Postoperative urinary retention (PUR) is a common problem seen after surgery, particularly after orthopedic surgery. There has been a great deal of research done surrounding the causes of PUR and the optimal treatment for PUR, all with conflicting results. Little research has been done with orthopedic nurses to find out how they actually treat PUR, and on what information they base those treatment decisions. Evidence-based practice has been gaining popularity recently and highlights the need for nurses to make treatment decisions based on sound research, patient preferences, clinical expertise, and taking into consideration health care resources and the clinical setting (DiCenso, Ciliska, & Guyatt, 2005). This study investigated nurses' views on the definition of PUR, how they assessed for PUR, how they treated PUR and what they based their treatment decisions on. Ten nurses who worked on orthopedic units were interviewed using a semi-structured format consisting of four questions. The interviews were recorded and then transcribed verbatim by the student researcher. Qualitative description, as described by Sandelowski (2000), was used to analyze data. All nurses defined PUR fairly similarly. Various contributing factors for PUR were mentioned, some that were studied in the literature, and some that were not. Each nurse had a slightly different way of treating PUR, and 'ward routine' was also described differently. Study results point to a need for more research and education in the area of PUR so that all nurses are treating PUR in the same manner based on the same sound knowledge base.

Postoperative urinary retention (PUR) is a common problem seen after surgery, particularly after orthopedic surgery. There has been a great deal of research done surrounding the causes of PUR and the optimal treatment for PUR, all with conflicting results. Little research has been done with orthopedic nurses to find out how they actually treat PUR, and on what information they base those treatment decisions. Evidence-based practice has been gaining popularity recently and highlights the need for nurses to make treatment decisions based on sound research, patient preferences, clinical expertise, and taking into consideration health care resources and the clinical setting (DiCenso, Ciliska, & Guyatt, 2005). This study investigated nurses' views on the definition of PUR, how they assessed for PUR, how they treated PUR and what they based their treatment decisions on. Ten nurses who worked on orthopedic units were interviewed using a semi-structured format consisting of four questions. The interviews were recorded and then transcribed verbatim by the student researcher. Qualitative description, as described by Sandelowski (2000), was used to analyze data. All nurses defined PUR fairly similarly. Various contributing factors for PUR were mentioned, some that were studied in the literature, and some that were not. Each nurse had a slightly different way of treating PUR, and 'ward routine' was also described differently. Study results point to a need for more research and education in the area of PUR so that all nurses are treating PUR in the same manner based on the same sound knowledge base.

Evidence-based management involves decision making based on the best available scientific knowledge about effective organization practice. This evidence can be obtained from internal or systematic external research. Analysis of measures to prevent infections in hemato-oncologic patients a Prague teaching hospital revealed, that current organization practices do not allow a high quality internal research assessing provided health care quality. Causes of barriers to practice evidence-based approach in the organization processes and potential solutions are debated. In healthcare, Evidence-based management has a significant impact on improving the quality of provided care via identification of the best processes of integrating the outcomes of evidence-based medicine into the routine clinical practice. The aim of this work was to fill in absent information about evidence-based management in Czech academic literature and to introduce the ideas, principles and tools of evidence-based practice, as well as information on available sources of scientific evidence and activities that help adopting the evidene-based approach to management.

No / This commentary explores the role of evidence-based management for evidence-based decision-making legitimacy in mental health nursing.

Provision of a high standard of care in addiction treatment and prevention services is dependent upon knowledge of evidence-based practice (EBP) principles, and the skills needed to apply those principles, among the substance abuse workforce (SAW). Competency profiles for Canada’s SAW define the need for skill and knowledge of EBP. Within Canada’s SAW, persons within the Occupational Cluster Senior Management are ultimately responsible for decisions and therefore must possess a high level of proficiency in EBP. This proficiency has not been assessed in this group; the objective of this study was to conduct such an assessment on Senior Management from Nova Scotia’s Addiction Services. Eighteen Senior Managers completed semi-structured qualitative interviews. Interviews were analyzed using content analysis, five main themes emerged. It appears that Senior Management possess an understanding of the principles of EBP, but that their knowledge and use of the skills required for their application requires further development.

Philosophiae Doctor - PhD / South Africa has placed emphasis on evidence-based decision-making for justifying service delivery improvement decisions. Evidence-based decision-making entails decisions made by referring to verifiable facts and figures available from a variety of sources of evidence such as organizational records. Records are created or received during the conduct of business and contain evidence of organizational activities. Their use as sources of evidence is continuous. Most records management scholars hypothesize that the use of records as sources of evidence for decision-making contributes to improved service delivery. In the same breath, some scholars lament their minimal use as sources of evidence for decision-making in the South African public sector due to poor records management. This descriptive, positivist quantitative study used a cross-sectional survey to determine the extent to which records as sources of evidence were used for evidence-based decision-making by senior managers in Western Cape governmental bodies,

This study aspired to gain a more a nuanced understanding of the emerging analytics technologies and the vital capabilities that ultimately drive evidence-based decision making. Big data technology is widely discussed by varying groups in society and believed to revolutionize corporate decision making. In spite of big data's promising possibilities only a trivial fraction of firms deploying big data analytics (BDA) have gained significant benefits from their initiatives. Trying to explain this inability we leaned back on prior IT literature suggesting that IT resources can only be successfully deployed when combined with organizational capabilities. We identified key theoretical components at an organizational, relational, and human level. The data collection included 20 interviews with decision makers and data scientist from four analytical leaders. Early on we distinguished the companies into two categories based on their empirical characteristics. The terms “Born analyticals” and “Big intelligent firms” were coined. The analysis concluded that social, non-technical elements play a crucial role in building BDA abilities. These capabilities differ among companies but can still enable BDA in different ways, indicating that organizations´ history and context seem to influence how firms deploy capabilities. Some capabilities have proven to be more important than others. The individual mindset towards data is seemingly the most determining capability in building BDA ability. Varying mindsets foster different BDA-environments in which other capabilities behave accordingly. Born analyticals seemed to display an environment benefitting evidence based decisions.

Submitted by Johnny Rodrigues (johnnyrodrigues@ufcg.edu.br) on 2018-07-31T13:24:56Z No. of bitstreams: 1 EXPEDITO CARLOS LOPES - TESE PPGCC 2010..pdf: 2264969 bytes, checksum: 6815e69976b1952aaaa1a4e74e9026b9 (MD5) / Made available in DSpace on 2018-07-31T13:24:56Z (GMT). No. of bitstreams: 1 EXPEDITO CARLOS LOPES - TESE PPGCC 2010..pdf: 2264969 bytes, checksum: 6815e69976b1952aaaa1a4e74e9026b9 (MD5) Previous issue date: 2010-10-20 / No cotidiano de muitos profissionais uma situação comum é estar confrontado com um problema que requer um processo decisório para sua resolução. Porém, nem todo problema é considerado trivial. Quando o problema apresenta dificuldades associadas à ausência de soluções disponíveis ou se exige número de recursos significativos, e conseqüentemente, muito esforço para sua solução ou para diagnosticar as suas causas; ele é considerado complexo. Raciocínio Baseado em Casos (RBC) usa o histórico de casos similares apoiando na resolução de casos complexos, exibindo soluções extraídas de uma Base de Casos, prevendo atividades para retenção de soluções individuais. Entretanto, o RBC pode não servir na solução de um problema complexo quando nenhum caso similar é encontrado na Base de Casos. Por outro lado, a Prática Baseada em Evidências (PBE), representa um processo decisório centrado em justificativas de informações relevantes contendo provas de pesquisas científicas comumente encontradas em sites confiáveis. Entretanto, procedimentos da PBE não provêem mecanismos para retenção de conhecimentos estratégicos de soluções individuais, o que poderia facilitar a aprendizagem de tomadores de decisão, preservando evidências utilizadas. Assim, a integração de RBC com PBE contempla mecanismos complementares para apoiar soluções de problemas complexos e não se encontra modelos que incorporem estes paradigmas, independente de domínios que tratam de PBE. Além disso, contexto é um tipo de conhecimento que ajuda a identificar o que é ou não é relevante em uma dada situação. Porém, o uso de contexto na PBE ainda é uma questão em aberto. Esta tese propõe um framework conceitual composto de uma arquitetura e de um esquema conceitual para representar a integração de evidências, contexto e casos, independente entre domínios que usam a PBE, servindo de apoio para projetistas de sistemas. Além disso, é especificada uma abordagem metodológica de apoio à decisão para guiar especialistas na resolução de problemas complexos utilizando RBC e PBE, considerando contextos de tomadas de decisão. Para tornar factível esta proposta, duas aplicações do framework foram realizadas em diferentes domínios (médico e jurídico criminal). A validação foi feita a partir de um estudo de caso realizado no domínio jurídico criminal, tendo como resultado um protótipo implementado. / In the routine of many professionals is a common situation being confronted with a problem that triggers a decision process for its resolution. However, not every problem is considered common. When the problem presents difficulties associated with the absence of available solutions, or requires significant number of resources and effort to its solution, or to diagnose its causes, it is considered a complex problem. Case Based Reasoning (CBR) uses the history of similar cases supporting the resolution of complex cases, based on solutions extracted from a Case-Base, providing mechanisms to retain new individual problem-solutions. But, CBR can not support the solution of complex problems when no similar case is found in the Case-Base. On the other hand, Evidence-Based Practice (EBP) represents a decision-making process centered on justifications of relevant information contained scientific research proof found, generally, in reliable sites. But, EBP procedures do not provide mechanisms to retain strategic knowledge from individual solutions, which could facilitate the learning of decision makers, preserving used evidences. However, the integration of CBR with EBP includes important mechanisms to support solutions to complex problems, but we did not find domain-independent models that incorporate these paradigms. Furthermore, Context is a type of knowledge that supports identifying what is or is not relevant in a given situation. However, the use of contextual information in EBP is still an open issue. This thesis proposes a conceptual framework consisting of: architectural elements, and a conceptual scheme to represent the integration of evidence, context and cases domain-independent that use research evidences, oriented to assist system designers. In addition, we specify a decision support methodology to guide experts in solving complex problems using CBR and EBP, considering the contexts of decision making. To investigate the feasibility of the proposal, we developed the design of two applications in different application domains (medical and juridical). The validation was realized with a case study conducted in juridical domain, resulting in a prototype implemented.

Research in risk awareness has been relatively neglected in the health informatics literature, which tends largely to examine project managers’ perspectives of risk awareness; very few studies explicitly address the perspectives held by senior executives such as directors. Another limitation evident in the current risk literature is that studies are often based on American data and/or they are restricted to American culture. Both factors highlight the need to examine how senior executives (i.e., directors) who oversee or direct eHealth projects in Canada perceive risk awareness. This research explores and discusses the perspectives of risk awareness (i.e., identification, analysis, and prioritization) held by directors and project managers who implement Canadian eHealth projects. Semi-structured interviews with nine directors and project managers uncovered six key distinctions in these two groups’ awareness of risk. First, all project managers valued transparency over anonymity, whereas directors believed that an anonymous reporting system for communicating risks had merit. Secondly, most directors emphasized the importance of evidence-based planning and decision making when balancing risks and opportunities, an aspect none of the project managers voiced. Thirdly, while project managers noted that the level of risk tolerance may evolve from being risk-averse to risk-neutral, directors believed that risk tolerance evolved toward risk-seeking. Directors also noted the importance of employing risk officers, a view that was not shared by project managers. Directors also believed the risk of too little end-user engagement and change management was the most important risk, whereas project managers ranked it as the least important. Finally, when directors and project managers were asked to identify and define the root cause(s) of eHealth risks, directors identified the complexity of health care industry, while project managers attributed it to political pressure and a lack of resources where eHealth projects are concerned. This research proposes that the varied perspectives of risk awareness held by directors and project managers must be considered and integrated to properly align expectations and build partnerships for successful eHealth project outcomes. Understanding risk awareness offers a means to systematically identify and analyze the complex nature of eHealth projects by embracing uncertainties, thereby enabling forward thinking (i.e., staying one step ahead of risks) and the ability to prevent avoidable risks and seize opportunities. / Graduate / 0723 / 0489 / 0454 / randbpark@gmail.com