Class of 2007 Abstract / Objectives: To evaluate the impact of decentralized clinical staff pharmacists (CSPs) on nursing staff in a university- affiliated teaching hospital. Areas of interest include perceived quality of patient care, job satisfaction and nursing job retention. Methods: CSP impact was evaluated using a print-based survey utilizing outcomes items and a four-point Likert-type scale with response options ranging from “Agree” to “Disagree.” Nurses also answered demographic questions about experience, time at the institution, education leve and frequency of interaction with a CSP. Analysis of the data included use of descriptive statistics as well as use of Kendall’s tau-b to evaluate differences between groups based frequency of CSP interaction. Results: Respondents included 122 nurses at University Medical Center (UMC) in Tucson, Arizona in positions supported by a CSP during the summer of 2006. Nurses overwhelmingly selected “Agree” or “Somewhat Agree” for all 12 statements about the CSPs indicating that they found their interaction with CSPs valuable. Nurses who interacted more frequently with CSPs were more likely to “Agree” or “Somewhat agree that CSPs were valuable members of the hospital (p=.049), one reason they remained at UMC (p=.007), helpful with medication questions (p=.008) and improved job satisfaction (p=.013), made their job easier (p=<.001) as well as more enjoyable (p=.027)

There is limited engagement with research based evidence among senior managers within the NHS, and a failure to consistently integrate research findings into the decision making process. While much is known about the decision making and information behaviour of clinical staff and policy makers, there is little knowledge of this for senior non-clinical managers within the NHS. There is also a lack of clarity on how best to facilitate and integrate research evidence into the decision making process and a lack of research regarding the context of non-clinical healthcare managers working in the NHS. This study addresses these shortcomings through in-depth analysis in a case study approach. Data was collected through semi-structured interview, questionnaire and observed scenario work. This data was analysed to increase knowledge and understanding of the current information behaviour and decision making practices of non-medical senior management staff working within the NHS in England. Several key barriers to research utilisation were identified in the analysis of the data. These barriers included insufficient information literacy skills in the cohort, shortcomings with the published research papers, a culture which was focused on achieving politically set targets, and a lack of defined processes to decision making. To address these barriers an embedded librarian and a SharePoint based knowledge management system were implemented and evaluated. Evaluation of these interventions concluded that an embedded librarian was effective in increasing and supporting evidence informed decision making. This provides a practical example of an effective service development which should be considered for implementation across the NHS and wider healthcare community. The study also recommends that, to increase use of their output, researchers need to include more explicit information on the implementation and financial elements of their findings rather than a narrow focus on the intervention outcome. In addition, findings showed the target driven culture of the NHS create an environment that stifles evidence informed decision making. To address this barrier the study recommends that the NHS adopts methods of quality assurance and metrics which place an emphasis on measures of process. This study contributes to theory by exploring the information behaviour of a specific group which have been overlooked in previous research, and contributes new understanding of mechanisms for knowledge translation and interactions between the research based evidence and decision making processes in the context of NHS non-clinical management.

Philosophiae Doctor - PhD / The mental health care environment is a stressful environment because of the environment, perceived unpreparedness of students and the emotional demands placed on the students which are inherent in the nature of the work. The use of the self as a therapeutic tool also presents challenges for students. Whilst researchers have identified supportive interventions and strategies to address students support needs in mental health care settings, these interventions/strategies focus on meeting clinical learning objectives with the assumption that if the student learning needs are met, they will feel emotionally supported. Literature and experience indicates that it is imperative that in this field of study, students should be prepared to cope emotionally with the demands of mental health work. The aim of this research was to develop a model of emotional support for student nurses working in mental health care settings. A theory-generating design based on a qualitative, explorative and descriptive research approach was used to achieve the aim of the study. Purposive sampling was employed to select participants namely: students, educators and clinical staff who met the eligibility criteria. A sample of 40 students, nine educators and nine clinical staff who worked in the four psychiatric hospitals and community mental health clinics in the Western Cape participated in the study. Data collection was by means of focus group interviews (students) and indepth individual interviews (educators and clinical staff). Data was analysed by means of Tesch’s method of content analysis. The model was developed by means of the four steps of the theory generation process. Step one was concept development which consisted of two sub-steps namely concept identification and concept definition. A total of 22 concepts were identified which was further synthesised into six main concepts. The main concepts which were used to develop the model were: positive self-concept; positive work environment; academic and professional development; effective communication; formal and informal supportive interventions and collaboration between the Higher Education Institution and the mental health care setting. Step two of the theory generating process was model development. These main concepts were placed in relation with each other which formed an emotional support model for students working in mental health care settings. Step three was model description. The model was described using the three phases of interpersonal communication namely orientation phase, working phase and the termination phase. A visual application of the model which depicts the main concepts, the process and the context was shown. Step four dealt with the development of the guidelines for the implementation of the emotional support model. A critical reflection of the model was done using five criteria for model evaluation according to Chinn & Kramer. Trustworthiness of the data was ensured by means of applying Guba’ model of truth value, applicability, consistency and neutrality. Reflexivity was used by the researcher to further enhance trustworthiness. Permission to conduct the study was obtained from the relevant authorities. The ethical principles of respect for human dignity, beneficence and justice were applied throughout the study. Limitations were identified and ecommendations for nursing practice, education concluded the study.

Submitted by Maicon Juliano Schmidt (maicons) on 2015-04-10T12:45:27Z No. of bitstreams: 2 Marcelo Paes.pdf: 10057344 bytes, checksum: b0121ff6fb4efa45286e495ee87e3cc1 (MD5) Marcelo Paes.pdf: 10057344 bytes, checksum: b0121ff6fb4efa45286e495ee87e3cc1 (MD5) / Made available in DSpace on 2015-04-10T12:45:27Z (GMT). No. of bitstreams: 2 Marcelo Paes.pdf: 10057344 bytes, checksum: b0121ff6fb4efa45286e495ee87e3cc1 (MD5) Marcelo Paes.pdf: 10057344 bytes, checksum: b0121ff6fb4efa45286e495ee87e3cc1 (MD5) Previous issue date: 2012-01-31 / Nenhuma / Esta dissertação teve como objetivo avaliar as contribuições que um contexto de Open Innovation poderia acrescentar a um projeto de design estratégico voltado ao desenvolvimento de novos serviços ao público médico do Hospital Mãe de Deus, em Porto Alegre. Para tanto, fez uma avaliação qualitativa do projeto estudado, descrevendo, compreendendo e interpretando fatos e fenômenos através do método da pesquisa-ação, de maneira a associar a pesquisa social com a ação colaborativa e participativa. A tarefa de pesquisa foi constituída de duas frentes de trabalho e coleta de dados: a primeira, de caráter científico-técnico, composta por técnicas de pesquisa documental e entrevistas semiestruturadas, fez uma busca criteriosa de dados inerentes às práticas e estratégias da instituição direcionadas ao problema da analise, e coletou percepções de diversos atores, internos e externos à instituição hospitalar, sobre o fenômeno estudado que não foram capturados na análise documental; e a segunda, de caráter científico-projetual, atuou de maneira prática no cenário da investigação, buscando uma abordagem experiencial do sentido ideal de criar valor pela inovação, através do uso de capacidades inerentes aos modelos de conhecimento do Design Estratégico. Os resultados alcançados mostram que o Hospital Mãe de Deus apresenta um contexto onde se observa a inovação aberta de forma prática, permitindo a entrada de recursos externos para gerar valor ao seu negócio, porém ainda carente de processos que tornem tal prática consciente e favoreçam a utilização do conhecimento tácito do pessoal interno, permitindo sua disseminação para além da área médico-assistencial. Os resultados também indicam que a instituição explora fatores condicionantes para o sucesso de projetos de desenvolvimento de novos serviços, entre os quais a disposição da liderança em buscar novos olhares e fontes externas para contribuir com soluções diferenciadoras, impulsionando favoravelmente a gestão dos modelos assistencial e econômico sobre os quais está apoiada. O projeto de um novo serviço conduzido pela lente do design estratégico encontrou no exercício da inovação aberta dessa instituição um clima propício para que suas práticas pudessem ser compatibilizadas. Assim, a lógica do fazer característica do design estratégico e que dá forma à estratégia elaborada pela empresa, fortalece-se junto a uma situação de inovação aberta que abre espaço para uma possível execução dos conceitos e serviços projetados. / The objective of this dissertation was to evaluate the contributions that a context of Open Innovation could add to a strategical project of design focused on the development of new services to the medical public of the Hospital Mãe de Deus, in Porto Alegre. For this purpose, it was made a qualitative evaluation of the studied project, describing, understanding and interpreting facts and phenomena through the method of action research, to associate the social research with the collaborative and participatory action. The research task was constituted of two fronts of work and data collection: the first, scientific-technical, consisting of documentary research techniques and semistructured interviews, made a detailed search of data inherent to the practices and strategies of the institution directed to the problem of analyze, and collected perceptions of diverse actors, both internal and external to the hospital institution, on the studied phenomenon that had not been captured in the documentary analysis; and the second one, scientific-design based, acted in a practical way in the scene of the research, seeking an experiential approach of the ideal sense of creating value by innovation, through the use of capabilities inherent to the Strategic Design knowledge models. The results show that the Hospital Mãe de Deus presents a context where it is observed the open innovation in a practical way, allowing the entrance of external resources to generate value to its business, but still lacking processes which make such practice conscientious and that encourage the use of the tacit knowledge of the internal staff, allowing its dissemination beyond the medical-assistencial area. The results also indicate that the institution explores determining factors for the success of projects of development of new services, including the willingness of the leadership in searching new looks and external sources to contribute with unique solutions, stimulating favorably the management of the assistencial and economic models on which it is supported. The design of a new service conducted by strategic design found, in the exercise of the open innovation of this institution, a favorable environment so that its practices could be made compatible. Thus, the logic of making characteristic of strategic design and that gives form to the strategy elaborated by the company, is strengthened next to a situation of open innovation that makes room for a possible execution of the concepts and services projected.

Within the nursing profession, the transition from the student to a graduate nurse is a common rite of passage that marks the end of initial educational preparation in the discipline and the beginning of a professional journey as a nurse and a member of the multidisciplinary team (Nash, Lemcke & Sacre. 2009:48). This is a period of adjustment, stress, growth and development and the transitional nurse is likely to feel uncomfortable, fearful and may experience feelings of inadequacy. This study was undertaken to explore and describe the experiences of final year nursing students at a public college of nursing in the Eastern Cape regarding their preparedness to become registered nurses, with the aim to identify gaps and make recommendations on strategies to close the gaps. The objectives were to explore and describe the experiences of final year nursing students at the public college of nursing in the Eastern Cape Province with regard to their preparedness to become registered nurses and to recommend strategies to improve the preparation of nursing students for transition to become registered nurses. To answer the research question “What are the experiences of final year nursing students at a public college of nursing in the Eastern Cape Province with regard their preparedness to become registered nurses”, a qualitative, explorative and descriptive design was used as a framework for the study. Data were collected by means of unstructured focus group interviews with a purposively selected sample of 27 final year nursing students at the particular college of nursing. Data were analysed using Tesch’s method of analysis for qualitative research. Two themes emerged, revealing that participants at the college experienced preparedness and lack of preparedness to assume the role of a professional nurse. This related to certain aspects that had an impact on the preparation of the final year nursing students for practice and included: curriculum-related aspects; clinical teaching and learning support; learning opportunities; interpersonal relationships between lecturers, students and clinical staff; equipment; and library resources. It was concluded that the learning needs of the nursing students were not adequately catered for, leading to lack of preparedness. Through the involvement of nursing students in the evaluation of their learning, shortfalls in both education and practice areas could therefore be detected. Recommendations regarding strategies to be used to promote preparedness of final year nursing students included: continuous feedback on student performance in the form of exit evaluations on the part of students to identify learning needs; writing of progress reports on the part of clinical practice; and the employment of clinical preceptors with clear role specifications between the lecturers, ward sisters and preceptors to avoid role confusion.