Nursing care is considered a primary predictor of patient assessment of the overall hospital experience. Yet, quality nursing care remains difficult to define. Limited research about nurse or patient perspectives on what constitutes quality nursing care in hospital settings prevents the identification of a shared description or insight into their possible interrelationship. Research about nurse and patient descriptions is needed to establish behaviors, attributes, and activities associated with quality nursing care to improve the health and well-being of hospitalized patients. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2015. / FAU Electronic Theses and Dissertations Collection

Effective decision support plays vital roles in people's daily life, as well as for professional practitioners such as health care providers. Without correct information and timely derived knowledge, a decision is often suboptimal and may result in signi cant nancial loss or compromises of the performance. In this dissertation, we study text mining and topic modeling and propose to use text mining methods, in combination with topic models, to discover knowledge from texts popularly available from a wide variety of sources, such as research publications, news, medical diagnose notes, and further employ discovered knowledge to assist social and medical decision support. Examples of such decisions include hospital patient readmission prediction, which is a national initiative for health care cost reduction, academic research topics discovery and trend modeling, and social preference modeling for friend recommendation in social networks etc. To carry out text mining, our research, in Chapter 3, first emphasizes on single document analyzing to investigate textual stylometric features for user pro ling and recognition. Our research confirms that by using properly designed features, it is possible to identify the authors who wrote the article, using a number of sample articles written by the author as the training data. This study serves as the base to assert that text mining is a powerful tool for capturing knowledge in texts for better decision making. In the Chapter 4, we advance our research from single documents to documents with interdependency relationships, and propose to model and predict citation relationship between documents. Given a collection of documents with known linkage relationships, our research will discover e ective features to train prediction models, and predict the likelihood of two documents involving a citation relationships. This study will help accurately model social network linkage relationships, and can be used to assist e ective decision making for friend recommendation in social networking, and reference recommendation in scienti c writing etc. In the Chapter 5, we advance a topic discovery and trend prediction principle to discover meaningful topics from a set of data collection, and further model the evolution trend of the topic. By proposing techniques to discover topics from text, and using temporal correlation between trend for prediction, our techniques can be used to summarize a large collection of documents as meaningful topics, and further forecast the popularity of the topic in a near future. This study can help design systems to discover popular topics in social media, and further assist resource planning and scheduling based on the discovered topics and the their evolution trend. In the Chapter 6, we employ both text mining and topic modeling to the medical domain for effective decision making. The goal is to discover knowledge from medical notes to predict the risk of a patient being re-admitted in a near future. Our research emphasizes on the challenge that re-admitted patients are only a small portion of the patient population, although they bring signficant financial loss. As a result, the datasets are highly imbalanced which often result in poor accuracy for decision making. Our research will propose to use latent topic modeling to carryout localized sampling, and combine models trained from multiple copies of sampled data for accurate prediction. This study can be directly used to assist hospital re-admission assessment for early warning and decision support. The text mining and topic modeling techniques investigated in the dissertation can be applied to many other domains, involving texts and social relationships, towards pattern and knowledge based e ective decision making. / Includes bibliography. / Dissertation (Ph.D.)--Florida Atlantic University, 2016. / FAU Electronic Theses and Dissertations Collection

The extent to which customers are satified with the care they receive from the health professionals has been an important area of interest for researchers, managers and health care workers. The physiotherapy cerebral palsy clinic at Mulago Hospital in Kampala Uganda provides physiotherapy services for parents/caregivers of children with cerebral palsy. The parents/caregivers visit the clinic seeking physiotherapy services that will address their problems and those of the child. The purpose of this study was to explore the satisfaction that the parents/caregivers of children with cerebral palsy get from utilising the physiotherapy services at the clinic and to identify the barriers/problems that they encounter that might affect their attendance.

Indiana University-Purdue University Indianapolis (IUPUI) / Nurses are a key component of the health care system and have the ability to provide innovative solutions to improve quality and safety for patients, while improving workplace conditions, and increasing recruitment and retention of nurses. Encouraging innovation behaviors among nurses is essential to improving health care. Innovation behaviors are defined as behavior from an employee toward developing new products, developing new markets, or improving business routines in their employing organization. The purpose of this descriptive study was to explore the relationships among individual and organizational characteristics and employee innovation behavior among nurses. The proposed model, The Framework for Study of Innovation Behaviors among Nurses, was developed based on the work by Kuratko, Hornsby, and Montagno and is specific to nursing innovation behaviors.

Today, in 21st century healthcare at least 10% of hospitalised patients are subjected to some degree of unintended harm as a result of the treatment they receive. Despite the growing patient safety agenda there is little empirical evidence to demonstrate that patient safety is improving. Patient Safety Leadership Walk Rounds (PSLWR) were introduced to the UK, in March 2005, as a component of the Safer Patients Initiative (SPI), the first dedicated, hospital wide programme to reduce harm in hospital care. PSLWR are designed, to create a dedicated ‘conversation’ about patient safety, between frontline staff, middle level managers and senior executives. This thesis, explored the use of PSLWR, as a proactive mechanism to engage staff in patient safety discussion and detect patient harm within a Scottish healthcare system- NHS Tayside. From May 2005 to June 2006, PSLWR were held on a weekly basis within the hospital departments. A purposive sample, (n=38) of PSLWR discussions were analysed to determine: staff engagement in the process, patient safety issues disclosed; recognition of unsafe systems (latent conditions) and actions agreed for improvement. As a follow-up, 42 semi-structured interviews were undertaken to determine staff perceptions of the PSLWR system. A wide range of clinical and non-clinical staff took part (n=218) including medical staff, staff in training, porters and cleaners, nurses, ward assistants and pharmacists. Participants shared new information, not formally recorded within the hospital incident system. From the participants perspectives, PSLWR, were non threatening; were easy to take part in; demonstrated a team commitment, from the Board to the ward for patient safety and action was taken quickly as a result of the ‘conversations’. Although detecting all patient harm remains a challenge, this study demonstrates PSLWR can be a useful tool in the patient safety arsenal for NHS healthcare organisations.

Heart disease including ischemic heart disease is the highest contributor to death and morbidity in the western world. The studies presented were conducted to determine possible pathways of protection of the heart against ischemia/reperfusion. We employed adenovirus mediated over-expression of Methionine sulfoxide reductase A (MsrA) in primary neonatal rat cardiac myocytes to determine the effect of this enzyme in protecting against hypoxia/reoxygenation. Cells transfected with MsrA encoding adenovirus and subjected to hypoxia/reoxygenation exhibited a 45% decrease in apoptosis as compared to controls. Likewise total cell death as determined by levels of Lactate Dehydrogenase (LDH) release was dramatically decreased by MsrA overexpression. The initial hypothesis that led to our testing sulindac was based on the fact that the S epimer of sulindac was a substrate for MsrA and that this compound might function as a catalytic anti-oxidant based on a reaction cycle that involved reductio n to sulindac sulfide followed by oxidation back to sulindac. To test this we examined the protective effect of sulindac in hypoxia re-oxygenation in both cardiac myocytes in culture and using a Langendorff model of myocardial ischemia. Using this model of myocardial ischemia we showed that pre-incubation of hearts with sulindac, or the S and R epimers of sulindac resulted in protection against cell death. We present several lines of evidence that the protective effect of sulindac is not dependent on the Msr enzyme system nor does it involve the well established role of sulindac as a Cyclooxygenase (COX) inhibitor. Numerous signaling pathways have been implicated in myocardial protective mechanisms, many of which require fluctuations in ROS levels as initiators or mediators. / Sulindac shows very good potential as a preconditioning agent that could induce tissue protection against oxidative damage.Blocking of preconditioning pathways by administration of the PKC blocker chelerythine abrogated the ischemic protection afforded by sulindac. Secondly, an end-effector of preconditioning, inducible nitric oxide synthase (iNOS),was found to be induced by greater than 5 fold after 48 h prior feeding sulindac. / by Ian Moench. / Thesis (Ph.D.)--Florida Atlantic University, 2008. / Includes bibliography. / Electronic reproduction. Boca Raton, Fla., 2008. Mode of access: World Wide Web.

Ecole de Santé Publique <p>Université Libre de Bruxelles <p>Academic Year 2010-2011<p><p>Al-Awa, Bahjat<p><p>Impact of Hospital Accreditation on Patients' Safety and Quality Indicators<p><p>Dissertation Summary <p><p>I.\ / Doctorat en Sciences / info:eu-repo/semantics/nonPublished

Indiana University-Purdue University Indianapolis (IUPUI) / A study design has been developed that employs a dual modeling approach to identify factors associated with facility-level cancer screening improvement and how this is mediated by the use of clinical decision support. This dual modeling approach combines principles of (1) Health Informatics, (2) Cancer Prevention and Control, (3) Health Services Research, and (4) Organizational Change/Theory. The study design builds upon the constructs of a conceptual framework developed by Jane Zapka, namely, (1) organizational and/or practice settings, (2) provider characteristics, and (3) patient population characteristics. These constructs have been operationalized as measures in a 2005 HRSA/NCI Health Disparities Cancer Collaborative inventory of 44 community health centers. The first, statistical models will use: sequential, multivariable regression models to test for the organizational determinants that may account for the presence and intensity-of-use of clinical decision support (CDS) and information systems (IS) within community health centers for use in colorectal, breast, and cervical cancer screening. A subsequent test will assess the impact of CDS/IS on provider reported cancer screening improvement rates. The second, computational models will use a multi-agent model of network evolution called CONSTRUCT® to identify the agents, tasks, knowledge, groups, and beliefs associated with cancer screening practices and CDS/IS use to inform both CDS/IS implementation and cancer screening intervention strategies. This virtual experiment will facilitate hypothesis-generation through computer simulation exercises. The outcome of this research will be to identify barriers and facilitators to improving community health center facility-level cancer screening performance using CDS/IS as an agent of change. Stakeholders for this work include both national and local community health center IT leadership, as well as clinical managers deploying IT strategies to improve cancer screening among vulnerable patient populations.

Submitted in fulfillment of the requirements for the Degree in Masters of Technology in Nursing, Durban University of Technology, Durban, South Africa, 2015. / Background The current health care system in South Africa and its diverse settings of health care delivery system require a nurse who can make decisions, think critically, solve problems and work effectively in a team. Traditional nursing education teaching strategies have over the years relied on didactic and often passive approaches to learning. In pursuit of quality, academics and students must be continually engaged in a process of finding opportunities for improving the teaching and learning process. Purpose of the study The purpose of this study was to evaluate the structure and the process in case based learning at the University of Technology. Methodology This study is qualitative in nature, governed by an interpretive paradigm. This is a case study, which enabled the researcher to merge student interview data with records in order to gain insight into the activities and details of case based learning as practised at the University of Technology under study. Most importantly, the case study method was deemed appropriate for the current study, since case-based learning as a pedagogical approach (and a case) cannot be abstracted from its context for the purposes of study. Case based learning is evaluated in its context namely, the undergraduate nursing programme, using the Donabedian framework of structure, process and product. Results The study recorded that students were positive towards case based learning though some identified dynamics of working in groups as demerits of case based learning. The structures that are in place in the programme and the CBL processes are adequate and support CBL. There are however areas that need attention such as the qualification of the programme coordinator, the size of the class-rooms and the service of the computer laboratory. Conclusion The study found that apart from a few minor discrepancies, case based learning is sufficiently implemented, and experienced as invaluable by students, at the University of Technology under study.

La satisfaction du patient et du personnel sont considérés comme des indicateurs importants afin de mesurer la qualité dans le secteur hospitalier.<p>Dans les services de revalidation, les rencontres thérapeutes-patients présentent une valeur significative par le temps consacré, l'approche thérapeutique mais également la relation qui découle du processus de soin.<p>L'objectif de la recherche fut d'évaluer la satisfaction du personnel travaillant dans les services de revalidation physique (thérapeutes et techniciens ou assistants) et les différents variables démographiques ou liés à l'environnement du travail ainsi que la satisfaction des patients traités dans ces services.<p><p>Une analyse transversale par questionnaire a permis de mesurer la satisfaction au travail et les éléments de productivité dans les services de revalidation. Simultanément, une enquête concernant la satisfaction des patients a été réalisée dans ces mêmes départements. La recherche fut effectuée au sein de dix centres hospitaliers au moyen d'un questionnaire d'enquête commun basé sur le modèle " Effort- Reward Imbalance" ou “déséquilibre efforts-récompenses” et des informations complémentaires sur les conditions de travail ont étés collectées au moyen de questionnaires spécifiques. L’étude met en évidence des variables démographiques tells l'âge, la nationalité, le niveau d'éducation, ainsi que la charge travail et les types de cas traités comme facteurs significatifs influençant le stress au travail.<p>Les résultats confirment une corrélation positive entre le stress au travail par le déséquilibre Efforts-Récompenses et la performance quantitative (productivité) des thérapeutes en revalidation. Il est basé sur la satisfaction des thérapeutes en fonction des heures de travail, du nombre moyen de patients par jours ainsi que des mesures de productivité élevées du département. En ce qui concerne les récompenses perçues comme positives, le soutien du médecin et du superviseur apparaissent comme facteurs de motivation importants. Il a été également déterminé que les thérapeutes appréciaient la participation et l’expression de son opinion dans la gestion thérapeutique du patient. Bien qu’une corrélation entre la satisfaction des patients et le degré de stress au travail des thérapeutes n’ait pas été démontrée, ces deux mesures varient de manière significative en fonction des types d’hôpitaux et du degré de « Over-commitment » des thérapeutes dans leur travail.<p>Les déterminants essentiels de la satisfaction des patients en revalidation apparaissent toutefois liés à l’intervention du thérapeute tel que sa capacité à rassurer le patient ou la qualité de l’information liée au plan de traitement et doivent être considérés dans l’approche thérapeutique en revalidation.<p>Les résultats de l’étude ont permis de concevoir un modèle systémique de satisfaction et de stress au travail résumant les éléments liés de manière significative au déséquilibre des efforts et récompenses dans les services de revalidation physique et qui pourrait inspirer les directeurs ou gestionnaires hospitaliers a promouvoir une atmosphère de travail positive. <p><p>Patient and staff satisfaction are considered as important indicators to monitor quality in healthcare. In rehabilitation services the patient and therapist encounters are of significant value by the amount of time, the therapeutic approach but also the personal relations in the care process. The aim of the research was to evaluate the staff job satisfaction in physical rehabilitation services and the related variables as well as its correlations to patients’ satisfaction. <p><p>A cross sectional survey approach in the rehabilitation services has measured the job satisfaction and the related elements of productivity. Simultaneously a survey of the patients’ satisfaction was performed. As the research in the physical rehabilitation services was conducted in ten different health care facilities of the Jeddah region, a common assessment tool was utilized based on the Effort Reward Imbalance (ERI) model and complementary information were collected using specifically developed survey questionnaires. Socio-demographic variables such as age, nationality, work specialty, educational levels, as well as the caseload and workload appeared also as significantly influencing job satisfaction. <p>The findings confirmed a positive correlation between the Effort Reward Imbalance and the quantitative performance (productivity) of the rehabilitation staffs. It is supported by the level of job satisfaction of the therapists which is related to the number of patients per day, caseload, hours of work and high productivity measures. From the aspects of positive rewards, the role of the supervisor and doctors appear as important motivators. It was also found that therapists valued the fact of being given the opportunity to participate and discuss opinions in the patient management and quality improvement.<p>While no evidence confirmed a positive correlation between patients’ satisfaction about the rehabilitation treatments and the staff job satisfaction, both measured patients’ and staff satisfaction varied significantly according to the hospital type and the degree of Over-commitment. <p>Essential determinants of patients’ satisfaction appeared however related to the therapists' input, such as the ability to reassure or the quality of information given in the treatment plan and have to be taken into account when delivering the patients’ care.<p>All the results allowed the design of a systemic model of staff job satisfaction resuming the significant related elements of effort and reward in the rehabilitation services and could be utilized to inspire the hospital leaders, managers and executive directors to promote a healthy work life environment based on a valued human resources approach. <p> / Doctorat en Sciences de la santé publique / info:eu-repo/semantics/nonPublished