Oisín Conaty, Leah Gaughan, Colum Downey, Noreen Carolan, Megan Joanne Brophy, Ruth Kavanagh, Deborah A.A. McNamara, Edmond Smyth, Karen Burns and Fidelma Fitzpatrick
The purpose of this paper is to improve surgical antimicrobial prophylaxis (SAP) prescribing in orthopaedic surgery using the model for improvement framework.
Abstract
Purpose
The purpose of this paper is to improve surgical antimicrobial prophylaxis (SAP) prescribing in orthopaedic surgery using the model for improvement framework.
Design/methodology/approach
Orthopaedic patients receiving joint replacements, hip fracture repairs or open-reduction internal-fixation procedures were included. Antimicrobial(s); dose, time of administration and duration of SAP were evaluated for appropriateness based on the local SAP guidelines. After baseline data collection, a driver diagram was constructed with interventions devised for plan-do-study-act cycles. Data were fed back weekly using a point prevalence design (PPD). Interventions included SAP guideline changes, reminders and tools to support key messages.
Findings
SAP in 168 orthopaedic surgeries from 15 June 2016 to 31 January 2017 was studied. Prescribing appropriateness improved from 20 to 78 per cent. Junior doctor changeover necessitated additional education and reminders.
Practical implications
Due to constant staff changeover; continuous data collection, communication, education and reminders are essential to ensure continuous compliance with clinical guidance. Patients with hip fractures are difficult to weigh, requiring weight estimation for weight-based antimicrobial dosing. Unintended consequences of interventions included the necessity to change pre-operative workflow to accommodate reconstitution time of additional antimicrobials and inadvertent continuation of new antimicrobials post-operatively.
Originality/value
Rather than perform the traditional retrospective focused audit, we established a prospective, continuous, interventional quality improvement (QI) project focusing on internal processes within the control of the project team with rapid cyclical changes and interventions. The weekly PPD was pragmatic and enabled the QI project to be sustained with no additional resources.
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Beverly B. Ray and Cynthia Lee A. Pemberton
This study explored perspectives of secondary social studies teachers, who reported using live media broad-casts to engage students in an examination of terrorism on 9/11…
Abstract
This study explored perspectives of secondary social studies teachers, who reported using live media broad-casts to engage students in an examination of terrorism on 9/11. Specifically, this study queried these teachers’ perceptions of preparedness on 9/11 to engage it as a learning event. Respondents (N=29) in one Mid-Atlantic state who were teaching in secondary social studies classrooms on September 11, 2001 (9/11), were asked to reflect on their level of preparedness to adapt and implement real-time teaching to address unfolding events. A Wilcoxon Signed Ranks Test for matched pairs revealed that respondents’ current perceptions of self-efficacy to teach about an unfolding terrorist act were positively modified by their experiences teaching about terrorism on 9/11 [Z = -4.507, p <.001 (two tailed)]. Respondents reported gains in confidence to teach about terrorism because of their teaching experiences on 9/11. Results add to the small knowledge base on the topic, even as they highlight the need for further research on the classroom response to 9/11.
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The purpose of this article is to offer an overview of the prestigious Jason Kinsey Award given by the National Association for School-University Partnerships (NASUP). The article…
Abstract
Purpose
The purpose of this article is to offer an overview of the prestigious Jason Kinsey Award given by the National Association for School-University Partnerships (NASUP). The article outlines the history and purpose, chronicles previous winners, and celebrates the 2024 honoree.
Design/methodology/approach
This article highlights recent winners of NASUP’s Jason Kinsey Award.
Findings
Due to the nature of this piece, there are no research findings. The article explains the history of the award, chronicles the winners over the years, and honors the most recent award recipient.
Originality/value
This article draws additional attention to this exemplary partnership work and may inspire future nominations.
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In this study, internal auditors are asked to come to a view on whether functions they perform in connection with internal audit engagements are essential, and to what degree…
Abstract
In this study, internal auditors are asked to come to a view on whether functions they perform in connection with internal audit engagements are essential, and to what degree. Inspired by Burns, Greenspan and Hartwell’s concept of the true professional, there is an underlying interest in determining whether, and under what circumstances, internal auditors’ enjoy the authority over and independence from management that we might expect of a professional. The findings emerge from a survey of New Zealand auditors, all of whom are IIA branch members. A 73 per cent response rate is achieved over the original and follow‐up survey. A factor analysis identifies converging issues, and t‐tests isolate responses by employment status, disciplinary background, experience, and audit charter existence. The findings suggest that characteristics of a “true” profession exist but do not dominate. Significantly, and as subgroups, public practice and experienced auditors may enjoy greater influence over management, and accountancy‐trained auditors may enjoy greater status owing to the “mystique” of their activities. Comments from the internal auditors shed further light on these results. Conclusions point to further avenues for research.
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In February 1991, OCLC began testing its newly developed product—the FirstSearch™ Catalog. Designed distinctly for the end‐user, FirstSearch is an online computer system providing…
Abstract
In February 1991, OCLC began testing its newly developed product—the FirstSearch™ Catalog. Designed distinctly for the end‐user, FirstSearch is an online computer system providing access to a variety of databases, most notably the OCLC Online Union Catalog. By October 1991, the system was made commercially available to all OCLC member libraries with a pricing structure different from any previously marketed system. As a test site, the Ohio State University has had experience with the system for several months, and has now made the transition from test site to customer.
– The purpose of this paper is to present a case study of the use of people surveys to enact change in human capital organization and practices in a University library.
Abstract
Purpose
The purpose of this paper is to present a case study of the use of people surveys to enact change in human capital organization and practices in a University library.
Design/methodology/approach
The study covers seven years of people surveys and the consequent interventions applied based on this and other data and evidence at the University of York, UK. The case describes measurement of staff’s lived experience, leading to innovation and intervention in management strategies, structures and policies. The research employs a mixed methodology; the paper draws on quantitative evidence from surveys, qualitative evidence from focus groups and desk research on human capital measurement and emotion in the workplace.
Findings
The paper describes the findings of investigations across seven years, discusses the available methods for people assessment, and the different theoretical foundations of the engagement, climate and excellence surveys used across the period. Strategic and structural interventions are described and their effectiveness discussed.
Research limitations/implications
The limitations of research in the field of human capital are discussed, including the participant observation of the library director, together with the potential confounding factors affecting data collected during the period of research.
Social implications
The paper reflects on advances in the understanding and practice of people evaluation in libraries. The development of a people strategy based on evidence, and repetition of surveys to gauge the effectiveness of interventions, with consequent refinement of solutions, appear to have had a real effect on the lived experience, culture and service provided by the case library.
Originality/value
The originality and value of the paper is that it provides a unique long-term case study of people surveys, strategy and structure in an academic research library.
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Jennifer J. Esala, Leora Hudak, Alyce Eaton and Maria Vukovich
The purpose of this paper is to explore the “active ingredients” of integrated behavioral health care (IBHC) from the perspective of Karen refugee participants in an IBHC…
Abstract
Purpose
The purpose of this paper is to explore the “active ingredients” of integrated behavioral health care (IBHC) from the perspective of Karen refugee participants in an IBHC intervention.
Design/methodology/approach
This paper is based on in-depth, semi-structured interviews with participants (n=40) who have received an IBHC intervention for one year. These qualitative data are supplemented by descriptive quantitative data from those same participants.
Findings
This research suggested that IBHC increased awareness and access to behavioral health services, and that IBHC may be especially amenable to treating complex health conditions. The research also found that IBHC provided a point of regular contact for patients who had limited time with their primary care providers, which helped to enhance access to and engagement with health care.
Practical implications
IBHC has the potential to meet the complex needs of Karen resettled refugees living in an urban setting in the USA.
Originality/value
IBHC is a promising approach to help meet the mental health needs of refugees in the USA. There are, however, gaps in knowledge about the “active ingredients” of IBHC. This paper helps fill these gaps by studying how IBHC works from the perspective of a group of Karen refugees; these are critical perspectives, missing in the literature, which must be heard in order to better address the complex conditions and needs of resettled refugees.