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The aim of our work was to map the process of identification, evaluation, and implementation of activities directed at prevention or management of nursing safety risks in organizations providing urgent ward care in the Czech Republic from the point of view of top management of nursing. Our work traced a quantitative research. For collecting data we used a non-standard questionnaire made up only for the purposes of this work. The questionnaire was distributed by the top representative of nursing management (ward sister/deputy in charge of nursing care) of the above specified health centres. The research was carried out in the period February - April 2008 and for assessment of the results obtained we used 110 questionnaires. For the purposes of our work we determined six hypotheses. Hypothesis 1 saying that hospitals create conditions for the development of safe organizational culture proved true. For the future it is essential to discuss this topic more profoundly, as well as to get rid of the fear of punishment for acknowledging a mistake and accept the fact that we all make mistakes, therefore we must minimalize their frequency and consequences and above all learn from them. Hypothesis 2 stating that hospitals watch risk factors for occurence of emergencies proved true, too. As a negative finding we can consider proving hypothesis 3 saying that hospitals do not reveal particulat risks of nursing care until the elimination of their consequences. Uncovering insufficient use of proactive strategy led us to a more detailed description of a FMEA method. Hypothesis 4 saying that hospitals have created a procedure for occurence of emergency and hypothesis 5 - nursing personnel is obligated to observe and report at minimum three kinds of emergencies related to nursing care proved true, too. The last hypothesis 6 presenting the fact that hospitals do not make their patients/clients involved in prevention of mistakes of medical workers was also confirmed by the results, but it was pleasant to find out that 43,3% of respondents stated that this possibility is being used at their place. We suggest to include the prevention of mistakes in the nursing process whether by means of particular nursing diagnoses or global education of patients/clients. As a suggestion of a feasible content of education we translated and adapted a document SPEAK UP into Czech named 7P.

Sustainability is a complex system of interaction between a hospital, individual, community, and environmental factors that is required to work in harmony to keep a patient healthy. With the complexities that exist within healthcare, the nurse leader is required to ensure that the care environment, processes and the safety behaviours required from nurses to provide safe healthcare is in place and sustained to contribute to the enhancement of patient safety, whilst in the care of the diverse nursing workforce. The aim of the study is to develop an action plan to sustain best safety culture practices for improved patient outcomes in hospitals with a culturally diverse nursing workforce. Methodology: A multiple method design was utilised to study the safety culture and positive work environment (hospital climate) that exists among culturally diverse nurses and how it is managed by the nurse managers in order to identify and describe actions that can be included in an action plan to sustain best safety culture practices for improved patient outcomes. Purposeful and convenience sampling methods were used in the study. Two hospitals, with a very diverse nursing workforce were purposefully selected to participate in the study. Pretesting of the questionnaire and e-Delphi embedded assessment validation instrument were done by participants not part of sample groups. Phase 1: The Hospitals outcomes data for nursing admission assessment within 24-hours, falls and hospital acquired pressure ulcer incidences and hand hygiene rates were collected on a checklist. Phase 2: Two questionnaires (1) nurses capturing: biographical data and culture, patient safety (nursing admission assessment within 24-hours, falls and HAPU and hand hygiene), and safety culture and positive work environment (hospital climate); (2) nurse managers capturing: biographical data and culture, patient safety (nursing admission assessment within 24- hours, falls and HAPU and hand hygiene), safety culture and Positive Work Environment (hospital climate) and just culture practices. Phase 3: the Draft e-Delphi action plan with embedded assessment validation instrument was developed. Phase 4: The panel experts selected to validate the e-Delphi draft action plan with embedded assessment validation instrument in pre-determined rounds. Data analysis: Phase 1: The outcomes data was displayed in bar graphs and illustrated that (1) the nursing admission assessment within 24 hour period not been sustained over time for the medical, surgical, paediatric and critical care areas; (2) a hundred and sixty two fall incidence; (3) ninety six HAPU incidences and (4) hand hygiene rate of between 80-94% being reported. Phase 2: A participation rate of 46.33% by nurses and 73.91% by nurse managers were achieved. The data for the 2 questionnaires indicated the need to include 54 action statement to address the culture, patient safety, hospital climate (PWE), safety culture and just culture gaps identified. Phase 3: the e-Delphi draft action plan developed based on literature review and data from phase 1 and phase 2. Phase 4: 100% participation rate was achieved. Consensus was reached within two rounds that the 54 action statements are essential and important for patient safety and identified the responsible persons required enacting on action statement and timeframe required to complete action. Recommendation: The Action Plan to enhance a sustainable Culture of Safety to improve patient outcomes were decided by panel experts. Plan to disseminate the plan among the CNO for implementation. / Health Studies / D. Litt. et Phil. (Health Studies)

Citizens in many provinces in South Africa have increasingly become more vocal about their unhappiness concerning service delivery in many departments of Government; their needs are not being met. Their violence and anger are usually aimed at emergency planners and government institutions, such as the police services, emergency medical services and fire services, therefore adding to various other challenges and difficulties these institution experience in carrying out their responsibilities (News Today, 2008). These institutions are also directly involved in the Disaster Risk Reduction process and play a key role in building a culture of safety and prevention within their communities by distributing knowledge and teaching skills (Twigg, 2004). Twigg (2004) argues that providing communities with information is the only way in which the scale, frequency, and complexity of disasters can be addressed. This should be done by following a multi–disciplinary approach that includes participatory development communication as a tool. The term participatory development communication refers to communication between parties where information transfer is de–emphasised and the process of dialogue between participants is favoured (Jacobson & Kolluri, 1999). This allows for solutions to problems to be identified in a collective fashion (Twigg, 2004; Jacobson & Kolluri, 1999). In light of the above the Maquassi Hills Fire Service’s relationship with the community has a major impact on the contribution the fire services make to building a culture of safety and also to what extent the community works towards building a culture of safety –– and thereby reducing disaster risk within the community. This study, consequently, aims to investigate the current relationship between the Maquassi Hills Fire Services and the community they serve, as well as the role of participatory development communication in this relationship. In order to do so this study explore various guidelines and principles set out by the literature in terms of participatory development communication and culture of safety to establish to what extent the Maquassi Hills Fire Services adhere to these principles and guidelines in their day–to–day functioning. This has been done by using a qualitative research design. Data collection methods appropriate to the qualitative research design were used to collect the necessary data. These methods included focus group discussions with members of the communities in the Maquassi Hills area and semi–structured interviews with the staff and management of the Maquassi Hills Fire Services. Guidelines and principles established in theory were used to describe and evaluate the current situation between the Maquassi Hills Fire Services and the surrounding communities to 5 whom they provide the service of fire fighting. The two main areas of theory addressed were that of Participatory Development Communication and that of a culture of safety as it presents in the Disaster Risk Reduction field. These were also the two main areas investigated in the empirical phase of the study. From the research it was found that in terms of Participatory Development Communication very little is being done by the fire services to establish dialogical communication. Thus creating opportunities for communities to communicate with the fire services by developing relevant communication channels is not being facilitated. However communities are eager to establish such an interactive relationship with the fire services. The data indicated that when the principles and guidelines for building a culture of safety are considered there exist various positive aspects. If these aspects are utilised and facilitated in the correct manner it may facilitate the process of building a culture of safety. It is therefore recommended that the fire services should start interacting with the communities in the Maquassi Hills area. Most of the issues experienced in the relationship between the fire services and the communities can to some extent be ascribed to the fact that the fire services do not reach out to the communities they serve. Interactions with the community should be based on the principles of participatory development communication which will ensure that dialogue is established and information is exchanged. Also very important in the Maquassi Hills area is supplying the communities with relevant, regular, correct and coherent fire safety information and skills. People in these communities need the necessary fire safety information to ensure their safety in terms of fire. By allowing people in these communities to participate in planning and implementing initiatives aimed at informing people, awareness campaigns and information sessions will be suited to the specific areas. This will mean that communities receive information relevant to their situation and circumstances and ultimately initiatives will be more effective, allowing the opportunity for a good culture of safety with regard to fire to be built. / Thesis (M. Development and Management)--North-West University, Potchefstroom Campus, 2012.

Citizens in many provinces in South Africa have increasingly become more vocal about their unhappiness concerning service delivery in many departments of Government; their needs are not being met. Their violence and anger are usually aimed at emergency planners and government institutions, such as the police services, emergency medical services and fire services, therefore adding to various other challenges and difficulties these institution experience in carrying out their responsibilities (News Today, 2008). These institutions are also directly involved in the Disaster Risk Reduction process and play a key role in building a culture of safety and prevention within their communities by distributing knowledge and teaching skills (Twigg, 2004). Twigg (2004) argues that providing communities with information is the only way in which the scale, frequency, and complexity of disasters can be addressed. This should be done by following a multi–disciplinary approach that includes participatory development communication as a tool. The term participatory development communication refers to communication between parties where information transfer is de–emphasised and the process of dialogue between participants is favoured (Jacobson & Kolluri, 1999). This allows for solutions to problems to be identified in a collective fashion (Twigg, 2004; Jacobson & Kolluri, 1999). In light of the above the Maquassi Hills Fire Service’s relationship with the community has a major impact on the contribution the fire services make to building a culture of safety and also to what extent the community works towards building a culture of safety –– and thereby reducing disaster risk within the community. This study, consequently, aims to investigate the current relationship between the Maquassi Hills Fire Services and the community they serve, as well as the role of participatory development communication in this relationship. In order to do so this study explore various guidelines and principles set out by the literature in terms of participatory development communication and culture of safety to establish to what extent the Maquassi Hills Fire Services adhere to these principles and guidelines in their day–to–day functioning. This has been done by using a qualitative research design. Data collection methods appropriate to the qualitative research design were used to collect the necessary data. These methods included focus group discussions with members of the communities in the Maquassi Hills area and semi–structured interviews with the staff and management of the Maquassi Hills Fire Services. Guidelines and principles established in theory were used to describe and evaluate the current situation between the Maquassi Hills Fire Services and the surrounding communities to 5 whom they provide the service of fire fighting. The two main areas of theory addressed were that of Participatory Development Communication and that of a culture of safety as it presents in the Disaster Risk Reduction field. These were also the two main areas investigated in the empirical phase of the study. From the research it was found that in terms of Participatory Development Communication very little is being done by the fire services to establish dialogical communication. Thus creating opportunities for communities to communicate with the fire services by developing relevant communication channels is not being facilitated. However communities are eager to establish such an interactive relationship with the fire services. The data indicated that when the principles and guidelines for building a culture of safety are considered there exist various positive aspects. If these aspects are utilised and facilitated in the correct manner it may facilitate the process of building a culture of safety. It is therefore recommended that the fire services should start interacting with the communities in the Maquassi Hills area. Most of the issues experienced in the relationship between the fire services and the communities can to some extent be ascribed to the fact that the fire services do not reach out to the communities they serve. Interactions with the community should be based on the principles of participatory development communication which will ensure that dialogue is established and information is exchanged. Also very important in the Maquassi Hills area is supplying the communities with relevant, regular, correct and coherent fire safety information and skills. People in these communities need the necessary fire safety information to ensure their safety in terms of fire. By allowing people in these communities to participate in planning and implementing initiatives aimed at informing people, awareness campaigns and information sessions will be suited to the specific areas. This will mean that communities receive information relevant to their situation and circumstances and ultimately initiatives will be more effective, allowing the opportunity for a good culture of safety with regard to fire to be built. / Thesis (M. Development and Management)--North-West University, Potchefstroom Campus, 2012.

Le 11 mars 2011, le Japon a subi un séisme suivi d’un tsunami aux conséquences terribles. Dans la centrale de Fukushima Dai-ichi s’est produit un accident nucléaire de niveau 7 (le plus élevé) sur l’échelle internationale, qui a marqué les esprits comme celui de Tchernobyl en 1986. Cet accident a laissé le monde en émoi face à ces nouvelles formes de menaces, d’autant que l’exploitant TEPCO n’a pas su maitriser la situation ni tirer les leçons du passé. Depuis Fukushima, l’échelle des fondamentaux en Europe et dans le monde a donc été bouleversée et la question de la sûreté et de la sécurité des centrales se pose avec une acuité renforcée, qui a nécessité de redéfinir en droit et en pratique certaines normes et principes au niveau national, européen et international en concordance avec ces nouvelles menaces extérieures, vers le plus haut niveau de sûreté. Mais les révisions entreprises nécessitent d’être plus ambitieuses. L’avenir du nucléaire implique dès lors : au niveau européen, une révision plus ambitieuse de la directive sûreté; la mise en place d’une autorité de réglementation indépendante de jure ; la définition d’un droit de la responsabilité civile harmonisé au sein de l’UE en faveur des victimes dans l’hypothèse d’un accident. Au niveau international, la gouvernance s’impose comme étant le vecteur d’une commune culture de sûreté et de sécurité nucléaires ; bien que la diversité des modèles nationaux de gestion et de contrôle de l’industrie nucléaire paraisse rendre a priori difficile l’évolution vers des règles communes. De même au niveau européen, dans ce même esprit, l’écriture d’un texte unique en droit de la réparation des dommages serait nécessaire. La révision de la Convention sûreté nucléaire est également un chantier important pour l’avenir. Dans l’immédiat, l’harmonisation concerne de nombreux domaines dont, pour l’essentiel : la gestion de crise pendant et après un accident nucléaire ; la mise en place des principes de sûreté et de sécurité les plus performants et les plus élevés, de la conception au démantèlement d’une installation ; la maîtrise d’une interaction adaptée entre sûreté et sécurité nucléaires. Il conviendra, par ailleurs, de veiller à l’intégration du public au processus décisionnel dans les domaines du nucléaire, condition nécessaire à l’acceptabilité de cette énergie. / On March 11, 2011, the Japan suffered an earthquake followed by a tsunami to the terrible consequences. In nuclear power plant Fukushima Dai-ichi happened a nuclear accident of level 7 (highest) on the international scale, which marked the spirits such as rivaled that of Chernobyl in 1986. This accident left the world agog with these new forms of threats, especially since the TEPCO operator did not master the situation or learn the lessons of the past. Since Fukushima, the fundamentals in Europe and worldwide has so upset been turned upside-down and this raises the question of safety and security of power plants with renewed acuity, which necessitated. It is imperative to redefine in law and in practice some standards and principles at the national, European and international level in accordance with these new threats to the highest level of safety. But the legal revisions need to be more ambitious. The future of nuclear power suggest therefore: at the European level: a more ambitious revision of the directive on nuclear safety; the establishment of a regulatory body with effective independence de jure ; the definition of a liability law harmonised throughout the EU and the IAEA for victims in the event of an accident. At the international level: the governance is necessary as a vector of a common safety culture and security culture ; although the diversity of national models of management and control of the nuclear industry appears a priori difficult to move towards common rules. As well as at the European level, the writing of a single text entitled to the repair of damages would be necessary for the same reasons already stated. The revision of the Convention on nuclear safety is also as important crucial for the future. For immediate harmonization concerns many fields, for the most part: during and after a nuclear accident crisis management; the implementation of the principles of safety and security at the most efficient and highest level from the conception to the dismantling of an installation; strengthening interaction adapted between nuclear safety and nuclear security ; but also the integration of the population in the decision-making process in the areas of nuclear is mandatory for the acceptance of nuclear energy.