 195 health facilities across Uganda which participated in an earlier study phase. The six health facilities were placed in three categories of sustainability; High Sustainers (2), Low Sustainers (2) and Non- Sustainers (2). Semi-structured interviews with ART Clinic managers (N = 18) were conducted. Questionnaire data were analyzed (N = 12). Document review augmented respondent data. Based on the data generated, across-case comparative analyses were performed. Data were collected between February and June 2015. Several distinguishing features were found between High Sustainers, and Low and Non-Sustainers' ART program characteristics. High Sustainers had larger ART programs with higher staffing and patient volumes, a broader 'menu' of ART services and more stable program leadership compared to the other cases. High Sustainers associated sustained ART programs with multiple funding streams, robust ART program evaluation systems and having internal and external program champions. Low and Non Sustainers reported similar barriers of shortage and attrition of ART-proficient staff, low capacity for ART program reporting, irregular and insufficient supply of ARV drugs and a lack of alignment between ART scale-up and their for-profit orientation in three of the cases. We found that ART program sustainability was embedded in a complex system involving dynamic interactions between internal (program champion, staffing strength, M &E systems, goal clarity) and external drivers (donors, ARVs supply chain, patient demand). ART program sustainability contexts were distinguished by the size of health facility and ownership-type. The study's implications for health systems strengthening in resource-limited countries are discussed.

The value of purpose built mental health facilities: Use of the Ward Atmosphere Scale to gauge the link between milieu and physical environment.

PubMed

Nicholls, Daniel; Kidd, Kevin; Threader, Jennifer; Hungerford, Catherine

2015-08-01

This study investigated changes in the 'atmosphere' of an acute adult mental health setting following relocation to a new purpose-built facility. The Ward Atmosphere Scale (WAS) was designed and validated for specific use in hospital-based psychiatric facilities, and measures several dimensions of an environment. In this study, the WAS was administered to consumers and staff at periods before and also after their relocation to a new purpose-built acute adult mental health facility. There were significant improvements in the physical atmosphere of the new facility, when compared with the old facility. In terms of ward atmosphere, however, improvements were seen to occur in only a small number of measures and there were minor differences between consumers' and staff perspectives on some indicators. Interestingly, it was found that consumers noted less 'staff control' in the new setting, raising the question of the differences in understanding of control. For staff only, there was a perception of greater levels of consumer 'involvement' in the new facility. Despite the minor differences in perception, the study does confirm that architecture is an important influence on the 'atmosphere' of a health facility, for both staff and consumers. © 2015 Australian College of Mental Health Nurses Inc.

Working in small-scale, homelike dementia care: effects on staff burnout symptoms and job characteristics. A quasi-experimental, longitudinal study

PubMed Central

Zwakhalen, Sandra MG; Hamers, Jan PH; van Rossum, Erik; Ambergen, Ton; Kempen, Gertrudis IJM; Verbeek, Hilde

2018-01-01

Aim This paper reports on a quasi-experimental, longitudinal study on the effects of working in a new type of dementia care facility (i.e. small-scale living facilities) on staff burnout symptoms and job characteristics (job autonomy, social support, physical demands and workload). Methods It is hypothesised that nursing staff working in small-scale facilities experience fewer burnout symptoms, more autonomy and social support, and fewer symptoms of physical demands and workload compared with staff in regular wards. Two types of long-term institutional nursing care settings were included: 28 houses in small-scale living facilities and 21 regular psychogeriatric wards in nursing homes. At baseline and at follow-ups after 6 and 12 months nursing staff were assessed by means of self-report questionnaires. In total, 305 nursing staff members were included in the study, 114 working in small-scale living facilities (intervention group) and 191 in regular wards (control group). Results No overall effects on burnout symptoms were detected. Significantly fewer physical demands and lower workload were experienced by staff working in small-scale living facilities compared with staff in regular wards. They also experienced more job autonomy. No significant effect was found for overall social support in the total group. Conclusions This study suggests positive effects of the work environment on several work characteristics. Organisational climate differs in the two conditions, which might account for our results. This may influence nursing staff well-being and has important implications for nursing home managers and policy makers. Future studies should enhance our understanding of the influence of job characteristics on outcomes. PMID:29805471

Preparedness of elderly long-term care facilities in HSE East for influenza outbreaks.

PubMed

O'Connor, L; Boland, M; Murphy, H

2015-01-01

Abstract We assessed preparedness of HSE East elderly long-term care facilities for an influenza outbreak, and identified Public Health Department support needs. We surveyed 166 facilities based on the HSE checklist document for influenza outbreaks, with 58% response rate. Client flu vaccination rates were > 75%; leading barriers were client anxiety and consent issues. Target flu vaccine uptake of 40% in staff occurred in 43% of facilities and was associated with staff vaccine administration by afacility-attached GP (p = 0.035), having a facility outbreak plan (p = 0.013) and being anon-HSE run facility (p = 0.013). Leading barriers were staff personal anxiety (94%) and lack of awareness of the protective effect on clients (21%). Eighty-nine percent found Public Health helpful, and requested further educational support and advocacy. Staff vaccine uptake focus, organisational leadership, optimal vaccine provision models, outbreak plans and Public Health support are central to the influenza campaign in elderly long-term care facilities.

We're not just playing games: Into aging--an aging simulation game.

PubMed

Dillon, Deborah; Ailor, Diane; Amato, Shelly

2009-01-01

The elderly represent the largest-growing segment of the population. Specialized training in geriatrics is essential for healthcare professionals to provide optimal health care. As part of an ongoing education program on geriatrics, the game Into Aging: Understanding Issues Affecting the Later Stages of Life, 2nd ed. (1991) was provided to staff members of a facility to help healthcare providers develop personal insight into the aging process through role play. This game has provided the staff members with a better understanding of the issues patients experience as they deal with declines in health.

Program and Management Support for the Office for Military Performance Assessment Technology

DTIC Science & Technology

1993-03-01

AD-A270 790 AD_ _ _ _ CONTRACT NO: DAMDI7-90-C-0061 TITLE: PROGRAM AND MANAGEMENT SUPPORT FOR THE OFFICE FOR MILITARY PERFORMANCE ASSESSMENT... the Office of Military Performance Assessment Technology (OMPAT). 1.1 Bag-kg n m. The OMPAT evolved from the Joint Working Group on Drug Dependent...facility was located, leased and occupied by Morgan Management Systems, Inc. staff and designated as the OMPAT Field Office. The office was located at 12075B

Relationship between staff-reported culture change and occupancy rate and organizational commitment among nursing homes in South Korea.

PubMed

Lee, Minhong; Choi, Jae-Sung; Lim, Jinseop; Kim, Young Sun

2013-04-01

This study aims to examine culture change in nursing homes in South Korea and to identify the outcomes of culture change implementation. Data were taken from survey responses from 223 top- or mid-level staff among nursing homes in South Korea that were selected through a proportionate random-stratified sampling method from four regions nationwide. Culture change in nursing homes was operationalized by five person-directed care (PDC) constructs and three organizational environment constructs, and outcome quality was indicated by changes to occupancy rate and organizational commitment. After controlling for facility characteristics, the effect of staff-reported culture change on occupancy rate and organizational commitment was analyzed through the multiple-regression method. Consistent with previous research, this study revealed positive effects of culture change for nursing homes in South Korea. The study found that staff-reported culture change correlated with occupancy rate and organizational commitment. Given that culture change variables were significantly related to occupancy rate and organizational commitment, the findings of the study provide a persuasive argument that policies and/or programs to support culture change in nursing homes should be enhanced. Management-level workers in these facilities should have the skills and knowledge to foster more PDC and a more person-directed environment.

UNAVCO's Education and Community Engagement Program: Evaluating Five years of Geoscience Education and Community Outreach

NASA Astrophysics Data System (ADS)

Charlevoix, D. J.; Dutilly, E.

2017-12-01

In 2013, UNAVCO, a facility co-sponsored by the NSF and NASA, received a five-year award from the NSF: Geodesy Advancing Geosciences and EarthScope (GAGE). Under GAGE, UNAVCO's Education and Community Engagement (ECE) program conducts outreach and education activities, in essence broader impacts for the scientific community and public. One major challenge of this evaluation was the breadth and depth of the dozens of projects conducted by the ECE program under the GAGE award. To efficiently solve this problem of a large-scale program evaluation, we adopted a deliberative democratic (DD) approach that afforded UNAVCO ECE staff a prominent voice in the process. The evaluator directed staff members to chose the projects they wished to highlight as case studies of their finest broader impacts work. The DD approach prizes inclusion, dialogue, and deliberation. The evaluator invited ECE staff to articulate qualities of great programs and develop a case study of their most valuable broader impacts work. To anchor the staff's opinion in more objectivity than opinion, the evaluator asked each staff member to articulate exemplary qualities of their chosen project, discuss how these qualities fit their case study, and helped staff to develop data collection systems that lead to an evidence-based argument in support of their project's unique value. The results of this evaluation show that the individual ECE work areas specialized in certain kinds of projects. However, when viewed at the aggregate level, ECE projects spanned almost the entire gamut of NSF broader impacts categories. Longitudinal analyses show that since the beginning of the GAGE award, many projects grew in impact from year 1 to year 5. While roughly half of the ECE projects were prior work projects, by year five at least 33% of projects were newly developed under GAGE. All selected case studies exemplified how education and outreach work can be productively tied to UNAVCO's core mission of promoting geodesy.

Acoustics Division recent accomplishments and research plans

NASA Technical Reports Server (NTRS)

Clark, L. R.; Morgan, H. G.

1986-01-01

The research program currently being implemented by the Acoustics Division of NASA Langley Research Center is described. The scope, focus, and thrusts of the research are discussed and illustrated for each technical area by examples of recent technical accomplishments. Included is a list of publications for the last two calendar years. The organization, staff, and facilities are also briefly described.

A Mathematical Model for Allocation of School Resources to Optimize a Selected Output.

ERIC Educational Resources Information Center

McAfee, Jackson K.

The methodology of costing an education program by identifying the resources it utilizes places all costs within the framework of staff, equipment, materials, facilities, and services. This paper suggests that this methodology is much stronger than the more traditional budgetary and cost per pupil approach. The techniques of data collection are…

Implementation of Systematic Instruction to Increase Client Engagement in a Day Habilitation Program

ERIC Educational Resources Information Center

Crites, Steven A.; Howard, Barbara H.

2011-01-01

Background: Individuals with severe disability exiting school are likely to be enrolled in day activity and sheltered workshops at least as often as in supported employment. Such facilities are often staffed by paraprofessionals who may not have the skills to engage clients in meaningful activities. This article describes a 3-phase staff training…

For support of USAMRMC Biological Weapons Convention, treaty and statement implementation activities. Final report, 1 March 1996-28 February 1997

DOE Office of Scientific and Technical Information (OSTI.GOV)

Fox, J.

Program of work to provide support to the Biological Arms Control Treaty Office (BACTO) of the U.S. Army Medical Research and Material Command (USAMRMC), in the development of Army and U.S. Government negotiation, implementation and compliance policies and preparations regarding potential verification and confidence measures for the 1975 Biological Weapons Convention (BWC) and related biological weapons agreements. Support services provided included the preparation of Army installations and commands for implementation of visits pursuant to the U.S./UK/Russian Trilateral Statement on BW. Support included site assistance visit, development of required facility documentation and briefings, identification of additional facilities potentially subject to access,more » and support to DOD development of guidelines, procedures, documentation, and other materials for the conduct of visits. Specific tasks under this contract included: identification and delineation of `Military Biological Facilities` and related activities at Army installations; development of visit implementation documentation for the Army; assessment of potentially at-risk equities and sensitivities at relevant facilities; facility staff training and preparation; and review and modification of facility inputs to annual BWC Confidence Building Measure Declarations. Also supported the provision of timely and critical technical support to the Joint Staff and OSD in the development of DoD negotiation biological arms control positions.« less

Implementation of systematic instruction to increase client engagement in a day habilitation program.

PubMed

Crites, Steven A; Howard, Barbara H

2011-03-01

Individuals with severe disability exiting school are likely to be enrolled in day activity and sheltered workshops at least as often as in supported employment. Such facilities are often staffed by paraprofessionals who may not have the skills to engage clients in meaningful activities. This article describes a 3-phase staff training project designed to increase client engagement in an adult habilitation centre. The first phase of the project was to develop curriculum guidelines. The second phase was conducting a series of training for paraprofessional staff. And the third was the implementation of the clinical experience. The first author conducted a graduate level methods class on site at the adult habilitation centre. Staff participants (paraprofessional staff, supervisors, and graduate students) learned the components of systematic instruction and developed and implemented activities for clients. Engagement was measured before and after the 5-week clinical experience. The engagement of clients increased with the implementation of systematic instruction following staff training. The implications are discussed.

Some Factors Influencing Effective Utilization of Drinking Water Facilities: Women, Income, and Health in Rural North Ghana

NASA Astrophysics Data System (ADS)

Kendie, S. B.

1996-01-01

In the examination of the implementation of rural drinking water facilities, not enough attention has been paid to analyzing the socioeconomic and political relationships that affect the effective utilization of the facilities, particularly as these relate to women in rural society. This paper suggests that much of the difficulty in instituting the utilization of safe water supply sources has to do with the rather low economic status of women—the main water collectors. Poverty consigns women to long periods of work in activities or jobs that bring little reward. This makes it difficult to effectively digest the messages delivered by program staff and limits the extent of usage of the safe water facilities.

Helping people in a minimally conscious state develop responding and stimulation control through a microswitch-aided program.

PubMed

Lancioni, Giulio E; Singh, Nirbhay N; O'Reilly, Mark F; Sigafoos, Jeff; D'Amico, Fiora; Buonocunto, Francesca; Navarro, Jorge; Lanzilotti, Crocifissa; Fiore, Pietro; Megna, Marisa; Damiani, Sabino; Marvulli, Riccardo

2017-06-01

Postcoma persons in a minimally conscious state (MCS) and with extensive motor impairment cannot independently access and control environmental stimulation. Assessing the effects of a microswitch-aided program aimed at helping MCS persons develop responding and stimulation control and conducting a social validation/evaluation of the program. A single-subject ABAB design was used for each participant to determine the impact of the program on his or her responding. Staff interviews were used for the social validation/evaluation of the program. Rehabilitation and care facilities that the participants attended. Eleven MCS persons with extensive motor impairment and lack of speech or any other functional communication. For each participant, baseline (A) phases were alternated with intervention (B) phases during which the program was used. The program relied on microswitches to monitor participants' specific responses (e.g., prolonged eyelid closures) and on a computer system to enable those responses to control stimulation. In practice, the participants could use a simple response such as prolonged eyelid closure to generate a new stimulation input. Sixty-six staff people took part in the social validation of the program. They were to compare the program to basic and elaborate forms of externally controlled stimulation, scoring each of them on a six-item questionnaire. All participants showed increased response frequencies (and thus higher levels of independent stimulation input/control) during the B phases of the study. Their frequencies for each intervention phase more than doubled their frequencies for the preceding baseline phase with the difference between the two being clearly significant (P<0.01). Staff involved in the social validation procedure provided significantly higher scoring (P<0.01) for the program on five of the six questionnaire items. A microswitch-aided program can be an effective and socially acceptable tool in the work with MCS persons. The participants and staff's data can be taken as an encouragement for the use of a microswitch-aided program within care and rehabilitation settings for MCS persons.

Implementation of 5S management method for lean healthcare at a health center in Senegal: a qualitative study of staff perception.

PubMed

Kanamori, Shogo; Sow, Seydou; Castro, Marcia C; Matsuno, Rui; Tsuru, Akiko; Jimba, Masamine

2015-01-01

5S is a lean method for workplace organization; it is an abbreviation representing five Japanese words that can be translated as sort, set in order, shine, standardize, and sustain. The 5S management method has been recognized recently as a potential solution for improving the quality of government healthcare services in low- and middle-income countries. To assess how the 5S management method creates changes in the workplace and in the process and outcomes of healthcare services, and how it can be applicable in a resource-poor setting, based on data from a pilot intervention of the 5S program implemented in a health facility in Senegal. In this qualitative study, we interviewed 21 health center staff members 1 year after the pilot intervention. We asked them about their views on the changes brought on by the 5S program in their workplace, daily routines, and services provided. We then transcribed interview records and organized the narrative information by emerging themes using thematic analysis in the coding process. Study participants indicated that, despite resource constraints and other demotivating factors present at the health center, the 5S program created changes in the work environment, including fewer unwanted items, improved orderliness, and improved labeling and directional indicators of service units. These efforts engendered changes in the quality of services (e.g. making services more efficient, patient-centered, and safe), and in the attitude and behavior of staff and patients. The pilot intervention of the 5S management method was perceived to have improved the quality of healthcare services and staff motivation in a resource-poor healthcare facility with a disorderly work environment in Senegal. Quantitative and qualitative research based on a larger-scale intervention would be needed to elaborate and validate these findings and to identify the cost-effectiveness of such intervention in low- and middle-income countries.

Implementation of 5S management method for lean healthcare at a health center in Senegal: a qualitative study of staff perception

PubMed Central

Kanamori, Shogo; Sow, Seydou; Castro, Marcia C.; Matsuno, Rui; Tsuru, Akiko; Jimba, Masamine

2015-01-01

Background 5S is a lean method for workplace organization; it is an abbreviation representing five Japanese words that can be translated as sort, set in order, shine, standardize, and sustain. The 5S management method has been recognized recently as a potential solution for improving the quality of government healthcare services in low- and middle-income countries. Objective To assess how the 5S management method creates changes in the workplace and in the process and outcomes of healthcare services, and how it can be applicable in a resource-poor setting, based on data from a pilot intervention of the 5S program implemented in a health facility in Senegal. Design In this qualitative study, we interviewed 21 health center staff members 1 year after the pilot intervention. We asked them about their views on the changes brought on by the 5S program in their workplace, daily routines, and services provided. We then transcribed interview records and organized the narrative information by emerging themes using thematic analysis in the coding process. Results Study participants indicated that, despite resource constraints and other demotivating factors present at the health center, the 5S program created changes in the work environment, including fewer unwanted items, improved orderliness, and improved labeling and directional indicators of service units. These efforts engendered changes in the quality of services (e.g. making services more efficient, patient-centered, and safe), and in the attitude and behavior of staff and patients. Conclusions The pilot intervention of the 5S management method was perceived to have improved the quality of healthcare services and staff motivation in a resource-poor healthcare facility with a disorderly work environment in Senegal. Quantitative and qualitative research based on a larger-scale intervention would be needed to elaborate and validate these findings and to identify the cost-effectiveness of such intervention in low- and middle-income countries. PMID:25854781

Feedback Survey of the Effect, Burden, and Cost of the National Endoscopic Quality Assessment Program during the Past 5 Years in Korea.

PubMed

Cho, Yu Kyung; Moon, Jeong Seop; Han, Dong Su; Lee, Yong Chan; Kim, Yeol; Park, Bo Young; Chung, Il-Kwun; Kim, Jin-Oh; Im, Jong Pil; Cha, Jae Myung; Kim, Hyun Gun; Lee, Sang Kil; Lee, Hang Lak; Jang, Jae Young; Kim, Eun Sun; Jung, Yunho; Moon, Chang Mo

2016-11-01

In Korea, the nationwide gastric cancer screening program recommends biennial screening for individuals aged 40 years or older by way of either an upper gastrointestinal series or endoscopy. The national endoscopic quality assessment (QA) program began recommending endoscopy in medical institutions in 2009. We aimed to assess the effect, burden, and cost of the QA program from the viewpoint of medical institutions. We surveyed the staff of institutional endoscopic units via e-mail. Staff members from 67 institutions replied. Most doctors were endoscopic specialists. They responded as to whether the QA program raised awareness for endoscopic quality (93%) or improved endoscopic practice (40%). The percentages of responders who reported improvements in the diagnosis of gastric cancer, the qualifications of endoscopists, the quality of facilities and equipment, endoscopic procedure, and endoscopic reprocessing were 69%, 60%, 66%, 82%, and 75%, respectively. Regarding reprocessing, many staff members reported that they had bought new automated endoscopic preprocessors (3%), used more disinfectants (34%), washed endoscopes longer (28%), reduced the number of endoscopies performed to adhere to reprocessing guidelines (9%), and created their own quality education programs (59%). Many responders said they felt that QA was associated with some degree of burden (48%), especially financial burden caused by purchasing new equipment. Reasonable quality standards (45%) and incentives (38%) were considered important to the success of the QA program. Endoscopic quality has improved after 5 years of the mandatory endoscopic QA program.

Evaluation of the US Department of Energy's occupational safety and health program for its government-owned contractor-operated facilities

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

The purpose of this report is to present to Secretary of Energy James Watkins the findings and recommendations of the Occupational Safety and Health Administration's (OSHA) evaluation of the Department of Energy's (DOE) programs for worker safety and health at DOE's government-owned contractor-operated (GOCO) nuclear facilities. The OSHA evaluation is based on an intensive and comprehensive review and analysis of DOE's worker safety and health programs including: written programs; safety and health inspection programs; and the adequacy of resource, training, and management controls. The evaluation began on April 10, 1990 and involved over three staff years before its conclusion. Themore » evaluation was initiated by former Secretary of Labor Elizabeth Dole in response to Secretary of Energy James Watkins' request that OSHA assist him in determining the actions needed to assure that DOE has an exemplary safety and health program in place at its GOCOs. 6 figs.« less

Operational Philosophy for the Advanced Test Reactor National Scientific User Facility

DOE Office of Scientific and Technical Information (OSTI.GOV)

J. Benson; J. Cole; J. Jackson

2013-02-01

In 2007, the Department of Energy (DOE) designated the Advanced Test Reactor (ATR) as a National Scientific User Facility (NSUF). At its core, the ATR NSUF Program combines access to a portion of the available ATR radiation capability, the associated required examination and analysis facilities at the Idaho National Laboratory (INL), and INL staff expertise with novel ideas provided by external contributors (universities, laboratories, and industry). These collaborations define the cutting edge of nuclear technology research in high-temperature and radiation environments, contribute to improved industry performance of current and future light-water reactors (LWRs), and stimulate cooperative research between user groupsmore » conducting basic and applied research. To make possible the broadest access to key national capability, the ATR NSUF formed a partnership program that also makes available access to critical facilities outside of the INL. Finally, the ATR NSUF has established a sample library that allows access to pre-irradiated samples as needed by national research teams.« less

Point-of-care: being a pilot site. Interview by Bill W. Childs.

PubMed

Bills, J

1988-11-01

Scripps Memorial Hospital in Chula Vista, CA, a 159-bed acute care facility, opened in 1964. The facility was acquired in 1986 by the Scripps Memorial Hospitals family which has acute care facilities in La Jolla, Encinitas and Chula Vista, CA. Prior to 1986, the hospital was in severe financial difficulty and was very near to closing its doors. With the help of an excellent group of employees and medical staff, Scripps Memorial Hospital--Chula Vista has made significant changes in all aspects of the operation. The CliniCom pilot program is only one of many changes the hospital has introduced in its effort to continue its role as a major healthcare provider in the South Bay area of San Diego. Scripps Memorial Hospital--Chula Vista is a very active facility with 85 percent occupancy, 32,000 emergency visits and 4,200 deliveries a year. The hospital is planning an expansion program to meet the current and future needs of the community.

Readiness for Implementation of Lung Cancer Screening. A National Survey of Veterans Affairs Pulmonologists.

PubMed

Tukey, Melissa H; Clark, Jack A; Bolton, Rendelle; Kelley, Michael J; Slatore, Christopher G; Au, David H; Wiener, Renda Soylemez

2016-10-01

To mitigate the potential harms of screening, professional societies recommend that lung cancer screening be conducted in multidisciplinary programs with the capacity to provide comprehensive care, from screening through pulmonary nodule evaluation to treatment of screen-detected cancers. The degree to which this standard can be met at the national level is unknown. To assess the readiness of clinical facilities in a national healthcare system for implementation of comprehensive lung cancer screening programs, as compared with the ideal described in policy recommendations. This was a cross-sectional, self-administered survey of staff pulmonologists in pulmonary outpatient clinics in Veterans Health Administration facilities. The facility-level response rate was 84.1% (106 of 126 facilities with pulmonary clinics); 88.7% of facilities showed favorable provider perceptions of the evidence for lung cancer screening, and 73.6% of facilities had a favorable provider-perceived local context for screening implementation. All elements of the policy-recommended infrastructure for comprehensive screening programs were present in 36 of 106 facilities (34.0%); the most common deficiencies were the lack of on-site positron emission tomography scanners or radiation oncology services. Overall, 26.5% of Veterans Health Administration facilities were ideally prepared for lung cancer screening implementation (44.1% if the policy recommendations for on-site positron emission tomography scanners and radiation oncology services were waived). Many facilities may be less than ideally positioned for the implementation of comprehensive lung cancer screening programs. To ensure safe, effective screening, hospitals may need to invest resources or coordinate care with facilities that can offer comprehensive care for screening through downstream evaluation and treatment of screen-detected cancers.

Effectiveness of interventions to improve family-staff relationships in the care of people with dementia in residential aged care: a systematic review protocol.

PubMed

Nguyen, Mynhi; Pachana, Nancy A; Beattie, Elizabeth; Fielding, Elaine; Ramis, Mary-Anne

2015-11-01

The objective of this review is to identify and appraise existing evidence regarding the effectiveness of interventions designed to enhance staff-family relationships for people with dementia living in residential aged care facilities.More specifically, the objectives are to identify the effectiveness of constructive communication, cooperation programs, and practices or strategies to enhance family-staff relationships. The effectiveness of these interventions will be measured by comparing the intervention to no intervention, comparing one intervention with another, or comparing pre- and post-interventions.Specifically the review question is: What are the most effective interventions for improving communication and cooperation to enhance family-staff relationships in residential aged care facilities? In our aging world, dementia is prevalent and is a serious health concern affecting approximately 35.6 million people worldwide. This figure is expected to increase two-fold by 2030 and three-fold by 2050. Although younger-onset dementia is increasingly recognized, dementia is most commonly a disease that affects the elderly. Among those aged 65 to 85, the prevalence of dementia increases exponentially, and doubles with every five-year increase in age.Dementia is defined as a syndrome, commonly chronic or progressive in nature, and caused by a range of brain disorders that affect memory, thinking and the ability to perform activities of daily living. While the rate of progression and manifestation of decline differs, all cases of dementia share a similar trajectory of decline. The progressive decline in cognitive functions and ultimately physical function that these people face affects not only the person with the disease but also their family caregivers and health care staff.The manifestation of dementia presents unique and extreme challenges for the family caregiver. Generally it causes great physical, emotional and social strain because the caregiving process is long in duration, unfamiliar, unpredictable and ambiguous. In the later stages of dementia, many family caregivers relocate their relative to a residential aged care facility, most often when the burden of care outweighs the means of the caregiver. This is especially likely when the person with dementia ages, and has lower cognitive function increased limitations in activities in daily living and poorer self-related health. As a result, approximately 50% of all persons aged 65 years or over admitted into residential aged care facilities have dementia.The relocation of a relative into a residential aged care facility can be complex and distressing for family caregivers. While relocation alleviates many issues for the family caregiver, it does not consequently reduce their stress. The stress experienced by the family caregivers who remain involved post-relocation often continues and may even worsen. This is because family caregivers are uncertain about how to transition from a direct caregiving role to a more indirect, supportive interpersonal role, and may be provided with little support from care staff in this regard. Although family caregivers experience a new form of stress post-relocation, family involvement in residential aged care settings has been shown to be beneficial to residents with dementia, their families and care staff.Family involvement is widely acknowledged to provide the resident physical and emotional healing, optimal well-being, and the sustainment of quality of life. Family caregivers benefit from improved satisfaction with the facility and experiences of care, and greater well-being. Care staff benefit from enhanced job satisfaction and greater motivation to remain in their job. The key to these positive outcomes is effective communication and strong relationships between care staff and family caregivers.Effective communication between care staff and family caregivers is crucial for residents with dementia. This is because residents with cognitive impairment may have difficulties articulating their needs, concerns and preferences effectively. Family caregivers rely on staff for information about their relative's behavior in the residential aged care facility; however they themselves have in-depth information about the resident's physical, psychosocial and emotional histories that are necessary for developing individualized care support plans. Family involvement can support care staff in reducing residents' behavioral symptoms by assisting to identify social and emotional needs, or unmet medical needs. Ineffective communication from family caregivers in conveying information to care staff may be disruptive in the caregiving process, and may lead to disagreement regarding respective roles and approaches to caring for the resident. Consequently, family caregivers may withhold information that may support care staff and improve care. They may also be concerned about negative repercussions for the resident.Care staff and family caregivers generally have differing needs and expectations. Care staff are usually in the position where they have to manage a relationship with the family, which is based on multiple roles. Perceptions of family caregivers by care staff include seeing them as colleagues, subordinates, or people who themselves may be in need of nursing care. These different perceptions lead to role ambiguity and result in separate approaches to the caregiving process.Cohen et al. suggest in their study that family involvement can benefit people with dementia in residential aged care settings, their family carers and staff; however further research is required. The relationship between care staff and family caregivers is often challenging due to problems with communication, role ambiguity of both care staff and family carers, and differing approaches to caring for the resident. These problems highlight the need for interventions to constructively enhance the quality of family-staff relationships. For example, one intervention called Partners and Caregiving has been reported as being designed to increase cooperation and effective communication between staff and family. In this study, staff and family members were randomly subjected to treatment and control conditions. The treatment group received parallel training sessions on communication and conflict resolution techniques, followed by a joint meeting with the facility administrators. The results of the study demonstrated improved outcomes in the form of improved attitudes of staff and family members towards each other, less conflict between family and staff, and fewer intentions of staff to quit. Further research is vital in order to identify effective family-staff intervention studies that can provide directions for implementation in residential aged care facilities. Furthermore, it is equally important to identify interventions that are ineffective, so as to provide insights into potential pitfalls to avoid in order to improve staff and family members' relationships and the provision of care to people living with dementia in the future.Previous systematic reviews have focused on factors associated with constructive family-staff relationships in caring for older adults in the institutional setting and the family's involvement in decision making for people with dementia in residential aged care facilites. This review will however specifically investigate interventions for improving communication and cooperation that promote effective family-staff relationships when caring for people with dementia living in residential aged care facilities.

The role of interventional patient hygiene in improving clinical and economic outcomes.

PubMed

Carr, Devin; Benoit, Richard

2009-02-01

To successfully educate, integrate, and empower nonlicensed personnel in the surgical intensive care unit in the use of a skin care protocol to maintain and improve skin integrity. Observational intervention study. Surgical intensive care unit. Data related to alterations in skin integrity were collected over 4 months, representing approximately 2000 patient-days. A total of 97 specific events representing 121 "areas of concern" were identified by nonlicensed personnel. Nonlicensed staff members' knowledge in 6 key areas related to pressure ulcer (PrU) development was surveyed before and after implementation of an interventional patient hygiene (IPH) program incorporating comprehensive bathing and incontinence protocols. A unique point-of-use skin inspection tool was used by nonlicensed personnel to communicate areas of concern to licensed personnel (registered nurses [RNs]). Reduction in PrUs and improvement in nonlicensed staff knowledge of facility protocols. Incidence of new PrUs decreased from 7.14% at baseline to 0% at the end of the study. Nonlicensed staff knowledge increased to 100% in all 6 knowledge areas. Implementation of an IPH program incorporating comprehensive bathing and incontinence management resulted in enhanced communication between nonlicensed staff and RNs as well as improved patient outcomes.

Current status and standards for establishment of hemodialysis units in Korea

PubMed Central

Lee, Young-Ki; Kim, Kiwon

2013-01-01

The number of hemodialysis patients and dialysis facilities is increasing each year, but there are no surveillance programs validating that the services and equipment of each hemodialysis unit meet specified safety and quality standards. There is a concern that excessive competition and illegal activities committed by some dialysis facilities may violate patients' right to health. Contrastingly, developed countries often have their own survey program to provide initial certification and monitoring to ensure that these clinics continue to meet basic requirements. Because hemodialysis units provide renal replacement therapy to critical patients suffering from severe chronic renal failure, appropriate legal regulation is important for the provision of initial certification and maintenance of facility, equipment, and human resource quality. Therefore, several standards providing minimum requirements for the area of hemodialysis unit, equipment for emergency care, physician and nurse staffs, water purification and quality management are urgently needed. PMID:23682218

The use of NUREGs 1199 and 1200 in the Illinois LLW licensing program

DOE Office of Scientific and Technical Information (OSTI.GOV)

Klinger, J.G.; Harmon, D.F.

1991-12-31

This paper will describe how the LLW licensing staff of the Illinois Department of Nuclear Safety used NRC`s NUREG 1199, NUREG 1200, NUREG 1300 and Regulatory Guide 4.18 in its licensing program for reviewing and evaluating a LLW disposal facility license application. The paper will discuss how Illinois guidance documents were prepared based on modifications made to these NRC documents which were necessary to take into account site and facility specific considerations, as well as changes required by Illinois statutes and regulatory codes. The paper will review the recent revisions (January 1991) to NUREG 1199 and 1200 and the importancemore » of these revisions. The paper will also discuss recommended modifications to these NRC documents and provide an update on the status of the Department`s review and evaluation of an application for a license to site, construct and operate a LLW disposal facility in Illinois.« less

Explaining the heterogeneity in average costs per HIV/AIDS patient in Nigeria: The role of supply-side and service delivery characteristics

PubMed Central

Amanze, Ogbonna O.; La Hera-Fuentes, Gina; Silverman-Retana, Omar; Contreras-Loya, David; Ashefor, Gregory A.; Ogungbemi, Kayode M.

2018-01-01

Objective We estimated the average annual cost per patient of ART per facility (unit cost) in Nigeria, described the variation in costs across facilities, and identified factors associated with this variation. Methods We used facility-level data of 80 facilities in Nigeria, collected between December 2014 and May 2015. We estimated unit costs at each facility as the ratio of total costs (the sum of costs of staff, recurrent inputs and services, capital, training, laboratory tests, and antiretroviral and TB treatment drugs) divided by the annual number of patients. We applied linear regressions to estimate factors associated with ART cost per patient. Results The unit ART cost in Nigeria was $157 USD nationally and the facility-level mean was $231 USD. The study found a wide variability in unit costs across facilities. Variations in costs were explained by number of patients, level of care, task shifting (shifting tasks from doctors to less specialized staff, mainly nurses, to provide ART) and provider´s competence. The study illuminated the potentially important role that management practices can play in improving the efficiency of ART services. Conclusions Our study identifies characteristics of services associated with the most efficient implementation of ART services in Nigeria. These results will help design efficient program scale-up to deliver comprehensive HIV services in Nigeria by distinguishing features linked to lower unit costs. PMID:29718906

Addressing Smoking in Supported Residential Facilities for People with Severe Mental Illness: Has Any Progress Been Achieved?

PubMed Central

Lawn, Sharon; Lucas, Teri

2016-01-01

Background: Smoking rates for people with severe mental illness have remained high despite significant declines in smoking rates in the general population, particularly for residents of community supported residential facilities (SRFs) where smoking has been largely neglected and institutionalized. Methods: Two studies undertaken 10 years apart (2000 and 2010) with SRFs in Adelaide, Australia looked at historical trends to determine whether any progress has been made to address smoking for this population. The first study was ethnographic and involved narrative description and analysis of the social milieu of smoking following multiple observations of smoking behaviours in two SRFs. The second study involved an eight-week smoking cessation group program providing tailored support and free nicotine replacement therapy to residents across six SRFs. Changes in smoking behaviours were measured using pre and post surveys with residents, with outcomes verified by also seeking SRF staff and smoking cessation group facilitator qualitative feedback and reflection on their observations of residents and the setting. Results: The culture of smoking in mental health SRFs is a complex part of the social milieu of these settings. There appears to have been little change in smoking behaviours of residents and attitudes and support responses by staff of SRFs since 2000 despite smoking rates declining in the general community. Tailored smoking cessation group programs for this population were well received and did help SRF residents to quit or cut down their smoking. They did challenge staff negative attitudes to residents’ capacity to smoke less or quit. Conclusions: A more systematic approach that addresses SRF regulations, smoke-free policies, staff attitudes and training, and consistent smoking cessation support to residents is needed. PMID:27735881

The effects of restorative care training on caregiver job satisfaction.

PubMed

Walker, Bonnie L; Harrington, Susan S

2013-01-01

The job satisfaction of assisted living facility staff was examined as part of an evaluation study of a restorative care training program. Participants completed a job satisfaction survey at registration (before the training) and again at follow-up 3 months after registration (1 month after the conclusion of the training). Researchers examined the effects of training on job satisfaction. Researchers found a high level of job dissatisfaction at registration. At follow-up, responses were more positive on most of the items suggesting a slight but significant change to a more positive attitude toward their jobs. Improving staff job satisfaction in the assisted living environment is an important goal and needs further investigation. Providing staff with inservice training may be one way to help nurse educators achieve that goal.

Smoking Behaviors and Attitudes Among Clients and Staff at New York Addiction Treatment Programs Following a Smoking Ban: Findings After 5 Years.

PubMed

Pagano, Anna; Guydish, Joseph; Le, Thao; Tajima, Barbara; Passalacqua, Emma; Soto-Nevarez, Arturo; Brown, Lawrence S; Delucchi, Kevin L

2016-05-01

Addiction treatment clients are more likely to die of tobacco-related diseases than of alcohol or illicit drug-related causes. We aimed to assess smoking behavior, and smoking-related attitudes and services, in New York addiction treatment programs before a statewide smoking ban in treatment facilities was implemented (2008), 1 year (2009) and 5 years after implementation (2013). We conducted surveys at each time point with clients (N = 329, 341, and 353, respectively) and staff (N = 202, 203, and 166, respectively) from five residential and two methadone maintenance programs in New York State. At each data collection wave, questionnaires measured smoking behavior as well as smoking-related knowledge, attitudes, and experiences with tobacco cessation services as part of addiction treatment. Staff smoking prevalence decreased from 35.2% in 2008 to 21.8% in 2013 (P = .005) while client smoking prevalence over the same period was unchanged (68.1% vs. 66.0%, P = .564). Among clients who smoked, mean cigarettes per day decreased from 13.7 (SD = 8.38) to 10.2 (SD = 4.44; P < .001). There were significant time-by-treatment-type interactions for client tobacco-related attitudes and cessation services received; and for staff self-efficacy and cessation services provided. In residential programs, scores for most items decreased (became less positive) in 2009 followed by a partial rebound in 2013. Methadone program scores tended to rise (become more positive) throughout the study period. Staff and clients may respond differentially to tobacco-free policies depending on type of treatment program, and this finding may help to inform the implementation of tobacco-free policies in other statewide addiction treatment systems. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Science in the Stratosphere

NASA Technical Reports Server (NTRS)

Lester, Dan

1997-01-01

The Science in the Stratosphere program, first established in 1992, was conceived to introduce K-6 teachers to airborne infrared astronomy through the Kuiper Airborne Observatory (KAO), and to use this venue as a basis for seeing scientists at work in a mission-intensive program. The teachers selected for this program would bring their new perspectives back to their schools and students. Unlike the related FOSTER program, the emphasis of this program was on more intensive exposure of the KAO mission to a small number of teachers. The teachers in the Science in the Stratosphere program essentially lived with the project scientists and staff for almost a week. One related goal was to imbed the KAO project with perspectives of working teachers, thereby sensitizing the project staff and scientists to educational outreach efforts in general, which is an important goal of the NASA airborne astronomy program. A second related goal was to explore the ways in which K-5 educators could participate in airborne astronomy missions. Also unlike FOSTER, the Science in the Stratosphere program was intentionally relatively unstructured, in that the teacher participants were wholly embraced by the science team, and were encouraged to 'sniff out' the flavor of the whole facility by talking with people.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owen, P. T.; Webb, J. R.; Knox, N. P.

The 664 abstracted references on environmental restoration, nuclear facility decommissioning, uranium mill tailings management, and site remedial actions constitute the twelfth in a series of reports prepared annually for the US Department of Energy Remedial Action Programs. Citations to foreign and domestic literature of all types -- technical reports, progress reports, journal articles, symposia proceedings, theses, books, patents, legislation, and research project descriptions -- have been included. The bibliography contains scientific, technical, economic, regulatory, and legal information pertinent to the US Department of Energy Remedial Action Programs. Major sections are (1) Decontamination and Decommissioning Program, (2) Nuclear Facilities Decommissioning, (3)more » Formerly Utilized Sites Remedial Action Program, (4) Facilities Contaminated with Naturally Occurring Radionuclides, (5) Uranium Mill Tailings Remedial Action Program, (6) Uranium Mill Tailings Management, (7) Technical Measurements Center, and (8) Environmental Restoration Program. Within these categories, references are arranged alphabetically by first author. Those references having no individual author are listed by corporate affiliation or by publication title. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, subject category, and key word. This report is a product of the Remedial Action Program Information Center (RAPIC), which selects, analyzes, and disseminates information on environmental restoration and remedial actions. RAPIC staff and resources are available to meet a variety of information needs. Contact the center at FTS 624-7764 or (615) 574-7764.« less

16 CFR 453.2 - Price disclosures.

Code of Federal Regulations, 2014 CFR

2014-01-01

... specific funeral goods and funeral services used in connection with the disposition of deceased human bodies, including at least the price of embalming, transportation of remains, use of facilities, caskets... the body; (H) Use of facilities and staff for viewing; (I) Use of facilities and staff for funeral...

16 CFR 453.2 - Price disclosures.

Code of Federal Regulations, 2013 CFR

2013-01-01

... specific funeral goods and funeral services used in connection with the disposition of deceased human bodies, including at least the price of embalming, transportation of remains, use of facilities, caskets... the body; (H) Use of facilities and staff for viewing; (I) Use of facilities and staff for funeral...

16 CFR 453.2 - Price disclosures.

Code of Federal Regulations, 2012 CFR

2012-01-01

... specific funeral goods and funeral services used in connection with the disposition of deceased human bodies, including at least the price of embalming, transportation of remains, use of facilities, caskets... the body; (H) Use of facilities and staff for viewing; (I) Use of facilities and staff for funeral...

16 CFR 453.2 - Price disclosures.

Code of Federal Regulations, 2011 CFR

2011-01-01

... specific funeral goods and funeral services used in connection with the disposition of deceased human bodies, including at least the price of embalming, transportation of remains, use of facilities, caskets... the body; (H) Use of facilities and staff for viewing; (I) Use of facilities and staff for funeral...

16 CFR 453.2 - Price disclosures.

Code of Federal Regulations, 2010 CFR

2010-01-01

... specific funeral goods and funeral services used in connection with the disposition of deceased human bodies, including at least the price of embalming, transportation of remains, use of facilities, caskets... the body; (H) Use of facilities and staff for viewing; (I) Use of facilities and staff for funeral...

Pyrotechnically Operated Valves for Testing and Flight

NASA Technical Reports Server (NTRS)

Conley, Edgar G.; St.Cyr, William (Technical Monitor)

2002-01-01

Pyrovalves still warrant careful description of their operating characteristics, which is consistent with the NASA mission - to assure that both testing and flight hardware perform with the utmost reliability. So, until the development and qualification of the next generation of remotely controlled valves, in all likelihood based on shape memory alloy technology, pyrovalves will remain ubiquitous in controlling flow systems aloft and will possibly see growing use in ground-based testing facilities. In order to assist NASA in accomplishing this task, we propose a three-phase, three-year testing program. Phase I would set up an experimental facility, a 'test rig' in close cooperation with the staff located at the White Sands Test Facility in Southern New Mexico.

Perceptions of the importance of physical setting in substance abuse treatment.

PubMed

Grosenick, J K; Hatmaker, C M

2000-01-01

Research indicates that architectural design can provide therapeutic effects. Six setting characteristics are considered of primary importance in health-care facilities: comforts and conveniences, safety, attractiveness, size, privacy, and arrangement/location. This study presents the perceptions regarding these and other setting features held by female clients and staff from a substance abuse treatment facility. Results support the importance of these six setting characteristics in influencing clients' treatment goals. Four other setting variables emerged as important to women's recovery: participation in a residential, drug-free, gender-specific program that provides on-site child care. Attention to these variables may provide facilities with an advantage in today's competitive market for clients.

Water Resources Division training catalog

USGS Publications Warehouse

Hotchkiss, W.R.; Foxhoven, L.A.

1984-01-01

The National Training Center provides technical and management sessions nesessary for the conductance of the U.S. Geological Survey 's training programs. This catalog describes the facilities and staff at the Lakewood Training Center and describes Water Resources Division training courses available through the center. In addition, the catalog describes the procedures for gaining admission, formulas for calculating fees, and discussion of course evaluations. (USGS)

In Situ Resource Utilization (ISRU 3) Technical Interchange Meeting: Abstracts

NASA Technical Reports Server (NTRS)

1999-01-01

This volume contains abstracts that have been accepted for presentation at the In Situ Resource Utilization (ISRU III) Technical Interchange Meeting, February 11-12, 1999, hosted by the Lockheed Martin Astronautics Waterton Facility, Denver, Colorado. Administration and publication support for this meeting were provided by the staff of the Publications and Program Services Department at the Lunar and Planetary Institute.

BDP Is Unified at the ATRF | Poster

Cancer.gov

By Ken Michaels, Staff Writer The Biopharmaceutical Development Program (BDP) at the Frederick National Laboratory is, for the first time ever, in a single building at the Advanced Technology Research Facility (ATRF). At Fort Detrick, BDP operations were spread out in about a dozen buildings, resulting in redundancies in maintaining various utilities (air handlers, clean steam, WFI, etc.) for multiple buildings rather than one.

The Ghosts of Music Teachers Past

ERIC Educational Resources Information Center

Maltas, Carla Jo

2007-01-01

You are starting a new job. You have survived the interview process and landed the job of your dreams (or what will suffice for the time being). You have moved into your new room and have taken initial stock of the program, the facilities, and all the material you have. You know your budget, and have the administrators, the support staff, and a…

More Effective Schools Program: Evaluation of ESEA Title I Projects in New York City 1967-68.

ERIC Educational Resources Information Center

Fox, David J.; And Others

This report presents the 1967-68 evaluation of New York City's More Effective Schools (MES) project. The evaluation describes the facilities and staff provided by ESEA Title I funds and estimates the effectiveness of the MES schools by comparing them with control schools and special services (SS) schools. Estimates are provided of the impact of…

Development and Evaluation of an Integrated Pest Management Toolkit for Child Care Providers

ERIC Educational Resources Information Center

Alkon, Abbey; Kalmar, Evie; Leonard, Victoria; Flint, Mary Louise; Kuo, Devina; Davidson, Nita; Bradman, Asa

2012-01-01

Young children and early care and education (ECE) staff are exposed to pesticides used to manage pests in ECE facilities in the United States and elsewhere. The objective of this pilot study was to encourage child care programs to reduce pesticide use and child exposures by developing and evaluating an Integrated Pest Management (IPM) Toolkit for…

[Parent support activities in neonatal intensive care units: a national survey in Israel].

PubMed

Glasser, Saralee; Lerner-Geva, Liat; Levitski, Orna; Reichman, Brian

2009-04-01

Parents of infants in Neonatal Intensive Care Units (NICU) suffer extended periods of stress. The staffs of these departments have a major role in assisting them through this period. To describe services, programs and facilities to support parents of these infants, during and following hospitalization. Social workers of 23 NICU's completed a structured questionnaire, and the responses were summarized. The majority of units have paramedical staff in addition to social workers. Twenty-two units offer structured instruction for parents, and 12 offer lecture series. Topics include: coping with the birth of a premature infant, the infant's development and care, breastfeeding, discharge preparation, etc. In 19 departments grandparents are allowed to visit and nine also allow siblings. Most departments have breast-pump facilities and a lounge for parents; some also have refrigerators, personal lockers, etc.. Twenty units employ the "Kangaroo" method of skin-to-skin contact, and three practice elements of "individualized developmental care". Communication with parents is conducted both formally and informally. All departments have guidelines for contact with community health providers - some regularly, and some as-needed. Despite the multiplicity of programs reported in the survey, many are conducted in only a few departments. It is recommended that national guidelines be developed, which would integrate many existing activities, taking into account the needs of parents and families, medical and paramedical staff, as well as economic constraints. Clear policy guidelines and standards are necessary for this aspect of care, as they are for the medical aspects.

Improving the management of warfarin in aged-care facilities utilising innovative technology: a proof-of-concept study.

PubMed

Bereznicki, Luke R E; Jackson, Shane L; Kromdijk, Wiete; Gee, Peter; Fitzmaurice, Kimbra; Bereznicki, Bonnie J; Peterson, Gregory M

2014-02-01

In aged-care facilities (ACFs) monitoring of warfarin can be logistically challenging and International Normalised Ratio (INR control) is often suboptimal. We aimed to determine whether an integrated information and communications technology system and the use of point-of-care (POC) monitors by nursing staff could improve the INR control of aged-care facility residents who take warfarin. Nursing staff identified residents who were prescribed warfarin in participating ACFs. A computer program (MedePOC) was developed to store and transmit INR results from the ACFs to general practitioners (GPs) for dosage adjustment. Nursing staff received training in the use of the CoaguChek XS point-of-care INR monitor and the MedePOC software. Following a run-in phase, eligible patients were monitored weekly for up to 12 weeks. The primary outcome was the change in the time in therapeutic range (TTR) in the intervention phase compared to the TTR in the 12 months preceding the study. All GPs, nursing staff and patients were surveyed for their experiences and opinions of the project. Twenty-four patients and 19 GPs completed the trial across six ACFs. The mean TTR for all patients improved non-significantly from 58.9 to 60.6% (P=0.79) and the proportion of INR tests in range improved non-significantly from 57.1 to 64.1% (P=0.21). The mean TTR improved in 14 patients (58%) and in these patients the mean absolute improvement in TTR was 23.1%. A post hoc analysis of the INR data using modified therapeutic INR ranges to reflect the dosage adjustment practices of GPs suggested that the intervention did lead to improved INR control. The MedePOC program and POC monitoring was well received by nursing staff. Weekly POC INR monitoring conducted in ACFs and electronic communication of the results and warfarin doses resulted in non-significant improvements in INR control in a small cohort of elderly residents. Further research involving modification to the communication strategy and a longer follow-up period is warranted to investigate whether this strategy can improve INR control and clinical outcomes in this vulnerable population. © 2013 The Authors. IJPP © 2013 Royal Pharmaceutical Society.

Evaluation of Patient Satisfaction with Tuberculosis Services in Southern Nigeria

PubMed Central

Onyeonoro, Ugochukwu U; Chukwu, Joseph N; Nwafor, Charles C; Meka, Anthony O; Omotowo, Babatunde I; Madichie, Nelson O; Ogbudebe, Chidubem; Ikebudu, Joy N; Oshi, Daniel C; Ekeke, Ngozi; Paul, Nsirimobu I; Duru, Chukwuma B

2015-01-01

OBJECTIVE Knowing tuberculosis (TB) patients’ satisfaction enables TB program managers to identify gaps in service delivery and institute measures to address them. This study is aimed at evaluating patients’ satisfaction with TB services in southern Nigeria. MATERIALS AND METHODS A total of 378 patients accessing TB care were studied using a validated Patient Satisfaction (PS-38) questionnaire on various aspects of TB services. Factor analysis was used to identify eight factors related to TB patient satisfaction. Test of association was used to study the relation between patient satisfaction scores and patient and health facility characteristics, while multilinear regression analysis was used to identify predictors of patient satisfaction. RESULTS Highest satisfaction was reported for adherence counseling and access to care. Patient characteristics were associated with overall satisfaction, registration, adherence counseling, access to care, amenities, and staff attitude, while health system factors were associated with staff attitude, amenities, and health education. Predictors of satisfaction with TB services included gender, educational status, if tested for HIV, distance, payment for TB services, and level and type of health-care facility. CONCLUSION Patient- and health system–related factors were found to influence patient satisfaction and, hence, should be taken into consideration in TB service programing. PMID:26508872

Creating trauma-informed correctional care: a balance of goals and environment

PubMed Central

Miller, Niki A.; Najavits, Lisa M.

2012-01-01

Background Rates of posttraumatic stress disorder and exposure to violence among incarcerated males and females in the US are exponentially higher than rates among the general population; yet, abrupt detoxification from substances, the pervasive authoritative presence and sensory and environmental trauma triggers can pose a threat to individual and institutional stability during incarceration. Objective The authors explore the unique challenges and promises of trauma-informed correctional care and suggest strategies for administrative support, staff development, programming, and relevant clinical approaches. Method A review of literature includes a comparison of gendered responses, implications for men's facilities, and the compatibility of trauma recovery goals and forensic programming goals. Results Trauma-informed care demonstrates promise in increasing offender responsivity to evidence-based cognitive behavioral programming that reduces criminal risk factors and in supporting integrated programming for offenders with substance abuse and co-occurring disorders. Conclusions Incorporating trauma recovery principles into correctional environments requires an understanding of criminal justice priorities, workforce development, and specific approaches to screening, assessment, and programming that unify the goals of clinical and security staff. PMID:22893828

YALINA facility a sub-critical Accelerator- Driven System (ADS) for nuclear energy research facility description and an overview of the research program (1997-2008).

DOE Office of Scientific and Technical Information (OSTI.GOV)

Gohar, Y.; Smith, D. L.; Nuclear Engineering Division

2010-04-28

The YALINA facility is a zero-power, sub-critical assembly driven by a conventional neutron generator. It was conceived, constructed, and put into operation at the Radiation Physics and Chemistry Problems Institute of the National Academy of Sciences of Belarus located in Minsk-Sosny, Belarus. This facility was conceived for the purpose of investigating the static and dynamic neutronics properties of accelerator driven sub-critical systems, and to serve as a neutron source for investigating the properties of nuclear reactions, in particular transmutation reactions involving minor-actinide nuclei. This report provides a detailed description of this facility and documents the progress of research carried outmore » there during a period of approximately a decade since the facility was conceived and built until the end of 2008. During its history of development and operation to date (1997-2008), the YALINA facility has hosted several foreign groups that worked with the resident staff as collaborators. The participation of Argonne National Laboratory in the YALINA research programs commenced in 2005. For obvious reasons, special emphasis is placed in this report on the work at YALINA facility that has involved Argonne's participation. Attention is given here to the experimental program at YALINA facility as well as to analytical investigations aimed at validating codes and computational procedures and at providing a better understanding of the physics and operational behavior of the YALINA facility in particular, and ADS systems in general, during the period 1997-2008.« less

28 CFR 115.313 - Supervision and monitoring.

Code of Federal Regulations, 2014 CFR

2014-07-01

... from internal or external oversight bodies; (5) All components of the facility's physical plant... juvenile facility shall maintain staff ratios of a minimum of 1:8 during resident waking hours and 1:16... fully documented. Only security staff shall be included in these ratios. Any facility that, as of the...

28 CFR 115.313 - Supervision and monitoring.

Code of Federal Regulations, 2012 CFR

2012-07-01

... from internal or external oversight bodies; (5) All components of the facility's physical plant... juvenile facility shall maintain staff ratios of a minimum of 1:8 during resident waking hours and 1:16... fully documented. Only security staff shall be included in these ratios. Any facility that, as of the...

28 CFR 115.313 - Supervision and monitoring.

Code of Federal Regulations, 2013 CFR

2013-07-01

... from internal or external oversight bodies; (5) All components of the facility's physical plant... juvenile facility shall maintain staff ratios of a minimum of 1:8 during resident waking hours and 1:16... fully documented. Only security staff shall be included in these ratios. Any facility that, as of the...

75 FR 45678 - Notice of Availability of Interim Staff Guidance Document for Fuel Cycle Facilities

Federal Register 2010, 2011, 2012, 2013, 2014

2010-08-03

... Document for Fuel Cycle Facilities AGENCY: Nuclear Regulatory Commission. ACTION: Notice of availability..., Division of Fuel Cycle Safety and Safeguards, Office of Nuclear Material Safety and Safeguards, U.S... Commission (NRC) prepares and issues Interim Staff Guidance (ISG) documents for fuel cycle facilities. These...

Special report. Revising your fire safety plans.

PubMed

1993-12-01

Every hospital has a fire safety plan, although some fail to update their plans when circumstances change, such as when the facility is refurbished or new fire protection equipment is added, or when new wings bring in additional patients and staff. Others may fail to develop new education programs to heighten staff awareness of what is expected of them during a fire and to train employees to meet those expectations. In this report, we'll examine the new fire safety plans at two Massachusetts hospitals and the revisions they made to address these issues. We'll offer suggestions for effectively evaluating and revising your own fire safety plans.

Using Data to Improve Programs: Assessment of a Data Quality and Use Intervention Package for Integrated Community Case Management in Malawi.

PubMed

Hazel, Elizabeth; Chimbalanga, Emmanuel; Chimuna, Tiyese; Nsona, Humphreys; Mtimuni, Angella; Kaludzu, Ernest; Gilroy, Kate; Guenther, Tanya

2017-09-27

Health Surveillance Assistants (HSAs) have been providing integrated community case management (iCCM) for sick children in Malawi since 2008. HSAs report monthly iCCM program data but, at the time of this study, little of it was being used for service improvement. Additionally, HSAs and facility health workers did not have the tools to compile and visualize the data they collected to make evidence-based program decisions. From 2012 to 2013, we worked with Ministry of Health staff and partners to develop and pilot a program in Dowa and Kasungu districts to improve data quality and use at the health worker level. We developed and distributed wall chart templates to display and visualize data, provided training to 426 HSAs and supervisors on data analysis using the templates, and engaged health workers in program improvement plans as part of a data quality and use (DQU) package. We assessed the package through baseline and endline surveys of the HSAs and facility and district staff in the study areas, focusing specifically on availability of reporting forms, completeness of the forms, and consistency of the data between different levels of the health system as measured through results verification ratio (RVR). We found evidence of significant improvements in reporting consistency for suspected pneumonia illness (from overreporting cases at baseline [RVR=0.82] to no reporting inconsistency at endline [RVR=1.0]; P =.02). Other non-significant improvements were measured for fever illness and gender of the patient. Use of the data-display wall charts was high; almost all HSAs and three-fourths of the health facilities had completed all months since January 2013. Some participants reported the wall charts helped them use data for program improvement, such as to inform community health education activities and to better track stock-outs. Since this study, the DQU package has been scaled up in Malawi and expanded to 2 other countries. Unfortunately, without the sustained support and supervision provided in this project, use of the tools in the Malawi scale-up is lower than during the pilot period. Nevertheless, this pilot project shows community and facility health workers can use data to improve programs at the local level given the opportunity to access and visualize the data along with supervision support. © Hazel et al.

Safety Evaluation Report for the Claiborne Enrichment Center, Homer, Louisiana (Docket No. 70-3070)

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1994-01-01

This report documents the US Nuclear Regulatory Commission (NRC) staff review and safety evaluation of the Louisiana Energy Services, L.P. (LES, the applicant) application for a license to possess and use byproduct, source, and special nuclear material and to enrich natural uranium to a maximum of 5 percent U-235 by the gas centrifuge process. The plant, to be known as the Claiborne Enrichment Center (CEC), would be constructed near the town of Homer in Claiborne Parish, Louisiana. At full production in a given year, the plant will receive approximately 4,700 tonnes of feed UF{sub 6} and produce 870 tonnes ofmore » low-enriched UF{sub 6}, and 3,830 tonnes of depleted UF{sub 6} tails. Facility construction, operation, and decommissioning are expected to last 5, 30, and 7 years, respectively. The objective of the review is to evaluate the potential adverse impacts of operation of the facility on worker and public health and safety under both normal operating and accident conditions. The review also considers the management organization, administrative programs, and financial qualifications provided to assure safe design and operation of the facility. The NRC staff concludes that the applicant`s descriptions, specifications, and analyses provide an adequate basis for safety review of facility operations and that construction and operation of the facility does not pose an undue risk to public health and safety.« less

Hope, Laughter, and Humor in Residents and Staff at an Assisted Living Facility.

ERIC Educational Resources Information Center

Westburg, Nancy G.

2003-01-01

Assesses and compares hope levels and laughter and humor experiences of 24 elderly residents and 21 staff at an assisted living facility. Residents and staff reported numerous benefits from humor and laughing, but differences arose between the two groups about the source and frequency of humor and laughter. Implications for mental health…

Physical aggressive resident behavior during hygienic care.

PubMed

Farrell Miller, M

1997-05-01

Management of aggressive behavior has been identified as a concern for nursing staff who provide institutional care for cognitively impaired elderly. The Omnibus Reconciliation Act (OBRA '87) mandates a trial reduction in the use of chemical and physical restraints, and the development of nursing interventions for the management of behavioral disorders of institutionalized cognitively impaired elderly. Most skilled nursing facilities, however, are limited in their ability to provide environmental and behavioral programs to manage aggressive patient behavior. For the purposes of this study, physically aggressive behavior was identified as threatened or actual aggressive patient contact which has taken place between a patient and a member of the nursing staff. This study explored the nursing staff's responses to patient physical aggression and the effects that physical aggression had on them and on nursing practice from the perspective of the nursing staff. Nursing staff employed on one Dementia Special Care Unit (DSCU) were invited to participate. Interviews with nursing staff were analyzed using qualitative descriptive methods described by Miles and Huberman (1994). Nursing staff reported that they were subjected to aggressive patient behaviors ranging from verbal threats to actual physical violence. Nursing staff reported that showering a resident was the activity of daily living most likely to provoke patient to staff physical aggression. The findings revealed geropsychiatric nursing practices for the management of physically aggressive residents, and offered recommendations for improving the safety of nursing staff and residents on a secured DSCU.

Report of the Task Force on SSC Magnet System Test Site

DOE Office of Scientific and Technical Information (OSTI.GOV)

NONE

1984-10-01

The Task Force on SSC Magnet Systems test Site was appointed by Maury Tigner, Director of the SSC, Phase 1 in August 1984. In brief, the charge asked the Task Force to make a critical evaluation of potential test sites for a major SSC magnet System Test Facility (STF) with regard to: (1) availability of the needed space, utilities, staff and other requirements on the desired time scale; and (2) the cost of preparing the sites for the tests and for operating the facilities during the test period. The charge further suggests that, by virtue of existing facilities and availabilitymore » of experienced staff, BNL and FNAL are the two best candidate sites and that is therefore appears appropriate to restrict the considerations of the Task Force to these sites. During the subsequent deliberations of the Task Force, no new facts were revealed that altered the assumptions of the charge in this regard. The charge does not ask for a specific site recommendation for the STF. Indeed, an agreement on such a recommendation would be difficult to achieve considering the composition of the Task Force, wherein a large fraction of the membership is drawn from the two contending laboratories. Instead, we have attempted to describe the purpose of the facility, outline a productive test program, list the major facilities required, carefully review the laboratories` responses to the facility requirements, and make objective comparisons of the specific features and capabilities offered.« less

Successful ingredients in the SMILE study: resident, staff, and management factors influence the effects of humor therapy in residential aged care.

PubMed

Brodaty, Henry; Low, Lee-Fay; Liu, Zhixin; Fletcher, Jennifer; Roast, Joel; Goodenough, Belinda; Chenoweth, Lynn

2014-12-01

To test the hypothesis that individual and institutional-level factors influence the effects of a humor therapy intervention on aged care residents. Data were from the humor therapy group of the Sydney Multisite Intervention of LaughterBosses and ElderClowns, or SMILE, study, a single-blind cluster randomized controlled trial of humor therapy conducted over 12 weeks; assessments were performed at baseline, week 13, and week 26. One hundred eighty-nine individuals from 17 Sydney residential aged care facilities were randomly allocated to the humor therapy intervention. Professional performers called "ElderClowns" provided 9-12 weekly humor therapy 2-hour sessions, augmented by trained staff, called "LaughterBosses." Outcome measures were as follows: Cornell Scale for Depression in Dementia, Cohen-Mansfield Agitation Inventory, Neuropsychiatric Inventory, the withdrawal subscale of Multidimensional Observation Scale for Elderly Subjects, and proxy-rated quality of life in dementia population scale. Facility-level measures were as follows: support of the management for the intervention, commitment levels of LaughterBosses, Environmental Audit Tool scores, and facility level of care provided (high/low). Resident-level measures were engagement, functional ability, disease severity, and time-in-care. Multilevel path analyses simultaneously modeled resident engagement at the individual level (repeated measures) and the effects of management support and staff commitment to humor therapy at the cluster level. Models indicated flow-on effects, whereby management support had positive effects on LaughterBoss commitment, and LaughterBoss commitment increased resident engagement. Higher resident engagement was associated with reduced depression, agitation, and neuropsychiatric scores. Effectiveness of psychosocial programs in residential aged care can be enhanced by management support, staff commitment, and active resident engagement. Copyright © 2014 American Association for Geriatric Psychiatry. Published by Elsevier Inc. All rights reserved.

Key ingredients for implementing intensive outpatient programs within patient-centered medical homes: A literature review and qualitative analysis.

PubMed

Breland, Jessica Y; Asch, Steven M; Slightam, Cindie; Wong, Ava; Zulman, Donna M

2016-03-01

Intensive outpatient programs aim to transform care while conserving resources for high-need, high-cost patients, but little is known about factors that influence their implementation within patient-centered medical homes (PCMHs). In this mixed-methods study, we reviewed the literature to identify factors affecting intensive outpatient program implementation, then used semi-structured interviews to determine how these factors influenced the implementation of an intensive outpatient program within the Veterans Affairs' (VA) PCMH. Interviewees included facility leadership and clinical staff who were involved in a pilot Intensive Management Patient Aligned Care Team (ImPACT) intervention for high-need, high-cost VA PCMH patents. We classified implementation factors in the literature review and qualitative analysis using the Consolidated Framework for Implementation Research (CFIR). The literature review (n=9 studies) and analyses of interviews (n=15) revealed key implementation factors in three CFIR domains. First, the Inner Setting (i.e., the organizational and PCMH environment), mostly enabled implementation through a culture of innovation, good networks and communication, and positive tension for change. Second, Characteristics of Individuals, including creativity, flexibility, and interpersonal skills, allowed program staff to augment existing PCMH services. Finally, certain Intervention Characteristics (e.g., adaptability) enabled implementation, while others (e.g., complexity) generated implementation barriers. Resources and structural features common to PCMHs can facilitate implementation of intensive outpatient programs, but program success is also dependent on staff creativity and flexibility, and intervention adaptations to meet patient and organizational needs. Established PCMHs likely provide resources and environments that permit accelerated implementation of intensive outpatient programs. V. Published by Elsevier Inc.

Staff experiences of providing maternity services in rural southern Tanzania - a focus on equipment, drug and supply issues.

PubMed

Penfold, Suzanne; Shamba, Donat; Hanson, Claudia; Jaribu, Jennie; Manzi, Fatuma; Marchant, Tanya; Tanner, Marcel; Ramsey, Kate; Schellenberg, David; Schellenberg, Joanna Armstrong

2013-02-14

The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse patient outcomes through delaying care provision. We aim to describe staff experiences of providing maternal and neonatal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies. Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items. The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures with potential health risks to themselves as a result. Inadequately stocked and equipped facilities compromise the health system's ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions.

Staff experiences of providing maternity services in rural southern Tanzania – a focus on equipment, drug and supply issues

PubMed Central

2013-01-01

Background The poor maintenance of equipment and inadequate supplies of drugs and other items contribute to the low quality of maternity services often found in rural settings in low- and middle-income countries, and raise the risk of adverse patient outcomes through delaying care provision. We aim to describe staff experiences of providing maternal and neonatal care in rural health facilities in Southern Tanzania, focusing on issues related to equipment, drugs and supplies. Methods Focus group discussions and in-depth interviews were conducted with different staff cadres from all facility levels in order to explore experiences and views of providing maternity care in the context of poorly maintained equipment, and insufficient drugs and other supplies. A facility survey quantified the availability of relevant items. Results The facility survey, which found many missing or broken items and frequent stock outs, corroborated staff reports of providing care in the context of missing or broken care items. Staff reported increased workloads, reduced morale, difficulties in providing optimal maternity care, and carrying out procedures with potential health risks to themselves as a result. Conclusions Inadequately stocked and equipped facilities compromise the health system’s ability to reduce maternal and neonatal mortality and morbidity by affecting staff personally and professionally, which hinders the provision of timely and appropriate interventions. Improving stock control and maintaining equipment could benefit mothers and babies, not only through removing restrictions to the availability of care, but also through improving staff working conditions. PMID:23410228

Using a qualitative approach for understanding hospital-affiliated integrated clinical and fitness facilities: characteristics and members' experiences.

PubMed

Yang, Jingzhen; Kingsbury, Diana; Nichols, Matthew; Grimm, Kristin; Ding, Kele; Hallam, Jeffrey

2015-06-19

With health care shifting away from the traditional sick care model, many hospitals are integrating fitness facilities and programs into their clinical services in order to support health promotion and disease prevention at the community level. Through a series of focus groups, the present study assessed characteristics of hospital-affiliated integrated facilities located in Northeast Ohio, United States and members' experiences with respect to these facilities. Adult members were invited to participate in a focus group using a recruitment flyer. A total of 6 focus groups were conducted in 2013, each lasting one hour, ranging from 5 to 12 participants per group. The responses and discussions were recorded and transcribed verbatim, then analyzed independently by research team members. Major themes were identified after consensus was reached. The participants' average age was 57, with 56.8% currently under a doctor's care. Four major themes associated with integrated facilities and members' experiences emerged across the six focus groups: 1) facility/program, 2) social atmosphere, 3) provider, and 4) member. Within each theme, several sub-themes were also identified. A key feature of integrated facilities is the availability of clinical and fitness services "under one roof". Many participants remarked that they initially attended physical therapy, becoming members of the fitness facility afterwards, or vice versa. The participants had favorable views of and experiences with the superior physical environment and atmosphere, personal attention, tailored programs, and knowledgeable, friendly, and attentive staff. In particular, participants favored the emphasis on preventive care and the promotion of holistic health and wellness. These results support the integration of wellness promotion and programming with traditional medical care and call for the further evaluation of such a model with regard to participants' health outcomes.

A Primer on Electric Utilities, Deregulation, and Restructuring of U.S. Electricity Markets

DOE Office of Scientific and Technical Information (OSTI.GOV)

Warwick, William M.

2002-06-03

This primer is offered as an introduction to utility restructuring to better prepare readers for ongoing changes in public utilities and associated energy markets. It is written for use by individuals with responsibility for the management of facilities that use energy, including energy managers, procurement staff, and managers with responsibility for facility operations and budgets. The primer was prepared by the Pacific Northwest National Laboratory under sponsorship from the U.S. Department of Energy?s Federal Energy Management Program. The impetus for this primer originally came from the Government Services Administration who supported its initial development.

The use of diacetyl (2,3-butanedione) and related flavoring substances as flavorings added to foods-Workplace safety issues.

PubMed

Hallagan, John B

2017-08-01

In 2001, staff of the National Institute of Occupational Safety and Health (NIOSH) identified diacetyl (2,3-butanedione) as a "marker" of exposure in a microwave popcorn manufacturing facility in which workers developed severe respiratory illness. Subsequent investigations identified additional workers in food and flavor manufacturing facilities also with severe respiratory illness. The flavor industry, NIOSH, and federal and state regulators conducted significant programs to address workplace safety concerns related to the manufacture of flavors and foods containing added flavors. These programs, initiated in 2001, continue today. Key to the success of these programs is understanding what flavors added to foods are and how they are manufactured, how they are incorporated into foods, the specific characteristics of diacetyl and related flavoring substances, and what actions may be taken to assure the safest workplaces possible. Copyright © 2017 Elsevier B.V. All rights reserved.

[Introduction of Shimane University's outside funded support project for female researchers and healthcare staff].

PubMed

Tsumori, Toshiko

2013-09-01

Shimane University has started to provide facilities and services to female researchers and healthcare staff who have worked for the university or its hospital after 2007. This initiative had been supported by grants from the Japanese Ministry of Education, Culture, Sports, Science and Technology until 2010. Over time, it has become clear that these efforts, including a day-and-night nursery, day-care for sick children, temporary day-care, after-school programs, and research support system have effectively sustained female researchers and staff in maintaining a balance between private life and work. It is essential that the university devote part of its budget along with outside funding for continued childcare, which has so motivated these female employees. Moreover, it is expected that these efforts will become an effective recruitment tool for excellent young teachers and researchers.

Staff Member Reactions to Same-Gender, Resident-to-Resident Sexual Behavior Within Long-Term Care Facilities.

PubMed

Ahrendt, Andrew; Sprankle, Eric; Kuka, Alex; McPherson, Keagan

2017-01-01

The current study assesses ageism and heterosexism relating to older adult sexual activity within long-term care facilities. To assess caregiver reactions, 153 residential care facility staff members read one of three vignettes. Each vignette described a scenario in which a staff member walks in on two residents (male/female, male/male, or female/female) engaging in sexual activity. Although no main effects were discovered for vignette type, exploratory analyses revealed that the facility where participants were employed was significantly related to their ratings of approval. Furthermore, an interaction effect between vignette and facility types was also discovered for caregivers' approval of sexual activity among residents. Additionally, a strong overall approval rating of older adult sexuality was reported by staff members. The results of this study warrant that further research is necessary regarding older adults' perception of caregiver bias, as well as further investigation of caregivers' perceptions of older adults' sexual activity.

Exploring nursing staff's attitudes and use of music for older people with dementia in long-term care facilities.

PubMed

Sung, Huei-Chuan; Lee, Wen-Li; Chang, Shu-Min; Smith, Graeme D

2011-06-01

This study aimed to explore nursing staff's attitudes and use of music for older people with dementia in long-term care facilities. Music has shown positive outcomes in managing behavioural symptoms of older people with dementia. Older people living in long-term care facilities often do not have access to trained music therapists. Nursing staff provide the majority of direct care for institutionalised older people with dementia, therefore, will be the most appropriate personnel to learn and implement music therapy for those with dementia. To date, no studies have explored nursing staff's attitudes and use of music for those with dementia. A cross-sectional research design was used. A convenience sample of 285 nursing staff caring for those with dementia in long-term care facilities in Taiwan were recruited. Participants received a self-administered questionnaire consisted of items exploring nursing staff's attitude and use of music for those with dementia. A total of 214 participants completed the questionnaires, giving a response rate of 75·1%. Most nursing staff held positive attitudes towards use of music for older people with dementia (mean=84·89, range 23-115), but only 30·6% (n=66) had used music for those with dementia in practice. The majority perceived that they had limited knowledge and skills about use of music (72·9%). Over half of the participants reported that they lacked resources and time to implement music therapy in practice. Nursing staff need more formal training to use music for those with dementia. Nursing staff can be the suitable personnel to learn easily and implement music therapy as a part of routine activity programmes for those with dementia. Appropriately trained nursing staff in long-term care facilities who use music therapy may help improve the mental health of older people with dementia. © 2011 Blackwell Publishing Ltd.

Personal and professional challenges confronted by hospital staff following hurricane sandy: a qualitative assessment of management perspectives.

PubMed

Morris, Andrea M; Ricci, Karen A; Griffin, Anne R; Heslin, Kevin C; Dobalian, Aram

2016-05-05

Adequate hospital staffing during and after a disaster is critical to meet increased health care demands and to ensure continuity of care and patient safety. However, when a disaster occurs, staff may become both victim and responder, decreasing their ability and willingness to report for work. This qualitative study assessed the personal and professional challenges that affected staff decisions to report to work following a natural disaster and examined the role of management in addressing staff needs and concerns. Semi-structured interviews were conducted with individuals who filled key management roles in the United States Department of Veterans Affairs New York Harbor Healthcare System's response to Superstorm Sandy and during the facility's initial recovery phase. All interviews were audio recorded and transcribed. Three major themes were identified: 1) Barriers to reporting ("Barriers"), 2) Facilitators to reporting ("Facilitators"), and 3) Responses to staff needs and concerns ("Responses"). Atlas.ti 7.1.6 software program was used for the management and analysis of the transcripts. Results indicated that staff encountered several barriers that impeded their ability to report to work at mobile vans at the temporarily nonoperational Manhattan campus or at two other VA facilities in Brooklyn and the Bronx in the initial post-Sandy period including transportation problems, personal property damage, and communication issues. In addition, we found evidence of facilitators to reporting as expressed through descriptions of professional duty. Our findings also revealed that management was aware of the challenges that staff was facing and made efforts to reduce barriers and accommodate staff affected by the storm. During and after a disaster event, hospital staff is often confronted with challenges that affect decisions to report for work and perform effectively under potentially harsh conditions. This study examined barriers and facilitators that hospital staff encountered following a major natural disaster from the management perspective. Insights gained from this study can be used to inform future disaster planning and preparedness efforts, and help ensure that there is adequate staffing to mount an effective response when a disaster occurs, and to recover from its aftermath.

A Public Private Partnership to Reopen Public Schools in New Orleans: The Edward Hynes Elementary School as a Model

ERIC Educational Resources Information Center

21st Century School Fund, 2006

2006-01-01

The State of Louisiana and the City of New Orleans have a daunting task before them. They must restore community access to public education. It will not be enough to repair and rebuild buildings. The educational programs and staff must also be redeveloped. However, the improvements to public school facilities is a critical first step in…

Improving the Quality of Staff and Participant Interaction in an Acquired Brain Injury Organization

ERIC Educational Resources Information Center

Guercio, John M.; Dixon, Mark R.

2010-01-01

Weekly observations of direct-care staff in a facility for persons with brain injury yielded less than optimal interactional style with facility residents. Following an observational baseline, staff were asked to self-rate a 15-min video sample of their interaction behavior with participants on their unit. They were then asked to compare their…

Staff satisfaction and its components in residential aged care.

PubMed

Chou, Shu-Chiung; Boldy, Duncan P; Lee, Andy H

2002-06-01

The purpose of this study was to assess the direction and magnitude of the effects among the components of staff satisfaction in residential aged care and to examine whether the relationships among satisfaction components vary according to facility type (i.e. nursing homes and hostels). A hostel is a low care facility in which residents are more independent, have a lower level of care needs, and receive personal but not nursing care. A cross-sectional survey design was adopted to collect the required information, and a stratified random sampling approach was utilized to select facilities. Structural equation modeling was used to examine relationships among satisfaction components. Seventy residential aged care facilities in Western Australia. The sample includes 610 nursing home and 373 hostel care staff. The relationships among satisfaction components are different for nursing home and hostel staff. Professional support is found to have a strong and positive effect on all other aspects of staff satisfaction. The findings lead to an improved understanding of the interrelationship among staff satisfaction components, which has important implications through enhancing professional support. This needs to be recognized and emphasized by managers, care providers, and policy makers so as to maintain stable personnel and continuity of care.

Air Quality, Biomarker Levels, and Health Effects on Staff in Korean Restaurants and Pubs Before and After a Smoking Ban.

PubMed

Kim, Jeonghoon; Kwon, Ho-Jang; Lee, Kiyoung; Lee, Do-Hoon; Paek, Yujin; Kim, Sung-Soo; Hong, Soyoung; Lim, Wanryung; Heo, Jae-Hyeok; Kim, Kyoosang

2015-11-01

The Korean government implemented a smoking ban at square floor area of ≥150 m(2), rather than <150 m(2), restaurants and pubs from July 2013. This study examined the effects of the smoking regulations in restaurants and pubs in terms of the air quality, biomarker levels and health effects on staff. Particulate matter smaller than 2.5 µm (PM2.5) was measured in 146 facilities before and 1 month after the ban. The urinary cotinine and 4-(methylnitrosamino)-1-(3-pyridyl)-1- butanol (NNAL) levels were measured in 101 staff members at 77 facilities before and 1 month after the ban. We also measured self-reported respiratory and sensory symptoms on both phases. Of the 146 facilities, 121 facilities were included in the PM2.5 analysis. In ≥150 m(2) pubs, the indoor PM2.5 concentration was significantly reduced after the ban (p < .05). While the urinary cotinine concentrations of the staff in all facilities were not changed after the ban, the total NNAL concentrations of the staff in ≥150 m(2) pubs were significantly reduced after the ban (p < .05). The health effects on staff show that only sensory symptoms significantly improved in ≥150 m(2) facilities after the ban (p < .05). The smoking ban significantly reduced the levels of PM2.5 and total NNAL concentrations in ≥150 m(2) pubs and improved sensory health among staff in ≥150 m(2) facilities. The results of this study can be useful in supporting an expansion of the smoking ban in all indoor places, including <150 m(2) restaurants and pubs. © The Author 2015. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail: journals.permissions@oup.com.

Barriers to providing palliative care in long-term care facilities.

PubMed

Brazil, Kevin; Bédard, Michel; Krueger, Paul; Taniguchi, Alan; Kelley, Mary Lou; McAiney, Carrie; Justice, Christopher

2006-04-01

To assess challenges in providing palliative care in long-term care (LTC) facilities from the perspective of medical directors. Cross-sectional mailed survey. A questionnaire was developed, reviewed, pilot-tested, and sent to 450 medical directors representing 531 LTC facilities. Responses were rated on 2 different 5-point scales. Descriptive analyses were conducted on all responses. All licensed LTC facilities in Ontario with designated medical directors. Medical directors in the facilities. Demographic and practice characteristics of physicians and facilities, importance of potential barriers to providing palliative care, strategies that could be helpful in providing palliative care, and the kind of training in palliative care respondents had received. Two hundred seventy-five medical directors (61%) representing 302 LTC facilities (57%) responded to the survey. Potential barriers to providing palliative care were clustered into 3 groups: facility staff's capacity to provide palliative care, education and support, and the need for external resources. Two thirds of respondents (67.1%) reported that inadequate staffing in their facilities was an important barrier to providing palliative care. Other barriers included inadequate financial reimbursement from the Ontario Health Insurance Program (58.5%), the heavy time commitment required (47.3%), and the lack of equipment in facilities (42.5%). No statistically significant relationship was found between geographic location or profit status of facilities and barriers to providing palliative care. Strategies respondents would use to improve provision of palliative care included continuing medical education (80.0%), protocols for assessing and monitoring pain (77.7%), finding ways to increase financial reimbursement for managing palliative care residents (72.1%), providing educational material for facility staff (70.7%), and providing practice guidelines related to assessing and managing palliative care patients (67.8%). Medical directors in our study reported that their LTC facilities were inadequately staffed and lacked equipment. The study also highlighted the specialized role of medical directors, who identified continuing medical education as a key strategy for improving provision of palliative care.

Teams communicating through STEPPS.

PubMed

Stead, Karen; Kumar, Saravana; Schultz, Timothy J; Tiver, Sue; Pirone, Christy J; Adams, Robert J; Wareham, Conrad A

2009-06-01

To evaluate the effectiveness of the implementation of a TeamSTEPPS (Team Strategies and Tools to Enhance Performance and Patient Safety) program at an Australian mental health facility. TeamSTEPPS is an evidence-based teamwork training system developed in the United States. Five health care sites in South Australia implemented TeamSTEPPS using a train-the-trainer model over an 8-month intervention period commencing January 2008 and concluding September 2008. A team of senior clinical staff was formed at each site to drive the improvement process. Independent researchers used direct observation and questionnaire surveys to evaluate the effectiveness of the implementation in three outcome areas: observed team behaviours; staff attitudes and opinions; and clinical performance and outcome. The results reported here focus on one site, an inpatient mental health facility. Team knowledge, skills and attitudes; patient safety culture; incident reporting rates; seclusion rates; observation for the frequency of use of TeamSTEPPS tools. Outcomes included restructuring of multidisciplinary meetings and the introduction of structured communication tools. The evaluation of patient safety culture and of staff knowledge, skills and attitudes (KSA) to teamwork and communication indicated a significant improvement in two dimensions of patient safety culture (frequency of event reporting, and organisational learning) and a 6.8% increase in the total KSA score. Clinical outcomes included reduced rates of seclusion. TeamSTEPPS implementation had a substantial impact on patient safety culture, teamwork and communication at an Australian mental health facility. It encouraged a culture of learning from patient safety incidents and making continuous improvements.

The Training Process of the Organization Development and Training Office

NASA Technical Reports Server (NTRS)

Johnson, Melissa S.

2004-01-01

The Organization Development and Training Office provides training and development opportunities to employees at NASA Glenn Research Center, as a division of the Office of Human Resources and Workforce Planning. Center-wide required trainings, new employee trainings, workshops and career development programs are organized by the OD&TO staff. They also arrange all academic, non-academic, headquarters, fellowship and learning center sponsored courses. They also service organizations wishing to work more effectively by facilitating teambuilding exercises. Equal Opportunity programs and upward mobility programs such as the STEP and GO programs for administrative staff. In working with my mentor I am very involved with Cuyahoga Community College classes, mandatory supervisory training and administrative staff workshops. My largest tasks are in the secretarial training category. The Supporting Organizations And Relationships workshop for administrative personnel, commonly known as SOAR, began last year and continued this summer with follow-up workshops. Months before a workshop or class is brought to Glenn, a need has to be realized. In this case, administrative staff did not feel they had an opportunity to receive relevant training and develop skills through teambuilding, networking and communication. A Statement of work is then created as several companies are contacted about providing the training. After the company best suited to meet the target group s needs is selected, the course is announced with an outline of all pertinent information. A reservation for a facility is made and applications or nominations, depending on the announcement s guidelines, are received from interested employees. Confirmations are sent to participants and final preparations are made but there are still several concluding steps. A training office staff member also assists the facilitator with setting up the facility and introducing the class. After the class, participants evaluations are read and summarized to determine the effectiveness of the class and instructor. In addition to the SOAR workshops, I have several projects and daily tasks to complete. Coding training applications, which require me to be familiar with Glenn s budgetary allocations and policies on training, is an ongoing process. It also requires verifying information reported by an employee via her C-478 form, more commonly known as the training application. I am also the point of contact for the Cuyahoga Community College Advising Sessions held here at NASA Glenn which involves coordinating counselors visits with employees schedules. Two databases had to be created. The first database holds information on administrative staff, and the other tracks supervisors training histories. Through these assignments I gained experience in Microsoft Access 2002 and spreadsheet creation, communicating with co-workers, and successfully facilitating a training to serve specific purposes. With trainings and evaluations to assessment them, the Organization Development and Training Office can assure a quality product and continued customer satisfaction.

The problem of bias when nursing facility staff administer customer satisfaction surveys.

PubMed

Hodlewsky, R Tamara; Decker, Frederic H

2002-10-01

Customer satisfaction instruments are being used with increasing frequency to assess and monitor residents' assessments of quality of care in nursing facilities. There is no standard protocol, however, for how or by whom the instruments should be administered when anonymous, written responses are not feasible. Researchers often use outside interviewers to assess satisfaction, but cost considerations may limit the extent to which facilities are able to hire outside interviewers on a regular basis. This study was designed to investigate the existence and extent of any bias caused by staff administering customer satisfaction surveys. Customer satisfaction data were collected in 1998 from 265 residents in 21 nursing facilities in North Dakota. Half the residents in each facility were interviewed by staff members and the other half by outside consultants; scores were compared by interviewer type. In addition to a tabulation of raw scores, ordinary least-squares analysis with facility fixed effects was used to control for resident characteristics and unmeasured facility-level factors that could influence scores. Significant positive bias was found when staff members interviewed residents. The bias was not limited to questions directly affecting staff responsibilities but applied across all types of issues. The bias was robust under varying constructions of satisfaction and dissatisfaction. A uniform method of survey administration appears to be important if satisfaction data are to be used to compare facilities. Bias is an important factor that should be considered and weighed against the costs of obtaining outside interviewers when assessing customer satisfaction among long term care residents.

Developing clinical leadership capability.

PubMed

Pintar, Kristi A; Capuano, Terry A; Rosser, Gwendolyn D

2007-01-01

Nursing facilities must be committed to ongoing leadership development and to developing and retaining their staff in the increasingly competitive healthcare market. In this article, the authors share the processes involved in creating a focused small group approach to developing clinical leaders. Programmatic approaches to development, clarity of needs of those targeted for development, individual development plans, external expertise partnerships, and small group session dynamics are discussed. Applications of the process and lessons learned from the program will benefit others in their efforts to enhance organization succession planning, leadership development, group learning, and program administration.

Cooperative Program In Space Science

NASA Technical Reports Server (NTRS)

Black, David

2003-01-01

The mission of this activity, know as the Cooperative Program in Space Sciences (CPSS), is to conduct space science research and leading-edge instrumentation and technology development, enable research by the space sciences communities, and to expedite the effective dissemination of space science research, technology, data, and information to the educational community and the general public. To fulfill this mission, USRA recruits and maintains a staff of scientific researchers, operates a series of guest investigator facilities, organizes scientific meetings and workshops, and encourages various interactions with students and university faculty members.

Installation Restoration Program. Phase II. Confirmation/Quantification. Stage I. Tyndall Air Force Base, Florida.

DTIC Science & Technology

1984-08-01

10 31984 . PREPARED FOR UNITED STATES AIR FORCE OCCUPATIONAL AND ENVIRONMENTAL HEALTH LABORATORY BROOKS AIR FORCE BASE, TEXAS 78235 ,,c.’p! ed di...Force August 1984 Occupational and Environmental Health Laboratory I3 NUMBER OF PAGES Aerospace Medical Division (AFSC) 249 total pages• ~~Brooks Air...PROGRAM BACKGROUND i-I 1.2 FACILITY HISTORY 1-3 1.3 DISPOSAL SITE DESCRIPTIONS 1-b 1.4 PROJECT STAFF 1-20 2.0 ENVIRONMENTAL SETTING 2-1 2.1 METEOROLOGY 2-1

Task sharing in Zambia: HIV service scale-up compounds the human resource crisis.

PubMed

Walsh, Aisling; Ndubani, Phillimon; Simbaya, Joseph; Dicker, Patrick; Brugha, Ruairí

2010-09-17

Considerable attention has been given by policy makers and researchers to the human resources for health crisis in Africa. However, little attention has been paid to quantifying health facility-level trends in health worker numbers, distribution and workload, despite growing demands on health workers due to the availability of new funds for HIV/AIDS control scale-up. This study analyses and reports trends in HIV and non-HIV ambulatory service workloads on clinical staff in urban and rural district level facilities. Structured surveys of health facility managers, and health services covering 2005-07 were conducted in three districts of Zambia in 2008 (two urban and one rural), to fill this evidence gap. Intra-facility analyses were conducted, comparing trends in HIV and non-HIV service utilisation with staff trends. Clinical staff (doctors, nurses and nurse-midwives, and clinical officers) numbers and staff population densities fell slightly, with lower ratios of staff to population in the rural district. The ratios of antenatal care and family planning registrants to nurses/nurse-midwives were highest at baseline and increased further at the rural facilities over the three years, while daily outpatient department (OPD) workload in urban facilities fell below that in rural facilities. HIV workload, as measured by numbers of clients receiving antiretroviral treatment (ART) and prevention of mother to child transmission (PMTCT) per facility staff member, was highest in the capital city, but increased rapidly in all three districts. The analysis suggests evidence of task sharing, in that staff designated by managers as ART and PMTCT workers made up a higher proportion of frontline service providers by 2007. This analysis of workforce patterns across 30 facilities in three districts of Zambia illustrates that the remarkable achievements in scaling-up HIV/AIDS service delivery has been on the back of sustained non-HIV workload levels, increasing HIV workload and stagnant health worker numbers. The findings are based on an analysis of routine data that are available to district and national managers. Mixed methods research is needed, combining quantitative analyses of routine health information with follow-up qualitative interviews, to explore and explain workload changes, and to identify and measure where problems are most acute, so that decision makers can respond appropriately. This study provides quantitative evidence of a human resource crisis in health facilities in Zambia, which may be more acute in rural areas.

Documenting the NICU design dilemma: parent and staff perceptions of open ward versus single family room units

PubMed Central

Domanico, R; Davis, D K; Coleman, F; Davis, B O

2010-01-01

Objective: With neonatal intensive care units (NICUs) evolving from multipatient wards toward family-friendly, single-family room units, the study objective was to compare satisfaction levels of families and health-care staff across these differing NICU facility designs. Study Design: This prospective study documented, by means of institutional review board-approved questionnaire survey protocols, the perceptions of parents and staff from two contrasting NICU environments. Result: Findings showed that demographic subgroups of parents and staff perceived the advantages and disadvantages of the two facility designs differently. Staff perceptions varied with previous experience, acclimation time and employment position, whereas parental perceptions revealed a naiveté bias through surveys of transitional parents with experience in both NICU facilities. Conclusion: Use of transitional parent surveys showed a subject naiveté bias inherent in perceptions of inexperienced parents. Grouping all survey participants demographically provided more informative interpretations of data, and revealed staff perceptions to vary with position, previous training and hospital experience. PMID:20072132

Reduction of Environmental Listeria Using Gaseous Ozone in a Cheese Processing Facility.

PubMed

Eglezos, Sofroni; Dykes, Gary A

2018-05-01

A cheese processing facility seeking to reduce environmental Listeria colonization initiated a regime of ozonation across all production areas as an adjunct to its sanitation regimes. A total of 360 environmental samples from the facility were tested for Listeria over a 12-month period. A total of 15 areas before and 15 areas after ozonation were tested. Listeria isolations were significantly ( P < 0.001) reduced from 15.0% in the preozonation samples to 1.67% in the postozonation samples in all areas. No deleterious effects of ozonation were noted on the wall paneling, seals, synthetic floors, or cheese processing equipment. The ozonation regime was readily incorporated by sanitation staff into the existing good manufacturing practice program. The application of ozone may result in a significant reduction in the prevalence of Listeria in food processing facilities.

Implementation of the TsunamiReady Supporter Program in Puerto Rico

NASA Astrophysics Data System (ADS)

Flores Hots, V. E.; Vanacore, E. A.; Gonzalez Ruiz, W.; Gomez, G.

2016-12-01

The Puerto Rico Seismic Network (PRSN) manages the PR Tsunami Program (NTHMP), including the TsunamiReady Supporter Program. Through this program the PRSN helps private organizations, businesses, facilities or local government entities to willingly engage in tsunami planning and preparedness that meet some requirements established by the National Weather Service. TsunamiReady Supporter organizations are better prepared to respond to a tsunami emergency, developing a response plan (using a template that PRSN developed and provides), and reinforcing their communication systems including NOAA radio, RSS, and loud speakers to receive and disseminate the alerts issued by the NWS and the Tsunami Warning Centers (TWC). The planning and the communication systems added to the training that PRSN provides to the staff and employees, are intend to help visitors and employees evacuate the tsunami hazard zone to the nearest assembly point minimizing loss of life. Potential TsunamiReady Supporters include, but are not limited to, businesses, schools, churches, hospitals, malls, utilities, museums, beaches, and harbors. However, the traditional targets for such programs are primarily tourism sites and hotels where people unaware of the tsunami hazard may be present. In 2016 the Tsunami Ready Program guided four businesses to achieve the TsunamiReady Supporter recognition. Two facilities were hotels near or inside the evacuation zone. The other facilities were the first and only health center and supermarket to be recognized in the United States and US territories. Based on the experience of preparing the health center and supermarket sites, here we present two case studies of how the TsunamiReady Supporter Program can be applied to non-traditional facilities as well as how the application of this program to such facilities can improve tsunami hazard mitigation. Currently, we are working on expanding the application of this program to non-traditional facilities by working with a banking facility located in a tsunami evacuation zone increasing their capacity to manage a tsunami event and to reinforce the entity's involvement in developing a plan for their clients and employees to evacuate the area and head to a safe place.

Effect of Staff Turnover on Staffing: A Closer Look at Registered Nurses, Licensed Vocational Nurses, and Certified Nursing Assistants

ERIC Educational Resources Information Center

Kash, Bita A.; Castle, Nicholas G.; Naufal, George S.; Hawes, Catherine

2006-01-01

Purpose: We examined the effects of facility and market-level characteristics on staffing levels and turnover rates for direct care staff, and we examined the effect of staff turnover on staffing levels. Design and Methods: We analyzed cross-sectional data from 1,014 Texas nursing homes. Data were from the 2002 Texas Nursing Facility Medicaid Cost…

Creativity and dementia: does artistic activity affect well-being beyond the art class?

PubMed

Gross, Susan M; Danilova, Deana; Vandehey, Michael A; Diekhoff, George M

2015-01-01

The Alzheimer's Association's Memories in the Making (MIM) art activity program is intended to enhance the well-being of individuals who are living with dementia. Previous evaluations of MIM have found that participants show benefits on several well-being domains measured by the Greater Cincinnati Chapter Well-Being Observation Tool. The current study extended those findings by looking for evidence of carry-over effects beyond the temporal boundaries of MIM sessions. Additionally, this study evaluated key psychometric qualities of the assessment instrument. Seventy-six MIM participants with middle- to late-stage dementia were evaluated by interns and care facility staff at the beginning, middle and end of a 12-week MIM program. Interns focused on behavior within MIM sessions and staff rated functioning outside MIM sessions. Staff reported no significant changes in resident well-being across the 12-week program. Interns reported significant improvements from the beginning to middle and end of the program on five well-being domains. Psychometric analyses of the Greater Cincinnati Chapter Well-Being Observation Tool identified weaknesses in inter-rater reliability and found that the instrument measures two orthogonal factors--interpreted as 'Well-Being' and 'Ill-Being' - not the seven domains claimed. Quantitative evidence for the effectiveness of MIM is ambiguous, but anecdotal observations indicate that the program is beneficial for some participants, if only fleetingly. © The Author(s) 2013 Reprints and permissions: sagepub.co.uk/journalsPermissions.nav.

Fostering good governance at peripheral public health facilities: an experience from Nepal.

PubMed

Gurung, G; Tuladhar, S

2013-01-01

The Nepalese primary healthcare system at sub-district level consists of three different levels of health facility to serve the mostly rural population. The Ministry of Health and Population decentralised health services by handing over 1433 health facilities in 28 districts to Health Facility Operation and Management Committees (HFOMCs), which were formed following a public meeting, and consist of 9 to 13 members, representing the health facility in-charge, elected members of the village development committee, dalit (disadvantaged caste) and women members. The purpose was to make this local committee responsible for managing all affairs of the health facility. However, the handing over of the health facilities to HFOMCs was not matched by an equivalent increase in the managerial capacity of the members, which potentially makes this initiative ineffective. The Health Facility Management Strengthening Program was implemented in 13 districts to foster good governance in the health facilities by increasing the capacity of HFOMCs. This effort focuses on capacity building of HFOMCs as a continuous process rather than a one-off event. Training, follow-up and promotional activities were conducted. This article focuses on how good governance at the peripheral public health facilities in Nepal can be fostered through the active engagement and capacity building of HFOMCs. This article used baseline and monitoring data collected during technical support visits to HFOMCs and their members between July 2008 and October 2011. The results show that the Health Facility Management Strengthening Program was quite successful in strengthening local health governance in the health facilities. The level of community engagement in governance improved, that is, the number of effective HFOMC meetings increased, the inclusion of dalit/women members in the decision-making process expanded, resource mobilization was facilitated, and community accountability, as measured by health facility opening days, increased. Furthermore, availability of technical staff, supervision and monitoring, and display of the citizen charter increased, and health services became more inclusive. Several lessons emerged. Functioning of HFOMCs is largely dependent on the process of selecting members, the staff and community's support of the HFOMC, and a sense of volunteerism and team spirit among the members. Similarly, to ensure the effective participation of dalit/woman members, the educational and livelihood empowerment of the members is deemed necessary. Furthermore, capacity building of and giving authority to HFOMCs should go hand-in-hand. Local governance of health facilities was fostered through the local people's active engagement in HFOMCs and capacity building of the HFOMC members.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Piette, Mary Ann; Sezgen, Osman; Watson, David S.

This report describes the results of a research project to develop and evaluate the performance of new Automated Demand Response (Auto-DR) hardware and software technology in large facilities. Demand Response (DR) is a set of activities to reduce or shift electricity use to improve electric grid reliability, manage electricity costs, and ensure that customers receive signals that encourage load reduction during times when the electric grid is near its capacity. The two main drivers for widespread demand responsiveness are the prevention of future electricity crises and the reduction of electricity prices. Additional goals for price responsiveness include equity through costmore » of service pricing, and customer control of electricity usage and bills. The technology developed and evaluated in this report could be used to support numerous forms of DR programs and tariffs. For the purpose of this report, we have defined three levels of Demand Response automation. Manual Demand Response involves manually turning off lights or equipment; this can be a labor-intensive approach. Semi-Automated Response involves the use of building energy management control systems for load shedding, where a preprogrammed load shedding strategy is initiated by facilities staff. Fully-Automated Demand Response is initiated at a building or facility through receipt of an external communications signal--facility staff set up a pre-programmed load shedding strategy which is automatically initiated by the system without the need for human intervention. We have defined this approach to be Auto-DR. An important concept in Auto-DR is that a facility manager is able to ''opt out'' or ''override'' an individual DR event if it occurs at a time when the reduction in end-use services is not desirable. This project sought to improve the feasibility and nature of Auto-DR strategies in large facilities. The research focused on technology development, testing, characterization, and evaluation relating to Auto-DR. This evaluation also included the related decisionmaking perspectives of the facility owners and managers. Another goal of this project was to develop and test a real-time signal for automated demand response that provided a common communication infrastructure for diverse facilities. The six facilities recruited for this project were selected from the facilities that received CEC funds for new DR technology during California's 2000-2001 electricity crises (AB970 and SB-5X).« less

Nuclear facility decommissioning and site remedial actions: A selected bibliography, volume 9

DOE Office of Scientific and Technical Information (OSTI.GOV)

Owen, P.T.; Knox, N.P.; Michelson, D.C.

1988-09-01

The 604 abstracted references on nuclear facility decommissioning, uranium mill tailings management, and site remedial actions constitute the ninth in a series of reports prepared annually for the US Department of Energy's Remedial Action Programs. Foreign and domestic literature of all types--technical reports, progress reports, journal articles, symposia proceedings, theses, books, patents, legislation, and research project descriptions--has been included. The bibliography contains scientific, technical, economic, regulatory, and legal information pertinent to the US Department of Energy's remedial action programs. Major sections are (1) Surplus Facilities Management Program, (2) Nuclear Facilities Decommissioning, (3) Formerly Utilized Sites Remedial Action Program, (4) Facilitiesmore » Contaminated with Naturally Occurring Radionuclides, (5) Uranium Mill Tailings Remedial Action Program, (6) Uranium Mill Tailings Management, (7) Technical Measurements Center, and (8) General Remedial Action Program Studies. Subsections for sections 1, 2, 5, and 6 include: Design, Planning, and Regulations; Environmental Studies and Site Surveys; Health, Safety, and Biomedical Studies; Decontamination Studies; Dismantlement and Demolition; Site Stabilization and Reclamation; Waste Disposal; Remedial Action Experience; and General Studies. Within these categories, references are arranged alphabetically by first author. Those references having no individual author are listed by corporate affiliation or by publication description. Indexes are provided for author, corporate affiliation, title word, publication description, geographic location, and keywords. This report is a product of the Remedial Action Program Information Center (RAPIC), which selects and analyzes information on remedial actions and relevant radioactive waste management technologies. RAPIC staff and resources are available to meet a variety of information needs. Contact the center at (615) 576-0568 or FTS 626-0568.« less

NASA Johnson Space Center Usability Testing and Analysis Facility (UTAF) Overview

NASA Technical Reports Server (NTRS)

Whitmore, M.

2004-01-01

The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility provides support to the Office of Biological and Physical Research, the Space Shuttle Program, the International Space Station Program, and other NASA organizations. In addition, there are ongoing collaborative research efforts with external businesses and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes. This presentation will provide an overview of ongoing activities, and will address how the projects will evolve to meet new space initiatives.

NASA Johnson Space Center Usability Testing and Analysis Facility (WAF) Overview

NASA Technical Reports Server (NTRS)

Whitmore, M.

2004-01-01

The Usability Testing and Analysis Facility (UTAF) is part of the Space Human Factors Laboratory at the NASA Johnson Space Center in Houston, Texas. The facility provides support to the Office of Biological and Physical Research, the Space Shuttle Program, the International Space Station Program, and other NASA organizations. In addition, there are ongoing collaborative research efforts with external businesses and universities. The UTAF provides human factors analysis, evaluation, and usability testing of crew interfaces for space applications. This includes computer displays and controls, workstation systems, and work environments. The UTAF has a unique mix of capabilities, with a staff experienced in both cognitive human factors and ergonomics. The current areas of focus are: human factors applications in emergency medical care and informatics; control and display technologies for electronic procedures and instructions; voice recognition in noisy environments; crew restraint design for unique microgravity workstations; and refinement of human factors processes. This presentation will provide an overview of ongoing activities, and will address how the projects will evolve to meet new space initiatives.

Clinical solid waste management practices and its impact on human health and environment - A review

DOE Office of Scientific and Technical Information (OSTI.GOV)

Hossain, Md. Sohrab; Santhanam, Amutha; Nik Norulaini, N.A.

2011-04-15

Research highlights: > Appropriate waste management technology for safe handling and disposal of clinical solid waste. > Infectious risk assessment on unsafe handling of clinical solid waste. > Recycling-reuse program of clinical solid waste materials. > Effective sterilization technology to reduce exposure of infectious risk. - Abstract: The management of clinical solid waste (CSW) continues to be a major challenge, particularly, in most healthcare facilities of the developing world. Poor conduct and inappropriate disposal methods exercised during handling and disposal of CSW is increasing significant health hazards and environmental pollution due to the infectious nature of the waste. This articlemore » summarises a literature review into existing CSW management practices in the healthcare centers. The information gathered in this paper has been derived from the desk study of open literature survey. Numerous researches have been conducted on the management of CSW. Although, significant steps have been taken on matters related to safe handling and disposal of the clinical waste, but improper management practice is evident from the point of initial collection to the final disposal. In most cases, the main reasons of the mismanagement of CSW are the lack of appropriate legislation, lack of specialized clinical staffs, lack of awareness and effective control. Furthermore, most of the healthcare centers of the developing world have faced financial difficulties and therefore looking for cost effective disposal methods of clinical waste. This paper emphasizes to continue the recycle-reuse program of CSW materials after sterilization by using supercritical fluid carbon dioxide (SF-CO2) sterilization technology at the point of initial collection. Emphasis is on the priority to inactivate the infectious micro-organisms in CSW. In that case, waste would not pose any threat to healthcare workers. The recycling-reuse program would be carried out successfully with the non-specialized clinical staffs. Therefore, the adoption of SF-CO2 sterilization technology in management of clinical solid waste can reduce exposure to infectious waste, decrease labor, lower costs, and yield better compliance with regulatory. Thus healthcare facilities can both save money and provide a safe environment for patients, healthcare staffs and clinical staffs.« less

The effects of small-scale, homelike facilities for older people with dementia on residents, family caregivers and staff: design of a longitudinal, quasi-experimental study.

PubMed

Verbeek, Hilde; van Rossum, Erik; Zwakhalen, Sandra M G; Ambergen, Ton; Kempen, Gertrudis I J M; Hamers, Jan P H

2009-01-20

Small-scale and homelike facilities for older people with dementia are rising in current dementia care. In these facilities, a small number of residents live together and form a household with staff. Normal, daily life and social participation are emphasized. It is expected that these facilities improve residents' quality of life. Moreover, it may have a positive influence on staff's job satisfaction and families involvement and satisfaction with care. However, effects of these small-scale and homelike facilities have hardly been investigated. Since the number of people with dementia increases, and institutional long-term care is more and more organized in small-scale and homelike facilities, more research into effects is necessary. This paper presents the design of a study investigating effects of small-scale living facilities in the Netherlands on residents, family caregivers and nursing staff. A longitudinal, quasi-experimental study is carried out, in which 2 dementia care settings are compared: small-scale living facilities and regular psychogeriatric wards in traditional nursing homes. Data is collected from residents, their family caregivers and nursing staff at baseline and after 6 and 12 months of follow-up. Approximately 2 weeks prior to baseline measurement, residents are screened on cognition and activities of daily living (ADL). Based on this screening profile, residents in psychogeriatric wards are matched to residents living in small-scale living facilities. The primary outcome measure for residents is quality of life. In addition, neuropsychiatric symptoms, depressive symptoms and social engagement are assessed. Involvement with care, perceived burden and satisfaction with care provision are primary outcome variables for family caregivers. The primary outcomes for nursing staff are job satisfaction and motivation. Furthermore, job characteristics social support, autonomy and workload are measured. A process evaluation is performed to investigate to what extent small-scale living facilities and psychogeriatric wards are designed as they were intended. In addition, participants' satisfaction and experiences with small-scale living facilities are investigated. A longitudinal, quasi-experimental study is presented to investigate effects of small-scale living facilities. Although some challenges concerning this design exist, it is currently the most feasible method to assess effects of this relatively new dementia care setting.

Examining the cost of delivering routine immunization in Honduras.

PubMed

Janusz, Cara Bess; Castañeda-Orjuela, Carlos; Molina Aguilera, Ida Berenice; Felix Garcia, Ana Gabriela; Mendoza, Lourdes; Díaz, Iris Yolanda; Resch, Stephen C

2015-05-07

Many countries have introduced new vaccines and expanded their immunization programs to protect additional risk groups, thus raising the cost of routine immunization delivery. Honduras recently adopted two new vaccines, and the country continues to broaden the reach of its program to adolescents and adults. In this article, we estimate and examine the economic cost of the Honduran routine immunization program for the year 2011. The data were gathered from a probability sample of 71 health facilities delivering routine immunization, as well as 8 regional and 1 central office of the national immunization program. Data were collected on vaccinations delivered, staff time dedicated to the program, cold chain equipment and upkeep, vehicle use, infrastructure, and other recurrent and capital costs at each health facility and administrative office. Annualized economic costs were estimated from a modified societal perspective and reported in 2011 US dollars. With the addition of rotavirus and pneumococcal conjugate vaccines, the total cost for routine immunization delivery in Honduras for 2011 was US$ 32.5 million. Vaccines and related supplies accounted for 23% of the costs. Labor, cold chain, and vehicles represented 54%, 4%, and 1%, respectively. At the facility level, the non-vaccine system costs per dose ranged widely, from US$ 25.55 in facilities delivering fewer than 500 doses per year to US$ 2.84 in facilities with volume exceeding 10,000 doses per year. Cost per dose was higher in rural facilities despite somewhat lower wage rates for health workers in these settings; this appears to be driven by lower demand for services per health worker in sparsely populated areas, rather than increased cost of outreach. These more-precise estimates of the operational costs to deliver routine immunizations provide program managers with important information for mobilizing resources to help sustain the program and for improving annual planning and budgeting as well as longer-term resource allocation decisions. Copyright © 2015. Published by Elsevier Ltd.

Chemical Technology Division: Progress report, January 1, 1987--June 30, 1988

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

1989-02-01

This progress report summarizes the research and development efforts conducted in the Chemical Technology Division (Chem Tech) during the period January 1, 1987, to June 30, 1988. The following major areas are covered: waste management and environmental programs, radiochemical and reactor engineering programs, basic science and technology, Nuclear Regulatory Commission programs, and administrative resources and facilities. The Administrative Summary, an appendix, presents a comprehensive listing of publications, oral presentations, awards and recognitions, and patents of Chem Tech staff members during this period. A staffing level and financial summary and lists of seminars and Chem Tech consultants for the period aremore » also included.« less

Affirmative Action Compliance Program for Fiscal Year 1980

DOE Office of Scientific and Technical Information (OSTI.GOV)

Not Available

Eleven chapters are used to delineate Lawrence Berkeley Lab's compliance, namely: (1) a description of LBL's facility, history, staff, mission, etc; (2) Affirmative Action policy statement; (3) dissemination (internal and external) per the implementation regulations; (4) identification of Affirmative Action responsibilities; (5) personnel policies; (6) past goal-setting process and accomplishment; (7) work-force array, job groups, availability determinations, identification of underutilization, and goals and timetables; (8) identification of problem areas and action-oriented programs; (9) listing and brief description of specific LBL Affirmative Action programs; (10) compliance with sex-discrimination guidelines; and (11) compliance with guidelines on discrimination because of religion or nationalmore » origin.« less

Summer Institute in Engineering and Computer Applications: Learning Through Experience

NASA Technical Reports Server (NTRS)

Langdon, Joan S.

1995-01-01

The document describing the Summer Institute project is made up of the following information: Administrative procedures; Seminars/Special Courses/Tours/College fair; Facilities/ Transportation; Staff and Administration; Collaboration; Participant/Project monitoring and evaluation; Fiscal and developmental activities; Job readiness/Job internship development and placement; and Student Follow-up/Tracking. Appendices include presentations, self-evaluations; abstracts and papers developed by the students during their participation in the program.

Quarterly Performance/Technical Report of the National Marrow Donor Program

DTIC Science & Technology

2010-03-31

Implemented the Business to Business ( B2B ) Gateway and Business Services to support : • Incoming HLA typing results incorporating HLA Nomenclature changes...maintenance was performed. IIA.3.2 Task 2: Critical Facility and Staff Related Functions Period 6 Activity: • Business Continuity Planning: o Continued...department development of appropriate detailed tasks to be tested at a remote (non-NMDP controlled) location for the 2010 Business Continuity

Awareness of cervical cancer and Pap smear among nursing staff at a rural tertiary care hospital in Central India.

PubMed

Jain, S M; Bagde, M N; Bagde, N D

2016-01-01

Cancer cervix is the leading cause of cancer deaths in females in developing countries and one in five women suffering from cervical cancer lives in India. The aim of this study is to determine the awareness about cervical cancer and Pap smear among nurses working in a tertiary care institute. Study Setting and Design: Cross-sectional survey in a tertiary care institute. Nurses working at our institute excluding those who have worked or working in the Obstetrics and Gynecology department were provided with a pre-designed questionnaire testing their knowledge about cervical cancer. Approximately, 86% were aware about cancer cervix and 69% were aware of a pre-cancerous stage. 42.3% were not aware of any risk factor and 27.6% were not aware of any symptom of cancer cervix. 86.2% were aware about Pap smear, but only 58.6% were aware that facilities of Pap smear were available at our hospital. Knowledge about cervical cancer and awareness of Pap smear as screening test was inadequate in nursing staff. Awareness programs about cervical cancer and screening are needed to increase awareness for this preventable condition. There is a need to arrange reorientation programs to sensitize nurses and establish cytology clinics to offer facilities for easily accessible and affordable screening.

Exploring Park Director Roles in Promoting Community Physical Activity

PubMed Central

Marsh, Terence; Derose, Kathryn Pitkin; Cohen, Deborah A.

2013-01-01

Background Parks provide numerous opportunities for physical activity (PA). Previous studies have evaluated parks’ physical features, but few have assessed how park staff influence PA. Methods We conducted semi -structured interviews with 49 park directors, focusing on perceptions of their role, park programs, marketing and outreach, external collaborations, and PA promotion. Directors also completed a questionnaire providing demographics, education and training, and other personal characteristics. Results Park directors’ descriptions of their roles varied widely, from primarily administrative to emphasizing community interaction, though most (70–80%) reported offering programs and community interaction as primary. Including PA in current programs and adding PA-specific programs were the most commonly reported ways of increasing PA. Also noted were facility and staffing improvements, and conducting citywide marketing. Many directors felt inadequately trained in marketing. Most parks reported community collaborations, but they appeared fairly superficial. An increasing administrative burden and bureaucracy were recurring themes throughout the interviews. Conclusions Staff training in marketing and operation of PA programs is needed. Partnerships with health departments and organizations can help facilitate the PA promotion potential of parks. As there are competing views of how parks should be managed, standardized benchmarks to evaluate efficiency may help to optimize usage and PA promotion. PMID:22733875

Exploring park director roles in promoting community physical activity.

PubMed

Marsh, Terry; Derose, Kathryn Pitkin; Cohen, Deborah A

2012-07-01

Parks provide numerous opportunities for physical activity (PA). Previous studies have evaluated parks' physical features, but few have assessed how park staff influence PA. We conducted semistructured interviews with 49 park directors, focusing on perceptions of their role, park programs, marketing and outreach, external collaborations, and PA promotion. Directors also completed a questionnaire providing demographics, education and training, and other personal characteristics. Park directors' descriptions of their roles varied widely, from primarily administrative to emphasizing community interaction, though most (70% to 80%) reported offering programs and community interaction as primary. Including PA in current programs and adding PA-specific programs were the most commonly reported ways of increasing PA. Also noted were facility and staffing improvements, and conducting citywide marketing. Many directors felt inadequately trained in marketing. Most parks reported community collaborations, but they appeared fairly superficial. An increasing administrative burden and bureaucracy were recurring themes throughout the interviews. Staff training in marketing and operation of PA programs is needed. Partnerships with health departments and organizations can help facilitate the PA promotion potential of parks. As there are competing views of how parks should be managed, standardized benchmarks to evaluate efficiency may help to optimize usage and PA promotion.

Determinants of routine immunization costing in Benin and Ghana in 2011.

PubMed

Ahanhanzo, Césaire Damien; Huang, Xiao Xian; Le Gargasson, Jean-Bernard; Sossou, Justin; Nyonator, Frank; Colombini, Anais; Gessner, Bradford D

2015-05-07

Existing tools to evaluate costs do not always capture the heterogeneity of costs at the facility level. This study seeks to address this issue through an analysis of determinants of health facility immunization costs. A statistical analysis on facility routine delivery and vaccine costs was conducted using ordinary least squares regression. Explanatory variables included the number of doses administered; proportion of time spent by facility staff on immunization; average staff wage; whether the health facility had enough staff; presence of cold chain equipment; distance to a vaccine collection point; and, facility ownership. Data were drawn from representative samples of primary care facilities in Benin and Ghana (46 and 50 facilities, respectively) collected as part of the EPIC studies. Weighted average RI immunization facility cost was US$ 16,459 in Ghana and US$ 14,994 in Benin. The regression found total doses administered to be positively and significantly associated with facility cost in both countries. A 10% increase in doses resulted in a 4% increase in cost in Ghana, and a 7.5% increase in Benin. In Ghana, the proportion of immunization time, presence of cold chain, and sufficiency of staff were positively and significantly associated with total cost. In Benin, facility cost was negatively and significantly related to distance to the vaccine collection point. In the pooled sample, facilities in capital cities were associated with significantly higher costs. This study provides evidence on the importance of the level of scale in determining facility immunization cost, as well as the role of availability of health workers and time they spend on immunization in Ghana and Benin. This type of analysis can provide insights into the costs of scaling up immunization services, and can assist with development of more efficient immunization strategies. Copyright © 2015 Elsevier Ltd. All rights reserved.

Summary of findings from the evaluation of a pilot medically supervised safer injecting facility

PubMed Central

Wood, Evan; Tyndall, Mark W.; Montaner, Julio S.; Kerr, Thomas

2006-01-01

In many cities, infectious disease and overdose epidemics are occurring among illicit injection drug users (IDUs). To reduce these concerns, Vancouver opened a supervised safer injecting facility in September 2003. Within the facility, people inject pre-obtained illicit drugs under the supervision of medical staff. The program was granted a legal exemption by the Canadian government on the condition that a 3-year scientific evaluation of its impacts be conducted. In this review, we summarize the findings from evaluations in those 3 years, including characteristics of IDUs at the facility, public injection drug use and publicly discarded syringes, HIV risk behaviour, use of addiction treatment services and other community resources, and drug-related crime rates. Vancouver's safer injecting facility has been associated with an array of community and public health benefits without evidence of adverse impacts. These findings should be useful to other cities considering supervised injecting facilities and to governments considering regulating their use. PMID:17116909

Surviving the storms: Emergency preparedness in Texas nursing facilities and assisted living facilities.

PubMed

Castro, Carmen; Persson, Diane; Bergstrom, Nancy; Cron, Stanley

2008-08-01

This study assesses the preparedness of long-term care facilities in Texas responding to Hurricanes Katrina and Rita. A 41-item questionnaire was mailed to facilities; the response rate was 42%. Among responding facilities, 4513 residents were evacuated, and 6% of respondents reported resident death. Financial losses were reported by 8% of nursing facilities and 45% of assisted living facilities due to transportation and staff overtime. Respondents indicated the need for improved disaster preparednesstraining, better coordination, and transportation. Changes in policy and practice will lead to better trained staff who will provide the care residents need for improved health outcomes during future public health disasters.

The Vocational Training FacilityAn Interactive Learning Program to Return Persons With Physical Disabilities to Employment.

PubMed

Hammel, J M; Van Der Loos, H F; Lepage, P; Burgar, C; Perkash, I; Shafer, D; Topp, E; Lees, D

1994-01-01

This paper describes the results of the program-development phase of the Vocational Training Facility (VTF) taking place at the Palo Alto Veterans Affairs Medical Center Rehabilitation Research and Development Center. The VTF staff has developed a self-paced, multimedia curriculum comprised of adapted training packages, interactive videos, and additional training and testing materials designed to teach entry-level desktop publishing and reasonable accommodation skills to individuals with spinal cord injuries. The curriculum is taught via the Macintosh™ computer to allow independent, "hands-off" access to training materials. Each student is given an integrated workstation that is equipped with the Desktop Vocational Assistant Robot (De VAR); a set of low-and high-technology assistive hardware, software, and devices; and ergonomic furniture and adaptations customized to fit individual learning and access needs. Each student completes a 12-week, full-time training program followed by a 3-month internship with a local corporate sponsor. This paper summarizes the evaluation results of the VTF program by the first nine students, with spinal cord injuries ranging paraplegia to high-level quadriplegia, who have completed the program.

Internship - practical education

DOE Office of Scientific and Technical Information (OSTI.GOV)

Porell, A.L.; Bauman, H.F.

1989-01-01

The current emphasis on regulatory compliance with environmental laws has depleted the availability of experienced environmental scientists and engineers needed to initiate critical environmental projects. Further, projects of short duration and long-term commitments to employment situations are considered a high risk for both the employer and the employee. Martin Marietta Energy Systems, Inc., has met this challenge for federal agencies through the US Department of Energy's (DOE's) Hazardous Waste Remedial Actions Program (HAZWRAP). Through unique interdepartmental agency agreements between the DOE and the Department of Defense (DOD) and contractual arrangements between Energy Systems, DOE, and the University of Tennessee's (UT's)more » Waste Management Institute (WMI), an intern program was formulated. HAZWRAP is a DOE headquarters' program for addressing hazardous-waste issues at all DOE facilities. Energy Systems is the support contractor office responsible for developing policies and implementing plans for this program. Under this charter, HAZWRAP assembled a large staff of experienced project managers for developing remedial actions plans, while providing other federal agencies assistance in implementing their remedial actions programs. HAZWRAP project managers are currently managing remedial investigations and feasibility studies at 130 federal facilities located throughout the DOD.« less

Association between health worker motivation and healthcare quality efforts in Ghana.

PubMed

Alhassan, Robert Kaba; Spieker, Nicole; van Ostenberg, Paul; Ogink, Alice; Nketiah-Amponsah, Edward; de Wit, Tobias F Rinke

2013-08-14

Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P <0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic's effort towards quality improvement and patient safety (P <0.05). As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst.

First Steps in Initiating an Effective Maternal, Neonatal, and Child Health Program in Urban Slums: the BRAC Manoshi Project's Experience with Community Engagement, Social Mapping, and Census Taking in Bangladesh.

PubMed

Marcil, Lucy; Afsana, Kaosar; Perry, Henry B

2016-02-01

The processes for implementing effective programs at scale in low-income countries have not been well-documented in the peer-reviewed literature. This article describes the initial steps taken by one such program--the BRAC Manoshi Project, which now reaches a population of 6.9 million. The project has achieved notable increases in facility births and reductions in maternal and neonatal mortality. The focus of the paper is on the initial steps--community engagement, social mapping, and census taking. Community engagement began with (1) engaging local leaders, (2) creating Maternal, Neonatal, and Child Health Committees for populations of approximately 10,000 people, (3) responding to advice from the community, (4) social mapping of the community, and (5) census taking. Social mapping involved community members working with BRAC staff to map all important physical features that affect how the community carries out its daily functions--such as alleys, lanes and roads, schools, mosques, markets, pharmacies, health facilities, latrine sites, and ponds. As the social mapping progressed, it became possible to conduct household censuses with maps identifying every household and listing family members by household. Again, this was a process of collaboration between BRAC staff and community members. Thus, social mapping and census taking were also instrumental for advancing community engagement. These three processes-community engagement, social mapping, and census taking--can be valuable strategies for strengthening health programs in urban slum settings of low-income countries.

Exploring staff perceptions on the role of physical environment in dementia care setting.

PubMed

Lee, Sook Y; Chaudhury, Habib; Hung, Lillian

2016-07-01

This study explored staff perceptions of the role of physical environment in dementia care facilities in affecting resident's behaviors and staff care practice. We conducted focus groups with staff (n = 15) in two purposely selected care facilities in Vancouver, Canada. Focus group participants included nurses, care aides, recreation staff, administrative staff, and family. Data analysis revealed two themes: (a) a supportive physical environment contributes positively to both quality of staff care interaction and residents' quality of life and (b) an unsupportive physical environment contributes negatively to residents' quality of life and thereby makes the work of staff more challenging. The staff participants collectively viewed that comfort, familiarity, and an organized space were important therapeutic resources for supporting the well-being of residents. Certain behaviors of residents were influenced by poor environmental factors, including stimulation overload, safety risks, wayfinding challenge, and rushed care This study demonstrates the complex interrelationships among the dementia care setting's physical environment, staff experiences, and residents' quality of life. © The Author(s) 2014.

From chaos to calm: one jail system's struggle with suicide prevention.

PubMed

Hayes, L M

1997-01-01

This article profiles the suicide prevention practices at a large metropolitan jail, a facility that experienced nine inmate suicides in a recent 24-month period. The suicide rate in this facility was found to far exceed the rate for jails of comparable size as well as the national rate of jail suicides. The nine suicides are summarized and common features (including the issue of protective custody) of the deaths and systemic jail deficiencies are discussed. The process by which the jail system developed a suicide prevention program based upon the principles of staff training, identification/screening, communication, levels of supervision, housing, and intervention is offered.

Developing partnerships for implementing continental-scale citizen science programs at the local-level

NASA Astrophysics Data System (ADS)

Newman, S. J.; Henderson, S.; Ward, D.

2012-12-01

Project BudBurst is a citizen science project focused on monitoring plant phenology that resides at the National Ecological Observatory Network (NEON, Inc). A central question for Project BudBurst and other national outreach programs is: what are the most effective means of engaging and connecting with diverse communities throughout the country? How can continental scale programs like NEON's Project BudBurst engage audiences in such a way as to be relevant at both the local and continental scales? Staff with Project BudBurst pursued partnerships with several continental scale organizations: the National Wildlife Refuge System, the National Park Service, and botanic gardens to address these questions. The distributed nature of wildlife refuges, national parks, and botanic gardens around the country provided the opportunity to connect with participants locally while working with leadership at multiple scales. Project BudBurst staff talked with hundreds of staff and volunteers prior to setting a goal of obtaining and developing resources for several Refuge Partners, a pilot National Park partner, and an existing botanic garden partner during 2011. We were especially interested in learning best practices for future partnerships. The partnership efforts resulted in resource development for 12 Refuge partners, a pilot National Park partner, and 2 botanic garden partners. Early on, the importance of working with national level leaders to develop ownership of the partner program and input about resource needs became apparent. Once a framework for the partnership program was laid out, it became critical to work closely with staff and volunteers on the ground to ensure needs were met. In 2012 we began to develop an online assessment to allow our current and potential partners to provide feedback about whether or not the partnership program was meeting their needs and how the program could be improved. As the year progressed, the timeline for resource development became more of a suggestion than a set schedule. Maintaining flexibility was critical to the success of the partnerships. Unanticipated fieldwork, new priorities within organizations, and differing levels of involvement from partner staff, advisory boards, or Friends groups, led to varying resource development timelines. The distributed nature of and the willingness of partner staff and volunteers to implement Project BudBurst at their facilities have broadened the participation of the public in this program more than could have been accomplished alone. The new partners benefit from the free and customized education and outreach materials provided by Project BudBurst, while Project BudBurst benefits from the local knowledge and contacts with the public from the partner organizations.

“It’s Somebody else’s responsibility” - perceptions of general practitioners, heart failure nurses, care home staff, and residents towards heart failure diagnosis and management for older people in long-term care: a qualitative interview study

PubMed Central

2013-01-01

Background Older people in care-facilities may be less likely to access gold standard diagnosis and treatment for heart failure (HF) than non residents; little is understood about the factors that influence this variability. This study aimed to examine the experiences and expectations of clinicians, care-facility staff and residents in interpreting suspected symptoms of HF and deciding whether and how to intervene. Methods This was a nested qualitative study using in-depth interviews with older residents with a diagnosis of heart failure (n=17), care-facility staff (n=8), HF nurses (n=3) and general practitioners (n=5). Results Participants identified a lack of clear lines of responsibility in providing HF care in care-facilities. Many clinical staff expressed negative assumptions about the acceptability and utility of interventions, and inappropriately moderated residents’ access to HF diagnosis and treatment. Care-facility staff and residents welcomed intervention but experienced a lack of opportunity for dialogue about the balance of risks and benefits. Most residents wanted to be involved in healthcare decisions but physical, social and organisational barriers precluded this. An onsite HF service offered a potential solution and proved to be acceptable to residents and care-facility staff. Conclusions HF diagnosis and management is of variable quality in long-term care. Conflicting expectations and a lack of co-ordinated responsibility for care, contribute to a culture of benign neglect that excludes the wishes and needs of residents. A greater focus on rights, responsibilities and co-ordination may improve healthcare quality for older people in care. Trial registration ISRCTN: ISRCTN19781227 PMID:23829674

"It's Somebody else's responsibility" - perceptions of general practitioners, heart failure nurses, care home staff, and residents towards heart failure diagnosis and management for older people in long-term care: a qualitative interview study.

PubMed

Close, Helen; Hancock, Helen; Mason, James M; Murphy, Jerry J; Fuat, Ahmet; de Belder, Mark; Hungin, A Pali S

2013-07-05

Older people in care-facilities may be less likely to access gold standard diagnosis and treatment for heart failure (HF) than non residents; little is understood about the factors that influence this variability. This study aimed to examine the experiences and expectations of clinicians, care-facility staff and residents in interpreting suspected symptoms of HF and deciding whether and how to intervene. This was a nested qualitative study using in-depth interviews with older residents with a diagnosis of heart failure (n=17), care-facility staff (n=8), HF nurses (n=3) and general practitioners (n=5). Participants identified a lack of clear lines of responsibility in providing HF care in care-facilities. Many clinical staff expressed negative assumptions about the acceptability and utility of interventions, and inappropriately moderated residents' access to HF diagnosis and treatment. Care-facility staff and residents welcomed intervention but experienced a lack of opportunity for dialogue about the balance of risks and benefits. Most residents wanted to be involved in healthcare decisions but physical, social and organisational barriers precluded this. An onsite HF service offered a potential solution and proved to be acceptable to residents and care-facility staff. HF diagnosis and management is of variable quality in long-term care. Conflicting expectations and a lack of co-ordinated responsibility for care, contribute to a culture of benign neglect that excludes the wishes and needs of residents. A greater focus on rights, responsibilities and co-ordination may improve healthcare quality for older people in care. ISRCTN19781227.

Horizontal equity and efficiency at primary health care facilities in rural Afghanistan: a seemingly unrelated regression approach.

PubMed

Johns, Benjamin; Steinhardt, Laura; Walker, Damian G; Peters, David H; Bishai, David

2013-07-01

Producing services efficiently and equitably are important goals for health systems. Many countries pursue horizontal equity - providing people with the same illnesses equal access to health services - by locating facilities in remote areas. Staff are often paid incentives to work at such facilities. However, there is little evidence on how many fewer people are treated at remote facilities than facilities in more densely settled areas. This research explores if there is an association between the efficiency of health centers in Afghanistan and the remoteness of their location. Survey teams collected data on facility level inputs and outputs at a stratified random sample of 579 health centers in 2005. Quality of care was measured by observing staff interact with patients and determining if staff completed a set of normative patient care tasks. We used seemingly unrelated regression to determine if facilities in remote areas have fewer outpatient visits than other rural facilities. In this analysis, one equation compares the number of outpatient visits to facility inputs, while another compares quality of care to determinants of quality. The results indicate remote facilities have about 13% fewer outpatient visits than non-remote facilities, holding inputs constant. Our analysis suggests that facilities in remote areas are realizing horizontal equity since their clients are receiving comparable quality of care to those at non-remote facilities. However, we find the average labor cost for a visit at a remote facility is $1.44, but only $0.97 at other rural facilities, indicating that a visit in a remote facility would have to be 'worth' 1.49 times a visit at a rural facility for there to be no equity - efficiency trade-off. In determining where to build or staff health centers, this loss of efficiency may be offset by progress toward a social policy objective of providing services to disadvantaged rural populations. Copyright © 2013 Elsevier Ltd. All rights reserved.

Achieving Medical Currency via Selected Staff Integration in Civilian and Veterans Administration Medical Facilities

DTIC Science & Technology

2012-10-01

medical license as long as care is delivered in a military facility.26 Hurdles—Liability Medical malpractice also presents a formidable challenge. In...AIR UNIVERSITY AIR WAR COLLEGE Achieving Medical Currency via Selected Staff Integration in Civilian and Veterans Administration... Medical Facilities THOMAS W. HARRELL Colonel, USAF, MC, SFS Air War College Maxwell Paper No. 68 Maxwell Air Force Base, Alabama

Interim Stabilization Equipment Essential and Support Drawing Plan

DOE Office of Scientific and Technical Information (OSTI.GOV)

KOCH, M.R.

The purpose of this document is to list the Interim Stabilization equipment drawings that are classified as Essential or Support drawings. Essential Drawings: Those drawings identified by the facility staff as necessary to directly support the safe operation of the facility or equipment. Support Drawings: Those drawings identified by the facility staff that further describe the design details of structures, systems or components shown on essential drawings.

Impact of organizational factors on adherence to laboratory testing protocols in adult HIV care in Lusaka, Zambia.

PubMed

Deo, Sarang; Topp, Stephanie M; Westfall, Andrew O; Chiko, Matimbo M; Wamulume, Chibesa S; Morris, Mary; Reid, Stewart

2012-05-02

Previous operational research studies have demonstrated the feasibility of large-scale public sector ART programs in resource-limited settings. However, organizational and structural determinants of quality of care have not been studied. We estimate multivariate regression models using data from 13 urban HIV treatment facilities in Zambia to assess the impact of structural determinants on health workers' adherence to national guidelines for conducting laboratory tests such as CD4, hemoglobin and liver function and WHO staging during initial and follow-up visits as part of Zambian HIV care and treatment program. CD4 tests were more routinely ordered during initial history and physical (IHP) than follow-up (FUP) visits (93.0 % vs. 85.5 %; p < 0.01). More physical space, higher staff turnover and greater facility experience with ART was associated with greater odds of conducting tests. Higher staff experience decreased the odds of conducting CD4 tests in FUP (OR 0.93; p < 0.05) and WHO staging in IHP visit (OR 0.90; p < 0.05) but increased the odds of conducting hemoglobin test in IHP visit (OR 1.05; p < 0.05). Higher staff burnout increased the odds of conducting CD4 test during FUP (OR 1.14; p < 0.05) but decreased the odds of conducting hemoglobin test in IHP visit (0.77; p < 0.05) and CD4 test in IHP visit (OR 0.78; p < 0.05). Physical space plays an important role in ensuring high quality care in resource-limited setting. In the context of protocolized care, new staff members are likely to be more diligent in following the protocol verbatim rather than relying on memory and experience thereby improving adherence. Future studies should use prospective data to confirm the findings reported here.

Evaluation of the built environment: staff and family satisfaction pre- and post-occupancy of the Children's Hospital.

PubMed

Kotzer, Anne Marie; Zacharakis, Susan Koch; Raynolds, Mary; Buenning, Fred

2011-01-01

To evaluate and compare the impact of an existing and newly built hospital environment on family and staff satisfaction related to light, noise, temperature, aesthetics, and amenities, as well as safety, security, and privacy. The United States is engaged in an unprecedented healthcare building boom driven by the need to replace aging facilities, understand the impact of the built environment on quality and safety, incorporate rapidly emerging technologies, and enhance patient- and family-centered care. More importantly, there is heightened attention to creating optimal physical environments to achieve the best possible outcomes for patients, families, and staff. Using a pre-post descriptive survey design, all nursing, social work, therapy staff, and families on selected inpatient units were invited to participate. A demographic form and Family and Staff Satisfaction Surveys were developed and administered pre- and post-occupancy of the new facility. Pre/post mean scores for staff satisfaction improved on all survey subscales with statistically significant improvement (p < .05) in most areas. The most improvement was seen with layout of the patient room, natural light, storage and writing surfaces, and comfort and appeal. Family satisfaction demonstrated statistically significant improvement on all subscales (p ≤ .01), especially for natural light, quiet space, parking, and the child's room as a healing environment. Families and staff reported greater satisfaction with the newly built hospital environment compared to the old facility. Study results will help guide future architectural design decisions, attract and retain staff at a world-class facility, and create the most effective healing environments.

How much is not enough? Human resources requirements for primary health care: a case study from South Africa.

PubMed

Daviaud, Emmanuelle; Chopra, Mickey

2008-01-01

To quantify staff requirements in primary health care facilities in South Africa through an adaptation of the WHO workload indicator of staff needs tool. We use a model to estimate staffing requirements at primary health care facilities. The model integrates several empirically-based assumptions including time and type of health worker required for each type of consultation, amount of management time required, amount of clinical support required and minimum staff requirements per type of facility. We also calculate the number of HIV-related consultations per district. The model incorporates type of facility, monthly travelling time for mobile clinics, opening hours per week, yearly activity and current staffing and calculates the expected staffing per category of staff per facility and compares it to the actual staffing. Across all the districts there is either an absence of doctors visiting clinics or too few doctors to cover the opening times of community health centres. Overall the number of doctors is only 7% of the required amount. There is 94% of the required number of professional nurses but with wide variations between districts, with a few districts having excesses while most have shortages. The number of enrolled nurses is 60% of what it should be. There are 17% too few enrolled nurse assistants. Across all districts there is wide variation in staffing levels between facilities leading to inefficient use of professional staff. The application of an adapted WHO workload tool identified important human resource planning issues.

Exploring Factors Affecting Emergency Medical Services Staffs' Decision about Transporting Medical Patients to Medical Facilities.

PubMed

Ebrahimian, Abbasali; Seyedin, Hesam; Jamshidi-Orak, Roohangiz; Masoumi, Gholamreza

2014-01-01

Transfer of patients in medical emergency situations is one of the most important missions of emergency medical service (EMS) staffs. So this study was performed to explore affecting factors in EMS staffs' decision during transporting of patients in medical situations to medical facilities. The participants in this qualitative study consisted of 18 EMS staffs working in prehospital care facilities in Tehran, Iran. Data were gathered through semistructured interviews. The data were analyzed using a content analysis approach. The data analysis revealed the following theme: "degree of perceived risk in EMS staffs and their patients." This theme consisted of two main categories: (1) patient's condition' and (2) the context of the EMS mission'. The patent's condition category emerged from "physical health statuses," "socioeconomic statuses," and "cultural background" subcategories. The context of the EMS mission also emerged from two subcategories of "characteristics of the mission" and EMS staffs characteristics'. EMS system managers can consider adequate technical, informational, financial, educational, and emotional supports to facilitate the decision making of their staffs. Also, development of an effective and user-friendly checklist and scoring system was recommended for quick and easy recognition of patients' needs for transportation in a prehospital situation.

Dialysis facility staff perceptions of racial, gender, and age disparities in access to renal transplantation.

PubMed

Lipford, Kristie J; McPherson, Laura; Hamoda, Reem; Browne, Teri; Gander, Jennifer C; Pastan, Stephen O; Patzer, Rachel E

2018-01-10

Racial/ethnic, gender, and age disparities in access to renal transplantation among end-stage renal disease (ESRD) patients have been well documented, but few studies have explored health care staff attitudes towards these inequalities. Staff perceptions can influence patient care and outcomes, and identifying staff perceptions on disparities could aid in the development of potential interventions to address these health inequities. The objective of this study was to investigate dialysis staff (n = 509), primarily social workers and nurse managers, perceptions of renal transplant disparities in the Southeastern United States. This is a mixed methods study that uses both deductive and inductive qualitative analysis of a dialysis staff survey conducted in 2012 using three open-ended questions that asked staff to discuss their perceptions of factors that may contribute to transplant disparities among African American, female, and elderly patients. Study results suggested that the majority of staff (n = 255, 28%) perceived patients' low socioeconomic status as the primary theme related to why renal transplant disparities exist between African Americans and non-Hispanic whites. Staff cited patient perception of old age as a primary contributor (n = 188, 23%) to the disparity between young and elderly patients. The dialysis staff responses on gender transplant disparities suggested that staff were unaware of differences due to limited experience and observation (n = 76, 14.7%) of gender disparities. These findings suggest that dialysis facilities should educate staff on existing renal transplantation disparities, particularly gender disparities, and collaboratively work with transplant facilities to develop strategies to actively address modifiable patient barriers for transplant.

Podiatric Medical Education: The Physical Facilities.

ERIC Educational Resources Information Center

Rubin, Abe

1979-01-01

A gross inventory of the teaching and clinical learning resources of the five U.S. colleges of podiatric medicine is described. A descriptive breakdown is provided along with illustrations of facilities. Some categories included in space allocation data are instructional staff, administrative staff, laboratory, outpatient clinic, learning…

An assessment of equity in the distribution of non-financial health care inputs across public primary health care facilities in Tanzania.

PubMed

Kuwawenaruwa, August; Borghi, Josephine; Remme, Michelle; Mtei, Gemini

2017-07-11

There is limited evidence on how health care inputs are distributed from the sub-national level down to health facilities and their potential influence on promoting health equity. To address this gap, this paper assesses equity in the distribution of health care inputs across public primary health facilities at the district level in Tanzania. This is a quantitative assessment of equity in the distribution of health care inputs (staff, drugs, medical supplies and equipment) from district to facility level. The study was carried out in three districts (Kinondoni, Singida Rural and Manyoni district) in Tanzania. These districts were selected because they were implementing primary care reforms. We administered 729 exit surveys with patients seeking out-patient care; and health facility surveys at 69 facilities in early 2014. A total of seventeen indices of input availability were constructed with the collected data. The distribution of inputs was considered in relation to (i) the wealth of patients accessing the facilities, which was taken as a proxy for the wealth of the population in the catchment area; and (ii) facility distance from the district headquarters. We assessed equity in the distribution of inputs through the use of equity ratios, concentration indices and curves. We found a significant pro-rich distribution of clinical staff and nurses per 1000 population. Facilities with the poorest patients (most remote facilities) have fewer staff per 1000 population than those with the least poor patients (least remote facilities): 0.6 staff per 1000 among the poorest, compared to 0.9 among the least poor; 0.7 staff per 1000 among the most remote facilities compared to 0.9 among the least remote. The negative concentration index for support staff suggests a pro-poor distribution of this cadre but the 45 degree dominated the concentration curve. The distribution of vaccines, antibiotics, anti-diarrhoeal, anti-malarials and medical supplies was approximately proportional (non dominance), whereas the distribution of oxytocics, anti-retroviral therapy (ART) and anti-hypertensive drugs was pro-rich, with the 45 degree line dominating the concentration curve for ART. This study has shown there are inequities in the distribution of health care inputs across public primary care facilities. This highlights the need to ensure a better coordinated and equitable distribution of inputs through regular monitoring of the availability of health care inputs and strengthening of reporting systems.

Aging in Hong Kong: the institutional population.

PubMed

Woo, Jean; Chau, Patsy P H

2009-09-01

The Hong Kong population is aging rapidly, such that there are concerns about residential care adequacy in terms of number of places as well as quality of care. A total of 1820 residents living in a representative sample of residential care facilities were surveyed. The survey showed a substantial proportion with cognitive dysfunction, mood problems, communication and vision problems, chronic disabling diseases, impairment in activities of daily living, and undernutrition. Programs of activities and rehabilitation were generally unavailable. Those in for-profit facilities had a worse profile. An approximate estimation of numbers of staff required based on case mix revealed considerable understaffing among the for-profit facilities. Issues of quality of care would be all the more important with anticipated future increase in the institutional population of older people.

Do interventions with staff in long-term residential facilities improve quality of care or quality for life people with dementia? A systematic review of the evidence.

PubMed

Bird, Mike; Anderson, Katrina; MacPherson, Sarah; Blair, Annaliese

2016-12-01

Common sense suggests and research indicates relationships between staff factors in residential dementia care and quality of life (QOL) for residents, with poor care increasing suffering. However, we do not have a coherent picture of which staff interventions have an impact on quality of care (QOC) or resident QOL. A comprehensive search of 20 years' peer-reviewed literature using Medline, PsycINFO, Embase, PubMed, CINAHL, and the Cochrane, Campbell Collaboration identified 4,760 studies meriting full text review. Forty-six met the inclusion criteria, namely interventions in long-term facilities helping staff develop their capacity to provide better care and/or QOL for residents with dementia. Thirty-five other papers comprised an associated predictor review. Conclusions from these limited data are further compromised because nine studies failed to measure effects on residents and only half assessed effects after the project team withdrew. Of these, excellent studies produced change over the medium (3-4 months) or longer term, including reduction in challenging behavior and restraint use but this applied only to a minority. A number of studies failed to measure effects on QOC, limiting conclusions about mechanisms underlying change. In general, level of intervention required depended on the target. For outcomes like restraint use, structured education sessions with some support appear adequate. Programs to reduce pain require more support. For complicated issues like challenging behavior and increasing co-operation in showering, detailed, supportive, on-site interventions are required. Improvements in restraint and staff/resident interactions were the most promising findings. (Review registration number: PROSPERO 2014:CRD42014015224).

An effective strategy for influenza vaccination of healthcare workers in Australia: experience at a large health service without a mandatory policy.

PubMed

Heinrich-Morrison, Kristina; McLellan, Sue; McGinnes, Ursula; Carroll, Brendan; Watson, Kerrie; Bass, Pauline; Worth, Leon J; Cheng, Allen C

2015-02-06

Annual influenza vaccination of healthcare workers (HCWs) is recommended in Australia, but uptake in healthcare facilities has historically been low (approximately 50%). The objective of this study was to develop and implement a dedicated campaign to improve uptake of staff influenza annual vaccination at a large Australian health service. A quality improvement program was developed at Alfred Health, a tertiary metropolitan health service spanning 3 campuses. Pre-campaign evaluation was performed by questionnaire in 2013 to plan a multimodal vaccination strategy. Reasons for and against vaccination were captured. A campaign targeting clinical and non-clinical healthcare workers was then implemented between March 31 and July 31 2014. Proportional uptake of influenza vaccination was determined by campus and staff category. Pre-campaign questionnaire responses were received from 1328/6879 HCWs (response rate 20.4%), of which 76% were vaccinated. Common beliefs held by unvaccinated staff included vaccine ineffectiveness (37.1%), that vaccination makes staff unwell (21.0%), or that vaccination is not required because staff are at low risk for acquiring influenza (20.2%). In 2014, 6009/7480 (80.3%) staff were vaccinated, with significant improvement in uptake across all campuses and amongst nursing, medical and allied health staff categories from 2013 to 2014 (p < 0.0001). A non-mandatory multimodal strategy utilising social marketing and a customised staff database was successful in increasing influenza vaccination uptake by all staff categories. The sustainability of dedicated campaigns must be evaluated.

Fear and overprotection in Australian residential aged-care facilities: The inadvertent impact of regulation on quality continence care.

PubMed

Ostaszkiewicz, Joan; O'Connell, Beverly; Dunning, Trisha

2016-06-01

Most residents in residential aged-care facilities are incontinent. This study explored how continence care was provided in residential aged-care facilities, and describes a subset of data about staffs' beliefs and experiences of the quality framework and the funding model on residents' continence care. Using grounded theory methodology, 18 residential aged-care staff members were interviewed and 88 hours of field observations conducted in two facilities. Data were analysed using a combination of inductive and deductive analytic procedures. Staffs' beliefs and experiences about the requirements of the quality framework and the funding model fostered a climate of fear and risk adversity that had multiple unintended effects on residents' continence care, incentivising dependence on continence management, and equating effective continence care with effective pad use. There is a need to rethink the quality of continence care and its measurement in Australian residential aged-care facilities. © 2015 AJA Inc.

Conflict resolution styles: a comparison of assisted living and nursing home facilities.

PubMed

Small, Jeff A; Montoro-Rodriguez, Julian

2006-01-01

In this exploratory study, the authors investigated how interpersonal conflict is resolved in assisted living and nursing home facilities. In particular, the authors examined whether conflict resolution styles differed between type of facility and between residents and staff in each type of facility. Four focus groups were conducted--two with residents and two with staff from each type of facility. The focus groups centered on discussing the occurrence of conflict and how each participant handled it. Discourse analysis was employed to identify participants' use of three styles of conflict resolution: controlling, solution-oriented, and non-confrontational. The results indicate that staff in each care context showed a preference for the solution-oriented approach. Residents in each setting reported equal use of the non-confrontational and solution-oriented styles. The findings suggest that preferred conflict resolution styles may vary more as a function of the role of each communicator than the context of the care setting.

Gemini base facility operations environmental monitoring: key systems and tools for the remote operator

NASA Astrophysics Data System (ADS)

Cordova, Martin; Serio, Andrew; Meza, Francisco; Arriagada, Gustavo; Swett, Hector; Ball, Jesse; Collins, Paul; Masuda, Neal; Fuentes, Javier

2016-07-01

In 2014 Gemini Observatory started the base facility operations (BFO) project. The project's goal was to provide the ability to operate the two Gemini telescopes from their base facilities (respectively Hilo, HI at Gemini North, and La Serena, Chile at Gemini South). BFO was identified as a key project for Gemini's transition program, as it created an opportunity to reduce operational costs. In November 2015, the Gemini North telescope started operating from the base facility in Hilo, Hawaii. In order to provide the remote operator the tools to work from the base, many of the activities that were normally performed by the night staff at the summit were replaced with new systems and tools. This paper describes some of the key systems and tools implemented for environmental monitoring, and the design used in the implementation at the Gemini North telescope.

Long-term disease management of patients with coronary disease by cardiac rehabilitation program staff.

PubMed

Squires, Ray W; Montero-Gomez, Aura; Allison, Thomas G; Thomas, Randal J

2008-01-01

Randomized-clinical trials have demonstrated the benefits of disease management for patients with coronary disease. It is not known if long-term disease management in routine clinical practice provided by cardiac rehabilitation (CR) program staff is possible. The goal of this study was to evaluate the feasibility and clinical benefits of a 3-year disease-management program in the setting of an outpatient CR facility. Consecutive patients (n = 503) referred to CR and who were available for long-term follow-up served as subjects. After a phase II CR program, disease managers assessed secondary-prevention goals every 3 to 6 months via face-to-face meetings with each patient. Outcome measures included use of cardioprotective medications, coronary risk factors, amount of habitual exercise training, and all-cause mortality. At 3 years, aspirin usage was 91%, statin usage 91%, beta-blocker usage 78%, and angiotensin-converting enzyme inhibitor usage 76%. Low-density lipoprotein cholesterol was 90 +/- 23 mg/dL, systolic blood pressure was 126 +/- 19 mm Hg, and body mass index was 29.0 +/- 5.1 kg/m2. Exercise training averaged 139 +/- 123 minutes per week. Annual mortality was 1.9%. There were no differences (P > .05) in medication usage or low-density lipoprotein cholesterol for men versus women, or for age below 65 years versus age 65 years or greater. Long-term disease management of patients with coronary disease in routine clinical practice by CR program staff is feasible and effective in achieving and maintaining secondary-prevention goals. Overweight remains a prevalent and persistent risk factor. We advocate expansion of CR programs into long-term coronary disease-management programs.

Fluor Hanford ALARA Center is a D and D Resource

DOE Office of Scientific and Technical Information (OSTI.GOV)

Waggoner, L.O.

2008-01-15

The mission at the Hanford Nuclear Reservation changed when the last reactor plant was shut down in 1989 and work was started to place all the facilities in a safe condition and begin decontamination, deactivation, decommissioning, and demolition (D and D). These facilities consisted of old shutdown reactor plants, spent fuel pools, processing facilities, and 177 underground tanks containing 53 million gallons of highly radioactive and toxic liquids and sludge. New skills were needed by the workforce to accomplish this mission. By 1995, workers were in the process of getting the facilities in a safe condition and it became obviousmore » improvements were needed in their tools, equipment and work practices. The Hanford ALARA Program looked good on paper, but did little to help contractors that were working in the field. The Radiological Control Director decided that the ALARA program needed to be upgraded and a significant improvement could be made if workers had a place they could visit that had samples of the latest technology and could talk to experienced personnel who have had success doing D and D work. Two senior health physics personnel who had many years experience in doing radiological work were chosen to obtain tools and equipment from vendors and find a location centrally located on the Hanford site. Vendors were asked to loan their latest tools and equipment for display. Most vendors responded and the Hanford ALARA Center of Technology opened on October 1, 1996. Today, the ALARA Center includes a classroom for conducting training and a mockup area with gloveboxes. Two large rooms have a containment tent, several glove bags, samples of fixatives/expandable foam, coating displays, protective clothing, heat stress technology, cutting tools, HEPA filtered vacuums, ventilation units, pumps, hydraulic wrenches, communications equipment, shears, nibblers, shrouded tooling, and several examples of innovative tools developed by the Hanford facilities. See Figures I and II. The ALARA Center staff routinely researches and tests new technology, sponsor vendor demonstrations, and redistribute tools, equipment and temporary shielding that may not be needed at one facility to another facility that needs it. The ALARA Center staff learns about new technology in several ways. This includes past radiological work experience, interaction with vendors, lessons learned, networking with other DOE sites, visits to the Hanford Technical Library, attendance at off-site conferences and ALARA Workshops. Personnel that contact the ALARA Center for assistance report positive results when they implement the tools, equipment and work practices recommended by the ALARA Center staff. This has translated to reduced exposure for workers and reduced the risk of contamination spread. For example: using a hydraulic shear on one job saved 16 Rem of exposure that would have been received if workers had used saws-all tools to cut piping in twenty-nine locations. Currently, the ALARA Center staff is emphasizing D and D techniques on size-reducing materials, decontamination techniques, use of remote tools/video equipment, capture ventilation, fixatives, using containments and how to find lessons learned. The ALARA Center staff issues a weekly report that discusses their interaction with the workforce and any new work practices, tools and equipment being used by the Hanford contractors. Distribution of this weekly report is to about 130 personnel on site and 90 personnel off site. This effectively spreads the word about ALARA throughout the DOE Complex. DOE EM-23, in conjunction with the D and D and Environmental Restoration work group of the Energy Facility Contractors Organization (EFCOG) established the Hanford ALARA Center as the D and D Hotline for companies who have questions about how D and D work is accomplished. The ALARA Center has become a resource to the nuclear industry and routinely helps contractors at other DOE Sites, power reactors, DOD sites, and sites in England, Europe and Indonesia. Other ALARA Centers are located at the Savannah River Site and Los Alamos National Lab.« less

Barriers and facilitators to provide quality TIA care in the Veterans Healthcare Administration

PubMed Central

Miech, Edward J.; Sico, Jason J.; Phipps, Michael S.; Arling, Greg; Ferguson, Jared; Austin, Charles; Myers, Laura; Baye, Fitsum; Luckhurst, Cherie; Keating, Ava B.; Moran, Eileen; Bravata, Dawn M.

2017-01-01

Objective: To identify key barriers and facilitators to the delivery of guideline-based care of patients with TIA in the national Veterans Health Administration (VHA). Methods: We conducted a cross-sectional, observational study of 70 audiotaped interviews of multidisciplinary clinical staff involved in TIA care at 14 VHA hospitals. We de-identified and analyzed all transcribed interviews. We identified emergent themes and patterns of barriers to providing TIA care and of facilitators applied to overcome these barriers. Results: Identified barriers to providing timely acute and follow-up TIA care included difficulties accessing brain imaging, a constantly rotating pool of housestaff, lack of care coordination, resource constraints, and inadequate staff education. Key informants revealed that both stroke nurse coordinators and system-level factors facilitated the provision of TIA care. Few facilities had specific TIA protocols. However, stroke nurse coordinators often expanded upon their role to include TIA. They facilitated TIA care by (1) coordinating patient care across services, communicating across service lines, and educating clinical staff about facility policies and evidence-based practices; (2) tracking individual patients from emergency departments to inpatient settings and to discharge for timely follow-up care; (3) providing and referring TIA patients to risk factor management programs; and (4) performing regular audit and feedback of quality performance data. System-level facilitators included clinical service leadership engagement and use of electronic tools for continuous care across services. Conclusions: The local organization within a health care facility may be targeted to cultivate internal facilitators and a systemic infrastructure to provide evidence-based TIA care. PMID:29117959

42 CFR 9.9 - Facility staffing.

Code of Federal Regulations, 2012 CFR

2012-10-01

... CHIMPANZEES HELD IN THE FEDERALLY SUPPORTED SANCTUARY SYSTEM § 9.9 Facility staffing. How many personnel are required to staff the chimpanzee sanctuary and what qualifications and training must the staff possess? (a... of the activities and chimpanzee population of the sanctuary. The level of staffing shall be adequate...

42 CFR 9.9 - Facility staffing.

Code of Federal Regulations, 2013 CFR

2013-10-01

... CHIMPANZEES HELD IN THE FEDERALLY SUPPORTED SANCTUARY SYSTEM § 9.9 Facility staffing. How many personnel are required to staff the chimpanzee sanctuary and what qualifications and training must the staff possess? (a... of the activities and chimpanzee population of the sanctuary. The level of staffing shall be adequate...

42 CFR 9.9 - Facility staffing.

Code of Federal Regulations, 2014 CFR

2014-10-01

... CHIMPANZEES HELD IN THE FEDERALLY SUPPORTED SANCTUARY SYSTEM § 9.9 Facility staffing. How many personnel are required to staff the chimpanzee sanctuary and what qualifications and training must the staff possess? (a... of the activities and chimpanzee population of the sanctuary. The level of staffing shall be adequate...

42 CFR 9.9 - Facility staffing.

Code of Federal Regulations, 2011 CFR

2011-10-01

... CHIMPANZEES HELD IN THE FEDERALLY SUPPORTED SANCTUARY SYSTEM § 9.9 Facility staffing. How many personnel are required to staff the chimpanzee sanctuary and what qualifications and training must the staff possess? (a... of the activities and chimpanzee population of the sanctuary. The level of staffing shall be adequate...

Improving heart failure disease management in skilled nursing facilities: lessons learned.

PubMed

Dolansky, Mary A; Hitch, Jeanne A; Piña, Ileana L; Boxer, Rebecca S

2013-11-01

The purpose of the study was to design and evaluate an improvement project that implemented HF management in four skilled nursing facilities (SNFs). Kotter's Change Management principles were used to guide the implementation. In addition, half of the facilities had an implementation coach who met with facility staff weekly for 4 months and monthly for 5 months. Weekly and monthly audits were performed that documented compliance with eight key aspects of the protocol. Contextual factors were captured using field notes. Adherence to the HF management protocols was variable ranging from 17% to 82%. Facilitators of implementation included staff who championed the project, an implementation coach, and physician involvement. Barriers were high staff turnover and a hierarchal culture. Opportunities exist to integrate HF management protocols to improve SNF care.

Rebuilding an empire. Once a crown jewel of healthcare in the Middle East, Iraq's system needs a complete overhaul, everything from equipment to staff.

PubMed

Tieman, Jeff

2003-11-17

As work begins to rebuild Iraq's infrastructure, hospitals and primary-care facilities are major priorities. While security concerns have prevented some U.S. civilians from traveling there to lend their assistance, hospital executives soon could participate in exchange programs to educate their Iraqi counterparts. James Haveman, left, is senior U.S. adviser to the Iraqi Ministry of Health.

Laboratory for Computer Science Progress Report 21, July 1983-June 1984.

DTIC Science & Technology

1984-06-01

Systems 269 4. Distributed Consensus 270 5. Election of a Leader in a Distributed Ring of Processors 273 6. Distributed Network Algorithms 274 7. Diagnosis...multiprocessor systems. This facility, funded by the new!y formed Strategic Computing Program of the Defense Advanced Research Projects Agency, will enable...Academic Staff P. Szo)ovits, Group Leader R. Patil Collaborating Investigators M. Criscitiello, M.D., Tufts-New England Medical Center Hospital R

Facility Reliability and Maintainability: An Investigation of the Air Force Civil Engineering Recurring Work Program

DTIC Science & Technology

1989-09-01

18:2). A recent survey by the Strategic Air Command (SAC) Mechanical Fquipment Management Evaluation Team ( MEMET ) determined that equipment was...identified by MEMET included Maintenance Action Sheets (MAS) that reported work which was not completed, and other MAS which annotated recurring work...readily apparent. Problem Military. The Deputy Chief of Staff for Engineering and Services, HQ SAC, established the MEMET in 1984 in response to a

Demonstration, Developmental and Research Project for Programs, Materials, Facilities and Educational Technology for Undereducated Adults: Ohio State Module. ABE Life-Centered Curriculum Development and Teaching Technique. Final Report.

ERIC Educational Resources Information Center

Morehead State Univ., KY.

This workshop was held for the purpose of training selected staff members of the Ohio Module Field Unit of the Appalachian Adult Basic Education Demonstration Center (AABEDC). Twelve persons, six teachers and six paraprofessionals, were selected to participate in the workshop. While their specific jobs vary, all will be concerned with utilization…

Data bank has operational impact. Proper peer review can protect hospitals from antitrust and defamation suits.

PubMed

Purtell, D L

1990-11-01

The Health Care Quality Improvement Act of 1986 can help protect medical professionals and healthcare facilities from antitrust and defamation claims and other forms of litigation arising from the peer review process. Some hospitals may need to make major changes in their peer review activity as a result of the act. The healthcare entity, not the physicians involved in peer review, has the burden of complying with the provisions of the act. Failure to comply with the act can lead to loss of immunity from damages, fines, and potential exclusion from the Medicare program. The potential for liability has sparked a need for hospitals to reexamine and possibly reorganize medical staff and update procedures and related governing documents. Healthcare entities may consider changes such as implementing a director of medical affairs function, choosing medical staff for multiple-year terms, and centralizing physician review files. In the 1980s many hospitals created quality assurance and risk management programs. Risk managers need to share data with quality assurance personnel, who must in turn share the information with medical staff involved with credentialing, peer review, and medical affairs management. Legal counsel will need to be familiar with the legalities of the act, as well as the hospital's peer review procedures and operations. General legal counsel should oversee coordination of hospital proceedings and assist in educating staff on the legalities of peer review.

Cornell University remote sensing program. [selected research projects in land and water resource management

NASA Technical Reports Server (NTRS)

Liang, T.; Belcher, D. J.; Mcnair, A. J.

1974-01-01

The major activities of the program staff from December 1, 1973 to May 31, 1974 are reported and include: (1) communication and instruction; (2) data and facilities; (3) research completed; (4) research in progress; (5) selected correspondence; (6) grant sponsored travel; and (7) seminars and newsletters. Detailed information and maps are given for the following selected projects: (1) ERTS mapping of waterways in the Tug Hill region of New York State; (2) photo-archeological investigation of Great Gully, New York; and (3) evaluation of selected highway impacts using aerial photography.

Evaluating Intention and Effect: The Impact of Healthcare Facility Design on Patient and Staff Well-Being.

PubMed

Alvaro, Celeste; Wilkinson, Andrea J; Gallant, Sara N; Kostovski, Deyan; Gardner, Paula

2016-01-01

This post occupancy evaluation (POE) assessed the impact of architectural design on psychosocial well-being among patients and staff in the context of a new complex continuing care and rehabilitation facility. Departing from typical POEs, the hospital design intentions formed the theoretical basis to assess outcomes. Intentions included creating an environment of wellness; enhancing connection to the community, the city, and nature; enhancing opportunities for social interaction; and inspiring activity. A pretest-posttest quasi experiment, including quantitative surveys, assessed the impact of the building design on well-being outcomes across three facilities-the new hospital, the former hospital, and a comparison facility with a similar population. With the exception of connection to neighborhood (for patients) and opportunities to visit with others (for staff) and wayfinding (for patients and staff), impressions of the new hospital mirrored the design intentions relative to the former hospital and the comparison facility among patients and staff. Perceptions of improvement in mental health, self-efficacy in mobility, satisfaction, and interprofessional interactions were enhanced at the new hospital relative to the former hospital, whereas optimism, depressive symptoms, general well-being, burnout, and intention to quit did not vary. Interestingly, patients and staff with favorable impressions of the building design fared better on most well-being-related outcomes relative to those with less favorable impressions. Beyond the value of assessing the impact of the design intentions on outcomes, the approach used in this study would benefit evaluation strategies across a diversity of health and other public and large-scale buildings. © The Author(s) 2015.

Staff attitudes and reactions towards residents' masturbation in Spanish long-term care facilities.

PubMed

Villar, Feliciano; Serrat, Rodrigo; Celdrán, Montserrat; Fabà, Josep

2016-03-01

To explore staff attitudes and reactions towards masturbation in long-term care facilities. Staff attitudes and reactions towards the expression of sexuality in long-term care facilities may be influenced by the nature of the sexual behaviour being expressed. Staff attitudes towards masturbation, a common sexual behaviour in such settings, have gone largely unexplored so far. An exploratory, descriptive, qualitative research design. Fifty-three staff members working in five different long-term care facilities participated in the study. They were asked about what they would think, how they would react, and what possible reactions they might expect from workmates if they entered a room and found a resident masturbating. The majority of participants considered that masturbation was acceptable and avoiding interference was by far the most common reaction, although other reactions also arose. When asked about reactions attributed to workmates, mentions to reprimanding the resident and gossiping/joking about the issue were more frequent than acceptance. The discrepancy between professionals' own reported attitudes and those attributed to workmates suggests the existence of widespread negative reactions towards sexual activity in later life. In the light of these results, we underline the necessity of developing explicit policies regarding sexual issues. Formal training offered to staff would also help to recognise and preserve resident's sexual rights and needs. © 2016 John Wiley & Sons Ltd.

Comprehensive programs for preventing pressure ulcers: a review of the literature.

PubMed

Niederhauser, Andrea; VanDeusen Lukas, Carol; Parker, Victoria; Ayello, Elizabeth A; Zulkowski, Karen; Berlowitz, Dan

2012-04-01

The objective of this study was to examine the evidence supporting the combined use of interventions to prevent pressure ulcers (PrUs) in acute care and long-term-care facilities. A systematic review of the literature describing multifaceted PrU prevention programs was performed. Articles were included if they described an intervention implemented in acute care settings or long-term-care facilities, incorporated more than 1 intervention component, involved a multidisciplinary team, and included information about outcomes related to the intervention. Twenty-four studies were identified. Recurring components used in the development and implementation of PrU prevention programs included preparations prior to the start of a program, PrU prevention best practices, staff education, clinical monitoring and feedback, skin care champions, and cues to action. Ten studies reported PrU prevalence rates; 9 of them reported decreased prevalence rates at the end of their programs. Of the 6 studies reporting PrU incidence rates, 5 reported a decrease in incidence rates. Four studies measured care processes: 1 study reported an overall improvement; 2 studies reported improvement on some, but not all, measures; and 1 study reported no change. There is a growing literature describing multipronged, multidisciplinary interventions to prevent PrUs in acute care settings and long-term-care facilities. Outcomes reported in these studies suggest that such programs can be successful in reducing PrU prevalence or incidence rates. However, to strengthen the level of evidence, sites should be encouraged to rigorously evaluate their programs and to publish their results.

Preventing Workplace Injuries Among Perinatal Nurses.

PubMed

Harolds, Laura; Hurst, Helen

2016-01-01

Many aspects of perinatal nursing put nurses at risk for injuries, including frequent repetitive bending, lifting of clients, and exposure to potentially large amounts of body fluids such as blood and amniotic fluid. Violence is also a potential risk with stressful family situations that may arise around childbirth. Workplace injuries put a health care facility at risk for staff turnover, decreases in the number of skilled nurses, client dissatisfaction, workers' compensation payouts, and employee lawsuits. Through the use of safety equipment, improved safety and violence training programs, "no manual lift" policies, reinforcement of personal protective equipment usage, and diligent staff training to improve awareness, these risks can be minimized. © 2016 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses.

20 CFR 1001.121 - Performance standard on facilities and support for Veterans' Employment and Training Service...

Code of Federal Regulations, 2010 CFR

2010-04-01

... support for Veterans' Employment and Training Service (VETS) staff. 1001.121 Section 1001.121 Employees' Benefits OFFICE OF THE ASSISTANT SECRETARY FOR VETERANS' EMPLOYMENT AND TRAINING SERVICE, DEPARTMENT OF... Training Service (VETS) staff. Each State agency shall provide adequate and appropriate facilities and...

Appreciating Staff.

ERIC Educational Resources Information Center

Rollins, Chris

1998-01-01

Suggests positive ways to deal with camp staff: reduce precamp jitters and first-session doubts, personalize paycheck envelopes, schedule breaks and parties, rotate staff, permit use of facilities, keep in touch off-season, develop an interstaff "buddy" system, post a thank-you board, and celebrate staff accomplishments. Sidebars offer…

A Focus Group Assessment to Determine Motivations, Barriers and Effectiveness of a University-Based Worksite Wellness Program

PubMed Central

Hill-Mey, Patricia E.; Merrill, Ray M.; Kumpfer, Karol L.; Reel, Justine; Hyatt-Neville, Beverly

2013-01-01

Background: This study explores university employee perceptions and under­standing about its Worksite Health Promotion Program (WHPP). The WHPP included a Health Risk Appraisal (HRA), biometric screening, publicity for on-campus health programs and facilities, and health coaching. Methods: A qualitative design was used based on a grounded theory ap­proach. Four 90 minutes focus groups with 6-8 participants in each were conducted within a two 2 week period among employees, representing fac­ulty/participants, fac­ulty/nonparticipants, staff/participants, and staff/nonparticipants. Responses to questions about motivations, barriers, and perceived health benefits that impacted participation in the WHPP were digi­tally recorded, transcribed and coded for themes. Results: Incentives effectively motivated participation. Biometric screening had the largest impact on behavior change, followed by the information learned from the HRA. However, despite two-thirds of the employees partici­pating in the pro­gram, lack of a full understanding of WHPP benefits and services lowered partici­pation in follow-up services and supplemental pro­grams. Conclusions: Biometric screening and HRAs effectively motivate program par­ticipation. Communication of benefits and services are important when providing WHPPs. PMID:24688965

PLAN Bicol, Philippines: health manpower development program in action.

PubMed

Lind, K

1994-06-01

PLAN Bicol in the Philippines is a community based Health Manpower Development Program (HMDP) geared toward training and mobilization of indigenous health practitioners, providing infrastructural and logistical support to individual families, and educating the community about health, nutrition, and the environment. The field officer recommends at the initiation of a project that program staff have roles that are well defined. New programs should be introduced to the community first and should involve the community in the planning stages. The HMDP program is directed to 38 villages located around national parks that have suffered from deforestation. Community health issues are malnutrition, low immunization, and lack of access to health services. HMDP established a training program for auxiliary health workers (AHWs), who make a commitment to return to their villages after training. Midwives are being trained at local schools. Village houses are being built and repaired; water systems and sanitary toilet facilities are being installed. Village health stations have been constructed and equipped with basic medicines, supplies, and equipment, and are open 5 days a week. Health education classes inform the community about nutrition and health. The problems at inception were the unwillingness of field staff to participate in the program and a high drop out rate among AHWs. Problems were worked out as the program progressed. Facilitative factors are the close coordination with the provincial health office, community acceptance, and the availability of qualified people.

School Climate Improvement Action Guide for Noninstructional Staff. School Climate Improvement Resource Package

ERIC Educational Resources Information Center

National Center on Safe Supportive Learning Environments, 2017

2017-01-01

Improving school climate takes time and commitment from a variety of people in a variety of roles. This document outlines key action steps that noninstructional staff--including guidance counselors, social workers, school psychologists, office staff, bus drivers, maintenance and facility staff, and food service staff--can take to support school…

Bill Lang's contributions to acoustics at International Business Machines Corporation (IBM), signal processing, international standards, and professionalism in noise control engineering

NASA Astrophysics Data System (ADS)

Maling, George C.

2005-09-01

Bill Lang joined IBM in the late 1950s with a mandate from Thomas Watson Jr. himself to establish an acoustics program at IBM. Bill created the facilities in Poughkeepsie, developed the local program, and was the leader in having other IBM locations with development and manufacturing responsibilities construct facilities and hire staff under the Interdivisional Liaison Program. He also directed IBMs acoustics technology program. In the mid-1960s, he led an IEEE standards group in Audio and Electroacoustics, and, with the help of James Cooley, Peter Welch, and others, introduced the fast Fourier transform to the acoustics community. He was the convenor of ISO TC 43 SC1 WG6 that began writing the 3740 series of standards in the 1970s. It was his suggestion to promote professionalism in noise control engineering, and, through meetings with Leo Beranek and others, led the founding of INCE/USA in 1971. He was also a leader of the team that founded International INCE in 1974, and he served as president from 1988 until 1999.

Questionnaire-based analysis of infection prevention and control in healthcare facilities in Saudi Arabia in regards to Middle East Respiratory Syndrome.

PubMed

Rabaan, Ali A; Alhani, Hatem M; Bazzi, Ali M; Al-Ahmed, Shamsah H

Effective implementation of infection prevention and control in healthcare facilities depends on training, awareness and compliance of healthcare workers. In Saudi Arabia recent significant hospital outbreaks, including Middle East Respiratory Syndrome Coronavirus (MERS-CoV), have resulted from lack of, or breakdown in, infection prevention and control procedures. This study was designed to assess attitudes to, and awareness of, infection prevention and control policies and guidelines among healthcare workers of different professions and institution types in Saudi Arabia. A questionnaire was administered to 607 healthcare workers including physicians (n=133), nurses (n=162), laboratory staff (n=233) and other staff (n=79) in government hospitals, private hospitals and poly clinics. Results were compared using Chi square analysis according to profession type, institution type, age group and nationality (Saudi or non-Saudi) to assess variability. Responses suggested that there are relatively high levels of uncertainty among healthcare workers across a range of infection prevention and control issues, including institution-specific issues, surveillance and reporting standards, and readiness and competence to implement policies and respond to outbreaks. There was evidence to suggest that staff in private hospitals and nurses were more confident than other staff types. Carelessness of healthcare workers was the top-cited factor contributing to causes of outbreaks (65.07% of total group), and hospital infrastructure and design was the top-cited factor contributing to spread of infection in the hospital (54.20%), followed closely by lack and shortage of staff (53.71%) and no infection control training program (51.73%). An electronic surveillance system was considered the most effective by staff (81.22%). We have identified areas of concern among healthcare workers in Saudi Arabia on infection prevention and control which vary between institutions and among different professions. This merits urgent multi-factorial actions to try to ensure outbreaks such as MERS-CoV can be minimized and contained. Copyright © 2017 The Authors. Published by Elsevier Ltd.. All rights reserved.

Health facilities at the district level in Indonesia

PubMed Central

Heywood, Peter; Harahap, Nida P

2009-01-01

Background At Independence the Government of Indonesia inherited a weak and unevenly distributed health system to which much of the population had only limited access. In response, the government decided to increase the number of facilities and to locate them closer to the people. To staff these health facilities the government introduced obligatory government service for all new graduates in medicine, nursing and midwifery. Most of these staff also established private practices in the areas in which they were located. The health information system contains little information on the health care facilities established for private practice by these staff. This article reports on the results of enumerating all health facilities in 15 districts in Java. Methods We enumerated all healthcare facilities, public and private, by type in each of 15 districts in Java. Results The enumeration showed a much higher number of healthcare facilities in each district than is shown in most reports and in the health information system which concentrates on public, multi-provider facilities. Across the 15 districts: 86% of facilities were solo-provider facilities for outpatient services; 13% were multi-provider facilities for outpatient services; and 1% were multi-provider facilities offering both outpatient and inpatient services. Conclusion The relatively good distribution of health facilities in Indonesia was achieved through establishing public health centers at the sub-district level and staffing them through a system of compulsory service for doctors, nurses and midwives. Subsequently, these public sector staff also established solo-provider facilities for their own private practice; these solo-provider facilities, of which those for nurses are almost half, comprise the largest category of outpatient care facilities, most are not included in official statistics. Now that Indonesia no longer has mandatory service for newly graduated doctors, nurses and midwives, it will have difficulty maintaining the distribution of facilities and providers established through the 1980s. The current challenge is to envision a new health system that responds to the changing disease patterns as well as the changes in distribution of health facilities. PMID:19445728

Effect of staff turnover on staffing: A closer look at registered nurses, licensed vocational nurses, and certified nursing assistants.

PubMed

Kash, Bita A; Castle, Nicholas G; Naufal, George S; Hawes, Catherine

2006-10-01

We examined the effects of facility and market-level characteristics on staffing levels and turnover rates for direct care staff, and we examined the effect of staff turnover on staffing levels. We analyzed cross-sectional data from 1,014 Texas nursing homes. Data were from the 2002 Texas Nursing Facility Medicaid Cost Report and the Area Resource File for 2003. After examining factors associated with staff turnover, we tested the significance and impact of staff turnover on staffing levels for registered nurses (RNs), licensed vocational nurses (LVNs) and certified nursing assistants (CNAs). All three staff types showed strong dependency on resources, such as reimbursement rates and facility payor mix. The ratio of contracted to employed nursing staff as well as RN turnover increased LVN turnover rates. CNA turnover was reduced by higher administrative expenditures and higher CNA wages. Turnover rates significantly reduced staffing levels for RNs and CNAs. LVN staffing levels were not affected by LVN turnover but were influenced by market factors such as availability of LVNs in the county and women in the labor force. Staffing levels are not always associated with staff turnover. We conclude that staff turnover is a predictor of RN and CNA staffing levels but that LVN staffing levels are associated with market factors rather than turnover. Therefore, it is important to focus on management initiatives that help reduce CNA and RN turnover and ultimately result in higher nurse staffing levels in nursing homes.

The Sepsis Early Recognition and Response Initiative (SERRI)

PubMed Central

Jones, Stephen L.; Ashton, Carol M.; Kiehne, Lisa; Gigliotti, Elizabeth; Bell-Gordon, Charyl; Pinn, Teresa T.; Tran, Shirley K.; Nicolas, Juan C.; Rose, Alexis L.; Shirkey, Beverly A.; Disbot, Maureen; Masud, Faisal; Wray, Nelda P.

2016-01-01

Duration of Initiative 48 months and currently ongoing. Setting The Houston Methodist Hospital System and affiliated hospitals (3 facilities with 2 hospital-run skilled nursing facilities in and around Houston), St. Joseph’s Regional Health Center (1 acute care hospital and 2 skilled nursing facilities in Bryan, Texas), Hospital Corporation of America (2 acute care facilities in Houston, 1 acute care facility in McAllen, Texas [Rio Grande Valley]), Kindred Healthcare (2 long term acute care facilities in Houston), Select Medical Specialty Hospitals (2 long term acute care facilities in Houston). Whom This Should Concern Hospital administrators, quality and safety officers, performance improvement and patient safety professionals, clinic managers, infection control and prevention staff, and other physicians, nurses, and clinical staff. PMID:26892701

Pressure ulcers and lateral rotation beds: a case study.

PubMed

Russell, Teresa; Logsdon, Angela

2003-05-01

During a 6-month period, the WOC nurses at a 500-bed medical treatment facility noticed the development of nosocomial pressure ulcers on the sacrum, occiput, and heel areas of patients who were placed on lateral rotation specialty beds because they had pulmonary disorders. Measures were taken to address the problem by repositioning the patients and through a staff education program. Repositioning included repositioning the patient's head every 2 hours, thorough skin assessments every 2 hours, and ensuring that the patient's heels were subject to zero pressure. Staff education centered on the importance of using a risk assessment tool (the Braden scale) and understanding the clinical uses for lateral rotation beds. During the subsequent 6 months, the incidence of hospital-acquired pressure ulcers decreased by 52%. Efforts to further decrease the number of pressure ulcers related to the use of lateral rotation beds continue. Issues such as length of stay on the bed and the appropriateness of manufacturer's guidelines still need to be addressed at this facility. This case study highlights the potential issues associated with lateral rotation beds and identifies the need for further research.

Exploring Staff Clinical Knowledge and Practice with LGBT Residents in Long-Term Care: A Grounded Theory of Cultural Competency and Training Needs.

PubMed

Donaldson, Weston V; Vacha-Haase, Tammi

2016-01-01

Existing literature shows that LGBT residents are likely to face suboptimal care in LTC facilities due to prejudice and discriminatory policies. The aim of this project was to assess the LGBT cultural competency of staff working in LTC facilities, identify their current training needs, and develop a framework for understanding LGBT cultural competency among LTC staff and providers. This grounded theory study comprised data from focus groups of interdisciplinary staff from three LTC facilities. Results suggested that LTC staff struggle with how to be sensitive to LGBT residents' needs. Tension appeared to exist between wanting to provide an equal standard of care to all LTC residents and fearing they would show "favoritism" or "special treatment," which might be viewed as unprofessional. Participants indicated training could help to address the ambivalence they experience about providing sensitive care to subpopulations of residents who face stigma and oppression. LTC staff stand to benefit from cultural competency training focused on LGBT residents. Training should be not only informational in nature, but also facilitate greater self-awareness and self-efficacy with respect to providing care to LGBT people.

Building a Unit-Level Mentored Program to Sustain a Culture of Inquiry for Evidence-Based Practice.

PubMed

Breckenridge-Sproat, Sara T; Throop, Meryia D; Raju, Dheeraj; Murphy, Deborah A; Loan, Lori A; Patrician, Patricia A

2015-01-01

This study tested the effectiveness of a dynamic educational and mentoring program, facilitated by unit-level mentors, to introduce, promote, and sustain an evidence-based practice (EBP) culture among nurses in a military healthcare setting. The need to identify gaps in practice, apply principles of EBP, and advance scientific applications in the pursuit of quality nursing care is as important to military healthcare as it is in the civilian sector. The Advancing Research through Close Collaboration Model guided the intervention and study. Three instruments were used: the Organizational Readiness for System-wide Integration of Evidence-Based Practice, EBP Beliefs, and EBP Implementation scales. The study took place in 3 military hospitals simultaneously undergoing facility and staff integration. Data were collected from staff nurses in the inpatient nursing units before and after a facilitated education and mentoring intervention. Three hundred sixty nurses (38%) completed baseline, and 325 (31%) completed follow-up surveys. Scores improved on all 3 measures following implementation of the program; however, the differences were statistically significant only for the Organizational Readiness for System-wide Integration of Evidence-Based Practice scale (70.96 vs 77.63, t = -3.95, P < .01). In the paired individual pretest/posttest subsample (n = 56), scores improved significantly on all 3 instruments. Despite typically high turnover rates of military personnel and restructuring of 3 facilities during the study period, the readiness for, beliefs about, and implementation of EBP improved. This study suggests that a commitment to an EBP culture may diffuse among individuals in an organization, even while experiencing significant change. It also demonstrates that a unit-level mentored EBP program is sustainable despite changes in organizational structure and workforce composition.

Planning for a Healthier School Facility

ERIC Educational Resources Information Center

Belew, Rachel

2012-01-01

One might assume that, within the walls of a school, it is the shared responsibility of the school nurse, guidance counselor, physical fitness instructor, and food services staff to protect student health. In truth, such an important responsibility also belongs, in very large part, to the educational facility planner and school maintenance staff.…

Ways that Families Engage with Staff in Long-Term Care Facilities

ERIC Educational Resources Information Center

Gladstone, James W.; Dupuis, Sherry L.; Wexler, Evelyn

2007-01-01

The purpose of this qualitative study was to explore styles of engagement used by families with staff in long-term care facilities. Data were gathered through personal interviews with 35 family members. Five styles of engagement were identified: positive, negative, peremptory, cautious, and limited. Factors associated with these different styles…

Integrating palliative care in long-term care facilities across Europe (PACE): protocol of a cluster randomized controlled trial of the 'PACE Steps to Success' intervention in seven countries.

PubMed

Smets, Tinne; Onwuteaka-Philipsen, Bregje B D; Miranda, Rose; Pivodic, Lara; Tanghe, Marc; van Hout, Hein; Pasman, Roeline H R W; Oosterveld-Vlug, Mariska; Piers, Ruth; Van Den Noortgate, Nele; Wichmann, Anne B; Engels, Yvonne; Vernooij-Dassen, Myrra; Hockley, Jo; Froggatt, Katherine; Payne, Sheila; Szczerbińska, Katarzyna; Kylänen, Marika; Leppäaho, Suvi; Barańska, Ilona; Gambassi, Giovanni; Pautex, Sophie; Bassal, Catherine; Deliens, Luc; Van den Block, Lieve

2018-03-12

Several studies have highlighted the need for improvement in palliative care delivered to older people long-term care facilities. However, the available evidence on how to improve palliative care in these settings is weak, especially in Europe. We describe the protocol of the PACE trial aimed to 1) evaluate the effectiveness and cost-effectiveness of the 'PACE Steps to Success' palliative care intervention for older people in long-term care facilities, and 2) assess the implementation process and identify facilitators and barriers for implementation in different countries. We will conduct a multi-facility cluster randomised controlled trial in Belgium, Finland, Italy, the Netherlands, Poland, Switzerland and England. In total, 72 facilities will be randomized to receive the 'Pace Steps to Success intervention' or to 'care as usual'. Primary outcome at resident level: quality of dying (CAD-EOLD); and at staff level: staff knowledge of palliative care (Palliative Care Survey). resident's quality of end-of-life care, staff self-efficacy, self-perceived educational needs, and opinions on palliative care. Economic outcomes: direct costs and quality-adjusted life years (QALYs). Measurements are performed at baseline and after the intervention. For the resident-level outcomes, facilities report all deaths of residents in and outside the facilities over a previous four-month period and structured questionnaires are sent to (1) the administrator, (2) staff member most involved in care (3) treating general practitioner, and (4) a relative. For the staff-level outcomes, all staff who are working in the facilities are asked to complete a structured questionnaire. A process evaluation will run alongside the effectiveness evaluation in the intervention group using the RE-AIM framework. The lack of high quality trials in palliative care has been recognized throughout the field of palliative care research. This cross-national cluster RCT designed to evaluate the impact of the palliative care intervention for long-term care facilities 'PACE Steps to Success' in seven countries, will provide important evidence concerning the effectiveness as well as the preconditions for optimal implementation of palliative care in nursing homes, and this within different health care systems. The study is registered at www.isrctn.com - ISRCTN14741671 (FP7-HEALTH-2013-INNOVATION-1 603111) Registration date: July 30, 2015.

Association between health worker motivation and healthcare quality efforts in Ghana

PubMed Central

2013-01-01

Background Ghana is one of the sub-Saharan African countries making significant progress towards universal access to quality healthcare. However, it remains a challenge to attain the 2015 targets for the health related Millennium Development Goals (MDGs) partly due to health sector human resource challenges including low staff motivation. Purpose This paper addresses indicators of health worker motivation and assesses associations with quality care and patient safety in Ghana. The aim is to identify interventions at the health worker level that contribute to quality improvement in healthcare facilities. Methods The study is a baseline survey of health workers (n = 324) in 64 primary healthcare facilities in two regions in Ghana. Data collection involved quality care assessment using the SafeCare Essentials tool, the National Health Insurance Authority (NHIA) accreditation data and structured staff interviews on workplace motivating factors. The Spearman correlation test was conducted to test the hypothesis that the level of health worker motivation is associated with level of effort by primary healthcare facilities to improve quality care and patient safety. Results The quality care situation in health facilities was generally low, as determined by the SafeCare Essentials tool and NHIA data. The majority of facilities assessed did not have documented evidence of processes for continuous quality improvement and patient safety. Overall, staff motivation appeared low although workers in private facilities perceived better working conditions than workers in public facilities (P <0.05). Significant positive associations were found between staff satisfaction levels with working conditions and the clinic’s effort towards quality improvement and patient safety (P <0.05). Conclusion As part of efforts towards attainment of the health related MDGs in Ghana, more comprehensive staff motivation interventions should be integrated into quality improvement strategies especially in government-owned healthcare facilities where working conditions are perceived to be the worst. PMID:23945073

Health Providers’ Perceptions of Clinical Trials: Lessons from Ghana, Kenya and Burkina Faso

PubMed Central

Angwenyi, Vibian; Asante, Kwaku-Poku; Traoré, Abdoulaye; Febir, Lawrence Gyabaa; Tawiah, Charlotte; Kwarteng, Anthony; Ouédraogo, Alphonse; Sirima, Sodiomon Bienvenue; Owusu-Agyei, Seth; Imoukhuede, Egeruan Babatunde; Webster, Jayne; Chandramohan, Daniel; Molyneux, Sassy; Jones, Caroline

2015-01-01

Background Clinical trials conducted in Africa often require substantial investments to support trial centres and public health facilities. Trial resources could potentially generate benefits for routine health service delivery but may have unintended consequences. Strengthening ethical practice requires understanding the potential effects of trial inputs on the perceptions and practices of routine health care providers. This study explores the influence of malaria vaccine trials on health service delivery in Ghana, Kenya and Burkina Faso. Methods We conducted: audits of trial inputs in 10 trial facilities and among 144 health workers; individual interviews with frontline providers (n=99) and health managers (n=14); and group discussions with fieldworkers (n=9 discussions). Descriptive summaries were generated from audit data. Qualitative data were analysed using a framework approach. Results Facilities involved in trials benefited from infrastructure and equipment upgrades, support with essential drugs, access to trial vehicles, and placement of additional qualified trial staff. Qualified trial staff in facilities were often seen as role models by their colleagues; assisting with supportive supervision and reducing facility workload. Some facility staff in place before the trial also received formal training and salary top-ups from the trials. However, differential access to support caused dissatisfaction, and some interviewees expressed concerns about what would happen at the end of the trial once financial and supervisory support was removed. Conclusion Clinical trials function as short-term complex health service delivery interventions in the facilities in which they are based. They have the potential to both benefit facilities, staff and communities through providing the supportive environment required for improvements in routine care, but they can also generate dissatisfaction, relationship challenges and demoralisation among staff. Minimising trial related harm and maximising benefits requires careful planning and engagement of key actors at the outset of trials, throughout the trial and on its’ completion. PMID:25933429

28 CFR 115.376 - Disciplinary sanctions for staff.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 28 Judicial Administration 2 2013-07-01 2013-07-01 false Disciplinary sanctions for staff. 115.376... NATIONAL STANDARDS Standards for Juvenile Facilities Discipline § 115.376 Disciplinary sanctions for staff. (a) Staff shall be subject to disciplinary sanctions up to and including termination for violating...

28 CFR 115.376 - Disciplinary sanctions for staff.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 28 Judicial Administration 2 2012-07-01 2012-07-01 false Disciplinary sanctions for staff. 115.376... NATIONAL STANDARDS Standards for Juvenile Facilities Discipline § 115.376 Disciplinary sanctions for staff. (a) Staff shall be subject to disciplinary sanctions up to and including termination for violating...

28 CFR 115.376 - Disciplinary sanctions for staff.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 28 Judicial Administration 2 2014-07-01 2014-07-01 false Disciplinary sanctions for staff. 115.376... NATIONAL STANDARDS Standards for Juvenile Facilities Discipline § 115.376 Disciplinary sanctions for staff. (a) Staff shall be subject to disciplinary sanctions up to and including termination for violating...

Providing smoking cessation programs to homeless youth: the perspective of service providers.

PubMed

Shadel, William G; Tucker, Joan S; Mullins, Leslie; Staplefoote, Lynette

2014-10-01

There is almost no information available on cigarette smoking among homeless youth, whether they are currently receiving services for smoking cessation, and how to best help them quit. This paper presents data collected from a series of semi-structured telephone interviews with service providers from 23 shelters and drop-in centers serving homeless youth in Los Angeles County about their current smoking cessation programming, interest in providing smoking cessation services to their clients, potential barriers to providing this service, and ways to overcome these barriers. Results indicated that 84% of facilities did not offer smoking cessation services, although nearly all (91%) were interested in doing so. Barriers to implementing formal smoking cessation programs on site included lack of resources (e.g., money, personnel) to support the programs, staff training, and concern that smoking cessation may not be a high priority for homeless youth themselves. Overall, service providers seemed to prefer a less intensive smoking cessation program that could be delivered at their site by existing staff. Data from this formative needs assessment will be useful for developing and evaluating a smoking cessation treatment that could be integrated into the busy, complex environment that characterizes agencies that serve homeless youth. Copyright © 2014 Elsevier Inc. All rights reserved.

Preventing Fire Death and Injury, Conducting a Fire Drill in a Group Home [and] When You Need a Fire Safety Expert. National Fire Safety Certification System. Continuing Education Program. Volume 1, Numbers 1-3.

ERIC Educational Resources Information Center

Walker, Bonnie

Three booklets provide fire safety information for staff of residential facilities serving people with developmental disabilities. Booklets focus on: (1) preventing fire death and injury, (2) conducting a fire drill in a group home, and (3) the role of fire safety experts. The first booklet stresses the elimination of the following dangers:…

Numbers, systems, people: how interactions influence integration. Insights from case studies of HIV and reproductive health services delivery in Kenya

PubMed Central

Mayhew, Susannah H; Warren, Charlotte E; Collumbien, Martine; Ndwiga, Charity; Mutemwa, Richard; Lut, Irina; Colombini, Manuela; Vassall, Anna

2017-01-01

Abstract Drawing on rich data from the Integra evaluation of integrated HIV and reproductive-health services, we explored the interaction of systems hardware and software factors to explain why some facilities were able to implement and sustain integrated service delivery while others were not. This article draws on detailed mixed-methods data for four case-study facilities offering reproductive-health and HIV services between 2009 and 2013 in Kenya: (i) time-series client flow, tracking service uptake for 8841 clients; (ii) structured questionnaires with 24 providers; (iii) in-depth interviews with 17 providers; (iv) workload and facility data using a periodic activity review and cost-instruments; and (v) contextual data on external activities related to integration in study sites. Overall, our findings suggested that although structural factors like stock-outs, distribution of staffing and workload, rotation of staff can affect how integrated care is provided, all these factors can be influenced by staff themselves: both frontline and management. Facilities where staff displayed agency of decision making, worked as a team to share workload and had management that supported this, showed better integration delivery and staff were able to overcome some structural deficiencies to enable integrated care. Poor-performing facilities had good structural integration, but staff were unable to utilize this because they were poorly organized, unsupported or teams were dysfunctional. Conscientious objection and moralistic attitudes were also barriers. Integra has demonstrated that structural integration is not sufficient for integrated service delivery. Rather, our case studies show that in some cases excellent leadership and peer-teamwork enabled facilities to perform well despite resource shortages. The ability to provide support for staff to work flexibly to deliver integrated services and build resilient health systems to meet changing needs is particularly relevant as health systems face challenges of changing burdens of disease, climate change, epidemic outbreaks and more. PMID:29194544

Evaluating complex health financing interventions: using mixed methods to inform further implementation of a novel PBI intervention in rural Malawi.

PubMed

McMahon, Shannon A; Brenner, Stephan; Lohmann, Julia; Makwero, Christopher; Torbica, Aleksandra; Mathanga, Don P; Muula, Adamson S; De Allegri, Manuela

2016-08-19

Gaps remain in understanding how performance-based incentive (PBI) programs affect quality of care and service quantity, whether programs are cost effective and how programs could be tailored to meet client and provider needs while remaining operationally viable. In 2014, Malawi's Ministry of Health launched the Service Delivery Integration-PBI (SSDI-PBI) program. The program is unique in that no portion of performance bonuses are paid to individual health workers, and it shifts responsibility for infrastructure and equipment procurement from facility staff to implementing partners. This protocol outlines an approach that analyzes processes and outcomes, considers expected and unexpected consequences of the program and frames the program's outputs relative to its costs. Findings from this evaluation will inform the intended future scale-up of PBI in Malawi. This study employs a prospective controlled before-and-after triangulation design to assess effects of the PBI program by analyzing quantitative and qualitative data from intervention and control facilities. Guided by a theoretical framework, the evaluation consists of four main components: service provision, health worker motivation, implementation processes and costing. Quality and access outcomes are assessed along four dimensions: (1) structural elements (related to equipment, drugs, staff); (2) process elements (providers' compliance with standards); (3) outputs (service utilization); (4) experiential elements (experiences of service delivery). The costing component includes costs related to start-up, ongoing management, and the cost of incentives themselves. The cost analysis considers costs incurred within the Ministry of Health, funders, and the implementing agency. The evaluation relies on primary data (including interviews and surveys) and secondary data (including costing and health management information system data). Through the lens of a PBI program, we illustrate how complex interventions can be evaluated via not only primary, mixed-methods data collection, but also through a wealth of secondary data from program implementers (including monitoring, evaluation and financial data), and the health system (including service utilization and service readiness data). We also highlight the importance of crafting a theory and using theory to inform the nature of data collected. Finally, we highlight the need to be responsive to stakeholders in order to enhance a study's relevance.

Cost analysis of public health influenza vaccine clinics in Ontario.

PubMed

Mercer, Nicola J

2009-01-01

Public health in Ontario delivers, promotes and provides each fall the universal influenza immunization program. This paper addresses the question of whether Ontario public health agencies are able to provide the influenza immunization program within the Ministry of Health fiscal funding envelope of $5 per dose. Actual program delivery data from the 2006 influenza season of Wellington-Dufferin-Guelph Public Health (WDGPH) were used to create a model template for influenza clinics capturing all variable costs. Promotional and administrative costs were separated from clinic costs. Maximum staff workloads were estimated. Vaccine clinics were delivered by public health staff in accordance with standard vaccine administration practices. The most significant economic variables for influenza clinics are labour costs and number of vaccines given per nurse per hour. The cost of facility rental was the only other significant cost driver. The ability of influenza clinics to break even depended on the ability to manage these cost drivers. At WDGPH, weekday flu clinics required the number of vaccines per nurse per hour to exceed 15, and for weekend flu clinics this number was greater than 21. We estimate that 20 vaccines per hour is at the limit of a safe workload over several hours. Managing cost then depends on minimizing hourly labour costs. The results of this analysis suggest that by managing the labour costs along with planning the volume of patients and avoiding expensive facilities, flu clinics can just break even. However, any increased costs, including negotiated wage increases or the move to safety needles, with a fixed revenue of $5.00 per dose will negate this conclusion.

Economic grand rounds: Variation in staffing and activities in psychiatric inpatient units.

PubMed

Cromwell, Jerry; Maier, Jan

2006-06-01

In 1999 the Balanced Budget Refinement Act mandated the development of a per diem prospective payment for all psychiatric inpatients. To assist Medicare in developing a per diem patient-based payment system, this study surveyed a representative sample of psychiatric inpatient units in 40 facilities for one week in 2001 through 2003 to determine how units are staffed and how staff members spend their time caring for patients. On general adult units, psychiatric staff averaged ten hours per patient per 24-hour day, roughly 55 percent of staff time was involved in psychiatric care, medical-related nursing and personal care accounted for 10 percent of staff time, and milieu time took up 34 percent of staff time. Small general adult and geriatric units required 50 percent more staff time per patient than large units. More research is needed to determine how recent changes in the method of payment affect these facilities.

Regulation and Mindful Resident Care in Nursing Homes

PubMed Central

Colón-Emeric, Cathleen S.; Plowman, Donde; Bailey, Donald; Corazzini, Kirsten; Utley-Smith, Queen; Ammarell, Natalie; Toles, Mark; Anderson, Ruth

2009-01-01

Regulatory oversight is intended to improve the health outcomes of nursing home residents, yet evidence suggests that regulations can inhibit mindful staff behaviors that are associated with effective care. We explored the influence of regulations on mindful staff behavior as it relates to resident health outcomes, and offer a theoretical explanation of why regulations sometimes enhance mindfulness and other times inhibit it. We analyzed data from an in-depth, multiple case study including field notes, interviews, and documents collected in 8 nursing homes. We completed a conceptual/thematic description using the concept of mindfulness to reframe the observations. Shared facility mission strongly impacted staff perceptions of the purpose and utility of regulations. In facilities with a resident-centered culture, regulations increased mindful behavior, whereas in facilities with a cost-focused culture, regulations reduced mindful care practices. When managers emphasized the punitive aspects of regulation we observed a decrease in mindful practices in all facilities. PMID:20479137

A Phenomenological Study of the Work Environment in Long-Term Care Facilities for the Older Adults.

PubMed

Choi, Sandy Pin Pin; Yeung, Cheryl Chi Yan; Lee, Joseph Kok Long

2018-05-01

Attempts to meet the increasing demand for long-term care (LTC) services have been hindered by acute staff shortages and high turnover. Distinct from previous studies, a descriptive phenomenological approach with van Kaam's controlled explication method was adopted in this study, to delineate how attributes of the LTC work environment shape the workforce crisis. Individual interviews were conducted with 40 LTC workers from 10 facilities in Hong Kong. The results suggest that the work environment in LTC facilities is not only characterized by organization- and job-related attributes that influence staff outcomes but also is a socially constructed concept with derogatory connotations that can influence staff recruitment and retention. Concerted efforts from facility administrators and policy makers are needed to improve the quality of the work environment. Future initiatives should focus on developing a vision and strategic plan to facilitate the rise of the LTC sector as a profession.

Five key players shape institution's ethical character.

PubMed

Craig, R P; Middleton, C J; O'Connell, L J

1986-05-01

Various individuals or groups play important roles in achieving moral insight and direction in a health care facility. The administration, medical and nursing staffs, the professional theologian, and the bishop all contribute unique perspectives to the complex process of developing an institution's ethical character. An institutional ethics committee's (IEC's) effectiveness depends largely on the administrator's ability to support educational programming in ethics for the entire staff, coordinate ethical reflection throughout the organization, and shape ethically informed policy based on an IEC's practical experience. The medical staff brings its scientific background and practical experience to ethical issues under a committee's consideration, and nurses offer valuable insights based on their close contact with patients and family. The theologian provides resources and background on Catholic tradition as well as information on current theological developments. The IEC also should maintain a relationship with the local bishop whose duty is to articulate the Church's positions in health care ethics. Forthright dialogue among all parties is central to the IEC's task.

"People don't understand what goes on in here": A consensual qualitative research analysis of inmate-caregiver perspectives on prison-based end-of-life care.

PubMed

Depner, Rachel M; Grant, Pei C; Byrwa, David J; Breier, Jennifer M; Lodi-Smith, Jennifer; Luczkiewicz, Debra L; Kerr, Christopher W

2018-05-01

The age demographic of the incarcerated is quickly shifting from young to old. Correctional facilities are responsible for navigating inmate access to healthcare; currently, there is no standardization for access to end-of-life care. There is growing research support for prison-based end-of-life care programs that incorporate inmate peer caregivers as a way to meet the needs of the elderly and dying who are incarcerated. This project aims to (a) describe a prison-based end-of-life program utilizing inmate peer caregivers, (b) identify inmate-caregiver motivations for participation, and (c) analyze the role of building trust and meaningful relationships within the correctional end-of-life care setting. A total of 22 semi-structured interviews were conducted with inmate-caregivers. Data were analyzed using Consensual Qualitative Research methodology. All inmate-caregivers currently participating in the end-of-life peer care program at Briarcliff Correctional Facility were given the opportunity to participate. All participants were male, over the age of 18, and also incarcerated at Briarcliff Correctional Facility, a maximum security, state-level correctional facility. In total, five over-arching and distinct domains emerged; this manuscript focuses on the following three: (a) program description, (b) motivation, and (c) connections with others. Findings suggest that inmate-caregivers believe they provide a unique and necessary adaptation to prison-based end-of-life care resulting in multilevel benefits. These additional perceived benefits go beyond a marginalized group gaining access to patient-centered end-of-life care and include potential inmate-caregiver rehabilitation, correctional medical staff feeling supported, and correctional facilities meeting end-of-life care mandates. Additional research is imperative to work toward greater standardization of and access to end-of-life care for the incarcerated.

Alex Pines

Science.gov Websites

@berkeley.edu 510-642-1220 Research profile » A U.S. Department of Energy National Laboratory Operated by the Computational Study of Excited-State Phenomena in Energy Materials Center for X-ray Optics MSD Facilities Ion Investigators Division Staff Facilities and Centers Staff Jobs Safety Personnel Resources Committees In Case of

Applying RUG-III in Japanese Long-Term Care Facilities.

ERIC Educational Resources Information Center

Ikegami, Naoki; And Others

1994-01-01

Tested U.S. nursing home case-mix system, Resource Utilization Groups, Version III (RUG-III) in Japanese long-term care facilities. Measured staff time and resident characteristics for 871 patients. Found acceptable reliability for items defining RUG-III, and system explained 44% of variance in wage-weighted staff time (cost). Japanese and U.S.…

The Need for Caregiver Education and Training in the Assisted Living Industry

ERIC Educational Resources Information Center

Falk-Huzar, Erica

2017-01-01

Assisted living is dedicated to serving individuals with a wide array of disabilities. Training and education are vital for staff and residents in assisted-living facilities because resident care depends on staff knowledge to provide for their safety and welfare. However, little research has been conducted on assisted-living facilities, let alone…

41 CFR Appendix C to Part 102 - 37-Glossary of Terms for Determining Eligibility of Public Agencies and Nonprofit Organizations

Code of Federal Regulations, 2012 CFR

2012-01-01

..., or rehabilitation of alcoholics or drug addicts. These centers must have on their staffs, or... departments, training facilities, and staff offices. Library means a public or nonprofit facility providing... institution may qualify as a medical institution. Museum means a public or nonprofit institution that is...

41 CFR Appendix C to Part 102 - 37-Glossary of Terms for Determining Eligibility of Public Agencies and Nonprofit Organizations

Code of Federal Regulations, 2014 CFR

2014-01-01

..., or rehabilitation of alcoholics or drug addicts. These centers must have on their staffs, or... departments, training facilities, and staff offices. Library means a public or nonprofit facility providing... institution may qualify as a medical institution. Museum means a public or nonprofit institution that is...

Barriers and facilitators to provide quality TIA care in the Veterans Healthcare Administration.

PubMed

Damush, Teresa M; Miech, Edward J; Sico, Jason J; Phipps, Michael S; Arling, Greg; Ferguson, Jared; Austin, Charles; Myers, Laura; Baye, Fitsum; Luckhurst, Cherie; Keating, Ava B; Moran, Eileen; Bravata, Dawn M

2017-12-12

To identify key barriers and facilitators to the delivery of guideline-based care of patients with TIA in the national Veterans Health Administration (VHA). We conducted a cross-sectional, observational study of 70 audiotaped interviews of multidisciplinary clinical staff involved in TIA care at 14 VHA hospitals. We de-identified and analyzed all transcribed interviews. We identified emergent themes and patterns of barriers to providing TIA care and of facilitators applied to overcome these barriers. Identified barriers to providing timely acute and follow-up TIA care included difficulties accessing brain imaging, a constantly rotating pool of housestaff, lack of care coordination, resource constraints, and inadequate staff education. Key informants revealed that both stroke nurse coordinators and system-level factors facilitated the provision of TIA care. Few facilities had specific TIA protocols. However, stroke nurse coordinators often expanded upon their role to include TIA. They facilitated TIA care by (1) coordinating patient care across services, communicating across service lines, and educating clinical staff about facility policies and evidence-based practices; (2) tracking individual patients from emergency departments to inpatient settings and to discharge for timely follow-up care; (3) providing and referring TIA patients to risk factor management programs; and (4) performing regular audit and feedback of quality performance data. System-level facilitators included clinical service leadership engagement and use of electronic tools for continuous care across services. The local organization within a health care facility may be targeted to cultivate internal facilitators and a systemic infrastructure to provide evidence-based TIA care. Copyright © 2017 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the American Academy of Neurology.

Evaluation of a Systems Analysis and Improvement Approach to Optimize Prevention of Mother-To-Child Transmission of HIV Using the Consolidated Framework for Implementation Research.

PubMed

Gimbel, Sarah; Rustagi, Alison S; Robinson, Julia; Kouyate, Seydou; Coutinho, Joana; Nduati, Ruth; Pfeiffer, James; Gloyd, Stephen; Sherr, Kenneth; Granato, S Adam; Kone, Ahoua; Cruz, Emilia; Manuel, Joao Luis; Zucule, Justina; Napua, Manuel; Mbatia, Grace; Wariua, Grace; Maina, Martin

2016-08-01

Despite large investments to prevent mother-to-child-transmission (PMTCT), pediatric HIV elimination goals are not on track in many countries. The Systems Analysis and Improvement Approach (SAIA) study was a cluster randomized trial to test whether a package of systems engineering tools could strengthen PMTCT programs. We sought to (1) define core and adaptable components of the SAIA intervention, and (2) explain the heterogeneity in SAIA's success between facilities. The Consolidated Framework for Implementation Research (CFIR) guided all data collection efforts. CFIR constructs were assessed in focus group discussions and interviews with study and facility staff in 6 health facilities (1 high-performing and 1 low-performing site per country, identified by study staff) in December 2014 at the end of the intervention period. SAIA staff identified the intervention's core and adaptable components at an end-of-study meeting in August 2015. Two independent analysts used CFIR constructs to code transcripts before reaching consensus. Flow mapping and continuous quality improvement were the core to the SAIA in all settings, whereas the PMTCT cascade analysis tool was the core in high HIV prevalence settings. Five CFIR constructs distinguished strongly between high and low performers: 2 in inner setting (networks and communication, available resources) and 3 in process (external change agents, executing, reflecting and evaluating). The CFIR is a valuable tool to categorize elements of an intervention as core versus adaptable, and to understand heterogeneity in study implementation. Future intervention studies should apply evidence-based implementation science frameworks, like the CFIR, to provide salient data to expand implementation to other settings.

Evaluation of a Systems Analysis and Improvement Approach to Optimize Prevention of Mother-To-Child Transmission of HIV Using the Consolidated Framework for Implementation Research

PubMed Central

Rustagi, Alison S.; Robinson, Julia; Kouyate, Seydou; Coutinho, Joana; Nduati, Ruth; Pfeiffer, James; Gloyd, Stephen; Sherr, Kenneth; Granato, S. Adam; Kone, Ahoua; Cruz, Emilia; Manuel, Joao Luis; Zucule, Justina; Napua, Manuel; Mbatia, Grace; Wariua, Grace; Maina, Martin

2016-01-01

Background: Despite large investments to prevent mother-to-child-transmission (PMTCT), pediatric HIV elimination goals are not on track in many countries. The Systems Analysis and Improvement Approach (SAIA) study was a cluster randomized trial to test whether a package of systems engineering tools could strengthen PMTCT programs. We sought to (1) define core and adaptable components of the SAIA intervention, and (2) explain the heterogeneity in SAIA's success between facilities. Methods: The Consolidated Framework for Implementation Research (CFIR) guided all data collection efforts. CFIR constructs were assessed in focus group discussions and interviews with study and facility staff in 6 health facilities (1 high-performing and 1 low-performing site per country, identified by study staff) in December 2014 at the end of the intervention period. SAIA staff identified the intervention's core and adaptable components at an end-of-study meeting in August 2015. Two independent analysts used CFIR constructs to code transcripts before reaching consensus. Results: Flow mapping and continuous quality improvement were the core to the SAIA in all settings, whereas the PMTCT cascade analysis tool was the core in high HIV prevalence settings. Five CFIR constructs distinguished strongly between high and low performers: 2 in inner setting (networks and communication, available resources) and 3 in process (external change agents, executing, reflecting and evaluating). Discussion: The CFIR is a valuable tool to categorize elements of an intervention as core versus adaptable, and to understand heterogeneity in study implementation. Future intervention studies should apply evidence-based implementation science frameworks, like the CFIR, to provide salient data to expand implementation to other settings. PMID:27355497

Nursing Administrators' Views on Oral Health in Long-Term Care Facilities: An exploratory study.

PubMed

Urata, Janelle Y; Couch, Elizabeth T; Walsh, Margaret M; Rowe, Dorothy J

2018-04-01

Purpose: To explore the knowledge, attitudes, and practices of supervising nurse administrators (SNAs) regarding the oral care provided to long-term care facility (LTCF) residents and the role of dental professionals in those facilities. Methods: The investigators of this study partnered with the National Association of Nursing Administrators to send this cross-sectional study consisting of a 35-item electronic survey to its members whose email addresses were in their database. Online software tabulated responses and calculated frequencies (percentages) of responses for each survey item. Results: Of the 2,359 potential participants, 171 (n=171) completed the survey for a 7% response rate. Only 25% of the respondents were familiar with the expertise of dental hygienists (DHs), however once informed, the majority were interested in having DHs perform oral health staff trainings, oral screenings, and dental referrals and initiate fluoride varnish programs. Most respondents correctly answered the oral health-related knowledge items, understood that oral health is important to general health, but reported that the LTCF residents' oral health was only "good" or "fair." Fewer than half, (48%) of the SNAs were "very satisfied" with the quality of oral care provided to the residents. While more than half reported that they had no dentist on staff or on-site dental equipment, 77% reported that they would consider on-site mobile oral care services. Oral health training for staff was provided primarily by registered nurses, however only 32% reported including identification of dental caries as part of the in-service training. Conclusion: This exploratory study lays the foundation for more extensive research investigating various strategies to improve the oral health of LTCF residents, including increased collaboration between DHs and SNAs. Copyright © 2018 The American Dental Hygienists’ Association.

Factors promoting resident deaths at aged care facilities in Japan: a review.

PubMed

Sugimoto, Kentaro; Ogata, Yasuko; Kashiwagi, Masayo

2018-03-01

Due to an increasingly ageing population, the Japanese government has promoted elderly deaths in aged care facilities. However, existing facilities were not designed to provide resident end-of-life care and the proportion of aged care facility deaths is currently less than 10%. Consequently, the present review evaluated the factors that promote aged care facility resident deaths in Japan from individual- and facility-level perspectives to exploring factors associated with increased resident deaths. To achieve this, MEDLINE, CINAHL, Web of Science and Ichushi databases were searched on 23 January 2016. Influential factors were reviewed for two healthcare services (insourcing and outsourcing facilities) as well as external healthcare agencies operating outside facilities. Of the original 2324 studies retrieved, 42 were included in analysis. Of these studies, five focused on insourcing, two on outsourcing, seven on external agencies and observed facility/agency-level factors. The other 28 studies identified individual-level factors related to death in aged care facilities. The present review found that at both facility and individual levels, in-facility resident deaths were associated with healthcare service provision, confirmation of resident/family end-of-life care preference and staff education. Additionally, while outsourcing facilities did not require employment of physicians/nursing staff to accommodate resident death, these facilities required visits by physicians and nursing staff from external healthcare agencies as well as residents' healthcare input. This review also found few studies examining outsourcing facilities. The number of healthcare outsourcing facilities is rapidly increasing as a result of the Japanese government's new tax incentives. Consequently, there may be an increase in elderly deaths in outsourcing healthcare facilities. Accordingly, it is necessary to identify the factors associated with residents' deaths at outsourcing facilities. © 2016 The Authors. Health and Social Care in the Community Published by John Wiley & Sons Ltd.

Organizational factors related to the confidence of workers in working with residents with dementia or depression in aged care facilities.

PubMed

McCabe, Marita P; Mellor, David; Karantzas, Gery; Von Treuer, Kathryn; Davison, Tanya E; O'Connor, Daniel

2017-05-01

There has been limited research examining how organizational factors are associated with the level of confidence of residential aged care staff in managing both residents' depression and the behavioural and psychological symptoms of residents with dementia (BPSD). This study investigated this issue. A cross-sectional study design was employed. In total, 255 aged care staff (131 senior staff, 124 junior staff) from 21 residential care facilities participated in the study. All staff completed measures of self-efficacy in managing BPSD as well as confidence in working with older people with depression. They also completed measures of organizational climate (autonomy, cohesion, trust, pressure, support, recognition, fairness and encouragement of innovation) and measures of workplace experience (job role, number of years working in aged care facilities), job stress and satisfaction, and knowledge of depression. The results demonstrated that autonomy, trust, support, and job stress were associated with confidence in managing BPSD, while the factors related to confidence in managing depression were autonomy, support, job stress, job satisfaction, and knowledge of depression. These findings highlight that organizational climate factors need to be addressed in order to increase staff confidence in managing BPSD and depression. In particular, the findings demonstrate the importance of fostering organizational environments in which autonomy is promoted and there is support and cooperation among aged care staff. Attention to these factors is likely to increase the confidence of staff as they carry out their carer role.

Patterns of health service utilization at a medical school clinic in Ghana.

PubMed

Yawson, A E; Malm, K L; Adu, A A; Wontumi, G-M; Biritwum, R B

2012-09-01

The University of Ghana Medical School (UGMS) Clinic provides healthcare service which is free at point of service to students, staff, retired staff and dependents of staff of the College of Health Sciences. However, since 1983, no in-depth review of health service provision or utilization has been undertaken. This study reviewed client characteristics, utilization and disease patterns at the clinic and also compared the disease patterns to that of other primary health facilities nationwide. This was an analytical cross-sectional study undertaken at the UGMS clinic in Korle-Bu. It was a retrospective review of records of all clients attending the facility from January 2002 to December, 2004. More males than females attended the clinic and majority (63.9%) of clients were between 15-44 years (median age was 26 years). Dependents of staff constituted the highest attendants (41%) to the clinic. Among staff, junior staffs were in the majority. Malaria, respiratory tract infection and musculoskeletal pain were the most common conditions seen. Overall, 83% of clients were treated and discharged per visit without the need for review visits. Dependents of staff used the facility the most and they live in many different part of the city of Accra, and to ask them to attend the clinic for care is not efficient. It will be better to provide or supplement their securing of insurance so that they could access health care close to their homes and save time and attention to students and staff.

Evaluating the capabilities model of dementia care: a non-randomized controlled trial exploring resident quality of life and care staff attitudes and experiences.

PubMed

Moyle, Wendy; Venturato, Lorraine; Cooke, Marie; Murfield, Jenny; Griffiths, Susan; Hughes, Julian; Wolf, Nathan

2016-07-01

This 12 month, Australian study sought to compare the Capabilities Model of Dementia Care (CMDC) with usual long-term care (LTC), in terms of (1) the effectiveness of the CMDC in assisting care staff to improve Quality Of Life (QOL) for older people with dementia; and (2) whether implementation of the CMDC improved staff attitudes towards, and experiences of working and caring for the person with dementia. A single blind, non-randomized controlled trial design, involving CMDC intervention group (three facilities) and a comparison usual LTC practice control group (one facility), was conducted from August 2010 to September 2011. Eighty-one staff members and 48 family members of a person with dementia were recruited from these four LTC facilities. At baseline, 6 and 12 months, staff completed a modified Staff Experiences of Working with Demented Residents questionnaire (SEWDR), and families completed the Quality of Life - Alzheimer's Disease questionnaire (QOL-AD). LTC staff in the usual care group reported significantly lower SEWDR scores (i.e. less work satisfaction) than those in the CMDC intervention group at 12 months (p = 0.005). Similarly, family members in the comparison group reported significantly lower levels of perceived QOL for their relative with dementia (QOL-AD scores) than their counterparts in the CMDC intervention group at 12 months (p = 0.012). Although the study has a number of limitations the CMDC appears to be an effective model of dementia care - more so than usual LTC practice. The CMDC requires further evaluation with participants from a diverse range of LTC facilities and stages of cognitive impairment.

Lowering nursing injuries using post offer pre-employment testing.

PubMed

Faris, Jason

2008-01-01

Nursing injuries are alarmingly high in the healthcare system. The rate of injuries adds to the shortage of nurses that are already employed. Preventing nursing injuries has focused on utilizing patient handling equipment. This project used post offer pre employment testing to attempt to control the injuries of nurses in a healthcare facility. Injuries were significantly lower in the employment pool that was tested when compared the nursing staff that had not been tested. Five injuries were reported in the tested group, resulting in $1,778 spent on the injuries, whereas the non-tested group had 54 injuries totaling $26,208. The total return on investment by this program was $4,541,059. Post Offer Pre employment testing can be a cost effective way to decrease the amount of injuries with nursing staff.

Case Study: Clinical Governance as an Approach to Improve Maternal and Newborn Health in 22 Hospitals in Indonesia.

PubMed

Amelia, Dwirani; Suhowatsky, Stephanie; Baharuddin, Mohammad; Tholandi, Maya; Hyre, Anne; Sethi, Reena

Clinical governance is a concept used to improve management, accountability and the provision of quality healthcare. An approach to strengthen clinical governance as a means to improve the quality of maternal and newborn care in Indonesia was developed by the Expanding Maternal and Neonatal Survival (EMAS) Program. This case study presents findings and lessons learned from EMAS program experience in 22 hospitals where peer-to-peer mentoring supported staff in strengthening clinical governance from 2012-2015. Efforts resulted in improved hospital preparedness and significantly increased the odds of facility-level coverage for three evidence-based maternal and newborn healthcare interventions.

Productivity of Veterans Health Administration laboratories: a College of American Pathologists Laboratory Management Index Program (LMIP) study.

PubMed

Valenstein, Paul N; Wang, Edward; O'Donohue, Tom

2003-12-01

The Veterans Health Administration (VA) operates the largest integrated laboratory network in the United States. To assess whether the unique characteristics of VA laboratories impact efficiency of operations, we compared the productivity of VA and non-VA facilities. Financial and activity data were prospectively collected from 124 VA and 131 non-VA laboratories enrolled in the College of American Pathologists Laboratory Management Index Program (LMIP) during 2002. In addition, secular trends in 5 productivity ratios were calculated for VA and non-VA laboratories enrolled in LMIP from 1997 through 2002. Veterans Health Administration and non-VA facilities did not differ significantly in size. Inpatients accounted for a lower percentage of testing at VA facilities than non-VA facilities (21.7% vs 37.3%; P <.001). Technical staff at the median VA facility were paid more than at non-VA facilities (28.11/h dollars vs 22.60/h dollars, salaries plus benefits; P <.001), VA laboratories employed a smaller percentage of nontechnical staff (30.0% vs 41.9%; P <.001), and workers at VA laboratories worked less time per hour paid (85.5% vs 88.5%; P <.001). However, labor productivity was significantly higher at VA than at non-VA facilities (30 448 test results/total full-time equivalent (FTE)/y vs 19 260 results/total FTE; P <.001), resulting in lower labor expense per on-site test at VA sites than at non-VA sites (1.79 dollars/result vs 2.08 dollars/result; P <.001). Veterans Health Administration laboratories paid less per test for consumables (P =.003), depreciation, and maintenance than their non-VA counterparts (all P <.001), resulting in lower overall cost per on-site test result (2.64 dollars vs 3.40 dollars; P <.001). Cost per referred (sent-out) test did not differ significantly between the 2 groups. Analysis of 6-year trends showed significant increases in both VA (P <.001) and non-VA (P =.02) labor productivity (on-site tests/total FTE). Expenses at VA laboratories for labor per test, consumables per test, overall expense per test, and overall laboratory expense per discharge decreased significantly during the 6-year period (P <.001), while in non-VA facilities the corresponding ratios showed no significant change. Overall productivity of VA laboratories is superior to that of non-VA facilities enrolled in LMIP. The principal advantages enjoyed by the VA are higher-than-average labor productivity (tests/FTE) and lower-than-average consumable expenses.

Using human rights in maternal mortality programs: from analysis to strategy.

PubMed

Freedman, L P

2001-10-01

This article describes an approach to maternal mortality reduction that uses human rights not simply to denounce the injustice of death in pregnancy and childbirth, but also to guide the design and implementation of maternal mortality policies and programs. As a first principle, programs and policies need to prioritize measures that promote universal access to high quality emergency obstetric care services, which we know from health research are essential to saving women's lives. With that priority, human rights principles can be integrated into programs at the clinical, facility management, and national policy levels. For example, a human rights 'audit' can help identify ways to encourage respectful, non-discriminatory treatment of patients, providers and staff in the clinical setting. Human rights principles of entitlement and accountability can inform mechanisms of community participation designed to improve responsiveness and functioning of health facilities. Human rights principles can inform analysis of health sector reform and its impact on access to emergency obstetric care. Whether applied to the intricacies of human relationships within a facility or to the impact of international financial institutions on health systems, the ultimate role of human rights is to identify the workings of power that keep unacceptable levels of maternal morality as they are and to use the human rights vision of dignity and social justice to work for the re-arrangements of power necessary for change.

Linking Resident Satisfaction to Staff Perceptions of the Work Environment in Assisted Living: A Multilevel Analysis

ERIC Educational Resources Information Center

Sikorska-Simmons, Elzbieta

2006-01-01

Purpose: This study examines the relationship between resident satisfaction and staff perceptions of the work environment in assisted living. Staff perceptions were assessed at the facility level, using aggregate measures of staff job satisfaction, organizational commitment, and views of organizational culture. Design and Methods: The sample…

Staff Development Program Evaluation.

ERIC Educational Resources Information Center

Ashur, Nina E.; And Others

An evaluation of the staff development program at College of the Canyons (California) was conducted in 1991 to provide information applicable to program improvement. Questionnaires were distributed to all faculty, classified staff, and flexible calendar program committee and staff development advisory committee members, resulting in response rates…

Using action research to build mentor capacity to improve orientation and quality of nursing students' aged care placements: what to do when the phone rings.

PubMed

Lea, Emma J; Andrews, Sharon; Stronach, Megan; Marlow, Annette; Robinson, Andrew L

2017-07-01

To describe whether an action research approach can be used to build capacity of residential aged care facility staff to support undergraduate nursing students' clinical placements in residential aged care facilities, using development of an orientation programme as an exemplar. Aged care facilities are unpopular sites for nursing students' clinical placements. A contributing factor is the limited capacity of staff to provide students with a positive placement experience. Strategies to build mentor capability to shape student placements and support learning and teaching are critical if nursing students are to have positive placements that attract them to aged care after graduation, an imperative given the increasing care needs of the ageing population worldwide. Action research approach employing mixed-methods data collection (primarily qualitative with a quantitative component). Aged care facility staff (n = 32) formed a mentor group at each of two Tasmanian facilities and met regularly to support undergraduate nursing students (n = 40) during placements. Group members planned, enacted, reviewed and reflected on orientation procedures to welcome students, familiarise them with the facility and prepare them for their placement. Data comprised transcripts from these and parallel student meetings, and orientation data from student questionnaires from two successive placement periods (2011/2012). Problems were identified in the orientation processes for the initial student placements. Mentors implemented a revised orientation programme. Evaluation demonstrated improved programme outcomes for students regarding knowledge of facility operations, their responsibilities and emergency procedures. Action research provides an effective approach to engage aged care facility staff to build their capacity to support clinical placements. Building capacity in the aged care workforce is vital to provide appropriate care for residents with increasing care needs. © 2016 John Wiley & Sons Ltd.

Consequences of electroplated targets on radiopharmaceutical preparations

NASA Astrophysics Data System (ADS)

Finn, R. D.; Tirelli, S.; Sheh, Y.; Knott, A.; Gelbard, A. S.; Larson, S. M.; Dahl, J. R.

1991-05-01

The staff of the cyclotron facility at Memorial Sloan-Kettering Cancer Center is involved in a comprehensive radionuclide preparation program which culminates with the formulation of numerous requested short-lived, positron-emitting radiopharmaceutical agents for clinical investigation. Both the produced radionuclide as well as the final radiolabeled compound are subjected to stringent quality control standards including assays for radiochemical and chemical purity. The subtle chemical consequences resulting from the irradiation of a nickel-plated target for 13N production serve to emphasize some of these potential technical difficulties.

ESEA: Arts Education and Magnet Schools. Hearing of the Committee on Health, Education, Labor, and Pensions on Examining Proposed Legislation Authorizing Funds for Programs of the Elementary and Secondary Education Act, Focusing on School Facilities. United States Senate, One Hundred Sixth Congress, First Session.

ERIC Educational Resources Information Center

Congress of the U.S., Washington, DC. Senate Committee on Health, Education, Labor, and Pensions.

This booklet contains statements of the members of the U.S. Senate Committee on Health, Education, Labor, and Pensions regarding financial support for arts education in magnet schools. The booklet identifies the committee members and staff members and then details the opening statements of Senator James M. Jeffords (Vermont), the Committee…

Expectations and needs of Ugandan women for improved quality of childbirth care in health facilities: A qualitative study.

PubMed

Kyaddondo, David; Mugerwa, Kidza; Byamugisha, Josaphat; Oladapo, Olufemi T; Bohren, Meghan A

2017-12-01

To describe the experiences, expectations, and needs of urban Ugandan women in relation to good-quality facility childbirth. Women who had given birth in the 12 months prior to the study were purposively sampled and interviewed, or included in focus groups. Thematic analysis was used, and the data were interpreted within the context of an existing quality of care framework. Forty-five in-depth interviews and six focus group discussions were conducted. Respect and dignity, timely communication, competent skilled staff, and availability of medical supplies were central to women's accounts of quality care, or a lack of it. The hope for a live baby motivated women to seek facility-based childbirth. They expected to encounter competent, respectful, and caring staff with appropriate skills. In some cases, they could only fulfill these expectations through additional personal financial payments to staff, for clinical supplies, or to guarantee that they would be attended by someone with suitable skills. Long-term improvement in quality of maternity care in Uganda requires enhancement of the interaction between women and health staff in facilities, and investment in staff and resources to ensure that safe, respectful care is not dependent on willingness and/or capacity to pay. © 2017 International Federation of Gynecology and Obstetrics. The World Health Organization retains copyright and all other rights in the manuscript of this article as submitted for publication.

Randomized Multilevel Intervention to Improve Outcomes of Residents in Nursing Homes in Need of Improvement

PubMed Central

Rantz, Marilyn J.; Nahm, Helen E.; Zwygart-Stauffacher, Mary; Hicks, Lanis; Mehr, David; Flesner, Marcia; Petroski, Gregory F.; Madsen, Richard W.; Scott-Cawiezell, Jill

2012-01-01

Purpose A comprehensive multilevel intervention was tested to build organizational capacity to create and sustain improvement in quality of care and subsequently improve resident outcomes in nursing homes in need of improvement. Intervention facilities (n=29) received a two-year multilevel intervention with monthly on-site consultation from expert nurses with graduate education in gerontological nursing. Attention control facilities (n=29) that also needed to improve resident outcomes received monthly information about aging and physical assessment of elders. Design and Methods Randomized clinical trial of nursing homes in need of improving resident outcomes of bladder and bowel incontinence, weight loss, pressure ulcers, and decline in activities of daily living (ADL). It was hypothesized that following the intervention, experimental facilities would have better resident outcomes, higher quality of care, higher staff retention, more organizational attributes of improved working conditions than control facilities, similar staffing and staff mix, and lower total and direct care costs. Results The intervention did improve quality of care (p=0.02); there were improvements in pressure ulcers (p=0.05), weight loss (p=0.05). Staff retention, organizational working conditions, staffing, and staff mix and most costs were not affected by the intervention. Leadership turnover was surprisingly excessive in both intervention and control groups. Implications Some facilities that are in need of improving quality of care and resident outcomes are able to build the organizational capacity to improve while not increasing staffing or costs of care. Improvement requires continuous supportive consultation and leadership willing to involve staff and work together to build the systematic improvements in care delivery needed. PMID:21816681

Multiresistant pathogens in geriatric nursing – infection control in residential facilities for geriatric nursing in Germany

PubMed Central

Peters, Claudia; Schablon, Anja; Bollongino, Kirsten; Maaß, Monika; Kaß, Dietmar; Dulon, Madeleine; Diel, Roland; Nienhaus, Albert

2014-01-01

Background: The increase of multidrug-resistant organisms (MDROs) causes problems in geriatric nursing homes. Older people are at increased a growing risk of infection due to multimorbidity and frequent stays in hospital. A high proportion of the elderly require residential care in geriatric nursing facilities, where hygiene requirements in nursing homes are similar to those in hospitals. For this reason we examined how well nursing homes are prepared for MDROs and how effectively protect their infection control residents and staff. Methods: A cross-sectional study was performed on infection control in residential geriatric nursing facilities in Germany 2012. The questionnaire recorded important parameters of hygiene, resident and staff protection and actions in case of existing MDROs. Results: The response was 54% in Hamburg and 27% in the rest of Germany. Nursing homes were generally well equipped for dealing with infection control: There were standards for MDROs and regular hygiene training for staff. The facilities provided adequate protective clothing, affected residents are usually isolated and hygienic laundry processing conducted. There are deficits in the communication of information on infected residents with hospitals and general practitioners. 54% of nursing homes performed risk assessments for staff infection precaution. Conclusion: There is a growing interest in MDROs and infection control will be a challenge in for residential geriatric nursing facilities in the future. This issue has also drawn increasing attention. Improvements could be achieved by improving communication between different participants in the health service, together with specific measures for staff protection at work. PMID:25285266

Implementation of a smoke-free policy in a high secure mental health inpatient facility: staff survey to describe experience and attitudes

PubMed Central

2013-01-01

Background In 2008, a new forensic hospital was opened as a totally smoke-free facility. This study describes the attitudes and experience of mental health professionals working in the high secure mental health facility three years after it was opened. It is part of a larger evaluation describing the experience of current and discharged hospital patients. Methods Quantitative data was collected using a survey of hospital staff (N = 111) with a 50% response rate. The survey collected demographic and smoking data to describe staff responses to statements relating to hospital smoking policy, patient care and staff support. Results Among staff surveyed, 13% were current smokers and 41% were ex-smokers (10% quit after commencing employment in the smoke-free hospital). Most (88%) preferred to work in a smoke-free environment, although this was significantly lower in smokers compared to non-smokers (39% vs. 95%). While most staff felt that the smoke-free environment had a positive impact on the health of patients (86%) and on themselves (79%), smokers were significantly less likely to agree. Just over half (57%) of staff surveyed agreed that patient care was easier in a totally smoke-free environment, although less smokers agreed compared to non-smokers. Staff who smoked were also significantly less likely to indicate they had sufficient support working in a smoke-free environment, compared to non-smokers (15% vs. 38%). Conclusions The staff surveyed supported the smoke-free workplace policy; most agreed that patient care was easier and that the policy did not lead to an increase in patient aggression. Implementation of a total smoking ban can result in positive health outcomes for patients and staff, and may influence some staff to quit. Staff who smoke have a less positive experience of the policy and require additional support. PMID:23566256

Institutional Staff Training and Management: A Review of the Literature and a Model for Geriatric, Long-Term-Care Facilities.

ERIC Educational Resources Information Center

Burgio, Louis D.; Burgio, Kathryn L.

1990-01-01

Asserts that, if long-term care is to progress from custodial model to therapeutic model of rehabilitation, role of nursing assistants must be redesigned. Reviews current methods of institutional staff training and management and proposes model for geriatric, long-term care facilities. Discusses organizational resistance and offers suggestions for…

Developing a Staff Physical Activity Program at Your School: Implementing the Lesser-Used Component of the CSPAP Model

ERIC Educational Resources Information Center

Langley, Katherine; Kulinna, Pamela Hodges

2018-01-01

The purpose of this article is to explore staff physical activity programs in the school setting, describe a viable option for a staff walking program in an elementary school, and determine elementary school staff members' participation and perceptions in one such program. Previous research has shown that placing a focus on staff involvement and…

Social work services in Army medical treatment facilities: are they reorganizing?

PubMed

Hamlin, E R; Pehrson, K L; Gemmill, R

1996-01-01

The end of the Cold War and the fall of Communism in Europe resulted in profound changes in U.S. defense policy. Those changes led to dramatic reductions in personnel and programs within the Army. The Army Medical Department (AMEDD) is also being reduced in size and reorganized. At the same time, the AMEDD is facing escalating health care costs associated with demand and access to medical care. Social work services in Army medical treatment facilities are being directly affected by these system changes. Therefore, the question is raised whether changes in the organization and delivery of social work services are being initiated or anticipated. To what extent are social work chiefs of service involved in these decisions at the medical treatment facility level, and what are the positive and negative effects of reorganization on social work staff and the clients they serve?

Facilitators and barriers to self-management of nursing home residents: perspectives of health-care professionals in Korean nursing homes.

PubMed

Park, Yeon-Hwan; Bang, Hwal Lan; Kim, Ga Hye; Ha, Ji Yeon

2015-01-01

To explore facilitators and barriers to self-management from the viewpoint of staff taking care of nursing home (NH) residents with chronic diseases in South Korea. A qualitative content analysis was done using the focus group interview method. A total of 23 health-care professionals (16 registered nurses and 7 social workers) were interviewed from three urban NHs, each with more than 100 beds. Five facilitators were identified: grouping the residents; the resident's awareness of his/her current health status; the willingness of residents to engage in self-management; residence in the facility; and support from the staff. Additionally, seven barriers were identified: deterioration of the resident's health; the dependency expectations of the resident; hesitation in asking for help; difference in expectations between the staff and the resident's family; insufficient staffing and time; lack of standardized guidelines; and conservative tendencies of the staff due to rigid policies. The findings of this study can help health-care professionals recognize the factors that influence self-management and provide direction for registered nurses and other health professionals involved in supporting self-management programs for NH residents.

Facilitators and barriers to self-management of nursing home residents: perspectives of health-care professionals in Korean nursing homes

PubMed Central

Park, Yeon-Hwan; Bang, Hwal Lan; Kim, Ga Hye; Ha, Ji Yeon

2015-01-01

Purpose To explore facilitators and barriers to self-management from the viewpoint of staff taking care of nursing home (NH) residents with chronic diseases in South Korea. Patients and methods A qualitative content analysis was done using the focus group interview method. A total of 23 health-care professionals (16 registered nurses and 7 social workers) were interviewed from three urban NHs, each with more than 100 beds. Results Five facilitators were identified: grouping the residents; the resident’s awareness of his/her current health status; the willingness of residents to engage in self-management; residence in the facility; and support from the staff. Additionally, seven barriers were identified: deterioration of the resident’s health; the dependency expectations of the resident; hesitation in asking for help; difference in expectations between the staff and the resident’s family; insufficient staffing and time; lack of standardized guidelines; and conservative tendencies of the staff due to rigid policies. Conclusion The findings of this study can help health-care professionals recognize the factors that influence self-management and provide direction for registered nurses and other health professionals involved in supporting self-management programs for NH residents. PMID:26491277

"India Population Projects" in Karnataka.

PubMed

Reddy, P H; Badari, V S

1991-12-01

An overview, objectives, implementation, and research and evaluation studies of 2 India Population Projects in Karnataka are presented. The India Population Project I (IPP-I) was conducted in Karnataka and Uttar Pradesh. India Population Project III (IPP-III) took place between 1984-92 in 6 districts of Karnataka: Belgaum, Bijapur, Dharwad, Bidar, Gulbarga, and Raichur, and 4 districts in Kerala. The 6 districts in Karnataka accounted for 36% (13.2 million) of the total national population. The project cost was Rs. 713.1 million which was shared by the World Bank, and the Indian national and regional government. Due to poor past performance, these projects were undertaken to improve health and family welfare status. Specific project objectives are outlined. IPP-I included an urban component, and optimal Government of India program, and an intensive rural initiative. The urban program aimed to improved pre- and postnatal services and facilities, and the family planning (FP) in Bangalore city. The rural program was primarily to provide auxiliary nurse-midwives and hospitals and clinics, and also supplemental feeding program for pregnant and nursing mothers and children up to 2 years. The government program provided FP staff and facilities. IPP-I had 3 units to oversee building construction, to recruit staff and provide supplies and equipment, and to establish a Population Center. IPP-III was concerned with service delivery; information, education, and communication efforts (IEC) and population education; research and evaluation; and project management. Both projects contributed significantly to improving the infrastructure. A brief account of the types and kinds of studies undertaken is given. Studies were grouped into longitudinal studies of fertility, mortality, and FP; management information and evaluation systems for health and family welfare programs; experimental strategies; and other studies. Research and evaluation studies in IPP-III encompassed studies in gaps in knowledge, skills, and practice of health and FP personnel; baseline and endline surveys; and operational evaluation of the management information and evaluation system; factors affecting primary health care in Gulbarga district; evaluation of radio health lessons and the impact of the Kalyana Matha Program; and studies of vaccination and child survival and maternal mortality. Training programs were also undertaken.

Differences among nursing homes in outcomes of a safe resident handling program

PubMed Central

Kurotvski, Alicia; Gore, Rebecca; Buchholz, Bryan; Punnett, Laura

2018-01-01

A large nursing home corporation implemented a safe resident handling program (SRHP) in 2004–2007. We evaluated its efficacy over a 2-year period by examining differences among 5 centers in program outcomes and potential predictors of those differences. We observed nursing assistants (NAs), recording activities and body postures at 60-second intervals on personal digital assistants at baseline and at 3-month, 12-month, and 24-month follow-ups. The two outcomes computed were change in equipment use during resident handling and change in a physical workload index that estimated spinal loading due to body postures and handled loads. Potential explanatory factors were extracted from post-observation interviews, investigator surveys of the workforce, from administrative data, and employee satisfaction surveys. The facility with the most positive outcome measures was associated with many positive changes in explanatory factors and the facility with the fewest positive outcome measures experienced negative changes in the same factors. These findings suggest greater SRHP benefits where there was lower NA turnover and agency staffing; less time pressure; and better teamwork, staff communication, and supervisory support. PMID:22833329

Staff Behavior toward Children and Adolescents in a Residential Facility: A Self-Report Questionnaire

ERIC Educational Resources Information Center

Huitink, C.; Embregts, P. J. C. M.; Veerman, J. W.; Verhoeven, L.

2011-01-01

The purpose of the present study was to examine psychometric properties of the Staff Behavior toward Clients questionnaire (SBC), a self-report measure for care staff working with children and adolescents with mild to borderline intellectual disabilities in residential care. Ninety-nine care staff completed the SBC and the Strengths and…

DOE Office of Scientific and Technical Information (OSTI.GOV)

Stillman, J. A.; Feldman, E. E.; Wilson, E. H.

This report contains the results of reactor accident analyses for the University of Missouri Research Reactor (MURR). The calculations were performed as part of the conversion from the use of highly-enriched uranium (HEU) fuel to the use of low-enriched uranium (LEU) fuel. The analyses were performed by staff members of the Global Threat Reduction Initiative (GTRI) Reactor Conversion Program at the Argonne National Laboratory (ANL), the MURR Facility, and the Nuclear Engineering Program – College of Engineering, University of Missouri-Columbia. The core conversion to LEU is being performed with financial support from the U. S. government. This report contains themore » results of reactor accident analyses for the University of Missouri Research Reactor (MURR). The calculations were performed as part of the conversion from the use of highly-enriched uranium (HEU) fuel to the use of low-enriched uranium (LEU) fuel. The analyses were performed by staff members of the Global Threat Reduction Initiative (GTRI) Reactor Conversion Program at the Argonne National Laboratory (ANL), the MURR Facility, and the Nuclear Engineering Program – College of Engineering, University of Missouri-Columbia. The core conversion to LEU is being performed with financial support from the U. S. government. In the framework of non-proliferation policies, the international community presently aims to minimize the amount of nuclear material available that could be used for nuclear weapons. In this geopolitical context most research and test reactors, both domestic and international, have started a program of conversion to the use of LEU fuel. A new type of LEU fuel based on an alloy of uranium and molybdenum (U-Mo) is expected to allow the conversion of U.S. domestic high performance reactors like MURR. This report presents the results of a study of core behavior under a set of accident conditions for MURR cores fueled with HEU U-Alx dispersion fuel or LEU monolithic U-Mo alloy fuel with 10 wt% Mo (U-10Mo).« less

Patient education and emotional support practices in abortion care facilities in the United States.

PubMed

Gould, Heather; Perrucci, Alissa; Barar, Rana; Sinkford, Danielle; Foster, Diana Greene

2012-01-01

Little is known about how patient education and emotional support is provided at abortion facilities. This pilot study documents 27 facilities' practices in this aspect of abortion care. We conducted confidential telephone interviews with staff from 27 abortion facilities about their practices. The majority of facilities reported they rely primarily on trained nonclinician staff to educate patients and provide emotional support. As part of their informed consent and counseling processes, facilities reported that staff always provide patients with information about the procedure (96%), assess the certainty of their abortion decisions (92%), assess their feelings and provide emotional support (74%), and provide contraceptive health education (92%). Time spent providing these components of care varied across facilities and patients. When describing their facility's care philosophy, many respondents expressed support for "patient-centered," "supportive," "nonjudgmental" care. Eighty-two percent agreed that it is the facility's role to provide counseling for emotional issues related to abortion. All facilities valued informed consent, patient education, and emotional support. Although the majority of facilities considered counseling for emotional issues to be a part of their role, some did not. Future research should examine patients' preferences regarding abortion care and counseling and how different approaches to care affect women's emotional well-being after having an abortion. This information is important in light of current, widespread legislative efforts that aim to regulate abortion counseling, which are being proposed without an understanding of patient needs or facility practices. Copyright © 2012 Jacobs Institute of Women's Health. Published by Elsevier Inc. All rights reserved.

[Comprehensive study on the prevention of food poisoning through the investigation of an affected hospital food service facility].

PubMed

Kubota, Satoshi; Kawai, Hiromi

2015-01-01

In Japan, more than 20,000 people suffer from various types of food poisoning annually. In this paper, we discuss the prevention of food poisoning in hospital food service facilities from the perspective of hygiene management and organizational behavior. We inspected the kitchen environment and the meal preparation process in a hospital food service facility in Japan that had been the site of a food poisoning incident. To clarify the present state of hygiene management, interviews were conducted with both the head of the nutrition and food service section and the administrative manager. In addition, questionnaires were distributed to the food service staff to assess their level of satisfaction with the working environment. The facility had been built about 10 years previously and was well maintained. Meal preparations were performed according to the operation manual, and education and training for the food service staff were carried out daily. No problems were evident regarding hygiene management. However, concerning organizational behavior, the satisfaction level of the staff was found to be relatively low, which may have led to a reduction in their organizational commitment and a decrease in their performance. To aid in the prevention of food poisoning incidents in hospital food service facilities, it is essential not only to conduct standard hygiene management and training, but also to consider the organizational behavior of the food service staff.

Improving safety and operational efficiency in residential care settings with WiFi-based localization.

PubMed

Doshi-Velez, Finale; Li, William; Battat, Yoni; Charrow, Ben; Curtis, Dorothy; Curthis, Dorothy; Park, Jun-geun; Hemachandra, Sachithra; Velez, Javier; Walsh, Cynthia; Fredette, Don; Reimer, Bryan; Roy, Nicholas; Teller, Seth

2012-07-01

To assess the effectiveness of a wireless network (WiFi-based) localization system (devices mounted on resident wheelchairs) in decreasing caretaker time spent searching for residents and providing alerts of residents going outdoors in a skilled nursing facility. A controlled study over two 2-month periods approved by the institutional review board. A long-term skilled nursing facility in Massachusetts specializing in multiple sclerosis previously instrumented with wireless network infrastructure. Nineteen residents and 9 staff members at the facility for the first 2-month period; 9 residents and 3 staff members at the facility for the second 2-month period. Software was installed on 4 staff computers to display the locations of residents enrolled in the study. This software was made available to enrolled staff for the second half of the first 2-month period and the entirety of the second 2-month study. In the second 2-month study, the software was modified to provide alerts if any 1 of 9 participating "high-risk"' residents went outdoors, and the accuracy of the alert system was evaluated. In the first 2-month study, 9 staff members recorded the amount of time it took them to locate participating residents (as and when needed during the course of their daily activities). In the second 2-month study, 3 staff members recorded whether outdoor-alerts correctly identified a resident leaving the building or if it was a false alarm. In both phases, participating staff members made frequent use of the system (44 searches and 215 outdoor alerts). Overall, the localization information decreased the average time needed to find residents by about two-thirds (from 311.1 seconds to 110.9 seconds). For outdoor alerts, the system had a false-alarm rate of 9.1% (under normal facility operations); systematic tests of the outdoor-alert system carried out by the authors had a false-negative, or missed-alarm, rate of 1.7%. Using timely resident location information can provide significant gains for both operational efficiency (finding residents) and enhanced resident safety (outdoor alerts). This approach may provide an inexpensive alternative for facilities that have sufficient wireless infrastructure; future work should assess its effectiveness in additional settings. Copyright © 2012 American Medical Directors Association. Published by Elsevier Inc. All rights reserved.

25 CFR 36.86 - Are there staff training requirements?

Code of Federal Regulations, 2011 CFR

2011-04-01

... 25 Indians 1 2011-04-01 2011-04-01 false Are there staff training requirements? 36.86 Section 36... Programs Staffing § 36.86 Are there staff training requirements? (a) All homeliving program staff as well... licensing requirements. (b) All homeliving program staff as well as all employees who supervise students...

25 CFR 36.86 - Are there staff training requirements?

Code of Federal Regulations, 2013 CFR

2013-04-01

... 25 Indians 1 2013-04-01 2013-04-01 false Are there staff training requirements? 36.86 Section 36... Programs Staffing § 36.86 Are there staff training requirements? (a) All homeliving program staff as well... licensing requirements. (b) All homeliving program staff as well as all employees who supervise students...

25 CFR 36.86 - Are there staff training requirements?

Code of Federal Regulations, 2014 CFR

2014-04-01

... 25 Indians 1 2014-04-01 2014-04-01 false Are there staff training requirements? 36.86 Section 36... Programs Staffing § 36.86 Are there staff training requirements? (a) All homeliving program staff as well... licensing requirements. (b) All homeliving program staff as well as all employees who supervise students...

25 CFR 36.86 - Are there staff training requirements?

Code of Federal Regulations, 2010 CFR

2010-04-01

... 25 Indians 1 2010-04-01 2010-04-01 false Are there staff training requirements? 36.86 Section 36... Programs Staffing § 36.86 Are there staff training requirements? (a) All homeliving program staff as well... licensing requirements. (b) All homeliving program staff as well as all employees who supervise students...

Special Programs in Medical Library Education, 1957-1971: Part II: Analysis of the Programs *†

PubMed Central

Roper, Fred W.

1973-01-01

In this report, responses to a questionnaire to the directors of the sixteen past and present medical library education programs are presented. The questionnaires indicate a rather wide variety of training programs with emphases that vary from preparation of management personnel to preparation of subject specialists and those skilled in the techniques of information storage and retrieval. The content of the degree programs is fairly evenly divided among general retrieval and outside courses. The internship programs place more emphasis on the work experience than do the degree programs, supplementing this experience with appropriate courses in science, health sciences, management, and information storage and retrieval. Program directors indicated that new or expanded programs are needed in medical library education, although caution is reflected in comments concerning the limited job market. Most of the internship directors stated that they could not accommodate more individuals in their programs without expansion of staff and facilities. PMID:4744344

Human resource development in rural health care facilities.

PubMed

Johnson, L

1991-01-01

In this paper, human resource development problems facing rural health care facilities are identified and it is recognised that, particularly in the face of escalating demands for training arising from environmental pressures such as implementation of the structural efficiency principle, a coordinated approach to meet these problems is desirable. Such coordination is often sought via a regional staff development service. Accordingly, using the organisational life cycle as a conceptual framework, staff development services in five NSW health regions are examined. Ranging from a cafeteria style to a results-orientation, a diversity of strategic approaches to staff development is reflected.

Staff members' perceived training needs regarding sexuality in residential aged care facilities.

PubMed

Villar, Feliciano; Celdrán, Montserrat; Fabà, Josep; Serrat, Rodrigo

2017-01-01

The purpose of the article is to ascertain if staff members of residential aged care facilities (RACF) perceive the need for training regarding residents' sexuality, and what, if any, benefits from the training were perceived, and to compare perceived benefits of training between care assistants and professional/managerial staff. Interviews were conducted with 53 staff members of five different RACF in Spain. Their responses to two semistructured questions were transcribed verbatim and submitted to content analysis. Results show that most interviewees said they lacked training about sexuality and aging. Two potential highlighted benefits of the training are knowledge/attitudinal (countering negative attitudes regarding sexuality) and procedural (developing common protocols and tools to manage situations related to sexuality). Care assistants and professional staff agreed on the need for training, though the former emphasized the procedural impact and the latter the knowledge/attitudinal benefits. The results suggest that RACF staff should have an opportunity to receive training on residents' sexuality, as sexual interest and behavior is a key dimension of residents' lives.

Knowledge of Staff Members of Residential Care Facilities for Individuals with Intellectual Disability on Medication Administration via Enteral Feeding Tube

ERIC Educational Resources Information Center

Joos, E.; Mehuys, E.; Van Bocxlaer, J.; Remon, J. P.; Van Winckel, M.; Boussery, K.

2016-01-01

Background: Guidelines for the safe administration of drugs through enteral feeding tube (EFT) are an important tool to minimise the risk of errors. This study aimed to investigate knowledge of these guidelines among staff of residential care facilities (RCF) for people with ID. Method: Knowledge was assessed using a 13-item self-administered…

Using Six Sigma and Lean methodologies to improve OR throughput.

PubMed

Fairbanks, Catharine B

2007-07-01

Improving patient flow in the perioperative environment is challenging, but it has positive implications for both staff members and for the facility. One facility in vermont improved patient throughput by incorporating Six Sigma and Lean methodologies for patients undergoing elective procedures. The results of the project were significantly improved patient flow and increased teamwork and pride among perioperative staff members. (c) AORN, Inc, 2007.

Current experiences and educational preferences of general practitioners and staff caring for people with dementia living in residential facilities.

PubMed

Beer, Christopher; Horner, Barbara; Almeida, Osvaldo P; Scherer, Samuel; Lautenschlager, Nicola T; Bretland, Nick; Flett, Penelope; Schaper, Frank; Flicker, Leon

2009-08-12

Residential care is important for older adults, particularly for those with advanced dementia and their families. Education interventions that achieve sustainable improvement in the care of older adults are critical to quality care. There are few systematic data available regarding the educational needs of Residential Care Facility (RCF) staff and General Practitioners (GPs) relating to dementia, or the sustainability of educational interventions. We sought to determine participation in dementia education, perceived levels of current knowledge regarding dementia, perceived unmet educational needs, current barriers, facilitators and preferences for dementia education. A mixed methods study design was utilised. A survey was distributed to a convenience sample of general practitioners, and staff in 223 consecutive residential care facilities in Perth, Western Australia. Responses were received from 102 RCF staff working in 10 facilities (out of 33 facilities who agreed to distribute the survey) and 202 GPs (19% of metropolitan GPs). Quantitative survey data were summarised descriptively and chi squared statistics were used to analyse the distribution of categorical variables. Qualitative data were collected from general practitioners, staff in residential care facilities and family carers of people with dementia utilizing individual interviews, surveys and focus groups. Qualitative data were analysed thematically. Among RCF staff and GPs attending RCF, participation in dementia education was high, and knowledge levels generally perceived as good. The individual experiences and needs of people with dementia and their families were emphasised. Participants identified the need for a person centred philosophy to underpin educational interventions. Limited time was a frequently mentioned barrier, especially in relation to attending dementia care education. Perceived educational needs relating to behaviours of concern, communication, knowledge regarding dementia, aspects of person centred care, system factors and the multidisciplinary team were consistently and frequently cited. Small group education which is flexible, individualized, practical and case based was sought. The effectiveness and sustainability of an educational intervention based on these findings needs to be tested. In addition, future interventions should focus on supporting cultural change to facilitate sustainable improvements in care.

Numbers, systems, people: how interactions influence integration. Insights from case studies of HIV and reproductive health services delivery in Kenya.

PubMed

Mayhew, Susannah H; Sweeney, Sedona; Warren, Charlotte E; Collumbien, Martine; Ndwiga, Charity; Mutemwa, Richard; Lut, Irina; Colombini, Manuela; Vassall, Anna

2017-11-01

Drawing on rich data from the Integra evaluation of integrated HIV and reproductive-health services, we explored the interaction of systems hardware and software factors to explain why some facilities were able to implement and sustain integrated service delivery while others were not. This article draws on detailed mixed-methods data for four case-study facilities offering reproductive-health and HIV services between 2009 and 2013 in Kenya: (i) time-series client flow, tracking service uptake for 8841 clients; (ii) structured questionnaires with 24 providers; (iii) in-depth interviews with 17 providers; (iv) workload and facility data using a periodic activity review and cost-instruments; and (v) contextual data on external activities related to integration in study sites. Overall, our findings suggested that although structural factors like stock-outs, distribution of staffing and workload, rotation of staff can affect how integrated care is provided, all these factors can be influenced by staff themselves: both frontline and management. Facilities where staff displayed agency of decision making, worked as a team to share workload and had management that supported this, showed better integration delivery and staff were able to overcome some structural deficiencies to enable integrated care. Poor-performing facilities had good structural integration, but staff were unable to utilize this because they were poorly organized, unsupported or teams were dysfunctional. Conscientious objection and moralistic attitudes were also barriers.Integra has demonstrated that structural integration is not sufficient for integrated service delivery. Rather, our case studies show that in some cases excellent leadership and peer-teamwork enabled facilities to perform well despite resource shortages. The ability to provide support for staff to work flexibly to deliver integrated services and build resilient health systems to meet changing needs is particularly relevant as health systems face challenges of changing burdens of disease, climate change, epidemic outbreaks and more. © The Author 2017. Published by Oxford University Press in association with The London School of Hygiene and Tropical Medicine.

32 CFR 191.7 - Civilian EEO program staff.

Code of Federal Regulations, 2010 CFR

2010-07-01

... 32 National Defense 2 2010-07-01 2010-07-01 false Civilian EEO program staff. 191.7 Section 191.7...) MISCELLANEOUS THE DOD CIVILIAN EQUAL EMPLOYMENT OPPORTUNITY (EEO) PROGRAM § 191.7 Civilian EEO program staff. (a) EEO Managers, including SEP Managers and other staff who are responsible for EEO and affirmative...

32 CFR 191.7 - Civilian EEO program staff.

Code of Federal Regulations, 2013 CFR

2013-07-01

... 32 National Defense 2 2013-07-01 2013-07-01 false Civilian EEO program staff. 191.7 Section 191.7...) MISCELLANEOUS THE DOD CIVILIAN EQUAL EMPLOYMENT OPPORTUNITY (EEO) PROGRAM § 191.7 Civilian EEO program staff. (a) EEO Managers, including SEP Managers and other staff who are responsible for EEO and affirmative...

32 CFR 191.7 - Civilian EEO program staff.

Code of Federal Regulations, 2011 CFR

2011-07-01

... 32 National Defense 2 2011-07-01 2011-07-01 false Civilian EEO program staff. 191.7 Section 191.7...) MISCELLANEOUS THE DOD CIVILIAN EQUAL EMPLOYMENT OPPORTUNITY (EEO) PROGRAM § 191.7 Civilian EEO program staff. (a) EEO Managers, including SEP Managers and other staff who are responsible for EEO and affirmative...

32 CFR 191.7 - Civilian EEO program staff.

Code of Federal Regulations, 2012 CFR

2012-07-01

... 32 National Defense 2 2012-07-01 2012-07-01 false Civilian EEO program staff. 191.7 Section 191.7...) MISCELLANEOUS THE DOD CIVILIAN EQUAL EMPLOYMENT OPPORTUNITY (EEO) PROGRAM § 191.7 Civilian EEO program staff. (a) EEO Managers, including SEP Managers and other staff who are responsible for EEO and affirmative...

32 CFR 191.7 - Civilian EEO program staff.

Code of Federal Regulations, 2014 CFR

2014-07-01

... 32 National Defense 2 2014-07-01 2014-07-01 false Civilian EEO program staff. 191.7 Section 191.7...) MISCELLANEOUS THE DOD CIVILIAN EQUAL EMPLOYMENT OPPORTUNITY (EEO) PROGRAM § 191.7 Civilian EEO program staff. (a) EEO Managers, including SEP Managers and other staff who are responsible for EEO and affirmative...

Knowledge, Skills, and Attitudes in Caring for Older Adults With Advanced Illness Among Staff Members of Long-Term Care and Assisted Living Facilities: An Educational Needs Assessment.

PubMed

Cimino, Nina M; Lockman, Kashelle; Grant, Marian; McPherson, Mary Lynn

2016-05-01

In long-term care and assisted living facilities, many groups of health care professionals contribute to the work of the health care team. These staff members perform essential, direct patient care activities. An educational needs assessment was conducted to determine the learning needs and preferences of staff members related to providing care for patients with life-limiting illnesses. Staff members placed importance on understanding topics such as principles of palliative care, pain assessment, pain management, and nonpain symptom management. The majority of survey respondents were also interested in learning more about these topics. The results of this educational needs analysis suggest staff members would benefit from a course tailored to these identified educational needs and designed to overcome previously identified educational barriers. © The Author(s) 2014.

Pilot statewide study of pediatric emergency department alignment with national guidelines.

PubMed

Costich, Julia F; Fallat, Mary E; Scaggs, C Morgan; Bartlett, Richard

2013-07-01

The American Academy of Pediatrics, American College of Emergency Physicians, and Emergency Nursing Association have developed consensus guidelines for pediatric emergency department policies, procedures, supplies, and equipment. Kentucky received funding from the Health Resources and Services Administration through the Emergency Medical Services for Children program to pilot test the guidelines with the state's hospitals. In addition to providing baseline data regarding institutional alignment with the guidelines, the survey supported development of grant funding to procure missing items. Survey administration was undertaken by staff and members of the Kentucky Board of Emergency Medical Services Emergency Medical Services for Children work group and faculty and staff of the University of Kentucky College of Public Health and the University of Louisville School of Medicine. Responses were solicited primarily online with repeated reminders and offers of assistance. Seventy respondents completed the survey section on supplies and equipment either online or by fax. Results identified items unavailable at 20% or more of responding facilities, primarily the smallest sizes of equipment. The survey section addressing policy and procedure received only 16 responses. Kentucky facilities were reasonably well equipped by national standards, but rural facilities and small hospitals did not stock the smallest equipment sizes because of low reported volume of pediatric emergency department cases. Thus, a centralized procurement process that gives them access to an adequate range of pediatric supplies and equipment would support capacity building for the care of children across the entire state. Grant proposals were received from 28 facilities in the first 3 months of funding availability.

Factors Related to Healthcare Service Quality in Long-term Care Hospitals in South Korea: A Mixed-methods Study.

PubMed

Sohn, Minsung; Choi, Mankyu

2017-10-01

The environment of long-term care hospitals (LTCHs) is critical to the management of the quality of their services and to patient safety, as highlighted by international studies. However, there is a lack of evidence on this topic in South Korea. This study aimed to examine the factors affecting healthcare quality in LTCHs and to explore the effectiveness of their quality management. This study used a mixed methods approach with quantitative data collected in a national survey and qualitative data from semi-structured interviews with practice-based managers. The samples included 725 nationally representative LTCHs in South Korea for the quantitative analysis and 15 administrators for the in-depth interviews. A higher installation rate of patient-safety and hygiene-related facilities and staff with longer-tenures, especially nurses, were more likely to have better healthcare quality and education for both employees and patients. The need for patient-safety- and hygiene-related facilities in LTCHs that serve older adults reflects their vulnerability to certain adverse events (e.g., infections). Consistent and skillful nursing care to improve the quality of LTCHs can be achieved by developing relevant educational programs for staff and patients, thereby strengthening the relationships between them.

Evaluation of the isoniazid preventive therapy (IPT) program in Shurugwi District, Midlands Province, Zimbabwe, January 2013 to August 2014.

PubMed

Makoni, Annamercy; Chemhuru, Milton; Tshimanga, Mufuta; Gombe, Notion Tafara; Mungati, More; Bangure, Donewell

2015-09-25

Midlands Province started implementing the Isoniazid (INH) preventive therapy (IPT) program in January 2013. Shurugwi and Gokwe North were the piloting district hospitals. In May 2014, four more districts hospitals (Gokwe South, Gweru, Kwekwe and Zvishavane) started implementing IPT. Shurugwi District decentralized the program to its rural health facilities in January 2014. A review of the Shurugwi IPT program, 2013 data, indicated that the majority of eligible clients were not started on IPT. None out of the 400 eligible clients were started on IPT in November against the 100% target according to the World Health Organization and the National Tuberculosis (TB) Program. We conducted a study to evaluate the IPT program in Shurugwi District from January 2013 to August 2014. The logical framework approach was used to evaluate inputs, processes, outputs and outcomes of the IPT program. An interviewer administered questionnaire was used to collect data from key informants. Checklists were used to collect data from IPT program records. Sixteen health facilities were implementing IPT in Shurugwi District. All the facilities had TB screening tools and three did not have TB screening algorithms. The district experienced medicine stock outs in 2013. One formal training at district level and on job trainings in implementing health facilities were done. From January 2013 to August 2014, Shurugwi District screened 6794 antiretroviral (ART) clients for TB. Out of those screened, 5255 were eligible for IPT and 2831 (54%) were started on IPT. A total of 700 clients had completed the IPT 6 month's course by August 2014. The dropout rate due to INH toxicity and TB was 0.6% (n = 18) and 0.3% (n = 8) respectively. Fifty-three advocacy and community sensitization meetings were done. The program had no Information Education and Communication (IEC) materials. The IPT program in Shurugwi District achieved half its target. This could be due to inadequate formally trained staff, lack of IEC materials, inadequate advocacy and community sensitization, non-availability of the INH 300 mg single dose and inadequate INH 100 mg dose tablets in 2013. To improve the IPT program, there is need for routine advocacy, communication and social mobilization.

Report on the Results of the 1999 Staff Institutional Survey.

ERIC Educational Resources Information Center

Abou-Sayf, Frank

This report presents the findings of the Staff Institutional Survey distributed to Hawaii's Kapi'olani Community College (KCC) staff in February 1999. This survey requested biographical information and data related to the following six categories: Facilities and Equipment, Leadership and Support, Personnel Policies, Professional Development…

Implementing OpenMRS for patient monitoring in an HIV/AIDS care and treatment program in rural Mozambique.

PubMed

Manders, Eric-Jan; José, Eurico; Solis, Manuel; Burlison, Janeen; Nhampossa, José Leopoldo; Moon, Troy

2010-01-01

We have adopted the Open Medical Record System (OpenMRS) framework to implement an electronic patient monitoring system for an HIV care and treatment program in Mozambique. The program provides technical assistance to the Ministry of Health supporting the scale up of integrated HIV care and support services in health facilities in rural resource limited settings. The implementation is in use for adult and pediatric programs, with ongoing roll-out to cover all supported sites. We describe early experiences in adapting the system to the program needs, addressing infrastructure challenges, creating a regional support team, training data entry staff, migrating a legacy database, deployment, and current use. We find that OpenMRS offers excellent prospects for in-country development of health information systems, even in severely resource limited settings. However, it also requires considerable organizational infrastructure investment and technical capacity building to ensure continued local support.

Human Reliability Program Workshop

DOE Office of Scientific and Technical Information (OSTI.GOV)

Landers, John; Rogers, Erin; Gerke, Gretchen

A Human Reliability Program (HRP) is designed to protect national security as well as worker and public safety by continuously evaluating the reliability of those who have access to sensitive materials, facilities, and programs. Some elements of a site HRP include systematic (1) supervisory reviews, (2) medical and psychological assessments, (3) management evaluations, (4) personnel security reviews, and (4) training of HRP staff and critical positions. Over the years of implementing an HRP, the Department of Energy (DOE) has faced various challenges and overcome obstacles. During this 4-day activity, participants will examine programs that mitigate threats to nuclear security andmore » the insider threat to include HRP, Nuclear Security Culture (NSC) Enhancement, and Employee Assistance Programs. The focus will be to develop an understanding of the need for a systematic HRP and to discuss challenges and best practices associated with mitigating the insider threat.« less

Findings From a Prospective Randomized Controlled Trial of an Individualized Music Listening Program for Persons With Dementia.

PubMed

Kwak, Jung; Anderson, Keith; O'Connell Valuch, Katharine

2018-06-01

Music & Memory (M&M) is a passive music intervention that uses personalized music playlists delivered on digital music players. This program has been increasingly adopted in nursing homes across the United States to facilitate communication, engagement, and socialization among persons with dementia (PWDs); however, few studies have evaluated the program's effect on PWDs' outcomes. In the present study, a randomized controlled crossover design was used to examine the impact of the M&M program on 59 PWDs in 10 nursing homes over a 14-week period. Residents' evaluated outcomes included agitation, behavioral symptoms, and use of psychotropic medications. Although trends supported the positive effects of M&M, no statistically significant differences were found in any of the outcomes measured over time. Methodological limitations withstanding, these findings call into question the effectiveness of the M&M program and the ability of facility staff to implement this intervention with fidelity.

A qualitative study of continuing education needs of rural nursing unit staff: the nurse administrator's perspective.

PubMed

Fairchild, Roseanne Moody; Everly, Marcee; Bozarth, Lisa; Bauer, Renee; Walters, Linda; Sample, Marilyn; Anderson, Louise

2013-04-01

This study reports perceptions of the continuing education (CE) needs of nursing unit staff in 40 rural healthcare facilities (10 hospitals and 30 long-term care facilities) in a rural Midwestern U.S. region from the perspective of nurse administrators in an effort to promote a community-based academic-practice CE partnership. Qualitative data collection involving naturalistic inquiry methodology was based on key informant interviews with nurse administrators (n=40) working and leading in the participating health care facilities. Major themes based on nurse administrators' perceptions of CE needs of nursing unit staff were in four broad conceptual areas: "Cultural issues", "clinical nursing skills", "patient care", and "patient safety". Major sub-themes for each conceptual area are highlighted and discussed with narrative content as expressed by the participants. Related cultural sub-themes expressed by the nurse administrators included "horizontal violence" (workplace-hospital and LTC nursing unit staff) and "domestic violence" (home-LTC nursing unit staff). The uniqueness of nurses' developmental learning needs from a situational point of view can be equally as important as knowledge-based and/or skill-based learning needs. Psychological self-reflection is discussed and recommended as a guiding concept to promote the development and delivery of relevant, empowering and evidence-based CE offerings for rural nursing unit staff. Copyright © 2012 Elsevier Ltd. All rights reserved.

Reduction of Neonatal Mortality Requires Strengthening of the Health System: A Situational Analysis of Neonatal Care Services in Ballabgarh.

PubMed

Gosain, Mudita; Goel, Akhil D; Kharya, Pradeep; Agarwal, Ramesh; Amarchand, Ritvik; Rai, Sanjay K; Kapoor, Suresh; Paul, Vinod K; Krishnan, Anand

2017-10-01

Planning a comprehensive program addressing neonatal mortality will require a detailed situational analysis of available neonatal-specific health infrastructure. We identified facilities providing essential and sick neonatal care (ENC, SNC) by a snowballing technique in Ballabgarh Block. These were assessed for infrastructure, human resource and equipment along with self-rated competency of the staff and compared with facility-based or population-based norms. A total of 35 facilities providing ENC and 10 facilities for SNC were identified. ENC services were largely in the public-sector domain (68.5% of births) and were well distributed in the block. SNC burden was largely being borne by the private sector (66% of admissions), which was urban-based. The private sector and nurses reported lower competency especially for SNC. Only 53.9% of government facilities and 17.5% of private facilities had a fully equipped newborn care corner. Serious efforts to reduce neonatal mortality would require major capacity strengthening of the health system, including that of the private sector. © The Author [2017]. Published by Oxford University Press. All rights reserved. For Permissions, please email: journals.permissions@oup.com

Environmental and nursing-staff factors contributing to aggressive and violent behaviour of patients in mental health facilities.

PubMed

van Wijk, Evalina; Traut, Annalene; Julie, Hester

2014-08-14

Aggressive and violent behaviour of inpatients in mental health facilities disrupts the therapeutic alliance and hampers treatment. The aim of the study was to describe patients' perceptions of the possible environmental and staff factors that might contribute to their aggressive and violent behaviour after admission to a mental health facility; and to propose strategies to prevent and manage such behaviour. A qualitative, phenomenological study was utilised, in which purposefully sampled inpatients were interviewed over a six-month period. Inpatients were invited to participate if they had been admitted for at least seven days and were in touch with reality. Forty inpatients in two mental health facilities in Cape Town participated in face-to-face, semi-structured interviews over a period of six months. Tesch's descriptive method of open coding formed the framework for the data analysis and presentation of the results. Trustworthiness was ensured in accordance with the principles of credibility, confirmability, transferability and dependability. Analysis of the data indicates two central categories in the factors contributing to patients' aggressive and violent behaviour, namely, environmental factors and the attitude and behaviour of staff. From the perspective of the inpatients included in this study, aggressive and violent episodes are common and require intervention. Specific strategies for preventing such behaviour are proposed and it is recommended that these strategies be incorporated into the in-service training programmes of the staff of mental health facilities. These strategies could prevent, or reduce, aggressive and violent behaviour in in-patient facilities.

End-of-life care policies and practices in pediatric skilled nursing facilities.

PubMed

Friedman, Sandra L; Helm, David T; Woodman, Ashley C

2014-11-01

Although most children with intellectual and developmental disabilities reside in the community, a subset of children with severe intellectual disability and complex medical needs reside in pediatric skilled nursing facilities. These children have elevated mortality with end-of-life care (EOLC) routinely provided. The present study explored policies and practice in such settings by surveying administrators, nursing directors, and medical directors in facilities across the United States. In addition to EOLC policies and practices, staff reported on their understanding of definitions of do-not-resuscitate orders, family involvement in EOLC planning, and the availability of in-service training. The presence of an official EOLC policy was associated with higher ratings of perception of effectiveness among staff. Staff felt more prepared and comfortable providing EOLC when in-service training was provided. © The Author(s) 2013.

Advance care planning for residents in aged care facilities: what is best practice and how can evidence-based guidelines be implemented?

PubMed

Lyon, Cheryl

2007-12-01

Background  Advance care planning in a residential care setting aims to assist residents to make decisions about future healthcare and to improve end-of-life care through medical and care staff knowing and respecting the wishes of the resident. The process enables individuals and others who are important to them, to reflect on what is important to the resident including their beliefs/values and preferences about care when they are dying. This paper describes a project conducted as part of the Joanna Briggs Institute Clinical Aged Care Fellowship Program implemented at the Manningham Centre in metropolitan Melbourne in a unit providing services for 46 low and high care residents. Objectives  The objectives of the study were to document implementation of best practice in advance care planning in a residential aged care facility using a cycle of audit, feedback and re-audit cycle audit with a clinical audit software program, the Practical Application of Clinical Evidence System. The evidence-based guidelines found in 'Guidelines for a Palliative Approach in Residential Aged Care' were used to inform the process of clinical practice review and to develop a program to implement advance care planning. Results  The pre-implementation audit results showed that advance care planning practice was not based on high level evidence as initial compliance with five audit criteria was 0%. The barriers to implementation that became apparent during the feedback stage included the challenge of creating a culture where advance care planning policy, protocols and guidelines could be implemented, and advance care planning discussions held, by adequately prepared health professionals and carers. Opportunities were made to equip the resident to discuss their wishes with family, friends and healthcare staff. Some residents made the decision to take steps to formally document those wishes and/or appoint a Medical Enduring Power of Attorney to act on behalf of the resident when they are unable to communicate wishes. The post-implementation audit showed a clear improvement as compliance ranged from 15-100% for the five audit criteria. Strong leadership by the project team was effective in engaging staff in this quality improvement program. Conclusion  The outcomes of the project were extremely positive and demonstrate a genuine improvement in practice. All audit criteria indicate that the Manningham Centre is now positively working towards improved practice based on the best available evidence. It is hoped that as the expertise developed during this project is shared, other areas of gerontological practice will be similarly improved and more facilities caring for the older person will embrace evidence-based practice.

Day hospital treatment for people with severe mental illness according to users' perspectives: what helps and what hinders recovery?

PubMed

Agrest, Martín; Barruti, Silvina; Gabriel, Raquel; Zalazar, Virginia; Wikinski, Silvia; Ardila-Gómez, Sara

2018-02-01

Scarce information is available about how users experience treatment at mental health day hospitals, particularly in South America. To explore users' perspectives about elements of day hospital treatment that facilitate or hinder the recovery process in a mental health facility in Buenos Aires, Argentina. Semi-structured individual interviews (n = 8) and focus groups (n = 4) were carried out with a convenience sample of users of a mental health day hospital program based on a formulation, testing and redevelopment of propositions approach. Results were analyzed through grounded theory techniques. Categories indicating recovery were: starting to do things, being able to see themselves from a new perspective, mood improvement and changes in interpersonal relationships. Aspects facilitating recovery were: activities organized by the facility, the group approach, the care provided by facility workers and the physical environment. Hindering aspects were: heterogeneity of users in terms of age, severity, diagnosis and being underestimated by staff. Being active again was considered to be the main recovery indicator in this cultural context and participating in activities led by skilled facilitators was the most beneficial factor of the program according to the users.

An approach to radiation safety department benchmarking in academic and medical facilities.

PubMed

Harvey, Richard P

2015-02-01

Based on anecdotal evidence and networking with colleagues at other facilities, it has become evident that some radiation safety departments are not adequately staffed and radiation safety professionals need to increase their staffing levels. Discussions with management regarding radiation safety department staffing often lead to similar conclusions. Management acknowledges the Radiation Safety Officer (RSO) or Director of Radiation Safety's concern but asks the RSO to provide benchmarking and justification for additional full-time equivalents (FTEs). The RSO must determine a method to benchmark and justify additional staffing needs while struggling to maintain a safe and compliant radiation safety program. Benchmarking and justification are extremely important tools that are commonly used to demonstrate the need for increased staffing in other disciplines and are tools that can be used by radiation safety professionals. Parameters that most RSOs would expect to be positive predictors of radiation safety staff size generally are and can be emphasized in benchmarking and justification report summaries. Facilities with large radiation safety departments tend to have large numbers of authorized users, be broad-scope programs, be subject to increased controls regulations, have large clinical operations, have significant numbers of academic radiation-producing machines, and have laser safety responsibilities.

Preparing emergency personnel in dialysis: a just-in-time training program for additional staffing during disasters.

PubMed

Stoler, Genevieve B; Johnston, James R; Stevenson, Judy A; Suyama, Joe

2013-06-01

There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster. A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects. When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P < .05 for all comparisons). PREP-D participants were able to demonstrate improved tests scores when taught in a just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster.

DOE Office of Scientific and Technical Information (OSTI.GOV)

Burton, J. C.; Environmental Research

The Commodity Credit Corporation (CCC) of the U.S. Department of Agriculture (USDA) has entered into an interagency agreement with the U.S. Department of Energy (DOE) under which Argonne National Laboratory provides technical assistance for hazardous waste site characterization and remediation for the CCC/USDA. Carbon tetrachloride is the contaminant of primary concern at sites in Kansas where former CCC/USDA grain storage facilities were located. Argonne applies its QuickSite(reg sign) Expedited Site Characterization (ESC) approach to these former facilities. The QuickSite environmental site characterization methodology is Argonne's proprietary implementation of the ESC process (ASTM 1998). Argonne has used this approach at severalmore » former CCC/USDA facilities in Kansas, including Agenda, Agra, Everest, and Frankfort. The Argonne ESC approach revolves around a multidisciplinary, team-oriented approach to problem solving. The basic features and steps of the QuickSite methodology are as follows: (1) A team of scientists with diverse expertise and strong field experience is required to make the process work. The Argonne team is composed of geologists, geochemists, geophysicists, hydrogeologists, chemists, biologists, engineers, computer scientists, health and safety personnel, and regulatory staff, as well as technical support staff. Most of the staff scientists are at the Ph.D. level; each has on average, more than 15 years of experience. The technical team works together throughout the process. In other words, the team that plans the program also implements the program in the field and writes the reports. More experienced scientists do not remain in the office while individuals with lesser degrees or experience carry out the field work. (2) The technical team reviews, evaluates, and interprets existing data for the site and the contaminants there to determine which data sets are technically valid and can be used in initially designing the field program. A basic mistake sometimes made in the site characterization process is failure to use technically sound available data to form working hypotheses on hydrogeology, contaminant distribution, etc. for initial testing. (3) After assembling and interpreting existing data for the site, the entire technical team visits the site to identify as a group the site characteristics that might prohibit or enhance any particular technological approach. Logistic and community constraints are also identified at this point. (4) After the field visit, the team selects a suite of technologies appropriate to the problem and completes the design of the field program. No one technique works well at all sites, and a suite of techniques is necessary to delineate site features fully. In addition, multiple technologies are employed to increase confidence in conclusions about site features. Noninvasive and minimally invasive technologies are emphasized to minimize risk to the environment, the community, and the staff. In no case is the traditional approach of installing a massive number of monitoring wells followed. A dynamic work plan that outlines the program is produced for the sponsoring and regulatory agencies. The word ''dynamic'' is emphasized because the work plan is viewed as a guide, subject to modification, for the site characterization activity, rather than a document that is absolute and unchangeable. Therefore, the health and safety plan and the quality assurance/quality control plan must be broad and encompass all possible alterations to the plan. The cooperation of the regulating agency is essential in successful implementation of this process. The sponsoring and regulatory agencies are notified if significant changes to the site-specific work plan are necessary. (5) The entire team participates in the technical field program. Several technical activities are undertaken simultaneously. These may range from different surface geophysics investigations to vegetation sampling. Data from the various activities are reduced and interpreted each day by the technical staff. Various computer programs are used to visualize and integrate the data. However, people do the data interpretation and integration, not the computers, which are just one more tool at the site. At the end of the day, the staff members meet, review results, and modify the next day's program as necessary to optimize activities that are generating overlapping or confirming site details. Data are not arbitrarily discarded -- each finding must be explained and understood. Anomalous readings may be due to equipment malfunctions, laboratory error, or the inability of a technique to work in a given setting. The suite of selected technologies is adjusted in the field if necessary. (6) The end result of this process is the optimization of the field activity to produce a high-quality technical product that is cost and time effective.« less

Effectiveness and acceptance of a health care-based mandatory vaccination program.

PubMed

Leibu, Rachel; Maslow, Joel

2015-01-01

To decrease the risk of transmission of hospital-associated transmission of influenza and pertussis through mandatory vaccination of staff. A mandatory influenza and toxoid-diphtheria toxoid-acellular pertussis program was implemented systemwide. A structured vaccine exemption program was implemented for those requesting a medical and/or religious/moral/ethical exemption. Systemwide influenza vaccination rates increased from 67% historically, 76.2% in the 2012 to 2013 influenza season, to 94.7% in 2013 to 2014 with an overall compliance rate of 97.8%. Toxoid-diphtheria toxoid-acellular pertussis vaccination rates systemwide reached 94.9%, with an overall compliance rate of 98%. Higher rates were experienced at individual hospital facilities compared with the corporate location. Successful vaccination campaign outcomes can be achieved through diligent enforcement of mandatory vaccination, masking, and other infection prevention procedures.

Rapid assessment of infrastructure of primary health care facilities - a relevant instrument for health care systems management.

PubMed

Scholz, Stefan; Ngoli, Baltazar; Flessa, Steffen

2015-05-01

Health care infrastructure constitutes a major component of the structural quality of a health system. Infrastructural deficiencies of health services are reported in literature and research. A number of instruments exist for the assessment of infrastructure. However, no easy-to-use instruments to assess health facility infrastructure in developing countries are available. Present tools are not applicable for a rapid assessment by health facility staff. Therefore, health information systems lack data on facility infrastructure. A rapid assessment tool for the infrastructure of primary health care facilities was developed by the authors and pilot-tested in Tanzania. The tool measures the quality of all infrastructural components comprehensively and with high standardization. Ratings use a 2-1-0 scheme which is frequently used in Tanzanian health care services. Infrastructural indicators and indices are obtained from the assessment and serve for reporting and tracing of interventions. The tool was pilot-tested in Tanga Region (Tanzania). The pilot test covered seven primary care facilities in the range between dispensary and district hospital. The assessment encompassed the facilities as entities as well as 42 facility buildings and 80 pieces of technical medical equipment. A full assessment of facility infrastructure was undertaken by health care professionals while the rapid assessment was performed by facility staff. Serious infrastructural deficiencies were revealed. The rapid assessment tool proved a reliable instrument of routine data collection by health facility staff. The authors recommend integrating the rapid assessment tool in the health information systems of developing countries. Health authorities in a decentralized health system are thus enabled to detect infrastructural deficiencies and trace the effects of interventions. The tool can lay the data foundation for district facility infrastructure management.