Sample records for understood staffing competence

  1. The influence of staffing and timetabling on achieving competence in surgical extractions. (United States)

    Moore, U; Durham, J; Corbett, I; Thomson, P


    Competence based education is becoming more important in dentistry and medicine. In dentistry clinical skills are assessed using longitudinal assessments or structured objective clinical tests. We have previously presented the assessment of competence in surgical extractions however the success rate for this was poor. The opportunity to alter staffing levels and timetabling arose and we present the influence of this on the achievement of competence. The competence assessments and portfolios of two consecutive years of dental undergraduates were examined after completing their surgical extraction course. The first cohort received 9 sessions of teaching spread over 2 years with one staff supervisor per session. The second cohort received 10 sessions with varying numbers of staff supervisors. The first cohort required 210 staff sessions and performed 275 surgical extractions (mean 4), and 23% achieved competence. The second cohort required 240 staff sessions and performed 403 surgical extractions (mean 6), and 66% achieved competence. Thirty six extra sessions were provided for students in the second cohort who failed to complete their competence during the allocated blocks and following this 99% of the second cohort achieved competence. These differences are significant (P timetabling changes which focus student experience and learning.

  2. Staffing in Radiotherapy: An Activity Based Approach

    International Nuclear Information System (INIS)


    Radiotherapy requires competent professional staff to ensure safe and effective patient treatment and management. There is a need to provide guidelines that recommend appropriate staffing levels to support the initiation of new services as well as the expansion or upgrade of existing services as even simple upgrades or replacement of existing equipment may have a significant impact on staffing needs. Similarly, the introduction of education and training programmes will require staffing adjustments. A calculation algorithm was developed to predict staffing levels based on the inputs that are known or can be easily estimated. This publication complements other IAEA publications used to support the initiation of basic radiation medicine services including Setting up a Radiotherapy Programme: Clinical, Medical Physics, Radiation Protection and Safety Aspects, published in 2008

  3. A grid to facilitate physics staffing justification. (United States)

    Klein, Eric E


    Justification of clinical physics staffing levels is difficult due to the lack of direction as how to equate clinical needs with the staffing levels and competency required. When a physicist negotiates staffing requests to administration, she/he often refers to American College of Radiology staffing level suggestions, and resources such as the Abt studies. This approach is often met with questions as to how to fairly derive the time it takes to perform tasks. The result is often insufficient and/or inexperienced staff handling complex and cumbersome tasks. We undertook development of a staffing justification grid to equate the clinical needs to the quantity and quality of staffing required. The first step is using the Abt study, customized to the clinical setting, to derive time per task multiplied by the anticipated number of such tasks. Inclusion of vacation, meeting, and developmental time may be incorporated along with allocated time for education and administration. This is followed by mapping the tasks to the level of competency/experience needed. For example, in an academic setting the faculty appointment levels correlate with experience. Non-staff personnel, such as IMRT QA technicians or clerical staff, should also be part of the equation. By using the staffing justification grid, we derived strong documentation to justify a substantial budget increase. The grid also proved useful when our clinical demands changed. Justification for physics staffing can be significantly strengthened with a properly developed data-based time and work analysis. A staffing grid is presented, along with a development methodology that facilitated our justification. Though our grid is for a large academic facility, the methodology can be extended to a non-academic setting, and to a smaller scale. This grid method not only equates the clinical needs with the quantity of staffing, but can also help generate the personnel budget, based on the type of staff and personnel required

  4. 77 FR 14832 - Plumchoice, Inc., Including On-Site Leased Workers From Balance Staffing, Insight Global Staffing... (United States)


    ... Staffing, Insight Global Staffing, and Technisource, Scarborough, ME; Amended Certification Regarding..., Inc., including on-site leased workers from Balance Staffing, Insight Global Staffing, and... from Balance Staffing, Insight Global Staffing, and Technisource, Scarborough, Maine, who became...

  5. Effective Staffing Takes a Village: Creating the Staffing Ecosystem. (United States)

    Gavigan, Margaret; Fitzpatrick, Therese A; Miserendino, Carole


    The traditional approaches to staffing and scheduling are often ineffective in assuring sufficient budgeting and deployment of staff to assure the right nurse at the right time for the right cost. As hospital merger activity increases, this exercise is further complicated by the need to rationalize staffing across multiple enterprises and standardize systems and processes. This Midwest hospital system successfully optimized staffing at the unit and enterprise levels by utilizing operations research methodologies. Savings were reinvested to improve staffing models which provided sufficient nonproductive coverage and patient-driven ratios. Over/under-staffing was eliminated in support of the system's recognition that adequate resource planning and deployment are critical to the culture of safety.

  6. Impact of staffing parameters on operational reliability

    International Nuclear Information System (INIS)

    Hahn, H.A.; Houghton, F.K.


    This paper reports on a project related to human resource management of the Department of Energy's (DOE's) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment safety, and health concerns. For the of the current paper, human resource management activities are identified as ''Staffing'' and include the of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability. The work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development

  7. Impact of staffing parameters on operational reliability

    International Nuclear Information System (INIS)

    Hahn, H.A.; Houghton, F.K.


    This paper reports on a project related to human resource management of the Department of Energy (DOEs) High-Level Waste (HLW) Tank program. Safety and reliability of waste tank operations is impacted by several issues, including not only the design of the tanks themselves, but also how operations and operational personnel are managed. As demonstrated by management assessments performed by the Tiger Teams, DOE believes that the effective use of human resources impacts environment, safety, and health concerns. For the purposes of the current paper, human resource management activities are identified as 'Staffing' and include the process of developing the functional responsibilities and qualifications of technical and administrative personnel. This paper discusses the importance of staff plans and management in the overall view of safety and reliability, the work activities and procedures associated with the project, a review of the results of these activities, including a summary of the literature and a preliminary analysis of the data. We conclude that, although identification of staffing issues and the development of staffing plans contributes to the overall reliability and safety of the HLW tanks, the relationship is not well understood and is in need of further development

  8. Poorly Understood Aspects of Striated Muscle Contraction

    Directory of Open Access Journals (Sweden)

    Alf Månsson


    Full Text Available Muscle contraction results from cyclic interactions between the contractile proteins myosin and actin, driven by the turnover of adenosine triphosphate (ATP. Despite intense studies, several molecular events in the contraction process are poorly understood, including the relationship between force-generation and phosphate-release in the ATP-turnover. Different aspects of the force-generating transition are reflected in the changes in tension development by muscle cells, myofibrils and single molecules upon changes in temperature, altered phosphate concentration, or length perturbations. It has been notoriously difficult to explain all these events within a given theoretical framework and to unequivocally correlate observed events with the atomic structures of the myosin motor. Other incompletely understood issues include the role of the two heads of myosin II and structural changes in the actin filaments as well as the importance of the three-dimensional order. We here review these issues in relation to controversies regarding basic physiological properties of striated muscle. We also briefly consider actomyosin mutation effects in cardiac and skeletal muscle function and the possibility to treat these defects by drugs.

  9. Fabulous award for staffing app. (United States)


    A safe staffing app giving up-to-date information on the number of nurses on the wards at Nottingham University Hospitals NHS Trust scooped top prize at the inaugural Academy of Fabulous NHS Stuffawards in London last week.

  10. Staffing Up for Technology Support. (United States)

    Carter, Kim


    Examines current technology staffing in school districts and compares technology-related roles with a similar study conducted in 1997. Discusses job titles; responsibilities; career paths; lack of technology support in schools; district-level support; teacher training; peer assistance; student roles; collaboration with library media specialists;…

  11. Raising the Bar with Trades Staffing Guidelines. (United States)

    Weidner, Theodore J.


    Examines the APPA's Trades Staffing Guidelines Task Force for college campus building maintenance and presents descriptions of the proposed guideline levels and a matrix of indicators for the Trades Staffing Guidelines. The levels and matrix are intended to mimic features of the custodial staffing guidelines. (GR)

  12. [Impact of Increased Supply of Newly Licensed Nurses on Hospital Nurse Staffing and Policy Implications]. (United States)

    Kim, Yunmi; You, Sunju; Kim, Jinhyun


    This study aimed to analyze the impact of increasing the supply of newly licensed nurses on improving the hospital nurse staffing grades for the period of 2009~2014. Using public administrative data, we analyzed the effect of newly licensed nurses on staffing in 1,594 hospitals using Generalized Estimating Equation (GEE) ordered logistic regression, and of supply variation on improving staffing grades in 1,042 hospitals using GEE logistic regression. An increase of one newly licensed nurse per 100 beds in general units had significantly lower odds of improving staffing grades (grades 6~0 vs. 7) (odds ratio=0.95, p=.005). The supply of newly licensed nurses increased by 32% from 2009 to 2014, and proportion of hospitals whose staffing grade had improved, not changed, and worsened was 19.1%, 70.1%, and 10.8% respectively. Compared to 2009, the supply variation of newly licensed nurses in 2014 was not significantly related to the increased odds of improving staffing grades in the region (OR=1.02, p=.870). To achieve a balance in the regional supply and demand for hospital nurses, compliance with nurse staffing legislation and revisions in the nursing fee differentiation policy are needed. Rather than relying on increasing nurse supply, retention policies for new graduate nurses are required to build and sustain competent nurse workforce in the future. © 2017 Korean Society of Nursing Science

  13. Health Promotion and Wellness Staffing Methods

    National Research Council Canada - National Science Library

    Thomsen, Kim


    ... injuries, and decrease the number of hospital visits. The Army does not have standardized staffing guidelines or models while the mechanisms to determine requirements are fragmented and inconsistent...

  14. Texas Nurse Staffing Trends Before and After Mandated Nurse Staffing Committees. (United States)

    Jones, Terry; Heui Bae, Sung; Murry, Nicole; Hamilton, Patti


    This article describes the evolution of mandated nurse staffing committees in Texas from 2002 to 2009 and presents a study that analyzed nurse staffing trends in Texas using a secondary analysis of hospital staffing data (N = 313 hospitals) from 2000 to 2012 obtained from the American Hospital Association Annual Survey. Nurse staffing patterns based on three staffing variables for registered nurses (RNs), licensed vocational nurses (LVNs), and total licensed nurses were identified: full-time equivalents per 1,000 adjusted patient days, productive hours per adjusted patient day, and RN skill mix. Similar to national trends between 2000 and 2012, most Texas hospitals experienced an increase in RN and total nurse staffing, decrease in LVN staffing, and an increase in RN skill mix. The magnitude of total nurse staffing changes in Texas (5% increase) was smaller than national trends (13.6% increase). Texas's small, rural, government hospitals and those with the highest preregulation staffing levels experienced the least change in staffing between 2000 and 2012: median change of 0 to .13 full-time equivalents per 1,000 adjusted patient days and median change in productive hours per patient day of 0 to .23. The varying effects of staffing committees in different organizational contexts should be considered in future staffing legislative proposals and other policy initiatives. © The Author(s) 2015.

  15. Staffing for Cyberspace Operations: Summary of Analysis (United States)


    I N S T I T U T E F O R D E F E N S E A N A L Y S E S Staffing for Cyberspace Operations: Summary of Analysis Thomas H. Barth Jerome J. Burke...7013 (a)(16) [Jun 2013]. Staffing for Cyberspace Operations: Summary of Analysis Thomas H. Barth Jerome J. Burke Stanley A. Horowitz Mark F. Kaye...civilian employment. 1 Thomas H. Barth et al., “(U) Staffing for Cyberspace Operations,” IDA Paper P

  16. How Book Publishers are Staffing for Multimedia. (United States)

    Protsik, Ralph


    Examines how book publishers are staffing for multimedia developments. Discussion includes competition from software developers, costs, partnerships, professional organizations as the most innovative electronic publishers, cultural problems, human resource polices, hiring, conflict between print and technology staff, marketing, outside…

  17. Human Resources Staffing Plan for the Tank Farm Contractor

    International Nuclear Information System (INIS)

    BOSLEY, J.W.


    The Human Resources Staffing Plan quantified the equivalent staffing needs required for the Tank Farm Contractor (TFC) and its subcontractors to execute the readiness to proceed baseline between FY 2000-2008. The TFC staffing needs were assessed along with the staffings needs of Fluor Hanford and the privatization contractor. The plan then addressed the staffing needs and recruitment strategies required to execute the baseline

  18. Human Resources Staffing Plan for the Tank Farm Contractor

    Energy Technology Data Exchange (ETDEWEB)

    BOSLEY, J.W.


    The Human Resources Staffing Plan quantified the equivalent staffing needs required for the Tank Farm Contractor (TFC) and its subcontractors to execute the readiness to proceed baseline between FY 2000-2008. The TFC staffing needs were assessed along with the staffings needs of Fluor Hanford and the privatization contractor. The plan then addressed the staffing needs and recruitment strategies required to execute the baseline.

  19. How Self-Reliance Is Understood: Viewpoints from One Local ...

    African Journals Online (AJOL)


    Tanzania's 1967 policy of self-reliance (Hultin 1985, p.8). Before looking at the way self-reliance is understood in rural Malawi during a process of development, it may be beneficial to look at some of the tensions between micro and macro forms of development. Leading to Self-Reliance. Development Aid is a term that has ...

  20. How self-reliance is understood: viewpoints from one local ...

    African Journals Online (AJOL)

    How self-reliance is understood: viewpoints from one local community in Malawi. ... model that resists dependence on external aid, empowers community development, and provides opportunities to sustain development activity through local initiative, can be employed to increase social capital leading to sustainable growth.

  1. Urachal tumour: case report of a poorly understood carcinoma

    Directory of Open Access Journals (Sweden)

    Vallarino Luigi


    Full Text Available Abstract Background Urachal carcinoma is an uncommon neoplasm associated with poor prognosis. Case presentation A 45-year-old man was admitted with complaints of abdominal pain and pollakisuria. A soft mass was palpable under his navel. TC-scan revealed a 11 × 6 cm tumor, which was composed of a cystic lesion arising from the urachus and a solid mass component at the urinary bladder dome. The tumor was removed surgically. Histological examination detected poor-differentiated adenocarcinoma, which had invaded the urinary bladder. The patient has been followed up without recurrence for 6 months. Conclusion The urachus is the embryological remnant of urogenital sinus and allantois. Involution usually happens before birth and urachus is present as a median umbilical ligament. The pathogenesis of urachal tumours is not fully understood. Surgery is the treatment of choice and role of adjuvant treatment is not clearly understood.

  2. Donors in Semiconductors - are they Understood in Electronic Era?

    International Nuclear Information System (INIS)

    Dmochowski, Janusz E


    The physics of semiconductors and contemporary electronics cannot be understood without impurities. The hydrogen-like shallow donor (and acceptor) state of electron (hole) bound by Coulomb electrostatic force of excess charge of impurity is used to control conductivity of semiconductors and construct semiconductor diodes, transistors and numerous types of semiconductor electronic and optoelectronic devices, including lasers. Recently, surprisingly, the physics of impurity donors appeared to be much reacher. Experimental evidence has been provided for universal existence of other types of electronic states of the same donor impurity: i) mysterious, deep, DX-type state resulting in metastability - slow hysteresis phenomena - understood as two-electron, acceptor-like state of donor impurity, formed upon large lattice distortion or rearrangement around impurity and accompanying capture of second electron, resulting in negative electron correlation energy U; ii) deep, localized, fully symmetric, A1, one-electron donor state of substitutional impurity. The latter state can be formed from the 'ordinary' shallow hydrogen-like state in the process of strong localization of electron by short range, local potential of impurity core, preserving full (A 1 ) symmetry of the substitutional impurity in the host lattice. The 'anticrossing' of the two A 1 (shallow hydrogenic and deep localized) energy levels upon transformation is observed. All types of electronic states of impurity can be universally observed for the same donor impurity and mutual transformation between different states occur upon changing experimental conditions. The knowledge about existence and properties of these n ew , molecular type, donor states in semiconductors seems still await general recognition and positive application in contemporary material and device science and engineering

  3. Selection and development of international indicators on staffing

    NARCIS (Netherlands)

    van Amelsvoort, H.W.C.H.; Hendriks, Maria A.; Scheerens, Jaap


    International comparisons of indicators on staffing are regarded as a useful information base to policymakers. Politically relevant staffing indicators in relation to the costs, planning and quality of education deal with training, working conditions, staff characteristics, and stability and

  4. 42 CFR 9.9 - Facility staffing. (United States)


    ... PUBLIC HEALTH SERVICE, DEPARTMENT OF HEALTH AND HUMAN SERVICES GENERAL PROVISIONS STANDARDS OF CARE FOR... of the activities and chimpanzee population of the sanctuary. The level of staffing shall be adequate... issues related to captive nonhuman primates. Experience in these areas dealing specifically with...

  5. Staffing the Global Organization: "Cultural Nomads" (United States)

    McPhail, Ruth; Fisher, Ron; Harvey, Michael; Moeller, Miriam


    This article explores the evolution of international staffing in an increasingly globalized and hypercompetitive marketplace. As the issue of staff retention becomes critical in global organizations, it is important to understand the types of managers that may be on or assigned to overseas assignments. The purpose of this article is to present a…

  6. Staffing Policy for Solving the Information Security

    Directory of Open Access Journals (Sweden)

    A. I. Tolstoy


    Full Text Available Determining staffing policy implementation of information security tasks is given. The basic requirements that must be taken into account when developing policies are defined. The policy framework is determined and recommendations for the design of such policies are formulated. Requirements for the implementation of the policy are defined.

  7. Computerized nursing staffing: a software evaluation. (United States)

    Pereira, Irene Mari; Gaidzinski, Raquel Rapone; Fugulin, Fernanda Maria Togeiro; Peres, Heloísa Helena Ciqueto; Lima, Antônio Fernandes Costa; Castilho, Valéria; Mira, Vera Lúcia; Massarollo, Maria Cristina Komatsu Braga


    The complexity involved in operationalizing the method for nursing staffing, in view of the uncountable variable related to identifying the workload, the effective working time of the staff, and the Technical Security Index (TSI) revealed the need to develop a software program named: Computerized Nursing Staffing (DIPE, in Portuguese acronyms). This exploratory, descriptive study was performed with the objective to evaluate the technical quality and functional performance of DIPE. Participants were eighteen evaluators, ten of whom where nurse faculty or nurse hospital unit managers, and eight health informatics experts. The software evaluation was performed according to norm NBR ISO/IEC 9126-1, considering the features functionality, reliability, usability, efficiency, and maintainability. The software evaluation reached positive results and agreement among the evaluators for all the evaluated features. The reported suggestions are important for proposing further improving and enhancing the DIPE.

  8. Spent Nuclear Fuel Project operational staffing plan

    International Nuclear Information System (INIS)

    Debban, B.L.


    Using the Spent Nuclear Fuel (SNF) Project's current process flow concepts and knowledge from cognizant engineering and operational personnel, an initial assessment of the SNF Project radiological exposure and resource requirements was completed. A small project team completed a step by step analysis of fuel movement in the K Basins to the new interim storage location, the Canister Storage Building (CSB). This analysis looked at fuel retrieval, conditioning of the fuel, and transportation of the fuel. This plan describes the staffing structure for fuel processing, fuel movement, and the maintenance and operation (M ampersand O) staffing requirements of the facilities. This initial draft does not identify the support function resources required for M ampersand O, i.e., administrative and engineering (technical support). These will be included in future revisions to the plan. This plan looks at the resource requirements for the SNF subprojects, specifically, the operations of the facilities, balances resources where applicable, rotates crews where applicable, and attempts to use individuals in multi-task assignments. This plan does not apply to the construction phase of planned projects that affect staffing levels of K Basins

  9. Competence is Competence

    DEFF Research Database (Denmark)

    Bramming, Pia


    The article will address competence, its' diffusion, application, and the consequence of this application within the field of Human Resource Management (HRM). The concept competence-in-practice will be presented and in conclusion the article will consider implications and possibilities...... of competence-in-practice as an alternative approach to Competence Development within Human Resource Management....

  10. Brown & Smith Communication Solutions: A Staffing System Simulation (United States)

    Small, Erika E.; Doll, Jessica L.; Bergman, Shawn M.; Heggestad, Eric D.


    Developing students' practical skills in strategic staffing and selection within the classroom can be challenging. This article describes a staffing system simulation designed to engage students and develop applied skills in strategic recruiting, assessment, and evaluation of job applicants. Instructors looking for a multifaceted team project…

  11. Staffing and job satisfaction: nurses and nursing assistants. (United States)

    Kalisch, Beatrice; Lee, Kyung Hee


    The aim of this study was to examine the relationship between staffing and job satisfaction of registered nurses (RNs) and nursing assistants (NAs). Although a number of previous studies have demonstrated the link between the numbers of patients cared for on the last shift and/or perceptions of staffing adequacy, we could find only one study that utilized a measure of actual staffing (opposed to perceptions of staffing adequacy) and correlated it with job satisfaction of registered nurses. This cross-sectional study included 3523 RNs and 1012 NAs in 131 patient care units. Staff were surveyed to determine job satisfaction and demographic variables. In addition, actual staffing data were collected from each of the study units. Hours per patient day was a significant positive predictor for registered nurse job satisfaction after controlling for covariates. For NAs, a lower skill mix was marginally significant with higher job satisfaction. In addition, the more work experience the NAs reported, the lower their job satisfaction. Adequate staffing levels are essential for RN job satisfaction whereas NA job satisfaction depends on the number of assistive personnel in the mix of nursing staff. Two implications are (1) providing adequate staffing is critical to maintain RN job satisfaction and (2) the NA job needs to be re-engineered to make it a more attractive and satisfying career. © 2012 John Wiley & Sons Ltd.

  12. Managerial implications of calculating optimal nurse staffing in medical units. (United States)

    Bordoloi, S K; Weatherby, E J


    A critical managerial decision in health care organizations is the staffing decision. We offer a model to derive an optimum mix of different staff categories that minimizes total cost subject to constraints imposed by the patient acuity system and minimum staffing policies in a medical unit of Fairbanks Memorial Hospital, Alaska. We also indicate several managerial implications on how our results and their sensitivity analyses can be used effectively in decision making in a variety of categories.

  13. Managerial implications of calculating optimum nurse staffing in medical units. (United States)

    Bordoloi, S K; Weatherby, E J


    A critical managerial decision in health care organizations is the staffing decision. We offer a model to derive an optimum mix of different staff categories that minimizes total cost subject to constraints imposed by the patient acuity system and minimum staffing policies in a medical unit of Fairbanks Memorial Hospital, Alaska. We also indicate several managerial implications on how our results and their sensitivity analyses can be used effectively in decision making in a variety of categories.

  14. Provider staffing effect on a decision aid intervention. (United States)

    Ersek, Mary; Sefcik, Justine S; Lin, Feng-Chang; Lee, Tae Joon; Gilliam, Robin; Hanson, Laura C


    This study examined the association between Nurse Practitioner (NP) and Physician Assistant (PA) staffing in nursing homes and the effect of a decision aid regarding feeding options in dementia on the frequency of surrogate-provider discussions and on surrogates' decisional conflict. We compared these outcomes for facilities that had no NPs/PAs, part-time-only NP/PA staffing, and full-time NP/PA staffing. The sample included 256 surrogate decision makers from 24 nursing homes. The decision aid was associated with significant increases in discussion rates in facilities with part-time or no NP/PA staffing (26% vs. 51%, p vs. 41%, p vs. -0.047, p = .008, and -0.30 vs. -0.68, p = .014, respectively). Sites with full-time NP/PA staffing had high baseline rates of discussions (41%). These findings suggest that the decision aid and full-time NP/PA staffing can enhance surrogate decision making in nursing homes.

  15. Improving Staffing and Nurse Engagement in a Neuroscience Intermediate Unit. (United States)

    Nadolski, Charles; Britt, Pheraby; Ramos, Leah C


    The neuroscience intermediate unit is a 23-bed unit that was initially staffed with a nurse-to-patient ratio of 1:4 to 1:5. In time, the unit's capacity to care for the exceeding number of progressively acute patients fell short of the desired goals in the staff affecting the nurse satisfaction. The clinical nurses desired a lower nurse-patient ratio. The purpose of this project was to justify a staffing increase through a return on investment and increased quality metrics. This initiative used mixed methodology to determine the ideal staffing for a neuroscience intermediate unit. The quantitative section focused on a review of the acuity of the patients. The qualitative section was based on descriptive interviews with University Healthcare Consortium nurse managers from similar units. The study reviewed the acuity of 9,832 patient days to determine the accurate acuity of neuroscience intermediate unit patients. Nurse managers at 12 University Healthcare Consortium hospitals and 8 units at the Medical University of South Carolina were contacted to compare staffing levels. The increase in nurse staffing contributed to an increase in many quality metrics. There were an 80% decrease in controllable nurse turnover and a 75% reduction in falls with injury after the lowered nurse-patient ratio. These 2 metrics established a return on investment for the staffing increase. In addition, the staffing satisfaction question on the Press Ganey employee engagement survey increased from 2.44 in 2013 to 3.72 in 2015 in response to the advocacy of the bedside nurses.

  16. Enhancing Nursing Staffing Forecasting With Safety Stock Over Lead Time Modeling. (United States)

    McNair, Douglas S


    In balancing competing priorities, it is essential that nursing staffing provide enough nurses to safely and effectively care for the patients. Mathematical models to predict optimal "safety stocks" have been routine in supply chain management for many years but have up to now not been applied in nursing workforce management. There are various aspects that exhibit similarities between the 2 disciplines, such as an evolving demand forecast according to acuity and the fact that provisioning "stock" to meet demand in a future period has nonzero variable lead time. Under assumptions about the forecasts (eg, the demand process is well fit as an autoregressive process) and about the labor supply process (≥1 shifts' lead time), we show that safety stock over lead time for such systems is effectively equivalent to the corresponding well-studied problem for systems with stationary demand bounds and base stock policies. Hence, we can apply existing models from supply chain analytics to find the optimal safety levels of nurse staffing. We use a case study with real data to demonstrate that there are significant benefits from the inclusion of the forecast process when determining the optimal safety stocks.

  17. Excellence and evidence in staffing: a data-driven model for excellence in staffing (2nd edition). (United States)

    Baggett, Margarita; Batcheller, Joyce; Blouin, Ann Scott; Behrens, Elizabeth; Bradley, Carol; Brown, Mary J; Brown, Diane Storer; Bolton, Linda Burnes; Borromeo, Annabelle R; Burtson, Paige; Caramanica, Laura; Caspers, Barbara A; Chow, Marilyn; Christopher, Mary Ann; Clarke, Sean P; Delucas, Christine; Dent, Robert L; Disser, Tony; Eliopoulos, Charlotte; Everett, Linda Q; Garcia, Amy; Glassman, Kimberly; Goodwin, Susan; Haagenson, Deb; Harper, Ellen; Harris, Kathy; Hoying, Cheryl L; Hughes-Rease, Marsha; Kelly, Lesly; Kiger, Anna J; Kobs-Abbott, Ann; Krueger, Janelle; Larson, Jackie; March, Connie; Martin, Deborah Maust; Mazyck, Donna; Meenan, Penny; McGaffigan, Patricia; Myers, Karen K; Nell, Kate; Newcomer, Britta; Cathy, Rick; O'Rourke, Maria; Rosa, Billy; Rose, Robert; Rudisill, Pamela; Sanford, Kathy; Simpson, Roy L; Snowden, Tami; Strickland, Bob; Strohecker, Sharon; Weems, Roger B; Welton, John; Weston, Marla; Valentine, Nancy M; Vento, Laura; Yendro, Susan


    The Patient Protection and Affordable Care Act (PPACA, 2010) and the Institute of Medicine's (IOM, 2011) Future of Nursing report have prompted changes in the U.S. health care system. This has also stimulated a new direction of thinking for the profession of nursing. New payment and priority structures, where value is placed ahead of volume in care, will start to define our health system in new and unknown ways for years. One thing we all know for sure: we cannot afford the same inefficient models and systems of care of yesterday any longer. The Data-Driven Model for Excellence in Staffing was created as the organizing framework to lead the development of best practices for nurse staffing across the continuum through research and innovation. Regardless of the setting, nurses must integrate multiple concepts with the value of professional nursing to create new care and staffing models. Traditional models demonstrate that nurses are a commodity. If the profession is to make any significant changes in nurse staffing, it is through the articulation of the value of our professional practice within the overall health care environment. This position paper is organized around the concepts from the Data-Driven Model for Excellence in Staffing. The main concepts are: Core Concept 1: Users and Patients of Health Care, Core Concept 2: Providers of Health Care, Core Concept 3: Environment of Care, Core Concept 4: Delivery of Care, Core Concept 5: Quality, Safety, and Outcomes of Care. This position paper provides a comprehensive view of those concepts and components, why those concepts and components are important in this new era of nurse staffing, and a 3-year challenge that will push the nursing profession forward in all settings across the care continuum. There are decades of research supporting various changes to nurse staffing. Yet little has been done to move that research into practice and operations. While the primary goal of this position paper is to generate research

  18. Nurse dose: linking staffing variables to adverse patient outcomes. (United States)

    Manojlovich, Milisa; Sidani, Souraya; Covell, Christine L; Antonakos, Cathy L


    Inconsistent findings in more than 100 studies have made it difficult to explain how variation in nurse staffing affects patient outcomes. Nurse dose, defined as the level of nurses required to provide patient care in hospital settings, draws on variables used in staffing studies to describe the influence of many staffing variables on outcomes. The aim of this study was to examine the construct validity of nurse dose by determining its association with methicillin-resistant Staphylococcus aureus (MRSA) infections and reported patient falls on a sample of inpatient adult acute care units. Staffing data came from 26 units in Ontario, Canada, and Michigan. Financial and human resource data were data sources for staffing variables. Sources of data for MRSA came from infection control departments. Incident reports were the data source for patient falls. Data analysis consisted of bivariate correlations and Poisson regression. Bivariate correlations revealed that nurse dose attributes (active ingredient and intensity) were associated significantly with both outcomes. Active ingredient (education, experience, skill mix) and intensity (full-time employees, registered nurse [RN]:patient ratio, RN hours per patient day) were significant predictors of MRSA. Coefficients for both attributes were negative and almost identical. Both attributes were significant predictors of reported patient falls, and coefficients were again negative, but coefficient sizes differed. By conceptualizing nurse and staffing variables (education, experience, skill mix, full-time employees, RN:patient ratio, RN hours per patient day) as attributes of nurse dose and by including these in the same analysis, it is possible to determine their relative influence on MRSA infections and reported patient falls.

  19. Perception of Self-Competence in Relation to Language Competence among Preschoolers. (United States)

    Jambunathan, Saigeetha; Norris, Janet A.


    Examined the relation between language competence and self-competence among 3-4 year olds, using the Preschool Language Assessment Inventory. Found that children's perception of self-competence is influenced by their language competence. The finding that linguistically complex items may not be completely understood by children with low-average…

  20. Cluster approach to staffing in the agricultural sector

    Directory of Open Access Journals (Sweden)

    Belaia Nataliia Vladimirovna


    Full Text Available The state of agricultural sector influences every person, determines the potential of national economy and politics. That is why the development of agricultural sector has always been one of the most urgent tasks for Russia and its regions. For the last few years the large-scale government support of the agricultural sector has been maintained which made the problem of peopleware of agricultural sector to be very significant. Staffing is known as fundamental principle of peopleware. Altai region is one of the farm production leaders, and problems of agricultural staffing are becoming more and more important.

  1. 77 FR 40638 - Syniverse Technologies, Inc., Including On-Site Leased Workers From Insight Global Stone Staffing... (United States)


    ... Insight Global Stone Staffing, and Randstad Formerly Known as Sapphire Technologies, Watertown, MA... workers from Insight Global, Stone Staffing, Randstad formerly known as Sapphire Technologies, Watertown... telecommunication services. The company reports that workers leased from Insight Global, Stone Staffing, Randstad...

  2. Relationship Between Staffing and Utilization of Special Collections ...

    African Journals Online (AJOL)

    Findings showed that, there was a gross under-utilization of special collections by users in the libraries studied. A further analysis revealed that significant relationships between staffing with utilization of special collections information resources existed. Based on the findings, the study concluded that, there was gross ...

  3. 5 CFR 9701.363 - Special staffing payments. (United States)


    ... HUMAN RESOURCES MANAGEMENT SYSTEM Pay and Pay Administration Special Payments § 9701.363 Special... 5 Administrative Personnel 3 2010-01-01 2010-01-01 false Special staffing payments. 9701.363 Section 9701.363 Administrative Personnel DEPARTMENT OF HOMELAND SECURITY HUMAN RESOURCES MANAGEMENT...

  4. Staffing UK University Campuses Overseas: Lessons from MNE Practice (United States)

    Salt, John; Wood, Peter


    This article suggests that as their internal labor markets become more multinational in scope, UK universities may acquire similar staffing characteristics to commercial multinational enterprises (MNEs). Comparing evidence from four UK universities with several surveys of MNEs it concludes that, although there are broad similarities in the…

  5. The labor market effects of California's minimum nurse staffing law. (United States)

    Munnich, Elizabeth L


    In 2004, California became the first state to implement statewide minimum nurse-to-patient ratios in general hospitals. In spite of years of work to establish statewide staffing regulations, there is little evidence that the law was effective in attracting more nurses to the hospital workforce or improving patient outcomes. This paper examines the effects of this legislation on employment and wages of registered nurses. By using annual financial data from California hospitals, I show that nurse-to-patient ratios in medical/surgical units increased substantially following the staffing mandate. However, survey data from two nationally representative datasets indicate that the law had no effect on the aggregate number of registered nurses or the hours they worked in California hospitals, and at most a modest effect on wages. My findings suggest that offsetting changes in labor demand due to hospital closures, combined with reclassification of workers within hospitals, and mitigated the employment effects of California's staffing regulation. This paper cautions that California's experience with minimum nurse staffing legislation may not be generalizable to states considering similar policies in very different hospital markets. Copyright © 2013 John Wiley & Sons, Ltd.

  6. Healthcare security staffing for smaller facilities: where science meets art. (United States)

    Warren, Bryan


    Obtaining effective security resourcing and staffing for smaller healthcare facilities presents many difficulties, according to the author In this article, he provides guidance to security practitioners on taking existing data and translating it into a language that administration will understand and appreciate.

  7. Flexible nurse staffing based on hourly bed census predictions

    NARCIS (Netherlands)

    Kortbeek, Nikky; Braaksma, Aleida; Burger, C.A.J.; Bakker, P.J.M; Boucherie, Richardus J.


    Workload on nursing wards depends highly on patient arrivals and patient lengths of stay, which are both inherently variable. Predicting this workload and staffing nurses accordingly is essential for guaranteeing quality of care in a cost effective manner. This paper introduces a stochastic method

  8. Flexible nurse staffing based on hourly bed census predictions

    NARCIS (Netherlands)

    Kortbeek, Nikky; Braaksma, Aleida; Burger, C.A.J.; Bakker, P.J.M; Boucherie, Richardus J.

    Workloads in nursing wards depend highly on patient arrivals and lengths of stay, both of which are inherently variable. Predicting these workloads and staffing nurses accordingly are essential for guaranteeing quality of care in a cost-effective manner. This paper introduces a stochastic method

  9. Leadership, staffing and quality of care in nursing homes

    Directory of Open Access Journals (Sweden)

    Havig Anders


    Full Text Available Abstract Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78. Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses

  10. Leadership, staffing and quality of care in nursing homes (United States)


    Background Leadership and staffing are recognised as important factors for quality of care. This study examines the effects of ward leaders' task- and relationship-oriented leadership styles, staffing levels, ratio of registered nurses and ratio of unlicensed staff on three independent measures of quality of care. Methods A cross-sectional survey of forty nursing home wards throughout Norway was used to collect the data. Five sources of data were utilised: self-report questionnaires to 444 employees, interviews with and questionnaires to 13 nursing home directors and 40 ward managers, telephone interviews with 378 relatives and 900 hours of field observations. Separate multi-level analyses were conducted for quality of care assessed by relatives, staff and field observations respectively. Results Task-oriented leadership style had a significant positive relationship with two of the three quality of care indexes. In contrast, relationship-oriented leadership style was not significantly related to any of the indexes. The lack of significant effect for relationship-oriented leadership style was due to a strong correlation between the two leadership styles (r = 0.78). Staffing levels and ratio of registered nurses were not significantly related to any of the quality of care indexes. The ratio of unlicensed staff, however, showed a significant negative relationship to quality as assessed by relatives and field observations, but not to quality as assessed by staff. Conclusions Leaders in nursing homes should focus on active leadership and particularly task-oriented behaviour like structure, coordination, clarifying of staff roles and monitoring of operations to increase quality of care. Furthermore, nursing homes should minimize use of unlicensed staff and address factors related to high ratios of unlicensed staff, like low staff stability. The study indicates, however, that the relationship between staffing levels, ratio of registered nurses and quality of care is

  11. Staff Assist: A Resource to Improve Nursing Home Quality and Staffing (United States)

    Castle, Nicholas G.


    Purpose: This study describes the creation and use of a web-based resource, designed to help nursing homes implement quality improvements through changes in staffing characteristics. Design and Methods: Information on staffing characteristics (i.e., staffing levels, turnover, stability, and use of agency staff), facility characteristics (e.g.,…

  12. Nurse staffing issues are just the tip of the iceberg: a qualitative study about nurses' perceptions of nurse staffing

    NARCIS (Netherlands)

    van Oostveen, Catharina J.; Mathijssen, Elke; Vermeulen, Hester


    To obtain in-depth insight into the perceptions of nurses in the Netherlands regarding current nurse staffing levels and use of nurse-to-patient-ratios (NPR) and patient classification systems (PCS). In response to rising health care demands due to ageing of the patient population and increasing

  13. Physician staffing needs in critical care departments. (United States)

    Gómez Tello, V; Ruiz Moreno, J; Weiss, M; González Marín, E; Merino de Cos, P; Franco Garrobo, N; Alonso Ovies, A; Montejo González, J C; Iber, T; Marx, G; Córcoles González, V; Gordo Vidal, F; Palencia Herrejón, E; Roca Guiseris, J

    Departments of Critical Care Medicine are characterized by high medical assistance costs and great complexity. Published recommendations on determining the needs of medical staff in the DCCM are based on low levels of evidence and attribute excessive significance to the structural/welfare approach (physician-to-beds ratio), thus generating incomplete and minimalistic information. The Spanish Society of Intensive Care Medicine and Coronary Units established a Technical Committee of experts, the purpose of which was to draft recommendations regarding requirements for medical professionals in the ICU. The Technical Committee defined the following categories: 1) Patient care-related aspects; 2) Activities outside the ICU; 3) Patient safety and clinical management aspects; 4) Teaching; and 5) Research. A subcommittee was established with experts pertaining to each activity category, defining criteria for quantifying the percentage time of the intensivists dedicated to each task, and taking into account occupational category. A quantitative method was applied, the parameters of which were the number of procedures or tasks and the respective estimated indicative times for patient care-related activities within or outside the context of the DCCM, as well as for teaching and research activities. Regarding non-instrumental activities, which are more difficult to evaluate in real time, a matrix of range versus productivity was applied, defining approximate percentages according to occupational category. All activities and indicative times were tabulated, and a spreadsheet was created that modified a previously designed model in order to perform calculations according to the total sum of hours worked and the hours stipulated in the respective work contract. The competencies needed and the tasks which a Department of Critical Care Medicine professional must perform far exceed those of a purely patient care-related character, and cannot be quantified using structural criteria

  14. Nursing home staffing requirements and input substitution: effects on housekeeping, food service, and activities staff. (United States)

    Bowblis, John R; Hyer, Kathryn


    To study the effect of minimum nurse staffing requirements on the subsequent employment of nursing home support staff. Nursing home data from the Online Survey Certification and Reporting (OSCAR) System merged with state nurse staffing requirements. Facility-level housekeeping, food service, and activities staff levels are regressed on nurse staffing requirements and other controls using fixed effect panel regression. OSCAR surveys from 1999 to 2004. Increases in state direct care and licensed nurse staffing requirements are associated with decreases in the staffing levels of all types of support staff. Increased nursing home nurse staffing requirements lead to input substitution in the form of reduced support staffing levels. © Health Research and Educational Trust.

  15. Health Care Evolution Is Driving Staffing Industry Transformation. (United States)

    Faller, Marcia; Gogek, Jim


    The powerful transformation in the health care industry is reshaping not only patient care delivery and the business of health care but also demanding new strategies from vendors who support the health care system. These new strategies may be most evident in workforce solutions and health care staffing services. Consolidation of the health care industry has created increased demand for these types of services. Accommodating a changing workforce and related pressures resulting from health care industry transformation has produced major change within the workforce solutions and staffing services sector. The effect of the growth strategy of mergers, acquisitions, and organic development has revealed organizational opportunities such as expanding capacity for placing physicians, nurses, and allied professionals, among other workforce solutions. This article shares insights into workforce challenges and solutions throughout the health care industry.

  16. Comparing the staffing models of outsourcing in selected companies


    Chaloupková, Věra


    This thesis deals with problems of takeover of employees in outsourcing. The capital purpose is to compare the staffing model of outsourcing in selected companies. To compare in selected companies I chose multi-criteria analysis. This thesis is dividend into six chapters. The first charter is devoted to the theoretical part. In this charter describes the basic concepts as outsourcing, personal aspects, phase of the outsourcing projects, communications and culture. The rest of thesis is devote...

  17. Nursing teamwork, staff characteristics, work schedules, and staffing. (United States)

    Kalisch, Beatrice J; Lee, Hyunhwa


    This study aimed to explore whether and how staff characteristics, staffing, and scheduling variables are associated with the level of teamwork in nursing staff on acute care hospital patient units. This was a cross-sectional study with a sample of 1,758 nursing staff members from two different hospitals on 38 patient care units who completed the Nursing Teamwork Survey in 2008. This study focused on nursing teams who are stationed on a particular patient care unit (as opposed to visitors to the units). The return rate was 56.9%. The sample was made up of 77.4% nurses (registered nurses and licensed practical nurses), 11.9% assistive personnel, and 7.9% unit secretaries. Teamwork varied by unit and service type, with the highest scores occurring in pediatrics and maternity and the lowest scores on the medical-surgical and emergency units. Staff with less than 6 months of experience, those working 8- or 10-hour shifts (as opposed to 12 hours or a combination of 8 and 12 hours), part-time staff (as opposed to full time), and those working on night shift had higher teamwork scores. The higher teamwork scores were also associated with no or little overtime. The higher perception of the adequacy of staffing and the fewer patients cared for on a previous shift, the higher the teamwork scores. There is a relationship between selected staff characteristics, aspects of work schedules, staffing, and teamwork. Nursing staff want to work where teamwork is high, and perceptions of good staffing lead to higher teamwork. Higher teamwork scores correlated with those who worked less overtime.


    Erlingmark, Julia; Hedström, Mariann; Lindberg, Magnus


    Current trends in renal anaemia management place greater emphasis, and thus increased workload, on the role of the nurse in haemodialysis settings. However, there is little evidence that demonstrates the relationship between nurse staffing and patient outcomes. To describe nurse staffing in haemodialysis settings, its relationship with target levels of renal anaemia management and to describe target level achievement for different ways of organising anaemia management. Cross-sectional audit. Forty (out of 78) haemodialysis centres in Sweden reported quality assurance data. The numbers of bedside registered nurses, licensed nurse assistants and patients undergoing haemodialysis during a predefined morning shift; type of anaemia management and achieved target levels of anaemia management. The mean patient:registered nurse ratio was 2.4 and the mean patient:nurse assistant ratio was 12.8. There were no significant relationships between registered nurse staffing and target level achievement. On average, 45.6% of the patients had haemoglobin within the target levels at centres applying nurse-driven anaemia management, compared with 47.3% at physician-driven centres. These cross-sectional data suggest that renal anaemia outcomes are unrelated to the patient:registered nurse ratio. There is, however, room for improvement in renal anaemia management in the units included in this study, particularly the achievement of target levels of haemoglobin and transferrin saturation. © 2016 European Dialysis and Transplant Nurses Association/European Renal Care Association.


    Directory of Open Access Journals (Sweden)

    Tuti Andriani


    Full Text Available Staffing in an organization can be defined as a series of processes and efforts to acquire, develop, motivate, and evaluate the overall human resources. It is required within the organization in achieving its goals. In staffing, putting a person in a work should be in accordance with his capabilities and expertise so that all are expected to be achieved. Job placement principle is the principle of humanity, democracy, the right man on the right place, equal pay for equal work, unity of direction, the principle of unity of purpose, unity of command, Efficiency and Productivity Work. The concept is the placement, promotion, transfer and demotion. Staffing in the Qur'an and Hadith seen from education management is an employee must complete properly, responsibility, trust, has the capability and expertise, serve, work ethic, strong and trustworthy, honest, sincere, true and trustful, physical and mental strength, and high manners. Professionalism in view of sharia is characterized by three things, namely ahliyah (expertise, himmatul 'charity (high work ethic, trustworthy (reliable.

  20. Mathematical Competences

    DEFF Research Database (Denmark)

    Westphael, Henning; Mogensen, Arne


    In this article we present the notion of Mathematical competences as a tool to describe the mathematically gifted students.......In this article we present the notion of Mathematical competences as a tool to describe the mathematically gifted students....

  1. Teacher competencies


    Svatošová, Kateřina


    This diploma thesis deals with adult teacher competencies. It describes current situation in adult education and it focuses on measuring quality level of teacher competencies. There is given the main overview of adult education specifics. These are the prerequisites for defining adult teacher competencies. There is given specific adult teacher competencies and related roles which are generally based on teacher's activities during educational courses. Next part describes present conception of ...

  2. AAOHN Competencies. (United States)


    The AAOHN Competency document is one of the core documents that define occupational health nursing practice. This article provides a description of the process used to update the competencies, as well as a description of the new competencies. © 2015 The Author(s).

  3. Nurse Staffing Patterns and Patient Experience of Care: An Empirical Analysis of U.S. Hospitals. (United States)

    Oppel, Eva-Maria; Young, Gary J


    To examine the relationship between nurse staffing patterns and patients' experience of care in hospitals with a particular focus on staffing flexibility. The study sample comprised U.S. general hospitals between 2010 and 2012. Nurse staffing data came from the American Hospital Association Annual Survey, and patient experience data came from the Medicare Hospital Consumer Assessment of Healthcare Providers and Systems. An observational research design was used entailing a pooled, cross-sectional data set. Regression models were estimated using generalized estimating equation (GEE) and hospital fixed effects. Nurse staffing patterns were assessed based on both levels (i.e., ratio of full-time equivalent nurses per 1,000 patient days) and composition (i.e., skill mix-percentage of registered nurses; staffing flexibility-percentage of part-time nurses). All three staffing variables were significantly associated with patient experience in the GEE analysis, but only staffing flexibility was significant in the fixed-effects analysis. A higher percentage of part-time nurses was positively associated with patient experience. Multiplicative and nonlinear effects for the staffing variables were also observed. Among three staffing variables, flexibility was found to be the most important relative to patient experience. Unobserved hospital characteristics appear to underlie patient experience as well as certain nurse staffing patterns. © Health Research and Educational Trust.

  4. Consequences of Inadequate Staffing Include Missed Care, Potential Failure to Rescue, and Job Stress and Dissatisfaction. (United States)

    Simpson, Kathleen Rice; Lyndon, Audrey; Ruhl, Catherine


    To evaluate responses of registered nurse members of the Association of Women's Health, Obstetric and Neonatal Nurses (AWHONN) to a survey that sought their recommendations for staffing guidelines and their perceptions of the consequences of inadequate nurse staffing. The goal was to use these member data to inform the work of the AWHONN nurse staffing research team. Secondary analysis of responses to the 2010 AWHONN nurse staffing survey. Online. AWHONN members (N = 884). Review of data from an online survey of AWHONN members through the use of thematic analysis for descriptions of the consequences of inadequate nurse staffing during the childbirth process. Three main themes emerged as consequences of inadequate staffing or being short-staffed: Missed Care, Potential for Failure to Rescue, and Job-Related Stress and Dissatisfaction. These themes are consistent with those previously identified in the literature related to inadequate nurse staffing. Based on the responses from participants in the 2010 AWHONN nurse staffing survey, consequences of inadequate staffing can be quite serious and may put patients at risk for preventable harm. Copyright © 2016 AWHONN, the Association of Women's Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  5. How operating room efficiency is understood in a surgical team: a qualitative study. (United States)

    Arakelian, Erebouni; Gunningberg, Lena; Larsson, Jan


    Building surgical teams is one attempt to ensure the health-care system becomes more efficient, but how is 'efficiency' understood or interpreted? The aim was to study how organized surgical team members and their leaders understood operating room efficiency. Qualitative study. A 1100-bed Swedish university hospital. Eleven participants, nine team members from the same team and their two leaders were interviewed. The analysis was performed according to phenomenography, a research approach that aims to discover variations in peoples' understanding of a phenomenon. Seven ways of understanding operating room efficiency were identified: doing one's best from one's prerequisites, enjoying work and adjusting it to the situation, interacting group performing parallel tasks, working with minimal resources to produce desired results, fast work with preserved quality, long-term effects for patient care and a relative concept. When talking about the quality and benefits of delivered care, most team members invoked the patient as the central focus. Despite seven ways of understanding efficiency between the team members, they described their team as efficient. The nurses and assistant nurses were involved in the production and discussed working in a timely manner more than the leaders. The seven ways of understanding operating room efficiency appear to represent both organization-oriented and individual-oriented understanding of that concept in surgical teams. The patient is in focus and efficiency is understood as maintaining quality of care and measuring benefits of care for the patients.

  6. Impact of nonphysician staffing on outcomes in a medical ICU. (United States)

    Gershengorn, Hayley B; Wunsch, Hannah; Wahab, Romina; Leaf, David; Brodie, Daniel; Li, Guohua; Factor, Phillip


    As the number of ICU beds and demand for intensivists increase, alternative solutions are needed to provide coverage for critically ill patients. The impact of different staffing models on the outcomes of patients in the medical ICU (MICU) remains unknown. In our study, we compare outcomes of nonphysician provider-based teams to those of medical house staff-based teams in the MICU. We conducted a retrospective review of 590 daytime (7:00 am-7:00 pm) admissions to two MICUs at one hospital. In one MICU staffed by nurse practitioners and physician assistants (MICU-NP/PA) there were nonphysicians (nurse practitioners and physicians assistants) during the day (7:00 am-7:00 pm) with attending physician coverage overnight. In the other MICU, there were medicine residents (MICU-RES) (24 h/d). The outcomes investigated were hospital mortality, length of stay (LOS) (ICU, hospital), and posthospital discharge destination. Three hundred two patients were admitted to the MICU-NP/PA and 288 to the MICU-RES. Mortality probability model III (MPM(0)-III) predicted mortality was similar (P = .14). There was no significant difference in hospital mortality (32.1% for MICU-NP/PA vs 32.3% for MICU-RES, P = .96), MICU LOS (4.22 ± 2.51 days for MICU-NP/PA vs 4.44 ± 3.10 days for MICU-RES, P = .59), or hospital LOS (14.01 ± 2.92 days for MICU-NP/PA vs 13.74 ± 2.94 days for MICU-RES, P = .86). Discharge to a skilled care facility (vs home) was similar (37.1% for MICU-NP/PA vs 32.5% for MICU-RES, P = .34). After multivariate adjustment, MICU staffing type was not associated with hospital mortality (P = .26), MICU LOS (P = .29), hospital LOS (P = .19), or posthospital discharge destination (P = .90). Staffing models including daytime use of nonphysician providers appear to be a safe and effective alternative to the traditional house staff-based team in a high-acuity, adult ICU.

  7. When caring stops, staffing doesn't matter: part II. (United States)

    Douglas, Kathy


    Response to a column on caring and staffing struck a cord with Nursing Economic$ readers worldwide. Measuring caring is complicated and a healthy debate exists over how exactly to do it. The extraordinary work of Dr. Jean Watson is an excellent resource for understanding how to measure and monitor caring. Beneath the instruments for measuring caring sits foundational work that can help us clarify and understand the topic of caring and just where it sits in our philosophies, intentions, patient care models, and care delivery systems.

  8. California's minimum-nurse-staffing legislation and nurses' wages. (United States)

    Mark, Barbara; Harless, David W; Spetz, Joanne


    In 2004, California became the first state to implement minimum-nurse-staffing ratios in acute care hospitals. We examined the wages of registered nurses (RNs) before and after the legislation was enacted. Using four data sets-the National Sample Survey of Registered Nurses, the Current Population Survey, the National Compensation Survey, and the Occupational Employment Statistics Survey-we found that from 2000 through 2006, RNs in California metropolitan areas experienced real wage growth as much as twelve percentage points higher than the growth in the wages of nurses employed in metropolitan areas outside of California.

  9. Competence articulation:

    DEFF Research Database (Denmark)

    Larsen, Simon Bo; Bardram, Jakob


    Many studies and concepts within CSCW deal with the temporal, spatial, social, and computational aspects of supporting collaborative work. In this paper we want to pay attention to another central aspect to the achievement of collaborative work, namely the competence of the people involved....... In particular, we want to look at the dynamic quality of competences, and investigate how competence is mutually developed in coordinated work. We have termed this process competence articulation, a concept which tries to emphasize competence as well as social development of competence as part of cooperation....... The concept has emerged out of a longitudinal participatory design process investigating telemedical treatment of diabetic foot ulcers using video phones. We analyze the transitions occurring with the introduction of synchronous telemedical consultations and detail how the online video facilitates...

  10. Congenital Vomer Agenesis: A Rare and Poorly Understood Condition Revealed by Cone Beam CT. (United States)

    Yan, David Jun; Lenoir, Vincent; Chatelain, Sibylle; Stefanelli, Salvatore; Becker, Minerva


    Isolated congenital vomer agenesis is a very rare and poorly understood condition. In the context of dental work-up by cone-beam computed tomography (CBCT), the explored volume of the facial bones occasionally reveals incidental abnormalities. We report the case of a 13-year old Caucasian female who underwent CBCT for the pre-treatment evaluation of primary failure of tooth eruption affecting the permanent right upper and inferior molars. CBCT depicted a large defect of the postero-inferior part of the nasal septum without associated soft tissue abnormality and without cranio-facial malformation or cleft palate. In the absence of a history of trauma, chronic inflammatory sinonasal disease, neoplasia and drug abuse, a posterior nasal septum defect warrants the diagnosis of vomer agenesis. A discussion of this condition and of salient CBCT features is provided.

  11. Poorly understood and often miscategorized congenital umbilical cord hernia: an alternative repair method. (United States)

    İnce, E; Temiz, A; Ezer, S S; Gezer, H Ö; Hiçsönmez, A


    Umbilical cord hernia is poorly understood and often miscategorized as "omphalocele minor". Careless clamping of the cord leads to iatrogenic gut injury in the situation of umbilical cord hernia. This study aimed to determine the characteristics and outcomes of umbilical cord hernias. We also highlight an alternative repair method for umbilical cord hernias. We recorded 15 cases of umbilical cord hernias over 10 years. The patients' data were retrospectively reviewed, and preoperative preparation of the newborn, gestational age, birth weight, other associated malformations, surgical technique used, enteral nutrition, and length of hospitalization were recorded. This study included 15 neonates with umbilical cord hernias. The mean gestational age at the time of referral was 38.2 ± 2.1 umbilical cord hernia, the body folds develop normally and form the umbilical ring. The double purse-string technique is easy to apply and produces satisfactory cosmetic results in neonates with umbilical cord hernias.

  12. Radiotherapy facilities, equipment, and staffing in Poland: 2005–2011 (United States)

    Reinfuss, Marian; Byrski, Edward; Malicki, Julian


    Background and purpose To evaluate the current status of radiotherapy facilities, staffing, and equipment, treatment and patients in Poland for the years 2005–2011 following implementation of the National Cancer Programme. Methods A survey was sent to the radiotherapy centres in Poland to collect data on available equipment, staffing, and treatments in the years 2005–2011. Results In 2011, 76,000 patients were treated with radiotherapy at 32 centres vs. 63,000 patients at 23 centres in 2005. Number of patients increased by 21%. In 2011, there were 453 radiation oncologists – specialists (1 in 168 patients), 325 medical physicists (1 in 215 patients), and 883 radiotherapy technicians (1 in 86 patients) vs. 320, 188, and 652, respectively, in 2005. The number of linear accelerators increased by 60%, from 70 units in 2005 to 112 in 2011. The current linac/patient ratio in Poland is 1 linac per 678 patients. Waiting times from diagnosis to the start of treatment has decreased. Conclusion Compared to 2005, there are more treatment facilities, more and better equipment (linacs), and more cancer care specialists. There are still large differences between the 16 Polish provinces in terms of equipment availability and ease of access to treatment. However, radiotherapy services in Poland have improved dramatically since the year 2005. PMID:24416548

  13. Competence Building

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    on the one hand, and the real world of innovation policy-making on the other, typically not speaking to each other. With this purpose in mind, this paper discusses the role of competences and competence-building in the innovation process from a perspective of innovation systems; it examines how governments...

  14. Outsourcing competence

    NARCIS (Netherlands)

    Bergstra, J.; Delen, G.; van Vlijmen, B.


    The topic of this paper, competences needed for outsourcing, is organized by first providing a generic competence scheme, which is subsequently instantiated to the area of sourcing and outsourcing. Sourcing and outsourcing are positioned as different areas of activity, neither one of which is

  15. Timespacing competence

    DEFF Research Database (Denmark)

    Laursen, Helle Pia; Mogensen, Naja Dahlstrup


    Drawing on Kramsch’s (2009) conceptualization of the multilingual subject and the symbolic self, in this paper, we explore how multilingual children re-signify three intertwined myths about the bilingual student, linguistic diversity and language competence, when, in the researcher......-generated activity My linguistic world 2014, they are invited to map and talk about their lived experiences as multiple language users seen in the light of place and movement. By demythifying themselves and their linguistic worlds, the children also raise important questions about the notion of linguistic competence....... By perceiving competences from a subjective child perspective, we learn how children do what we call timespacing competence. On that basis, we suggest paying attention to how children themselves timespace competence by focusing (more consistently) on the subjective, social, spatial and temporal dimensions...

  16. Competence Building

    DEFF Research Database (Denmark)

    Borrás, Susana; Edquist, Charles

    The main question that guides this paper is how governments are focusing (and must focus) on competence building (education and training) when designing and implementing innovation policies. With this approach, the paper aims at filling the gap between the existing literature on competences...... on the one hand, and the real world of innovation policy-making on the other, typically not speaking to each other. With this purpose in mind, this paper discusses the role of competences and competence-building in the innovation process from a perspective of innovation systems; it examines how governments...... and public agencies in different countries and different times have actually approached the issue of building, maintaining and using competences in their innovation systems; it examines what are the critical and most important issues at stake from the point of view of innovation policy, looking particularly...

  17. Testing biochemistry revisited: how in vivo metabolism can be understood from in vitro enzyme kinetics.

    Directory of Open Access Journals (Sweden)

    Karen van Eunen

    Full Text Available A decade ago, a team of biochemists including two of us, modeled yeast glycolysis and showed that one of the most studied biochemical pathways could not be quite understood in terms of the kinetic properties of the constituent enzymes as measured in cell extract. Moreover, when the same model was later applied to different experimental steady-state conditions, it often exhibited unrestrained metabolite accumulation.Here we resolve this issue by showing that the results of such ab initio modeling are improved substantially by (i including appropriate allosteric regulation and (ii measuring the enzyme kinetic parameters under conditions that resemble the intracellular environment. The following modifications proved crucial: (i implementation of allosteric regulation of hexokinase and pyruvate kinase, (ii implementation of V(max values measured under conditions that resembled the yeast cytosol, and (iii redetermination of the kinetic parameters of glyceraldehyde-3-phosphate dehydrogenase under physiological conditions.Model predictions and experiments were compared under five different conditions of yeast growth and starvation. When either the original model was used (which lacked important allosteric regulation, or the enzyme parameters were measured under conditions that were, as usual, optimal for high enzyme activity, fructose 1,6-bisphosphate and some other glycolytic intermediates tended to accumulate to unrealistically high concentrations. Combining all adjustments yielded an accurate correspondence between model and experiments for all five steady-state and dynamic conditions. This enhances our understanding of in vivo metabolism in terms of in vitro biochemistry.

  18. The market of human organs: a window into a poorly understood global business. (United States)

    Surman, O S; Saidi, R; Purtilo, R; Simmerling, M; Ko, D; Burke, T F


    The global demand for human organs has set the stage for an exploding and poorly understood global business in human organs. Whenever there is demand for a product, the opportunity for business arises. The form that a business takes is dependent on a complex network of inputs and outputs, each affecting the others. Historically, the details of any specific market are drastically underestimated. Nowhere is this truer than in the market of human organs. The drivers, which propel the "goods" of human organs, form a flourishing business. Critical analysis is essential to understanding of the supply and demand sides and to determine the role of government in regulating the industry. Governmental groups have dismissed formation of a regulated market for organ sales. The concept is nonetheless a topic of active discussion, motivated by the suffering of patients in need of organs and exploitation of the victims of human trafficking. Ethical principles have been invoked on each side of the ensuing debate. Theory in the absence of sufficient data is shaky ground for enactment of new policy. The Aristotelian concept of "practical wisdom" and the pragmatism of William James illuminate the importance of scientific investigation as guide to policy formation. How will stakeholders benefit or lose? What impact might be anticipated in regard to organized medicine's social contract? What can we learn about cross-cultural differences and their effect on the global landscape?

  19. How spirituality is understood and taught in New Zealand medical schools. (United States)

    Lambie, D; Egan, R; Walker, S; MacLeod, R


    The objective of this research was to explore how spirituality is currently understood and taught in New Zealand Medical Schools. A mixed methods study was carried out involving interviews (n = 14) and a survey (n = 73). The first stage of the study involved recorded semi-structured interviews of people involved in curriculum development from the Dunedin School of Medicine (n = 14); which then informed a cross-sectional self-reported electronic survey (n = 73). The results indicate that spirituality is regarded by many involved in medical education in New Zealand as an important part of healthcare that may be taught in medical schools, but also that there is little consensus among this group as to what the topic is about. These findings provide a basis for further discussion about including spirituality in medical curricula, and in particular indicate a need to develop a shared understanding of what 'spirituality' means and how it can be taught appropriately. As a highly secular country, these New Zealand findings are significant for medical education in other secular Western countries. Addressing spirituality with patients has been shown to positively impact a range of health outcomes, but how spirituality is taught in medical schools is still developing across the globe.

  20. Improvements in nuclear plant staffing resulting from the AP600 design programme

    International Nuclear Information System (INIS)

    Mycoff, C.


    The staffing for a single-unit AP600 is estimated to require a staff for operation and maintenance about 32% smaller than current generation power plants of similar size. These staffing reductions are driven primarily by various features incorporated into the AP600 plant design. (author)

  1. Development of Staffing Patterns in Six New Medical Schools Established 1952-1960. (United States)

    National Institutes of Health (DHEW), Bethesda, MD. Resources Analysis Branch.

    This summary report of staffing patterns in 6 medical schools established between 1952 and 1960 is the first phase of a proposed study of biomedical staffing requirements in institutions of higher education, 1965-1975. The 6 schools are: the University of Miami, Albert Einstein College of medicine at Yeshiva University, the University of Florida,…

  2. High School Administrative Staffing in Washington State: Principal Perspectives on Resource Needs and Utilization (United States)

    Steach, John C.


    This mixed methods study explored how high school principals prioritize their work and utilize available human resources to adjust to inadequate administrative staffing. Analysis of staffing levels across the state of Washington and specifically inside two eastern Washington districts framed interview questions for central office administration…

  3. The Influence of Nurse Staffing Levels on Quality of Care in Nursing Homes (United States)

    Hyer, Kathryn; Thomas, Kali S.; Branch, Laurence G.; Harman, Jeffrey S.; Johnson, Christopher E.; Weech-Maldonado, Robert


    Objective: This study examines the relationship between increasing certified nursing assistants (CNAs) and licensed nurse staffing ratios and deficiencies in Florida nursing homes over a 4-year period. Methods: Data from Florida staffing reports and the Online Survey Certification and Reporting database examine the relationship among staffing…

  4. Pre-hospital critical care by anaesthesiologist-staffed pre-hospital services in Scandinavia

    DEFF Research Database (Denmark)

    Krüger, A J; Lossius, H M; Mikkelsen, S


    All Scandinavian countries provide anaesthesiologist-staffed pre-hospital services. Little is known of the incidence of critical illness or injury attended by these services. We aimed to investigate anaesthesiologist-staffed pre-hospital services in Scandinavia with special emphasis on incidence...

  5. The vulnerability of family caregivers in relation to vulnerability as understood by nurses. (United States)

    Sarvimäki, Anneli; Stenbock-Hult, Bettina; Sundell, Eija; Oesch-Börman, Christine


    In Finland, the care of older persons is shifting from institutional care to family care. Research shows that family caregivers experience their situation much in the same way as professional nurses. The nurses' experiences have been studied in terms of vulnerability, and the same perspective could deepen our understanding of family caregivers' experiences. The aim of this study was to gain knowledge of the vulnerability of older caregivers taking care of an ageing family member. The research questions were as follows: How do family caregivers experience vulnerability? How do their experiences relate to vulnerability as understood by nurses? The study was done as a secondary analysis of focus group interviews on the experiences and daily life of older family caregivers. Four caregivers had taken part in monthly interviews during a period of 10 months. The interviews were analysed by deductive and inductive content analysis. The results showed that the caregivers saw caregiving as part of being human. They experienced a variety of feelings and moral agony and were harmed physically, mentally and socially. They showed courage, protected themselves and recognised that being a caregiver also was a source of maturing and developing. These results corresponded with the nurses' understanding of vulnerability. Shame, the experience of duty as a burden, worry and loneliness were themes that were found only among the family caregivers. The use of a matrix may have restricted the analysis, but using it in an unconstrained way allowed for new themes to be created. The results indicate a common humanness and vulnerability in professional and family caregiving. They also show that family caregivers need more support both from society and professionals. © 2016 Nordic College of Caring Science.

  6. Risk-Adjusted Staffing to Improve Patient Value. (United States)

    Pappas, Sharon; Davidson, Nan; Woodard, Jim; Davis, Jennifer; Welton, John M


    The presence of hospital-acquired conditions, infections, or other adverse events are a reflection of inadequate patient safety and can have short and long-term impacts of quality of life for patients as well as financial implications for the hospital. Using unit-level information to develop a tool, the Patient Risk Assessment Profile, nurses on an inpatient surgical unit proactively assessed patient risk to guide staffing decisions and nurse-patient assignment with the goal to improve patient value, reduce adverse events, and avoid unnecessary hospital costs. Findings showed decreased adverse event rates for patient falls, catheter-acquired urinary tract infection, central line-acquired blood stream infection, and pressure ulcer prevalence after the intervention was implemented. In addition, end-of-shift over-time and patient cost per case decreased as well yielding an operational impact in hospital financial performance.

  7. Staffing and Workflow of a Maturing Institutional Repository

    Directory of Open Access Journals (Sweden)

    Debora L. Madsen


    Full Text Available Institutional repositories (IRs have become established components of many academic libraries. As an IR matures it will face the challenge of how to scale up its operations to increase the amount and types of content archived. These challenges involve staffing, systems, workflows, and promotion. In the past eight years, Kansas State University's IR (K-REx has grown from a platform for student theses, dissertations, and reports to also include faculty works. The initial workforce of a single faculty member was expanded as a part of a library-wide reorganization, resulting in a cross-departmental team that is better able to accommodate the expansion of the IR. The resultant need to define staff responsibilities and develop resources to manage the workflows has led to the innovations described here, which may prove useful to the greater library community as other IRs mature.

  8. Managerial Ownership in Nursing Homes: Staffing, Quality, and Financial Performance. (United States)

    Huang, Sean Shenghsiu; Bowblis, John R


    Ownership of nursing homes (NHs) has primarily focused broadly on differences between for-profit (FP), nonprofit (NFP), and government-operated facilities. Yet, among FPs, the understanding of detailed ownership structures at individual NHs is rather limited. Particularly, NH administrators may hold significant equity interests in their facilities, leading to heterogeneous financial incentives and NH outcomes. Through the principal-agent theory, this article studies how managerial ownership of individual facilities affects NH outcomes. We use a unique panel dataset of Ohio NHs (2005-2010) to empirically examine the relationship between managerial equity ownership and NH staffing, quality, and financial performance. We identify facility administrators as owner-managers if they have more than 5% of the equity stakes or are relatives of the owners. The statistical analysis is based on the pooled ordinary least squares and NH-fixed effect models. We find that owner-managed NHs are associated with higher nursing staff levels compared to other FP NHs. Surprisingly, despite higher staffing levels, owner-managed NHs are not associated with better quality and we find no statistically significant difference in financial performance between owner-managed and nonowner-managed FP NHs. Our results do not support the principal-agent model and we offer alternative explanations for future research. Our findings provide empirical evidence that NH ownership structures are more nuanced than simply broadly categorizing facilities as FP or NFP, and our results do not fully align with the standard principal-agent model. The role of managerial ownership should be considered in future NH research and policy discussions. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail:

  9. Graduating Physiotherapy Students' Conceptions of Their Own Competence (United States)

    Kurunsaari, Merja; Tynjälä, Päivi; Piirainen, Arja


    A competence-oriented approach has recently emerged in higher education and thus far, not much attention has been paid to how "competence" itself is understood in education. The purpose of this study was to examine how graduating physiotherapy students perceive their competence at the end of their studies. The data comprised interviews…

  10. Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada (United States)

    Battista, Jerry J.; Patterson, Michael S.; Beaulieu, Luc; Sharpe, Michael B.; Schreiner, L. John; MacPherson, Miller S.; Van Dyk, Jacob


    The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center‐specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per‐case staffing ratios were also determined for larger‐scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center‐specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full‐time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively. PACS numbers: 87.55.N‐, 87.55.Qr PMID:22231223

  11. How Does Rurality Influence the Staffing of Social Service Departments in Nursing Homes? (United States)

    Roberts, Amy Restorick; Bowblis, John R


    Social service departments in nursing homes (NHs) are staffed by qualified social workers (QSWs) and paraprofessionals. Due to greater workforce challenges in rural areas, this article aims to describe the staffing levels and composition of these departments by rurality. Certification and Survey Provider Enhanced Reports data from 2009 to 2015 are used to examine the effect of rurality on social service staffing using random-effects linear panel regressions. The average NH employed 1.8 full-time equivalents (FTEs), with approximately two thirds of social services staffed by QSWs. Large NHs had more staff, but employed fewer staff hours per resident day. Staffing levels were lower and QSWs made up a smaller percentage of staff in rural areas. National trends indicate variability in staffing by NH size and degree of rurality. Very low staffing within rural NHs is a concern, as staff may have less time to respond to residents' needs and these NHs may utilize fewer QSWs. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail:

  12. The relationship of California's Medicaid reimbursement system to nurse staffing levels. (United States)

    Mukamel, Dana B; Kang, Taewoon; Collier, Eric; Harrington, Charlene


    Policy initiatives at the Federal and state level are aimed at increasing staffing in nursing homes. These include direct staffing standards, public reporting, and financial incentives. To examine the impact of California's Medicaid reimbursement for nursing homes which includes incentives directed at staffing. Two-stage limited-information maximum-likelihood regressions were used to model the relationship between staffing [registered nurses (RNs), licensed practical nurses, and certified nursing assistants hours per resident day] and the Medicaid payment rate, accounting for the specific structure of the payment system, endogeneity of payment and case-mix, and controlling for facility and market characteristics. A total of 927 California free-standing nursing homes in 2006. The model included facility characteristics (case-mix, size, ownership, and chain affiliation), market competition and excess demand, labor supply and wages, unemployment, and female employment. The instrumental variable for Medicaid reimbursement was the peer group payment rate for 7 geographical market areas, and the instrumental variables for resident case-mix were the average county revenues for professional therapy establishments and the percent of county population aged 65 and over. Consistent with the rate incentives and rational expectation behavior, expected nursing home reimbursement rates in 2008 were associated with increased RN staffing levels in 2006 but had no relationship with licensed practical nurse and certified nursing assistant staffing. The effect was estimated at 2 minutes per $10 increase in rate. The incentives in the Medicaid system impacted only RN staffing suggesting the need to improve the state's rate setting methodology.

  13. Medical physics staffing for radiation oncology: a decade of experience in Ontario, Canada. (United States)

    Battista, Jerry J; Clark, Brenda G; Patterson, Michael S; Beaulieu, Luc; Sharpe, Michael B; Schreiner, L John; MacPherson, Miller S; Van Dyk, Jacob


    The January 2010 articles in The New York Times generated intense focus on patient safety in radiation treatment, with physics staffing identified frequently as a critical factor for consistent quality assurance. The purpose of this work is to review our experience with medical physics staffing, and to propose a transparent and flexible staffing algorithm for general use. Guided by documented times required per routine procedure, we have developed a robust algorithm to estimate physics staffing needs according to center-specific workload for medical physicists and associated support staff, in a manner we believe is adaptable to an evolving radiotherapy practice. We calculate requirements for each staffing type based on caseload, equipment inventory, quality assurance, educational programs, and administration. Average per-case staffing ratios were also determined for larger-scale human resource planning and used to model staffing needs for Ontario, Canada over the next 10 years. The workload specific algorithm was tested through a survey of Canadian cancer centers. For center-specific human resource planning, we propose a grid of coefficients addressing specific workload factors for each staff group. For larger scale forecasting of human resource requirements, values of 260, 700, 300, 600, 1200, and 2000 treated cases per full-time equivalent (FTE) were determined for medical physicists, physics assistants, dosimetrists, electronics technologists, mechanical technologists, and information technology specialists, respectively.

  14. Staffing decision processes and issues: Case studies of seven US Nuclear Power Plants

    International Nuclear Information System (INIS)

    Melber, B.; Roussel, A.; Baker, K.; Durbin, N.; Hunt, P.; Hauth, J.; Forslund, C.; Terrill, E.; Gore, B.


    The objective of this report is to identify how decisions are made regarding staffing levels and positions for a sample of U.S. nuclear power plants. In this report, a framework is provided for understanding the major forces driving staffing and the implications of staffing decisions for plant safety. The focus of this report is on driving forces that have led to changes in staffing levels and to the establishment of new positions between the mid-1980s and the early 1990s. Processes used at utilities and nuclear power plants to make and implement these staffing decisions are also discussed in the report. While general trends affecting the plant as a whole are presented, the major emphasis of this report is on staffing changes and practices in the operations department, including the operations shift crew. The findings in this report are based on interviews conducted at seven nuclear power plants and their parent utilities. A discussion of the key findings is followed by a summary of the implications of staffing issues for plant safety

  15. Optimizing staffing, quality, and cost in home healthcare nursing: theory synthesis. (United States)

    Park, Claire Su-Yeon


    To propose a new theory pinpointing the optimal nurse staffing threshold delivering the maximum quality of care relative to attendant costs in home health care. Little knowledge exists on the theoretical foundation addressing the inter-relationship among quality of care, nurse staffing, and cost. Theory synthesis. Cochrane Library, PubMed, CINAHL, EBSCOhost Web and Web of Science (25 February - 26 April 2013; 20 January - 22 March 2015). Most of the existing theories/models lacked the detail necessary to explain the relationship among quality of care, nurse staffing and cost. Two notable exceptions are: 'Production Function for Staffing and Quality in Nursing Homes,' which describes an S-shaped trajectory between quality of care and nurse staffing and 'Thirty-day Survival Isoquant and Estimated Costs According to the Nurse Staff Mix,' which depicts a positive quadric relationship between nurse staffing and cost according to quality of care. A synthesis of these theories led to an innovative multi-dimensional econometric theory helping to determine the maximum quality of care for patients while simultaneously delivering nurse staffing in the most cost-effective way. The theory-driven threshold, navigated by Mathematical Programming based on the Duality Theorem in Mathematical Economics, will help nurse executives defend sufficient nurse staffing with scientific justification to ensure optimal patient care; help stakeholders set an evidence-based reasonable economical goal; and facilitate patient-centred decision-making in choosing the institution which delivers the best quality of care. A new theory to determine the optimum nurse staffing maximizing quality of care relative to cost was proposed. © 2017 The Author. Journal of Advanced Nursing © John Wiley & Sons Ltd.

  16. Homeless Caseload is Associated with Behavioral Health and Case Management Staffing in Health Centers. (United States)

    Jones, Emily B; Zur, Julia; Rosenbaum, Sara


    Community health centers provide co-located medical, behavioral, and case management services to meet the unique and complex needs of the underserved, including homeless individuals. Multivariate analysis of staffing patterns in health centers serving high homeless caseloads highlights above-average behavioral and case management staffing, regardless of Health Care for the Homeless funding status. Rural health centers and those in the South had lower behavioral health and enabling services staffing. Implications include the need to monitor disparities, link health centers with available technical assistance, and emphasize integrating co-located behavioral health, enabling, and medical services through grant oversight mechanisms.

  17. How Global Education Is Understood and to What Extent It Is Implemented in One Educator Preparation Program (United States)

    Amewu-Sirleaf, Lydia Valentina


    This mixed method study investigated the overarching question "how global education is understood and implemented in an educator preparation program in a Colorado university". The sub-questions used to answer the research question are: (1) How is global education/perspective understood and implemented by the faculty; (2) How do students…

  18. Avoiding crisis: right-sizing staffing for the future. (United States)

    Best, Michele L


    Workforce issues, especially recruitment and retention of qualified laboratory staff, are major strategic issues that will continue to face laboratory managers over the next 10 years. Major factors affecting the laboratory labor market in the next decade include increased health-care and laboratory testing needs of an aging population, the graying of the laboratory workforce as baby boomers retire, and new technology development. At least two of these factors will increase the demand for qualified laboratory professionals. Vacancy rates for laboratory professionals are increasing at a significant rate and will continue over the next 10 years. Planning will require creativity in staff recruitment and retention strategies and in human resources. Laboratorians no longer will have the luxury of using medical technologists for nonspecialized testing assignments and will need to develop more creative recruiting approaches using fewer highly qualified testing personnel. This article proposes a staffing deployment model that will use medical technologist education and skills more appropriately, will improve retention of medical technologists, and will alleviate the shortage of medical technologists by reducing dependence on them as routine laboratory testing personnel.

  19. Extension Staffing Models to Serve 4-H Clientele in Changing Times

    Directory of Open Access Journals (Sweden)

    Donna R. Gillespie


    Full Text Available In response to budget cuts in 2002, 4-H staffing models were restructured. The response by University of Idaho Extension was intended to continue meeting the needs of Idaho’s citizens with fewer UI Extension faculty. This staffing reorganization led to the formation of the District III 4-H Team who united to bring stronger 4-H programs to south central Idaho and expand programs to underserved audiences. Information from surveys and interviews over the past seven years reflects the effectiveness, challenges and successes of the District III 4-H Team. In Making the Best Better: 4-H Staffing Patterns and Trends in the Largest Professional Network in the Nation (2007, author Kirk A. Astroth notes a nationwide change in 4-H leadership at the county level from 4-H faculty to program assistants or coordinators. The information gathered in our research may help other states determine staffing models to meet the needs of clientele in these changing times.

  20. Synthesis of the project leadership staffing needs for successful development of alternative delivery programs. (United States)


    This research provides a synthesis of practices in organizational structuring and professional staffing of the innovative delivery units in several state DOTs across the nation that are actively utilizing alternative project delivery. Several major c...

  1. Optimizing Fire Department Operations Through Work Schedule Analysis, Alternative Staffing, and Nonproductive Time Reduction (United States)


    fatigue attributed to work-related stressors .19 On the other hand, research has shown that the 48/96 schedule exacerbates sleep deprivation and wellness initiatives, brown-out, fire department funding, peak-usage staffing, four-person staffing, schedule modification, sleep deprivation a significant sleep deprivation risk that impacts the employee’s ability to function at peak levels.7 The 10/14-hour schedule produces better

  2. Minimum Nurse Staffing Legislation and the Financial Performance of California Hospitals (United States)

    Reiter, Kristin L; Harless, David W; Pink, George H; Mark, Barbara A


    Objective To estimate the effect of minimum nurse staffing ratios on California acute care hospitals’ financial performance. Data Sources/Study Setting Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states. Study Design The study employs a difference-in-difference analytical approach. Hospitals are grouped into quartiles based on pre-regulation nurse staffing levels in adult medical-surgical and pediatric units (quartile 1 = lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period. Data Collection/Extraction Methods Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD. Principal Findings Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3. Conclusions Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals. PMID:22150627

  3. Association between patient classification systems and nurse staffing costs in intensive care units: An exploratory study. (United States)

    Stafseth, Siv K; Tønnessen, Tor Inge; Fagerström, Lisbeth


    Nurse staffing costs represent approximately 60% of total intensive care unit costs. In order to analyse resource allocation in intensive care, we examined the association between nurse staffing costs and two patient classification systems: the nursing activities score (NAS) and nine equivalents of nursing manpower use score (NEMS). A retrospective descriptive correlational analysis of nurse staffing costs and data of 6390 patients extracted from a data warehouse. Three intensive care units in a university hospital and one in a regional hospital in Norway. Nurse staffing costs, NAS and NEMS. For merged data from all units, the NAS was more strongly correlated with monthly nurse staffing costs than was the NEMS. On separate analyses of each ICU, correlations were present for the NAS on basic costs and external overtime costs but were not significant. The annual mean nurse staffing cost for 1% of NAS was 20.9-23.1 euros in the units, which was comparable to 53.3-81.5 euros for 1 NEMS point. A significant association was found between monthly costs, NAS, and NEMS. Cost of care should be based on individual patients' nursing care needs. The NAS makes nurses' workload visible and may be a helpful classification system in future planning and budgeting of intensive care resources. Copyright © 2018 Elsevier Ltd. All rights reserved.

  4. [Structure of nurse labor market and determinants of hospital nurse staffing levels]. (United States)

    Park, Bohyun; Seo, Sukyung; Lee, Taejin


    To analyze the structure of Korean nurse labor market and examine its effect on hospital nurse staffing. Secondary data were obtained from Statistics Korea, Education Statistics, and Health Insurance Review & Assessment Service and Patient Survey. Intensity of monopsony in the nurse labor market was measured by Herfindahl Hirshman Index (HHI). Hospital nurse staffing level was divided into high and low. While controlling for confounding factors such as inpatient days and severity mix of patients, effects of characteristics of nurse labor markets on nurse staffing levels were examined using multi-level logistic regressions. For characteristics of nurse labor markets, metropolitan areas had high intensity of monopsony, while the capital area had competitive labor market and the unemployed nurse rate was higher than other areas. Among hospital characteristics, bed occupancy rate was significantly associated with nurse staffing levels. Among characteristics of nurse labor markets, the effect of HHI was indeterminable. The Korean nurse labor market has different structure between the capital and other metropolitan areas. But the effect of the structure of nurse labor market on nurse staffing levels is indeterminable. Characteristics such as occupancy rate and number of beds are significantly associated with nurse staffing levels. Further study in support of the effect of nurse labor market is needed.

  5. Nurse burnout in China: a questionnaire survey on staffing, job satisfaction, and quality of care. (United States)

    Lu, Minmin; Ruan, Hui; Xing, Weijie; Hu, Yan


    The investigators examined how nurse staffing affects nurse job satisfaction and quality of care. Inadequate nurse staffing is a worldwide issue with profound effects on nurse job satisfaction and quality of care. Few studies have examined the relationship between nurse staffing and job satisfaction and quality of care in China. A cross-sectional design was adopted, wherein 873 nurses were surveyed on demographics, nurse staffing, job-related burnout, job dissatisfaction, intent to leave, and quality of care. The median patient-nurse ratio was five; 45.1% nurses reported high levels of job-related burnout, and 55.6%, job dissatisfaction. In adjusted regression models, patient-nurse ratios of four or less were related to a decrease in the odds of job dissatisfaction (odds ratio 0.55, 95% confidence interval 0.36-0.85) and increase in the odds of quality of care (odds ratio 1.78, 95% confidence interval 1.02-2.82). Nurse staffing is associated with job dissatisfaction and quality of care. Nurse managers should maintain an adequate level of nurse staffing, referring to the patient-nurse ratio. They should create new initiatives to increase job satisfaction among nurses and to evaluate their effects. © 2013 John Wiley & Sons Ltd.

  6. The effects of nurse staffing on hospital financial performance: competitive versus less competitive markets. (United States)

    Everhart, Damian; Neff, Donna; Al-Amin, Mona; Nogle, June; Weech-Maldonado, Robert


    Hospitals facing financial uncertainty have sought to reduce nurse staffing as a way to increase profitability. However, nurse staffing has been found to be important in terms of quality of patient care and nursing-related outcomes. Nurse staffing can provide a competitive advantage to hospitals and as a result of better financial performance, particularly in more competitive markets. In this study, we build on the Resource-Based View of the Firm to determine the effect of nurse staffing on total profit margin in more competitive and less competitive hospital markets in Florida. By combining a Florida statewide nursing survey with the American Hospital Association Annual Survey and the Area Resource File, three separate multivariate linear regression models were conducted to determine the effect of nurse staffing on financial performance while accounting for market competitiveness. The analysis was limited to acute care hospitals. Nurse staffing levels had a positive association with financial performance (β = 3.3, p = .02) in competitive hospital markets, but no significant association was found in less competitive hospital markets. Hospitals in more competitive hospital markets should reconsider reducing nursing staff, as these cost-cutting measures may be inefficient and negatively affect financial performance.

  7. Minimum nurse staffing legislation and the financial performance of California hospitals. (United States)

    Reiter, Kristin L; Harless, David W; Pink, George H; Mark, Barbara A


    To estimate the effect of minimum nurse staffing ratios on California acute care hospitals' financial performance. Secondary data from Medicare cost reports, the American Hospital Association's (AHA) Annual Survey, and the California Office of Statewide Health Planning and Development (OSHPD) are combined from 2000 to 2006 for 203 hospitals in California and 407 hospitals in 12 comparison states. The study employs a difference-in-difference analytical approach. Hospitals are grouped into quartiles based on pre-regulation nurse staffing levels in adult medical-surgical and pediatric units (quartile 1=lowest staffing). Differences in operating margin, operating expenses per day, and inpatient operating expenses per discharge for California hospitals within a staffing quartile during the period of regulation are compared to differences at hospitals in comparison states during the same period. Hospital data from Medicare cost reports are merged with nurse staffing measures obtained from AHA and from OSPHD. Relative to hospitals in comparison states, operating margins declined significantly for California hospitals in quartiles 2 and 3. Operating expenses increased significantly in quartiles 1, 2, and 3. Implementation of minimum nurse staffing legislation in California put substantial financial pressure on some hospitals. © Health Research and Educational Trust.

  8. Community health centers employ diverse staffing patterns, which can provide productivity lessons for medical practices. (United States)

    Ku, Leighton; Frogner, Bianca K; Steinmetz, Erika; Pittman, Patricia


    Community health centers are at the forefront of ambulatory care practices in their use of nonphysician clinicians and team-based primary care. We examined medical staffing patterns, the contributions of different types of staff to productivity, and the factors associated with staffing at community health centers across the United States. We identified four different staffing patterns: typical, high advanced-practice staff, high nursing staff, and high other medical staff. Overall, productivity per staff person was similar across the four staffing patterns. We found that physicians make the greatest contributions to productivity, but advanced-practice staff, nurses, and other medical staff also contribute. Patterns of community health center staffing are driven by numerous factors, including the concentration of clinicians in communities, nurse practitioner scope-of-practice laws, and patient characteristics such as insurance status. Our findings suggest that other group medical practices could incorporate more nonphysician staff without sacrificing productivity and thus profitability. However, the new staffing patterns that evolve may be affected by characteristics of the practice location or the types of patients served. Project HOPE—The People-to-People Health Foundation, Inc.

  9. 42 CFR 483.430 - Condition of participation: Facility staffing. (United States)


    ... in psychology from an accredited school. (vi) To be designated as a social worker, an individual must...) Be eligible for a Certificate of Clinical Competence in Speech-Language Pathology or Audiology...: sociology, special education, rehabilitation counseling, and psychology). (xi) If the client's individual...

  10. Intercultural competence


    Barrett, MD


    Intercultural competence is the set of attitudes, skills, knowledge and behaviours which are required for appropriate and effective interaction and communication with people who are perceived to be from a different cultural background from oneself. The term ‘appropriate’ means that the interactions do not violate the cultural rules and norms which are valued by one’s interlocutors, while the term ‘effective’ means that one is able to achieve one’s objectives in the interactions. Intercultural...

  11. Linking Core Competence, Innovation and Firm Performance

    Directory of Open Access Journals (Sweden)

    Öznur Gökkaya


    Full Text Available Organizational resources and capabilities realized by business practitioners and researchershave significant importanceas they support firmperformance and competitive advantage. However, what exactly core competence is not clearly understood since terms such as resource, capability and compe tence are used interchangeably by researchers. From this point forth, this article provides a framework for separating organization's core competencies from resource and capability. We propose three empirical determiners such as uniqueness,inimitability and extendibilityto the research modelfor separating organization's core competencies from resource and capability.Second, the proposed core competence framework serves as a tool for assessing the relationship between core competencies and innovation. Finally, the paper intended to help leaders and managers about how they can enhance firm performance by means of supporting core competencies and innovation.

  12. Staffing requirements for future small and medium reactors

    International Nuclear Information System (INIS)

    McQuade, D.


    As power generators around the world grapple with the challenges of the environment, deregulation, competitions and changing prices of fuels, the economics of running a future power plant are influenced significantly by the component of labour costs. These costs, from plant staff, corporate support and purchased services, will affect the overall plant economics. To achieve improved efficiency and effectiveness of organization structures and staff, vendors and utilities are working jointly to apply lessons learned for future designs. This paper will examine the experience gained to date with Canadian CANDU 6 type reactors both in Canada and abroad. The strategies which have been very successful will be reviewed, together with the results of collaboration between Atomic Energy of Canada and the utilities. An assessment of the staffing numbers is provided as a comparison between current number at a Canadian utility and the projected number from a future plant with the improvements in the design. The influence to the overall plant economics are discussed with some broad generalities that look at the effects of increasing and reducing staff levels showing the probable impact on capacity factor. The lessons from other plants can contribute significantly to the performance improvement process. The paper points to the need for a balanced approach in the future for the distribution of operating maintenance and administration (OM and A) cost between nuclear safety studies; maintenance programs and staff training. In the future, utilities, together with the designers, will have to greatly improve plant maintenance and training. The improved design features detailed in the paper will support this strategy by utilizing operational experience. (author)

  13. The association between nurse staffing and omissions in nursing care: a systematic review. (United States)

    Griffiths, Peter; Recio-Saucedo, Alejandra; Dall'Ora, Chiara; Briggs, Jim; Maruotti, Antonello; Meredith, Paul; Smith, Gary B; Ball, Jane


    To identify nursing care most frequently missed in acute adult inpatient wards and determine evidence for the association of missed care with nurse staffing. Research has established associations between nurse staffing levels and adverse patient outcomes including in-hospital mortality. However, the causal nature of this relationship is uncertain and omissions of nursing care (referred as missed care, care left undone or rationed care) have been proposed as a factor which may provide a more direct indicator of nurse staffing adequacy. Systematic review. We searched the Cochrane Library, CINAHL, Embase and Medline (2006-2016) for quantitative studies of associations between staffing and missed care. We searched key journals, personal libraries and reference lists of articles. Two reviewers independently selected studies. Quality appraisal was based on the National Institute for Health and Care Excellence quality appraisal checklist for studies reporting correlations and associations. Data were abstracted on study design, missed care prevalence and measures of association. Synthesis was narrative. Eighteen studies gave subjective reports of missed care. 75% or more nurses reported omitting some care. Fourteen studies found low nurse staffing levels were significantly associated with higher reports of missed care. There was little evidence that adding support workers to the team reduced missed care. Low Registered Nurse staffing is associated with reports of missed nursing care in hospitals. Missed care is a promising indicator of nurse staffing adequacy. The extent to which the relationships observed represent actual failures is yet to be investigated. This article is protected by copyright. All rights reserved. This article is protected by copyright. All rights reserved.

  14. Organizational Relationship Termination Competence

    DEFF Research Database (Denmark)

    Ritter, Thomas; Geersbro, Jens


    Most firms are involved in a number of customer relationships that drain the firm's resources. However, many firms are hesitant to address this problem. This paper investigates customer relationship termination at the organizational level. We develop and analyze the organizational dimensions...... that a firm's percentage of unwanted customers decreases significantly as acceptance of termination increases, if the firm's definition of unwanted customers is well understood, and if a firm has clear termination routines. In addition, general focus on profitability and external constraints on relationship...... termination are found to significantly affect a firm's relationship termination competence. The findings suggest that managers should regard termination as a legitimate option in customer relationship management. In order to decrease the number of unwanted customers, managers must accept termination...

  15. Examining the value of inpatient nurse staffing: an assessment of quality and patient care costs. (United States)

    Martsolf, Grant R; Auerbach, David; Benevent, Richele; Stocks, Carol; Jiang, H Joanna; Pearson, Marjorie L; Ehrlich, Emily D; Gibson, Teresa B


    Inpatient quality deficits have important implications for the health and well-being of patients. They also have important financial implications for payers and hospitals by leading to longer lengths of stay and higher intensity of treatment. Many of these costly quality deficits are particularly sensitive to nursing care. To assess the effect of nurse staffing on quality of care and inpatient care costs. Longitudinal analysis using hospital nurse staffing data and the Healthcare Cost and Utilization Project State Inpatient Databases from 2008 through 2011. Hospital discharges from California, Nevada, and Maryland (n=18,474,860). A longitudinal, hospital-fixed effect model was estimated to assess the effect of nurse staffing levels and skill mix on patient care costs, length of stay, and adverse events, adjusting for patient clinical and demographic characteristics. Increases in nurse staffing levels were associated with reductions in nursing-sensitive adverse events and length of stay, but did not lead to increases in patient care costs. Changing skill mix by increasing the number of registered nurses, as a proportion of licensed nursing staff, led to reductions in costs. The study findings provide support for the value of inpatient nurse staffing as it contributes to improvements in inpatient care; increases in staff number and skill mix can lead to improved quality and reduced length of stay at no additional cost.

  16. Physician staffing for the practice of psychosomatic medicine in general hospitals: a pilot study. (United States)

    Kunkel, Elisabeth J S; Del Busto, Elena; Kathol, Roger; Stern, Theodore A; Wise, Thomas N; Stoddard, Frederick R; Straus, Joshua; Saravay, Stephen M; Muskin, Philip R; Dresner, Nehama; Harrington, Colin J; Weiner, Joseph; Barnhill, John; Becker, Madeleine; Joseph, Robert C; Oyesanmi, Olugbenga; Fann, Jesse R; Colon, Eduardo; Epstein, Steven; Weinrieb, Robert


    The treatment of psychiatric illnesses, prevalent in the general hospital, requires broadly trained providers with expertise at the interface of psychiatry and medicine. Since each hospital operates under different economic constraints, it is difficult to establish an appropriate ratio of such providers to patients. The authors sought to determine the current staffing patterns and ratios of Psychosomatic Medicine practitioners in general hospitals, to better align manpower with clinical service and educational requirements on consultation-liaison psychiatry services. Program directors of seven academic Psychosomatic Medicine (PM) programs in the Northeast were surveyed to establish current staffing patterns and patient volumes. Survey data were reviewed and analyzed along with data from the literature and The Academy of Psychosomatic Medicine (APM) fellowship directory. Staffing patterns varied widely, both in terms of the number and disciplines of staff providing care for medical and surgical inpatients. The ratio of initial consultations performed per hospital bed varied from 1.6 to 4.6. Although staffing patterns vary, below a minimum staffing level, there is likely to be significant human and financial cost. Efficient sizing of a PM staff must be accomplished in the context of a given institution's patient population, the experience of providers, the presence/absence and needs of trainees, and the financial constraints of the department and institution. National survey data are needed to provide benchmarks for both academic and nonacademic PM services.

  17. Toward cost-effective staffing mixes for Veterans Affairs substance use disorder treatment programs. (United States)

    Im, Jinwoo J; Shachter, Ross D; Finney, John W; Trafton, Jodie A


    In fiscal year (FY) 2008, 133,658 patients were provided services within substance use disorders treatment programs (SUDTPs) in the U.S. Department of Veterans Affairs (VA) health care system. To improve the effectiveness and cost-effectiveness of SUDTPs, we analyze the impacts of staffing mix on the benefits and costs of specialty SUD services. This study demonstrates how cost-effective staffing mixes for each type of VA SUDTPs can be defined empirically. We used a stepwise method to derive prediction functions for benefits and costs based on patients' treatment outcomes at VA SUDTPs nationally from 2001 to 2003, and used them to formulate optimization problems to determine recommended staffing mixes that maximize net benefits per patient for four types of SUDTPs by using the solver function with the Generalized Reduced Gradient algorithm in Microsoft Excel 2010 while conforming to limits of current practice. We conducted sensitivity analyses by varying the baseline severity of addiction problems between lower (2.5 %) and higher (97.5 %) values derived from bootstrapping. Compared to the actual staffing mixes in FY01-FY03, the recommended staffing mixes would lower treatment costs while improving patients' outcomes, and improved net benefits are estimated from $1472 to $17,743 per patient.

  18. An international comparison of commercial nuclear power plant staffing regulations and practice, 1980--1990

    International Nuclear Information System (INIS)

    Melber, B.; Hauth, J.; Terrill, E.; Berk, B.; Gore, B.


    In this report an international review of regulatory and industry practices is provided in the area of nuclear power plant staffing during the 1980s in Canada, France, Germany, Japan, Sweden, and the United Kingdom. The objective of this review is to highlight trends in staffing regulatory approaches, industry practices, and issues of concern in other countries that have potential relevance to nuclear power plant staffing issues in the United States. The decade of the 1980s was marked by a great deal of growth in nuclear power operations internationally; however, growth of nuclear power is not expected to continue in the 1990s except in France and Japan. A continuum of regulatory approaches to staffing was identified, ranging from prescribed regulations that are applied to all licensees (Germany is most similar to the United States in this regard), to indirect staffing regulations where the regulatory authority oversees plant operating practices that are agreed to in the plant operating license (most notably, France and the United Kingdom). Most of the changes observed in staffing regulations and practices in the early 1980s were made in response to the accident at the Three Mile Island Unit 2 nuclear power plant (TMI) in 1979. These changes included the widespread issuance of new operator and licensing requirements and the establishment of national training centers. After the post-TMI changes were implemented, a period of relative stability followed. Changes in the latter half of the 1980s have focused on continuing improvements and additions to training curricula and methods, most notably increased reliance on simulator training

  19. Implementing an inclusive staffing model for today's reference services a practical guide for librarians

    CERN Document Server

    Nims, Julia K; Stevens, Robert


    Reference service remains a core function of modern libraries. However, how and where we provide assistance has evolved with changing technologies and the shifting habits and preferences of our users. One way libraries can provide the on-demand, in-person assistance while managing and developing new services and resources that will benefit current and future users is to reconsider how their reference points and services are staffed and adopt a staff-based reference model. In Implementing an Inclusive Staffing Model for Today's Reference Services, Nims, Storm, and Stevens describe step-by-step

  20. Organization and staffing of the regulatory body for nuclear facilities. Safety guide

    International Nuclear Information System (INIS)


    The purpose of this safety guide is to provide recommendations for national authorities on the appropriate management system, organization and staffing for the regulatory body responsible for the regulation of nuclear facilities in order to achieve compliance with the applicable safety requirements. This safety guide covers the organization and staffing in relation to nuclear facilities such as: enrichment and fuel manufacturing plants. Nuclear power plants. Other reactors such as research reactors and critical assemblies. Spent fuel reprocessing plants. And radioactive waste management facilities such as treatment, storage and disposal facilities. This safety guide also covers issues related to the decommissioning of nuclear facilities, the closure of waste disposal facilities and site rehabilitation

  1. Is restlessness best understood as a process? Reflecting on four boys’ restlessness during music therapy in kindergarten (United States)

    Helle-Valle, Anna; Binder, Per-Einar; Anderssen, Norman; Stige, Brynjulf


    ABSTRACT ADHD can be considered an internationally recognized framework for understanding children’s restlessness. In this context, children’s restlessness is understood as a symptom of neurodevelopmental disorder. However, there are other possible understandings of children’s restlessness. In this article, we explore four boys’ collaborative and creative process as it is described and understood by three adults. The process is framed by a community music therapy project in a Norwegian kindergarten, and we describe four interrelated phases of this process: Exploring musical vitality and cooperation, Consolidating positions, Performing together, and Discovering ripple effects. We discuss these results in relation to seven qualities central to a community music therapy approach: participation, resource orientation, ecology, performance, activism, reflexivity and ethics. We argue that in contrast to a diagnostic approach that entails a focus on individual problems, a community music therapy approach can shed light on adult and systemic contributions to children’s restlessness. PMID:28532331

  2. Determinants and Effects of Nurse Staffing Intensity and Skill Mix in Residential Care/Assisted Living Settings (United States)

    Stearns, Sally C.; Park, Jeongyoung; Zimmerman, Sheryl; Gruber-Baldini, Ann L.; Konrad, Thomas R.; Sloane, Philip D.


    Purpose: Residential care/assisted living facilities have become an alternative to nursing homes for many individuals, yet little information exists about staffing in these settings and the effect of staffing. This study analyzed the intensity and skill mix of nursing staff using data from a four-state study, and their relationship to outcomes.…

  3. 75 FR 45166 - Jeld-Wen, Inc., Hawkins Window Division, Including On-Site Leased Workers of Nicolet Staffing... (United States)


    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-71,014] Jeld-Wen, Inc., Hawkins Window Division, Including On-Site Leased Workers of Nicolet Staffing, Hawkins, WI; Notice of Negative...., Hawkins Window Division, including on-site leased workers of Nicolet Staffing, Hawkins, Wisconsin. Signed...

  4. Guam Medical Staffing Plan Needs Improvement to Ensure Eligible Beneficiaries Will Have Adequate Access to Health Care (United States)


    Commandant of the Marine Corps submits updated force projections and the Secretary of Defense submits a master plan to Congress. Guam Realignment...are responsible for medical personnel assets. 5 NMW personnel used the following formula to determine physician staffing requirements...Okinawa discussed staffing requirements for multiple specialties, including pediatrics , psychiatry, psychology, and emergency room care. NMW

  5. 45 CFR 1336.65 - Staffing and organization of the Revolving Loan Fund: Responsibilities of the Loan Administrator. (United States)


    ... organization table, including: (a) The structure and composition of the Board of Directors of the RLF; (b) The... 45 Public Welfare 4 2010-10-01 2010-10-01 false Staffing and organization of the Revolving Loan... Hawaiian Revolving Loan Fund Demonstration Project § 1336.65 Staffing and organization of the Revolving...

  6. A Bermuda Triangle? A Case Study of the Disappearance of Competence-Based Vocational Training Policy in the Context of Practice. (United States)

    Bates, Inge; Dutson, Judith


    Observations of job training of special needs students were analyzed in terms of operational demands, staffing levels, resources, and trainee interaction. The competence approach often disappeared in the face of more pressing concerns; it serves to legitimate a political response rather than solve an educational problem. (SK)

  7. A Functional Model of Quality Assurance for Psychiatric Hospitals and Corresponding Staffing Requirements. (United States)

    Kamis-Gould, Edna; And Others


    A model for quality assurance (QA) in psychiatric hospitals is described. Its functions (general QA, utilization review, clinical records, evaluation, management information systems, risk management, and infection control), subfunctions, and corresponding staffing requirements are reviewed. This model was designed to foster standardization in QA…

  8. Library/Media Centers in U.S. Public Schools: Growth, Staffing, and Resources. Executive Summary (United States)

    Tuck, Kathy D.; Holmes, Dwight R.


    This study analyzes data collected between 2000 and 2013 from the annual National Center for Education Statistics (NCES) Common Core of Data (CCD) Local Education Agency (School District) Universe Survey; the NCES Schools and Staffing Survey (SASS); and the U.S. Census Bureau Small Area Income and Poverty Estimates Survey (SAIPE). The findings…

  9. Survey of foreign reactor operator qualifications, training, and staffing requirements. Final report

    International Nuclear Information System (INIS)

    Au, M.L.; DiSalvo, R.; Merschoff, E.


    The report is a compilation of the data obtained from a survey of foreign nuclear power plant operator requirements. Included among the considerations are: (1) shift staffing; (2) operator eligibility; (3) operator training programs; (4) operator licensing or certification; and (5) operator retraining. The data obtained from this survey are presented in matrix form and contrasted with U.S. requirements

  10. 76 FR 14101 - Commercial Furniture Group, Inc., Including On-Site Leased Workers From Staffing Solutions... (United States)


    ... Furniture Group, Inc., Including On-Site Leased Workers From Staffing Solutions; Morristown, TN; Commercial Furniture Group, Inc., Chicago, IL; Amended Certification Regarding Eligibility To Apply for Worker... Adjustment Assistance on May 5, 2010, applicable to workers of Commercial Furniture Group, Inc., including on...

  11. Physical Attacks: An Analysis of Teacher Characteristics Using the Schools and Staffing Survey (United States)

    Williams, Thomas O., Jr.; Ernst, Jeremy V.


    This study investigated physical attacks as reported by public school teachers on the most recent Schools and Staffing Survey (SASS) from the National Center for Education Statistics administered by the Institute of Educational Sciences. For this study, characteristics of teachers who responded affirmatively to having been physically attacked in…

  12. Outcomes and Costs of Community Living: Semi-Independent Living and Fully Staffed Group Homes (United States)

    Felce, David; Perry, Jonathan; Romeo, Renee; Robertson, Janet; Meek, Andrea; Emerson, Eric; Knapp, Martin


    In a matched-groups design, costs and quality of life outcomes for adults with intellectual disabilities with relatively low support needs were compared between those in fully staffed group homes (n = 35) and in semi-independent living (n = 35). Data were collected on participant characteristics, setting organization, various lifestyle outcomes,…

  13. A Staffing Profile of United States Online Database Producers: A Model and Discussion of Educational Implications. (United States)

    Lowry, Glenn R.


    Reports results of survey of United States online database producers designed to determine number of personnel employed in intellectual production of databases and provide basis for generation of people employed in frequently recurring staff categories. Implications for education based on needs suggested by staffing patterns are examined.…

  14. 76 FR 73683 - Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing... (United States)


    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing, Andrews International, IBM Corporation... refrigerators and trash compactors. The notice was published in the Federal Register on October 25, 2010 (75 FR...

  15. 76 FR 72978 - Whirlpool Corporation Including On-Site Leased Workers From Career Solutions TEC Staffing... (United States)


    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation Including On-Site Leased Workers From Career Solutions TEC Staffing, Andrews International, IBM Corporation... workers are engaged in the production of refrigerators and trash compactors. The notice was published in...

  16. 75 FR 16512 - Willstaff Staffing Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., Working... (United States)


    ... Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., Working On-Site at Tyler Pipe... MDS Industrial Resources, Inc., working on-site at Tyler Pipe Company, Waterworks Division, South... Staffing Agency, Willstaff Crystal, Inc., and MDS Industrial Resources, Inc., working on-site at Tyler Pipe...

  17. Library/Media Centers in U.S. Public Schools: Growth, Staffing, and Resources. Full Report (United States)

    Tuck, Kathy D.; Holmes, Dwight R.


    At the request of New Business Item: 89 (NBI: 89) adopted at the 2015 NEA Representative Assembly, this study examines the extent to which students have access to public school library/media centers with qualified staff and up-to-date resources. The study explores trends in library/media center openings and closings as well as staffing patterns…

  18. Registered Nurse Staffing Mix and Quality of Care in Nursing Homes: A Longitudinal Analysis (United States)

    Kim, Hongsoo; Harrington, Charlene; Greene, William H.


    Purpose: To examine the relationship between registered nurse (RN) staffing mix and quality of nursing home care measured by regulatory violations. Design and Methods: A retrospective panel data study (1999-2003) of 2 groups of California freestanding nursing homes. One group was 201 nursing homes that consistently met the state's minimum standard…

  19. Successful Implementation of Six Sigma to Schedule Student Staffing for Circulation Service Desks (United States)

    Jankowski, Janiece


    In fall of 2011 the University at Buffalo Libraries circulation department undertook Six Sigma training for the purpose of overhauling its student scheduling process. The department was able to mitigate significant staffing budgetary reductions and resource reallocations and to overcome the unique challenges of scheduling student labor for a…

  20. Nuclear power plant organization and staffing for improved performance: Lessons learned

    International Nuclear Information System (INIS)


    Experience from well operated nuclear power plants (NPPs) around the world indicates that an organizational structure which efficiently supports plant operation is essential in economically achieving both high level of safety and operational performance. At the same time energy markets are being opened to competition in many Member States. It is in consideration of this new competitive energy market that the overall objective of this document is to provide NPP managers information on lessons learned on improving the organization and staffing of NPP activities. Within this overall objective, specific objectives are to: Identify organisational design and staffing principles, Provide examples of how NPPs implement these principles, Identify typical NPP staffing levels, Factors affecting these levels, and staffing trends among various NPP types. Although it is not expected that any particular utility or NPP manager would consider all of the suggestions provided here to be appropriate, it is anticipated that nearly every NPP manager in IAEA Member States would find some ideas useful in improving the efficiency and effectiveness of NPP activities

  1. 38 CFR 58.10 - VA Form 10-3567-State Home Inspection Staffing Profile. (United States)


    ... 38 Pensions, Bonuses, and Veterans' Relief 2 2010-07-01 2010-07-01 false VA Form 10-3567-State Home Inspection Staffing Profile. 58.10 Section 58.10 Pensions, Bonuses, and Veterans' Relief... Profile. ER06JA00.000 ER06JA00.001 ER06JA00.002 ...

  2. 45 CFR 1321.9 - Organization and staffing of the State agency. (United States)


    ... 45 Public Welfare 4 2010-10-01 2010-10-01 false Organization and staffing of the State agency. 1321.9 Section 1321.9 Public Welfare Regulations Relating to Public Welfare (Continued) OFFICE OF HUMAN... PROGRAMS GRANTS TO STATE AND COMMUNITY PROGRAMS ON AGING State Agency Responsibilities § 1321.9...

  3. Reversing Course: The Troubled State of Academic Staffing and a Path Forward (United States)

    American Federation of Teachers (NJ), 2008


    Over the last generation, the instructional staffing system in American higher education has experienced a significant reduction in the proportion of jobs for full-time tenured and tenure-track faculty members and a dramatic growth in fixed-term full- and part-time instructional jobs without tenure. About 70 percent of the people teaching in…

  4. Pharmacist Staffing, Technology Use, and Implementation of Medication Safety Practices in Rural Hospitals (United States)

    Casey, Michelle M.; Moscovice, Ira S.; Davidson, Gestur


    Context: Medication safety is clearly an important quality issue for rural hospitals. However, rural hospitals face special challenges implementing medication safety practices in terms of their staffing and financial and technical resources. Purpose: This study assessed the capacity of small rural hospitals to implement medication safety…

  5. Examining the implementation of collaborative competencies in a critical care setting: Key challenges for enacting competency-based education. (United States)

    Goldman, Joanne; Kitto, Simon; Reeves, Scott


    Interprofessional collaboration is recognised as an important factor in improving patient care in intensive care units (ICUs). Competency frameworks, and more specifically interprofessional competency frameworks, are a key strategy being used to support the development of attitudes, knowledge, skills, and behaviours needed for an interprofessional approach to care. However, evidence for the application of competencies is limited. This study aimed to extend our empirically based understanding of the significance of interprofessional competencies to actual clinical practice in an ICU. An ethnographic approach was employed to obtain an in-depth insight into healthcare providers' perspectives, behaviours, and interactions of interprofessional collaboration in a medical surgical ICU in a community teaching hospital in Canada. Approximately 160 hours of observations were undertaken and 24 semi-structured interviews with healthcare workers were conducted over a period of 6 months. Data were analysed using a directed content approach where two national competency frameworks were used to help generate an understanding of the practice of interprofessional collaboration. Healthcare professionals demonstrated numerous instances of interprofessional communication, role understandings, and teamwork in the ICU setting, which supported a number of key collaborative competencies. However, organisational factors such as pressures for discharge and patient flow, staffing, and lack of prioritisation for interprofessional learning undermined competencies designed to improve collaboration and teamwork. The findings demonstrate that interprofessional competencies can play an important role in promoting knowledge, attitudes, skills, and behaviours needed. However, competencies that promote interprofessional collaboration are dependent on a range of contextual factors that enable (or impede) individuals to actually enact these competencies.

  6. The effects of staffing and training on firm productivity and profit growth before, during, and after the Great Recession. (United States)

    Kim, Youngsang; Ployhart, Robert E


    This study integrates research from strategy, economics, and applied psychology to examine how organizations may leverage their human resources to enhance firm performance and competitive advantage. Staffing and training are key human resource management practices used to achieve firm performance through acquiring and developing human capital resources. However, little research has examined whether and why staffing and training influence firm-level financial performance (profit) growth under different environmental (economic) conditions. Using 359 firms with over 12 years of longitudinal firm-level profit data, we suggest that selective staffing and internal training directly and interactively influence firm profit growth through their effects on firm labor productivity, implying that staffing and training contribute to the generation of slack resources that help buffer and then recover from the effects of the Great Recession. Further, internal training that creates specific human capital resources is more beneficial for prerecession profitability, but staffing is more beneficial for postrecession recovery, apparently because staffing creates generic human capital resources that enable firm flexibility and adaptation. Thus, the theory and findings presented in this article have implications for the way staffing and training may be used strategically to weather economic uncertainty (recession effects). They also have important practical implications by demonstrating that firms that more effectively staff and train will outperform competitors throughout all pre- and postrecessionary periods, even after controlling for prior profitability. (c) 2014 APA, all rights reserved.

  7. Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions. (United States)

    Ms, Suzie Aparicio; Welch Bacon, Cailee E; Parsons, John T; Bay, R Curtis; Cohen, Randy P; DeZeeuw, Terry; McLeod, Tamara C Valovich


    The "Appropriate Medical Coverage for Intercollegiate Athletics" (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices. To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions. Cross-sectional study. Web-based survey. Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff. The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use. The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14). The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1-3 FTE athletic trainers for football would change their compliance status. A uniform definition of the term FTE within collegiate athletics is needed to allow for structured

  8. The Size and Scope of Collegiate Athletic Training Facilities and Staffing. (United States)

    Gallucci, Andrew R; Petersen, Jeffrey C


      Athletic training facilities have been described in terms of general design concepts and from operational perspectives. However, the size and scope of athletic training facilities, along with staffing at different levels of intercollegiate competition, have not been quantified.   To define the size and scope of athletic training facilities and staffing levels at various levels of intercollegiate competition. To determine if differences existed in facilities (eg, number of facilities, size of facilities) and staffing (eg, full time, part time) based on the level of intercollegiate competition.   Cross-sectional study.   Web-based survey.   Athletic trainers (ATs) who were knowledgeable about the size and scope of athletic training programs.   Athletic training facility size in square footage; the AT's overall facility satisfaction; athletic training facility component spaces, including satellite facilities, game-day facilities, offices, and storage areas; and staffing levels, including full-time ATs, part-time ATs, and undergraduate students.   The survey was completed by 478 ATs (response rate = 38.7%) from all levels of competition. Sample means for facilities were 3124.7 ± 4425 ft 2 (290.3 ± 411 m 2 ) for the central athletic training facility, 1013 ± 1521 ft 2 (94 ± 141 m 2 ) for satellite athletic training facilities, 1272 ± 1334 ft 2 (118 ± 124 m 2 ) for game-day athletic training facilities, 388 ± 575 ft 2 (36 ± 53 m 2 ) for athletic training offices, and 424 ± 884 ft 2 (39 ± 82 m 2 ) for storage space. Sample staffing means were 3.8 ± 2.5 full-time ATs, 1.6 ± 2.5 part-time ATs, 25 ± 17.6 athletic training students, and 6.8 ± 7.2 work-study students. Division I schools had greater resources in multiple categories (P training staffing and facilities. The results (1) suggest that the ATs were satisfied with their facilities and (2) highlight the differences in resources among competition levels.

  9. Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions (United States)

    MS, Suzie Aparicio; Welch Bacon, Cailee E.; Parsons, John T.; Bay, R. Curtis; Cohen, Randy P.; DeZeeuw, Terry; McLeod, Tamara C. Valovich


    Context The “Appropriate Medical Coverage for Intercollegiate Athletics” (AMCIA) document was created to support assessment and calculation of athletic training personnel requirements. However, little is known regarding disparities between current and recommended staffing practices. Objective To identify the staffing and employment characteristics of athletic health care services at Football Bowl Subdivision-level institutions. Design Cross-sectional study. Setting Web-based survey. Patients or Other Participants Head athletic trainers and athletic training staff members who were knowledgeable about budget and staff. Main Outcome Measure(s) The survey, Assessment of Staffing Levels at National Collegiate Athletic Association Football Bowl Subdivision-Level Institutions, was used to evaluate personal, university, and staff demographics; staffing and employment topics; and AMCIA variables and use. Results The survey was accessed and partially completed by 104 individuals (response rate = 84.6%). A total of 79 athletic trainers (response rate = 76%) completed the entire survey. One-third of the respondents (34.2%, n = 26) met the recommended number of full-time equivalents (FTEs) for football, two-thirds of the respondents (65.7%, n = 50) failed to meet the recommendation, and 26.2% (n = 27) were missing data needed for FTE calculation. Among those who did not meet the recommended FTEs (n = 50), 38.0% (n = 19) were within 1 FTE of being compliant, 26.0% (n = 13) were within 2 FTEs, and 24.0% (n = 12) were within 3 FTEs. About one-third of respondents (35.9%, n = 37) reported not using the AMCIA, citing lack of funding (29.7%, n = 11), lack of administrative support (21.6%, n = 8), and other reasons (37.8%, n = 14). Conclusions The majority of institutions that used the AMCIA were able to provide justification for staffing. For most of the institutions that failed to meet their recommendation, adding 1–3 FTE athletic trainers for football would change their

  10. Surgeon-level reporting presented by funnel plot is understood by doctors but inaccurately interpreted by members of the public. (United States)

    Bhalla, Ashish; Mehrotra, Prerna; Amawi, Falah; Lund, Jonathan N


    Risk-adjusted outcome data for general surgeons practicing in the United Kingdom were published for the first time in 2013 with the aim of increasing transparency, improving standards, and providing the public with information to aid decision making. Most specialties used funnel plots to present their data. We assess the ability of members of the public (MoP), medical students, nonsurgical doctors (NSD), and surgeons to understand risk-adjusted surgical outcome data. A fictitious outcome dataset was created and presented in the form of a funnel plot to 10 participants from each of the aforementioned group. Standard explanatory text was provided. Each participant was given 5 minutes to review the funnel plot and complete a questionnaire. For each question, there was only 1 correct answer. Completion rate was 100% (n = 40). No difference existed between NSD and surgeons. A significant difference for identification of the "worst performing surgeon" was noted between surgeons and MoP (p funnel plot significantly "more difficult" to interpret than surgeons did (p < 0.01) and NSD (p < 0.01). MoP found these data significantly more "difficult to understand" and were less likely to both spot "outliers" and use this data to inform decisions than doctors. Surgeons should be aware that outcome data may require an alternative method of presentation to be understood by MoP. Copyright © 2015 Association of Program Directors in Surgery. Published by Elsevier Inc. All rights reserved.

  11. Medical physics personnel for medical imaging: requirements, conditions of involvement and staffing levels-French recommendations. (United States)

    Isambert, Aurélie; Le Du, Dominique; Valéro, Marc; Guilhem, Marie-Thérèse; Rousse, Carole; Dieudonné, Arnaud; Blanchard, Vincent; Pierrat, Noëlle; Salvat, Cécile


    The French regulations concerning the involvement of medical physicists in medical imaging procedures are relatively vague. In May 2013, the ASN and the SFPM issued recommendations regarding Medical Physics Personnel for Medical Imaging: Requirements, Conditions of Involvement and Staffing Levels. In these recommendations, the various areas of activity of medical physicists in radiology and nuclear medicine have been identified and described, and the time required to perform each task has been evaluated. Criteria for defining medical physics staffing levels are thus proposed. These criteria are defined according to the technical platform, the procedures and techniques practised on it, the number of patients treated and the number of persons in the medical and paramedical teams requiring periodic training. The result of this work is an aid available to each medical establishment to determine their own needs in terms of medical physics. © The Author 2014. Published by Oxford University Press. All rights reserved. For Permissions, please email:

  12. Guidelines for equipment and staffing of radiotherapy facilities in the European countries

    DEFF Research Database (Denmark)

    Dunscombe, Peter; Grau, Cai; Defourny, Noémie


    BACKGROUND AND PURPOSE: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project...... changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed...... guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. CONCLUSION: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon...

  13. Industrial Fuel Gas Demonstration Plant Program: staffing plan. Deliverable No. 34

    Energy Technology Data Exchange (ETDEWEB)



    This report describes the staffing plans of each industrial team member during final design and construction of the IFGDP. The internal organization of each team member, including the delegation of authority and responsibility within the structure, is discussed. The primary function of the various organizational units are also identified. In addition, a brief summary of the Phase II role of each industrial partner is included. The overall Phase II organization chart is attached.

  14. Generalizable items and modular structure for computerised physician staffing calculation on intensive care units. (United States)

    Weiss, Manfred; Marx, Gernot; Iber, Thomas


    Intensive care medicine remains one of the most cost-driving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks (performed in every patient) and additional tasks (necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks. All three tasks have to be taken into account for calculating the required number of physicians. The calculation tool further allows to determine minimal personnel staffing, distribution of calculated personnel demand regarding type of employee due to working hours per year, shift work or standby duty. This model was introduced and described first by the German Board of Anesthesiologists and the German Society of Anesthesiology and Intensive Care Medicine in 2008 and since has been implemented and updated 2012 in Germany. The modular, flexible nature of the Excel-based calculation tool should allow adaption to the respective legal and organizational demands of different countries. After 8 years of experience with this calculation, we report the generalizable key aspects which may help physicians all around the world to justify realistic workload-oriented personnel staffing needs.

  15. A scientific model to determine the optimal radiographer staffing component in a nuclear medicine department

    International Nuclear Information System (INIS)

    Shipanga, A.N.; Ellmann, A.


    Full text: Introduction: Nuclear medicine in South Africa is developing fast. Much has changed since the constitution of a scientific model for determining an optimum number of radiographer posts in a Nuclear Medicine department in the late 1980's. Aim: The aim of this study was to ascertain whether the number of radiographers required by a Nuclear Medicine department can still be determined according to the norms established in 1988. Methods: A quantitative study using non-experimental evaluation design was conducted to determine the ratios between current radiographer workload and staffing norms. The workload ratios were analysed using the procedures statistics of the Nuclear Medicine department at Tygerberg Hospital. Radiographers provided data about their activities related to patient procedures, including information about the condition of the patients, activities in the radiopharmaceutical laboratory, and patient related administrative tasks. These were factored into an equation relating this data to working hours, including vacation and sick leave. The calculation of Activity Standards and an annual Standard Workload was used to finally calculate the staffing requirements for a Nuclear Medicine department. Results: Preliminary data confirmed that old staffing norms cannot be used in a modern Nuclear Medicine department. Protocols for several types of study have changed, including the additional acquisition of tomographic studies. Interest in the use of time-consuming non-imaging studies has been revived and should be factored Into the equation. Conclusions: All Nuclear Medicine departments In South Africa, where the types of studies performed have changed over the past years, should look carefully at their radiographer staffing ratio to ascertain whether the number of radiographers needed is adequate for the current workload. (author)

  16. Assessment of Innovation Competency

    DEFF Research Database (Denmark)

    Nielsen, Jan Alexis


    of the recorded talk in interaction that occurred in teacher group discussion sessions at 5 upper secondary schools. Based on the analysis, it was possible to extrapolate assessment criteria for 5 subcompetencies relevant to innovation (creative competency, collaboration competency, navigation competency, action...... competency, and communication competency) as well as assessment criteria for a number of skills relevant to these subcompetencies. These assessment criteria, it is argued, largely resonate with existing literature and they provide a detailed glimpse into how assessment of innovation competency could...

  17. Evaluation of a Peer-Staffed Hotline for Families Who Received Genetic Testing for Risk of Breast Cancer

    National Research Council Canada - National Science Library

    Coyne, James


    This project proposed to develop, implement, and evaluate a peer-staffed toll-free hotline for individuals at high risk of developing hereditary breast cancer, either through family history or known BRCA1/2 mutations...

  18. SAP Nuclear Competence Centre

    International Nuclear Information System (INIS)

    Andrlova, Z.


    In this issue we continue and introduce the SAP Nuclear Competence Centre and its head Mr. Igor Dzama. SAP Nuclear Competence Centrum is one of the fi rst competence centres outside ENEL headquarters. It should operate in Slovakia and should have competencies within the whole Enel group. We are currently dealing with the issues of organisation and funding. We are trying to balance the accountability to the NPP directors and to the management of the competence centres at Enel headquarters; we are looking at the relations between the competence centres within the group and defining the services that we will provide for the NPPs. author)

  19. Strategies for using international domain standards within a national context: The case of the Dutch temporary staffing industry

    NARCIS (Netherlands)

    Folmer, Erwin Johan Albert; van Bekkum, Michael; Verhoosel, Jack


    This paper will discuss strategies for using international domain standards within a national context. The various strategies are illustrated by means of a case study of the temporary staffing industry.

  20. [Relationship between nurse staffing and nursing outcomes: a narrative review of literature]. (United States)

    Petrucci, Cristina; Calandro, Maria Teresa; Tresulti, Federica; Baldacchini, Antonio; Lancia, Loreto


    The measurement of nursing sensitive outcomes represents a fundamental element in "Health Management" in order to assess the suitability and quality of care given, particoulaly in hospitals for the acutely ill. To highlight how some variables connected with nurse-staffing can determine the quality of processes and the care outcomes. A narrative review of international literature has been carried out on investigating possible correlation between nurse-staffing characteristics and care outcomes regarding patients, taking into account primary and secondary sources, written either in English or Italian, without time limits. The bibliographical research strategies used, have brought about the restitution of no. 4244 articles were retrived, of these 56 were analyzed. Articles were categorized into 3 specific areas: 1) Which aspects determine the efficacy and quality of nursing care; 2) The direct effects of nursing care on care outcomes; 3) The indirect effects of nursing care on care outcomes. Results confirm the existence of a noticeable relationship between the main components of nurse-staffing and the direct and indirect outcomes on patients health. Longitudinal studies shound be carried out highlighting the results obtained up till now even more and assist in accurately measuring the importance of possible predictive variables on care outcomes correlated to nursing care.

  1. Benefits of High-Intensity Intensive Care Unit Physician Staffing under the Affordable Care Act

    Directory of Open Access Journals (Sweden)

    Sachin Logani


    Full Text Available The Affordable Care Act signed into law by President Obama, with its value-based purchasing program, is designed to link payment to quality processes and outcomes. Treatment of critically ill patients represents nearly 1% of the gross domestic product and 25% of a typical hospital budget. Data suggest that high-intensity staffing patterns in the intensive care unit (ICU are associated with cost savings and improved outcomes. We evaluate the literature investigating the cost-effectiveness and clinical outcomes of high-intensity ICU physician staffing as recommended by The Leapfrog Group (a consortium of companies that purchase health care for their employees and identify ways to overcome barriers to nationwide implementation of these standards. Hospitals that have implemented the Leapfrog initiative have demonstrated reductions in mortality and length of stay and increased cost savings. High-intensity staffing models appear to be an immediate cost-effective way for hospitals to meet the challenges of health care reform.

  2. Hospital nurse staffing and patient mortality, emotional exhaustion, and job dissatisfaction. (United States)

    Halm, Margo; Peterson, Michelle; Kandels, Mary; Sabo, Julie; Blalock, Miriam; Braden, Rebecca; Gryczman, Anna; Krisko-Hagel, Kathryn; Larson, Dave; Lemay, Diane; Sisler, Bette; Strom, Linda; Topham, Debra


    To conduct an investigation similar to a landmark study that investigated the association between nurse-to-patient ratio and patient mortality, failure-to-rescue, emotional exhaustion and job satisfaction of nurses. Cross-sectional analysis of 2709 general, orthopedic, and vascular surgery patients, and 140 staff nurses (42% response rate) caring for these patients in a large Midwestern institution. The main outcome measures were mortality, failure-to-rescue, emotional exhaustion, and job dissatisfaction. Staffing was not a significant predictor of mortality or failure-to-rescue, nor did clinical specialty predict emotional exhaustion or job dissatisfaction. Although these findings reinforce adequate staffing ratios at this institution, programs that support nurses in their daily practice and positively impact job satisfaction need to be explored. The Nursing Research Council not only has heightened awareness of how staffing ratios affect patient and nurse outcomes, but also a broader understanding of how the research process can be used to effectively shape nurse's practice and work environments.

  3. Staffing requirements for future small and medium reactors (SMRs) based on operating experience and projections

    International Nuclear Information System (INIS)


    At the time of this study there were about 160 small and medium sized nuclear power reactors (referred to as SMRs) in operation worldwide, and about 25 more under construction. Operation and maintenance costs for operating SMRs represent a substantial portion of the cost of electricity produced. Of these costs, the direct and indirect cost of staff represents the major cost component. In recent years, particularly since 1990, there has been increased interest in SMRs by many developing countries wishing to take advantage of nuclear power and several small and medium reactor designs are in various stages of development. To enhance the economic competitive position of SMRs relative to alternative methods of electricity generation, it is essential to ensure that new SMRs can be operated reliably and efficiently using the optimum number of staff. This publication reviews the lessons learned from the reactor operation, and the insights gained through the design of new SMRs, with a view to optimizing staffing in order to improve overall plant economics without compromising safety.This publication is intended to evaluate the estimated staffing size of various SMRs, the staff qualification and training required for the operation of future SMRs. and the key issues which impact the staffing requirements that should be considered in the development and deployment of future SMRs

  4. Conflict Prevalence in Primary School and How It Is Understood to Affect Teaching and Learning in Ghana

    Directory of Open Access Journals (Sweden)

    Nana Afia Amponsaa Opoku-Asare


    Full Text Available Verbal and non-verbal interactions that occur daily between teachers and headteachers, teachers and pupils, and among pupils can generate conflict that may adversely affect teaching, learning, and schooling effectiveness. Little attention is, however, paid to the quality of relationships that exists between teachers and pupils, among teachers, among pupils, between teachers and their school heads, and between schools and their local communities. This study sought to investigate conflict prevalence in Ghana’s primary schools, and how relationship conflict is understood to affect teaching and learning at the level of headteachers as administrators, teachers as classroom managers, and pupils as learners, and direct beneficiaries of primary education. Using data gathered via interview, questionnaire administration, and observation in 30 public primary schools in 10 circuits of one district of Ashanti Region, the findings revealed a high prevalence of fighting, heckling, bullying, and other forms of relationship conflict among pupils; strained teacher–pupil relations due to insolence, indiscipline, and use of offensive language; and teacher–parent arguments and quarrels due to harsh punishment and verbal assault of pupils. Teacher–pupil conflicts may extend to teachers excluding the affected pupils from teaching and learning activities, denying them the rights to ask and answer questions, and have their class exercises marked, leading to lowered pupil self-esteem, reduced concentration during lessons, and passive involvement in learning activities, which could result in truancy and school dropout. Strengthening guidance mechanisms and encouraging peer mediation could significantly curb conflict in school environments and thereby raise educational standards in the district.

  5. Developing Approaches to Competence: Away from the Metaphor of Competence as a Hidden Object. (United States)

    Byers, Patrick


    Assessments of linguistic ability amongst inner city African American children in the 1960's and cross-cultural assessments of problem solving skills amongst participants without formal education in several contexts around the world have both demonstrated the need for investigators to distinguish the possible existence of some form of competency from the matter of whether evidence of that competency can be elicited with a particular assessment tool. In both of the previously mentioned cases, the evidence suggests that participants had the competencies in question and failed to demonstrate them (at least partially) as a result of the nature of the assessment context. The current article takes these demonstrations of the need for culturally sensitive assessment as a point of departure, and argues that today, a further development in how competence is understood is necessary. For all its benefits, the idea of culturally sensitive assessment still relies on the problematic characterization of competencies as discrete sets of stable underlying dispositions. Current research from the dynamic systems perspective in psychology suggests that intelligent human action involves the contextual and self-organized emergence of adaptive behavioral solutions, rather than the expression of preplanned, latent competencies. An adequate conceptualization of competence must therefore account for this emergence, rather than positing competencies as hidden or latent behavioral performances.

  6. Developing mathematical modelling competence

    DEFF Research Database (Denmark)

    Blomhøj, Morten; Jensen, Tomas Højgaard


    In this paper we introduce the concept of mathematical modelling competence, by which we mean being able to carry through a whole mathematical modelling process in a certain context. Analysing the structure of this process, six sub-competences are identified. Mathematical modelling competence...... cannot be reduced to these six sub-competences, but they are necessary elements in the development of mathematical modelling competence. Experience from the development of a modelling course is used to illustrate how the different nature of the sub-competences can be used as a tool for finding...... the balance between different kinds of activities in a particular educational setting. Obstacles of social, cognitive and affective nature for the students' development of mathematical modelling competence are reported and discussed in relation to the sub-competences....

  7. Implementation of a Team-based Physician Staffing Model at an Academic Emergency Department

    Directory of Open Access Journals (Sweden)

    Jose V. Nable


    Full Text Available Introduction: There is scant literature regarding the optimal resident physician staffing model of academic emergency departments (ED that maximizes learning opportunities. A department of emergency medicine at a large inner-city academic hospital initiated a team-based staffing model. Its pre-interventional staffing model consisted of residents and attending physicians being separately assigned patients, resulting in residents working with two different faculty providers in the same shift. This study aimed to determine if the post-interventional team-based system, in which residents were paired with a single attending on each shift, would result in improved residents’ learning and clinical experiences as manifested by resident evaluations and the number of patients seen. Methods: This retrospective before-and-after study at an academic ED with an annual volume of 52,000 patients examined the mean differences in five-point Likert-scale evaluations completed by residents assessing their ED rotation experiences in both the original and team-based staffing models. The residents were queried on their perceptions of feeling part of the team, decision-making autonomy, clinical experience, amount of supervision, quality of teaching, and overall rotational experience. We also analyzed the number of patients seen per hour by residents. Paired sample t-tests were performed. Residents who were in the program in the year preceding and proceeding the intervention were eligible for inclusion. Results: 34 of 38 eligible residents were included (4 excluded for lack of evaluations in either the pre- or post-intervention period. There was a statistically significant improvement in resident perception of the quality and amount of teaching, 4.03 to 4.27 (mean difference=0.24, p=0.03. There were non-statistically significant trends toward improved mean scores for all other queries. Residents also saw more patients following the initiation of the team-based model

  8. Building Project Competence

    DEFF Research Database (Denmark)

    Pemsel, Sofia; Wiewiora, Anna

    This research investigates the development of project competence, and particularly, three related dynamic capabilities (shifting, adapting, leveraging) that contribute to project competence development. In doing so, we make use of the emerging literature on knowledge governance and theorize how...... of dynamic capability building promoting project competence development....

  9. Cultural Competence and Related Factors Among Taiwanese Nurses. (United States)

    Lin, Chin-Nu; Mastel-Smith, Beth; Alfred, Danita; Lin, Yu-Hua


    Taiwan is a multicultural and multiethnic society with a growing number of immigrants who have diverse ethnic, racial, and cultural needs. Although this diversity highlights the pressing need for culturally competent healthcare providers, cultural competence is a concept that is little understood and implemented only sporadically in Taiwan. This study investigates the cultural competence of Taiwanese nurses and the related factors of influence. An online self-report survey was used to collect data from 221 Taiwanese nurses from December 2012 through January 2013. Data from the demographic questionnaire, the Nurses' Cultural Competence Scale, and the Perceived Nurses' Cultural Competence Rating were analyzed using descriptive statistics, Pearson correlation, independent sample t tests, and multiple regressions. The cultural competence of the participants was in the "low to moderate" range, with relatively higher mean scores for the subscales of cultural awareness and cultural sensitivity and relatively lower scores for the subscales of cultural knowledge and cultural skills. Participants generally perceived themselves as being "not culturally competent." Variables found to predict cultural competence included years of work experience, hours of continuing education related to cultural nursing care, and frequency of caring for clients from culturally and ethnically diverse backgrounds. Participating Taiwanese nurses rated their level of cultural competence as in the low-to-moderate range and self-perceived as being not culturally competent. These findings support the need to further expand and enhance cultural-competence-related continuing education and to address the topic of cultural care in the nursing curricula.

  10. The European Federation of Organisations for Medical Physics. Policy Statement No. 7.1: The roles, responsibilities and status of the medical physicist including the criteria for the staffing levels in a Medical Physics Department approved by EFOMP Council on 5th February 2016. (United States)

    Evans, Stephen; Christofides, Stelios; Brambilla, Marco


    This EFOMP Policy Statement is an amalgamation and an update of the EFOMP Policy Statements No. 2, 4 and 7. It presents guidelines for the roles, responsibilities and status of the medical physicist together with recommended minimum staffing levels. These recommendations take into account the ever-increasing demands for competence, patient safety, specialisation and cost effectiveness of modern healthcare services, the requirements of the European Union Council Directive 2013/59/Euratom laying down the basic safety standards for protection against the dangers arising from exposure to ionising radiation, the European Commission's Radiation Protection Report No. 174: "Guidelines on medical physics expert", as well as the relevant publications of the International Atomic Energy Agency. The provided recommendations on minimum staffing levels are in very good agreement with those provided by both the European Commission and the International Atomic Energy Agency. Copyright © 2016. Published by Elsevier Ltd.

  11. Organisational quality, nurse staffing and the quality of chronic disease management in primary care: observational study using routinely collected data. (United States)

    Griffiths, Peter; Maben, Jill; Murrells, Trevor


    An association between quality of care and staffing levels, particularly registered nurses, has been established in acute hospitals. Recently an association between nurse staffing and quality of care for several chronic conditions has also been demonstrated for primary care in English general practice. A smaller body of literature identifies organisational factors, in particular issues of human resource management, as being a dominant factor. However the literature has tended to consider staffing and organisational factors separately. We aim to determine whether relationships between the quality of clinical care and nurse staffing in general practice are attenuated or enhanced when organisational factors associated with quality of care are considered. We further aim to determine the relative contribution and interaction between these factors. We used routinely collected data from 8409 English general practices. The data, on organisational factors and the quality of clinical care for a range of long term conditions, is gathered as part of "Quality and Outcomes Framework" pay for performance system. Regression models exploring the relationship of staffing and organisational factors with care quality were fitted using MPLUS statistical modelling software. Higher levels of nurse staffing, clinical recording, education and reflection on the results of patient surveys were significantly associated with improved clinical care for COPD, CHD, Diabetes and Hypothyroidism after controlling for organisational factors. There was some evidence of attenuation of the estimated nurse staffing effect when organisational factors were considered, but this was small. The effect of staffing interacted significantly with the effect of organisational factors. Overall however, the characteristics that emerged as the strongest predictors of quality of clinical care were not staffing levels but the organisational factors of clinical recording, education and training and use of patient

  12. Pre-hospital severe traumatic brain injury - comparison of outcome in paramedic versus physician staffed emergency medical services. (United States)

    Pakkanen, Toni; Virkkunen, Ilkka; Kämäräinen, Antti; Huhtala, Heini; Silfvast, Tom; Virta, Janne; Randell, Tarja; Yli-Hankala, Arvi


    Traumatic brain injury (TBI) is one of the leading causes of death and permanent disability. Emergency Medical Services (EMS) personnel are often the first healthcare providers attending patients with TBI. The level of available care varies, which may have an impact on the patient's outcome. The aim of this study was to evaluate mortality and neurological outcome of TBI patients in two regions with differently structured EMS systems. A 6-year period (2005 - 2010) observational data on pre-hospital TBI management in paramedic-staffed EMS and physician-staffed EMS systems were retrospectively analysed. Inclusion criteria for the study were severe isolated TBI presenting with unconsciousness defined as Glasgow coma scale (GCS) score ≤ 8 occurring either on-scene, during transportation or verified by an on-call neurosurgeon at admission to the hospital. For assessment of one-year neurological outcome, a modified Glasgow Outcome Score (GOS) was used. During the 6-year study period a total of 458 patients met the inclusion criteria. One-year mortality was higher in the paramedic-staffed EMS group: 57 % vs. 42 %. Also good neurological outcome was less common in patients treated in the paramedic-staffed EMS group. We found no significant difference between the study groups when considering the secondary brain injury associated vital signs on-scene. Also on arrival to ED, the proportion of hypotensive patients was similar in both groups. However, hypoxia was common in the patients treated by the paramedic-staffed EMS on arrival to the ED, while in the physician-staffed EMS almost none of the patients were hypoxic. Pre-hospital intubation by EMS physicians probably explains this finding. The results suggest to an outcome benefit from physician-staffed EMS treating TBI patients. ID NCT01454648.

  13. Development and application of an objective staffing calculator for antimicrobial stewardship programs in the Veterans Health Administration. (United States)

    Echevarria, Kelly; Groppi, Julie; Kelly, Allison A; Morreale, Anthony P; Neuhauser, Melinda M; Roselle, Gary A


    The development and validation of a staffing calculator and its use in creating staffing guidance for antimicrobial stewardship programs (ASPs) in Veterans Health Administration (VHA) facilities are described. The Tools and Resources Work Group of the Antimicrobial Stewardship Task Force and PBM Clinical Pharmacy Practice Office of the Department of Veterans Affairs developed, tested, and validated a staffing calculator to track patient care and ASP management activities needed to maintain a comprehensive ASP. Time spent on activities was based on time-in-motion tracking studies and input from experienced antimicrobial stewards. The staffing calculator was validated across VHA facilities of varying sizes and complexities to determine the number of needed clinical pharmacist full-time equivalents (FTEs) to implement and maintain ASPs per 100 occupied beds. A total of 12 facilities completed the staffing calculator for 1 calendar week. The median number of occupied beds was 226. Most facilities had at least 100 occupied beds, and 6 of the 12 were considered high complexity facilities. The median calculated FTE personnel requirement was 2.62, or 1.01 per 100 occupied beds. The majority of FTE time (70%) was spent on patient care activities and 30% on program management activities, including infectious diseases or ASP rounds. The final recommendations indicated that in order to implement and manage a robust ASP, a pharmacist FTE investment of 1.0 per 100 occupied beds would be needed. A staffing calculator to account for the time needed to implement ASP activities and provide staffing guidance across a large health-care system was validated. Copyright © 2017 by the American Society of Health-System Pharmacists, Inc. All rights reserved.

  14. The Association of Team-Specific Workload and Staffing with Odds of Burnout Among VA Primary Care Team Members. (United States)

    Helfrich, Christian D; Simonetti, Joseph A; Clinton, Walter L; Wood, Gordon B; Taylor, Leslie; Schectman, Gordon; Stark, Richard; Rubenstein, Lisa V; Fihn, Stephan D; Nelson, Karin M


    Work-related burnout is common in primary care and is associated with worse patient safety, patient satisfaction, and employee mental health. Workload, staffing stability, and team completeness may be drivers of burnout. However, few studies have assessed these associations at the team level, and fewer still include members of the team beyond physicians. To study the associations of burnout among primary care providers (PCPs), nurse care managers, clinical associates (MAs, LPNs), and administrative clerks with the staffing and workload on their teams. We conducted an individual-level cross-sectional analysis of survey and administrative data in 2014. Primary care personnel at VA clinics responding to a national survey. Burnout was measured with a validated single-item survey measure dichotomized to indicate the presence of burnout. The independent variables were survey measures of team staffing (having a fully staffed team, serving on multiple teams, and turnover on the team), and workload both from survey items (working extended hours), and administrative data (patient panel overcapacity and average panel comorbidity). There were 4610 respondents (estimated response rate of 20.9%). The overall prevalence of burnout was 41%. In adjusted analyses, the strongest associations with burnout were having a fully staffed team (odds ratio [OR] = 0.55, 95% CI 0.47-0.65), having turnover on the team (OR = 1.67, 95% CI 1.43-1.94), and having patient panel overcapacity (OR = 1.19, 95% CI 1.01-1.40). The observed burnout prevalence was 30.1% lower (28.5% vs. 58.6%) for respondents working on fully staffed teams with no turnover and caring for a panel within capacity, relative to respondents in the inverse condition. Complete team staffing, turnover among team members, and panel overcapacity had strong, cumulative associations with burnout. Further research is needed to understand whether improvements in these factors would lower burnout.

  15. Variation Across U.S. Assisted Living Facilities: Admissions, Resident Care Needs, and Staffing. (United States)

    Han, Kihye; Trinkoff, Alison M; Storr, Carla L; Lerner, Nancy; Yang, Bo Kyum


    Though more people in the United States currently reside in assisted living facilities (ALFs) than nursing homes, little is known about ALF admission policies, resident care needs, and staffing characteristics. We therefore conducted this study using a nationwide sample of ALFs to examine these factors, along with comparison of ALFs by size. Cross-sectional secondary data analysis using data from the 2010 National Survey of Residential Care Facilities. Measures included nine admission policy items, seven items on the proportion of residents with selected conditions or care needs, and six items on staffing characteristics (e.g., access to licensed nurse, aide training). Facilities (n = 2,301) were divided into three categories by size: small, 4 to 10 beds; medium, 11 to 25 beds; and large, 26 or more beds. Analyses took complex sampling design effects into account to project national U.S. estimates. More than half of ALFs admitted residents with considerable healthcare needs and served populations that required nursing care, such as for transfers, medications, and eating or dressing. Staffing was largely composed of patient care aides, and fewer than half of ALFs had licensed care provider (registered nurse, licensed practical nurse) hours. Smaller facilities tended to have more inclusive admission policies and residents with more complex care needs (more mobility, eating and medication assistance required, short-term memory issues, p < .01) and less access to licensed nurses than larger ALFs (p < .01). This study suggests ALFs are caring for and admitting residents with considerable care needs, indicating potential overlap with nursing home populations. Despite this finding, ALF regulations lag far behind those in effect for nursing homes. In addition, measurement of care outcomes is critically needed to ensure appropriate ALF care quality. As more people choose ALFs, outcome measures for ALFs, which are now unavailable, should be developed to allow for oversight

  16. Experiences and lessons learnt on staffing from the first Indian nuclear power plant (PHWR)

    International Nuclear Information System (INIS)

    Bhattacharya, A.S.


    Three decades of operating experience in India has led to sustained high performance of NPPs. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. Specific qualification levels apply to each position - six at management positions, five licensed positions with the rest qualified through an equivalent training scheme. Practically all O and M activities are carried out on-site by the utility manpower with minimum involvement of contractors. The entire process of human resource development is in-house - with each NPP organisation comprised of 30% experienced staff transferred from older NPPs and 70% totally developed out of fresh recruits. Four to eight years lead time goes to qualify fresh recruits depending on the position. This optimisation of manpower is a result of continuous learning - through operating experience and regulatory feed back and self assessment for (i) optimising quantum of work load and (ii) improving productivity. For the first category, design improvements over older NPP's increased reliability, operability, maintainability and human factors are described separately in the companion paper. In this paper the organisation factors are discussed, starting with the initial lessons that demanded improved management and enhanced quality programmes and caused temporarily, high demand of staffing for bringing out new systems, e.g., (i) attaining maturity of units; (ii) standardising training, retraining and cross training and qualifications; (in) job rotations, (iv) in service inspection of reactor components; (v) quality audits. The experiences on subsequent optimisation of staffing levels are outlined. (author)

  17. Ontario: linking nursing outcomes, workload and staffing decisions in the workplace: the Dashboard Project. (United States)

    Fram, Nancy; Morgan, Beverley


    Research shows that nurses want to provide more input into assessing patient acuity, changes in patient needs and staffing requirements. The Dashboard Project involved the further development and application of an electronic monitoring tool that offers a single source of nursing, patient and organizational information. It is designed to help inform nurse staffing decisions within a hospital setting. The Dashboard access link was installed in computers in eight nursing units within the Hamilton Health Sciences (HHS) network. The Dashboard indicators are populated from existing information/patient databases within the Decision Support Department at HHS. Committees composed of the unit manager, staff nurses, project coordinator, financial controller and an information controller met regularly to review the Dashboard indicators. Participants discussed the ability of the indicators to reflect their patients' needs and the feasibility of using the indicators to inform their clinical staffing plans. Project findings suggest that the Dashboard is a work in progress. Many of the indicators that had originally been incorporated were refined and will continue to be revised based on suggestions from project participants and further testing across HHS. Participants suggested the need for additional data, such as the time that nurses are off the unit (for code blue response, patient transfers and accompanying patients for tests); internal transfers/bed moves to accommodate patient-specific issues and particularly to address infection control issues; deaths and specific unit-centred data in addition to the generic indicators. The collaborative nature of the project enabled staff nurses and management to work together on a matter of high importance to both, providing valuable recommendations for shared nursing and interprofessional planning, further Dashboard development and project management.

  18. Determinants of hospital fall rate trajectory groups: a longitudinal assessment of nurse staffing and organizational characteristics. (United States)

    Everhart, Damian; Schumacher, Jessica R; Duncan, R Paul; Hall, Allyson G; Neff, Donna F; Shorr, Ronald I


    Patient falls in acute care hospitals represent a significant patient safety concern. Although cross-sectional studies have shown that fall rates vary widely between acute care hospitals, it is not clear whether hospital fall rates remain consistent over time. The aim of this study was to determine whether hospitals can be categorized into fall rate trajectory groups over time and to identify nurse staffing and hospital characteristics associated with hospital fall rate trajectory groups. We conducted a 54-month (July 2006-December 2010) longitudinal study of U.S. acute care general hospitals participating in the National Database for Nursing Quality Indicators (2007). We used latent class growth modeling to categorize hospitals into groups based on their long-term fall rates. Nurse staffing and hospital characteristics associated with membership in the highest hospital fall rate group were identified using logistic regression. A sample of 1,529 hospitals (mean fall rate of 3.65 per 1,000 patient days) contributed data to the analysis. Latent class growth modeling findings classified hospital into three groups based on fall rate trajectories: consistently high (mean fall rate of 4.96 per 1,000 patient days), consistently medium (mean fall rate of 3.63 per 1,000 patient days), and consistently low (mean fall rate of 2.50 per 1,000 patient days). Hospitals with higher total nurse staffing (odds ratio [OR] = 0.92, 95% confidence interval [CI] [0.85, 0.99]), Magnet status (OR = 0.49, 95% CI [0.35, 0.70]), and bed size greater than 300 beds (OR = 0.70, 95% CI [0.51, 0.94]) were significantly less likely to be categorized in the "consistently high" fall rate group. Over this 54-month period, hospitals were categorized into three groups based on long-term fall rates. Hospital-level factors differed among these three groups. This suggests that there may be hospitals in which "best practices" for fall prevention might be identified. In addition, administrators may be able

  19. [Danish emergency departments are not staffed by consultants 24/7]. (United States)

    Mackenhauer, Julie; Møller, Cecilie; Fjældstad, Alexander; Østervig, Rebecca; Kole, Ayhan Al; Folkestad, Lars; Hallas, Peter; Brabrand, Mikkel; Møllekær, Anders; Kirkegaard, Hans


    The Danish health care system is undergoing a major reorganisation, resulting in fewer emergency departments (ED) with consultants in attendance 24/7. This questionnaire-based study evaluates the status of the reorganisation with emphasis on physician attendance and recruitment. 76% of the EDs are not staffed by consultants 24/7, 51% report difficulties in recruiting qualified personnel and 33% report problems connected to retaining them. 71% believe that a specialty in emergency medicine could help solve these problems. Danish EDs do not comply with the visions of the reorganisation plan.

  20. Using a nursing productivity committee to achieve cost savings and improve staffing levels and staff satisfaction. (United States)

    McKenna, Erin; Clement, Kristina; Thompson, Elizabeth; Haas, Kathy; Weber, William; Wallace, Michelle; Stauffer, Cindy; Frailey, Jan; Anderson, Aimee; Deascenti, Missy; Hershiser, Lisa; Roda, Patricia Inama


    Challenged by rising costs, higher registered nurse vacancy rates and declining staff morale, a Nursing Productivity Committee was formed to analyze productive and nonproductive hours and seek improvements in our staffing models and scheduling processes. The changes implemented led to lower nurse to patient ratios, better control of labor costs, elimination of agency staff, greater staff satisfaction, and introduction of new technologies. Nurse managers, nursing supervisors, and frontline staff are now more knowledgeable and empowered to use creative solutions to manage their budgets and schedules in these times of fluctuating census and varying vacancy rates.

  1. Predicting future staffing needs at teaching hospitals: use of an analytical program with multiple variables. (United States)

    Mitchell, Christine C; Ashley, Stanley W; Zinner, Michael J; Moore, Francis D


    To develop a model to predict future staffing for the surgery service at a teaching hospital. Tertiary hospital. A computer model with potential future variables was constructed. Some of the variables were distribution of resident staff, fellows, and physician extenders; salary/wages; work hours; educational value of rotations; work units, inpatient wards, and clinics; future volume growth; and efficiency savings. Outcomes Number of staff to be hired, staffing expense, and educational impact. On a busy general surgery service, we estimated the impact of changes in resident work hours, service growth, and workflow efficiency in the next 5 years. Projecting a reduction in resident duty hours to 60 hours per week will require the hiring of 10 physician assistants at a cost of $1 134 000, a cost that is increased by $441 000 when hiring hospitalists instead. Implementing a day of didactic and simulator time (10 hours) will further increase the costs by $568 000. A 10% improvement in the efficiency of floor care, as might be gained by advanced information technology capability or by regionalization of patients, can mitigate these expenses by as much as 21%. On the other hand, a modest annual growth of 2% will increase the costs by $715 000 to $2 417 000. To simply replace residents with alternative providers requires large amounts of human and fiscal capital. The potential for simple efficiencies to mitigate some of this expense suggests that traditional patterns of care in teaching hospitals will have to change in response to educational mandates.

  2. Association between Nurse Staffing and In-Hospital Bone Fractures: A Retrospective Cohort Study. (United States)

    Morita, Kojiro; Matsui, Hiroki; Fushimi, Kiyohide; Yasunaga, Hideo


    To determine if sufficient nurse staffing reduced in-hospital fractures in acute care hospitals. The Japanese Diagnosis Procedure Combination inpatient (DPC) database from July 2010 to March 2014 linked with the Surveys for Medical Institutions. We conducted a retrospective cohort study to examine the association of inpatient nurse-to-occupied bed ratio (NBR) with in-hospital fractures. Multivariable logistic regression with generalized estimating equations was performed, adjusting for patient characteristics and hospital characteristics. We identified 770,373 patients aged 50 years or older who underwent planned major surgery for some forms of cancer or cardiovascular diseases. We used ICD-10 codes and postoperative procedure codes to identify patients with in-hospital fractures. Hospital characteristics were obtained from the "Survey of Medical Institutions and Hospital Report" and "Annual Report for Functions of Medical Institutions." Overall, 662 (0.09 percent) in-hospital fractures were identified. Logistic regression analysis showed that the proportion of in-hospital fractures in the group with the highest NBR was significantly lower than that in the group with the lowest NBR (adjusted odd ratios, 0.67; 95 percent confidence interval, 0.44-0.99; p = .048). Sufficient nurse staffing may be important to reduce postsurgical in-hospital fractures in acute care hospitals. © Health Research and Educational Trust.

  3. Lessons learned from Gen II NPP staffing approaches applicable to new reactors - 15003

    International Nuclear Information System (INIS)

    Goodnight, C.


    This paper discusses lessons learned from the operation of the Gen II fleet of existing nuclear power plants (NPPs), in terms of staffing, that can be applied to the final design, deployment, and operation of new reactor designs. The most significant of these lessons is the need to appropriately staff the facility, having the right number of people with the required skills and experience. This begs the question of how to identify those personnel requirements. For NPPs, there are five key factors that ultimately will determine the effectiveness and costs of operating nuclear power plants (NPPs): 1) The Nuclear Steam Supply System (NSSS) and the layout of the plant site; 2) The processes which the operating organization applies; 3) The organizational structure of the operating organization; 4) The organizational culture of the operating organization, and 5) The regulatory framework under which the licensee must operate. In summary, this paper identifies opportunities to minimize staffing and costs learned from Gen II NPPs that may be applicable for new nuclear plants. (author)

  4. [Model to predict staffing for anesthesiology and post-anesthesia intensive care units and pain clinics]. (United States)

    Canet, J; Moral, V; Villalonga, A; Pelegrí, D; Gomar, C; Montero, A


    Human resources account for a large part of the budgets of anesthesia and post-anesthesia intensive care units and pain clinics (A-PICU-PC). Adequate staffing is a key factor in providing for both effective care and professional staff development. Changes in professional responsibilities have rendered obsolete the concept of one anesthesiologist per operating room. Duties must be analyzed objectively to facilitate understanding between hospital administrators and A-PICU-PC chiefs of service when assigning human resources. The Catalan Society of Anesthesiology, Post-anesthesia Intensive Care and Pain Therapy has developed a model for estimating requirements for A-PICU-PC staffing based on three factors: 1) Definition of staff positions that must be filled and criteria for assigning human resources; 2) Estimation of non-care-related time required by the department for training, teaching, research and internal management, and 3) Estimation of staff required to cover absences from work for vacations, personal leave or illness. The model revealed that the ratio of number of staff positions to number of persons employed by an A-PICU-PC is approximately 1.3. Differences in the nature of services managed by an A-PICU-PC or the type of hospital might change the ratio slightly. The model can be applied universally, independently of differences that might exist among departments. Widespread application would allow adoption of a common language to be used by health care managers and A-PICU-PC departments when discussing a basis for consensus about our specialty.

  5. Influence of design improvements in optimising staffing of NPPs - an Indian experience

    International Nuclear Information System (INIS)

    Bhattacharya, A.S.


    Three decades of operating experience in India has led to sustained high performance of NPP's. The staffing modules and policies are standardised. The basic functions of operation, maintenance, technical support and quality assurance are carried out by a team of 727 in-plant persons (for a 2 x 220 MW PHWR station) organised at five levels, for fifty positions in ten job families. The organisational factors that led to optimising of staff are described in the companion paper. This optimisation of manpower is a result of continuous learning - for (i) optimising quantum of workload and (ii) improving productivity. For the first category, design improvements over older Indian NPP's have increased reliability, operability, maintainability and human factors. Few examples: (i) improved man-machine interface in plant controls and on-power refuelling system with operator guidance, logging as well as diagnostic/health monitoring features; (ii) spread out layout for better access and ease of maintenance, separation of plant services for unit-1 from unit-2 and, removal of reactor auxiliaries out to separate buildings; (iii) reduction of maintenance tasks through redesigned equipment and improved condition monitoring means. However, design and procedural improvements also include additional equipment for upgradation of safety measures, e.g. larger number of safety related pumps separate switchyard control room and increased service system equipment. This paper outlines experience of design improvements in optimising staffing and uses a specific case illustration to establish the findings for better use of staff. (author)

  6. [Effects of cost saving strategies and staffing levels on patient and nurse outcomes. A literature review]. (United States)

    Schubert, Maria; Schaffert-Witvliet, Bianca; De Geest, Sabina


    The effects of cost saving strategies and changes in staffing levels and skill mix in the inpatient care setting on patient and nurse outcomes have not yet been examined in Switzerland. In 2002 the Swiss Federal Office of Health mandated the Institute of Nursing Science at the University of Basel to conduct a literature review to examine the evidence available on this topic. The literature research and analysis cover the period from 1991 to 2003. Sixty publications out of a total of 260 reviewed abstracts were included and analyzed. The results show that in the inpatient care settings in Switzerland as well as in other countries positions for registered nurses have been reduced and/or the qualification and skill mix in care teams have been downgraded. Given the present health care situation where the intensity and complexity of caring for hospitalized patients is increasing, an imbalance occurs between the need for high quality care and the possibilities to offer this care. This affects patients' and nurses outcomes. The international results show a significant relationship between lower staffing levels and skill mix in care teams and higher complication, "failure-to-rescue", and mortality rates in patients, as well as a lower job satisfaction, and higher fluctuation, burnout and work-related injury rates in nursing personnel. Thus, nursing care within hospitals represents not only a cost factor but also an important quality factor which is essential in order to be able to realize good patient's outcomes.

  7. A consensus-based template for documenting and reporting in physician-staffed pre-hospital services

    DEFF Research Database (Denmark)

    Kruger, Andreas J; Lockey, David; Kurola, Jouni


    -staffed pre-hospital services in Europe. METHODS: Using predefined criteria, we recruited sixteen European experts in the field of pre-hospital care. These experts were guided through a four-step modified nominal group technique. The process was carried out using both e-mail-based communication and a plenary...... have established a core data set for documenting and reporting in physician-staffed pre-hospital services. We believe that this template could facilitate future studies within the field and facilitate standardised reporting and future shared research efforts in advanced pre-hospital care....

  8. Quality assurance in radiotherapy: the importance of medical physics staffing levels. Recommendations from an ESTRO/EFOMP joint task group. (United States)

    Belletti, S; Dutreix, A; Garavaglia, G; Gfirtner, H; Haywood, J; Jessen, K A; Lamm, I L; Mijnheer, B; Noël, A; Nüsslin, F; Rosenow, U; Schneider, P; Seelentag, W; Sheriff, S; Svensson, H; Thwaites, D


    The safe application of ionising radiation for diagnosis and therapy requires a high level of knowledge of the underlying processes and of quality assurance. Sophisticated modern equipment can be used effectively for complicated diagnostic and therapeutic techniques only with adequate physics support. In the light of recent analyses and recommendations by national and international societies a joint working group of representatives from ESTRO (European Society for Therapeutic Radiology and Oncology) and from EFOMP (European Federation of Organisations for Medical Physics) was set up to assess the necessary staffing levels for physics support to radiotherapy. The method used to assess the staffing levels, the resulting recommendations and examples of their practical application are described.

  9. Core Competence and Education. (United States)

    Holmes, Gary; Hooper, Nick


    Outlines the concept of core competence and applies it to postcompulsory education in the United Kingdom. Adopts an educational perspective that suggests accreditation as the core competence of universities. This economic approach suggests that the market trend toward lifetime learning might best be met by institutions developing a core competence…

  10. Competencies and Their Assessment (United States)

    Drisko, James W.


    This article explores competencies and methods for their assessment in higher education and in social work's accreditation standards. Many contemporary policy and educational accreditation efforts employ the model of competency assessment. The current emphasis on accountability in higher education, including the Council on Social Work…

  11. Financing Competency Based Programs. (United States)

    Daniel, Annette

    Literature on the background, causes, and current prevalence of competency based programs is synthesized in this report. According to one analysis of the actual and probable costs of minimum competency testing, estimated costs for test development, test administration, bureaucratic structures, and remedial programs for students who cannot pass the…

  12. Developing Clinical Competence

    NARCIS (Netherlands)

    P.F. Wimmers (Paul)


    textabstractThe development of clinical competence is the main purpose of medical education. The long road to become clinically competent starts on the first day of medical school, and every institution strives to select the best students. The responsibility of medical schools is to train

  13. Competencies in Ornamental Horticulture (United States)

    Loewen, Curtis E.


    Based on the author's dissertation, this article pertains to the identification of competencies for ornamental horticulture workers in Oregon. Findings were based on interviews with 56 ornamental horticulture business employers regarding 100 competencies. The method used can serve as a model for obtaining occupational information to develop and…

  14. ICT Competences: Algorithmic Thinking (United States)

    Zsakó, László; Szlávi, Péter


    A lot has been said about what to teach in ICT in primary and secondary education. There are serious discussions even debates about it. Much less has been said about why ICT should be taught. [1] Competences are related actions and tasks done by people (somebody is competent in a certain field if they are able to solve common tasks related to that…

  15. Home is to be understood

    DEFF Research Database (Denmark)

    Buhl, Mie; Werner Hansen, Siv


    situation in Denmark is, as in many other countries at the moment, complex. On the one hand laws and regulations are concurrently tightened concerning residency permits, boarder control, and possession of belongings. On the other hand a nationwide humanitarian (non-political) network of citizens who have...... engages with the current societal issue of migration by instigating a co-creation experiment, which aims to convert the museum’s vision (defined by values such as ‘community’, ‘participation’, ‘responsibility’ and ‘change’) into practice. In particular, we address how the museum creates a space...... and visual ethnography (Pink, 2013; Rose, 2012) from the process of initiating and planning of the project and including visual material from the launch of the exhibition. References: Bishop, C. (2006). The Social turn: Collaboration and Its Discontents, Artforum http...

  16. How flares can be understood

    International Nuclear Information System (INIS)

    Severny, A.B.


    Specific features of the flare phenomenon which are important for understanding of flares are the following: (1) Fine structure of visible emission of flares, especially at the very beginning and in the pre-flare active region. This structure can be seen also in later stages of development as bright points, some of which exist from the flare beginning (Babin's observations at Crimea, 1972-1976). (2) Turbulent motion with velocities up to 250-300 km s -1 as can be estimated from broadening of emission lines. (3) Predominantly red asymmetry of emission lines in the explosive phase and during further development of flares. (4) 'Supersonic' velocities and supergravitational accelerations of separate moving masses of the flare plasma. (5) The appearance of flares in areas with high grad H, exceeding 0.1 G km -1 which is equivalent to regions of electric currents > approximately 10 11 A. (6) Strong variations of net magnetic flux through the active region, as it follows from Meudon, Crimean, and Sacramento Peak (Rust's) observations. (Auth.)

  17. Can delusions be understood linguistically? (United States)

    Hinzen, Wolfram; Rosselló, Joana; McKenna, Peter


    ABSTRACT Delusions are widely believed to reflect disturbed cognitive function, but the nature of this remains elusive. The “un-Cartesian” cognitive-linguistic hypothesis maintains (a) that there is no thought separate from language, that is, there is no distinct mental space removed from language where “thinking” takes place; and (b) that a somewhat broadened concept of grammar is responsible for bestowing meaning on propositions, and this among other things gives them their quality of being true or false. It is argued that a loss of propositional meaning explains why delusions are false, impossible and sometimes fantastic. A closely related abnormality, failure of linguistic embedding, can additionally account for why delusions are held with fixed conviction and are not adequately justified by the patient. The un-Cartesian linguistic approach to delusions has points of contact with Frith’s theory that inability to form meta-representations underlies a range of schizophrenic symptoms. It may also be relevant to the nature of the “second factor” in monothematic delusions in neurological disease. Finally, it can inform the current debate about whether or not delusions really are beliefs. PMID:27322493

  18. We Have Not Understood Descartes. (United States)

    Vallias, Andras


    Describes a personal involvement with digital media and the origins of the conception of the "diagrammatic" poem. Reflects on what is considered to be a poem in tune with today's computerized society. (PA)

  19. An investigation into the competence of workplace trainers to meet ...

    African Journals Online (AJOL)

    This article focussses on the competence of trainers in the South African workplace to provide training to underprepaired learners whose special learning need should be understood by the trainers. The National Qualifications Framework, brought into being by the South African Qualifications ity Act of 1995, has as one of its ...

  20. Ten-Competence: Life-Long Competence Development and Learning

    NARCIS (Netherlands)

    Koper, Rob; Specht, Marcus


    Koper, R., & Specht, M. (2008). Ten-Competence: Life-Long Competence Development and Learning. In M-A. Cicilia (Ed.), Competencies in Organizational e-learning: concepts and tools (pp. 234-252). Hershey: IGI-Global.

  1. ACCP Clinical Pharmacist Competencies. (United States)

    Saseen, Joseph J; Ripley, Toni L; Bondi, Deborah; Burke, John M; Cohen, Lawrence J; McBane, Sarah; McConnell, Karen J; Sackey, Bryan; Sanoski, Cynthia; Simonyan, Anahit; Taylor, Jodi; Vande Griend, Joseph P


    The purpose of the American College of Clinical Pharmacy (ACCP) is to advance human health by extending the frontiers of clinical pharmacy. Consistent with this mission and its core values, ACCP is committed to ensuring that clinical pharmacists possess the knowledge, skills, attitudes, and behaviors necessary to deliver comprehensive medication management (CMM) in team-based, direct patient care environments. These components form the basis for the core competencies of a clinical pharmacist and reflect the competencies of other direct patient care providers. This paper is an update to a previous ACCP document and includes the expectation that clinical pharmacists be competent in six essential domains: direct patient care, pharmacotherapy knowledge, systems-based care and population health, communication, professionalism, and continuing professional development. Although these domains align with the competencies of physician providers, they are specifically designed to better reflect the clinical pharmacy expertise required to provide CMM in patient-centered, team-based settings. Clinical pharmacists must be prepared to complete the education and training needed to achieve these competencies and must commit to ongoing efforts to maintain competence through ongoing professional development. Collaboration among stakeholders will be needed to ensure that these competencies guide clinical pharmacists' professional development and evaluation by educational institutions, postgraduate training programs, professional societies, and employers. © 2017 Pharmacotherapy Publications, Inc.

  2. On Verbal Competence

    Directory of Open Access Journals (Sweden)

    Zhongxin Dai


    Full Text Available This paper explored a new concept, verbal competence, to present a challenge to Chomsky’s linguistic competence and Hymes’ communicative competence. It is generally acknowledged that Chomsky concerned himself only with the syntactic/grammatical structures, and viewed the speaker’s generation and transformation of syntactic structures as the production of language. Hymes challenged Chomsky’s conception of linguistic competence and argued for an ethnographic or sociolinguistic concept, communicative competence, but his concept is too broad to be adequately grasped and followed in such fields as linguistics and second language acquisition. Communicative competence can include abilities to communicate with nonverbal behaviors, e.g. gestures, postures or even silence. The concept of verbal competence concerns itself with the mental and psychological processes of verbal production in communication. These processes originate from the speaker’s personal experience, in a certain situation of human communication, and with the sudden appearance of the intentional notion, shape up as the meaning images and end up in the verbal expression.

  3. The relationship between UK hospital nurse staffing and emotional exhaustion and job dissatisfaction. (United States)

    Sheward, Louisa; Hunt, Jennifer; Hagen, Suzanne; Macleod, Margaret; Ball, Jane


    To explore the relationship between nurse outcomes (dissatisfaction and emotional exhaustion) and nurse workload, nurse characteristics and hospital variables. Concern about the impact of restructuring of nurse staffing, and reports of nurse shortages, on nurse and patient outcomes led to the research being reported on in this article. A questionnaire survey of registered nurses in Scotland and England. A questionnaire survey of the hospitals in which these nurses worked. Respondents in the two countries were similar in terms of demographic, work and employment characteristics. Significant relationships were found using the combined English and Scottish data between nurse patient ratios and (1) emotional exhaustion and (2) dissatisfaction with current job reported by nurses. Increasing numbers of patients to nurses was associated with increasing risk of emotional exhaustion and dissatisfaction with current job.

  4. Strategic foresight, leadership, and the future of rural healthcare staffing in the United States. (United States)

    Reimers-Hild, Connie


    This article uses a strategic foresight tool, megatrends, to examine forces influencing long-term healthcare staffing in the rural United States. Two megatrends-exponential advances in science and technology and the continued evolution of the decentralized global marketplace-will influence and ultimately help shape the future of rural healthcare. Successful health ecosystems of the future will need to be customer-driven, more affordable, and tech-savvy. Successful evolution in an era of continuous change will require a blend of intentional engagement with stakeholders, strategic foresight, and future-focused leadership. More research is needed to fully understand not only the challenges of rural healthcare but also the emerging opportunities.

  5. An Innovative Approach to Staffing a Simulation Center in a College of Health Professions. (United States)

    Berro, Elizabeth A; Knoesel, Joanne M


    The current limited number of nurse faculty and available clinical sites requires innovative strategies to provide education to current and future nurses. Simulation centers and clinical education laboratories can meet this need, but staffing issues can be problematic. This article describes how an urban university developed a cost-effective model to staff its clinical education laboratory. After two faculty members proposed a pilot program to fully integrate simulation into both the accelerated and traditional undergraduate nursing programs on two campuses, a need was identified for more nursing staff dedicated to the simulation program. Knowing that many recent nurse graduates were available while waiting to obtain their first nursing position, these new nurses were recruited to serve in a volunteer capacity, supporting nursing faculty in the simulation program. The new nurse graduate volunteer position quickly evolved into a paid nurse intern position and has proven to benefit students, faculty, and new nurse graduates. Copyright 2016, SLACK Incorporated.

  6. Competences and life management programmes

    International Nuclear Information System (INIS)

    Brunatti, S.; Bergara, A.; Ranalli, J.; Versaci, R.


    surveillance. In some cases, it may be impossible to rebuild information. As a consequence assumptions may have to be made that cannot be easily substantiated. It is therefore essential that the strategies for plant life management are developed with sufficient clarity to enable the associated human resource strategy or long term Human Resources plan to be developed. This strategy/plan should be reviewed and updated periodically to verify that it is consistent with and supports the nuclear power plant life cycle needs. In this work we analyze the competences of young peoples for working in the Life Management and Life Extension of Nuclear Power Plants Programmes. Competences and skills are understood as including knowing and understanding (theoretical knowledge of an academic field, the capacity to know and understand), knowing how to act (practical and operational application of knowledge to certain situations), knowing how to be (values as an integral element of the way of perceiving and living with others and in a social context). Competences represent a combination of attributes (with respect to knowledge and its application, attitudes, skills and responsibilities) that describe the level or degree to which a person is capable of performing them. In this context, a competence or a set of competences mean that a person puts into play a certain capacity or skill and performs a task, where he/she is able to demonstrate that he/she can do so in a way that allows evaluation of the level of achievement. Competences can be carried out and assessed. It also means that a normally person does not either possess or lack a competence in absolute terms, but commands it to a varying degree, so that competences can be placed on a continuum. The following was taken as a working classification: - Instrumental Competences: Those having an instrumental function. They include: Cognitive abilities, capacity to understand and manipulate ideas and thoughts; Methodological capacities to

  7. Factors that guide nurse managers regarding the staffing of agency nurses in intensive care units at private hospitals in Pretoria

    Directory of Open Access Journals (Sweden)

    Karien Jooste


    Full Text Available Staffing needs affect the nursing department’s budget, staff productivity, the quality of care provided to patients and even the retention of nurses. It is unclear how the role players (the nursing agency manager, the nurse manager and the agency nurse perceive the staffing of agency nurses in intensive care units (ICUs. The purpose of this study was to explore and describe the factors that guide nurse managers regarding the staffing of agency nurses in ICUs at private hospitals in Pretoria. A quantitative exploratory and descriptive design was used. A survey by means of a structured questionnaire was carried out. Probability sampling was implemented to obtain a study sample (n = 124. One similar self-administered 5-point scale instrument was completed by the participants. Data was analysed by means of descriptive and inferential statistics. The principles of validity and reliability were adhered to and ethical considerations were also taken into account. The results indicated limitations in the determining of posts, recruitment and advertising, as well as the selection and appointment of agency nurses in ICUs at private hospitals in Pretoria. Recommendations on staffing are made to nurse managers in ICUs.

  8. Determinants and effects of nurse staffing intensity and skill mix in residential care/assisted living settings. (United States)

    Stearns, Sally C; Park, Jeongyoung; Zimmerman, Sheryl; Gruber-Baldini, Ann L; Konrad, Thomas R; Sloane, Philip D


    Residential care/assisted living facilities have become an alternative to nursing homes for many individuals, yet little information exists about staffing in these settings and the effect of staffing. This study analyzed the intensity and skill mix of nursing staff using data from a four-state study, and their relationship to outcomes. We obtained longitudinal data for 1,894 residents of 170 residential care/assisted living facilities participating in the Collaborative Studies of Long-Term Care. Descriptive statistics assessed the levels of direct care staff (registered nurse, licensed practical nurse, personal care aide). Regression analyses evaluated the relationship between two staffing measures (intensity measured as care hours per resident and skill mix measured as the percentage of total care hours by licensed nurses), facility characteristics, and four health outcomes (mortality, nursing home transfer, hospitalization, and incident morbidity). Care hours per resident decreased with facility size (economies of scale) only for very small facilities and increased with dementia prevalence (case-mix effect). Licensed staff accounted for a greater proportion of total hours in nonprofit settings. Health outcomes did not vary by total care hours per resident, but hospitalization rates were significantly lower in facilities with higher proportions of skilled staff hours; this effect was stronger as dementia case mix increased. Current staffing levels for the outcomes analyzed meet most residents' needs. Reduced hospitalization in relation to greater use of licensed staff suggests that increased use of these workers might result in reductions in acute care expenditures.

  9. 9 CFR 310.1 - Extent and time of post-mortem inspection; post-mortem inspection staffing standards. (United States)


    ... 288 4 4 2 289 to 316 5 4 2 317 to 343 5 5 2 (3) Swine Inspection. The following inspection staffing standards are applicable to swine slaughter configurations. The inspection standards for all slaughter lines..., liver, heart, lungs, and mediastinal lymph nodes. In addition, for one- and two-inspector lines, the...

  10. 75 FR 69468 - Progressive Furniture, Inc., Including On-Site Leased Workers From Onin Staffing, a Subsidiary of... (United States)


    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-73,756] Progressive Furniture, Inc., Including On-Site Leased Workers From Onin Staffing, a Subsidiary of Sauder Furniture, Claremont, NC; Notice of Affirmative Determination Regarding Application for Reconsideration On July 19, 2010...

  11. 77 FR 63873 - Johnson Controls, Inc. Including On-Site Leased Workers of Valley Staffing and AZ Quality Hudson... (United States)


    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-81,067] Johnson Controls, Inc... workers of Johnson Controls, Inc., including on-site leased workers from Valley Staffing, Hudson... subject firm. The company reports that workers leased from AZ Quality were employed on-site at the Hudson...

  12. 77 FR 19719 - Whirlpool Corporation Including On-Site Leased Workers From Career Solutions TEC Staffing, IBM... (United States)


    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation... Staffing, Fort Smith, Arkansas. The workers are engaged in the production of refrigerators and trash... trash compactors to Mexico. The amended notice applicable to TA-W-74,593 is hereby issued as follows...

  13. 75 FR 77665 - Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing and... (United States)


    ... DEPARTMENT OF LABOR Employment and Training Administration [TA-W-74,593] Whirlpool Corporation, Including On-Site Leased Workers From Career Solutions TEC Staffing and Andrews International, Fort Smith... subject firm. The workers are engaged in the production of refrigerators and trash compactors. The company...

  14. Design Effects and Generalized Variance Functions for the 1990-91 Schools and Staffing Survey (SASS). Volume I. User's Manual. (United States)

    Salvucci, Sameena; And Others

    This user's manual summarizes the results and use of design effects and generalized variance functions (GVF) to approximate standard errors for the 1990-91 Schools and Staffing Survey (SASS). It is Volume I of a two-volume publication that is part of the Technical Report series of the National Center for Education Statistics (NCES). The SASS is a…

  15. The Impact of Office Automation on the Roles and Staffing Patterns of Office Employees: A Case Study. (United States)

    Goodrich, Elizabeth A.


    The study examined impact of office automation on the roles and staffing patterns of office employees at the National Institute of Neurological and Communicative Disorders and Stroke. Results of an interview study indicate that automation has had a favorable impact on the way work is accomplished and on the work environment. (Author/CH)

  16. The effects of ownership, staffing level and organisational justice on nurse commitment, involvement, and satisfaction: a questionnaire study. (United States)

    Heponiemi, Tarja; Elovainio, Marko; Kouvonen, Anne; Kuusio, Hannamaria; Noro, Anja; Finne-Soveri, Harriet; Sinervo, Timo


    Elderly care systems have undergone a lot of changes in many European countries, including Finland. Most notably, the number of private for-profit firms has increased. Previous studies suggest that employee well-being and the quality of care might differ according to the ownership type. The present study examined whether the ownership type and the staffing level were associated with organisational commitment, job involvement, and job satisfaction. In addition, we examined the potential moderating effect of organisational justice on these associations. Cross-sectional questionnaire study. 1047 Finnish female staff members aged 18-69 years working in sheltered housing or nursing homes (units n=179). The relationships were studied with analyses of covariance (ANCOVA), adjusting for the effects of age and case-mix. Organisational commitment and job satisfaction levels were low in for-profit sheltered homes when justice levels were low, but when justice levels were high, for-profit sheltered homes did not differ from other ownership types. Similarly, organisational justice acted as a buffer against low commitment resulting from low staffing levels. Staffing levels were lowest in public sheltered homes and highest in not-for-profit sheltered homes. The results show that organisational justice can act as a buffer against low organisational commitment that results from low staffing levels and working in for-profit sheltered homes. Increasing justice in regard to the management, outcomes, and procedures in the organisation would thus be important. 2011 Elsevier Ltd. All rights reserved.

  17. Applying cost accounting to operating room staffing in otolaryngology: time-driven activity-based costing and outpatient adenotonsillectomy. (United States)

    Balakrishnan, Karthik; Goico, Brian; Arjmand, Ellis M


    (1) To describe the application of a detailed cost-accounting method (time-driven activity-cased costing) to operating room personnel costs, avoiding the proxy use of hospital and provider charges. (2) To model potential cost efficiencies using different staffing models with the case study of outpatient adenotonsillectomy. Prospective cost analysis case study. Tertiary pediatric hospital. All otolaryngology providers and otolaryngology operating room staff at our institution. Time-driven activity-based costing demonstrated precise per-case and per-minute calculation of personnel costs. We identified several areas of unused personnel capacity in a basic staffing model. Per-case personnel costs decreased by 23.2% by allowing a surgeon to run 2 operating rooms, despite doubling all other staff. Further cost reductions up to a total of 26.4% were predicted with additional staffing rearrangements. Time-driven activity-based costing allows detailed understanding of not only personnel costs but also how personnel time is used. This in turn allows testing of alternative staffing models to decrease unused personnel capacity and increase efficiency. © American Academy of Otolaryngology—Head and Neck Surgery Foundation 2015.

  18. 77 FR 29362 - Kohler Company, Malvern Division, Including On-Site Leased Workers From Manpower Staffing and Dow... (United States)


    ... Division, Including On-Site Leased Workers From Manpower Staffing and Dow Cleaning Services, Malvern, AR..., and components. The company reports that workers from Dow Cleaning Services were employed on-site at... leased from Dow Cleaning Services working on-site at the Malvern, Arkansas location of Kohler Company...

  19. Trauma Center Staffing, Infrastructure, and Patient Characteristics that Influence Trauma Center Need

    Directory of Open Access Journals (Sweden)

    Faul, Mark


    Full Text Available Introduction: The most effective use of trauma center resources helps reduce morbidity and mortality, while saving costs. Identifying critical infrastructure characteristics, patient characteristics and staffing components of a trauma center associated with the proportion of patients needing major trauma care will help planners create better systems for patient care.   Methods: We used the 2009 National Trauma Data Bank-Research Dataset to determine the proportion of critically injured patients requiring the resources of a trauma center within each Level I-IV trauma center (n=443. The outcome variable was defined as the portion of treated patients who were critically injured. We defined the need for critical trauma resources and interventions (“trauma center need” as death prior to hospital discharge, admission to the intensive care unit, or admission to the operating room from the emergency department as a result of acute traumatic injury. Generalized Linear Modeling (GLM was used to determine how hospital infrastructure, staffing Levels, and patient characteristics contributed to trauma center need.     Results: Nonprofit Level I and II trauma centers were significantly associated with higher levels of trauma center need. Trauma centers that had a higher percentage of transferred patients or a lower percentage of insured patients were associated with a higher proportion of trauma center need.  Hospital infrastructure characteristics, such as bed capacity and intensive care unit capacity, were not associated with trauma center need. A GLM for Level III and IV trauma centers showed that the number of trauma surgeons on staff was associated with trauma center need. Conclusion: Because the proportion of trauma center need is predominantly influenced by hospital type, transfer frequency, and insurance status, it is important for administrators to consider patient population characteristics of the catchment area when planning the

  20. Does mental health staffing level affect antipsychotic prescribing? Analysis of Italian national statistics. (United States)

    Starace, Fabrizio; Mungai, Francesco; Barbui, Corrado


    In mental healthcare, one area of major concern identified by health information systems is variability in antipsychotic prescribing. While most studies have investigated patient- and prescriber-related factors as possible reasons for such variability, no studies have investigated facility-level characteristics. The present study ascertained whether staffing level is associated with antipsychotic prescribing in community mental healthcare. A cross-sectional analysis of data extracted from the Italian national mental health information system was carried out. For each Italian region, it collects data on the availability and use of mental health facilities. The rate of individuals exposed to antipsychotic drugs was tested for evidence of association with the rate of mental health staff availability by means of univariate and multivariate analyses. In Italy there were on average nearly 60 mental health professionals per 100,000 inhabitants, with wide regional variations (range 21 to 100). The average rate of individuals prescribed antipsychotic drugs was 2.33%, with wide regional variations (1.04% to 4.01%). Univariate analysis showed that the rate of individuals prescribed antipsychotic drugs was inversely associated with the rate of mental health professionals available in Italian regions (Kendall's tau -0.438, p = 0.006), with lower rates of antipsychotic prescriptions in regions with higher rates of mental health professionals. After adjustment for possible confounders, the total availability of mental health professionals was still inversely associated with the rate of individuals exposed to antipsychotic drugs. The evidence that staffing level was inversely associated with antipsychotic prescribing indicates that any actions aimed at decreasing variability in antipsychotic prescribing need to take into account aspects related to the organization of the mental health system.

  1. Analysis of patients with decompression illness transported via physician-staffed emergency helicopters

    Directory of Open Access Journals (Sweden)

    Yasumasa Oode


    Full Text Available Context: There have been few reports investigating the effects of air transportation on patients with decompression illness (DCI. Aims: To investigate the influence of air transportation on patients with DCI transported via physician-staffed emergency helicopters (HEMS: Emergency medical system of physician-staffed emergency helicopters. Settings and Design: A retrospective medical chart review in a single hospital. Materials and Methods: A medical chart review was retrospectively performed in all patients with DCI transported via HEMS between July 2009 and June 2013. The exclusion criteria included cardiopulmonary arrest on surfacing. Statistical analysis used: The paired Student′s t-test. Results: A total of 28 patients were treated as subjects. Male and middle-aged subjects were predominant. The number of patients who suddenly surfaced was 15/28. All patients underwent oxygen therapy during flight, and all but one patient received the administration of lactate Ringer fluid. The subjective symptoms of eight of 28 subjects improved after the flight. The range of all flights under 300 m above sea level. There were no significant differences between the values obtained before and after the flight for Glasgow coma scale, blood pressure, and heart rate. Concerning the SpO 2 , statistically significant improvements were noted after the flight (96.2 ± 0.9% versus 97.3 ± 0.7%. There were no relationships between an improvement in subjective symptoms and the SpO 2 . Conclusion: Improvements in the subjective symptoms and/or SpO 2 of patients with DCI may be observed when the patient is transported via HEMS under flights less than 300 m in height with the administration of oxygen and fluids.

  2. TENCompetence Competence Observatory

    NARCIS (Netherlands)

    Vervenne, Luk


    Vervenne, L. (2007) TENCompetence Competence Observatory. Sources available Available under the three clause BSD license, copyright TENCompetence Foundation.

  3. Competent poverty training. (United States)

    Stabb, Sally D; Reimers, Faye A


    Despite numerous calls to the discipline, attention to poverty and social class remains minimal in psychology even though most human experience is significantly affected by social ranking. As a result, educators lack models for training in the context of poverty. Recent and concerted efforts to define and implement competency-based models for the practice of professional psychology have resulted in the creation of Competency Benchmarks (American Psychological Association, 2011). Here, these Competency Benchmarks frame the integration of best practices in working with poor and working-class clients with what we know about what constitutes good training. The result is a competency-based approach for those who are training psychologists-to-be to work effectively with economically challenged clients. © 2012 Wiley Periodicals, Inc.

  4. Production competence revisited

    DEFF Research Database (Denmark)

    Szász, Levente; Demeter, Krisztina; Boer, Harry


    Purpose – The purpose of this paper is to seek remedy to two major flaws of the production competence literature, which concern: the way the production competence construct is operationalized and the way its effects on performance are measured. Design/methodology/approach – The paper proposes...... to measure production competence as the two-dimensional operational level construct it actually is, and to use Slack’s (1994) importance performance matrix to study its business level performance effects. The three hypotheses developed are tested using a subsample of the International Manufacturing Strategy...... Survey database, which includes 465 manufacturing companies from 21 countries. Findings – The study offers additional empirical support for production competence theory. Going beyond supporting existing theory, the results give more detailed insight by indicating that low operational performance on even...

  5. Developing Leadership Competencies. (United States)

    Croft, Lucy; Seemiller, Corey


    This chapter provides an overview of leadership competencies including the history of emergence, contemporary uses, common frameworks, challenges, benefits, and future implications. © 2017 Wiley Periodicals, Inc., A Wiley Company.

  6. Adult educators' core competences

    DEFF Research Database (Denmark)

    Wahlgren, Bjarne


    Abstract Which competences do professional adult educators need? This research note discusses the topic from a comparative perspective, finding that adult educators’ required competences are wide-ranging, heterogeneous and complex. They are subject to context in terms of national and cultural...... environment as well as the kind of adult education concerned (e.g. basic education, work-related education etc.). However, it seems that it is possible to identify certain competence requirements which transcend national, cultural and functional boundaries. This research note summarises these common or “core......” requirements, organising them into four thematic subcategories: (1) communicating subject knowledge; (2) taking students’ prior learning into account; (3) supporting a learning environment; and (4) the adult educator’s reflection on his or her own performance. At the end of his analysis of different competence...

  7. Strategic Leader Competencies (United States)


    competencies in line with his "visionary leadership theory ." His concept draws extensively from sound, quantitative research and social learning theory . A key...element of Sashkin’s theory identifies and distinguishes between "behavioral skills" required at the highest leadership levels and "personal... LEADERSHIP COMPETENCIES: - drawn from theory and research .... Co, sistent with broad groups of personality characteristics identified by Stogdill (1948

  8. Managing Regulatory Body Competence

    International Nuclear Information System (INIS)


    In 2001, the IAEA published TECDOC 1254, which examined the way in which the recognized functions of a regulatory body for nuclear facilities results in competence needs. Using the systematic approach to training (SAT), TECDOC 1254 provided a framework for regulatory bodies for managing training and developing and their maintaining their competence. It has been successfully used by many regulators. The IAEA has also introduced a methodology and an assessment tool - Guidelines for Systematic Assessment of Regulatory Competence Needs (SARCoN) - which provides practical guidance on analysing the training and development needs of a regulatory body and, through a gap analysis, guidance on establishing competence needs and how to meet them. In 2009, the IAEA established a steering committee (supported by a bureau) with the mission to advise the IAEA on how it could best assist Member States to develop suitable competence management systems for their regulatory bodies. The committee recommended the development of a safety report on managing staff competence as an integral part of a regulatory body's management system. This Safety Report was developed in response to this request. It supersedes TECDOC 1254, broadens its application to regulatory bodies for all facilities and activities, and builds upon the experience gained through the application of TECDOC 1254 and SARCoN and the feedback received from Member States. This Safety Report applies to the management of adequate competence as needs change, and as such is equally applicable to the needs of States 'embarking' on a nuclear power programme. It also deals with the special case of building up the competence of regulatory bodies as part of the overall process of establishing an 'embarking' State's regulatory system

  9. Acquiring specific interpreting competence

    Directory of Open Access Journals (Sweden)

    Jana Zidar Forte


    Full Text Available In postgraduate interpreter training, the main objective of the course is to help trainees develop various competences, from linguistic, textual and cultural competence, to professional and specific interpreting competence. For simultaneous interpreting (SI, the main focus is on mastering the SI technique and strategies as well as on developing and strengthening communicative skills, which is discussed and illustrated with examples in the present paper. First, a brief overview is given of all the necessary competences of a professional interpreter with greater emphasis on specific interpreting competence for SI. In the second part of the paper, various approaches are described in terms of acquiring specific skills and strategies, specifically through a range of exercises. Besides interpreting entire speeches, practical courses should also consist of targeted exercises, which help trainees develop suitable coping strategies and mechanisms (later on almost automatisms, while at the same time "force" them to reflect on their individual learning process and interpreting performance. This provides a solid base on which trained interpreters can progress and develop their skills also after joining the professional sphere.

  10. Metadata Quality in Institutional Repositories May be Improved by Addressing Staffing Issues

    Directory of Open Access Journals (Sweden)

    Elizabeth Stovold


    Full Text Available A Review of: Moulaison, S. H., & Dykas, F. (2016. High-quality metadata and repository staffing: Perceptions of United States–based OpenDOAR participants. Cataloging & Classification Quarterly, 54(2, 101-116. Objective – To investigate the quality of institutional repository metadata, metadata practices, and identify barriers to quality. Design – Survey questionnaire. Setting – The OpenDOAR online registry of worldwide repositories. Subjects – A random sample of 50 from 358 administrators of institutional repositories in the United States of America listed in the OpenDOAR registry. Methods – The authors surveyed a random sample of administrators of American institutional repositories included in the OpenDOAR registry. The survey was distributed electronically. Recipients were asked to forward the email if they felt someone else was better suited to respond. There were questions about the demographics of the repository, the metadata creation environment, metadata quality, standards and practices, and obstacles to quality. Results were analyzed in Excel, and qualitative responses were coded by two researchers together. Main results – There was a 42% (n=21 response rate to the section on metadata quality, a 40% (n=20 response rate to the metadata creation section, and 40% (n=20 to the section on obstacles to quality. The majority of respondents rated their metadata quality as average (65%, n=13 or above average (30%, n=5. No one rated the quality as high or poor, while 10% (n=2 rated the quality as below average. The survey found that the majority of descriptive metadata was created by professional (84%, n=16 or paraprofessional (53%, n=10 library staff. Professional staff were commonly involved in creating administrative metadata, reviewing the metadata, and selecting standards and documentation. Department heads and advisory committees were also involved in standards and documentation

  11. Identifying nurse staffing research in Medline: development and testing of empirically derived search strategies with the PubMed interface. (United States)

    Simon, Michael; Hausner, Elke; Klaus, Susan F; Dunton, Nancy E


    The identification of health services research in databases such as PubMed/Medline is a cumbersome task. This task becomes even more difficult if the field of interest involves the use of diverse methods and data sources, as is the case with nurse staffing research. This type of research investigates the association between nurse staffing parameters and nursing and patient outcomes. A comprehensively developed search strategy may help identify nurse staffing research in PubMed/Medline. A set of relevant references in PubMed/Medline was identified by means of three systematic reviews. This development set was used to detect candidate free-text and MeSH terms. The frequency of these terms was compared to a random sample from PubMed/Medline in order to identify terms specific to nurse staffing research, which were then used to develop a sensitive, precise and balanced search strategy. To determine their precision, the newly developed search strategies were tested against a) the pool of relevant references extracted from the systematic reviews, b) a reference set identified from an electronic journal screening, and c) a sample from PubMed/Medline. Finally, all newly developed strategies were compared to PubMed's Health Services Research Queries (PubMed's HSR Queries). The sensitivities of the newly developed search strategies were almost 100% in all of the three test sets applied; precision ranged from 6.1% to 32.0%. PubMed's HSR queries were less sensitive (83.3% to 88.2%) than the new search strategies. Only minor differences in precision were found (5.0% to 32.0%). As with other literature on health services research, nurse staffing studies are difficult to identify in PubMed/Medline. Depending on the purpose of the search, researchers can choose between high sensitivity and retrieval of a large number of references or high precision, i.e. and an increased risk of missing relevant references, respectively. More standardized terminology (e.g. by consistent use of the

  12. Nurse staffing and education and hospital mortality in nine European countries: a retrospective observational study. (United States)

    Aiken, Linda H; Sloane, Douglas M; Bruyneel, Luk; Van den Heede, Koen; Griffiths, Peter; Busse, Reinhard; Diomidous, Marianna; Kinnunen, Juha; Kózka, Maria; Lesaffre, Emmanuel; McHugh, Matthew D; Moreno-Casbas, M T; Rafferty, Anne Marie; Schwendimann, Rene; Scott, P Anne; Tishelman, Carol; van Achterberg, Theo; Sermeus, Walter


    Austerity measures and health-system redesign to minimise hospital expenditures risk adversely affecting patient outcomes. The RN4CAST study was designed to inform decision making about nursing, one of the largest components of hospital operating expenses. We aimed to assess whether differences in patient to nurse ratios and nurses' educational qualifications in nine of the 12 RN4CAST countries with similar patient discharge data were associated with variation in hospital mortality after common surgical procedures. For this observational study, we obtained discharge data for 422,730 patients aged 50 years or older who underwent common surgeries in 300 hospitals in nine European countries. Administrative data were coded with a standard protocol (variants of the ninth or tenth versions of the International Classification of Diseases) to estimate 30 day in-hospital mortality by use of risk adjustment measures including age, sex, admission type, 43 dummy variables suggesting surgery type, and 17 dummy variables suggesting comorbidities present at admission. Surveys of 26,516 nurses practising in study hospitals were used to measure nurse staffing and nurse education. We used generalised estimating equations to assess the effects of nursing factors on the likelihood of surgical patients dying within 30 days of admission, before and after adjusting for other hospital and patient characteristics. An increase in a nurses' workload by one patient increased the likelihood of an inpatient dying within 30 days of admission by 7% (odds ratio 1·068, 95% CI 1·031-1·106), and every 10% increase in bachelor's degree nurses was associated with a decrease in this likelihood by 7% (0·929, 0·886-0·973). These associations imply that patients in hospitals in which 60% of nurses had bachelor's degrees and nurses cared for an average of six patients would have almost 30% lower mortality than patients in hospitals in which only 30% of nurses had bachelor's degrees and nurses cared

  13. Developing Creative Competencies

    DEFF Research Database (Denmark)

    Friis, Silje Alberthe Kamille


    This paper offers a theoretical framework for how to think about and understand creativity – and how to work with the development of creative competencies in design education. Most design students experience recurrent, individual challenges in design work, which have to do with their personal...... from the field of psychology, as well as research-in-practice with students at the Kolding School of Design and presents the outline of a model for how to work with and facilitate the development of creative competencies. While the research is still in its early phases, response from participants...

  14. Competence development in UAS

    DEFF Research Database (Denmark)

    Thorslund, Jørgen; Brodersen, Anne Mygind

    As a University of Applied Science (UAS) University College Lillebaelt in Denmark is addressing education, knowledge production and professional development in perspective of life-long and life-wide learning. It is our basic assumption that that internal competence development ? individually...... and organizationally - among UAS educators should be based on same learning concepts as used in professional development to avoid parallelism. Do for yourself, what you preach for others. Second, competence development of faculty is a central element in transformation of our institutions from schools of higher...

  15. Hospital staffing and local pay: an investigation into the impact of local variations in the competitiveness of nurses' pay on the staffing of hospitals in France. (United States)

    Combes, Jean-Baptiste; Delattre, Eric; Elliott, Bob; Skåtun, Diane


    Spatial wage theory suggests that employers in different regions may offer different pay rates to reflect local amenities and cost of living. Higher wages may be required to compensate for a less pleasant environment or a higher cost of living. If wages in a competing sector within an area are less flexible and therefore less competitive this may lead to an inability to employ staff. This paper considers the market for nursing staff in France where there is general regulation of wages and public hospitals compete for staff with the private hospital and non-hospital sectors. We consider two types of nursing staff, registered and assistant nurses and first establish the degree of spatial variation in the competitiveness of pay of nurses in public hospitals. We then consider whether these spatial variations are associated with variation in the employment of nursing staff. We find that despite regulation of pay in the public and private sector, there are substantial local variations in the competitiveness of nurses' pay. We find evidence that the spatial variations in the competitiveness of pay are associated with relative numbers of assistant nurses but not registered nurses. While we find the influence of the competitiveness of pay is small, it suggests that nonpay conditions may be an important factor in adjusting the labour market as might be expected in such a regulated market.

  16. Customer Perception of a Supermarket Nutrition Centre Staffed by a Registered Dietitian. (United States)

    Evans, KATE; Taper, JANETTE; Quintal, DEBORAH


    The purpose of this study was to examine consumers' attitudes toward a supermarket nutrition centre staffed full time by a registered dietitian. A questionnaire was administered over three consecutive days in that store and in a control store that was similar to the experimental site in every way, except for the absence of a nutrition centre. Participants were chosen randomly at timed intervals in specific areas of the store. Of 428 customers approached, 232 agreed to participate in the survey. At the experimental site, 75% of the participants were extremely satisfied with the registered dietitian's services and 69% ranked having a registered dietitian on staff in any store as extremely important, compared to 31% at the control site (p importance of 13 required and optional services offered by the supermarkets, 15% of participants at the experimental site ranked having a registered dietitian on staff in the top five, compared with 4% at the control site (p service. There may therefore be an expanded role for registered dietitians in the supermarket setting.

  17. Does safety climate moderate the influence of staffing adequacy and work conditions on nurse injuries? (United States)

    Mark, Barbara A; Hughes, Linda C; Belyea, Michael; Chang, Yunkyung; Hofmann, David; Jones, Cheryl B; Bacon, Cynthia T


    Hospital nurses have one of the highest work-related injury rates in the United States. Yet, approaches to improving employee safety have generally focused on attempts to modify individual behavior through enforced compliance with safety rules and mandatory participation in safety training. We examined a theoretical model that investigated the impact on nurse injuries (back injuries and needlesticks) of critical structural variables (staffing adequacy, work engagement, and work conditions) and further tested whether safety climate moderated these effects. A longitudinal, non-experimental, organizational study, conducted in 281 medical-surgical units in 143 general acute care hospitals in the United States. Work engagement and work conditions were positively related to safety climate, but not directly to nurse back injuries or needlesticks. Safety climate moderated the relationship between work engagement and needlesticks, while safety climate moderated the effect of work conditions on both needlesticks and back injuries, although in unexpected ways. DISCUSSION AND IMPACT ON INDUSTRY: Our findings suggest that positive work engagement and work conditions contribute to enhanced safety climate and can reduce nurse injuries.

  18. The Nuclear Education and Staffing Challenge: Rebuilding Critical Skills in Nuclear Science and Technology

    International Nuclear Information System (INIS)

    Wogman, Ned A.; Bond, Leonard J.; Waltar, Alan E.; Leber, R E.


    The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory where 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of Nuclear Legacies, Global Security, Nonproliferation, Homeland Security and National Defense, Radiobiology and Nuclear Energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. This paper presents the current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs

  19. Costs, Staffing, and Services of Assisted Living in the United States: A Literature Review. (United States)

    Kisling-Rundgren, Amy; Paul, David P; Coustasse, Alberto


    Assisted-living facilities (ALFs), which provide a community for residents who require assistance throughout their day, are an important part of the long-term-care system in the United States. The costs of ALFs are paid either out of pocket, by Medicaid, or by long-term-care insurance. Monthly costs of ALFs have increased over the past 5 years on an average of 4.1%. The purpose of this research was to examine the future trends in ALFs in the United States to determine the impact of health care on costs. The methodology for this study was a literature review, and a total of 32 sources were referenced. Trends in monthly costs of ALFs have increased from 2004 to 2014. Within the past 5 years, there has been an increase on average of 4.1% in assisted-living costs. Medicaid is one payer for residents of ALFs, whereas another alternative is the use of long-term-care insurance. Unfortunately, Medicare does not pay for ALFs. Staffing concerns in ALFs are limited because of each state having different rules and regulations. Turnover and retention rates of nurses in ALFs are suggested to be high, whereas vacancy rate for nurses is suggested to be lower. The baby-boomer generation can be one contribution to the increase in costs. Over the years, there has been an increase in Alzheimer disease, which has had also an effect on cost in ALFs.

  20. The Nuclear Education and Staffing Challenge: Rebuilding Critical Skills in Nuclear Science and Technology

    International Nuclear Information System (INIS)

    Wogman, Ned A.; Bond, Leonard J.; Waltar, Alan E.; Leber, R E.


    The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory were 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of Nuclear Legacies, Global Security, Nonproliferation, Homeland Security and National Defense, Radiobiology and Nuclear Energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. This paper presents the current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs

  1. The nuclear education and staffing challenge: Rebuilding critical skills in nuclear science and technology

    International Nuclear Information System (INIS)

    Wogman, N.A.; Bond, L.J.; Waltar, A.E.; Leber, R.E.


    The United States, the Department of Energy (DOE) and its National Laboratories, including the Pacific Northwest National Laboratory (PNNL), are facing a serious attrition of nuclear scientists and engineers and their capabilities through the effects of aging staff. Within the DOE laboratories, 75% of nuclear personnel will be eligible to retire by 2010. It is expected that there will be a significant loss of senior nuclear science and technology staff at PNNL within five years. PNNL's nuclear legacy is firmly rooted in the DOE Hanford site, the World War II Manhattan Project, and subsequent programs. Historically, PNNL was a laboratory where 70% of its activities were nuclear/radiological, and now just under 50% of its current business science and technology are nuclear and radiologically oriented. Programs in the areas of nuclear legacies, global security, nonproliferation, homeland security and national defense, radiobiology and nuclear energy still involve more than 1,000 of the 3,800 current laboratory staff, and these include more than 420 staff who are certified as nuclear/radiological scientists and engineers. Current challenges faced by PNNL that require an emerging strategy to solve the nuclear staffing issues through the maintenance and replenishment of the human nuclear capital needed to support PNNL nuclear science and technology programs are presented. (author)

  2. Analysis of patients with bodyboarding injuries transported by physician-staffed emergency helicopter

    Directory of Open Access Journals (Sweden)

    Kazuhiko Omori


    Full Text Available Context: There have been no reports that have studied the characteristics specific to bodyboard injuries. Aims: To clarify characteristics to bodyboard injuries. Settings and Design: A retrospective medical chart review. Materials and Methods: A medical chart review was retrospectively performed for all patients with spinal cord injuries transported via physician-staffed emergency helicopters between January 2009 and October 2013. The subjects were divided into two groups based on whether they had a spinal cord injury induced by bodyboarding (Bodyboard group, n = 14 or not (Control group, n = 14. Statistical Analysis Used: Using a χ2 -test, Mann-Whitney U-test and non-paired Student′s t-test. Results: All but one of the subjects had spinal canal stenosis. The age of the patients in the Bodyboard group was younger than that of the Control group. The ratio of males and Glasgow Coma Scale of the Bodyboard group were higher than those on the Control group. The spinal cord injury induced by bodyboarding typically occurred after impacts of the head or face with the sea bottom while the subject was being buffeted by the waves. The severity of the spinal cord injury in the Bodyboard group was lower than that in the Control group. Conclusion: Bodyboarding tended to induce spinal cord injuries after the head or face collided with the sea bottom, and was more common in middle-aged males during the summer season, and was associated with a favorable outcome.


    Directory of Open Access Journals (Sweden)

    Anatoliy Gorban


    Full Text Available In the article the staffing problems of transport complex in the period of its fundamental technical change and intensive development of 1960–1980-ies are described. The main purpose of this article is to analyze the peculiarities of personnel potential development of transport complex of the Ukrainian SSR in the years of the intensive development of transport sectors, figure out the social component of the measures to improve the efficiency of transport networks. Methodology. In this article we used the method of analysis. The qualitative personnel structure, training of skilled workers in the educational institutions and other forms of improvement of personal skills of transport workers are analyzed. The causes of staff turnover and low labour discipline are studied. Practical implementation. This article shows the possible opportunities for the modern transport complex of Ukraine, how to be successful and competitive in the market. The historical background of this article can be very useful for present managers of the transport complex. Results. The author makes a general conclusion that the main causes of personnel fluctuation in transport brunches are low wages, pour conditions of work and lack of accomodations for the staff. The social and practical measures to improve effectiveness of work with personnel of all brunches of transport system are characterized.

  4. Ant colony optimization and event-based dynamic task scheduling and staffing for software projects (United States)

    Ellappan, Vijayan; Ashwini, J.


    In programming change organizations from medium to inconceivable scale broadens, the issue of wander orchestrating is amazingly unusual and testing undertaking despite considering it a manual system. Programming wander-organizing requirements to deal with the issue of undertaking arranging and in addition the issue of human resource portion (also called staffing) in light of the way that most of the advantages in programming ventures are individuals. We propose a machine learning approach with finds respond in due order regarding booking by taking in the present arranging courses of action and an event based scheduler revives the endeavour arranging system moulded by the learning computation in perspective of the conformity in event like the begin with the Ander, the instant at what time possessions be free starting to ended errands, and the time when delegates stick together otherwise depart the wander inside the item change plan. The route toward invigorating the timetable structure by the even based scheduler makes the arranging method dynamic. It uses structure components to exhibit the interrelated surges of endeavours, slip-ups and singular all through different progression organizes and is adjusted to mechanical data. It increases past programming wander movement ask about by taking a gander at a survey based process with a one of a kind model, organizing it with the data based system for peril assessment and cost estimation, and using a choice showing stage.

  5. Nurse staffing and system integration and change indicators in acute care hospitals: evidence from a balanced scorecard. (United States)

    McGillis Hall, Linda; Peterson, Jessica; Baker, G Ross; Brown, Adalsteinn D; Pink, George H; McKillop, Ian; Daniel, Imtiaz; Pedersen, Cheryl


    This study examined relationships between financial indicators for nurse staffing and organizational system integration and change indicators. These indicators, along with hospital location and type, were examined in relation to the nursing financial indicators. Results showed that different indicators predicted each of the outcome variables. Nursing care hours were predicted by the hospital type, geographic location, and the system. Both nursing and patient care hours were significantly related to dissemination and benchmarking of clinical data.

  6. Impact of an electronic health record operating room management system in ophthalmology on documentation time, surgical volume, and staffing. (United States)

    Sanders, David S; Read-Brown, Sarah; Tu, Daniel C; Lambert, William E; Choi, Dongseok; Almario, Bella M; Yackel, Thomas R; Brown, Anna S; Chiang, Michael F


    Although electronic health record (EHR) systems have potential benefits, such as improved safety and quality of care, most ophthalmology practices in the United States have not adopted these systems. Concerns persist regarding potential negative impacts on clinical workflow. In particular, the impact of EHR operating room (OR) management systems on clinical efficiency in the ophthalmic surgery setting is unknown. To determine the impact of an EHR OR management system on intraoperative nursing documentation time, surgical volume, and staffing requirements. For documentation time and circulating nurses per procedure, a prospective cohort design was used between January 10, 2012, and January 10, 2013. For surgical volume and overall staffing requirements, a case series design was used between January 29, 2011, and January 28, 2013. This study involved ophthalmic OR nurses (n = 13) and surgeons (n = 25) at an academic medical center. Electronic health record OR management system implementation. (1) Documentation time (percentage of operating time documenting [POTD], absolute documentation time in minutes), (2) surgical volume (procedures/time), and (3) staffing requirements (full-time equivalents, circulating nurses/procedure). Outcomes were measured during a baseline period when paper documentation was used and during the early (first 3 months) and late (4-12 months) periods after EHR implementation. There was a worsening in total POTD in the early EHR period (83%) vs paper baseline (41%) (P system implementation was associated with worsening of intraoperative nursing documentation time especially in shorter procedures. However, it is possible to implement an EHR OR management system without serious negative impacts on surgical volume and staffing requirements.

  7. Pragmatics and Communicative Competences (United States)

    Lin, Grace Hui Chin; Su, Simon Chun Feng; Ho, Max Ming Hsuang


    Pragmatics is included in one of four communicative competences (Canale, 1980). It is necessary and important to teach pragmatics at school in our globalized world in order to avoid as much as misunderstanding, which is likely to stem from cultural difference. As a result, greater importance should be attached to diverse customs and pragmatics.…

  8. The MUPPLE competence continuum

    NARCIS (Netherlands)

    Wild, Joanna; Wild, Fridolin; Kalz, Marco; Specht, Marcus; Hofer, Margit


    Wild, J., Wild, F., Kalz, M., Specht, M., & Hofer, M. (2009). The MUPPLE competence continuum. In F. Wild, M. Kalz, M. Palmér & D. Müller (Eds.), Proceedings of 2nd Workshop Mash-Up Personal Learning Envrionments (MUPPLE'09). Workshop in conjunction with 4th European Conference on Technology

  9. Evolution of subsidiary competences

    DEFF Research Database (Denmark)

    Geisler Asmussen, Christian; Pedersen, Torben; Dhanaraj, Charles

    of competitive advantage of nations, we hypothesize the contingencies under which heterogeneity in host environments influences subsidiary competence configuration. We test our model with data from more than 2,000 subsidiaries in seven Western European countries. Our results provide new insights on the evolution...

  10. Competing for Criminal Money

    NARCIS (Netherlands)

    Rawlings, G.; Unger, B.


    To compete for criminal money by means of low bank secrecy seems a tempting strategy for countries in order to attract additional funds. We show in a model that this “Seychelles-strategy” can increase national output, in particular if a country takes a (Stackelberg ) leadership in the competition

  11. Diesel Vehicle Maintenance Competencies. (United States)

    Braswell, Robert; And Others

    Designed to provide a model set of competencies, this manual presents tasks which were identified by employers, employees, and teachers as important in a postsecondary diesel vehicle maintenance curriculum. The tasks are divided into seven major component areas of instruction: chassis and suspension, diesel engines, diesel fuel, electrical,…

  12. Competencies, skills and assessment

    DEFF Research Database (Denmark)

    Højgaard, Tomas


    This paper is an analysis of the challenge of assessing student learning and how that is affected by using descriptions of competencies as a core element when describing the aims of the learning process. Assessment is modelled as a three step process; characterising, identifying and judging, to a...... the characterisation part of an assessment process. From a teaching and teachers' perspective, the latter is far more important than the former.......This paper is an analysis of the challenge of assessing student learning and how that is affected by using descriptions of competencies as a core element when describing the aims of the learning process. Assessment is modelled as a three step process; characterising, identifying and judging......, to allow for the following argument: Working with competency descriptions is rightly said to make judging more difficult. This potentially lowers the reliability of the assessment. But competency descriptions also carry a great potential of raising the validity of the assessment by focusing...

  13. Competence preservation through education

    International Nuclear Information System (INIS)

    Ham, U.; Koessler, M.


    For fulfilling their tasks GNS depends on personnel with specific knowledge and competence. GNS answers to these challenges by various measures for education and training in order to have skilled personnel available nowadays and in the future. By these measures and the internal organisation regarding responsibilities in radiation protection requirements resulting from the expected Euratom Basic Safety Standards (BSS) are met. (orig.)

  14. Promoting Intercultural Competencies

    International Nuclear Information System (INIS)

    Bachner, Katherine M.


    What is culture? • Culture is the acquired knowledge people use to interpret experience and generate behavior. • It is the way of life a people pass down from one generation to the next through learning. • It is the rules for living and functioning in society that come from growing up in a specific society, and it is a set of acquired skills, habits and society-specific training that gives a group of people its identity. What is intercultural competency? • Cultures can have widely varying perspectives. • These perspectives influence the way that a person develops relationships, responds to situations, and operates in a professional setting. • Intercultural competency is the ability to comprehend and navigate the ways that culture can influence behavior, relationships, and the results of collaboration and interaction. What does becoming interculturally competent entail? • Intercultural preparedness is not merely travelling, learning a foreign language, or being exposed to other cultures. • Developing competency requires thinking about the challenges posed to our work by a multi-cultural workforce in a way that prepares employees and staff for potential incidents or misunderstandings. • It is impossible to avoid all intercultural misunderstandings, but learning to anticipate them and deal with them is key to developing any training program on culture

  15. Classical competing risks

    CERN Document Server

    Crowder, Martin J


    If something can fail, it can often fail in one of several ways and sometimes in more than one way at a time. There is always some cause of failure, and almost always, more than one possible cause. In one sense, then, survival analysis is a lost cause. The methods of Competing Risks have often been neglected in the survival analysis literature. Written by a leading statistician, Classical Competing Risks thoroughly examines the probability framework and statistical analysis of data of Competing Risks. The author explores both the theory of the subject and the practicalities of fitting the models to data. In a coherent, self-contained, and sequential account, the treatment moves from the bare bones of the Competing Risks setup and the associated likelihood functions through survival analysis using hazard functions. It examines discrete failure times and the difficulties of identifiability, and concludes with an introduction to the counting-process approach and the associated martingale theory.With a dearth of ...

  16. Competing Auctions of Skills

    DEFF Research Database (Denmark)

    Kennes, John; le Maire, Christian Daniel

    The model of competing sellers McAfee (1993) is applied to a labor market environment with heterogeneous workers, who differ by outside option and skill type, and heterogeneous firms, who differ by the amount of output produced when matched to each possible worker tyoe. We derive both a static...

  17. Competence and the Workplace

    NARCIS (Netherlands)

    Van Yperen, Nico W.; Elliot, Andrew J.; Dweck, Carol S.; Yeager, David S.


    The focus of this chapter on competence at the workplace is on workers’ willingness to perform, which is defined as individuals’ psychological characteristics that affect the degree to which they are inclined to perform their tasks. People may be motivated by either the positive, appetitive

  18. Assessing cataract surgical competency

    NARCIS (Netherlands)

    Lee, Andrew G.; Greenlee, Emily; Oetting, Thomas A.; Beaver, Hilary A.; Johnson, A. Tim; Boldt, H. Culver; Abramoff, Michael; Olson, Richard; Carter, Keith


    The Accreditation Council for Graduate Medical Education has mandated that all residency training programs teach and assess 6 general competencies.1 A.G. Lee and K.D. Carter, Managing the new mandate in resident education: A blueprint for translating a national mandate into local compliance,

  19. Calibrating Communication Competencies (United States)

    Surges Tatum, Donna


    The Many-faceted Rasch measurement model is used in the creation of a diagnostic instrument by which communication competencies can be calibrated, the severity of observers/raters can be determined, the ability of speakers measured, and comparisons made between various groups.

  20. Skills and Competencies

    Directory of Open Access Journals (Sweden)

    Nasios Orinos


    Full Text Available This article presents the results of a study aimed to investigate the requirements of the business sector in light of the skills and competencies students should have in order to be recruited. In this fashion, the study intended to measure the importance of the skills and competencies sought by the business world, revealing ways through which students can develop such skills. This project portrayed that, some of the required classes will certainly give students a strong theoretical background but they will neither completely prepare this student with all possible skills or competencies nor provide the student with any practical experience that will enable him/her to be more competitive when entering the business market. In some classes, however, like Public Speaking, which is designed to teach presentation skills, successful students are able to build good communication and interpersonal skills. Additionally, an English writing class will certainly attempt to provide them with strong writing skills, and a business class will possibly demand reading skills. Moreover, a calculus and a statistics class will provide basic arithmetic/mathematical skills. However, through this project it is proven that all of these classes will neglect the indoctrination of creative thinking in students, or make students believe in their own self-worth (self-esteem skills; the courses will also fail to develop the sense of urgency, drive and determination that students should possess not just to compete but also to survive in a business world.

  1. Equal opportunity to compete

    International Development Research Centre (IDRC) Digital Library (Canada)

    advantage of their customers by fixing prices or skimping on quality. The underlying idea is that true competition in the marketplace produces a range of efficiencies and asso- ciated benefits that the competing firms, in their quest to win customer loyalty, will feel compelled to pass along to consumers. In recent years, many ...

  2. Nursing Informatics Competency Program (United States)

    Dunn, Kristina


    Currently, C Hospital lacks a standardized nursing informatics competency program to validate nurses' skills and knowledge in using electronic medical records (EMRs). At the study locale, the organization is about to embark on the implementation of a new, more comprehensive EMR system. All departments will be required to use the new EMR, unlike…

  3. Competence, governance, and entrepreneurship

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Mahnke, Volker

    This title illustrates modern economics. Because it informs strategic choices, it is relevant to business administration in general, and for strategic management in particular. Two dominant streams may be identified in the literature, namely the "competence" and "governance" perspectives on the f......, and entrepreneurship to advance and stimulate economic strategy research....

  4. Competences of IT Architects

    NARCIS (Netherlands)

    Wieringa, Roelf J.; van Eck, Pascal; Steghuis, Claudia; Proper, Erik


    The field of architecture in the digital world uses a plethora of terms to refer to different kinds of architects, and recognises a confusing variety of competences that these architects are required to have. Different service providers use different terms for similar architects and even if they use

  5. Competences of IT Architects

    NARCIS (Netherlands)

    Wieringa, Roelf J.; van Eck, Pascal; Steghuis, C.; Proper, E.


    The field of architecture in the digital world uses a plethora of terms to refer to different kinds of architects, and recognizes a confusing variety of competences that these architects are required to have. Different service providers use different terms for similar architects and even if they use

  6. Guidelines for equipment and staffing of radiotherapy facilities in the European countries: Final results of the ESTRO-HERO survey

    International Nuclear Information System (INIS)

    Dunscombe, Peter; Grau, Cai; Defourny, Noémie; Malicki, Julian; Borras, Josep M.; Coffey, Mary; Bogusz, Marta; Gasparotto, Chiara; Slotman, Ben; Lievens, Yolande; Kokobobo, Arianit; Sedlmayer, Felix; Slobina, Elena; De Hertogh, Olivier; Hadjieva, Tatiana; Petera, Jiri; Eriksen, Jesper Grau; Jaal, Jana; Bly, Ritva; Azria, David


    Background and purpose: In planning to meet evidence based needs for radiotherapy, guidelines for the provision of capital and human resources are central if access, quality and safety are not to be compromised. A component of the ESTRO-HERO (Health Economics in Radiation Oncology) project is to document the current availability and content of guidelines for radiotherapy in Europe. Materials and methods: An 84 part questionnaire was distributed to the European countries through their national scientific and professional radiotherapy societies with 30 items relating to the availability of guidelines for equipment and staffing and selected operational issues. Twenty-nine countries provided full or partial evaluable responses. Results: The availability of guidelines across Europe is far from uniform. The metrics used for capital and human resources are variable. There seem to have been no major changes in the availability or specifics of guidelines over the ten-year period since the QUARTS study with the exception of the recent expansion of RTT staffing models. Where comparison is possible it appears that staffing for radiation oncologists, medical physicists and particularly RTTs tend to exceed guidelines suggesting developments in clinical radiotherapy are moving faster than guideline updating. Conclusion: The efficient provision of safe, high quality radiotherapy services would benefit from the availability of well-structured guidelines for capital and human resources, based on agreed upon metrics, which could be linked to detailed estimates of need

  7. Competing views on cancer

    Indian Academy of Sciences (India)

    Despite intense research efforts that have provided enormous insight, cancer continues to be a poorly understood disease. There has been much debate over whether the cancerous state can be said to originate in a single cell or whether it is a reflection of aberrant behaviour on the part of a 'society of cells'. This article ...

  8. The Interrelations between Competences for Sustainable Development and Research Competences (United States)

    Lambrechts, Wim; Van Petegem, Peter


    Purpose: The purpose of this paper is to explore how competences for sustainable development and research interrelate within a context of competence-based higher education. Specific focus is oriented towards strengthening research competences for sustainability. Design/methodology/approach: Following a hermeneutic-interpretive methodology, this…

  9. Competency Analytics Tool: Analyzing Curriculum Using Course Competencies (United States)

    Gottipati, Swapna; Shankararaman, Venky


    The applications of learning outcomes and competency frameworks have brought better clarity to engineering programs in many universities. Several frameworks have been proposed to integrate outcomes and competencies into course design, delivery and assessment. However, in many cases, competencies are course-specific and their overall impact on the…

  10. Preparing Pre-Service Teachers to Integrate Technology: An Analysis of the Emphasis on Digital Competence in Teacher Education Curricula (United States)

    Instefjord, Elen; Munthe, Elaine


    This article focuses on integration of digital competence in curriculum documents for teacher education in Norway. A model inspired by the work of Zhao, Pugh, Sheldon and Byers, as well as Krumsvik and Mishra and Koehler, has been developed as an analytical framework. Teachers' digital competence is here understood as comprising three knowledge…

  11. Experts views' on Digital Competence

    NARCIS (Netherlands)

    Janssen, José; Stoyanov, Slavi


    Janssen, J., & Stoyanov, S. (2012, 20 November). Online Consultation for a Digital Competence Framework: Experts' views on Digital Competence. Workshop presentation at the Institute for Prospective Technological Studies, Seville, Spain.

  12. Documentation of Improvement Competences

    DEFF Research Database (Denmark)

    Johansen, Jørn; Back, Karsten Kristensen; Korsaa, Morten


    competences, which should or could be brought into play during the project – and therefor also in one way or another addresses the quality of the activated competences in the improvement project – a kind of qualification. The clue is that the structure of the report follows the units and element in the SPI......This paper demonstrates how a report used in a Master in Project management and Process improvement training at Roskilde University Denmark can be used to evaluate if a student can pass the ECQA SPI Manager exam. It also demonstrates how the structure of the report addresses all necessary...... Manager job role, which is based on the SPI Manifesto and the ImprovAbilityTM model (part of ISO/IEC 33014 Guideline for Process Improvement) among other types of knowledge and research....

  13. Language competence in movement

    DEFF Research Database (Denmark)

    Laursen, Helle Pia; Mogensen, Naja Dahlstrup


    This article examines how, in a multilingual perspective, language competence is experienced, talked about and practiced by language users themselves. By viewing children as active co-creators of the spaces in which language is used, this article contributes to a research tradition in which focus...... multilingual children's language and literacy acquisition processes, we direct our focus to a single child's active exploration of what it means to know a language. Through analysis of interviews and researcher generated activities, we see how this child both describes and does language competence...... as a phenomenon that has several meanings, is social, is dependent on location and is unpredictable. Thus, we demonstrate how focus on the child's perspective of what it means to ‘know language’ can lead to insights into the creative, complex and dynamic processes that are part of children's active meaning making...

  14. Intercultural Competence: Another Challenge

    Directory of Open Access Journals (Sweden)

    Norma Barletta Manjarrés


    Full Text Available This paper intends to draw the attention of language teachers and educational authorities to the area of culture teaching in foreign language education at a time when the recently issued Basic Standards of Competencies in Foreign Language have conferred modest attention to this aspect of language education. The paper first describes the notion of Intercultural communicative competence. It then discusses the tensions between this new understanding of the teaching of culture and the prevailing teaching practices, approaches, beliefs and discourses associated with the learning and teaching of culture. Third, it reports on the results of a study which critically analyzed the academic discourses of in-service teachers in Colombia regarding the cultural component of foreign language programs; finally, it proposes ways to start taking new directions.


    Directory of Open Access Journals (Sweden)

    Carmen-Laura ZARZU


    Full Text Available The current essay focuses on the need for formal education in the area of intercultural communication and training of intercultural competences. It builds on cultural identity and diversity literature, on the experiment conducted in the Low Countries in introducing a new topic for students from social sciences referring to intercultural communication and on reports and papers of international companies, organizations and agencies. The argument of globalization which should give equal opportunities to each and every world’s citizen adds pressure on managers dealing with multicultural teams. Intercultural competences gain importance in recruiting, while turning cultural diversity in team performance requires skills, knowledge and experience. Managing cultural diversity presupposes that people are aware, recognize, understand and deal with differences. Thus intercultural communication should be studied as a stand-alone topic or imbedded in other subjects in different forms of education or training, so people are prepared for intercultural, social and professional relationships.

  16. Competence, governance, and entrepreneurship

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Mahnke, Volker

    This title illustrates modern economics. Because it informs strategic choices, it is relevant to business administration in general, and for strategic management in particular. Two dominant streams may be identified in the literature, namely the "competence" and "governance" perspectives on the f......This title illustrates modern economics. Because it informs strategic choices, it is relevant to business administration in general, and for strategic management in particular. Two dominant streams may be identified in the literature, namely the "competence" and "governance" perspectives...... on the firm. While there has been little direct discussion between the main proponents of these perspectives, both claim that they are reaching for a "strategic theory of the firm". Such a theory would not only shed light on the classical questions considered in the theory of the firm (e.g. why firms exist......, and entrepreneurship to advance and stimulate economic strategy research....

  17. FIRST robots compete (United States)


    FIRST teams and their robots work to go through the right motions at the FIRST competition. Students from all over the country are at the KSC Visitor Complex for the FIRST (For Inspiration and Recognition of Science and Technology) Southeast Regional competition March 9-11 in the Rocket Garden. Teams of high school students are testing the limits of their imagination using robots they have designed, with the support of business and engineering professionals and corporate sponsors, to compete in a technological battle against other schools' robots. Of the 30 high school teams competing, 16 are Florida teams co-sponsored by NASA and KSC contractors. Local high schools participating are Astronaut, Bayside, Cocoa Beach, Eau Gallie, Melbourne, Melbourne Central Catholic, Palm Bay, Rockledge, Satellite, and Titusville.

  18. Spiritual Competency Scale: Further Analysis (United States)

    Dailey, Stephanie F.; Robertson, Linda A.; Gill, Carman S.


    This article describes a follow-up analysis of the Spiritual Competency Scale, which initially validated ASERVIC's (Association for Spiritual, Ethical and Religious Values in Counseling) spiritual competencies. The study examined whether the factor structure of the Spiritual Competency Scale would be supported by participants (i.e., ASERVIC…

  19. Managing Person-Centered Dementia Care in an Assisted Living Facility: Staffing and Time Considerations. (United States)

    Simmons, Sandra F; Coelho, Chris S; Sandler, Andrew; Shah, Avantika S; Schnelle, John F


    To describe (a) the unlicensed staff time necessary to provide quality activities of daily living (ADL) care to residents receiving dementia care within an assisted living facility and (b) a staff management approach to maintain quality ADL care. Supervisory staff used a standardized observational method to measure ADL care quality and the staff time to provide care during the morning and evening across 12 consecutive months. Staff were given individual feedback about the quality of their care provision following each observation. The average staff time to provide ADL care averaged 35 (± 11) minutes per resident per care episode with bathing and 18 (± 6) minutes/resident/care episode without bathing. Morning ADL care required significantly more staff time than evening care. There was not a significant relationship between residents' levels of cognitive impairment or ADL dependency and the staff time to provide ADL care. Quality ADL care was maintained for 12 months. This study provides novel data related to the amount of staff time necessary to provide quality ADL care for persons with dementia in an assisted living care setting. This study also describes a standardized approach to staff management that was effective in maintaining quality ADL care provision. Assisted living facilities should consider these data when determining the necessary unlicensed staffing level to provide person-centered ADL care and how to effectively manage direct care providers. © The Author 2017. Published by Oxford University Press on behalf of The Gerontological Society of America. All rights reserved. For permissions, please e-mail:

  20. Neuroscience Intermediate-Level Care Units Staffed by Intensivists: Clinical Outcomes and Cost Analysis. (United States)

    Kyeremanteng, Kwadwo; Hendin, Ariel; Bhardwaj, Kalpana; Thavorn, Kednapa; Neilipovitz, Dave; Kubelik, Dalibour; D'Egidio, Gianni; Stotts, Grant; Rosenberg, Erin


    With an aging population and increasing numbers of intensive care unit admissions, novel ways of providing quality care at reduced cost are required. Closed neurointensive care units improve outcomes for patients with critical neurological conditions, including decreased mortality and length of stay (LOS). Small studies have demonstrated the safety of intermediate-level units for selected patient populations. However, few studies analyze both cost and safety outcomes of these units. This retrospective study assessed clinical and cost-related outcomes in an intermediate-level neurosciences acute care unit (NACU) before and after the addition of an intensivist to the unit's care team. Starting in October 2011, an intensivist-led model was adopted in a 16-bed NACU unit, including daytime coverage by a dedicated intensivist. Data were obtained from all patients admitted 1 year prior to and 2 years after this intervention. Primary outcomes were LOS and hospital costs. Safety outcomes included mortality and readmissions. Descriptive and analytic statistics were calculated. Individual and total patient costs were calculated based on per-day NACU and ward cost estimates and significance measured using bootstrapping. A total of 2931 patients were included over the study period. Patients were on average 59.5 years and 53% male. The most common reasons for admission were central nervous system (CNS) tumor (27.6%), ischemic stroke (27%), and subarachnoid hemorrhage (11%). Following the introduction of an intensivist, there was a significant reduction in NACU and hospital LOS, by 1 day and 3 days, respectively. There were no differences in readmissions or mortality. Adding an intensivist produced an individual cost savings of US$963 in NACU and US$2687 per patient total hospital stay. An intensivist-led model of intermediate-level neurointensive care staffed by intensivists is safe, decreases LOS, and produces cost savings in a system increasingly strained to provide quality

  1. A survey of nurse staffing levels in interventional radiology units throughout the UK

    International Nuclear Information System (INIS)

    Christie, A.; Robertson, I.


    Aim: To supplement previous surveys analysing provision of interventional radiology (IR), in-hours (IH) and out-of-hours (OOH), by specifically surveying the level of nursing support provided. Materials and methods: A web-based questionnaire was distributed to all British Society of Interventional Radiology (BSIR) members. This addressed several aspects of radiology nursing support for IR procedures, both IH and OOH. Results: Sixty percent of respondents indicated that they have a formal OOH service. Of these, all have a dedicated nursing rota, with the vast majority operating with one nurse. IH, 77% of respondents always have a scrubbed nurse assistant, but this reduces to 40% OOH. IH, 4% never have a scrubbed radiology nurse assistant, which rises to 25% OOH. IH, 75% of respondents always have a radiology nurse dedicated to patient monitoring, but this reduces to 20% OOH. IH, 3% never have a radiology nurse dedicated to patient monitoring, which rises to 42% OOH. Conclusion: A significant disparity exists in the level of IR nursing support between IH and OOH. The majority of sites provide a single nurse with ad hoc additional support. This is potentially putting patients at increased risk. Radiology nurses are integral to the safe and sustainable provision of IR OOH services and a greater focus is required to ensure adequate and safe staffing levels for 24/7 IR services. - Highlights: • A significant disparity exists between the level of nursing support provided in-hours and OOH. • This applies to both the availability of a nurse to scrub and to monitor the patient. • Having a dedicated 24/7 nursing rota is mandatory to providing a deliverable OOH service.

  2. Dementia and Legal Competency


    Filaković, Pavo; Petek Erić, Anamarija; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven


    The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity – fully or partially. Given ...

  3. [Competence based medical education]. (United States)

    Bernabó, Jorge G; Buraschi, Jorge; Olcese, Juan; Buraschi, María; Duro, Eduardo


    The strategy of curriculum planning in the majority of the Schools of Medicine has shifted, in the past years, from curriculum models based in contents to outcome oriented curricula. Coincidently the interest in defining and evaluating the clinical competences that a graduate must have has grown. In our country, and particularly in the Associated Hospitals belonging to the Unidad Regional de Enseñanza IV of the UBA School of Medicine, evidence has been gathered showing that the acquisition of clinical competences during the grade is in general insufficient. The foundations and characteristics of PREM (Programa de Requisitos Esenciales Mínimos) are described. PREM is a tool to promote the apprenticeship of abilities and necessary skills for the practice of medicine. The objective of the program is to promote the apprenticeship of a well defined list of core competences considered indispensable for a general practitioner. An outcome oriented curriculum with a clear definition of the expected knowledge, skills and attitudes of a graduate of the programme, the promotion of learning experiences centered in the practice and evaluation tools based in direct observation of the student's performance should contribute to close the gap between what the Medicine Schools traditionally teach and evaluate, and what the doctor needs to know and needs to do to perform correctly its profession.

  4. Dissociative State and Competence

    Directory of Open Access Journals (Sweden)

    Yu-Ju Lin


    Full Text Available This report presents the results of forensic evaluation of the civil competence of a case of alleged dissociative identity disorder (DID and discusses whether such dissociative states substantially jeopardize civil competence. A 40-year-old woman claimed that she had had many personalities since her college days. From the age of 37 to 40, she shopped excessively, which left her with millions of dollars of debt. She ascribed her shopping to a certain identity state, over which she had no control. (In this article, we use the term identity state to replace personality as an objective description of a mental state. She thus raised the petition of civil incompetence. During the forensic evaluation, it was found that the identity states were relatively stable and mutually aware of each other. The switch into another identity state was sometimes under voluntary control. The subject showed consistency and continuity in behavioral patterns across the different identity states, and no matter which identity state she was in, there was no evidence of impairment in her factual knowledge of social situations and her capacity for managing personal affairs. We hence concluded that she was civilly competent despite the claimed DID. Considering that the existence and diagnosis of DID are still under dispute and a diagnosis of DID alone is not sufficient to interdict a person's civil right, important clinical and forensic issues remain to be answered.

  5. Nuclear safety and human competence

    International Nuclear Information System (INIS)

    Stefanescu, Petre


    Competence represents a very well defined ensemble of knowledge and skills, behavior modalities, standard procedures and judgement types that can be used in a given situation, without a priori learning. It is obvious that a person competence should fulfill the needs of the company he works for. For a Nuclear Power Plant operator competence is a constitutive part of his individuality. Competence includes: 1. Knowledge that can be classified in three main items: - procedural and declarative knowledge; - practical knowledge and skills; - fundamental knowledge. 2. 'Non cognitive' knowledge components, such as 'social information', team collective competence, safety education, risks perception and management. The last item presents a special interest for nuclear safety. On the other hand, competence level defines the quality of procedures applied in different operational situations. Competence - procedures relations are presented. Competence fundament results from operator activity analysis. The analyst has to take into consideration several phases of activity in which competence is highlighted like: - genesis, during formation; - transformation, during adaptation to a technical modification; - transfer, from expert to probationer. Competence is subject to a continuous transformation process due to technical and organizational evolutions and 'operator ageing'. Cognitive ageing of operators or the technical ageing of competence often appear to be superimposed. Technical progress acceleration increases the ageing effects of competence. Knowledge - skills dynamic relations are discussed. The changing of organizational form determines appearance of new competence gained from others domains or defined by multidisciplinary studies. Ergonomics can help the changing of organizational form through analysis of operators evolution activity which will generate new competence. Ergonomics can contribute to identify means of raising competence starting from learning process

  6. Dementia and legal competency. (United States)

    Filaković, Pavo; Erić, Anamarija Petek; Mihanović, Mate; Glavina, Trpimir; Molnar, Sven


    The legal competency or capability to exercise rights is level of judgment and decision-making ability needed to manage one's own affairs and to sign official documents. With some exceptions, the person entitles this right in age of majority. It is acquired without legal procedures, however the annulment of legal capacity requires a juristic process. This resolution may not be final and could be revoked thorough the procedure of reverting legal capacity - fully or partially. Given the increasing number of persons with dementia, they are often subjects of legal expertise concerning their legal capacity. On the other part, emphasis on the civil rights of mentally ill also demands their maximal protection. Therefore such distinctive issue is approached with particular attention. The approach in determination of legal competency is more focused on gradation of it's particular aspects instead of existing dual concept: legally capable - legally incapable. The main assumption represents how person with dementia is legally capable and should enjoy all the rights, privileges and obligations as other citizens do. The aspects of legal competency for which person with dementia is going to be deprived, due to protection of one's rights and interests, are determined in legal procedure and then passed over to the guardian decided by court. Partial annulment of legal competency is measure applied when there is even one existing aspect of preserved legal capability (pension disposition, salary or pension disposition, ability of concluding contract, making testament, concluding marriage, divorce, choosing whereabouts, independent living, right to vote, right to decide course of treatment ect.). This measure is most often in favour of the patient and rarely for protection of other persons and their interests. Physicians are expected to precisely describe early dementia symptoms which may influence assessment of specific aspects involved in legal capacity (memory loss, impaired task


    Directory of Open Access Journals (Sweden)

    Jyrki Kalliokoski


    Full Text Available The paper explores plurilingual competence in respect to language proficiency, language education and pluri- and multilingualism. The notion of communicative competence was introduced by Hymes (1972 as a reaction to chomskyan view of language as an autonomous system. Hymes’ notion of communicative competence originally included plurilingualism. The concept of communicative competence was quickly adopted to applied linguistics but the idea of a linguistic repertoire consisting of the competencies of linguistic varieties was not imported to SLA or language testing. The Hymesian perspective to plurilingualism as an essential dimension of communicative competence was revived in the Common European Framework (CEFR. However,the practice of applying the CEFR has mostly neglected the dimension on plurilingualism and plurilingual competence. The focus in the use of the CEFR has been on the different areas of language skills within one single language at a time, while the application of plurilingual practices has gained very little attention. The Hymesian notion of communicative competence has lived on in the sociolinguistic research tradition, especially within interactional sociolinguistics. The present paper relates the notion of plurilingual competence to its hymesian origin, to recent trends in plurilingual and pluricultural education, and to the sociolinguistic study of style and linguistic variation in multilingual communities. The article uses Finnish L2 data to show how plurilingual competence is used as an interactional resource.From the perspective of language learning, plurilingual competence enables speakers with different linguistic backgrounds to use their shared linguistic repertoire in order to ensure smooth interaction and achieve mutual understanding.

  8. Competencies for disaster mental health. (United States)

    King, Richard V; Burkle, Frederick M; Walsh, Lauren E; North, Carol S


    Competencies for disaster mental health are essential to domestic and international disaster response capabilities. Numerous consensus-based competency sets for disaster health workers exist, but no prior study identifies and discusses competency sets pertaining specifically to disaster mental health. Relevant competency sets were identified via MEDLINE, PsycINFO, EBSCO, and Google Scholar searches. Sixteen competency sets are discussed, some providing core competencies for all disaster responders and others for specific responder groups within particular professions or specialties. Competency sets specifically for disaster mental health professionals are lacking, with the exception of one set that focused only on cultural competence. The identified competency sets provide guidance for educators in developing disaster mental health curricula and for disaster health workers seeking education and training in disaster mental health. Valid, criterion-based competencies are required to guide selection and training of mental health professionals for the disaster mental health workforce. In developing these competencies, consideration should be given to the requirements of both domestic and international disaster response efforts.

  9. Do staffing and workload levels influence the risk of new acquisitions of meticillin-resistant Staphylococcus aureus in a well-resourced intensive care unit? (United States)

    Kong, F; Cook, D; Paterson, D L; Whitby, M; Clements, A C A


    Staffing deficits and workload have may a bearing on transmission of meticillin-resistant Staphylococcus aureus (MRSA) within intensive care units (ICUs). New MRSA acquistions may provide a clearer picture of the relationship between MRSA acquisition and staffing in the ICU setting. To determine whether staffing and bed occupancy rates had an immediate or delayed impact on the number of new MRSA acquisitions in a well-staffed ICU, and whether these variables could be used as predictors of future MRSA acquisitions. Data on new MRSA acquisitions in the ICU of a 796-bed metropolitan Australian hospital between January 2003 and December 2006 were used to build a model to predict the probabilility of actual new MRSA acquisitions in 2007. Cross validation was performed using receiver operator characteristic analysis. Sixty-one new MRSA acquisitions (21 infections, 40 colonizations) were identified in 51 individual weeks over the study period. The number of non-permanent staffing hours was relatively small. The area under the curve in the cross-validation analysis was 0.46 [95% CI 0.25-0.67] which suggests that the model, built on data from 2003-2006, was not able to predict weeks in which new MRSA acquisitions occurred in 2007. The risks posed by high workloads may have been mitigated by good compliance with infection control measures, nurse training and adequate staffing ratios in the ICU. Consequently, staffing policies and the infection control practices in the ICU do not need to be modified to address the rate of new MRSA acquisitions. Copyright © 2011 The Healthcare Infection Society. All rights reserved.

  10. Does Motor Competence Affect Self-Perceptions Differently for Adolescent Males and Females?


    Elizabeth Rose; Dawne Larkin; Helen Parker; Beth Hands


    Little is understood about the impact of level of motor competence on self-perceptions in adolescence, in particular how this may differentially affect girls and boys. A sample of 1,568 14-year-old participants (766 girls and 802 boys) were grouped into four motor competence levels (very low to high) based on the McCarron Assessment of Neuromuscular Development (MAND). Self-perceptions were assessed using the Self-Perc...

  11. [Creativity and innovation: competences on nursing management]. (United States)

    Feldman, Liliane Bauer; Ruthes, Rosa Maria; Cunha, Isabel Cristina Kowal Olm


    This article presents the importance of the creativity and innovation on health services, distinguishing those concepts. Creative behavior is the improvement of an element or known actions: whereas innovation means finding new alternatives. Considering competences like knowledge, skill and attitude--KSA, it is understood that by stimulating creativity and innovation, the performance of the health professional will be optimized. Therefore, creativity and innovation are key elements for improvement and organization, and, more specifically, for Nursing to find alternatives for solving problems related to the occupation as a whole. In this way, this approach brings a strategic tool on the process of management and a differential for the nurse, which by innovating and creating will amaze herself with her potential.

  12. Developing professional competence

    DEFF Research Database (Denmark)

    Wahlgren, Bjarne


    The purpose of university programs for professionals is to qualify the students to act competently in a subsequent job situation. Practical experiences as well as comprehensive research studies have shown that only a limited part of what is learned during the coursework is applied in the subsequent...... professional practice. There is too little transfer from the training programs to application in the workplace. Based on Danish research the relation between school and professional work, between scholastic knowledge and practical knowledge, is analyzed. Guideline for a new and more efficient curricula...

  13. Designing for competences

    DEFF Research Database (Denmark)

    Christiansen, Rene B; Gundersen, Peter Bukovica


    of these professionals has changed - and has become more cross-professional, more complex and analytic and reflective competencies have entered the policy papers of these human-professions as central, important forms of knowledge. These bachelor degrees in Denmark within the field of education (teaching and preschool...... pedagogy) have therefore been subjects of reformations regarding structure and content. In this paper we specifically deal with three major and overlapping tendencies in these changes that create new opportunities within the field of educational design and development: namely identifying design challenges...

  14. Developing professional competence

    DEFF Research Database (Denmark)

    Wahlgren, Bjarne


    The purpose of university programs for professionals is to qualify the students to act competently in a subsequent job situation. Practical experiences as well as comprehensive research studies have shown that only a limited part of what is learned during the coursework is applied in the subsequent...... professional practice. There is too little transfer from the training programs to application in the workplace. Based on Danish research the relation between school and professional work, between scholastic knowledge and practical knowledge, is analyzed. Guideline for a new and more efficient curricula...... for professional educational programs are suggested....

  15. Competence, governance, and entrepreneurship

    DEFF Research Database (Denmark)

    Foss, Nicolai Juul; Mahnke, Volker

    on the firm. While there has been little direct discussion between the main proponents of these perspectives, both claim that they are reaching for a "strategic theory of the firm". Such a theory would not only shed light on the classical questions considered in the theory of the firm (e.g. why firms exist......This title illustrates modern economics. Because it informs strategic choices, it is relevant to business administration in general, and for strategic management in particular. Two dominant streams may be identified in the literature, namely the "competence" and "governance" perspectives...

  16. Competing Auctions of Skills

    DEFF Research Database (Denmark)

    Kennes, John; le Maire, Daniel

    We generalize McAfee’s (1993) game of competing sellers to the case of heterogeneous sellers. In the generalized McAfee (GM) game, the equilibrium expected job offer distribution of each worker (seller) type evolves over time as a function of stochastic events. We derive a tractable method...... of solving the GM game. We estimate, using non-parametric methods, a close fit between a benchmark GM game and a cross-section of Danish data on productivity and unemployment. The theoretical properties of the GM game, which relate to on-the-job search, assortative matching, aggregate and match specific...

  17. Meeting human resources for health staffing goals by 2018: a quantitative analysis of policy options in Zambia

    Directory of Open Access Journals (Sweden)

    Schroder Kate


    Full Text Available Abstract Background The Ministry of Health (MOH in Zambia is currently operating with fewer than half of the health workers required to deliver basic health services. The MOH has developed a human resources for health (HRH strategic plan to address the crisis through improved training, hiring, and retention. However, the projected success of each strategy or combination of strategies is unclear. Methods We developed a model to forecast the size of the public sector health workforce in Zambia over the next ten years to identify a combination of interventions that would expand the workforce to meet staffing targets. The key forecasting variables are training enrolment, graduation rates, public sector entry rates for graduates, and attrition of workforce staff. We model, using Excel (Office, Microsoft; 2007, the effects of changes in these variables on the projected number of doctors, clinical officers, nurses and midwives in the public sector workforce in 2018. Results With no changes to current training, hiring, and attrition conditions, the total number of doctors, clinical officers, nurses, and midwives will increase from 44% to 59% of the minimum necessary staff by 2018. No combination of changes in staff retention, graduation rates, and public sector entry rates of graduates by 2010, without including training expansion, is sufficient to meet staffing targets by 2018 for any cadre except midwives. Training enrolment needs to increase by a factor of between three and thirteen for doctors, three and four for clinical officers, two and three for nurses, and one and two for midwives by 2010 to reach staffing targets by 2018. Necessary enrolment increases can be held to a minimum if the rates of retention, graduation, and public sector entry increase to 100% by 2010, but will need to increase if these rates remain at 2008 levels. Conclusions Meeting the minimum need for health workers in Zambia this decade will require an increase in health

  18. To Meet the Needs of the Nations: Staffing the U.S. Civil Service and the Public Service of Canada (United States)


    the Civil Service Reform Act of 1978, it is my honor to submit the U.S. Merit Systems Protection Board report titled "To Meet the Needs of the...Representatives Washington, DC 2 05 027 92-02948 "IuIII II IIIh I A Spedal Study TO MEET THE NEEDS OF THE NATIONS: STAFFING THE U.S. CiVIL SERVICE AND THE close scutiny in appeals, inc flg ones that am a useful way to meet the needs of rapidly chang- reach the Fdu comt. As oe depotinental Ing Izadons

  19. Competence development: Key issues and trends in European competence policies

    DEFF Research Database (Denmark)

    Milana, Marcella

    papers, reports, and communications that led to directives and resolutions concerning the development and recognition of skills and competences in a lifelong learning perspective. In 2005 this process led to the definition of a European Framework on Key Competences for Lifelong Learning - covering those...... competences that are given priority within the Union - as well as a European Qualification Framework, a reference tool for making qualifications - here described in terms of progressive levels of competence - transparent and transferable within the European borders. The aim of the paper is to investigate...

  20. Organization and staffing practices in US cardiac intensive care units: a survey on behalf of the American Heart Association Writing Group on the Evolution of Critical Care Cardiology. (United States)

    O'Malley, Ryan G; Olenchock, Benjamin; Bohula-May, Erin; Barnett, Christopher; Fintel, Dan J; Granger, Christopher B; Katz, Jason N; Kontos, Michael C; Kuvin, Jeffrey T; Murphy, Sabina A; Parrillo, Joseph E; Morrow, David A


    The cardiac intensive care unit (CICU) has evolved into a complex patient-care environment with escalating acuity and increasing utilization of advanced technologies. These changing demographics of care may require greater clinical expertise among physician providers. Despite these changes, little is known about present-day staffing practices in US CICUs. We conducted a survey of 178 medical directors of ICUs caring for cardiac patients to assess unit structure and physician staffing practices. Data were obtained from 123 CICUs (69% response rate) that were mostly from academic medical centres. A majority of hospitals utilized a dedicated CICU (68%) and approximately half of those hospitals employed a 'closed' unit model. In 46% of CICUs, an intensivist consult was available, but not routinely involved in care of critically ill cardiovascular patients, while 11% did not have a board-certified intensivist available for consultation. Most CICU directors (87%) surveyed agreed that a closed ICU structure provided better care than an open ICU and 81% of respondents identified an unmet need for cardiologists with critical care training. We report contemporary structural models and staffing practices in a sample of US ICUs caring for critically ill cardiovascular patients. Although most hospitals surveyed had dedicated CICUs, a minority of CICUs employed a 'closed' CICU model and few had routine intensivist staffing. Most CICU directors agree that there is a need for cardiologists with intensivist training and expertise. These survey data reveal potential areas for continued improvement in US CICU organizational structure and physician staffing.

  1. Comprehensive evaluation of contemporary assisted reproduction technology laboratory operations to determine staffing levels that promote patient safety and quality care. (United States)

    Alikani, Mina; Go, Kathryn J; McCaffrey, Caroline; McCulloh, David H


    To consider how staffing requirements have changed with evolving and increasingly more complex assisted reproduction technology (ART) laboratory practice. Analysis by four laboratory directors from three different ART programs of the level of complexity and time requirements for contemporary ART laboratory activities to determine adequate staffing levels. University-based and private ART programs. None. None. Human resource requirements for ART procedures. Both complexity and time required for completion of a contemporary ART cycle have increased significantly compared with the same requirements for the "traditional cycle" of the past. The latter required roughly 9 personnel hours, but a contemporary cycle can require up to 20 hours for completion. Consistent with this increase, a quantitative analysis shows that the number of embryologists required for safe and efficient operation of the ART laboratory has also increased. This number depends on not only the volume but also the types of procedures performed: the higher the number of complex procedures, the more personnel required. An interactive Personnel Calculator is introduced that can help determine staffing needs. The increased complexity of the contemporary ART laboratory requires a new look at the allocation of human resources. Our work provides laboratory directors with a practical, individualized tool to determine their staffing requirements with a view to increasing the safety and efficiency of operations. The work could serve as the basis for revision of the 2008 American Society for Reproductive Medicine (ASRM) staffing guidelines. Copyright © 2014 American Society for Reproductive Medicine. Published by Elsevier Inc. All rights reserved.





    The concepts of interpersonal communication competence, intercultural communication competence and intercultural competence are prone to frequent misunderstanding as a result of an epistemic field that does not draw clear cut distinctions among the disciplines the former are subject of. With a view to facilitating future research in the fields of the aforementioned concepts, this paper will focus on their operationalization by delineating not only the differences among them, but also their in...

  3. Competency Based Future Leadership Requirements

    National Research Council Canada - National Science Library

    Horey, Jeffrey


    .... A competency framework that is used consistently throughout the force and that focuses on the functions of leadership will help align training, development, and performance management processes...

  4. Preparing emergency personnel in dialysis: a just-in-time training program for additional staffing during disasters. (United States)

    Stoler, Genevieve B; Johnston, James R; Stevenson, Judy A; Suyama, Joe


    There are 341 000 patients in the United States who are dependent on routine dialysis for survival. Recent large-scale disasters have emphasized the importance of disaster preparedness, including supporting dialysis units, for people with chronic disease. Contingency plans for staffing are important for providing continuity of care for a technically challenging procedure such as dialysis. PReparing Emergency Personnel in Dialysis (PREP-D) is a just-in-time training program designed to train individuals having minimum familiarity with the basic steps of dialysis to support routine dialysis staff during a disaster. A 5-module educational program was developed through a collaborative, multidisciplinary effort. A pilot study testing the program was performed using 20 nontechnician dialysis facility employees and 20 clinical-year medical students as subjects. When comparing pretest and posttest scores, the entire study population showed a mean improvement of 28.9%, with dialysis facility employees and medical students showing improvements of 21.8% and 36.4%, respectively (P just-in-time training format. The knowledge gained by using the PREP-D program during a staffing shortage may allow for continuity of care for critical services such as dialysis during a disaster.

  5. Enhancing conflict competency. (United States)

    Waite, Roberta; McKinney, Nicole S


    Professional nurses are taking on leadership roles of diverse healthcare teams. Development of conflict competence is essential, yet requires self-awareness and deliberate effort. Heightened awareness of one's preferred conflict style and cognizance of the implications of overuse and/or underuse of these styles is important. DESIGN/METHODOLOGICAL APPROACH: A pre-post survey design (N = 14) used paired sample T-test. Paired sample correlations and an overview of the paired sample test are reported. Students gained self-awareness about their preferred conflict style, recognized that each conflict style has its utility depending on any given situation, and demonstrated a difference in their most frequently used style. Limited data conveys conflict behavior styles among pre-licensure nursing; however, students can influence their own environments (either causing or fueling situations) by their personal conflict-handling styles. Early development of these skills can raise awareness and cultivate ease in the management of conflict within varied settings.

  6. Customer satisfaction and competencies

    DEFF Research Database (Denmark)

    Gritti, Paola; Foss, Nicolai Juul

    We empirically address how customer satisfaction and loyalty in the banking industry may affect profitability. This helps to identify the strategy and competencies necessary to benefit from customer relationships which are important sources for improved performance in the banking. We do...... this by analyzing data collected on 2,105 customers of 118 branches of one of the biggest banks of an Italian banking group. We find that customer satisfaction impacts loyalty, which in turn has a direct effect on financial and non-financial customer value/total customer value/complex customer value. Moreover......, loyalty is a mediator between financial and not-financial customer value and two sources of customer satisfaction, namely relationships with the front office and the branch, on the one hand, and the products offered, on the other....

  7. Competing on talent analytics. (United States)

    Davenport, Thomas H; Harris, Jeanne; Shapiro, Jeremy


    Do investments in your employees actually affect workforce performance? Who are your top performers? How can you empower and motivate other employees to excel? Leading-edge companies such as Google, Best Buy, Procter & Gamble, and Sysco use sophisticated data-collection technology and analysis to answer these questions, leveraging a range of analytics to improve the way they attract and retain talent, connect their employee data to business performance, differentiate themselves from competitors, and more. The authors present the six key ways in which companies track, analyze, and use data about their people-ranging from a simple baseline of metrics to monitor the organization's overall health to custom modeling for predicting future head count depending on various "what if" scenarios. They go on to show that companies competing on talent analytics manage data and technology at an enterprise level, support what analytical leaders do, choose realistic targets for analysis, and hire analysts with strong interpersonal skills as well as broad expertise.

  8. Competing For industry Resources

    International Nuclear Information System (INIS)

    Arnstad, Marit


    This presentation by Norway's Minister of Petroleum and Energy describes (1) Norway in the energy picture, (2) oil market developments, (3) the establishment of an energy policy and (4) the investment level of the Norwegian petroleum activities. Value creation from Norwegian petroleum resources is directly connected with the commercial companies' participation in the activities. Thus, it has been a main challenge for Norway to establish a balanced petroleum policy and a legal framework. Presumably Norway will remain a prospective and attractive petroleum province for a long time. Over the years, Norway has developed three very competent and competitive national oil companies and a significant national supply industry. This industry is highly competitive internationally. Many new petroleum provinces are opening up for foreign investors and energy consumption of the world is expected to increase significantly the next 20 - 30 years. This implies increased demand for the products, but also strong competition for industry resources

  9. Competence-based education to develop digital competence

    NARCIS (Netherlands)

    Wesselink, R.; Giaffredo, Silvio


    The competence approach to learning and teaching has been described by several theoretical models. These formal models are often not integrated with concrete educational activity. On the contrary, this article proposes a practical implementation of the competence approach in education. The model of

  10. Competence Based Educational Metadata for Supporting Lifelong Competence Development Programmes

    NARCIS (Netherlands)

    Sampson, Demetrios; Fytros, Demetrios


    Sampson, D., & Fytros, D. (2008). Competence Based Educational Metadata for Supporting Lifelong Competence Development Programmes. In P. Diaz, Kinshuk, I. Aedo & E. Mora (Eds.), Proceedings of the 8th IEEE International Conference on Advanced Learning Technologies (ICALT 2008), pp. 288-292. July,

  11. Metaphorical Competence: A Neglected Component of Communicative Competence (United States)

    Sabet, Masoud Khalili; Tavakoli, Marjaneh


    The ability to comprehend and use metaphors in L2 which is referred to as metaphorical competence is an important issue in second language acquisition. Metaphors are so pervasive in our life that we might not realize their presence and simply neglect them even in our first language. Different models of communicative competence have been suggested…

  12. Building Intercultural Competence through Intercultural Competency Certification of Undergraduate Students (United States)

    Janeiro, Maria G. Fabregas; Fabre, Ricardo Lopez; Nuno de la Parra, Jose Pablo


    The Intercultural Competency Certificate (CCI in Spanish) designed for the Universidad Popular Autonoma del Estado de Puebla (UPAEP University) is a theory based comprehensive plan to develop undergraduate students' intercultural competence. This Certificate is based in the Developmental Model of Intercultural Sensitivity (DMIS) developed by…

  13. Competence Models in Technology-enhanced Competence-based Learning

    NARCIS (Netherlands)

    Sampson, Demetrios; Fytros, Demetrios


    Please cite as: Sampson, D., & Fytros, D. (2008). Competence Models in Technology-enhanced Competence-based Learning. In H. H. Adelsberger, Kinshuk, J. M. Pawlowski & D. Sampson (Eds.), International Handbook on Information Technologies for Education and Training, 2nd Edition, Springer, June 2008

  14. Socialization of Perceived Academic Competence among Highly Competent Children. (United States)

    Phillips, Deborah A.


    Academically competent third-graders and their parents were studied to (1) determine whether the illusion of incompetence documented in fifth graders appears in younger children; and (2) examine the influence that parents exert on their children's development of self-perceptions of academic competence. (PCB)

  15. Competing on analytics. (United States)

    Davenport, Thomas H


    We all know the power of the killer app. It's not just a support tool; it's a strategic weapon. Companies questing for killer apps generally focus all their firepower on the one area that promises to create the greatest competitive advantage. But a new breed of organization has upped the stakes: Amazon, Harrah's, Capital One, and the Boston Red Sox have all dominated their fields by deploying industrial-strength analytics across a wide variety of activities. At a time when firms in many industries offer similar products and use comparable technologies, business processes are among the few remaining points of differentiation--and analytics competitors wring every last drop of value from those processes. Employees hired for their expertise with numbers or trained to recognize their importance are armed with the best evidence and the best quantitative tools. As a result, they make the best decisions. In companies that compete on analytics, senior executives make it clear--from the top down--that analytics is central to strategy. Such organizations launch multiple initiatives involving complex data and statistical analysis, and quantitative activity is managed atthe enterprise (not departmental) level. In this article, professor Thomas H. Davenport lays out the characteristics and practices of these statistical masters and describes some of the very substantial changes other companies must undergo in order to compete on quantitative turf. As one would expect, the transformation requires a significant investment in technology, the accumulation of massive stores of data, and the formulation of company-wide strategies for managing the data. But, at least as important, it also requires executives' vocal, unswerving commitment and willingness to change the way employees think, work, and are treated.

  16. Competence Map of Regulatory Body: Personal and Interpersonal Effectiveness Competencies

    International Nuclear Information System (INIS)

    Volkov, E.


    Full text: The paper presents implementation stages and outcomes of the project “Nuclear Facility Competences” fulfilled in JSC “Rosenergoatom” and outcomes of the project “Knowledge Management, Training and Staff Retention” fulfilled for Romania regulatory authority. The goal of the project was a development of competence profiles for nuclear power plant and corporate inspectorate key job positions. The paper is focused on personal and interpersonal effectiveness competencies for inspectorate job positions which are a part of well-known 4-Quadrant Competence Model. Each competence is described by one or two behavior scales. One can consider those competencies like common ones for organizations implementing inspection activity and could be used in human resource management processes like personnel selection, job assessment, career planning, training, mentoring. (author



    Hermanto Hermanto


    Writing is a skill derived from a long way of learning and exercises. Different from other language skills, writing is considered the difficult language skill to acquire since it involves many aspects of linguistics, social, and writing knowledge and conventions. There are at least three important elements of writing useful to produce a good piece of composition, language competence, writing competence and cultural competence. This paper shows the influence of these three elements in order t...

  18. Organizational strategy for the development of nurses' competences: possibilities of Continuing Education in Health

    Directory of Open Access Journals (Sweden)

    Amanda de Lemos Mello


    Full Text Available ABSTRACT Objective: To reflect on Continuing Education in Health as an organizational strategy for the development of nurses' competences. Methods: A theoretical-reflective study was performed, combining concepts from Continuing Education in Health, organizational strategy and professional competence, understood as key elements for the work of nurses in health services. Results: To understand how to live together, individuals need to have knowledge about others, their history and traditions. When "learning how to do", they acquire broader competence to deal with unexpected situations and to facilitate team work. With regard to "learning how to be", they are encouraged to acquire autonomy and discernment on behalf of the group. If the focus is on development rather than control, there is shared interest and an integrated and strategic model for nurses' competences to be improved. Conclusion: The development of competences in nurses is the basis for the Learning Paths as a possible operationalization of Continuing Education in Health.

  19. Staffing in postnatal units: is it adequate for the provision of quality care? Staff perspectives from a state-wide review of postnatal care in Victoria, Australia

    Directory of Open Access Journals (Sweden)

    Lumley Judith


    Full Text Available Abstract Background State-wide surveys of recent mothers conducted over the past decade in Victoria, one state of Australia, have identified that women are consistently less satisfied with the care they received in hospital following birth compared with other aspects of maternity care. Little is known of caregivers' perspectives on the provision ofhospital postnatal care: how care is organised and provided in different hospitals; what constrains the provision of postnatal care (apart from funding and what initiatives are being undertaken to improve service delivery. A state-widereview of organisational structures and processes in relation to the provision of hospital postnatal care in Victoria was undertaken. This paper focuses on the impact of staffing issues on the provision of quality postnatal care from the perspective of care providers. Methods A study of care providers from Victorian public hospitals that provide maternity services was undertaken. Datawere collected in two stages. Stage one: a structured questionnaire was sent to all public hospitals in Victoria that provided postnatal care (n = 73, exploring the structure and organisation of care (e.g. staffing, routine observations, policy framework and discharge planning. Stage two: 14 maternity units were selected and invited to participate in a more in-depth exploration of postnatal care. Thirty-eight key informant interviews were undertaken with midwives (including unit managers, associate unit managers and clinical midwives and a medical practitioner from eachselected hospital. Results Staffing was highlighted as a major factor impacting on the provision of quality postnatal care. There were significant issues associated with inadequate staff/patient ratios; staffing mix; patient mix; prioritisation of birth suites over postnatal units; and the use of non-permanent staff. Forty-three percent of hospitals reported having only midwives (i.e. no non-midwives providing postnatal care

  20. Cultural competency training in psychiatry. (United States)

    Qureshi, A; Collazos, F; Ramos, M; Casas, M


    Recent reports indicate that the quality of care provided to immigrant and ethnic minority patients is not at the same level as that provided to majority group patients. Although the European Board of Medical Specialists recognizes awareness of cultural issues as a core component of the psychiatry specialization, few medical schools provide training in cultural issues. Cultural competence represents a comprehensive response to the mental health care needs of immigrant and ethnic minority patients. Cultural competence training involves the development of knowledge, skills, and attitudes that can improve the effectiveness of psychiatric treatment. Cognitive cultural competence involves awareness of the various ways in which culture, immigration status, and race impact psychosocial development, psychopathology, and therapeutic transactions. Technical cultural competence involves the application of cognitive cultural competence, and requires proficiency in intercultural communication, the capacity to develop a therapeutic relationship with a culturally different patient, and the ability to adapt diagnosis and treatment in response to cultural difference. Perhaps the greatest challenge in cultural competence training involves the development of attitudinal competence inasmuch as it requires exploration of cultural and racial preconceptions. Although research is in its infancy, there are increasing indications that cultural competence can improve key aspects of the psychiatric treatment of immigrant and minority group patients.

  1. The TENCompetence Personal Competence Manager

    NARCIS (Netherlands)

    Kew, Christopher


    The European Network for Lifelong Competence Development is an Integrated Project funded by the EU. Its goal is to establish an innovative technical and organizational infrastructure using open-source, standards-based technology to support lifelong competence development. In this paper

  2. Conditions for Developing Communicative Competence (United States)

    Zascerinska, Jelena


    Introduction. Individuals need communicative competence for personal fulfillment and development, active citizenship, social inclusion and employment. Materials and Methods. The meaning of the key concepts of "communicative competence" and "opportunities" is studied within the search for conditions to develop. Conclusion. The theoretical findings…

  3. Conversational Competence in Academic Settings (United States)

    Bowman, Richard F.


    Conversational competence is a process, not a state. Ithaca does not exist, only the voyage to Ithaca. Vibrant campuses are a series of productive conversations. At its core, communicative competence in academic settings mirrors a collective search for meaning regarding the purpose and direction of a campus community. Communicative competence…

  4. Competence: Commodification of Human Ability (United States)

    Han, Soonghee


    The purpose of this article is to analyze the meaning and presumptions of competence in the concrete context of knowledge capitalism. First, the nature of competence as a "commodification of human ability" that obtains a standardized monetary value to sell in the labor market, is elucidated by applying Karl Marx's critical theory. Second, it is…

  5. Forecasting Communication Competencies of Teachers. (United States)

    Young, Wanda

    Home economics professionals were surveyed to determine the communication competencies necessary for the completion of their tasks. The most highly rated of the 13 competencies listed by the subjects were the abilities to converse in professional situations, to use other oral processes (argument, complaint, opinion, persuasion, questioning), and…

  6. eCompetence Case Studies

    DEFF Research Database (Denmark)

    Jensen, Helle Bækkelund


    In this paper we present some details of the processes undertaken in the European eCompetence Initiative. We present two illustrative and representative case studies. The research aims to identify and understand patterns of individual and organisational eCompetence approaches....

  7. Assessing Competence in Pediatric Cardiology (United States)

    Johnson, Apul E.; And Others


    In response to the need to assure physician competence, a rating scale was developed at the University of Minnesota Medical School for use in evaluating clinical competence in pediatric cardiology. It was tested on first- and second-year specialists. Development and testing procedures are described. (JT)

  8. Mediational Competencies for Online Education

    Directory of Open Access Journals (Sweden)

    María Elena Chan Núñez


    Full Text Available Addressed in the article is a position taken within and in favor of education and virtuality, considering the importance of training constructors of the digital environment. The competencies needed by actors of educational processes, the same which are necessary for their construction, are conceptualized as mediational. Because these are not usually the competencies most visibly when teachers and students are trained for online education, we found it of interest to present part of a research project on this type of competencies. The work starts out from an axiological position on virtual education, the recognition of the way the technologies model educational interactions on line. It follows with the notion of mediation and meditational competency, and comes to a design model that would consider these competencies in the development of learning environments. The article closes with reflections about the interdisciplinary integration necessary for a technological and educational development based on a communicative paradigm.

  9. Cultural competence: a constructivist definition. (United States)

    Blanchet Garneau, Amélie; Pepin, Jacinthe


    In nursing education, most of the current teaching practices perpetuate an essentialist perspective of culture and make it imperative to refresh the concept of cultural competence in nursing. The purpose of this article is to propose a constructivist definition of cultural competence that stems from the conclusions of an extensive critical review of the literature on the concepts of culture, cultural competence, and cultural safety among nurses and other health professionals. The proposed constructivist definition is situated in the unitary-transformative paradigm in nursing as defined by Newman and colleagues. It makes the connection between the field of competency-based education and the nursing discipline. Cultural competence in a constructivist paradigm that is oriented toward critical, reflective practice can help us develop knowledge about the role of nurses in reducing health inequalities and lead to a comprehensive ethical reflection about the social mandate of health care professionals. © The Author(s) 2014.

  10. Constructivism in cultural competence education. (United States)

    Hunter, Jennifer L; Krantz, Steven


    A graduate course on cultural diversity, based in constructivist theory and structured on the Process of Cultural Competence in the Delivery of Healthcare Services model, was developed and taught through classroom and online methods. The following research questions were explored: 1) Can an educational experience, built on constructivist learning theory tenets, change students' perceptions, attitudes, knowledge, and skills in the area of cultural competence? 2) Does the delivery method, online or traditional classroom, influence the degree of change? The study used a quasi-experimental, pretest-posttest control group design using the Inventory for Assessing the Process of Cultural Competence Among healthcare Professionals Revised. Findings showed significant changes (p<0.001) in cultural competence scores and subscores for all learners with both teaching modalities based on interval scale and in categories of cultural knowledge, skills, desire, and overall competence based on a nominal scale. The untaught construct of cultural desire showed the most significant improvement.

  11. Facilitating a Major Staffing Transition in a State Psychiatric Hospital With Changes to Nursing Orientation. (United States)

    Birnbaum, Shira; Sperber-Weiss, Doreen; Dimitrios, Timothy; Eckel, Donald; Monroy-Miller, Cherry; Monroe, Janet J; Friedman, Ross; Ologbosele, Mathias; Epo, Grace; Sharpe, Debra; Zarski, Yongsuk

    A large state psychiatric hospital experienced a state-mandated Reduction in Force that resulted in the abrupt loss and rapid turnover of more than 40% of its nursing and paraprofessional staff. The change exemplified current national trends toward downsizing and facility closure. This article describes revisions to the nursing orientation program that supported cost containment and fidelity to mission and clinical practices during the transition. An existing nursing orientation program was reconfigured in alignment with principles of rational instructional design and a core-competencies model of curriculum development, evidence-based practices that provided tactical clarity and commonality of purpose during a complex and emotionally charged transition period. Program redesign enabled efficiencies that facilitated the transition, with no evidence of associated negative effects. The process described here offers an example for hospitals facing similar workforce reorganization in an era of public sector downsizing.

  12. Intercultural Competence – Key Competence of Multicultural Teams

    Directory of Open Access Journals (Sweden)

    Diana Bebenova - Nikolova


    Full Text Available The article deals with intercultural competence of multicultural teams elaborating European projects. Firstly, it discusses basic theoretical aspects of the related concepts: culture and intercultural competence, then presents its impact on multicultural team effectiveness and models for improving it. The article finds ground on studies of intercultural competence as a set of strategic, personal, social and professional competences. The paper uses the project cycle management theory and proves that in multi-ethnic surroundings, the project membersř communication skills might not be sufficient to generate mutual understanding. Provisionally, the study performed a standardized Internet survey on self-assessment of intercultural competence among 50 experts on European projects. Another applied approach is field observation (attendance and note-taking of the 5- day training "To become diplomats between cultures", based on Bennettřs theoretical model for "Development of Intercultural Sensitivity". A training model for improving intercultural competence of multicultural team members. Possible approach for improvement of project management of crossborder or trans-border funding programs. Building intercultural competence in European project management is important, timely and necessity-driven, especially under the framework of the Danube Region Strategy.

  13. Ability Grouping, Segregation and Civic Competences among Adolescents. Research Briefing No. 76 (United States)

    Janmaat, Jan Germen


    This research examines the linkages between ability grouping, classroom social and ethnic segregation, and civic competences (understood here as referring to attitudes and behaviours as well as knowledge and skills). It does so by analysing data from the International Association for the Evaluation of Educational Achievement (IEA) Civic Education…

  14. Competencies for rural development professionals in the Era of HIV/AIDS

    NARCIS (Netherlands)

    Brinkman, B.; Westendorp, A.M.B.; Wals, A.E.J.; Mulder, M.


    The impact of HIV/AIDS on food security and rural livelihoods is still insufficiently understood. It is evident, however, that rural development professionals need to respond to the changes that have taken place in rural areas due to the pandemic. This article explores competencies that they need in

  15. Effects of Communication Competence and Social Network Centralities on Learner Performance (United States)

    Jo, Il-Hyun; Kang, Stephanie; Yoon, Meehyun


    Collaborative learning has become a dominant learning apparatus for higher level learning objectives. Much of the psychological and social mechanisms operating under this complex group activity, however, is not yet well understood. The purpose of this study was to investigate the effects of college students' communication competence and degree…

  16. Towards an Epistemically Neutral Curriculum Model for Vocational Education: From Competencies to Threshold Concepts and Practices (United States)

    Hodge, Steven; Atkins, Liz; Simons, Michele


    Debate about the benefits and problems with competency-based training (CBT) has not paid sufficient attention to the fact that the model satisfies a unique, contemporary demand for cross-occupational curriculum. The adoption of CBT in the UK and Australia, along with at least some of its problems, can be understood in terms of this demand. We…


    Directory of Open Access Journals (Sweden)

    Hélio Teixeira MD.


    Full Text Available Medical competence is the result of a lifelong evolving process, based on the development of efficiency, experience and ethical principles. Efficiency in medical practice depends on scientific knowledge, technical abilities and communication skills. Experience is a process of personal refinement, breeding knowledge and wisdom. Finally, medical ethics is founded on the quest for justice, compassion and love. Didactically, we can distinguish three phases in the professional evolution of a physician: a Professional infancy, or linear vision: the physician restricts his attention to the morbid process only, often neglecting the patient in his totality. His approach is almost exclusively technical, with limited perception of medicine as an art. b Professional maturity or humanistic vision: it results from the evolution of personality, culture and experience of the physician, who foccuses now on the patient as a whole with his disease(s. c Professional excellence, or holistic vision, the highest stage: when the physician's integrated dimensions and wisdom are projected into the patient, fostering the natural conditions for optimal healing. We conclude that the practice of medicine is best fulfilled when both, art and cience, are considered and exercised together by the doctor.

  18. Revisiting purchasing competence - In a project context

    DEFF Research Database (Denmark)

    Lutz, Salla


    purchasing and competences required undertaking these activities. Four overall purchasing competence areas were identified. Hence, four propositions related to the purchasing competence were developed by iteratively combining elements from the purchasing literature with an empirical inquiry in an offshore...

  19. Situating competence development in higher education

    DEFF Research Database (Denmark)

    Lystbæk, Christian Tang


    . Inspired by Batesons logical categories of learning, I develop a conceptual typology of research methodology competencies in higher education, which highlight that research methodology competence includes not only instrumental, but also practical, analytical and critical competencies....

  20. Fostering Communicative Competence through Technology

    Directory of Open Access Journals (Sweden)

    Muhammad Aslam Sipra


    Full Text Available The article explores the use of technology in EFL classes to promote communicative competence. It elucidates communicative competence and explicates obstructions in communicative tasks. Moreover, it interprets the use of technology in fostering and supporting the development of communicative competence and explains how it is pragmatic in maintaining learners’ level of motivation and interest in learning a foreign language. The present article identifies the significance and use of mobile phone, camera, computer and internet, tape recorder, projector, and language labs in EFL classes. Besides, it discusses the use of technology as an educational tool in language teaching and learning.

  1. Intercultural communicative competence: a step beyond communicative competence


    Coperías Aguilar, María José


    The concept of "communicative competence", first proposed by Hymes, referred basically to abilities speakers have in their first language. This term, however, was appropriated and reworked (Canale & Swain 1980; van Ek 1986) within the field of foreign language teaching and new approaches or dimensions (sociolingustic, socio-cultural, social, etc.) were added to the original idea. Consequently, the prescriptive model based upon native speaker competence started to be put into question and the ...

  2. Different Levels of Leadership for Learning: Investigating Differences between Teachers Individually and Collectively Using Multilevel Factor Analysis of the 2011-2012 Schools and Staffing Survey (United States)

    Boyce, Jared; Bowers, Alex J.


    This study investigated the differences between how individual teachers perceive leadership for learning and how teachers collectively perceive leadership for learning, using a large nationally generalizable data-set of 7070 schools from the National Center for Education Statistics 2011-2012 Schools and Staffing Survey. This study used…

  3. "Get a Blue and You Will See Your Money Back Again": Staffing and Marketing the English Prep School, 1890-1912 (United States)

    Benson, John


    This article explores the ways in which English prep schools were staffed and marketed in the years before the First World War. Its aim more specifically is to employ a biographical approach to consider the emphasis that the schools placed upon sport, and in particular the extent to which they recruited Oxford and Cambridge Blues as teachers…

  4. Perceptions of Risk and Safety in the ICU: A Qualitative Study of Cognitive Processes Relating to Staffing. (United States)

    D'Lima, Danielle M; Murray, Eleanor J; Brett, Stephen J


    The aims of this study were to 1) examine individual professionals' perceptions of staffing risks and safe staffing in intensive care and 2) identify and examine the cognitive processes that underlie these perceptions. Qualitative case study methodology with nurses, doctors, and physiotherapists. Three mixed medical and surgical adult ICUs, each on a separate hospital site within a 1,200-bed academic, tertiary London hospital group. Forty-four ICU team members of diverse professional backgrounds and seniority. None. Four themes (individual, team, unit, and organizational) were identified. Individual care provision was influenced by the pragmatist versus perfectionist stance of individuals and team dynamics by the concept of an "A" team and interdisciplinary tensions. Perceptions of safety hinged around the importance of achieving a "dynamic balance" influenced by the burden of prevailing circumstances and the clinical status of patients. Organizationally, professionals' risk perceptions affected their willingness to take personal responsibility for interactions beyond the unit. This study drew on cognitive research, specifically theories of cognitive dissonance, psychological safety, and situational awareness to explain how professionals' cognitive processes impacted on ICU behaviors. Our results may have implications for relationships, management, and leadership in ICU. First, patient care delivery may be affected by professionals' perfectionist or pragmatic approach. Perfectionists' team role may be compromised and they may experience cognitive dissonance and subsequent isolation/stress. Second, psychological safety in a team may be improved within the confines of a perceived "A" team but diminished by interdisciplinary tensions. Third, counter intuitively, higher "situational" awareness for some individuals increased their stress and anxiety. Finally, our results suggest that professionals have varying concepts of where their personal responsibility to minimize

  5. Comparison of physician staffed emergency teams with paramedic teams assisted by telemedicine--a randomized, controlled simulation study. (United States)

    Rörtgen, Daniel; Bergrath, Sebastian; Rossaint, Rolf; Beckers, Stefan K; Fischermann, Harold; Na, In-Sik; Peters, David; Fitzner, Christina; Skorning, Max


    Emergency medical services (EMSs) vary considerably. While some are physician staffed, most systems are run by paramedics. The objective of this randomized, controlled simulation study was to compare the emergency care between physician staffed EMS teams (control group) and paramedic teams that were supported telemedically by an EMS physician (telemedicine group). Overall 16 teams (1 EMS physician, 2 paramedics) were randomized to the control group or the telemedicine group. Telemedical functionalities included two-way audio communication, transmission of vital data (numerical values and curves) and video streaming from the scenario room to the remotely located EMS physician. After a run-in scenario all teams completed four standardized scenarios, in which no highly invasive procedures (e.g. thoracic drain) were required, two using high-fidelity simulation (burn trauma, intoxication) and two using standardized patients (renal colic, barotrauma). All scenarios were videotaped and analyzed by two investigators using predefined scoring items. Non case-specific items (31 vs. 31 scenarios): obtaining of 'symptoms', 'past medical history' and 'events' were carried out comparably, but in the telemedicine group 'allergies' (17 vs. 28, OR 7.69, CI 2.1-27.9, p=0.002) and 'medications' (17 vs. 27, OR 5.55, CI 1.7-18.0, p=0.004) were inquired more frequently. No significant differences were found regarding the case-specific items and in both groups no potentially dangerous mistreatments were observed. Telemedically assisted paramedic care was feasible and at least not inferior compared to standard EMS teams with a physician on-scene in these scenarios. Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

  6. The Digital Competence Framework for Consumers


    BRECKO Barbara; FERRARI Anusca


    The European Digital Competence Framework for Consumers, or "DigCompConsumers", offers a reference framework to support and improve consumers’ digital competence. Consumer digital competence is defined as the competence consumers need to function actively, safely and assertively in the digital marketplace. This definition builds on existing work on consumers’ competence, and on the general digital competences as defined in the DigComp 2.0 framework. This report introduces the conceptual refer...

  7. Moral competency: meta-competence of nursing care (United States)

    Zafarnia, Niloofar; Abbaszadeh, Abbas; Borhani, Fariba; Ebadi, Abbas; Nakhaee, Nouzar


    Introduction To follow the progress of technology and increasing domain of nurses’ duties, ethical challenges can be observed more than ever. Therefore, the growing and dynamic system of nursing requires nurses with professional and ethical competence who can provide optimal care. The aim of the present study was to define and explain dimensions of moral competency among the clinical nurses of Iran. Methods This qualitative content analysis study was carried out in the years 2014 and 2015 in Iran. Data were collected through in-depth semistructured interviews and field notes. The resulting data were analyzed by Graneheim and Lundman’s method of conventional content analysis. The participants were 12 clinical nurses who were selected using purposive convenient sampling and continued interviews until data saturation. Results Themes obtained in the present study were posited in three main categories of “moral character,” with subcategories of altruism, search for meaning, be pioneering, perfectionism, self-control, honesty, and forgiveness; “moral care” with subcategories of dignified care, safe care, fair care, and holistic care; and “moral decision-making” with subcategories of moral sensitivity, moral thinking, moral reasoning, and moral courage. Conclusions Findings of the present study suggest that nurses’ moral competency is an adorable character with a wide range that includes moral virtues and character, moral decision-making, and ultimately providing moral care; therefore, moral competency is a meta-competence in the field of nursing. Because there are many competencies in different fields. PMID:28848630

  8. Competence with fractions predicts gains in mathematics achievement. (United States)

    Bailey, Drew H; Hoard, Mary K; Nugent, Lara; Geary, David C


    Competence with fractions predicts later mathematics achievement, but the codevelopmental pattern between fractions knowledge and mathematics achievement is not well understood. We assessed this codevelopment through examination of the cross-lagged relation between a measure of conceptual knowledge of fractions and mathematics achievement in sixth and seventh grades (N=212). The cross-lagged effects indicated that performance on the sixth grade fractions concepts measure predicted 1-year gains in mathematics achievement (ß=.14, pmathematics achievement did not predict gains on the fractions concepts measure (ß=.03, p>.50). In a follow-up assessment, we demonstrated that measures of fluency with computational fractions significantly predicted seventh grade mathematics achievement above and beyond the influence of fluency in computational whole number arithmetic, performance on number fluency and number line tasks, central executive span, and intelligence. Results provide empirical support for the hypothesis that competence with fractions underlies, in part, subsequent gains in mathematics achievement. Copyright © 2012 Elsevier Inc. All rights reserved.

  9. Efektifitas Penerapan Program Penanganan Turnover Karyawan Staf Manajemen PT. BEHAESTEX Group

    Directory of Open Access Journals (Sweden)

    Ratna Juita


    Full Text Available The purpose of this research are to recognize turnover management program implementation effectiveness of management staffs of PT. BEHAESTEX Group and know the causes aspect the employee who leave out then program that given is the target precise. This research used qualitative method with qualitative descriptive research type. Information digging by in depth interview, observation, and documentation taken from HRD data. Research subjects as 18 respondents obtained from staff employee who already terminated from PT. BEHAESTEX Group since 2010 until 2012 and represented each department. The result of the research indicates that effective turnover management program only one program that is employee training. While three other programs that are induction and orientation, coaching and counseling, building and brainstorming ineffective. The causes are the aim does not appropriate, human resources development qualification as program implementer is lack of competence and inconsistency program implementation. Beside found that the causes aspect which result employee terminated could be classified with work term under two years namely unable to adjustment with corporate culture, high idealism and accepted as civil servant. While work term over two years the causes are injustice pay, superior mind pattern still departmental and career stage is unobvious.

  10. Towards a National Discursive Construction of Nurses' Diversity Related Competencies?

    DEFF Research Database (Denmark)

    Jensen, Annie Aarup; Jæger, Kirsten


    's journal, "The Nurse", covering an eight-year period it is concluded that the nursing profession understood as a community of practice continues to encounter the same type of problems related to diversity and that increased knowledge, skills and competencies are needed. The discourse of a new Bachelor...... degree programme in nursing containing a national, standardised curriculum is therefore analysed to uncover how cultural difference and intercultural issues are prioritised in terms of learning goals and resources, and to examine whether the discourse contributes significantly to the understanding...

  11. Discovering the Army's Core Competencies

    National Research Council Canada - National Science Library

    Rudesheim, Frederick


    This paper seeks to answer the question, "Has the Army correctly identified its core competencies to ensure the Army can adequately respond to the national military strategy?" FM 1, The Army (Prototype Draft...

  12. Intercultural Competence in Host Students?

    DEFF Research Database (Denmark)

    Egekvist, Ulla Egidiussen; Lyngdorf, Niels Erik; Du, Xiangyun


    Although substantial work in intercultural education has been done on the intercultural competences of mobile students engaging in international study visits, there is a need to explore intercultural competences in host students. This chapter seeks to answer questions about the challenges and pos...... experience. The study suggests that challenges and possibilities are found within the following categories: (1) Experiential learning, (2) Stereotypes and (3) Coping strategies and support.......Although substantial work in intercultural education has been done on the intercultural competences of mobile students engaging in international study visits, there is a need to explore intercultural competences in host students. This chapter seeks to answer questions about the challenges......-secondary students hosting same-age Chinese students in homestays during a four-day study visit to Denmark in 2012. Qualitative data from student portfolios and focus group interviews are analysed with a focus on host students’ pre-understandings, experiences during the visit and overall reflections on the host...


    Directory of Open Access Journals (Sweden)

    Hermanto Hermanto


    Full Text Available Writing is a skill derived from a long way of learning and exercises. Different from other language skills, writing is considered the difficult language skill to acquire since it involves many aspects of linguistics, social, and writing knowledge and conventions. There are at least three important elements of writing useful to produce a good piece of composition, language competence, writing competence and cultural competence. This paper shows the influence of these three elements in order to produce good, readable, communicative, and successful writing

  14. Defining Tobacco Regulatory Science Competencies. (United States)

    Wipfli, Heather L; Berman, Micah; Hanson, Kacey; Kelder, Steven; Solis, Amy; Villanti, Andrea C; Ribeiro, Carla M P; Meissner, Helen I; Anderson, Roger


    In 2013, the National Institutes of Health and the Food and Drug Administration funded a network of 14 Tobacco Centers of Regulatory Science (TCORS) with a mission that included research and training. A cross-TCORS Panel was established to define tobacco regulatory science (TRS) competencies to help harmonize and guide their emerging educational programs. The purpose of this paper is to describe the Panel's work to develop core TRS domains and competencies. The Panel developed the list of domains and competencies using a semistructured Delphi method divided into four phases occurring between November 2013 and August 2015. The final proposed list included a total of 51 competencies across six core domains and 28 competencies across five specialized domains. There is a need for continued discussion to establish the utility of the proposed set of competencies for emerging TRS curricula and to identify the best strategies for incorporating these competencies into TRS training programs. Given the field's broad multidisciplinary nature, further experience is needed to refine the core domains that should be covered in TRS training programs versus knowledge obtained in more specialized programs. Regulatory science to inform the regulation of tobacco products is an emerging field. The paper provides an initial list of core and specialized domains and competencies to be used in developing curricula for new and emerging training programs aimed at preparing a new cohort of scientists to conduct critical TRS research. © The Author 2016. Published by Oxford University Press on behalf of the Society for Research on Nicotine and Tobacco. All rights reserved. For permissions, please e-mail:

  15. Using games to demonstrate competency. (United States)

    Pauli, Pamela


    Providing annual mandatory safety training while finding ways to assess the competency of staff creates several challenges. Meeting staff's needs, especially when working with diverse staff of various educational levels, languages, and learning abilities, as well as meeting the institution's needs for training and assessment can be especially difficult. The author describes a gaming strategy that promotes learning, self-efficacy, and assesses staff competency using a cooperative and interactive learning approach.

  16. Competence building capacity shortage

    International Nuclear Information System (INIS)

    Doorman, Gerard; Wangensteen, Ivar; Bakken, Bjoern


    The objective of the project 'Competence Building Capacity Shortage' has been 'to increase knowledge about central approaches aimed at solving the peaking capacity problem in restructured power systems'. With respect to reserve markets, a model was developed in the project to analyze the relations between reserve requirements and prices in the spot and reserve markets respectively. A mathematical model was also developed and implemented, which also includes the balance market, and has a good ability to predict the relations between these markets under various assumptions. With some further development, this model can be used fore realistic analyses of these markets in a Nordic context. It was also concluded that certain system requirements with respect to frequency and time deviation can be relaxed without adverse effects. However, the requirements to system bias, Frequency Activated Operating Reserves and Frequency Activated Contingency Reserves cannot be relaxed, the latter because they must cover the dimensioning fault in the system. On the other hand, Fast Contingency Reserves can be reduced by removing requirements to national balances. Costs can furthermore be reduced by increasingly adapting a Nordic as opposed to national approach. A model for stepwise power flow was developed in the project, which is especially useful to analyze slow power system dynamics. This is relevant when analysing the effects of reserve requirements. A model for the analysis of the capacity balance in Norway and Sweden was also developed. This model is useful for looking at the future balance under various assumptions regarding e.g. weather conditions, demand growth and the development of the generation system. With respect to the present situation, if there is some price flexibility on the demand side and system operators are able to use reserves from the demand side, the probability for load shedding during the peak load hour is close to zero under the weather conditions after

  17. Professional communication competences of nurses. (United States)

    Włoszczak-Szubzda, Anna; Jarosz, Mirosław Jerzy


    Dissonance between the high 'technical' professionalism of nurses and the relatively low level of patient satisfaction with care received is a phenomenon observed in many countries. Many studies show that it occurs in the case of an inadequate interpersonal communication between nurses and patients. Three basic scopes of communication competences were involved in the research process: a) motivation, b) knowledge, c) skills, and the following three methods were used: 1) documentation analysis (standards, plans and educational programmes); 2) diagnostic survey concerning professional communication competences of nurses in nursing care--a questionnaire form designed by the authors; 3) self-reported communication skills in nursing care--adjective check list. The study group covered a total number of 108 respondents in the following subgroups: 1) professional nurses who, as a rule, were not trained in interpersonal communication (42 respondents); students of nursing covered by a standard educational programme (46 respondents); 3) students of nursing who, in addition to a standard educational programme, attended extra courses in professional interpersonal communications nursing (20 respondents). The data obtained were subjected to statistical analysis with the use of descriptive statistics and hypothesis testing. The results of studies indicate poor efficacy of shaping communication competences of nurses based on education in the area of general psychology and general interpersonal communication. Communication competences acquired during undergraduate nursing education, are subject to regression during occupational activity. Methods of evaluating communication competences are useful in constructing group and individual programmes focused on specific communication competences rather than on general communication skills.

  18. The assessment of medical competencies. (United States)

    Sureda-Demeulemeester, E; Ramis-Palmer, C; Sesé-Abad, A


    To describe the most widely used tools in the assessment of medical competencies, analyse their prevalence of use, their advantages and disadvantages and propose an appropriate model for our context. We conducted a narrative review of articles from MEDLINE, following the PRISM protocol, and analysed a total of 62 articles. The assessment of competencies is heterogeneous, especially in the educational and professional settings. The specific and technical competencies acquired during university education are mainly assessed using the objective structured clinical assessment. In the professional setting, core competencies are assessed using the 360° technique. We need a rigorous empiric comparison of the efficiency of the tools according to the type of competency. We propose a competency management model for the «undergraduate/graduate/active professional» continuum, whose goal is to improve training and professional practice and thereby increase the quality of patient care. Copyright © 2017 Elsevier España, S.L.U. and Sociedad Española de Medicina Interna (SEMI). All rights reserved.



    Mariana ENUŞI


    As firms evolve in an ever-changing environment, new perspectives are needed to explain management practices and the competence management that involves several heavy processes. We have categorised them in four classes: competence identification, competence assessment, competence acquisition and competence usage. Partnership is a relationship that emphasises equality, shared responsibility, co-operation, individual competence and competence management information systems that are defined by t...

  20. Assessing Core Competencies (United States)

    Narayanan, M.


    Catherine Palomba and Trudy Banta offer the following definition of assessment, adapted from one provided by Marches in 1987. Assessment in the systematic collection, review, and use of information about educational programs undertaken for the purpose of improving student learning and development. (Palomba and Banta 1999). It is widely recognized that sophisticated computing technologies are becoming a key element in today's classroom instructional techniques. Regardless, the Professor must be held responsible for creating an instructional environment in which the technology actually supplements learning outcomes of the students. Almost all academic disciplines have found a niche for computer-based instruction in their respective professional domain. In many cases, it is viewed as an essential and integral part of the educational process. Educational institutions are committing substantial resources to the establishment of dedicated technology-based laboratories, so that they will be able to accommodate and fulfill students' desire to master certain of these specific skills. This type of technology-based instruction may raise some fundamental questions about the core competencies of the student learner. Some of the most important questions are : 1. Is the utilization of these fast high-powered computers and user-friendly software programs creating a totally non-challenging instructional environment for the student learner ? 2. Can technology itself all too easily overshadow the learning outcomes intended ? 3. Are the educational institutions simply training students how to use technology rather than educating them in the appropriate field ? 4. Are we still teaching content-driven courses and analysis oriented subject matter ? 5. Are these sophisticated modern era technologies contributing to a decline in the Critical Thinking Capabilities of the 21st century technology-savvy students ? The author tries to focus on technology as a tool and not on the technology

  1. Design studies on staffing requirements for the new generation nuclear power units of WWER-640 and BN-800 reactor types

    International Nuclear Information System (INIS)

    Solovyov, D.F.


    The paper outlines the main staffing requirements for the new generation power units with nuclear reactors. These requirements were developed taking into account IAEA recommendations. NPP staffing structure is described, including the main and auxiliary personnel. The main principles of personnel number determination are given. Special attention is taken to the issues of personnel skill and training, including both theoretical education and practical work on the power units in operation. The use of simulators, system of knowledge control and structure of training are considered. ''Shopless'' staffing structure approach is proposed for the NPP, assuming that the main scope of repair work is performed by the central repair organization, thus increasing the quality of repair and decreasing the number of personnel on the plant. Data are given on the personnel number for the WWER-640 and the BN-800 reactor designs. Specialists of the ''ATOMENERGOPROJECT'' Institute started their work on staffing on the early development stage of the basic design of WWER-640 reactor power unit which is the forerunner of the new generation reactors. This work was based on the approaches taken by the chief engineers of NPPs in operation during their meeting held in 1989 in Kalinin NPP. At this meeting definite decision was taken on changing over to involving manufacturer in the repair work of NPP components using manufacturer's technology. In 1992 the meeting of representatives of suppliers of the main components was held where representatives of ''ATOMENERGOREMONT'' and ''LENENERGOREMONT'' were present. The suppliers agreed on carrying out repair works on the components they produced. For this purpose special departments were set up having some experience. This repair work is already carried out by ''ATOMENERGOREMONT'' on some nuclear power plants. ''LENENERGOREMONT'' has gained considerable experience in this kind of repair work on the turbines of LO-1 and LO-2 NPP in Finland. Within the

  2. Country of origin and racio-ethnicity: are there differences in perceived organizational cultural competency and job satisfaction among nursing assistants in long-term care? (United States)

    Allensworth-Davies, Donald; Leigh, Jennifer; Pukstas, Kim; Geron, Scott Miyake; Hardt, Eric; Brandeis, Gary; Engle, Ryann L; Parker, Victoria A


    Long-term care facilities nationwide are finding it difficult to train and retain sufficient numbers of nursing assistants, resulting in a dire staffing situation. Researchers, managers, and practitioners alike have been trying to determine the correlates of job satisfaction to address this increasingly untenable situation. One factor that has received little empirical attention in the long-term care literature is cultural competence. Cultural competence is defined as a set of skills, attitudes, behaviors, and policies that enable organizations and staff to work effectively in cross-cultural situations. To examine organizational cultural competence as perceived by nursing assistants and determine if this was related to differences in job satisfaction across countries of origin and racio-ethnic groups. Primary data collected from a cross-section of 135 nursing assistants at four New England nursing homes. Demographics, perceptions of organizational cultural competence, and ratings of job satisfaction were collected. A multivariate, generalized linear model was used to assess predictors of job satisfaction. A secondary analysis was then conducted to identify the most important components of organizational cultural competency. Perception of organizational cultural competence (p = .0005) and autonomy (p = .001) were the strongest predictors of job satisfaction among nursing assistants; as these increase, job satisfaction also increases. Neither country of origin nor racio-ethnicity was associated with job satisfaction, but racio-ethnicity was associated with perceived organizational cultural competence (p = .05). A comfortable work environment for employees of different races/cultures emerged as the strongest organizational cultural competency factor (p = .04). Developing and maintaining organizational cultural competency and employee autonomy are important managerial strategies for increasing job satisfaction and improving staff retention. Toward this end, creating a

  3. Machine Trades. Ohio's Competency Analysis Profile. (United States)

    Ohio State Univ., Columbus. Vocational Instructional Materials Lab.

    This Ohio Competency Analysis Profile (OCAP), derived from a modified Developing a Curriculum (DACUM) process, is a current comprehensive and verified employer competency program list for machine trades. Each unit (with or without subunits) contains competencies and competency builders that identify the occupational, academic, and employability…

  4. Competences, competences assessment, validity of instruments, Preschool Education

    Directory of Open Access Journals (Sweden)

    Rigoberto Marín Uribe


    Full Text Available The purpose of this article is to describe the design process, validation and assurance of an instrument for the assessment of the success level of competences in preschool children. Initially is presented a theoretical and contextual framework of the competences in preschool. With this, it is problematized about the absence of tools for that the educators could perform the diagnostic evaluation of competences required in the reform of preschool education 2004. In the design of the instrument, the concept of “situation” is central. The validation and assurance included a process of pilotage with 512 preschool children with the implementing in practice of three different ways of application of the instrument. The results show high levels of assurance and power of discrimination that allow to distinguish significantly people by age and socioeconomic level, not finding differences by genre.


    Directory of Open Access Journals (Sweden)

    Neamţu Adina Claudia


    Full Text Available The current economical evolution determines the improvement process of the employees that should be prepared as well as possible at all levels, so that they could accomplish the objectives of the organization in a world where the success depends on the capacity to supply quality, diversity, the satisfaction of the clients’ needs, optimal advantages and promptness. The easy access to information in the current world forces the universities to keep up to the requirements of the labour market and of the future graduates, to change into open, active, dynamic, emphatic spaces, in launching ramps for them, allowing the simulation of the roles the students will have as adults in the knowledge economy. In this context, the higher education institutions in Romania have understood that only by means of performance and competence we may reach the global domination of a category of complex situation, by mobilizing certain diverse resources (knowledge, practical abilities, social representations, values and attitudes. All of these may develop in the context of a university centre that understands that, next to the theory, the students’ practice is based on an integrated ensemble of knowledge, skills and attitudes that allow the subject, in front of a category of situations of adapting, solving problems and accomplishing projects.

  6. A competence executive coaching model

    Directory of Open Access Journals (Sweden)

    Pieter Koortzen


    Research purpose: The purpose of this article is to address the training and development needs of these consulting psychologists by presenting a competence executive coaching model for the planning, implementation and evaluation of executive coaching interventions. Research design, approach and method: The study was conducted while one of the authors was involved in teaching doctoral students in consulting psychology and executive coaching, specifically in the USA. The approach involved a literature review of executive coaching models and a qualitative study using focus groups to develop and evaluate the competence executive coaching model. Main findings: The literature review provided scant evidence of competence executive coaching models and there seems to be a specific need for this in the training of coaches in South Africa. Hence the model that was developed is an attempt to provide trainers with a structured model for the training of coaches. Contribution/value-add: The uniqueness of this competence model is not only described in terms of the six distinct coaching intervention phases, but also the competencies required in each.

  7. One Health Core Competency Domains

    Directory of Open Access Journals (Sweden)

    Rebekah Frankson


    Full Text Available The emergence of complex global challenges at the convergence of human, animal, and environmental health has catalyzed a movement supporting ‘One Health’ approaches. Despite recognition of the importance of One Health approaches to address these complex challenges, little effort has been directed at identifying the seminal knowledge, skills and attitudes necessary for individuals to successfully contribute to One Health efforts. Between 2008 and 2011, three groups independently embarked on separate initiatives to identify core competencies for professionals involved with One Health approaches. Core competencies were considered critically important for guiding curriculum development and continuing professional education as they describe the knowledge, skills and attitudes required to be effective. A workshop was convened in 2012 to synthesize the various strands of work on One Health competencies. Despite having different mandates, participants, and approaches, all of these initiatives identified similar core competency domains: management; communication and informatics; values and ethics; leadership; teams and collaboration; roles and responsibilities; and systems thinking. These core competency domains have been used to develop new continuing professional education programs for One Health professionals and help university curricula prepare new graduates to be able to contribute more effectively to One Health approaches.

  8. Action competence: A concept analysis. (United States)

    Bergen, Jennie; Santo, LaTonya


    The aim of this article is to analyze the concept of action competence and comprise a definition of the concept suitable to apply to virtual simulation in nursing education. Virtual simulation has become an instructional method increasingly used in nursing education which creates a challenge for assessment of clinical competence. This concept analysis was performed using Walker and Avant's eight stages of concept analysis. A literature search was conducted using search engines and included peer-reviewed articles from various disciplines. The concept analysis resulted in an operational definition of action competence that is useful in nursing education. The use of action competence during virtual simulation sessions provides a means for knowledge transfer, accountability of actions on the part of the students, self-awareness, and reflection. Through this process, students gain critical problem-solving skills that, through sustainability, can be applied to varying future patient scenarios. Action competence contains concrete components applicable to sustainability of knowledge gained by nursing students during virtual simulation. © 2018 Wiley Periodicals, Inc.

  9. External validation of the ROSC after cardiac arrest (RACA) score in a physician staffed emergency medical service system. (United States)

    Kupari, Petteri; Skrifvars, Markus; Kuisma, Markku


    The return of spontaneous circulation (ROSC) after cardiac arrest (RACA) score may have implications as a quality indicator for the emergency medical services (EMS) system. We aimed to validate this score externally in a physician staffed urban EMS system. We conducted a retrospective cohort study. Data on resuscitation attempts from the Helsinki EMS cardiac arrest registry from 1.1.2008 to 31.12.2010 were collected and analyzed. For each attempted resuscitation the RACA score variables were collected and the score calculated. The endpoint was ROSC defined as palpable pulse over 30 s. Calibration was assessed by comparing predicted and observed ROSC rates in the whole sample, separately for shockable and non-shockable rhythm, and separately for resuscitations lead by a specialist, registrar or medical supervisor (i.e., senior paramedic). Data are presented as medians and interquartile ranges. Statistical testing included chi-square test, the Mann-Whitney U test, Hosmer-Lemeshow goodness of fit test and calculation of 95% confidence intervals (CI) for proportions. A total of 680 patients were included of whom 340 attained ROSC. The RACA score was higher in patients with ROSC (0.62 [0.46-0.69] than in those without (0.46 [0.36-0.57]) (p system for out-of-hospital cardiac arrest patients would allow patient heterogeneity adjustment and measurement of quality of care in analogy to commoly used severity-of-illness- scores developed for the similar purposes for the general intensive care unit population. However, transferring RACA score to another country with different population and EMS system might affect the performance and generalizability of the score. This study found a good overall calibration and moderate discrimination of the RACA score in a physician staffed urban EMS system which suggests external validity of the score. Calibration was suboptimal in patients with a non-shockable rhythm which may due to a local do-not-attempt-resuscitation policy. The lower

  10. Competencies required for occupational health nurses (United States)

    Kono, Keiko; Goto, Yuki; Hatanaka, Junko; Yoshikawa, Etsuko


    Objectives: For occupational health (OH) nurses to perform activities effectively, not only skills and knowledge but also competencies proposed by Dr. McClelland are indispensable. This study aimed to identify competencies required for OH nurses and to show their structure diagram. Methods: Qualitative descriptive research was conducted from October 2010 to August 2011. Eight high-performing OH nurses participated, and data were collected from semi-structured interviews held for each nurse. Data were qualitatively and inductively analyzed using the KJ method. Results: Seven competencies were identified: "self-growth competency," "OH nursing essence perpetuation competency," "strategic planning and duty fulfillment competency," "coordination competency," "client growth support competency," "team empowerment competency," and "creative competency." A structure diagram of the seven competencies was clarified. As the definitions of the competencies were different, the findings of competencies for OH nursing in the United States of America (USA) could not simply be compared with the findings of our study; however, all seven competencies were compatible with those in AAOHN model 1 and AAOHN model 2 in the USA. Conclusion: Our seven competencies are essential for OH nurses to perform activities that meet the expectations of employees and the employer. PMID:28993570

  11. Competencies required for occupational health nurses. (United States)

    Kono, Keiko; Goto, Yuki; Hatanaka, Junko; Yoshikawa, Etsuko


    For occupational health (OH) nurses to perform activities effectively, not only skills and knowledge but also competencies proposed by Dr. McClelland are indispensable. This study aimed to identify competencies required for OH nurses and to show their structure diagram. Qualitative descriptive research was conducted from October 2010 to August 2011. Eight high-performing OH nurses participated, and data were collected from semi-structured interviews held for each nurse. Data were qualitatively and inductively analyzed using the KJ method. Seven competencies were identified: "self-growth competency," "OH nursing essence perpetuation competency," "strategic planning and duty fulfillment competency," "coordination competency," "client growth support competency," "team empowerment competency," and "creative competency." A structure diagram of the seven competencies was clarified. As the definitions of the competencies were different, the findings of competencies for OH nursing in the United States of America (USA) could not simply be compared with the findings of our study; however, all seven competencies were compatible with those in AAOHN model 1 and AAOHN model 2 in the USA. Our seven competencies are essential for OH nurses to perform activities that meet the expectations of employees and the employer.

  12. Cultural competence in medical education

    DEFF Research Database (Denmark)

    Sørensen, Janne; Jervelund, Signe Smith; Nørredam, Marie Louise


    Aims: The cultural competence training of healthcare professionals is a key element in ensuring the quality of both the access and delivery of healthcare to increasingly ethnically diverse populations. The aim of this study is to investigate Danish medical teachers’ opinions about cultural...... competence, their willingness to receive training and preparedness to teach cultural competence topics. Methods: The survey was sent to medical teachers, clinical teachers and external lecturers who teach in the medical programme at the University of Copenhagen. A total of 1400 medical teachers received...... the survey, and 199 responded. The response rate is 14%. Data were analysed through descriptive calculations, and answers to open-ended questions were coded using content analysis. Results: Results showed that 82.4% of the informants agreed or strongly agreed that the medical education programme should...

  13. Literacy competence based on fiction

    DEFF Research Database (Denmark)

    Broström, Stig

    tool towards children's general Bildung and more specific development of literacy competence in the first years of school, in 2007 we carried out an investigation about fiction as a part of mother-tongue teaching and the process of children's learning to read. Via the investigation and general studies...... we want to get more knowledge ablout following questions:   How to define fiction which holds a personal and language "Bildung"? How to define the importance of fiction related to children's literacy competence? What kind of fiction do teachers use? How do teachers mediate fiction, how and in what...... extend do teachers make use of drawing and play activities? How to find a balance between to maintain the aesthetical and narrative methods and expressions AND gaining a literacy competence?   This paper has focus on the fourth question....

  14. Yes Virginia, quantum mechanics can be understood

    CERN Document Server

    Wallace, John P


    Virginia, B. W. Wooster, and Jeeves take up physics with the hope of understanding quantum mechanics. In the process they take a rather grand tour on an old sailing ship and aid a sow in distress. On their journey they discover that physics is not as difficult a subject as they imagined. When they dismantled physics and reassembled it in a form where gravity, strong, electromagnetic and the weak forces all stem from understanding the gaming strategy known as the fair-game. That great cultural divide first expounded by the novelist C.P.Snow was found to be a mere ditch that can be stepped over. The sins of the past were violations of energy conservation and strange notions about what mass actually represents. Now mass is defined without the assistance of the Standard Model. Things will not be the same. Singularities have been banished. The electron now has a scale and is no longer captive in a point. The gluon is no longer essential along with the single virtual photon.

  15. The Center of Gravity, Systemically Understood (United States)


    Swain and Larry G. Heysteck (Riyadh, Saudi Arabia: CMH , Desert Storm Interviews, 1991), 33. 91Purvis, et al., 17. 40...Sullivan. "Interview: Centcom Planning Cell." In Unedited Transcript, edited by Richard Swain and Larry G. Heysteck. Riyadh, Saudi Arabia: CMH

  16. Evil Understood as the Absence of Freedom

    DEFF Research Database (Denmark)

    Rabjerg, Bjørn


    Self-development is closely related to the idea of formation (or what is referred to as Bildung in German). But when speaking of formation, we have to address the question, ‘what are we formed by?’ Is the human being formed by him- or herself, or by resources originating from outside the self? Fr...

  17. Competence linguistique et environnement social (Linguistic Competence and Social Environment). (United States)

    Laflamme, Simon; Berger, Jacques


    A study found native French-speaking and native English-speaking university students had similar writing skill levels and error patterns despite their position as language-minority or language-majority members of society. It is concluded that language competency is not necessarily linked to language difficulty or to the position of the language.…

  18. The competence of social entrepreneurship : A multidimensional competence approach

    NARCIS (Netherlands)

    Loredana Orhei


    This paper is aimed at presenting a theoretical definition for the construct of social entrepreneurship as competence for the social economy in Europe. This definition is part of a study that was designed and developed in two phases. This paper will present only the results of the first one: the

  19. Assuring the competence of nuclear power plant contractor personnel

    International Nuclear Information System (INIS)


    This report was prepared in response to a recommendation by the IAEA International Working Group on Training and Qualification of NPP Personnel (JWG-T and Q) and supported by a number of IAEA meetings on NPP personnel training. IAEA publications on NPP training are the only international documents available to all Member States with nuclear programmes. This report complements the following IAEA publications on NPP personnel training: Technical Reports Series No. 380, Nuclear Power Plant Personnel Training and its Evaluation, A Guidebook; IAEA-TECDOC-1057, Experience in the Use of Systematic Approach to Training (SAT) for Nuclear Power Plant Personnel and IAEA-TECDOC-1063, IAEA World Survey on Nuclear Power Plant Personnel Training. This TECDOC also supplements the IAEA Safety Guide 50-SG-O1 (Rev. 1), Staffing of Nuclear Power Plants and the Recruitment Training and Authorization of Operating Personnel and Safety Standards Series No. NS-R-2, Safety of Nuclear Power Plants. Operation. Within the context of this report NPP contractors are defined as any personnel working for a nuclear power plant who are not directly employed by the nuclear power plant. Competence is the ability to perform to identified standards; it comprises skills, knowledge and attitudes and may be developed through education, experience and training. Qualification is a formal statement of achievement, resulting from an auditable assessment; if competence is assessed, the qualification becomes a formal statement of competence and may be shown on a certificate, diploma, etc. It is recognized that personnel are used to perform tasks that are of a specialised or temporary nature where it is not feasible to hire or maintain a full-time NPP employee. Accordingly, contractors may be used in a variety of situations to support NPPs. Typical situations include: supplies and services being delivered by the contractors that are subject to different quality standards based on a graded approach to assuring

  20. Does Motor Competence Affect Self-Perceptions Differently for Adolescent Males and Females?

    Directory of Open Access Journals (Sweden)

    Elizabeth Rose


    Full Text Available Little is understood about the impact of level of motor competence on self-perceptions in adolescence, in particular how this may differentially affect girls and boys. A sample of 1,568 14-year-old participants (766 girls and 802 boys were grouped into four motor competence levels (very low to high based on the McCarron Assessment of Neuromuscular Development (MAND. Self-perceptions were assessed using the Self-Perception Profile for Adolescents. Boys had higher self-perceptions of global self-worth, athletic competence, and physical appearance, whereas girls had higher scores for close friendships and behavioral conduct. Main effects in the predicted direction were found for motor competence for self-perceptions of global self-worth, athletic competence, physical appearance, close friendships, social acceptance, and romantic appeal. These findings indicate that level of motor competence is important in many aspects of self-perceptions, affecting girls and boys differently. Higher motor competence has a protective effect on psychosocial health, particularly for girls.

  1. Social competence of physicians and medical students – a preliminary report

    Directory of Open Access Journals (Sweden)

    Bożena Mroczek


    Full Text Available Background . Efficient functioning at work and in the environment depends on social and emotional competence, understood as complex skills that determine the effectiveness of behaviors in various professional and social situations. Objectives. The aim of this study was to determine the social competence of physicians and medical students with regard to the sociodemographic contributors which shape social competence. Material and methods . The study was conducted in 2015 and 2016 and it involved 90 physicians, including 25 GPs (27.8% and 53 medical students of PMU in Szczecin. The median age of the physicians and the students was 32 and 25, respectively. The Social Competencies Questionnaire (SC Q by Anna Matczak and a self-developed survey questionnaire were employed. Results. The ability of physicians to achieve medium and high levels of social competence increases by 8.5% with every year of seniority. Membership in scientific societies increases the odds of a high level of social competence fivefold in the ES scale and fourfold in the A scale. Physicians involved in the education of medical students were less likely to obtain medium and high scores (5 stens in the A scale. An increase in seniority in the last workplace is accompanied by a 0.93 times lower probability of obtaining a high competence score in the A scale. Similarly, third cycle degree studies increase the odds of achieving high competence level by 7.48 times in the A scale. Conclusions . Low levels of competence can be expected from physicians with less seniority, not belonging to scientific societies, not involved in students’ education, working in only one place, and not participating in third cycle degree studies. This group should be provided with social competence training.

  2. Nursing Management Minimum Data Set: Cost-Effective Tool To Demonstrate the Value of Nurse Staffing in the Big Data Science Era. (United States)

    Pruinelli, Lisiane; Delaney, Connie W; Garciannie, Amy; Caspers, Barbara; Westra, Bonnie L


    There is a growing body of evidence of the relationship of nurse staffing to patient, nurse, and financial outcomes. With the advent of big data science and developing big data analytics in nursing, data science with the reuse of big data is emerging as a timely and cost-effective approach to demonstrate nursing value. The Nursing Management Minimum Date Set (NMMDS) provides standard administrative data elements, definitions, and codes to measure the context where care is delivered and, consequently, the value of nursing. The integration of the NMMDS elements in the current health system provides evidence for nursing leaders to measure and manage decisions, leading to better patient, staffing, and financial outcomes. It also enables the reuse of data for clinical scholarship and research.

  3. Is innovative workforce planning software the solution to NHS staffing and cost crisis? An exploration of the locum industry. (United States)

    Theodoulou, Iakovos; Reddy, Akshaya Mohan; Wong, Jeremy


    Workforce planning in the British healthcare system (NHS) is associated with significant costs of agency staff employment. The introduction of a novel software (ABG) as a 'people to people economy' (P2PE) platform for temporary staff recruitment offers a potential solution to this problem. Consequently, the focus of this study was twofold - primarily to explore the locum doctor landscape, and secondarily to evaluate the implementation of P2PE in the healthcare industry. Documentary analysis was conducted alongside thirteen semi structured interviews across five informant groups: two industry experts, two healthcare consultants, an executive director, two speciality managers and six doctors. We found that locum doctors are indispensable to covering workforce shortages, yet existing planning and recruitment practices were found to be inefficient, inconsistent and lacking transparency. Contrarily, mobile-first solutions such as ABG seem to secure higher convenience, better transparency, cost and time efficiency. We also identified factors facilitating the successful diffusion of ABG; these were in line with classically cited characteristics of innovation such as trialability, observability, and scope for local reinvention. Drawing upon the concept of value-based healthcare coupled with the analysis of our findings led to the development of Information Exchange System (IES) model, a comprehensive framework allowing a thorough comparison of recruitment practices in healthcare. IES was used to evaluate ABG and its diffusion against other recruitment methods and ABG was found to outperform its alternatives, thus suggesting its potential to solve the staffing and cost crisis at the chosen hospital.

  4. The Leapfrog initiative for intensive care unit physician staffing and its impact on intensive care unit performance: a narrative review. (United States)

    Gasperino, James


    The field of critical care has changed markedly in recent years to accommodate a growing population of chronically critically ill patients. New administrative structures have evolved to include divisions, departments, and sections devoted exclusively to the practice of critical care medicine. On an individual level, the ability to manage complex multisystem critical illnesses and to introduce invasive monitoring devices defines the intensivist. On a systems level, critical care services managed by an intensivist-led multidisciplinary team are now recognized by their ability to efficiently utilize hospital resources and improve patient outcomes. Due to the numerous cost and quality issues related to the delivery of critical care medicine, intensive care unit physician staffing (IPS) has become a charged subject in recent years. Although the federal government has played a large role in regulating best practices by physicians, other third parties have entered the arena. Perhaps the most influential of these has been The Leapfrog Group, a consortium representing 130 employers and 65 Fortune 500 companies that purchase health care for their employees. This group has proposed specific regulatory guidelines for IPS that are purported to result in substantial cost containment and improved quality of care. This narrative review examines the impact of The Leapfrog Group's recommendations on critical care delivery in the United States. Copyright © 2011 Elsevier Ireland Ltd. All rights reserved.

  5. Lifelong Competence Development: On the Advantages of Formal Competence-Performance Modeling

    NARCIS (Netherlands)

    Kickmeier-Rust, Michael D.; Albert, Dietrich; Steiner, Christina


    Please, cite this publication as: Kickmeier-Rust, M.D., Albert, D., & Steiner, C. (2006). Lifelong Competence Development: On the Advantages of Formal Competence-Performance Modeling. Proceedings of International Workshop in Learning Networks for Lifelong Competence Development, TENCompetence

  6. Effect of a staffing strategy based on voluntary increase in working hours on quality of patient care in a hospital in KwaZulu-Natal

    Directory of Open Access Journals (Sweden)

    J. McIntosh


    Full Text Available Two of the issues facing the South African Health Care System are the shortage of nursing staff and a lack of adequate skills to provide quality patient care. The hospital under study experienced a critical shortage of applications from professional registered nurses, consequently a staffing strategy was implemented to overcome the shortage of nurses and to maintain quality patient care. The strategy introduced encouraged nurses to voluntarily work an additional ten hours per week with remuneration. A non-experimental, descriptive design with a quantitative approach was applied to investigate the effect of a staffing strategy aimed at improving the quality of care in a hospital in Kwa-Zulu Natal based on voluntarily increasing staff working hours. The investigation compared the quality of nursing care before and after the implementation of the staffing strategy through retrospective audits of randomly selected patient files 372 (11% of the total population of 400 files were audited. A random sample of 4 boxes each containing a 100 patient files, of a total of 34 boxes, was selected from the hospital filing system. Descriptive statistical analyses were performed and correlations between various variables using the Chi-square test. No statistically significant differences (p<0.05 were found between the quality of nursing care before and after the implementation of the management strategy, even though deterioration of results after the implementation was observed. The study shows that the quality of nursing care in most wards deteriorated after implementation. The staffing strategy failed to improve or maintain the quality of nursing care.

  7. Variation in cancer surgical outcomes associated with physician and nurse staffing: a retrospective observational study using the Japanese Diagnosis Procedure Combination Database

    Directory of Open Access Journals (Sweden)

    Yasunaga Hideo


    Full Text Available Abstract Background Little is known about the effects of professional staffing on cancer surgical outcomes. The present study aimed to investigate the association between cancer surgical outcomes and physician/nurse staffing in relation to hospital volume. Methods We analyzed 131,394 patients undergoing lung lobectomy, esophagectomy, gastrectomy, colorectal surgery, hepatectomy or pancreatectomy for cancer between July and December, 2007–2008, using the Japanese Diagnosis Procedure Combination database linked to the Survey of Medical Institutions data. Physician-to-bed ratio (PBR and nurse-to-bed ratio (NBR were determined for each hospital. Hospital volume was categorized into low, medium and high for each of six cancer surgeries. Failure to rescue (FTR was defined as a proportion of inhospital deaths among those with postoperative complications. Multi-level logistic regression analysis was performed to examine the association between physician/nurse staffing and FTR, adjusting for patient characteristics and hospital volume. Results Overall inhospital mortality was 1.8%, postoperative complication rate was 15.2%, and FTR rate was 11.9%. After adjustment for hospital volume, FTR rate in the group with high PBR (≥19.7 physicians per 100 beds and high NBR (≥77.0 nurses per 100 beds was significantly lower than that in the group with low PBR ( Conclusions Well-staffed hospitals confer a benefit for cancer surgical patients regarding reduced FTR, irrespective of hospital volume. These results suggest that consolidation of surgical centers linked with migration of medical professionals may improve the quality of cancer surgical management.

  8. Analysis Influence of Managerial Competence, Technical Competence, and Strategic Competence on Firm Performance in Electrical Engineering Company in Bandung (United States)

    Wijaya, E. R.; Irianto, D.


    The industry sectors that have an important role in the era of globalization is the electro engineering sector. The era of globalization led to intense competition. One of the negative effects of the intense competition is declining profits. Drop in profits caused many firms reduces their employees without seeking the root cause of declining profits in detail. Whereas, employee is the important resources to maintain competitive advantage. Competitive advantage can be measured by the performance of which is owned by the firm. The firm's performance can be formed of competencies that is unique, rare, irreplaceable, and difficult to imitate within the firm, one of them is the competence of the individual. According to a competency-based approach and the resource- based approach, individual competence that affect the performance of the firm is managerial competence, technical competence, and strategic competence. Questionnaire is built based on the dimensions of the firm's performance, managerial competence, technical competence, and strategic competence, are processed using partial least squares application. The results indicate that managerial competence negatively impact firm’s performance with weak ties. The technical competence and strategic competence positively affect firm’s performance with moderate ties.

  9. Competing values in public management

    NARCIS (Netherlands)

    van der Wal, Z.; de Graaf, G.; Lawton, A.


    The main objective of the article is to review relevant literature on (competing) public values in public management and to present a number of perspectives on how to deal with value conflicts in different administrative settings and contexts. We start this symposium with the assumption that value

  10. Clinical Competency in Podiatric Medicine. (United States)

    Lanham, Richard H., Jr.


    The Council on Podiatry Education evaluates colleges of podiatric medicine with on-site accreditation teams, and has established criteria and guidelines for colleges of podiatric medicine. A Delphi technique survey, need for defining competency, and establishment of educational objectives are discussed. (MLW)

  11. Instruction of Competent Psychomotor Skill (United States)

    Olson, Valerie Dong


    Instruction of competent psychomotor skill necessitates an eclectic approach. The principles of learning, complemented with learning styles and sensory modalities preferences, provide a background for teaching physical skills. The use of the psychomotor domain of Bloom's Taxonomy as a map and corresponding behavioral objectives foster the mastery…

  12. Cator Can't Compete

    DEFF Research Database (Denmark)

    Lookofsky, Joseph


    In his contribution to this volume, Professor Joseph Lookofsky argues that the resolution of a given buyer’s non-conformity claim is likely to reflect an attempt to balance competing interests: the countervailing pulls between traditional caveat emptor doctrine (what you see is what you get...

  13. Competent Systems: Effective, Efficient, Deliverable. (United States)

    Abramson, Bruce

    Recent developments in artificial intelligence and decision analysis suggest reassessing the approaches commonly taken to the design of knowledge-based systems. Competent systems are based on models known as influence diagrams, which graphically capture a domain's basic objects and their interrelationships. Among the benefits offered by influence…

  14. What makes a competent psychologist?

    NARCIS (Netherlands)

    Roe, R.A.


    In developing European standards for the psychological profession, 2 approaches to the definition of professional competence have been proposed. One focuses on the roles and functions psychologists should be able to perform (output model), the other on the educational curricula that should be

  15. The Myth about Student Competency (United States)

    Oblinger, Diana G.; Hawkins, Brian L.


    Students appear to be highly technologically competent yet their information literacy skills are in question. College and university executives should consider how to equip their students with information literacy -- not just IT skills -- for a lifelong ability to evaluate and address information needs since part of a college or university's…

  16. Cultural Competence in Business Japanese. (United States)

    Koike, Shohei

    Cultural competence in business Japanese requires more than superficial knowledge of business etiquette. One must truly understand why Japanese people think and act differently from their American counterparts. For example, instruction in the use of Japanese taxis must be accompanied by instruction in the concept and implications of seating order…

  17. Decentering and recentering communicative competence

    NARCIS (Netherlands)

    Kataoka, K.; Ikeda, K.; Besnier, N.


    Communicative competence, a concept that emerged in the 1970s, is in need of rethinking. This rethinking operates in two directions: on the one hand, by taking into account the new forms of interaction and contexts associated with globalization; on the other hand, by locating communicative

  18. Ohio Construction Technologies Competency Profile. (United States)

    Miller, Lavonna; Bowermeister, Bob

    This document, which lists construction technologies competencies as identified by representatives from government agencies and labor organizations as well as secondary and postsecondary educators throughout Ohio, is intended to assist individuals and organizations in developing both college tech prep programs and apprenticeship training/education…

  19. Multilevel joint competing risk models (United States)

    Karunarathna, G. H. S.; Sooriyarachchi, M. R.


    Joint modeling approaches are often encountered for different outcomes of competing risk time to event and count in many biomedical and epidemiology studies in the presence of cluster effect. Hospital length of stay (LOS) has been the widely used outcome measure in hospital utilization due to the benchmark measurement for measuring multiple terminations such as discharge, transferred, dead and patients who have not completed the event of interest at the follow up period (censored) during hospitalizations. Competing risk models provide a method of addressing such multiple destinations since classical time to event models yield biased results when there are multiple events. In this study, the concept of joint modeling has been applied to the dengue epidemiology in Sri Lanka, 2006-2008 to assess the relationship between different outcomes of LOS and platelet count of dengue patients with the district cluster effect. Two key approaches have been applied to build up the joint scenario. In the first approach, modeling each competing risk separately using the binary logistic model, treating all other events as censored under the multilevel discrete time to event model, while the platelet counts are assumed to follow a lognormal regression model. The second approach is based on the endogeneity effect in the multilevel competing risks and count model. Model parameters were estimated using maximum likelihood based on the Laplace approximation. Moreover, the study reveals that joint modeling approach yield more precise results compared to fitting two separate univariate models, in terms of AIC (Akaike Information Criterion).

  20. Ten-year trends in family medicine residency productivity and staffing: impact of electronic health records, resident duty hours, and the medical home. (United States)

    Lesko, Sarah; Hughes, Lauren; Fitch, Wes; Pauwels, Judith


    Electronic health records (EHRs), resident duty hour restrictions, and Patient-centered Medical Home (PCMH) innovations have all impacted the clinical practices of residency programs over the past decade. The University of Washington Family Medicine Network (UWFMN) residencies have collaborated for 10 years in collecting and comparing data regarding the productivity and operations of their training programs to identify the program-level effects of such changes. Based on five survey results from 2000 to 2010, this study examines changes in faculty and resident productivity and staffing models of UWFMN residency training clinics using a standardized methodology, specifically describing the productivity impact of EHR changes and duty hour restrictions and the implementation of the PCMH by residencies. Data were systematically collected via standardized questionnaire, evaluated for quality, clarified, and then analyzed. Resident productivity decreased over the 10-year interval, with resident total yearly patient visits down 17.2%. Core family medicine faculty productivity was highly variable among programs, and nonphysician provider visits increased. Faculty part-time status increased. Front office, medical assistant, and nursing staffing grew significantly, but other administrative staff decreased, resulting in minimal change in total non-provider staffing. A majority of programs engaged in PCMH initiatives in 2010 and had implemented an EHR. Physician productivity in UWFMN residency programs decreased for all resident physicians from 2000 to 2010, likely due to a combination of decreased resident duty hours and other clinical practice changes. Productivity trends have implications for the structure and training requirements for family medicine residency programs.

  1. Competencies for psychology practice in primary care. (United States)

    McDaniel, Susan H; Grus, Catherine L; Cubic, Barbara A; Hunter, Christopher L; Kearney, Lisa K; Schuman, Catherine C; Karel, Michele J; Kessler, Rodger S; Larkin, Kevin T; McCutcheon, Stephen; Miller, Benjamin F; Nash, Justin; Qualls, Sara H; Connolly, Kathryn Sanders; Stancin, Terry; Stanton, Annette L; Sturm, Lynne A; Johnson, Suzanne Bennett


    This article reports on the outcome of a presidential initiative of 2012 American Psychological Association President Suzanne Bennett Johnson to delineate competencies for primary care (PC) psychology in six broad domains: science, systems, professionalism, relationships, application, and education. Essential knowledge, skills, and attitudes are described for each PC psychology competency. Two behavioral examples are provided to illustrate each competency. Clinical vignettes demonstrate the competencies in action. Delineation of these competencies is intended to inform education, practice, and research in PC psychology and efforts to further develop team-based competencies in PC.

  2. Practice environment and its association with professional competence and work-related factors: perception of newly graduated nurses. (United States)

    Numminen, Olivia; Ruoppa, Eija; Leino-Kilpi, Helena; Isoaho, Hannu; Hupli, Maija; Meretoja, Riitta


    To explore newly graduated nurses' (NGN) perception of their practice environment and its association with their self-assessed competence, turnover intentions and job satisfaction as work-related factors. The impact of practice environment on nurses' work is important. Positive practice environments are associated with positive organisational, nurse and patient outcomes. How this applies to NGNs needs further exploration. A cross-sectional descriptive correlation design was used. Data were collected with PES-NWI and NCS instruments from 318 Finnish registered nurses, and analysed statistically. Newly graduated nurses' perception of their practice environment was mainly positive. Most positive perceptions related to collegial nurse-physician relations, and the least positive to staffing and resource adequacy. Positive perceptions were also associated with higher professional competence, higher perceptions of quality of care and lower intentions to leave the job or profession. The findings revealed strong and significant associations between practice environment and work-related factors. Practice environment is an important element in supporting NGNs' competence, retention and job satisfaction. Nursing management should pay attention to NGNs' perceptions of their practice environment. Management's ability to create and maintain positive practice environments can foster NGNs' professional development and job satisfaction, and consequently retain them in the workforce. © 2015 John Wiley & Sons Ltd.

  3. Narratives of Girls and Boys with Autism Spectrum Disorders: Gender Differences in Narrative Competence and Internal State Language (United States)

    Kauschke, Christina; van der Beek, Bettina; Kamp-Becker, Inge


    Since gender differences in the symptomatology of autism spectrum disorder (ASD) are not well understood, the current study examines the communicative skills of males and females with ASD. Narrative competence and internal state language (ISL) was investigated using narrations elicited by a wordless picture book. 11 girls and 11 boys with ASD and…

  4. What Core Competencies Are Related to Teachers' Innovative Teaching? (United States)

    Zhu, Chang; Wang, Di; Cai, Yonghong; Engels, Nadine


    The purpose of this study is to investigate teachers' core competencies in relation to their innovative teaching performance. Based on the literature and previous studies in this field, four competencies (learning competency, educational competency, social competency and technological competency) are theorised as core competencies for teachers'…

  5. The relationship of staffing and work environment with implicit rationing of nursing care in Swiss nursing homes--A cross-sectional study. (United States)

    Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René


    Implicit rationing of nursing care refers to the withdrawal of or failure to carry out necessary nursing care activities due to lack of resources, in the literature also described as missed care, omitted care, or nursing care left undone. Under time constraints, nurses give priority to activities related to vital medical needs and the safety of the patient, leaving out documentation, rehabilitation, or emotional support of patients. In nursing homes, little is known about the occurrence of implicit rationing of nursing care and possible contributing factors. The purpose of this study was (1) to describe levels and patterns of self-reported implicit rationing of nursing care in Swiss nursing homes and (2) to explore the relationship between staffing level, turnover, and work environment factors and implicit rationing of nursing care. Cross-sectional, multi-center sub-study of the Swiss Nursing Home Human Resources Project (SHURP). Nursing homes from all three language regions of Switzerland. A random selection of 156 facilities with 402 units and 4307 direct care workers from all educational levels (including 25% registered nurses). We utilized data from established scales to measure implicit rationing of nursing care (Basel Extent of Rationing of Nursing Care), perceptions of leadership ability and staffing resources (Practice Environment Scale of the Nursing Work Index), teamwork and safety climate (Safety Attitudes Questionnaire), and work stressors (Health Professions Stress Inventory). Staffing level and turnover at the unit level were measured with self-developed questions. Multilevel linear regression models were used to explore the proposed relationships. Implicit rationing of nursing care does not occur frequently in Swiss nursing homes. Care workers ration support in activities of daily living, such as eating, drinking, elimination and mobilization less often than documentation of care and the social care of nursing homes residents. Statistically

  6. Enterprising behaviour in an integrating competence

    NARCIS (Netherlands)

    Loredana Orhei; S. Nandram; Marise Born


    We present insights from literature on enterprising behaviour and competence followed by an application of the competence perspective. Data collection is based on the critical incident technique among 205 entrepreneurs. The study shows how entrepreneurial behaviour benefits from an integrating

  7. Turning university professors into competent learners

    NARCIS (Netherlands)

    Stefanova, Eliza; Ilieva, Miroslava; Nikolova, Nikolina; Stefanov, Krassen


    Stefanova, E., Ilieva, M., Nikolova, N, & Stefanov, K. (2008). Turning university professors into competent learners. In H. W. Sligte & R. Koper (Eds.), Proceedings of the 4th TENCompetence Open Workshop. Empowering Learners for Lifelong Competence Development: pedagogical, organisational and

  8. Learning Networks for Lifelong Competence Development

    NARCIS (Netherlands)

    Koper, Rob; Stefanov, Krassen


    Koper, R., & Stefanov, K. (Eds.) (2006). Learning networks for lifelong competence development. Proceedings of International Workshop in Learning Networks for Lifelong Competence Development. March, 30-31, 2006. Sofia, Bulgaria: TENCompentence Conference. Retrieved June 30th, 2006, from

  9. Competencies - a roadmap for CERN Staff

    CERN Multimedia

    CERN Bulletin


    Back in November, the new CERN Competency Model (CCM), a framework defining the competencies that “ drive performance and lead to excellence”, was introduced by Anne-Sylvie Catherin, Head of the Human Resources (HR) Department, in a special edition of the "Spotlight on CERN" interviews.   What are competencies? Competencies are the characteristics that allow you to do the job you have been assigned. In more precise terms, competencies may be described as the knowledge, skills and types of behaviour that individuals demonstrate in carrying out a given task. Listing all the competencies that make CERN work is an impossible task but one can identify the two main types: technical and behavioural. Both are needed to work effectively in this Organization. While technical competencies are simply the domains of expertise that CERN needs – examples include physics, mechanical engineering and information technology – behavioural competencies are th...

  10. Association between competing interests and authors' conclusions

    DEFF Research Database (Denmark)

    Kjaergard, Lise L; Als-Nielsen, Bodil


    To assess the association between competing interests and authors' conclusions in randomised clinical trials.......To assess the association between competing interests and authors' conclusions in randomised clinical trials....

  11. Administrative Management Competencies for Safety Professionals. (United States)

    Blair, Earl H.; Logan, Joyce P.


    In a 1997 study, 245 safety professionals and educators identified and prioritized management competencies that are important for safety professionals. Results show that the most important competencies are communication, listening, motivating others, creative thinking, and flexibility. (JOW)

  12. International Evolution of TIGER Informatics Competencies. (United States)

    Sensmeier, Joyce; Anderson, Christel; Shaw, Toria


    The TIGER Initiative aims to explain how to equip practicing nurses with informatics competencies. This chapter describes a collaborative effort to identify global informatics requirements in relation to core competencies and to match them with national and regional needs. Recommendations from the TIGER Informatics Competency Synthesis Project, described here, have implications for an international framework of informatics competencies for all types of health care professionals including nurses.

  13. Nurse competence scale: development and psychometric testing. (United States)

    Meretoja, Riitta; Isoaho, Hannu; Leino-Kilpi, Helena


    Self-assessment assists nurses to maintain and improve their practice by identifying their strengths and areas that may need to be further developed. Professional competence profiles encourage them to take an active part in the learning process of continuing education. Although competence recognition offers a way to motivate practising nurses to produce quality care, few measuring tools are available for this purpose. This paper describes the development and testing of the Nurse Competence Scale, an instrument with which the level of nurse competence can be assessed in different hospital work environments. The categories of the Nurse Competence Scale were derived from Benner's From Novice to Expert competency framework. A seven-step approach, including literature review and six expert groups, was used to identify and validate the indicators of nurse competence. After a pilot test, psychometric testing of the Nurse Competence Scale (content, construct and concurrent validity, and internal consistency) was undertaken with 498 nurses. The 73-item scale consists of seven categories, with responses on a visual analogy scale format. The frequency of using competencies was additionally tested with a four-point scale. Self-assessed overall scores indicated a high level of competence across categories. The Nurse Competence Scale data were normally distributed. The higher the frequency of using competencies, the higher was the self-assessed level of competence. Age and length of work experience had a positive but not very strong correlation with level of competence. According to the item analysis, the categories of the Nurse Competence Scale showed good internal consistency. The results provide strong evidence of the reliability and validity of the Nurse Competence Scale.

  14. Peran Marketing Competency dalam Meningkatkan Keunggulan Bersaing


    Rahayu, Fatik


    Functional area competencies are considered as sources of competitive advantage (Porter, 1994; Heene & Stanches, 1997; Cravens, 1996; Vickery el AI, 1993; Vickery et. Al, 1994), and marketing competency is one of them. Marketing competency construct is defined as the sum of the performed on 31 competitive items, weighted by importance and extent of marketing responsibility (Vickery et al., 1994).This study examines a model of relationships between marketing competency and business perform...



    Діана Терещук


    In the article the author analyses how intercultural competency can provide realization of the main purpose of foreign language education, namely developing intercultural communication competence. The author concretizes the content of intercultural communication competence, its components, and frames the educational potential of intercultural communication in the development of this competence. The principal ways of through which educators can foster students to take part in intercultural com...


    Directory of Open Access Journals (Sweden)

    Pakhomova Irina Yurevna


    Full Text Available This article describes the concept of "communicative competence of future teachers," describes the essential characteristics and features of pedagogical communication. Objective: To define the notion of "communicative competence of future teachers' Methodology of work: competence approach. Scope of the results: the preparation of future teachers at the Pedagogical University. Results: This article describes the concept of "communicative competence of future teachers," describes the essential characteristics and features of pedagogical communication.

  17. Professional competence of social workers’: management methods


    V. V. Dudaryov


    In the article the problem of social workers’ professional competence is actualized. It is proved that finding ways to optimize the specialists for social welfare system professional training is in line with common didactic problems of the high school pedagogies. The theoretical analysis of Ukrainian and foreign scientists’ works connected with the aspects of social workers’ professional competence is done. The definition of «competence» and «professional competence» is given. The main compon...

  18. Competence assessment toolbox for event industry professionals


    Heinonen, Elina


    The purpose of this project based thesis is to design an effective competence assess-ment tool for event management industry professionals. The writer noticed the lack of competence tools for the event management industry and therefore wanted to follow the topic trough a project thesis. The competence assessment tools will be designed through a portfolio of competence related instruments. The design of the assessment tools based on a careful literature review about the event management, p...

  19. Life History and Demographic Drivers of Reservoir Competence for Three Tick-Borne Zoonotic Pathogens


    Ostfeld, Richard S.; Levi, Taal; Jolles, Anna E.; Martin, Lynn B.; Hosseini, Parviez R.; Keesing, Felicia


    Animal and plant species differ dramatically in their quality as hosts for multi-host pathogens, but the causes of this variation are poorly understood. A group of small mammals, including small rodents and shrews, are among the most competent natural reservoirs for three tick-borne zoonotic pathogens, Borrelia burgdorferi, Babesia microti, and Anaplasma phagocytophilum, in eastern North America. For a group of nine commonly-infected mammals spanning >2 orders of magnitude in body mass, we as...

  20. Simulation of a Novel Schedule for Intensivist Staffing to Improve Continuity of Patient Care and Reduce Physician Burnout. (United States)

    Geva, Alon; Landrigan, Christopher P; van der Velden, Meredith G; Randolph, Adrienne G


    Despite widespread adoption of in-house call for ICU attendings, there is a paucity of research on optimal scheduling of intensivists to provide continuous on-site coverage. Overnight call duties have traditionally been added onto 7 days of continuous daytime clinical service. We designed an alternative ICU staffing model to increase continuity of attending physician care for patients while also decreasing interruptions to attendings' nonclinical weeks. Computer-based simulation of a 1-year schedule. A simulated ICU divided into two daytime teams each covered by a different attending and both covered by one overnight on-call attending. Simulated patients were randomly admitted on different service days to assess continuity of care. A "shared service schedule" was compared to a standard "7 days on schedule." For the 7 days on schedule, an attending covered a team for 7 consecutive days and off-service attendings cross-covered each night. For the shared schedule, four attendings shared the majority of daytime and nighttime service for two teams over 2 weeks, with recovery periods built into the scheduled service time. Continuity of care as measured by the Continuity of Attending Physician Index increased by 9% with the shared schedule. Annually, the shared service schedule was predicted to increase free weekends by 3.4 full weekends and 1.3 weekends with either Saturday or Sunday off. Full weeks without clinical obligations increased by 4 weeks. Mean time between clinical obligations increased by 5.8 days. A shared service schedule is predicted to improve continuity of care while increasing free weekends and continuity of uninterrupted nonclinical weeks for attendings. Computer-based simulation allows assessment of benefits and tradeoffs of the alternative schedule without disturbing existing clinical systems.

  1. Home health care agency staffing patterns before and after the Balanced Budget Act of 1997, by rural and urban location. (United States)

    McAuley, William J; Spector, William; Van Nostrand, Joan


    The Balanced Budget Act (BBA) of 1997 and other recent policies have led to reduced Medicare funding for home health agencies (HHAs) and visits per beneficiary. We examine the staffing characteristics of stable Medicare-certified HHAs across rural and urban counties from 1996 to 2002, a period encompassing the changes associated with the BBA and related policies. Data were drawn from Medicare Provider of Service files and the Area Resource File. The unit of analysis was the 3,126 counties in the United States, grouped into 5 categories: metropolitan, nonmetropolitan adjacent, and 3 nonmetropolitan nonadjacent groups identified by largest town size. Only relatively stable HHAs were included. We generated summary HHA staff statistics for each county group and year. All staff categories, other than therapists, declined from 1997 to 2002 across the metropolitan and nonmetropolitan county groupings. There were substantial population-adjusted decreases in stable HHA-based home health aides in all counties, including remote counties. The limited presence of stable HHA staff in certain nonmetropolitan county types has been exacerbated since implementation of the BBA, especially in the most rural counties. The loss of aides in more rural counties may limit the availability of home-based long-term care in these locations, where the need for long-term care is considerable. Future research should examine the degree to which the presence of HHA staff influences actual access and whether other paid and unpaid sources of care substitute for Medicare home health care in counties with limited supplies of HHA staff.

  2. Identifying competencies of boxing coaches

    Directory of Open Access Journals (Sweden)

    Ioannis Tasiopoulos


    Full Text Available The purpose of this study was to find out the management skills required by boxing coaches to administrate their clubs. For the purposes of this study a scale was constructed which was answered by 98 boxing coaches. Explanatory factor analysis revealed seven factors: Communication-public relations (5 items, event management (4 items, management techniques (4 items, new technologies (4 items, prevention-safety (2 items, sport (5 items and sports facilities (2 items. The Cronbach of the scale was 0.85. The five competencies that rated by the coaches were: Supervisors of the area of training, maintaining excellent communication with athletes, using new technologies (e-mail, internet, handling disciplinary matters, accidents, complaints and reports on some sporting games and promoted harmony among athletes. We concluded that boxing coaches understand that the competencies required for meeting their obligations, were related to sports, prevention, safety and communications-public relations.

  3. Enhancing Safety through Generic Competencies

    Directory of Open Access Journals (Sweden)

    S. Mockel


    Full Text Available This article provides insights into proactive safety management and mitigation. An analysis of accident reports reveals categories of supervening causes of accidents which can be directly linked to the concept of generic competencies (information management, communication and coordination, problem solving, and effect control. These findings strongly suggest adding the human element as another safety-constituting pillar to the concept of ship safety next to technology and regulation. We argue that the human element has unique abilities in dealing with critical and highly dynamic situations which can contribute to the system's recovery from non-routine or critical situations. By educating seafarers in generic competencies we claim to enable the people onboard to successfully deal with critical situations.

  4. Developing Communicative Competence in University Language Programmes (United States)

    Šajgalíková, Helena; Breeze, Ruth


    This article deals with university language teaching in the perspective of its shift from linguistic competence towards communicative competence, and presents some aspects of the underlying process. It analyses the findings from a survey conducted within the Leonardo project "Transparency in the Acquired Language Competences" (TALC;…

  5. Competency-based continuing professional development

    NARCIS (Netherlands)

    Campbell, Craig; Silver, Ivan; Sherbino, Jonathan; Ten Cate, Olle; Holmboe, Eric S.


    Competence is traditionally viewed as the attainment of a static set of attributes rather than a dynamic process in which physicians continuously use their practice experiences to "progress in competence'' toward the attainment of expertise. A competency-based continuing professional development

  6. Competence Matching Tool - Explanations and Implementation

    NARCIS (Netherlands)

    Herder, Eelco; Kärger, Philipp


    Herder, E., Kärger, P. (2009) Competence Matching Tool - Explanations and Implementation. The document contains the technical specification of the competence matching tool. The tool can be found at and the location

  7. Examining Factors Predicting Students' Digital Competence (United States)

    Hatlevik, Ove Edvard; Guðmundsdóttir, Gréta Björk; Loi, Massimo


    The purpose of this study was to examine factors predicting lower secondary school students' digital competence and to explore differences between students when it comes to digital competence. Results from a digital competence test and survey in lower secondary school will be presented. It is important to learn more about and investigate what…

  8. Enterprising Behavior in an Integral Competence Framework

    NARCIS (Netherlands)

    Loredana Orhei; S. Nandram; Marise Born


    We present insights from literature on enterprising behavior and competence followed by an application of the competence perspective. Data collection is based on the Critical Incident Technique among 205 entrepreneurs. The study shows how entrepreneurial behavior benefits from an Integral competence

  9. Domestic Violence, Emotional Competence, and Child Adjustment (United States)

    Katz, Lynn Fainsilber; Hessler, Danielle M.; Annest, Amalia


    This article examined emotion competence in children exposed to domestic violence (DV). It also examined the hypothesis that children's emotional competence mediates relations between DV and children's later difficulties with peers and behavioral adjustment. DV was assessed when children were at the age of five, emotional competence was assessed…

  10. Cultural Competence in Nursing: Foundation or Fallacy? (United States)

    Dreher, Melanie; MacNaughton, Neil


    The recommendations for nurses to become culturally competent fall into two categories. The first focuses on the content and structure of the encounter between provider and patient; the second charges providers with becoming knowledge about the culture of their patients. Cultural competence is really nursing competence--the capacity to be equally…

  11. A Research Review of Nurse Teachers' Competencies (United States)

    Zlatanovic, Tatjana; Havnes, Anton; Mausethagen, Sølvi


    The conceptions of what constitutes nursing competence and how such competence is taught and learned are changing, due to rapid changes in in the health sector. Nurse teachers' competencies for providing high-quality, up-to-date nursing education, are developing accordingly. This paper reviews the existing research on nurse teachers' competencies…

  12. Competencies Essential for School Media Specialists. (United States)

    Pfister, Fred C.


    A study conducted to determine essential competencies for school media specialists revealed that 21 competencies (in library organization and management, library services, instruction) met Florida Council of Teacher Education criteria for an essential competency and 42 did not (in curriculum planning, research, audiovisual production,…

  13. Digital Competence Model of Distance Learning Students (United States)

    da Silva, Ketia Kellen A.; Behar, Patricia A.


    This article presents the development of a digital competency model of Distance Learning (DL) students in Brazil called CompDigAl_EAD. The following topics were addressed in this study: Educational Competences, Digital Competences, and Distance Learning students. The model was developed between 2015 and 2016 and is being validated in 2017. It was…

  14. Generic competences in Higher Education: Studying their ...

    African Journals Online (AJOL)

    Generic competences in Higher Education: Studying their development in undergraduate social science studies by means of a specific methodology. ... A methodology for the study of competence acquisition and for the characterisation of a competence-focused educational model is thus implicitly developed. The aim of the ...

  15. Perceived Competence of Children with Visual Impairments (United States)

    Shapiro, Deborah R.; Moffett, Aaron; Lieberman, Lauren; Dummer, Gail M.


    This study examined the perceptions of competence of 43 children with visual impairments who were attending a summer sports camp. It found there were meaningful differences in the perceived competence of the girls, but not the boys, after they attended the camp, and no differences in the perceptions of competence with age.

  16. Dell Hymes's Construct of "Communicative Competence" (United States)

    Cazden, Courtney B.


    Cazden reflects on theoretical and sociopolitical origins of Hymes's construct of communicative competence in events occurring just before and after 1960 in the U.S. She comments on Hymes's emphasis on competence not as abstract systemic potential of a language, but as capability located in individual persons; and she explores competence as both…

  17. Unnoticed Professional Competence in Day Care Work

    DEFF Research Database (Denmark)

    Ahrenkiel, Annegrethe; Schmidt, Camilla; Nielsen, Birger Steen


    This article presents a double perspective on social educators’ professional competence: It discusses how everyday life in day care centres (preschools) is dependent on professional competences that can be conceived as “unnoticed.” These aspects of professional competence are embedded in routines...

  18. Ethical Competence and Possibilities of Dialogic Education


    Kincāns, Vladimirs


    This article is dedicated to the possibilities of shaping ethical competence through dialogic education. The problem of shaping a future specialist’s ethical competence in many respects depends on the quality of teaching ethics as a training discipline as well as on the teaching methods. Dialogic education is the most promising form of moral values introduction and ethical competence development. 

  19. Towards a Taxonomy for Project Management Competences

    NARCIS (Netherlands)

    Nijhuis, S.A.; Vrijhoef, R.; Kessels, Joseph


    Recent research on project management competences did not use a standard set of competences. Twenty-five publications, published in or after 2000, show little agreement on their competences: of the 353 only twelve percent is named more than once. Of the 353, 31 are linked to communication, but a

  20. Competencies Framework for Climate Services. (United States)

    Aguilar, Enric


    The World Climate Conference-3 (Geneva, 2009) established the Global Framework for Climate Services (GFCS) to enable better management of the risks of climate variability and change and adaptation to climate change at all levels, through development and incorporation of science-based climate information and prediction into planning, policy and practice. The GFCS defines Climate Services as the result of transforming climate data into climate information in a way that responds to user needs and assists decision-making by individuals and organizations. Capacity Development is a cross-cutting pillar of the GFCS to ensure that services are provided by institutions with professionals whom achieved the adequate set of competencies recommended by WMO, which are yet to be fully defined. The WMO-Commission for Climatology Expert Team on Education and Training, ET-ETR, has been working to define a Competencies Framework for Climate Services to help the institutions to deliver high quality climate services in compliance with WMO standards and regulations, specifically those defined by WMO's Commission for Climatology and the GFCS. This framework is based in 5 areas or competence, closely associated to the areas of work of climate services providers: create and manage climate data sets; derive products from climate data; create and/or interpret climate forecasts and model output; ensure the quality of climate information and services; communicate climatological information with users. With this contribution, we intend to introduce to a wider audience the rationale behind these 5 top-level competency statements and the performance criteria associated with them, as well as the plans of the ET-ETR for further developing them into an instrument to support education and training within the WMO members, specially the National Meteorological and Hydrological Services.

  1. Competencies and (global) talent management

    CERN Document Server


    This book covers the main issues on the study of competencies and talent management in modern and competitive organizations. The chapters show how organizations around the world are facing (global) talent management challenges and give the reader information on the latest research activity related to that. Innovative theories and strategies are reported in this book, which provides an interdisciplinary exchange of information, ideas and opinions about the workplace challenges.

  2. Leadership Competencies for Managing Diversity


    Jan Visagie; Herman Linde; Werner Havenga


    The new understanding of diversity involves more than increasing the number of different identity groups on the payroll. An important proposal is that the experience of diversity in an organisation results from pervasive styles of management. This article dealt with the specific paradigms of diversitymanagement and leadership style theory used to address the research problem in the empirical study, namely ‘Is diversity management experience related to leadership styles or competencies?’ The m...

  3. Visions of technology: : Big data lessons understood by EU policy makers in their review of the legal frameworks on intellectual property rights, access to and re-use of PSI and the protection of personal data

    NARCIS (Netherlands)

    Lammerant, Hans; de Hert, Paul; Gutwirth, Serge; Leenes, Ronald; De Hert, Paul


    This article’s focus is on how the advent of big data technology and practices has been understood and addressed by policy makers in the EU. We start with a reflection on of how big data affects business processes and how it con- tributes to the creation of a data economy. Then we look at EU policy

  4. Professional Competence in Psychosociology Research

    Directory of Open Access Journals (Sweden)

    Maria Constantinescu


    Full Text Available Dealing with labour activity through perspective of factors that condition it’s efficiency is a problem of great interest in psychosociology. The performances’ evaluation is a manner to appreciate the degree of adequation of the human operator to professional exigences of the labour he does. "The proffesional competence" is the intrinsic potentiality of person and the performance - the achieved potentiality showen in material or spiritual products or servicies and which is, often, influenced not only by factors depending on the person (the specific skills, the motivation, the degree of implication in decisional process, but olso by factors independent of person. Through the present study we have verified the interpretative-thoretical pattern suggessted for profesional competence (mental skills of cognitional kind and socio-emotional skills, the consciousness of profesional competence of a group of subjects that carried on in army. In this study the used method is secondary analysis, analysis and interpretation in a different manner of collected information with different reasons.

  5. Professional Competence in Psychosociology Research

    Directory of Open Access Journals (Sweden)

    Maria Constantinescu


    Full Text Available Dealing with labour activity through perspective of factors that condition it's efficiency is a problem of great interest in psychosociology. The performances' evaluation is a manner to appreciate the degree of adequation of the human operator to professional exigences of the labour he does. "The proffesional competence" is the intrinsic potentiality of person and the performance - the achieved potentiality showen in material or spiritual products or servicies and which is, often, influenced not only by factors depending on the person (the specific skills, the motivation, the degree of implication in decisional process, but olso by factors independent of person. Through the present study we have verified the interpretative-thoretical pattern suggessted for profesional competence (mental skills of cognitional kind and socio-emotional skills, the consciousness of profesional competence of a group of subjects that carried on in army. In this study the used method is secondary analysis, analysis and interpretation in a different manner of collected information with different reasons.

  6. Microfluidic study of environmental control of genetic competence in Streptococcus mutans (United States)

    Son, Minjun; Ghoreishilangroudi, Seyedehdelaram; Ahn, Sang-Joon; Burne, Robert; Hagen, Stephen


    The bacterial pathogen Streptococcus mutans has the ability to enter a transient state of genetic competence in which it can integrate exogenous DNA. It regulates the competent state in response to several environmental inputs that include two quorum sensing peptides (CSP and XIP) as well as pH and other variables. However the interplay of these variables in regulating the competent state is poorly understood. We are using microfluidics to isolate and control environmental inputs and examine how the competence regulatory circuit responds at the single cell level. Our studies reveal that the pH of the growth environment plays a critical role in determining how cells respond to the quorum sensing signals: The response to both peptides is sharply tuned to a narrow window of near-neutral pH. Within this optimal pH range, a population responds unimodally to a XIP stimulus, and bimodally to CSP; outside this range the response to both signals is suppressed. Because a growing S. mutans culture acidifies its medium, our findings suggest that the passage of the pH through the sensitivity window transiently activates the competence circuit. In this way a sharply tuned environmental response gives S. mutans fine control over the duration of its competent state. This work is supported by the NIH under NIDCR awards R01 DE023339.

  7. Competences for All: Recognizing and Developing Competences of Young People with Fewer Opportunities (United States)

    Usakli, Hakan


    This qualitative study clarifies opinion of 32 European volunteer youth leaders on concepts of competence, fewer opportunities and enlargement strategies on competence of fewer opportunities. Leaders underline main competencies as follows: tongue, languages, mathematical, digital, learning, social, entrepreneurship, cultural. Key competences are…

  8. Competency Based Hospital Radiopharmacy Training

    International Nuclear Information System (INIS)


    Quality management systems in nuclear medicine are vital to a high level of nuclear medicine (NM) practice. Trained and competent staffs are essential for achieving high standards and growth in NM. One of the key bottlenecks for NM is the shortfall in human resources, especially of radiopharmacists. There is an acute shortage in most Member States and in some countries an absence of nationally registered pharmacists with radiopharmacy experience. Most nuclear medicine facilities operate their radiopharmacies (commonly referred to as the hot laboratories) with the support of technologists and radiographers. Recent surveys have found the level of training amongst technologists to be extremely variable. Most had little or no training in hot laboratory practices. The survey also indicated the poor state of hot laboratories in many countries. Basic quality systems in the hot laboratory could be improved significantly with better training. This competency-based education manual is designed with those radiopharmacy practitioners in mind. This competency-based trainer's manual provides trainers in each of the IAEA regions with the essentials of a training programme for all radiopharmacy practitioners. The competency-based training is a two week programme followed up with three months of practice achievements. The syllabus provides a standardized approach to lectures, practical sessions, and interactive workshops focusing on critical aspects of hot laboratory practices. The trainers, with the assistance of this manual, can deliver essential skills, competencies, and underpinning knowledge to operate safely and effectively in their hot laboratory. The course focuses on simple but practical steps that could be undertaken to improve staff performance. In addition, a basic framework of quality management principles related to radiopharmacy practices is also covered. Further, the syllabus can be adapted to the particular needs and characteristics of any training centre, country

  9. Shaping instructional communication competence of preservice teachers (United States)

    Tandyonomanu, D.; Mutiah; Setianingrum, V. M.


    This study aims to understand the process of shaping communication competence. Participants were pre-service teachers in the primary school education teacher who conducted teaching program internship program. Observations and interviews found that culture, experience, and education were the components that developed the communication competence within the instructional context. The former two components dominantly shape communication instructional competencies, whereas the latter contributes insignificantly. Education emphasizes on teacher’s pedagogy and professional competences. In the future, educational institutions for pre-service teachers could use this research results to Determine the process of developing communication competence.

  10. Clients' ratings of counselor multicultural competency. (United States)

    Fuertes, Jairo N; Brobst, Karen


    Differences in perceptions between Euro American and ethnic minority respondents were examined to compare the role of counselor multicultural competency in multicultural versus traditional counseling. Results showed a strong positive correlation between clients' ratings of counselors' multicultural competencies and clients' ratings of counselors' general competency and empathy. However, when comparisons were made between Euro American and ethnic minority clients' on satisfaction, counselor multicultural competency explained a large and significant amount of variance for the ethnic minority sample only, above and beyond counselor general competency and empathy. Results are discussed in the context of relevant literature and suggestions for future research.

  11. Competence-based Competence Management: a Pragmatic and Interpretive Approach. The Case of a Telecommunications Company


    Lorino, Philippe


    In this research we explore the issue of “competence management”, as usually defined in the corporate vocabulary, mostly in the human resource (HR) function, and more particularly of “strategic competence management” (long run management of competences which are critical to achieve strategic goals). We try to show that competence management is a dynamic organizational competence. We analyze it in the case of a large European telecommunications company, France Télécom, in the years 2001-2003. ...



    Rubén Molina Martínez; Argelia Calderón Gutiérrez


    This paper examines what business competencies a learner of English as a Foreign Language (EFL) can develop while developing communicative competence in English. The analysis is focused on the business competencies undergraduate students at the Administration Faculty of Universidad Michoacana de San Nicolás de Hidalgo need to develop. The study aims to demonstrate that using a competence formation model enables learners to attain better levels of communicative competence. Moreover, it strengt...

  13. Intercultural competence: A key competence of The Third Millennium

    Directory of Open Access Journals (Sweden)



    Full Text Available For the professionals of education, in general, and for those that form teachers, particularly, appears the explicit concern about what interculturalism should represent within the personality profile of graduates of nowadays. We enrolled ourselves in this context because we are trainers of trainers; we conduct the initial training of teachers. The research presented in this paperwork is part of a more complex strategy; it has well defined stages, carried out over several years and succeeds to dovetail quantitative and qualitative dimensions. In the context of this paper we present the summary of the results emerged from an ascertaining research that aimed to establish the determinants of intercultural competence.

  14. Competency model and standards for media education

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    Full Text Available In Germany, educational standards for key school subjects have been developed as a consequence of the results of international comparative studies like PISA. Subsequently, supporters of interdisciplinary fields such as media education have also started calling for goals in the form of competency models and standards. In this context a competency standard model for media education will be developed with regard to the discussion about media competence and media education. In doing so the development of a competency model and the formulation of standards is described consequently as a decision making process. In this process decisions have to be made on competence areas and competence aspects to structure the model, on criteria to differentiate certain levels of competence, on the number of competence levels, on the abstraction level of standard formulations and on the tasks to test the standards. It is shown that the discussion on media education as well as on competencies and standards provides different possibilities of structuring, emphasizing and designing a competence standard model. Against this background we describe and give reasons for our decisions and our competency standards model. At the same time our contribution is meant to initiate further developments, testing and discussion.

  15. The Cultural Competence of Graduating Nursing Students. (United States)

    Repo, Hanna; Vahlberg, Tero; Salminen, Leena; Papadopoulos, Irena; Leino-Kilpi, Helena


    Cultural competence is an essential component in nursing. The purpose of this study was to evaluate the level of cultural competence of graduating nursing students, to identify associated background factors to cultural competence, and furthermore to establish whether teaching multicultural nursing was implemented in nursing education. A structured Cultural Competence Assessment Tool was used in a correlational design with a sample of 295 nursing students in southern Finland. The level of cultural competence was moderate, and the majority of students had studied multicultural nursing. Minority background (p = .001), frequency of interacting with different cultures (p = .002), linguistic skills (p = .002), and exchange studies (p = .024) were positively associated to higher cultural competence. To improve cultural competence in students, nursing education should provide continuous opportunities for students to interact with different cultures, develop linguistic skills, and provide possibilities for internationalization both at home and abroad. © The Author(s) 2016.

  16. Communicative Competence: A Pedagogically Motivated Model with Content Specifications


    Celce-Murcia, Marianne; Dornyei, Zoltan; Thurrell, Sarah


    This paper argues the need for an updated and explicit description of language teaching areas generated with reference to a detailed model of communicative competence. We describe two existing models of communicative competence and then propose our own pedagogically motivated construct, which includes five components: (1) discourse competence, (2) linguistic competence, (3) actional competence, (4) sociocultural competence, and (5) strategic competence. We discuss these competencies in as muc...

  17. An inventory of biomedical imaging physics elements-of-competence for diagnostic radiography education in Europe

    Energy Technology Data Exchange (ETDEWEB)

    Caruana, Carmel J. [University of Malta, Institute of Health Care, St Lukes Hospital, Gwardamangia (Malta)]. E-mail:; Plasek, Jaromir [Charles University, Faculty of Mathematics and Physics, Institute of Physics, Division of Biophysics, Prague (Czech Republic)


    Purpose: To develop an inventory of biomedical physics elements-of-competence for diagnostic radiography education in Europe. Method: Research articles in the English literature and UK documentation pertinent to radiography education, competences and role development were subjected to a rigorous analysis of content from a functional and competence analysis perspective. Translations of radiography curricula from across Europe and relevant EU legislation were likewise analysed to ensure a pan-European perspective. Broad Subject Specific Competences for diagnostic radiography that included major biomedical physics components were singled out. These competences were in turn carefully deconstructed into specific elements-of-competence and those elements falling within the biomedical physics learning domain inventorised. A pilot version of the inventory was evaluated by participants during a meeting of the Higher Education Network for Radiography in Europe (HENRE), held in Marsascala, Malta, in November 2004. The inventory was further refined taking into consideration suggestions by HENRE members and scientific, professional and educational developments. Findings: The evaluation of the pilot inventory was very positive and indicated that the overall structure of the inventory was sensible, easily understood and acceptable - hence a good foundation for further development. Conclusions: Use of the inventory by radiography programme leaders and biomedical physics educators would guarantee that all necessary physics elements-of-competence underpinning the safe, effective and economical use of imaging devices are included within radiography curricula. It will also ensure the relevancy of physics content within radiography education. The inventory is designed to be a pragmatic tool for curriculum development across the entire range of radiography education up to doctorate level and irrespective of whether curriculum delivery is discipline-based or integrated, presentation

  18. An inventory of biomedical imaging physics elements-of-competence for diagnostic radiography education in Europe

    International Nuclear Information System (INIS)

    Caruana, Carmel J.; Plasek, Jaromir


    Purpose: To develop an inventory of biomedical physics elements-of-competence for diagnostic radiography education in Europe. Method: Research articles in the English literature and UK documentation pertinent to radiography education, competences and role development were subjected to a rigorous analysis of content from a functional and competence analysis perspective. Translations of radiography curricula from across Europe and relevant EU legislation were likewise analysed to ensure a pan-European perspective. Broad Subject Specific Competences for diagnostic radiography that included major biomedical physics components were singled out. These competences were in turn carefully deconstructed into specific elements-of-competence and those elements falling within the biomedical physics learning domain inventorised. A pilot version of the inventory was evaluated by participants during a meeting of the Higher Education Network for Radiography in Europe (HENRE), held in Marsascala, Malta, in November 2004. The inventory was further refined taking into consideration suggestions by HENRE members and scientific, professional and educational developments. Findings: The evaluation of the pilot inventory was very positive and indicated that the overall structure of the inventory was sensible, easily understood and acceptable - hence a good foundation for further development. Conclusions: Use of the inventory by radiography programme leaders and biomedical physics educators would guarantee that all necessary physics elements-of-competence underpinning the safe, effective and economical use of imaging devices are included within radiography curricula. It will also ensure the relevancy of physics content within radiography education. The inventory is designed to be a pragmatic tool for curriculum development across the entire range of radiography education up to doctorate level and irrespective of whether curriculum delivery is discipline-based or integrated, presentation

  19. Staffing for Success (United States)

    Perozzi, Brett; Seifert, Tricia; Al-Sharif, Mary Ann Bodine


    This chapter explores institutional capacity building in cross-border student affairs and services. The focus is on human capital and its importance to international higher education within local contexts.

  20. Strengthening Regulatory Competence in Pakistan

    International Nuclear Information System (INIS)

    Sadiq, M.


    Capacity building of Pakistan Nuclear Regulatory Authority is considered an essential element in pursuit of its vision to become a world class regulatory body. Since its inception in 2001, PNRA has continuously endeavoured to invest in its people, develop training infrastructure and impart sound knowledge and professional skills with the aim to improve its regulatory effectiveness. The use of nuclear and radioactive material in Pakistan has increased manifold in recent years, thus induction of more manpower was needed for regulatory oversight. PNRA adopted two pronged approach for meeting the manpower demand (a) employment of university graduates through fast track recruitment drive and (b) induction of graduates by offering fellowships for Master degree programs. Although, the newly employed staff was selected on the basis of their excellent academic qualifications in basic and applied sciences, but they required rigorous knowledge and skills in regulatory perspectives. In order to implement a structured training program, PNRA conducted Training Needs Assessment (TNA) and identified competency gaps of the regulatory staff in legal, technical, regulatory practice and behavioural domains. PNRA took several initiatives for capacity building which included establishment of a training centre for sustainability of trainings, initiation of a fellowship scheme for Master program, attachment of staff at local institutes for on-the-job training and placement at foreign regulatory bodies and organizations for technical development with the assistance of IAEA. The above strategies have been very beneficial in competence building of the PNRA staff to perform all regulatory activities indigenously for nuclear power plants, research reactors and radiation facilities. Provision of vibrant technical support to IAEA and Member States in various programs by PNRA is a landmark of these competence development efforts. This paper summarizes PNRA initiatives and the International Atomic

  1. Suicidal thoughts and emotion competence. (United States)

    Paradiso, Sergio; Beadle, Janelle N; Raymont, Vanessa; Grafman, Jordan


    During deployment and upon returning home, veterans experience emotional challenges that test their social and psychological adaptation and place them at risk for suicidal thinking. Individual variability in skill-based capacity to adaptively perceive, understand, correctly use, and manage emotions (called emotional competence) may play a role in the development of psychological suffering and suicidal thinking. Based on research in healthy and clinical samples, poor emotional competence was predicted to be associated with suicidal thinking among returning veterans. Participants were selected from the W. F. Caveness Vietnam Head Injury Study (VHIS) registry, which in the late 1960s began prospectively assessing 1221 veterans). The study sample was composed of veterans examined between 2003 and 2006 and included 185 participants who at the time of assessment with the Beck Depression Inventory (BDI) did (N= 46) or did not endorse (N= 139) suicidal thinking then or during the previous two weeks and received performance-based measures of emotional competence (Mayer-Salovey-Caruso Emotional Intelligence Test; MSCEIT, Version 2.0) and theory of mind. MSCEIT subtests and theory of mind tasks were condensed via principal component analysis: Component 1 (Emotion Processing) included use, understand, and manage emotions tasks, and Component 2 (Emotion Perception) included perceive emotions. Veterans endorsing suicidal thoughts showed poorer emotion processing whereas emotion perception and theory of mind tasks did not show significant group effects. In addition, veterans who endorsed thoughts of suicide were deployed at a younger age, had lower education, and tended to report more negative experiences in social interactions upon return to the United States. The capacity to understand, use, and manage emotionally charged stimuli and situations may represent risk factors for suicidal thinking among veterans.

  2. Are Staffing, Work Environment, Work Stressors, and Rationing of Care Related to Care Workers' Perception of Quality of Care? A Cross-Sectional Study. (United States)

    Zúñiga, Franziska; Ausserhofer, Dietmar; Hamers, Jan P H; Engberg, Sandra; Simon, Michael; Schwendimann, René


    To describe care worker-reported quality of care and to examine its relationship with staffing variables, work environment, work stressors, and implicit rationing of nursing care. Cross-sectional study. National, randomly selected sample of Swiss nursing homes, stratified according to language region and size. A total of 4311 care workers of all educational backgrounds (registered nurses, licensed practical nurses, nurse aides) from 402 units in 155 nursing homes completed a survey between May 2012 and April 2013. Care worker-reported quality of care was measured with a single item; predictors were assessed with established instruments (eg, Practice Environment Scale-Nurse Working Index) adapted for nursing home use. A multilevel logistic regression model was applied to assess predictors for quality of care. Overall, 7% of care workers rated the quality of care provided as rather low or very low. Important factors related to better quality of care were higher teamwork and safety climate (odds ratio [OR] 6.19, 95% confidence interval [CI] 4.36-8.79); better staffing and resources adequacy (OR 2.94, 95% CI 2.08-4.15); less stress due to workload (OR 0.71, 95% CI 0.55-0.93); less implicit rationing of caring, rehabilitation, and monitoring (OR 0.34, 95% CI 0.24-0.49); and less rationing of social care (OR 0.80, 95% CI 0.69-0.92). Neither leadership nor staffing levels, staff mix, or turnover was significantly related to quality of care. Work environment factors and organizational processes are vital to provide high quality of care. The improvement of work environment, support in handling work stressors, and reduction of rationing of nursing care might be intervention points to promote high quality of care in nursing homes. Copyright © 2015 AMDA – The Society for Post-Acute and Long-Term Care Medicine. Published by Elsevier Inc. All rights reserved.

  3. Teaching Competences and Inclusive Education

    Directory of Open Access Journals (Sweden)

    José María Fernández Batanero


    Full Text Available This paper focuses on teaching competencies that are conducive to good educational practices in relation to inclusion, from the perspective of teachers. The methodology employed in the study is descriptive/comprehensive, and of an exploratory nature. By means of four case studies, the perceptions of teachers from two secondary schools—characterized by the Spanish Educational Administration as having “good practices”— are examined. The techniques used for information collection in this study include documentary analysis, in-depth interviews and focus groups. The findings emphasize the importance of strategic skills, combined with innovation and creativity, among others.

  4. Exploring a categorization of main competencies for digital librarians


    Machin-Mastromatteo, Juan-Daniel


    This brief essay is concerned with the main topic “Job Analysis in a Digital Library Context” and its purpose is to explore some of the competencies that digital librarians must have to successfully work in a digital library context. The competencies explored are categorized under the headings of information management competencies, technological competencies, information literacy related competencies, and interpersonal competencies.

  5. [How to promote health competence at work]. (United States)

    Eickholt, Clarissa; Hamacher, W; Lenartz, N


    Health competence is a key concept in occupational health and safety and workplace health promotion for maintaining and enhancing health resources. The effects of governmental or occupational measures to protect or improve health fall short of what is required with regard to the challenges of a changing workplace, e.g., due to the delimitation of work. To secure employability it is becoming more and more important to encourage the personal responsibility of employees. To offer new conclusions on how employers and employees can promote health competence, a survey is required of the research within the fields of health competence and competence development, and of the status quo in enterprises. In this context, a Delphi Study provides an important contribution, with a focus on small and medium-sized enterprises. The development of an extensive understanding of health competence is essential in a work-related context. Beyond knowledge-based health literacy, an action-oriented concept of competence implies the ability and willingness to act in a reasonable and creative manner in complex situations. The development of health competence requires learning embedded in working processes, which challenges competent behaviour. Enabling informal learning is a promising innovative approach and therefore coordinated operational activities are necessary. Ultimately, this is a matter of suitable organisational measures being implemented to meet the health competence needs of an enterprise. Even though the each individual employee bears his or her own health competence, the development potential lies largely within the prevailing working conditions.


    Directory of Open Access Journals (Sweden)

    Iztok Retar


    Full Text Available The paper presents the results of research that examined the key competences in the management field in Slovenian sports. The success rate of sport organisations and sportsmen is based on the creative, innovative and quality expert work of employees or/and volunteers. Their work is planned, organised, managed and supervised by a sport manager who possesses knowledge as well as managerial, technical, social, creative and other competences. The purpose of the presented research, which involved successful Slovenian sport managers, was to establish which competences are the most important for successful work in the field of sport management. The paper also presents the technical framework for the selected determination of sport management terminology and competences as well as a competence structure model, prepared by the authors. We have found that the human resources management competence most significantly contributes to the success of Slovenian sport managers in the field of general competences. Respondents evaluated the competence of developing a positive working environment as the most important specific competence that supplements general competences.

  7. Leadership and Cultural Competence of Healthcare Professionals (United States)

    Dauvrin, Marie; Lorant, Vincent


    Background International migration is a global phenomenon challenging healthcare professionals to provide culturally competent care. Objectives The purpose of this study was to investigate the influence of leaders on the cultural competence of healthcare professionals. Methods A cross-sectional survey was conducted from 2010 to 2012 to obtain data for a social network analysis in 19 inpatient services and five primary care services in Belgium. The Competences in Ethnicity and Health questionnaire was used. A total of 507 healthcare professionals, including 302 nurses, identified their social relationships with other healthcare professionals working in their service. Highest in-degree centrality was used to identify the leaders within each health service. Multiple regressions with the Huber sandwich estimator were used to link cultural competence of leaders with the cultural competence of the rest of the healthcare staff. Results Cultural competence of the healthcare staff was associated with the cultural competence of the leaders. This association remained significant for two specific domains of cultural competence—mediation and paradigm—after controlling for contextual and sociodemographic variables. Interaction analysis suggested that the leadership effect varied with the degree of cultural competence of the leaders. Discussion Cultural competence among healthcare professionals is acquired partly through leadership. Social relationships and leadership effects within health services should be considered when developing and implementing culturally competent strategies. This requires a cautious approach as the most central individuals are not always the same persons as the formal leaders. PMID:25871625

  8. Examining Factors Predicting Students’ Digital Competence

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    Ove Edvard Hatlevik


    Full Text Available The purpose of this study was to examine factors predicting lower secondary school students’ digital competence and to explore differences between students when it comes to digital competence. Results from a digital competence test and survey in lower secondary school will be presented. It is important to learn more about and investigate what characterizes students’ digital competence. A sample of 852 ninth-grade Norwegian students from 38 schools participated in the study. The students answered a 26 item multiple-choice digital competence test and a self-report questionnaire about family background, motivation, and previous grades. Structural equation modeling was used to test a model of the hypothesised relationship between family background, mastery orientation, previous achievements, and digital competence. The results indicate variation in digital competence among the ninth-graders. Further, analyses showed that students’ conditions at home, i.e., language integration and cultural capital, together with mastery orientation and academic achievements predict students digital competence. This study indicates that that there is evidence of digital diversity between lower secondary students. It does not seem like the development of digital competence among the students happens automatically. Students’ family background and school performance are the most important factors. Therefore, as this study shows, it is necessary to further investigate how schools can identify students’ level of competence and to develop plans and actions for how schools can help to try to equalize differences.

  9. Adopsi Model Competency Based Training dalam Kewirausahaan

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    I Ketut Santra


    Full Text Available The aim of the research is improving the teaching method in entrepreneurship subject. This research adopted the competency based training (CBT into the entrepreneurship. The major task in this research is formulated and designed the entrepreneurship competency. Entrepreneurship competency indicated by Personal, Strategic and Situational and Business competence. All of entrepreneurship competences are described into sub topic of competence. After designing and formulating the game and simulation the research continuing to implement the competency based training in the real class. The time consumed to implementing the CBT one semester, starting on September 2006 to early February 2007. The lesson learnt from the implementation period, the CBT could improve the student competence in Personal, Situational Strategic and Business. The three of the competencies are important for the success entrepreneur. It is a sign of application of “Kurikulum Berbasis Kompetensi”. There are many evidences to describe the achievement of the CBT in entrepreneurship subject. Firstly, physically achievement, that all of the student’s business plan could became the real business. The evidences are presented by picture of the student’s real business. Secondly theoretically achievement, that the Personal, Situational Strategic and Business competence statistically have significant relation with Business Plan even Real Business quality. The effect of the Personal, Situational Strategic and Business competence to Business Plan quality is 84.4%. and, to the Real Business quality 77.2%. The statistic’s evidence suggests that the redesign of the entrepreneurship subject is the right way. The content of the entrepreneur competence (Personal, Situational and Strategic and Business competence have impact to the student to conduct and running for own business.

  10. Communicative competence of sport volunteers

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    Irina Petrenko


    Full Text Available Purpose: to investigate the level of communicative competence of sport volunteers. Material & Methods: students of Kharkov state academy of physical culture (2–4 courses who are engaged in sports volunteering. The theoretic-methodological analysis of problem is carried out; the technique "Need for communication and achievements", "Self-checking assessment in communication", "Machiavellianism level" is used for studying of indicators of self-assessment. Results: the high level of communicative competence on three indicators is revealed at sport volunteers: need for communication (60,71%, communicative control (57%, Machiavellianism (91% that gives them the chance to come into contacts with people around quickly, to correlate the reactions to behavior of surrounding people and to operate the emotions, at the same time they are inclined to manipulations and demonstration of the strengths at communication with people. Conclusions: the purposeful psychology and pedagogical preparation, which program has to include the communicative block and the block of personal development, is necessary for sport volunteers.

  11. Grammatical competence of ESL teachers

    Directory of Open Access Journals (Sweden)

    Mafisa, Palesa J.


    Full Text Available The aim of this article is to report on a study investigating the grammatical competence of English Second Language teachers in secondary schools. This study came about as a result of the widespread concern that these teachers may not always be competent enough in English. We determined the teachers’ familiarity with standard English grammar as well as their acceptance of Black South African English features. The findings indicate that teachers had problems with the grammatical structures tested and accepted some Black South African English grammatical features as correct usage. Die doel van hierdie artikel is om verslag te doen oor ‘n studie wat die grammatikale vermoë van onderwysers van Engels Tweedetaal-onderwysers in sekondêre skole gemeet het. Die studie is gedoen na aanleiding van ‘n wydverspreide besorgdheid dat onderwysers van Engels nie altyd vaardig genoeg in Engels is nie. Ons het die onderwysers se bekendheid met standaard-Engels grammatika vasgestel asook hul aanvaarding van Swart Suid-Afrikaanse Engelse grammatikale verskynsels. Die bevindinge dui aan dat onderwysers probleme het met die grammatikale strukture wat getoets is en dat hulle sekere Swart Suid-Afrikaanse Engelse grammatikale verskynsels as korrek aanvaar.

  12. Vegetation engineers marsh morphology through multiple competing stable states (United States)

    Marani, Marco; Da Lio, Cristina; D’Alpaos, Andrea


    Marshes display impressive biogeomorphic features, such as zonation, a mosaic of extensive vegetation patches of rather uniform composition, exhibiting sharp transitions in the presence of extremely small topographic gradients. Although generally associated with the accretion processes necessary for marshes to keep up with relative sea level rise, competing environmental constraints, and ecologic controls, zonation is still poorly understood in terms of the underlying biogeomorphic mechanisms. Here we find, through observations and modeling interpretation, that zonation is the result of coupled geomorphological–biological dynamics and that it stems from the ability of vegetation to actively engineer the landscape by tuning soil elevation within preferential ranges of optimal adaptation. We find multiple peaks in the frequency distribution of observed topographic elevation and identify them as the signature of biologic controls on geomorphodynamics through competing stable states modulated by the interplay of inorganic and organic deposition. Interestingly, the stable biogeomorphic equilibria correspond to suboptimal rates of biomass production, a result coherent with recent observations. The emerging biogeomorphic structures may display varying degrees of robustness to changes in the rate of sea level rise and sediment availability, with implications for the overall resilience of marsh ecosystems to climatic changes. PMID:23401529

  13. The Core Competencies for General Orthopaedic Surgeons. (United States)

    Kellam, James F; Archibald, Douglas; Barber, James W; Christian, Eugene P; D'Ascoli, Richard J; Haynes, Richard J; Hecht, Suzanne S; Hurwitz, Shepard R; Kellam, James F; McLaren, Alexander C; Peabody, Terrance D; Southworth, Stephen R; Strauss, Robert W; Wadey, Veronica M R


    With the changing delivery of orthopaedic surgical care, there is a need to define the knowledge and competencies that are expected of an orthopaedist providing general and/or acute orthopaedic care. This article provides a proposal for the knowledge and competencies needed for an orthopaedist to practice general and/or acute care orthopaedic surgery. Using the modified Delphi method, the General Orthopaedic Competency Task Force consisting of stakeholders associated with general orthopaedic practice has proposed the core knowledge and competencies that should be maintained by orthopaedists who practice emergency and general orthopaedic surgery. For relevancy to clinical practice, 2 basic sets of competencies were established. The assessment competencies pertain to the general knowledge needed to evaluate, investigate, and determine an overall management plan. The management competencies are generally procedural in nature and are divided into 2 groups. For the Management 1 group, the orthopaedist should be competent to provide definitive care including assessment, investigation, initial or emergency care, operative or nonoperative care, and follow-up. For the Management 2 group, the orthopaedist should be competent to assess, investigate, and commence timely non-emergency or emergency care and then either transfer the patient to the appropriate subspecialist's care or provide definitive care based on the urgency of care, exceptional practice circumstance, or individual's higher training. This may include some higher-level procedures usually performed by a subspecialist, but are consistent with one's practice based on experience, practice environment, and/or specialty interest. These competencies are the first step in defining the practice of general orthopaedic surgery including acute orthopaedic care. Further validation and discussion among educators, general orthopaedic surgeons, and subspecialists will ensure that these are relevant to clinical practice. These

  14. Neoliberalism and the government of nursing through competency-based education. (United States)

    Foth, Thomas; Holmes, Dave


    Competency has become a key concept in education in general over the last four decades. This article examines the development of the competency-based movement with a particular focus on the significance it has had for nursing education. Our hypothesis is that the competency movement can only adequately be understood if it is analyzed in relation to the broad societal transformation of the last decades-often summarized under the catchword neoliberalism-and with it the emergence of managerial models for Human Resource Management (HRM) for the reorganization of social services. Classical professions, which were characterized under welfarism by an esoteric knowledge based on ethical norms, have now become marketable commodities that can be evaluated in the same way as other commodities. We want to underline that while this development is still under way, it is the concept of competency that was the decisive political instrument enabling this profound change. With the widespread implementation of competency-based education that now governs nursing knowledge, the development of a critical, oppositional perspective becomes more challenging, if not entirely impossible. We will be focusing primarily on nursing education in Canada, although we maintain that it has relevance for nursing internationally. © 2016 John Wiley & Sons Ltd.

  15. Competency-based continuing professional development. (United States)

    Campbell, Craig; Silver, Ivan; Sherbino, Jonathan; Cate, Olle Ten; Holmboe, Eric S


    Competence is traditionally viewed as the attainment of a static set of attributes rather than a dynamic process in which physicians continuously use their practice experiences to "progress in competence" toward the attainment of expertise. A competency-based continuing professional development (CPD) model is premised on a set of learning competencies that include the ability to (a) use practice information to identify learning priorities and to develop and monitor CPD plans; (b) access information sources for innovations in development and new evidence that may potentially be integrated into practice; (c) establish a personal knowledge management system to store and retrieve evidence and to select and manage learning projects; (d) construct questions, search for evidence, and record and track conclusions for practice; and (e) use tools and processes to measure competence and performance and develop action plans to enhance practice. Competency-based CPD emphasizes self-directed learning processes and promotes the role of assessment as a professional expectation and obligation. Various approaches to defining general competencies for practice require the creation of specific performance metrics to be meaningful and relevant to the lifelong learning strategies of physicians. This paper describes the assumptions, advantages, and challenges of establishing a CPD system focused on competencies that improve physician performance and the quality and safety of patient care. Implications for competency-based CPD are discussed from an individual and organizational perspective, and a model to bridge the transition from residency to practice is explored.

  16. Nurse leaders and the innovation competence gap. (United States)

    White, Kenneth R; Pillay, Rubin; Huang, Xuan


    Nurses are well-positioned for innovation in health care delivery, although innovation is not generally learned in formal educational programs. The purpose of this study was to assess critical competencies for innovation success among nurse leaders in academia and practice, the perceived gaps on those competencies, and teaching methods that would be helpful in developing competencies related to innovation. A Web-enabled descriptive survey design was used to capture nurse leaders' perceptions of important innovation competencies and how they assess their level of competence in the particular innovation domain. Preferred approaches for innovation pedagogy were also queried. Respondents indicated significant gaps in 18 of 19 innovation competencies. Implications are for inclusion of innovation competencies in formal and continuing nursing education. The most preferred innovation pedagogical approaches are case studies of failures and successes and project- and field-based approaches. Traditional lectures are the least preferred way to address innovation competency gaps. There is a significant gap in innovation competencies among nurse leaders in practice and academia. The way we teach innovation needs to involve closer collaboration between academia and practice. Copyright © 2015 Elsevier Inc. All rights reserved.

  17. Competency Education and Evaluation: Issues and Dilemmas (United States)

    Short, Ronald R.


    Competency education in the applied behavioral sciences can be enhanced by synethesizing the values of humanistic psychology with the measurement, evaluation, and accountability that characterize behavioral psychology. (Author)

  18. Developing gerontological competency: a curriculum approach. (United States)

    Galambos, Colleen; Curl, Angela


    This study describes a competency-based educational approach to course development, implementation, and evaluation. The course model is presented, including its philosophical base. The authors hypothesized that student participation in a competency-based graduate gerontology course would increase their perceived competency level. Results indicate that students (N = 74 students; 2008-2011) rated their competency skill level as higher at posttest than at the pretest (paired t-tests, p curriculum so that students are better prepared to work with older adults when they graduate.

  19. Perspectives from nurse managers on informatics competencies. (United States)

    Yang, Li; Cui, Dan; Zhu, Xuemei; Zhao, Qiuli; Xiao, Ningning; Shen, Xiaoying


    Nurse managers are in an excellent position for providing leadership and support within the institutions they serve and are often responsible for accessing information that is vital to the improvement of health facility processes and patients' outcomes. Therefore, competency in informatics is essential. The purposes of this study are to examine current informatics competency levels of nurse managers and to identify the variables that influence these competencies. A questionnaire designed to assess demographic information and nursing informatics competency was completed by 68 nurse managers. Multiple linear regression analysis was conducted to analyze the factors influencing informatics competency. Descriptive analysis of the data revealed that informatics competency of these nurse managers was in the moderate range (77.65 ± 8.14). Multiple linear regression analysis indicated that level of education, nursing administration experience, and informatics education/training were significant factors affecting competency levels. The factors identified in this study can serve as a reference for nurse managers who were wishing to improve their informatics competency, hospital administrators seeking to provide appropriate training, and nursing educators who were making decisions about nursing informatics curricula. These findings suggest that efforts to enhance the informatics competency of nurse managers have marked potential benefits.

  20. Cultural competencies for graduate nursing education. (United States)

    Clark, Lauren; Calvillo, Evelyn; Dela Cruz, Felicitas; Fongwa, Marie; Kools, Susan; Lowe, John; Mastel-Smith, Beth


    Nursing is challenged to meet the health needs of ethnic and socioculturally diverse populations. To this end, American Association of Colleges of Nursing (AACN) charged an expert nursing faculty advisory group to formulate competencies for graduate nursing education, expanding them to integrate leadership and scholarship. The Cultural Competency in Baccalaureate Nursing Education served as the springboard for the initiative. In formulating the graduate cultural competencies and the toolkit, the advisory group reviewed all AACN Essentials documents and the cultural competency literature, drew upon their collective experiences with cultural diversity, and used cultural humility as the supporting framework. Six core competencies were formulated and endorsed by the AACN board of directors and key professional nursing organizations. A companion toolkit was compiled to provide resources for the implementation of the competencies. A 1-day conference was held in California to launch the cultural competencies and toolkit. Dissemination to graduate nursing programs is in process, with emphasis on faculty readiness to undertake this graduate educational transformation. The AACN Cultural Competencies for Graduate Nursing Education set national standards to prepare culturally competent nurses at the graduate level who will contribute to the elimination of health disparities through education, clinical practice, research, scholarship, and policy. 2011 Elsevier Inc. All rights reserved.

  1. The Impact of an Electronic Medication Administration Record (eMAR) and Computerized Physician Order Entry (CPOE) on Nurse Extender and Unit Clerk Staffing. (United States)

    Robinson, Edmondo J; Bergey, Meredith R; Brady, Elizabeth; Mapp, Alexandra M; Goldsack, Jennifer C


    The aim of this study is to describe the impact of the introduction of health information technology (HIT) on the utilization and payroll costs of nurse extenders and unit clerks in medicine and surgery units in a large regional health system. Long-term policy goals of HIT implementation are reported to include system-level reductions in labor costs, achieved through improved efficiency. Using a retrospective cohort model, we analyzed how hours worked per patient day and staffing costs per patient day varied with the implementation of HIT over time at 2 different hospitals within a health system. Implementation of electronic medication administration records was not associated with significant changes in staffing or labor costs. Both labor hours and costs associated with nurse extenders and unit clerks were significantly reduced after the subsequent addition of computerized provider order entry. Simultaneously, units that did not implement any HIT experienced a significant increase in both labor hours and costs. Health information technology implementation in the inpatient setting is associated with significant savings in labor hours and costs in non-registered nursing roles.

  2. Organizational structure, leadership and readiness for change and the implementation of organizational cultural competence in addiction health services. (United States)

    Guerrero, Erick G; Kim, Ahraemi


    Increasing representation of racial and ethnic minorities in the health care system and on-going concerns about existing health disparities have pressured addiction health services programs to enhance their cultural competence. This study examines the extent to which organizational factors, such as structure, leadership and readiness for change contribute to the implementation of community, policy and staffing domains representing organizational cultural competence. Analysis of a randomly selected sample of 122 organizations located in primarily Latino and African American communities showed that programs with public funding and Medicaid reimbursement were positively associated with implementing policies and procedures, while leadership was associated with staff having greater knowledge of minority communities and developing a diverse workforce. Moreover, program climate was positively associated with staff knowledge of communities and having supportive policies and procedures, while programs with graduate staff and parent organizations were negatively associated with knowledge of and involvement in these communities. By investing in funding, leadership skills and a strategic climate, addiction health services programs may develop greater understanding and responsiveness of the service needs of minority communities. Implications for future research and program planning in an era of health care reform in the United States are discussed. Copyright © 2013 Elsevier Ltd. All rights reserved.

  3. Adolescents, curriculum, and literary competence

    Directory of Open Access Journals (Sweden)

    Guadalupe López Bonilla


    Full Text Available In this paper we look at access to literary texts, and analyze literacy practices in a specific context and domain: high school literature classes. We start out from a sociocultural perspective for our study of literacy events and practices. In particular, we have begun our research supported by the work of Mary Hamilton and the New Literacy Studies to identify events and their components, in order to infer the practices that give meaning to the events observed. The study was conducted in a state high school (COBACH, and in a federal high school offering two different programs: the General Diploma (GD, similar to that of the COBACH, and the International Baccalaureate Diploma (IB. The results allow us to surmise what type of reader and level of literary competency is offered by each scholastic culture.

  4. Competencies for the Contemporary Career: Development and Preliminary Validation of the Career Competencies Questionnaire

    NARCIS (Netherlands)

    Akkermans, J.; Brenninkmeijer, V.; Huibers, M.; Blonk, R.W.B.


    A new and promising area of research has recently emerged in the field of career development: career competencies. The present article provides a framework of career competencies that integrates several perspectives from the literature. The framework distinguishes between reflective, communicative,

  5. Competencies for the contemporary career: Development and preliminary validation of the Career Competencies Questionnaire.

    NARCIS (Netherlands)

    Akkermans, J.; Brenninkmeijer, V.; Huibers, M.; Blonk, R.W.B.


    A new and promising area of research has recently emerged in the field of career development: career competencies. The present article provides a framework of career competencies that integrates several perspectives from the literature. The framework distinguishes between reflective, communicative,

  6. Using competing risks model and competing events in outcome of pulmonary tuberculosis patients

    Directory of Open Access Journals (Sweden)

    Mehdi Kazempour Dizaji


    Conclusions: Use of competing risks model with competing events can provide a better way to understand the associated risk factors co-related with outcome of the pulmonary TB process, especially among DR-TB patients.

  7. [The Competence Network Parkinson (CNP)]. (United States)

    Oertel, Wolfgang H; Deuschl, Guenther; Eggert, Karla


    The Competence Network Parkinson (CNP) is a research infrastructure for disease-oriented translational and clinical research in the field of Parkinson syndromes (PS). It was initiated in 1999 and funded until 2008 by the German Ministry for Education and Research (BMBF). The CNP created a highly frequented website with information on PS for the general public and for experts. The CNP designed and established one of the first electronic internet-based data entry systems (secuTrial®) - fulfilling the legal standards of data safety and security - a material bank for genetic research on Parkinson's disease (PD), implemented and investigated new methods for early diagnosis of PD and related atypical PS including in vivo dopamine transporter imaging (DAT SPECT), established the German Parkinson Study Group (GPS-Pharma) with 40 certified trial centres for pharmacotherapeutical trials and the German interdisciplinary Parkinson Study Group (neurology and neurosurgery) for deep brain stimulation (GPS-DBS), and carried out several pharmacoeconomic and health care studies on PD in Germany. Sustainability of the infrastructure CNP has in part been achieved in form of the GPS-Pharma and the GPS-DBS, as well as in the German Study Group on REM Sleep Behaviour Disorder (RBD), a prodromal phase of PD. Part of the CNP activities, such as genetic research and research on cohorts of PD patients, have been incorporated into the German Center for Neurodegenerative Disorders (DZNE). Furthermore, topics such as health care research are funded within projects of the EU research program. The article describes problems in setting up a competence network from scratch and contains recommendations how to avoid them in the future.

  8. An Ontology-centered Approach for Designing an Interactive Competence Management System for IT Companies

    Directory of Open Access Journals (Sweden)



    Full Text Available The paper presents a generic framework for an intelligent information system of competence management based on ontologies for information technology companies. In a first step it will be applied in an information technology (IT small enterprise and then its applicability will be verified for other organizations of the same type. The work presented in the paper is performed under the project "CONTO – Ontology-based Competencies Management in Information Technology" funded by the Romanian Ministry of Education and Research, involving two universities, a research institute and an IT private company. A competence management system (CMS, in our vision has to achieve three functions: (a to support the complete and systematic acquisition of knowledge about the competence of the members of an enterprise; (b to provide the knowledge about competences and their owners; (c to apply the available knowledge to serve a purpose. The core of the competence management information system is an ontology that plays the role of the declarative knowledge repository containing the basic concepts (such as: company-job, competence, domain, group, person etc. and their relationships with other concepts, instances and properties. The Protégé environment was used for the development of this ontology. The structure of the ontology is conceived so that description logics can be used to represent the concept definitions of the application domain in a structured and formally well-understood way. Knowledge acquisition is performed in our approach by enriching the ontology, according to the requirements of the IT company. An advantage of using an ontology-based system is the possibility of the identification of new relations among concepts based on inferences starting from the existing knowledge. The user can choose to query instances of one type of concept. The paper also presents some use-cases.

  9. Transparency and transfer of individual competencies - A concept of integrative competence management


    Reinhardt, K.; North, K.


    The present state of research on competence management does not provide any suitable model that can be used in practice. Neither results from organizational nor from cognitive and social sciences meet the requirements for an application-oriented competence management completely as yet. An integrative competence management must be able to synchronise individual with organisational competencies. This linking is still neglected in research. A convenient solution has not been described yet. This ...

  10. Competencies for the Contemporary Career: Development and Preliminary Validation of the Career Competencies Questionnaire (United States)

    Akkermans, Jos; Brenninkmeijer, Veerle; Huibers, Marthe; Blonk, Roland W. B.


    A new and promising area of research has recently emerged in the field of career development: career competencies. The present article provides a framework of career competencies that integrates several perspectives from the literature. The framework distinguishes between reflective, communicative, and behavioral career competencies. Six career…

  11. Employees' Perceptions of the Opportunities to Utilize Their Competences: Exploring the Role of Perceived Competence Mobilization (United States)

    Lai, Linda


    Perceived competence mobilization is the degree to which employees perceive that they have adequate opportunities to utilize their competences in their current jobs. The findings of the research reported here suggest that employees' perceived competence mobilization is associated with a number of favourable employee attitudes, including intrinsic…

  12. An International Study in Competency Education: Postcards from Abroad. CompetencyWorks Issue Brief (United States)

    Bristow, Sara Frank; Patrick, Susan


    "An International Study in Competency Education: Postcards from Abroad" seeks to highlight components of competency education in international practice, to inform US policymakers and decision makers seeking to implement high-quality competency pathways at the state or local level. Other countries are studying our innovations, and we are…

  13. Competence without a competence pheromone in a natural isolate of Streptococcus infantis

    DEFF Research Database (Denmark)

    Ween, O; Teigen, S; Gaustad, P


    C and a two-component regulatory system encoded by comDE. Here we report that a natural isolate of a mitis group streptococcus (Atu-4) is competent for genetic transformation even though it has lost the gene encoding the competence pheromone. In contrast to other strains, induction of competence in Atu-4...

  14. Oral Communicative Competence of Primary School Students (United States)

    Mayo, Isabel Cantón; Barrioluengo, Elena Pérez


    Oral communicative competence enables speakers of a language to interact effectively with each other. Oral communicative competence includes a wide semantic field since the oral expression is a way of expression for the thought and it provides feedback and develops by means of the linguistic function (Vygotsky, 1992; Piaget, 1983a, 1983b; Pinker,…

  15. Developing Intercultural Communicative Competence through Online Exchanges (United States)

    Chun, Dorothy M.


    Based on Byram's (1997) definition of intercultural communicative competence (ICC) and on specific types of discourse analysis proposed by Kramsch and Thorne (2002) and Ware and Kramsch (2005), this article explores how online exchanges can play a role in second language learners' development of pragmatic competence and ICC. With data obtained…

  16. Strategic Imperative of Human Resource Leadership Competencies (United States)

    Rajini, G.; Gomathi, S.


    Using multiple constituencies approach, variances in competencies in human resource leadership have been studied as this is becoming highly significant in India's globalisation efforts. Previous research in leadership orientation focused on localisation of human resource competencies rather than its globalisation. For this, human resource…

  17. Developing the Intercultural Competence of Graduate Students (United States)

    Dimitrov, Nanda; Dawson, Debra L.; Olsen, Karyn C.; Meadows, Ken N.


    This study explores how teaching development programs may facilitate the development of intercultural competence in graduate students and prepare them for communicating effectively in the global workplace after graduation. First, we describe the concept of intercultural teaching competence and examine the skills that graduate students may need to…

  18. Cultural Competence of Obstetric and Neonatal Nurses. (United States)

    Heitzler, Ella T

    To measure the cultural competence level of obstetric and neonatal nurses, explore relationships among cultural competence and selected sociodemographic variables, and identify factors related to cultural competence. Descriptive correlational study. Online survey. A convenience sample of 132 obstetric and neonatal registered nurses practicing in the United States. Nurse participants completed the Cultural Competence Assessment (CCA) instrument, which included Cultural Awareness and Sensitivity (CAS) and Cultural Competence Behaviors (CCB) subscales, and a sociodemographic questionnaire. Correlation and regression analyses were conducted. The average CCA score was 5.38 (possible range = 1.00-7.00). CCA scores were negatively correlated with age and positively correlated with self-ranked cultural competence, years of nursing experience, years of experience within the specialty area, and number of types of previous cultural diversity training. CCB subscale scores were correlated positively with age, years of nursing experience, years of experience within the specialty area, and number of types of previous diversity training. CAS subscale scores were positively correlated with number of types of previous diversity training. Standard multiple linear regression explained approximately 10%, 12%, and 11% of the variance in CCA, CAS, and CCB scores, respectively. Obstetric and neonatal registered nurses should continue to work toward greater cultural competence. Exposing nurses to more types of cultural diversity training may help achieve greater cultural competence. Copyright © 2017 AWHONN, the Association of Women’s Health, Obstetric and Neonatal Nurses. Published by Elsevier Inc. All rights reserved.

  19. Teaching Competencies for the Online Environment (United States)

    Farmer, Heather M.; Ramsdale, Jennifer


    The goals of this study are to identify key competency areas that lead to success in online instruction and to develop a framework that supports professional development and self-assessment. To identify the key competency areas, skills and behaviours presented within current literature were analyzed. Secondly, gaps were identified and levels of…

  20. Nuclear energy can compete, industry watchers say

    International Nuclear Information System (INIS)

    Cash, C.J.


    Nuclear power plants with outstanding operating records and cost-conscious management can continue to compete with other forms of generation as the electricity business becomes more competitive. Natural gas-fired units will set the pricing standard with which nuclear power plants must compete