Essän handlar om samlingen i förskolan där jag har utgått från ett dilemma där ett barn blir utskickad från samlingen för att hen inte kan sitta still och behålla fokus. Då jag betraktar denna situation utifrån börjar jag reflektera kring om det är rätt av oss pedagoger att utesluta barn från samlingen. Jag börjar ifrågasätta om samlingen är meningsfull för alla barn och varför vi har samling. Jag blir nyfiken på hur synen på samlingen utvecklat sig i den svenska förskolan från 1830-talet och fram till nu och om barn ska delta mot sin vilja? Mitt syfte med min essä är att ta reda på om jag anser att samlingen är viktig. Samlingen som rutin i vår verksamhet diskuteras och jag vill granska dess betydelse och vilken roll pedagogen har i samlingen. Är det viktigt att alla barn deltar? Jag reflekterar kring om vi kan plocka ut samlingens innehåll och implementera det i andra aktiviteter under dagen. Analysen har tre delar. Samlingens historia, pedagogens roll utifrån Foucaults maktteoretiska tankar och pedagogens praktiska kunskap. Jag lyfter genom mitt arbete upp ett obekvämt ämne då jag skriver om pedagogens makt över barnen. Detta är dock ett ämne som behöver lyftas. I mitt arbete använder jag skrivandet som metod för att reflektera och en hermeneutisk tolkning av min personliga berättelse för att kunna reflektera över förskollärarens roll. Det jag har kommit fram till genom mitt arbete är att pedagogen har makt över barnen men att även rutinerna har makt över verksamheten. Pedagogernas makt över barnen kan vara mer eller mindre medveten. Jag kan också se att pedagogens praktiska klokhet har betydelse för hur samlingens utfall blir.

Syfte. Vårdrelaterade infektioner är ett stort problem inom hälso- och sjukvård. Dessa infektioner drabbar patienten och dess anhöriga samt bidrar till stora kostnader för samhället. Studier har visat att god följsamhet till de basala hygienrutinerna är ett effektivt sätt att minska förekomsten av vårdrelaterade infektioner. Syftet med denna studie var att studera två mottagningars följsamhet till basala hygienrutiner, varav den ena deltar i kvalitetsprojektet VRISS – Vårdrelaterade Infektioner Ska Stoppas. Syftet var även att jämföra mottagningen som deltar i VRISS-projektet med den som inte deltagit, för att undersöka om det förekommer någon skillnad mellan dem. Metod. Sjukvårdspersonal i tjänst på en mottagning som deltar, samt på en mottagning som inte deltar i VRISS-projektet observerades gällande följsamhet till basala hygienrutiner. Observationstillfällena gjordes under en veckas tid på varje mottagning. Resultat. Den mottagning som deltar i VRISS-projektet hade högre följsamhet gällande spritning av händer samt helt korrekt utförande i alla tre stegen. Ingen signifikant skillnad mellan mottagningarna avseende följsamhet till någon annan studievariabel förekom. Slutsats. Den mottagning som deltar i VRISS-projektet visar på en bättre följsamhet av bland annat spritning av händer än den mottagning som inte deltagit. För att uppnå följsamhet till 100 procent krävs utbildningsprogram som kontinuerligt uppmanar och påminner personalen om riktlinjerna för de basala hygienrutinerna och deras effekt mot vårdrelaterade infektioner. / Aim. Hospital-related infections are a major problem in healthcare. These infections occur among patients and their relatives, contributing to high costs for society. Studies have shown that good adherence to basic hygiene routines are an effective way to reduce the incidence of the infections. The purpose of this study was to examine adherence to basic hygiene routines among healthcare staff, and compare a healthcare reception which was included in the VRISS-project (healthcare-related infections shall be stopped) with a reception that did not participate, in order to investigate whether there is any difference in the adherence to basic hygiene routines between them. Method. Healthcare staff at service within a healthcare reception that participated, and a reception that did not participate in the VRISS-project was observed. Data observations were accounted during a week within each reception. Results. The healthcare reception involved in the VRISS-project had a higher compliance current shelling of hands and accomplish to the routines properly in all three steps. No difference between the receptions in adherence to any other of the variable that were studied was shown. Conclusion. The healthcare reception that participates in the VRISS-project shows a higher adherence to the basic hygiene routines including shelling of hands. Although, for a higher compliance, training is required to continually remind the healthcare staff about the guidelines for basic hygiene routines and its impact on hospital-related infections.

The thesis had its starting point in the first paragraph of the eleventh chapter in the Swedish social services act, which discusses the immediate risk assessments that has to be made when the social services receive a report about a child. The thesis highlights an area that has received a lot of attention in media since the spring of 2014, when an eight year old girl was fatally abused by her legal guardians. The social services had at the time received a report about the girl but it was left unread. This tragic case has brought attention to the routines used by the social services for dealing with reports and risk assessments. This thesis was conducted through individual interviews with social workers working with children and families in the social services, with the aim to acquire an enhanced understanding of how social workers perform immediate risk assessments and what these assessments are based on. The results of the study showed that several of the municipalities had a routine for how to handle incoming reports, but lacked specific routines regarding the immediate risk assessments. Without specific routines, the informants stated experience, intuition and cooperation with co-workers and managers as important factors of making risk assessments. / Studien tog avstamp i socialtjänstlagens elfte kapitel, första paragrafen, vilken behandlar den omedelbara skyddsbedömning som ska göras av socialtjänsten vid en inkommen anmälan gällande ett barn. Studien belyser ett medialt uppmärksammat område som sedan våren 2014 blivit vida diskuterat då en åttaårig flicka misshandlades till döds av sina vårdnadshavare. Socialtjänsten hade då fått in en anmälan om flickan men som ingen ännu hade läst. Detta tragiska fall har uppmärksammat socialtjänstens rutiner kring anmälningar och hur de genomför skyddsbedömningar. Studien genomfördes genom individuella intervjuer med socialsekreterare som arbetar inom Barn och familj i socialtjänsten och syftet med studien var att få en ökad förståelse för hur socialsekreterarna utför skyddsbedömningar och vad som ligger till grund för dessa bedömningar. Studiens resultat visade att det i flera av kommunerna fanns en rutin för hur en inkommen anmälan skulle hanteras, men att det saknades specifika riktlinjer för hur de omedelbara skyddsbedömningarna skulle göras. I avsaknad av specifika riktlinjer uppgav informanterna att erfarenhet, intuition och samarbete med kollegor och chefer utgjorde viktiga delar av att göra skyddsbedömningar.

Abstract The main subject of this essay is conflicts at work and the effect it has on the employee´s health.  I can through various reports read that bad health at workplaces is too high and that conflicts are a reason. What can be done to the work environment so it will be better from a psychosocial perspective? Sweden has a regulation that makes the employer responsible to work for an improvement in the work environment; can these regulations be used in purpose to reduce conflicts? My first question concerns the possibility to establish preventive procedures in the workplace systematic work regarding to improve the work environment. My second question is about the obligations of the employer to attempt to reduce conflicts at the workplace and the third question regards the documenting and monitoring of conflicts and the preventing work to reduce them. The purpose of this essay is to clarify how conflict preventive work can be included in the Systematic work environment management. To find answers to my questions I will interpret and analyze the current Swedish law but also international law. Current law and regulations will be supplemented with interviews to obtain information about the employer´s approach to preventive work regarding conflicts. After analyzing the material I come to my conclusion that it´s possible to use current regulations as a tool to reduce conflicts at workplaces and through that also reduce sick leave due to psychological disorders. But there is a need to set up more concrete routines that makes the employer´s obliged to take all measures deemed necessary.

Current legislation and recommended practice have a primary focus on Early Intervention that meets the priorities set forth by families with children who have disabilities. Many theories and current research emphasize the importance of delivering services in a way that supports families to enhance the development of their children through models that reflect the recommendations. Although there are multiple contributions to what is recommended for family-centered philosophy and practice, one single document, the IFSP, guides the delivery of services.Using the content of 91 IFSPs from the state of Kentucky, 8 indicators were analyzed along with service coordinator demographics. This tool was used to determine the frequency of identified unsatisfactory routines that were used as the foundation for outcome development, if service coordinator demographics impacted this process and if certain domains lent more opportunity for inclusion in outcomes. In addition, frequency of sibling inclusion in priorities, concerns, outcomes and strategies were analyzed.Findings indicate that approximately 50% of the routines identified as unsatisfactory were used in outcome development. Significant interactions between service coordinator demographics were discovered as well as a strong correlation between routines and domain. Sibling interaction is discussed as well as limitations and future research.

Bakgrund God vårdhygien kan reducera antalet vårdrelaterade infektioner med en tredjedel och med dagens kunskaper går det med enkla medel att iaktta de förhållningsregler som är nödvändiga för att säkerställa en god vårdhygien. Ändå följs ofta inte hygienrutiner. Syfte Att belysa vilka faktorer som underlättar att vårdpersonal på vårdavdelningar på sjukhus följer basala hygienrutiner. Metod Studiens design är en deskriptiv litteraturstudie. Denna metod valdes för att utforska det aktuella kunskapsläget inom området. Metoden beskriver det nuvarande kunskapsläget inom ett område genom att granska, analysera och beskriva valda vetenskapliga studier. Resultat Analysen av data från studierna gav sju teman: ansvarskänsla, arbetsbelastning, attityder och beteende, kunskap och utbildningens inverkan, ledningens ansvar i hygienfrågan, återkoppling samt tillgänglighet. De viktigaste faktorerna är ”attityder och beteende” och ”ledningens ansvar i hygienfrågan”. Slutsats Ett tydligt ledarskap med motiverade chefer och en uppmuntrande miljö ger störst möjlighet till att påverka attityder och beteenden hos personalen. För att förbättra följsamheten till hygienrutiner behöver dock alla sju underliggande faktorer beaktas. Därigenom kan patienters lidande undvikas genom en minskning i antal vårdrelaterade infektioner (VRI) och vårddygn. / Background Good healthcare hygiene can reduce the number of healthcare associated infections by one-third and with current knowledge we can with simple means observe the precautions necessary to ensure good healthcare hygiene. Yet these hygiene rules are often not followed. Aim To elucidate the factors that facilitate for nursing staff in hospital wards in to follow basic hygiene procedures. Methods The study design is a descriptive literature study. This method was chosen to get an idea of the current state of knowledge in the field. The method describes the state of knowledge of a field by reviewing, analyzing and describing selected scientific studies. Results Analysis of data from the articles gave seven themes: sense of responsibility, workload, attitude and behaviour, knowledge and education, responsibilities with regard to hygiene, feedback and availability. The most important factors are “attitudes and behaviour” and “management’s responsibility considering the hygiene”. Conclusion A clear leadership with motivated managers and an encouraging environment gives the best opportunity to change the staffs' behaviour and attitudes. However, to improve compliance with hygiene routines all seven factors need to be considered. Thus patients suffering can be avoided through a reduction in health care associated infections and days of care.

The importance of studying challenges in implementing information technology solutions in health care organizations is highlighted by the huge investments in health care information technology (HIT) which has been spurred by recent government mandates. Information technology can help improve health care delivery cost by facilitating the standardization of work processes or routines and reducing variations among them. Set in a premier 950+ bed hospital in the south eastern part of US, this dissertation consists of two studies examining the challenges involved in implementing HIT solutions. In the first study, we seek to gain deep insights into how the process of creating a patient’s chart evolves over time in a health care institution. The second study focuses on the users of Electronic Health Records (EHR) system, investigating the compliance behavior of various providers with respect to patient records in the system. In the first study, through the lens of Activity theory our results show that the charting routine is implicated by the following environmental factors: (1) Tools, (2) Rules, (3) Community, and (4) Roles, and by individual factors: (5) Computer Self-Efficacy and (6) Risk Propensity. In the second study, our results indicate that there is a substantial effect of subculture of the different occupational groups on IT security compliance intent and behavior in a health care institution.

Bakgrund: : Vårdrelaterade infektioner är kostsamma för vården och orsakar lidande förpatienten. Operationspersonal har en viktig uppgift att förebygga smittspridning och följahygienrutiner. Dessa är bland andra att använda rätt arbetskläder, arbeta aseptiskt och enligtbasala hygienrutiner samt att bibehålla steriliteten. Syfte: Syftet med studien var att observeraföljsamheten till aseptik och basala hygienrutiner på operationssal vid allmänkirurgiskt ingreppvid två sjukhus i Mellansverige. Metod: Studien var en observationsstudie med kvantitativansats. Observationerna genomfördes utifrån ett observationsprotokoll. Ingreppen somobserverades var av allmänkirurgisk karaktär och totalt tio observationer utfördes.Yrkeskategorier som ingår i operationsteamet observerades i olika arbetsmoment, såsomarbetskläder, insättning av PVK, preoperativ huddesinfektion och steril drapering. Följsamhetentill de olika momenten beräknades i procent. Resultat: Totalt tio observationer genomfördes. Dearbetsmoment som hade bäst följsamhet var arbetskläder, insättning av PVK, preoperativhuddesinfektion och steril drapering. I alla arbetsmoment som observerades var handdesinfektionden underkategori som hade sämst följsamhet. Slutsats: I samtliga av de sex arbetsmoment somobserverades i studien fanns brister gällande följsamhet till aseptik och basala hygienrutiner trotsatt vissa moment, såsom preoperativ huddesinfektion och steril drapering av operationsområdet,hade hög följsamhet. / Background: Hospital acquired infections are costly for health care and causes distress for thepatient. Operational staff have an important role in preventing the spread of infection and followhygiene procedures. These include using the proper work clothes, work aseptically and accordingto basic hygiene and to maintain sterility. Aim: The aim of the study was to observe adherence toaseptic technique and basic hygiene procedures in the operating theater for general surgery attwo hospitals in central Sweden. Method: The study was an observational study withquantitative approach. The observations were carried out on the basis of an observation protocol.The surgical intervention that were observed was of a general surgical nature and a total of tenobservations were performed. Professional categories included in the operating team wereobserved in different tasks, such as work clothes, insertion of PVK, preoperative skindisinfection and sterile draping. Adherence to the various elements was calculated in percent.Result: A total of ten observations were made. The observed tasks that had the best adherencewere working clothes, insertion of PVK, preoperative skin disinfection and sterile draping. Handdisinfection was the subcategory that had the lowest adherence of all observed tasks.Conclusion: In each of the six tasks that were observed in the study there were deficienciesregarding adherence to aseptic technique and basic hygiene despite some tasks, such aspreoperative skin disinfection and sterile draping of the surgical field, which had high adherence.

This thesis is an auto-ethnographic study of teaching methods proposed to be effective in developing thinking skills that advance meaning making in my middle school art classes. The study explored the use of Visible Thinking Routines Ritchart et all, 2001) and Art Investigations (Herz, 2010) in middle school art classes.Reflections and other field texts reveal the extent to which I found these methods effective in guiding students to develop higher order thinking skills that support more meaningful outcomes in art and could be beneficial in other areas of their lives.

Accomplishing desired benefits from investments in planned change is problematical for organizations, their leaders and the change agents charged with delivery. This is despite a well-developed literature, replete with advice on how change should be achieved. Examination of this literature shows the primary focus on change agents and their practices. This research widens the focus by observing the influence of change agents, change recipients and line managers on organizational routines undergoing planned change. It examines the interplay between stability and change in organizational routines, adopting a social practice perspective, and the routine intended to change as the unit of analysis (Feldman and Pentland, 2003, 2005). The research builds on claims that to understand the patterns of action within routines requires the internal dynamics – the claimed duality between ostensive (in principle) and performative (in practice) aspects - to be examined. A research method to operationalize the study of this claimed duality was devised following the principles of Strong Structuration (Stones, 2005). This method enabled a unique conceptualization of the study of routine dynamics, focused on planned change from the perspective of multiple, interdependent actors. Two cases of change agents following the advice in the planned change literature were explored. In one case, stability of the routine persisted when change was intended. In the other, change was relatively easy to achieve irrespective of change agent actions. The primary contribution is the demonstration of how the attitudes to change of change recipients, line managers and change agents influence the internal dynamics of routines undergoing planned change. Other contributions pertain to the method of ‘unpacking’ organizational routines and its potential for shaping future practice. This research does not offer new ‘normative’ advice but instead sensitizes planned change practitioners to the level of analysis they need to carry out to ensure that their interventions are suitably designed.