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)

In this project we used structural equation method to analyze the data collected during the period of re-engineering in hospitals in Ontario 1995 to 1997. We want to understand how organizational change affect the well being of the staff of large teaching hospital. Two main models were considered in this project: cross-sectional models and longitudinal models for the data collected in 1995 and 1997. We tested six models for each year's data in cross-sectional model, effect-indicator, cause-indicator and mixed-indicator were used in both standard and non-standard models. We explored standard model with effect-indicators in our longitudinal case. The study was carried by SAS software program. We demonstrated an important association of job stressors with psychological outcomes of hospital staff directly and indirectly via interference. Decision-making capacity was associated with psychological outcomes in the opposite direction. Similar results were concluded from longitudinal model. The limitation was discussed. / Thesis / Master of Science (MS)

Made available in DSpace on 2016-08-02T21:42:45Z (GMT). No. of bitstreams: 1 ANTERO PAULO DOS SANTOS MATIAS.pdf: 313553 bytes, checksum: 23c290ac428ace88193833fff090d94f (MD5) Previous issue date: 2008-01-25 / The Veterinary Medicine course is composed essentially of theoretical and practical course works that is developed by the diverse disciplines that exists in the curricula matrix of the course. For the practical courses, principally those related to the professional disciplines to be lectured, the course must have a Teaching Hospital. This Teaching Hospital has as a mission: Teaching (Practical Lectures), Research (development of new technologies and knowledge) and Extension or Assistance (Attendance it the will and anxiety and necessity of the community with it operates Even though it reflect the context of the course, the hospital must present some elements of control, no only to meet the financial standpoint but also in accordance with its operating premise so as to meet the client satisfaction and those who work there not to mention the community at large. The process of managerial control is the process that leaders have to ensure that the other members of the organization do follow the strategies determined. Health and educational organizations develop their activities through their cost or center of responsibilities, which exist in order to meet their purpose. As the organization is a set center of responsibilities, each center of responsibility would have to comply with their own strategies to enhance the achievement of organizational goals. The General Manager of the hospital decides on what strategy to follow in congruence with the premises or goals of the organization. This decision should be based on parameters and results to be achieved through decision tools. Many organizations use the performance evaluation results of their centers of responsibilities to take decisions. The present study is an action research, which proposes the presentation of a theoretical model, that is represented by a tool that will provide performance evaluation decision indicators with the premises of education, research and assistance as well as embracing financial indicators that management would oversee and decide which path to follow, thus serving as an enhancement to administrative decisions. We compared the classification and ranking of each of the productive sectors in accordance with the financial performance, in this case, the contribution margin and after the calculations presented we observed a change in the ranking of the sectors. This model was based on multicriteria ranking tool. The most important factor was to understand that all productive sectors had their ranking altered after the calculations presented with the tool. Thus, this tool would become a form of broader decision procedure that contemplates other criteria, or in this case, assumptions that are imperative to the decision, and also very useful to identify between the premises which present variable deviate performance. Based on our findings, we conclude that managers could implement corrective measures aiming at ameliorating operating weaknesses, seeking targets that can be achieved in determining financial contribution, and in this the case, to achieve them.(AU) / O curso de Medicina Veterinária compõe-se essencialmente de aulas práticas e teóricas desenvolvidas pelas mais diversas disciplinas presentes em sua matriz curricular. Para que as aulas práticas, principalmente aquelas relacionadas às disciplinas profissionalizantes, possam ser ministradas, o curso deve apresentar um Hospital Escola. Este local tem como missões: o ensino (aulas práticas), a pesquisa (desenvolvimento de novas tecnologias e conhecimentos) e a extensão ou assistência (atendimento aos anseios e necessidades das comunidades onde está inserido). Apesar de estar inserido no contexto do curso, o hospital deve apresentar um controle, não só sob o ponto de vista financeiro, mas de acordo com suas premissas a fim de garantir tanto a satisfação das pessoas que ali trabalham e a continuidade de suas atividades, bem como permitir que seus clientes internos (os alunos) e externos (a comunidade) possam ser atendidos em suas necessidades. O termo controle predispõe um pensamento de comando, que tem como objetivo principal permitir que a organização cumpra com os seus objetivos. O processo de controle gerencial é o processo que os líderes encontram para assegurar que os outros membros da organização respeitem as estratégias determinadas. Instituições de saúde e ensino desenvolvem suas atividades através de seus centros de responsabilidades, que existem para cumprir suas finalidades. Como a organização é o conjunto de centro de responsabilidades, e se cada centro de responsabilidade cumpre com suas estratégias a própria organização atinge suas metas. Cabe ao gestor hospitalar decidir qual a estratégia a seguir congruindo com as premissas ou objetivos da organização. Esta decisão deve ser fundamentada em parâmetros e resultados que podem ser conseguidos através de ferramentas de decisão. Muitas organizações utilizam a avaliação do desempenho financeiro de seus centros de responsabilidade para tomar suas decisões. O presente trabalho é uma pesquisa ação, que propõe a apresentação de um modelo teórico, aqui representado por uma ferramenta de decisão que disponibilizará como indicadores de avaliação de desempenho as premissas de ensino, pesquisa e extensão, bem como as de cunho financeiro que permitirão ao gestor hospitalar decidir qual o foco ou caminho a seguir, auxiliando-o em situações de decisões administrativas. Foi realizada a comparação da classificação ou ranqueamento de cada um dos setores produtivos de acordo com o desempenho financeiro, neste caso, a margem de contribuição própria e seu ranqueamento após os cálculos apresentados pelo modelo proposto a fim de demonstrar que ocorreu mudança no ranqueamento dos setores. Este modelo baseou-se em uma ferramenta de hierarquização multicriterial. O fato mais importante foi de perceber que todos os setores produtivos tiveram seu ranqueamento modificado após os cálculos com a ferramenta apresentada. Assim, esta ferramenta torna-se uma forma de decisão mais abrangente, pois contempla outros critérios, ou neste caso, premissas importantes para a decisão, sendo muito útil também para identificar entre as premissas apresentadas quais foram as de pior desempenho em cada setor. Desta forma, o gestor pode determinar ações de melhorias, buscando metas que possam ser alcançadas e determinando aporte financeiro, sendo este o caso, para alcançá-las.(AU)

Antimicrobial resistance is a significant global health problem. Misuse of antibiotics is associated with antimicrobial resistance which presents clinicians with treatment challenges and increases the complexity of the decision making process related to the selection of appropriate antibiotic therapy. Antibiotic resistant organisms can often lead to nosocomial infections (NIs) and undoubtedly causes patient harm and increases healthcare costs. According to the National Institute of Allergy and Infectious Diseases (NIAID), at least 70% of the nosocomial infections are caused by antibiotic-resistant organisms. In addition to the problem of inappropriate prescribing, the decreased production of antimicrobial agents over the past 25 years has restricted the arsenal of available antimicrobial agents. The combination of inappropriate antibiotic prescribing practices and reduced research and development of new antimicrobial agents have promoted concerns that society may soon return to a pre-antibiotic era. Addressing the attitudes and behaviours that contribute to inappropriate antibiotic prescribing is a potentially effective and immediate solution to the growing antimicrobial resistance problem. Modifying clinicians' prescribing behaviour with antibiotic decision guidelines and highlighting the problematic side of this issue can promote judicious antibiotic prescribing practices. Representing the existing data regarding the use and misuse of antimicrobials in a Lebanese hospital can support and encourage initiating and complying with antibiotic stewardship programs and prescription guidelines. Purpose: The objectives of this study were to determine current levels and trends in prescribing antibiotics to patients in a Lebanese hospital, (2) to identify the factors that physicians considered when deciding to start antibiotics, (3) to explore whether antimicrobial use (empiric, prophylactic, targeted) will change when physicians fill out a form to document why they prescribed antibiotics, (4) to explore whether an increase in bacterial resistance occurs when antimicrobial consumption increases, (5) to explore the clinicians' perception towards antimicrobial use and antimicrobial stewardship program pre- and post- implementation of an antibiotic assessment form, (6) to explore the effect of the implemented antimicrobial stewardship intervention combined with hand hygiene (HH) on healthcare associated infection rate (HAIs) in the hospital. One-year retrospective study in a Lebanese hospital was conducted to determine the percentage of patients who received antimicrobial treatment and to identify the inappropriateness of their use in different hospital departments. A 12-months intervention was then implemented during which all attending physicians were asked to fill an antimicrobial assessment form (AAF) to document their rationale for starting antimicrobial therapy. In addition, this AAF was used to identify factors physicians considered when deciding to prescribe antimicrobials. Data from the AAFs suggested that physicians in the hospital often considered elevated C-reactive protein, elevated white blood cell counts, and elevated temperatures when deciding to start antimicrobial therapy. Data showed that antibiotic consumption and the median duration of empiric and targeted therapies decreased significantly during the intervention period when compared to the pre-intervention period. Antibiotic appropriateness was also increased significantly after the intervention was conducted. In addition, a better understanding of antimicrobial stewardship strategies was also noted by physicians after the implementation of the intervention. On the basis of these results, AAF filling was a successful intervention to reduce antibiotic use and to urge physicians to refer to antibiotic guidelines when initiating an antimicrobial agent. However, additional measures such as automatic stop orders and computer decision support may be easier and useful for reducing the duration of therapy in hospitals.

The aim of this work is carried out using selected methods the financial analysis of a Health-Care facility of the nature a hospital, an assessment of its financial health, its operation and financing.

No description available.

The study sought to assess the knowledge of adolescents regarding abortion in a selected area in Lagos Nigeria. The researcher used a non-experimental, exploratory, descriptive research design for the study. One hundred adolescents participated in the study. The study found that many adolescents will not admit to having had an abortion. Moreover, the respondents gave different meanings for abortion, had inadequate knowledge of abortion and sexual and reproductive health. Cultural taboos and religious beliefs have a great impact on adolescents’ sexual behaviour. Most adolescents would not access abortions services because they regard it as killing an innocent baby. Efforts should be strengthened to make contraceptives and family life education available and accessible to the adolescents. / Health Studies / Thesis (M.A. (Health Studies))

The study sought to assess the knowledge of adolescents regarding abortion in a selected area in Lagos Nigeria. The researcher used a non-experimental, exploratory, descriptive research design for the study. One hundred adolescents participated in the study. The study found that many adolescents will not admit to having had an abortion. Moreover, the respondents gave different meanings for abortion, had inadequate knowledge of abortion and sexual and reproductive health. Cultural taboos and religious beliefs have a great impact on adolescents’ sexual behaviour. Most adolescents would not access abortions services because they regard it as killing an innocent baby. Efforts should be strengthened to make contraceptives and family life education available and accessible to the adolescents. / Health Studies / Thesis (M.A. (Health Studies))

Act no. 328/2001 of the Collection of Laws defines that, apart from others, evacuation must be planned for handling emergency situations that require an alarm of the third or spe-cial degree to be raised. Successful evacuation requires an evacuation plan be made as part of crisis preparedness plans and this project could become a template for preparing evacuation plans for emergency situations at Fakultní nemocnice (a teaching hospital) in Motol, Prague. The teaching hospital in Motol is one of the largest hospitals in central Europe. It has 2,500 beds at its disposal, 350 of which are with intensive care. The hospital has large prem-ises the heart of which consists of two monoblocks, one for children patients and the other for adult ones. The other buildings in the hospital house its technical and administrative facilities or some special departments. The set of persons in question includes all the people in danger on the premises at the time of raised evacuation. It means hospitalized patients, outpatient ones, employees, students and teachers of the 2. Lékařská fakulta UK (the Medical Faculty of Charles University) and visitors. The objective of this work is to create model templates for evacuation plans for se-lected wards as well as larger departments, including the entire hospital complex. The other objective is to verify, or refute, the hypothesis that evacuation, partial or complete, of a large hospital can be finished within 12 hours. The methodology was based on detailed data collection about each ward and bed de-partments (location, number of beds, number of staff at various time of the day etc). Another source of information was a detailed survey of the entire premises focused at finding potential evacuation routes inside as well as outside the buildings, capacity of corridors, stairways, lifts, and other important information related to evacuation. The results of the project are presented in the form of ten model evacuation plans for various individual parts as well as whole units of the hospital: 1. Evacuation of one ward of the children{\crq}s monoblock, 2. Evacuation of one wing of the children{\crq}s monoblock, 3. Entire evacuation of the children{\crq}s monoblock, 4. Evacuation of one ward of the adult{\crq}s monoblock, 5. Evacuation of one floor in one communication node of the adult{\crq}s monoblock, 6. Evacua-tion of one entire communication node of the adult{\crq}s monoblock, 7. Entire evacuation of the adult{\crq}s monoblock, 8. Evacuation of the other hospital facilities, 9. Evacuation of another pa-vilion, 10. Entire evacuation of the whole hospital. The final results show that it is not possible to have one universal evacuation plan that would include all potential situations but several plans for particular kinds of exposure and sizes of departments in danger. The hypothesis was verified for variants 1., 2., 3., 4., 5., 6., 8. and 9. but it was not verified for variants 7. and 10. Evacuation of the entire adult{\crq}s mon-oblock and evacuation of the whole hospital cannot be finished within 12 hours after alert.

Orientador: Vera Lúcia Sabongi De Rossi / Dissertação (mestrado) - Universidade Estadual de Campinas, Faculdade de Educação / Made available in DSpace on 2018-08-17T00:17:05Z (GMT). No. of bitstreams: 1 Oliveira_FabianaAparecidadeMelo_M.pdf: 2640209 bytes, checksum: d8cc05c98127f7ce91987f5148ad3ac2 (MD5) Previous issue date: 2010 / Resumo: Esta pesquisa tem como objeto de estudo apresentar um panorama das dissertações de mestrado brasileiras dedicadas ao desenvolvimento de atividades pedagógicas em ambiente hospitalar (1989-2008), o qual será cotejado com a análise da cultura escolar contida no Projeto Pedagógico Hospitalar Escola Móvel-Aluno Específico, sediado no Instituto de Oncologia Pediátrica, em São Paulo (SP). Como referencial teórico-metodológico, apoiamo-nos em contribuções da nova história cultural, bem como no conceito de cultura escolar inspirado por Viñao Frago (2003). As fontes documentais utilizadas abarcam documentos oficiais que prevêem a oferta à educação básica para crianças e adolescentes hospitalizados e/ou em tratamento de doença crônica, a produção científica nacional dedicada ao atendimento pedagógico em âmbito hospitalar, bem como a materialidade inerente ao quotidiano da escola hospitalar. A análise permitiu trazer à tona os principais desafios da institucionalização e legitimação da oferta da Educação Básica em hospitais, dentro de contextos de âmbito nacional e internacional. / Abstract: This research purposes to present the Brazilian works done for attainment of a master?s degree, dedicated to the development of pedagogic activities in hospital environment (1989-2008), and compare them to the analysis of the scholar culture in the Projeto Pedagógico Hospitalar Escola Móvel-Aluno Específico, based on the Instituto de Oncologia Pediátrica, em São Paulo (SP). As theoretical and methodological references, we use the contributions of the new cultural history and the concept of scholar culture inspired by Viñao Frago (2003). The primary sources include official documents that refer to the offering basic education to children and adolescents hospitalized and/or during the treatment of chronicle diseases, the Brazilian scientific production dedicated to the pedagogic hospital attendance and the materiality inherent to the school assistance in the quotidian hospital environment. The analysis brought up the main challenge of the basic education?s institutionalization and legitimization in Brazilian hospitals and abroad. / Mestrado / Educação, Conhecimento, Linguagem e Arte / Mestre em Educação