Flexibility in competency-based workplace transition programs : an exploratory study of community child and family health nursing.

Background: Successful transition to practice programs that use competency-based assessment require the involvement of all staff, especially those undertaking the preceptor role. Methods: Qualitative data were collected using interview methods. Participants were 14 newly employed nurses and 7 preceptors in the child and family community health service in South Australia. Participant narratives were recorded electronically, transcribed, and thematically analyzed using the paradigm of critical social science. Results: Five themes were identified that describe enablers as well as barriers to applying a flexible transition to practice program using competency-based assessment. These included flexibility in the program design, flexibility on the part of preceptors, flexibility to enable recognition of previous learning, flexibility in the assessment of competencies, and flexibility in workload. Conclusion: To ensure successful application of a transition to practice program using competency-based assessment, preceptors must understand the flexible arrangements built into the program design and have the confidence and competence to apply them.Lynette Cusack, Sandra Gilbert, Jennifer Fereday

Magnetic metamaterial superlens for increased range wireless power transfer.

The ability to wirelessly power electrical devices is becoming of greater urgency as a component of energy conservation and sustainability efforts. Due to health and safety concerns, most wireless power transfer (WPT) schemes utilize very low frequency, quasi-static, magnetic fields; power transfer occurs via magneto-inductive (MI) coupling between conducting loops serving as transmitter and receiver. At the "long range" regime - referring to distances larger than the diameter of the largest loop - WPT efficiency in free space falls off as (1/d)(6); power loss quickly approaches 100% and limits practical implementations of WPT to relatively tight distances between power source and device. A "superlens", however, can concentrate the magnetic near fields of a source. Here, we demonstrate the impact of a magnetic metamaterial (MM) superlens on long-range near-field WPT, quantitatively confirming in simulation and measurement at 13-16 MHz the conditions under which the superlens can enhance power transfer efficiency compared to the lens-less free-space system

Where to focus efforts to improve overall ratings of care and willingness to return: The case of Tuscan emergency departments.

Objectives: Both regression and optimization models were used to identify an efficient combination of aspects of care (e.g., comfort of waiting room) necessary to improve global emergency department (ED) patient satisfaction. The approach, based on patient survey data, tends to favor aspects of care with large regression coefficients and those whose current performance is low, because improvements produce a greater effect on global satisfaction. Methods: The authors used ED patient satisfaction survey data collected between September and October 2007 from a random sample of 5,277 adult patients who visited 43 EDs in Tuscany, Italy. Ordinal logistic regression models were run to predict overall ratings of care and willingness to return using 20 independent variables (i.e., aspects of care). An optimization model was run to increase these two global items to a maximum of 15%. This model minimizes the total combined percentage increase of the aspects of care. Models using all cases (n = 5,277), cases from local hospitals (n = 4,264), and cases from teaching hospitals (n = 1,013) were run. Results: Four aspects selected by the optimization algorithm were in all models: ‘‘satisfaction with waiting time,’’ ‘‘comfort of the waiting room,’’ ‘‘professionalism of physicians’’ (technical skills), and ‘‘level of collaboration between physicians and nursing staff.’’ Most aspects needed a 15% increase to comply with the percentage increases set for the global satisfaction items. The model found that to increase overall ratings of care by 1, 2, or 8%, hospitals would need to focus only on one aspect: ‘‘level of collaboration between physicians and nursing staff.’’ The total number of variables increased to six when the improvement in overall ratings of care was set at 15%. To increase 3 or 5% willingness to return, the optimization algorithm found that 6 or 14 aspects, respectively, are needed. An increase of 6% or more was unfeasible. Conclusions: This approach is only somewhat efficient, as a cost structure is absent. The optimization model assumes that the cost to increase each aspect by 1% is equivalent. By applying this modeling technique we have demonstrated that, at least, two elements are important to consider when developing efficient improvement strategies to increase global satisfaction: 1) the current level of satisfaction of the aspects of care and 2) the importance ascribed to the aspects of care. A third element, the cost to increase the aspects of care, might also be important. However, the impact of this element on the optimal solution is currently unknown. ACADEMIC EMERGENCY MEDICINE 2009; 16:136–144 ª 2008 by the Society for Academic Emergency Medicine Keywords: patient satisfaction, emergency services, quality assuranc

Nurse‐Physician Relationships in Ambulatory Oncology Settings

Purpose: The purpose of this study was to explore nurses’ perceptions of nurse‐physician relationships in ambulatory oncology settings, which are linked to patient safety. Design: This cross‐sectional, descriptive study analyzed survey data collected in 2010 from oncology nurses employed in ambulatory settings. The sampling frame was the nurse licensure database in one state in the Southeastern United States. Nurses completed the Practice Environment Scale of the Nursing Work Index (PES‐NWI), reported on the quality of care in their setting, and commented on factors that promoted or inhibited high‐quality care delivery. Methods: Data analysis used three study variables: empirically derived values from the PES‐NWI, a scale of nurse‐reported quality of care in their setting, and open‐text comments about features in their workplace that promoted or hindered high‐quality care. After categorizing open‐text comments, analysis of variance was used to evaluate differences in PES‐NWI subscales by comment category. Chi‐square test statistics were calculated to examine differences in overall practice environment and quality of care by comment category. Results: Nurses reported their relationships with physicians as generally favorable. Qualitative findings suggest two themes that influence how nurses characterize their working relationships with physicians: (a) physician behaviors and (b) structural factors. Both PES‐NWI scores and quality of care were rated significantly higher by nurses who wrote favorably about physicians. Conclusions: Favorable nurse‐physician relationships in ambulatory settings may reflect positive workplaces and promote high‐quality care. Clinical Relevance : Consistent with findings from inpatient units, nurse‐physician relationships are important to the quality of ambulatory oncology care. Systematic measurement and attention to reported deficits in these relationships may promote higher quality care. Journal of Nursing Scholarship , 2012; 00:0, 1–8. ©2012 Sigma Theta Tau International .Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/93556/1/j.1547-5069.2012.01458.x.pd

Nucleation in continuous flow cooling sonocrystallization for coiled capillary crystallizers

Nucleation in continuously operated capillary coiled cooling crystallizers is experimentally investigated under the influence of ultrasound. It was found that there is no sharp boundary but rather a transition zone for nucleation under sonication. For this purpose, a tube with an inner diameter of 1.6 mm and a length of 6 m was winded in a coiled flow inverter (CFI) design and immersed into a cooled ultrasonic bath (37 kHz). The CFI design was chosen for improved radial mixing and narrow residence time distribution, which is also investigated. Amino acid l-alanine dissolved in deionized water is employed in a supersaturation range of 1.10 to 1.46 under quiet and sonicated conditions. Nucleation is non-invasive detected using a flow cell equipped with a microscope and camera

The nursing work environment and quality of care: A cross-sectional study using the Essentials of Magnetism II Scale in England

Aims and objectives. To explore the structure of the Essentials of Magnetism II (EOMII) scale using data from nurses working in England; and to describe the impact of different aspects of the nursing work environment on nurse assessed care quality (NACQ). Background. The EOMII Scale was developed in the United States to measure nursing work environments. It has been widely used in the United States and in a number of other countries, but has not yet been used in the United Kingdom. Design. Cross-sectional study. Methods. Registered nurses (n=247) providing direct patient care in two National Health Service hospitals in England completed the EOMII scale and a single-item measuring NACQ. Principal Components Analysis was used to assess the structure of the scale. Correlation and regression analyses were used to describe the relationships between factors and NACQ. Results. A solution with explanatory variance of 45.25% was identified. Forty items loaded on five factors, with satisfactory consistency: i) ward manager support; ii) working as a team; iii) concern for patients; iv) organisational autonomy; and v) constraints on nursing practice. While in univariate analyses each of the factors was significantly associated with NACQ, in multivariate analyses, the relationship between organisational autonomy and NACQ no longer reached significance. However, a multiple mediation model indicated that the effect of organisational autonomy on NACQ was mediated by nurse manager support, working as a team, and concern for patients but not constraints on nursing practice. Conclusions. Subscales of the EOMII identified in an English sample of nurses measured important aspects of the nursing work environment, each of which is related to NACQ. Relevance to clinical practice. The EOMII could be a very useful tool for measuring aspects of the nursing work environment in the English Trusts particularly in relation to the quality of care

Augmented Road Line Detection And Display System

An augmented road line display system that includes one or more sensors installed on a vehicle, one or more external databases, and processing circuitry. The processing circuitry is configured to receive inputs from the one or more databases, sensors of the vehicle, and a sub-system of the vehicle, build and validate a road line model to detect or predict a road line based on the inputs received, determine environmental conditions based on the inputs from one or more of the databases, and a sub-system of the vehicle, assign weights to the inputs received based on the environmental conditions to generate weighted inputs, and execute the road line model to determine the road line based on the weighted inputs.https://digitalcommons.mtu.edu/patents/1157/thumbnail.jp

Structures and Practices Enabling Staff Nurses to Control Their Practice

This mixed-methods study uses interviews, participant observations, and the CWEQII empowerment tool to identify structures and attributes of structures that promote control over nursing practice (CNP). Nearly 3,000 staff nurses completed the Essentials of Magnetism (EOM), an instrument that measures CNP, one of the eight staff nurse-identified essential attributes of a productive work environment. Strategic sampling is used to identify 101 high CNP-scoring clinical units in 8 high-EOM scoring magnet hospitals. In addition to 446 staff nurses, managers, and physicians on these high-scoring units, chief nursing officers, chief operating officers, and representatives from other professional departments are interviewed; participant observations are made of all unit/departmental/hospital council and interdisciplinary meetings held during a 4 to 6 day site visit. Structures and components of viable shared governance structures that enabled CNP are identified through constant comparative analysis of interviews and observations, and through analysis of quantitative measures

Efficient short-cut method for determining the process window in stirred-pulsed extraction columns

Recent studies showed the superior separation performance of stirred‐pulsed columns of different diameters in liquid‐liquid extraction processes. Here, an efficient shortcut method will be presented, which is time and resource‐efficient as well as cost‐effective to determine the operational window of these columns for industrial separation tasks. Savings in time of less experiments and costs of materials consumption can be estimated with up to 30 %. The presented method is particularly suitable before the application of new chemical systems, which are particularly cost‐intensive and scarce in material supply

A DFD Based Approach to Model Data Processing Solutions

This paper introduces procedures, which facilitate the development of as well as the linking between modular data processing processes into different and versatile system solutions. Based on the concept of data flow diagrams (Yourdon 1989), processes and data flows are used. With the ability of a process to harness any amount of in- and outputs with different sources and destinations, it is possible to model any conceivable data processing problem. By aggregating a diagram as a new process, it becomes possible to outsource partial process chains to different abstraction levels. As a result, even very complex solutions can be modeled and explained in a clear way. The introduced uniform termination flow while traversing the graph creates a good readability, which also makes it possible to quickly detect weaknesses. Moreover, this solution is comprehensive and advances the cooperation in teams and development.In diesem Beitrag wird ein Verfahren vorgestellt, welches die Entwicklung und Verknüpfung modularer Datenverarbeitungsprozesse zu beliebigen, unterschiedlichen Gesamtlösungen ermöglicht. Aufbauend auf dem Konzept der Datenflussdiagramme (Yourdon 1989) kommen Prozesse und Datenströme zum Einsatz. Dabei kann ein Prozess beliebig viele Inputs und Outputs mit unterschiedlichen Quellen und Senken haben und jedes denkbare Datenverarbeitungsproblem modelliert werden. Durch das verschachtelte Modellieren dieser Diagramme und deren Aggregation zu neuen Prozessen können Teilprozessketten auf unterschiedlichen Abstraktionsebenen ausgelagert werden. So lassen sich auch äußerst komplexe Lösungen übersichtlich modellieren, darstellen und erklären. Eine einheitliche Ablaufregel bei der Traversierung macht dieses Verfahren gut lesbar und lässt gegebenenfalls vorhandene Schwachstellen schnell erkennen. Zudem ist es verständlich und fördert die Zusammenarbeit sowie die gemeinsame Entwicklung