bluuebunny/crossref_metadata_2025_split huggingface dataset:
An audit investigating documentation of hospital urethral catheterisation and the improvements using proforma stickers
Authors: Tempest H.V. , Kumar N. , Rucker J. , Knight A. , Saleemi A. 
Published: January 2007

PurposeAn audit was undertaken, aimed at investigating documentation of hospital urethral catheterisation in patients’ notes.Design/methodology/approachStandards were devised by the urology department and documentation of these standards was recorded. After identifying deficiencies in the quality of record keeping, proforma catheterisation stickers were produced and distributed throughout the hospital wards. The standards were then re‐audited a month later.FindingsThere was only 3 per cent full documentation using the catheterisation standards set for this study in the initial audit. In the re‐audit there was a 55 per cent usage rate of stickers. Of the notes with stickers 84 per cent had full documentation compared to only 2 per cent without stickers.Practical implicationsThe use of proforma stickers improves documentation of urethral catheterisation in patients’ notes.Originality/valueThis paper identifies a way of improving documentation of urethral catheterisation in patients’ notes.
Continuous quality improvement using a practice improvement model
Authors: Kellett Stephen , Clarke Suzanne , Matthews Linda 
Published: January 2007

PurposeCape and Barkham's practice improvement model (PIM) describes how healthcare systems can be designed to facilitate the usage of self‐generated clinical outcomes in the delivery of subsequent interventions. This article aims to describe the application of the PIM in the implementation of group‐based cognitive‐behavioural therapy, for clients referred from Primary Care with anxiety disorders.Design/methodology/approachThe groups were evaluated using and pre‐ and post‐intervention design using a variety of validated measures of psychological functioning as part of a wider audit and evaluation system. The conclusions drawn from the audit and evaluation system, in the form of PIMs, were fed‐back into the design of successive groups in the attempt to increase subsequent effectiveness. Group 1 had no PIM applied, group 2 had a single PIM applied and group 3 had two PIMs applied.FindingsThe introduction of the single PIM for group 2 increased the effectiveness of clinical outcomes, while for group 3, the introduction of two PIMs increased effectiveness again in comparison to group 1, but not in comparison to group 2.Practice implicationsThe results indicate that the active use of feedback of outcomes from interventions conducted can be utilised to design and then evaluate the application of resultant PIMs. This represents attempts to introduce and operationalise the concept of continuous quality improvement in the delivery of a clinical service.Originality/valueThe evaluation of PIMs is in its practical and methodological infancy and this initiative represents the first attempt to utilise PIMs in the design of Primary Care psychological services.
Copying patient letters – making it work
Authors: Brockbank Katrina 
Published: January 2007

PurposeThat patients should be able to receive a copy of any letter written about them is part of the British Government's policy to increase patients' involvement in their care and treatment. All National Health Service (NHS) organisations are expected to implement this by April 2005. This paper aims to describe how one acute Trust has used basic change management principles to implement the initiative.Design/methodology/approachExamines the approach of the Salisbury Health Care NHS Trust, where initially a survey of all consultants, senior nurses and allied health professionals was carried out.FindingsInitial concerns that patients would not understand the letter were generally unfounded with 98.9 per cent of patients saying that they understood their letter. Of patients, 96.9 per cent said that they found receiving a copy letter useful.Originality/valueThe research demonstrated a high percentage of patients wanting a copy letter, which has huge resource implications in terms of secretarial time, additional stationery and postage costs. Change is difficult and an emotionally charged issue however, using examples of good practice and taking a multi‐faceted approach to the change process the initiative has been successfully implemented.
Treatment of acute behavioural disturbance
Authors: Jacob Rebecca , Hunt Neil 
Published: January 2007

PurposeTo improve the quality of care of patients who are given parenteral medication for an episode of disturbed or violent behaviour in the context of a psychotic illness.Design/methodology/approachCurrent guidelines are described, and adherence to the standards is audited, with particular emphasis on the performance of physical observations following an episode of behavioural disturbance. Comparisons are made with the findings of previous audits performed at Addenbrooke's and Fulbourn Hospital, Cambridge.FindingsThe results revealed an improvement in following the guidelines whilst highlighting concerns regarding the unwarranted and potentially dangerous use of intravenous medication in these situations. The results also demonstrated a significant improvement in routine physical observations performed, following treatment of acute behavioural disturbance.Practical implicationsCareful risk management is needed when considering the safety of both patients and staff when dealing with behaviourally disturbed psychotic patients.Originality/valueThe completion of this audit cycle suggests that regular review and dissemination of guidelines, as well as conducting a comprehensive audit cycle, have led to safer prescribing and evidence based practice.
Is our evidence‐based practice effective?
Authors: Holden John , Wooff Emma 
Published: January 2007

PurposeThe purpose of this article is to review all patients having received a steroid injection for rheumatic problems in the period 1995‐2003 by one general practitioner.Design/methodology/approachSelf‐completion questionnaire given to patients at the time of the injection to be returned after one month.FindingsMost of the 435 patients (92 per cent) were pleased that they had received the injection. Pain was relieved better than mobility. Results for different sites were similar. Complication rates were low and many patients had further steroid injections.Practical implicationsIt is feasible to collect large series reviewing the outcome of interventions in general practice. Results can be usefully compared with those obtained in randomised controlled trials.Originality/valueThis is the largest review of steroid injections carried out in a single general practice in the UK. It provides information with which others can compare their own practice and results, especially in primary care.
Low back pain: barriers to effective clinical governance
Authors: Langworthy Jennifer , Clow Wendy , Breen Alan 
Published: January 2007

PurposeThe purpose of this article is to investigate acceptability, dissemination and use of a multidisciplinary audit toolkit to monitor evidence‐based care for acute low back pain and to identify barriers to implementation of the RCGP evidence‐based LBP guideline and associated audit process.Design/methodology/approachA survey was carried out of 707 clinical governance leads (CGLs) and 336 clinical audit leads in English/Welsh Health Authorities, NHS Trusts, Primary Care Groups and Primary Care Trusts. Subsequently, structured telephone interviews with 50 CGLs and 22 CALs in 72 Primary Care Trusts were qualitatively analysed.FindingsSubstantive barriers specific to implementation of the RCGP LBP guideline and associated audit toolkit could not be identified. Issues were raised pertaining to the wider healthcare system, which itself may restrain implementation of evidence‐based health care for LBP sufferers. Qualitative analysis revealed six categories responsible for poor clinical governance. Results suggest that LBP is not a priority area and that without National Service Framework status this is unlikely to change.Research limitations/implicationsResponse to the initial survey was only 37 per cent; thus results may not be representative of all relevant UK NHS organisations. It coincided with a particularly busy period of change and ongoing reform, making it difficult to reach relevant personnel. This problem was accentuated by frequent change of persons in the post of clinical governance lead. All of this may have impacted on the response rate. In addition, some organisations/individuals were reluctant to be identified for the purpose of this study.Originality/valueThis study identifies the practical difficulties of delivering the clinical governance agenda, particularly in non‐priority areas, as reported by those responsible for doing so.
Psychosocial care within a multidisciplinary breast cancer team
Authors: Lewis Sarah , White Craig A. , Dorris Liam 
Published: January 2007

PurposeThe purpose of this article is to identify the range of psychosocial care components used by a multidisciplinary breast cancer team.Design/methodology/approachA questionnaire was developed to assess the range of psychosocial care components used by the team, their confidence using them and their training needs in relation to them. A total of 15 people completed the questionnaire from seven different professions.FindingsThe breast cancer team carried out a wide range of psychosocial care components despite little formal training to support their work. They valued the importance of psychosocial interventions and recognised their learning needs in relation to them.Research limitations/implicationsThe small sample size limited ability to detect correlations and significant trends within the data. Future research could sample other cancer teams and use the questionnaire before and after training to detect changes in the use of psychosocial care components.Practical implicationsThe psychosocial needs of cancer patients are best met when all members of the team are aware of and respond to those needs. This study suggests that team members' confidence in using psychosocial care components should be regularly assessed and training provided. It is proposed that a questionnaire is a valuable way of gathering information and evaluating training.Originality/valueThis paper would be of value to a manager or clinician aiming to develop a multidisciplinary approach to the psychosocial care of cancer patients.
The dark side of organizations: forensic management – an emerging theoretical perspective
Authors: Gray Harry 
Published: January 2007

PurposeMost writing about organizations assumes that everyone is sensible and rational and there is a simple and homogenous culture. The paper describes why organizations are in fact difficult to manage and why leadership is always problematical.Design/methodology/approachThe article is based on a review of the literature plus experience.FindingsThe dark side of organizations needs recognizing.Practical implicationsOrganizational members need to pay attention to unrecognized elements of organizational life.Originality/valueThe article exposes much of the naïve writing in management and leadership.
What is the key to combating the IT skills gap?
Authors: Sweeney Alan 
Published: January 2007

PurposeThe aim of the paper is to highlight the IT skills gap and promote training and development as a solution.Design/methodology/approachThe objectives are achieved by tackling the topic of IT skills gap and training and development head‐on. The approach to the subject is business‐focussed, keeping in mind the target audience are key decision makers within a wide number of industry sectors.FindingsThe paper discusses how organisations can use third‐party training specialists can help to plug IT skills gaps.Practical implicationsThis paper should encourage organisations to look carefully at their workforce, noting skills gaps, and consider training and development programmes for their staff.Originality/valueThis paper is the first article issued to DLO on behalf of Computeach, the IT training specialists.
Learning in knowledge‐intensive organisations – moving from training to learning
Authors: Sloman Martyn 
Published: January 2007

PurposeTo highlight the shift from training to learning.Design/methodology/approachThis was case‐study driven.FindingsThere has been a shift from training to learning.Practical implicationsIt is about how the individual learns. The type of training or learning must meet the needs of both the individual and the organization.Originality/valueThis is valuable to trainers, employers, managers and staff.
Hazardous effects of sewage water on the environment
Authors: Sadiq Butt Masood , Sharif Kamran , Ehsan Bajwa Babar , Aziz Abdul 
Published: January 2007

PurposePakistan is an agricultural country having the world's largest canal irrigation system. Indus basin that covers 70 percent of irrigated area for crop production is the major source of water in the country. Owing to rapid increase in population and uncertain environmental conditions, this water is not adequate to cope with the crop water requirement and needs additional means to provide extra water for agricultural purposes. The main source of irrigation is canal and ground water but the quality of ground water is so poor for the sustainability of agriculture system. To cope with the present demand, use of municipal sewage water that consists of domestic liquid waste, as well as industrial effluents, is becoming a common practice. The present study aims to reflect the hazardous effects of sewage water on the environment, with the main focus on heavy metals and chemical composition of soil and vegetables.Design/methodology/approachIndustrial effluent was collected from one ghee mill, one flour mill, three textile industries and three hosieries located in Faisalabad, an industrial city of Pakistan highly affected with water pollution. All water samples were analyzed for pH, EC, SAR and RSC. Water analysis was also carried out for various nutrients and heavy metals (K+1, P2+, Fe2+, Cu2+, Zn2+, Mn2+, Ni2+ and Pb2+). Soil samples from various depths (0‐15, 15‐30, 30‐60, 60‐90 and 90‐120 cm) were taken to analyze for EC, pH, SAR, Na+1, SO4, K+1, P2+, Fe2+, Cu2+, Zn2+, Mn2+, Ni2+ and Pb2+ after irrigation with canal water and sewage water. Cadmium, lead and copper concentration was determined in various vegetables grown in areas irrigated with canal water and industrial effluents to determine their final concentration in the final product ultimately affecting the human health.FindingsAlthough the sewage water is a source of many nutrients, it also includes a significant amount of heavy metals like Fe2+, Cu2+, Zn2+, Mn2+, Ni2+, Pb2+ and pathogens. Extensive use of this effluent for irrigation purpose has resulted in an upsurge of such metals in soils and various crops, which ultimately resulted in clinical problems in human beings.Originality/valueThe present study reflects the composition of sewage water and heavy metal accumulation in soil, as well as crops. It further highlights the different potential hazards to humans due to these contaminants.
An appraisal of environment management systems
Authors: Chavan Meena 
Published: January 2007

PurposeThe main aim of this paper is to prove that an Environmental Management System (EMS) can be a powerful tool for organizations to both improve their environmental performance, and enhance their business efficiency.Design/methodology/approachA case study methodology is used putting forth the “Implementation of an EMS system at Pioneer Building and Construction”, a registered company in the construction industry whose primary business activities relate to development and construction of projects on a contract basis.FindingsThe findings stated that by implementing an EMS, Pioneer obtained a 10 per cent cost reduction; an estimated $1.2 million now could be saved annually as the annual costs were $12 million – which more than offsets the costs sustained in the implementation of ISO 14001.Practical implicationsThis paper validates that although the causes of environmental degradation are well known, the business logic for environmental improvement has been largely operational and technical. Few firms have incorporated sustainability into their strategic thinking. A sustainable business should use its unique position to develop and achieve sustainable production and sustainable consumption at the same time. A responsible and sustainable system of environmental management should start with pollution prevention then expand into control and environmental design. The practical implications of this paper are to assist small business to embark on their implementation of the EMS.Originality/valueEMS relevant information specifically with regards to the building and construction industry within the small business sector has been observed in this paper which is very important for similar such organizations to get cracking on their implementation of an EMS which is valuable in terms of improving their efficiency as well as being a social obligation for the future generation and the economy.
Sustainable urban transport in Pakistan: threats and opportunities
Authors: Imran Muhammad , Low Nicholas 
Published: January 2007

PurposeThe purpose of the paper is to explore this phenomenon, how initial choice in the history of transport policy in Pakistan became “locked into” suboptimal transport policies biased towards private vehicles and roads and now resisting change to a more sustainable transport policy.Design/methodology/approachThe methodology was designed by applying the concept of “path dependence” on a case study of Pakistan. This approach helped to locate the “critical juncture” for explaining how transport decision has been made over time and on which basis.FindingsPakistan transport development, including urban transport planning, has become both “resource dependent” and “path dependent” upon international agencies which shapes the outcomes and limits the application of sustainable solutions in transport in ways that could be consistent with the local situation.Research limitations/implicationsThe paper is a part of a research project, “identifying the institutional barriers to sustainable urban transport in Pakistan” which is in progress. Therefore, the paper may develop its findings at the end of the research project.Practical implicationsThe paper provides valuable information to getting insight into urban transport politics of Pakistan.Originality/valueThe research paper has implied the concept of “path dependence” to explain the difference between reality and ideal in urban transport planning of Pakistan by the interventions of global agencies.
Agrotechnical anti‐erosion reinforcement of slopes of the linear earthen structures by hydroseeding with fly‐ash utilization
Authors: Głażewski Marian , Eymontt Andrzej 
Published: January 2007

PurposeProposes to discuss the implementation of biological methods of the reinforcement and protection of slopes and dissemination to designers and builders of earthen structures.Design/methodology/approachThe methodology of the process developed consists of field experiments including plant selection, preparation of the slope, hydroseeding mass composition, structure and rheological properties, as well as observation of the growing process and proper management of the layer covering. Laboratory tests and field experiments were conducted.FindingsThe research results confirm that covering slopes with a hydroseeding layer contributes to a reduction of the erosion process. The most important effect of the protection process is the creation of favorable conditions for seedlings growing in the third leaf phase with the effect of compact green cover.Practical implicationsThe research results could be an important basis for the development of legislation acts related to road building, including proper slope management, together with seeding, underseeding and prototechnical operations that should be done during the first two years for both shaded and sunny slopes. The next step should be the training of designers and builders, and implementation of the technology.Originality/valueThis technology is new in Poland. The authors have realized several hundred slopes with this technology. However, for further improvement of slopes, protection was a necessary realization of the research discussed in the paper.
Reciprocal insurance: a case of supply created by demand
Authors: Venezian Emilio C. 
Published: January 2007

PurposeThe purpose of this study is to determine the characteristics of the equilibrium between demand and supply for a reciprocal insurance firm.Design/methodology/approachThe model developed assumes a fixed number of individuals with identical characteristics and of constant absolute risk aversion who can choose between remaining self‐insured or forming a reciprocal insurer to serve their needs.FindingsThe results show that under those conditions the individuals either remain self‐insured or form a reciprocal and buy full insurance. Which of the two decisions will be made depends on the relation between the number of members of the reciprocal and the expenses that will be incurred by that entity.Research limitations/implicationsMost alternative models of insurance demand imply that, in the presence of transaction costs, partial insurance is the rule.Practical implicationsThe major practical implication is that there can be serious agency problems in the management of reciprocals if attorneys‐in‐fact have influence over their salaries, since they may be able to increase their private welfare at the expense of that of the policyholders.Originality/valueThe model is new and its practical implications have not been discussed previously.
The effect of capital structure on profitability: an empirical analysis of listed firms in Ghana
Authors: Abor Joshua 
Published: January 2007

PurposeThis paper seeks to investigate the relationship between capital structure and profitability of listed firms on the Ghana Stock Exchange (GSE) during a five‐year period.Design/methodology/approachRegression analysis is used in the estimation of functions relating the return on equity (ROE) with measures of capital structure.FindingsThe results reveal a significantly positive relation between the ratio of short‐term debt to total assets and ROE. However, a negative relationship between the ratio of long‐term debt to total assets and ROE was found. With regard to the relationship between total debt and return rates, the results show a significantly positive association between the ratio of total debt to total assets and return on equity.Originality/valueThe research suggests that profitable firms depend more on debt as their main financing option. In the Ghanaian case, a high proportion (85 percent) of the debt is represented in short‐term debt.
The after‐effect of Rule 203(b)(3)‐2: what it means to take on the role of CCO to comply with the controversial measure
Authors: Panebianco Colette 
Published: January 2007

PurposeTo describe the role and requirements for the chief compliance officer (CCO), appointed by hedge fund managers within an investment advisory firm.Design/methodology/approachSummarizes Rule 203(b)(3)‐2 under the 1940 Investment Advisers Act, provides a recent case study in which a CCO failed to fulfill his responsibilities, suggests guidelines on how to become an effective CCO, emphasizes the need to be proactive, recommends safeguards to take, and discusses the CCO's need for self‐protection.FindingsRecent statements and actions indicate that the SEC will be relentless in holding CCOs to their duties.Originality/valueProvides a useful case study of how a CCO failed to fulfill his responsibilities and suggests helpful guidelines on how the CCO can work within the culture of the firm.