Caregivers often associate fevers with permanent harm and bring children to emergency departments (EDs) unnecessarily. However, families using EDs for nonurgent complaints often have difficulty accessing quality primary care. Mutual misconceptions among caregivers and healthcare providers regarding nonurgent ED use are a barrier to implementing meaningful interventions. The purpose of this project was to identify dominant themes in caregivers’ narratives about bringing children to the ED for nonurgent fevers. Thirty caregivers were recruited in a pediatric ED for participation in qualitative semi-structured interview from August to November 2014. Interview transcripts were coded and analyzed for themes. Caregivers’ decisions to come to the ED revolved around their need for reassurance that children were not in danger. Several major themes emerged: caregivers came to the ED when they felt they had no other options; parents feared that fevers would result in seizures; caregivers frequently drew on family members and the internet for health information; and many families struggled to access their PCPs for sick care due to challenging family logistics. Reducing nonurgent ED utilization requires interventions at the individual and structural level. Individual-level interventions should empower caregivers to manage fevers and other common illnesses at home. However, such interventions may have limited impact on utilization outcomes among families with poor access to primary care. Afterhours primary care should be expanded to accommodate families with rigid work schedules and limited transportation resources.

Bakgrund Sepsis är ett allvarligt tillstånd som drabbar många miljoner människor i världen, och kan bli livshotande om inte en tidig identifiering sker eller om behandlingsåtgärder blir fördröjda. Därmed har sjuksköterskor en vital roll och ett stort ansvar att upptäcka tidiga symtom eller försämringar hos patienter med sepsis eftersom de utför det patientnära arbetet. Dock finns svårigheter med att göra en korrekt bedömning då symtomen ofta är svårtolkade.   Syfte  Syftet var att belysa sjuksköterskors erfarenhet vid omvårdnaden av vuxna patienter med sepsis på akutmottagningar.     Metod  En allmän litteraturöversikt baserad på 10 vetenskapliga artiklar, av kvalitativ och mixad metoddesign. Samtliga artiklar kvalitetsgranskades och analyserades genom att använda kvalitativ innehållsanalys.   Resultat  Efter genomarbetad dataanalys framkom tre kategorier: Organisatoriska faktorer, Adekvat utbildning och erfarenhet samt Samverkan grupp, därefter tillkom sju subkategorier.   Slutsats Sjuksköterskor möter stora utmaningar vid omvårdnaden av patienter med sepsis. Sjuksköterskor har ett stort ansvar och en viktig roll att upptäcka patienter med misstänkt sepsis i ett tidigt skede. Detta är dock en utmaning för de flesta sjuksköterskor framför allt för de som har en bristfällig kompetensnivå, eftersom det krävs både kunskap och erfarenhet att göra en snabb och korrekt bedömning. I situationer då sjuksköterskor saknar erfarenhet är det betydelsefullt att ha grundläggande kunskap om sepsis och att använda identifieringsverktyg vid bedömningen, samt samarbeta med sjuksköterskor som har en högre kompetensnivå för att på så vis erhålla värdefull kunskap / Background Sepsis is a serious condition that affects many millions of people worldwide and can be life-threatening if early identification is not made or treatment measures are delayed. Thus, nurses have a vital role and a great responsibility to detect early symptoms or deterioration in patients with sepsis because they perform the work close to the patient. However, there are difficulties in making a correct assessment as the symptoms are often difficult to interpret.   Purpose  The purpose was to shed light on nurses' experiences caring for adult sepsis patients in emergency departments.   Method  A general literature review based on 10 scientific articles of qualitative and mixed method design. All articles were quality-reviewed and analysed using qualitative content analysis.   Results  After elaborate data analysis, three categories emerged: Organizational factors, Adequate training and experience, and Group collaboration, then seven subcategories were added.   Conclusions Nurses face major challenges when caring for patients with sepsis. Nurses have a great responsibility and an important role in detecting patients with suspected sepsis at an early stage. However, this is a challenge for most nurses, especially for those who have a deficient level of competence, as it requires both knowledge and experience to make a quick and accurate assessment. In situations where nurses lack experience, it is important to have basic knowledge of sepsis and to use identification tools in the assessment, as well as to collaborate with nurses who have a higher level of competence to obtain valuable knowledge.

ABSTRAKT Gustafsson O & Karlsson P. Äldres upplevelser av att vistas på akutmottagning. Enlitteraturstudie. Examensarbete i omvårdnad 15 högskolepoäng. Malmö Universitet:Fakulteten för Hälsa och samhälle, Institutionen för vårdvetenskap, 2024  Bakgrund: En växande befolkning av äldre personer kommer att öka kravet påakutmottagningar Detta eftersom patientgruppen är överrepresenterad blandbesökarna samt ofta multisjuka med komplexa åkommor. Därav är det viktigt attförstå äldres upplevelser av att besöka en akutmottagning. Syfte: Syftet var att utforska äldre patienters upplevelse av att vårdas på enakutmottagning. Metod: Litteraturstudien utfördes genom att sammanställa tio stycken vetenskapligaartiklar med kvalitativ ansats. Artiklar söktes strukturerat enligt ett sökschema idatabaserna Cinahl och PubMed. Artiklar som bedömdes svara på litteraturstudienssyfte kvalitetsgranskades enligt SBU:s granskningsmall för kvalitativa studier. Resultat: Sju kategorier framkom efter analysen: behov av tydlig information,bemötande från vårdpersonal, förminskning av egna behov, känsla av oro ochosäkerhet, organisation & miljö, tilltro till personal samt upplevelsen av att vänta. Slutsats: Äldre patienter upplever en stark tilltro till sjukvårdspersonalen ochförminskar sina egna behov i förtur till andra under vistelsen på akutmottagningar. Endel patienter känner oro för att bli sjuka, för en förändrad livssituation och ävendöden. Patienterna känner ofta en tacksamhet för den vård de får och vill få begripliginformation och uppmärksamhet under väntetiden. Detta bidrar till att minskapatienternas oro och ger ökat positivt intryck av den totala upplevelsen av vistelsen. / ABSTRACT Gustafsson O & Karlsson P. Elders experiences of visiting the emergencydepartment. A literature review. Degree Project in nursing 15 credit points, MalmöUniversity: Faculty of Health and society, Department of Care Science, 2024. Background: A growing population of elderly individuals will increase the demandfor emergency departments. This patient group is overrepresented among visitors andoften presents with multiple illnesses and complex conditions. Therefore, it isimportant to understand the experiences of older adults when visiting an emergencydepartment. Aim: The aim of this study was to explore the experiences of older patients receivingcare in an emergency department. Method:The literature review was conducted by compiling ten scientific articles witha qualitative approach. Articles were systematically searched using a search protocolin the databases Cinahl and PubMed. Articles that were deemed to address thepurpose of the literature review were quality-assessed according to the SwedishAgency for Health Technology Assessment and Assessment of Social Services (SBU)guidelines for qualitative studies. Results: Seven categories emerged from the analysis: need for information,interaction with healthcare staff, minimizing needs, feelings of worry and uncertainty,trust in staff, organization and environment, and the experience of waiting. Conclusion: Older patients experienced a strong trust in staff and minimized theirneeds in favor of others during their stay in the emergency departments. Somepatients worry about getting sick, a changed life situation and even death. Patientsfeel grateful for the care and want to receive understandable information and attentionduring the waiting time. This helps to reduce patients' anxiety and gives them anincreased positive impression of the overall experience of the visit.

No description available.

The structure and systems of state health departments (SHD) may affect reporting of foodborne disease outbreak (FBDO) hospitalizations. Evaluation of SHD by investigating the contributions of structural capacity elements (SCE) will provide an accurate measure of performance and highlight areas for development of effective strategies for improvement. This study investigated the relationship between organizational and structural characteristics of SHD and systems for FBDO reporting, and included three manuscripts designed to address seven hypotheses, as well as a conclusion chapter interpreting the findings as they relate to the overall research question. Study findings identified consistently higher reports of hospitalization due to foodborne illness from third party payers compared to SHDs between 2006 and 2009 in 30 of the 31 states analyzed. Furthermore, significantly different rates of reporting among states with mixed governance classification were seen when compared to those with centralized and decentralized governance; associations between total laboratory expenditures and total food-related hospitalizations reported were also identified when analyzing healthcare claims data. This dissertation contributes to the current knowledge base for public health services and systems research, as well as food safety surveillance and reporting, and provides an innovative approach to using secondary databases to investigate food safety issues. Findings support the conclusion that collaboration between public and private agencies would support improvements in data collection and foodborne illness surveillance. / Public Health

This study is phase two of a two-phase research effort designed to describe the role of the academic department chairperson in the public universities of Jordan and to develop a systematic, formal process for evaluating the performance of this position. The purpose of this phase (phase II) was to develop an evaluation model for the academic chairperson's performance that can be used in the public universities of Jordan. In phase I, the actual and the ideal role expectations were identified through interviews with deans, chairpersons, and faculty members in Jordan public universities during Summer, 1992. These expectations were profiled and used as the basis for phase II research. / Ph. D.

This study is phase one of a two-phase research effort designed to develop a systematic, formal process for evaluating the performance of department chairpersons in public universities in Jordan. In this phase, the role of the department chairperson was reviewed and analyzed. Interviews were conducted with five academic deans, ten chairpersons, and five faculty members. Both actual and ideal role expectations were identified. These role expectations will become the basis for phase II, which will be an evaluation of the performance of department chairpersons in the public universities of Jordan. / Master of Arts

The chasm in the protection of classified information in South African government indicates that all the departments have at their disposal information that is to some extent sensitive in nature and obviously requires security measures. This study shows that government officials who in their official duties come to contact with classified information are either vulnerable or are implementing the security controls incorrectly. It is also clear that in the absence of a comprehensive statutory framework, the government departments’ classified information has resulted in an unstable and inconsistent classification and declassification environment. The statutory framework would, in addition to other things, address the rising threat of espionage and antagonistic activities, the selling of information and the protection of critical records in government, without hindering the constitutional rights of citizens to access information. This would create a system of valuable informantion and clarify which information requires security measures with respect to the protection of classified information. / Kgaohanao e tshireletsong ya tlhahisoleseding e sireleditsweng ke mmuso wa Afrika Borwa e supa hore mafapha ohle a ona a na le tlhahisoleseding eo, ka ho hong, e leng ya sephiri mme e hloka maemo a tshireletso. Boithuto bona bo bontsha hore bahlanka ba mmuso bao, tshebetsong ya bona ya semmuso, ba teanang le tlhahisoleseding ya sephiri, ba kotsing hobane ba sebedisa ditaelo tsa polokeho ka mokgwa o fosahetseng. Ho boetse ho hlakile hore, bosikong ba moralo o phethahetseng wa semolao, disistimi tse sa sebetseng hantle tsa mafapa a mmuso tsa tlhahisoleseding ya sephiri di bakile tikoloho e sa tsitsang hape e sa hlophiswang ya tlhophiso le tloso ya tlhophiso ya tlhahisoleseding. Moralo wa semolao, hara tse ding, o ka sebetsana le phephetso e eketsehang ya bohlwela le diketsahalo tse ding tse belaetsang tse jwalo ka thekiso ya tlhahisoleseding, mme o sireletse direkote tsa mmuso tsa bohlokwa ntle le ho hatakela tokelo ya Molaotheo ya baahi ya phihlello ho tlhahisoleseding. Hona ho ka theha sistimi ya tlhahisoleseding ya bohlokwa le ho hlakisa hore na ke tlhahisoleseding efe e hlokang maemo a tshireletso ha ho tluwa ntlheng polokeho ya tlhahisoleseding ya sephiri. / Umsantsa okhoyo ekukhuseleni ulwazi olukhethekileyo kurhulumente woMzantsi Afrika ubonisa ukuba onke amaSebe anolwazi analo olunokuba nkenenkene, kwaye oludinga ukhuseleko. Esi sifundo sibonisa ukuba asesichengeni amagosa karhulumente aye athi apha ekusebenzeni kwawo, adibane nolwazi olukhethekileyo, ngoba azisebenzisa gwenxa iindlela zokulawula ukhuseleko. Kukwacaca ukuba, ekubeni kungekho sikhokelo namigaqo isemthethweni, iinkqubo ezingasebenzi kakuhle zamaSebe karhulumente, ulwazi olukhethekileyo aluhlelwa ngendlela eyiyo kwaye lufumaneka kwiimeko ezingaluphathi ngokukhetheka. Ubukho besikhokelo nemigaqo yokhuseleko lolwazi inganceda ekunqandeni isoyikiso esikhulu sobhukuqo mbuso nezinye iziganeko ezikrokrisayo, ezifana nokuthengiswa kolwazi, Esi sikhokelo singanceda nasekukhuseleni iingxelo zikarhulumente ezinkenenkene ngaphandle kokucinezela amalungelo abemi okufumana ulwazi njengoko uvuma uMgaqo Siseko. Oku kuya kuvelisa inkqubo yolwazi olunexabiso kwaye kuya kucacisa ukuba loluphi ulwazi oludinga imimiselo yokhuseleko malunga nokukhuselwa kolwazi olukhethekileyo. / Criminology and Security Science / M. Tech. (Forensic Investigation)

Des études récentes confirment que la violence au travail dans le secteur de la santé est universelle, malgré certaines différences locales, et qu’elle impacte aussi bien les hommes que les femmes, (Di Martino, 2002). Cette recherche, s’attache à décrire les perceptions de la violence et de la souffrance chez ces professionnels de santé, à travers l’évaluation de la perception des risques psychosociaux, par les infirmiers et ce, dans les services des urgences, et d’hospitalisation à Tunis.Il s’agit de souffrances délétères multiples, qui se teintent du stress, et du burn out, s’alimentent de l’anxiété, s’amplifient par un système organisationnel défaillant et une qualité relationnelle inconsistante Il s’agit d’une étude, descriptive, transversale, prospective, portant sur une population d’infirmiers, exerçant dans trois hôpitaux répartis sur des services d’urgence et des services d’hospitalisation. L’étude est divisée, en parties ; exploratoire, quantitative et qualitative. Le cadre de référence général, étant l’approche systémique, notamment par Brondenfenbrenner (1979), ainsi que ; dans le domaine de l’organisation, par Mintzberg et en communication par l’école Palo Alto…, associée, essentiellement, à L’approche transactionnelle, sur le stress et le coping ; ainsi que l’approche humaniste en sciences infirmières (en matière de la relation soignant-soigné). / Recent studies, confirm that workplace violence in the health sector is universal, despite some local differences. It affects both men and women. (Di Martino, 2002). This research attempts to describe the perceptions of violence and suffering within these health professionals through the evaluation of perception of psychosocial risks by nurses in the emergency and hospitalization departments in the governorate of Tunis. It is about multiple deleterious sufferings, which are tinged with stress, and burn out. Fed with anxiety, and amplified by a faulty organizational system, and an inconsistent relational quality. It is a descriptive cross-sectional prospective study of a nursing population working in three hospitals distributed over emergency and hospitalization departments. The study isdivided into exploratory, quantitative and qualitative parts. The general frame of reference, being the systemic approach, notably by Brondenfenbrenner (1979), as well as; in the field of organization, by Mintzberg, and in communication, by the school Palo Alto ..., associated essentially with the transactional approach, on stress and coping as well as the humanistic approach to nursing (Healer-healed relationship).

Made available in DSpace on 2015-12-03T18:33:07Z (GMT). No. of bitstreams: 1 Danilo_Dupas_Ribeiro.pdf: 1820309 bytes, checksum: 284b9ae7e8a5bcb9a76d528a31c38230 (MD5) Previous issue date: 2014-05-09 / The complexity of information and its computerization generate large changes in the development of knowledge. In this scenario, the Purchasing area has undergone significant changes and have been considered strategic in many organizations. Depending on the company size and market segment, it is estimated that total spending by companies with purchases ranging from 50 % to 80 % of gross revenue. Therefore, reductions in the cost of acquisitions impacting significantly on the financial results of the company. The purpose of this paper is to analyze the evolution of the shopping area in organizations, to present some concepts, analyze the influence of electronic trading in the percentage of annual gross revenue that is committed to purchasing products and contracting services, candor procurement processes, lead time internal customer service and the risk of diversion, embezzlement and fraud in procurement transactions. Due the educational segment undergoing a process of expansion in course offerings and improving quality of service, it was possible to associate it with the theories discussed on increasing market competitiveness and the need to improve processes on purchases. Three Institutions of Higher Education (IHE) that use the same Electronic Trading System (ETS) were selected because the aim was to analyze the effectiveness of using the tool before the events described in this study. The study combines the support of ETS in organizations before the stimulation and complexity of information, which directly affect the management of companies. After analysis of the research, it is evident that the ETS is an essential tool in the development of purchasing processes, new methods of negotiation and governance / A complexidade das informa????es e sua informatiza????o geram grandes mudan??as no desenvolvimento do conhecimento. Neste cen??rio, a ??rea de Compras passou por transforma????es significativas, vindo a ser considerada estrat??gica em muitas organiza????es. Dependendo do tamanho da empresa e setor, calcula-se que o total gasto pelas empresas com compras varia de 50% a 80% da receita bruta. Portanto, redu????es no custo das aquisi????es repercutem de forma significativa no resultado financeiro da empresa. O prop??sito deste trabalho ?? analisar a evolu????o da ??rea de compras nas organiza????es, apresentar alguns conceitos, analisar a influ??ncia das negocia????es eletr??nicas no percentual do faturamento bruto anual que ?? comprometido com compra de produtos e contrata????o de servi??os, lisura nos processos de compras, tempo de processamento do pedido ao cliente interno e o risco de ocorr??ncia de desvios, desfalques e fraudes nas transa????es de compras. Devido ao segmento educacional passar por um processo de expans??o na oferta de cursos e na melhora da qualidade do servi??o prestado, foi poss??vel associ??-lo com as teorias abordadas sobre a crescente competitividade no mercado e a necessidade de aprimorar os processos em compras. Foram selecionadas tr??s Institui????es de Ensino Superior (IES) privadas que utilizam o mesmo Sistema Eletr??nico de Negocia????o (SEN), pois o objetivo foi analisar a efetividade da utiliza????o da ferramenta perante as hip??teses descritas neste estudo. O estudo associa o suporte do SEN nas organiza????es perante a dinamiza????o e a complexidade da informa????o, que afetam diretamente na gest??o das empresas. Ap??s an??lise da pesquisa, fica evidente que o SEN ?? uma ferramenta essencial no desenvolvimento dos processos de compras, novos m??todos de negocia????o e governan??a