Government Team Research Articles

Innovation in Green Building Projects: An Exploratory Inquiry

Green building (GB) projects, although being developed and operated for more than two decades, may still be regarded as innovative. To address the socio-environmental challenges of the built environment, GBs need to continuously innovate. A comprehensive account of the innovation frontiers and factors affecting GB project innovation is missing in previous studies. In this study, for an in-depth understanding of what makes these projects innovative and how to create an enabling environment for their innovation, semi-structured interviews with 45 GB experts from six regions were conducted. Innovation in GBs was found to be a function of the GB idea, constituent building technologies, potential performance, and the project development process. Key frontiers where innovation in GB projects is needed include environmental performance, health and well-being, and the resolution of mutually contradicting project aspirations. The study also identified some factors contributing to innovation in GBs, which are primarily related to support from the government, client, and project team; availability of time and budget; scalability of innovative solutions; and nature of the construction industry. A nexus between green certifications, sustainability, and innovation is also explained. The awareness and understanding of industry experts regarding GB project innovation will add to the theory of GB projects and green innovation, and will help stakeholders to create a more enabling environment for innovation.

Determinants of the dissemination of economic, social and environmental information at the university level in the context of commitment to the Sustainable Development Goals

AbstractIn the context of universities' commitment to the Sustainable Development Goals (SDGs), the paper aims to analyse the factors that influence the degree of information disclosure related to the economic, social, and environmental (ESE) aspects of SDGs. Based on a content analysis of the annual and/or sustainability reports for 2021 and the websites of the top 200 universities in the Shanghai ranking, the results show that the volume of ESE disclosures at universities is associated with gender diversity in the governance team, stakeholder commitment and position in academic and environmental rankings. By taking entities that are global benchmarks, the results make practical and managerial contributions. First, they can serve as a guide to setting policy frameworks for institutions to create procedures to develop their SDG‐compliant actions. Second, the promotion of women's participation on the board and the active presence of stakeholders favour universities' information disclosure policies. Third, the results show that the efforts towards disclosure at the top universities in both academic and environmental rankings are related to legitimising their actions and meeting stakeholders' demands. In addition, this study proposes the development of an index that could help improve the ESE information disclosed by universities, which is currently low, yet some aspects of it, such as economic aspects, are barely covered but essential to ensure sustainability. Finally, the proposed indicators can also serve as a guide for governing bodies' management of SDG‐related aspects.

WTP5.3 Setting up a Complex Abdominal Wall Reconstruction Unit: Our first 12 months’ experience in a District General Hospital

Abstract Aims Incisional hernias are distressing post-operative complications which develop in 25% of surgical incisions. We present our initial experience of setting up a Complex Abdominal Wall Reconstruction (CAWR) unit in line with international guidelines and Get It Right First Time (GIRFT) model of care. Methods A bespoke CAWR Multidisciplinary Team was established in our trust in January 2022, comprising 2 colorectal surgeons, 2 bariatric surgeons and anaesthetists (who performed the preoperative Botox injections and optimized high-risk patients). The unit had support from radiologists, the weight management service, and the orthotics department. We had approval from our governance, drugs and therapeutics team. Pathways for risk stratification, risk modification with pre-optimisation, standardised surgical techniques and post-operative care were created. Results Between January and December 2022, 8 MDT meetings held and 52 patients were discussed. The average BMI was 34 (22-50.5) All patients underwent a preoperative CT scan to delineate the anatomy of the hernia. The median size of the defect was 6 cm (range 3 to 22 cm). Open Rives-Stoppa repair was performed in 19 patients, with transversus abdominal muscle release in 6 and 3 patients had laparoscopic repair. One recurrence and 2 superficial surgical site infections were noted. 38.4% patients had BOTOX, 40.3% advised preoperative weight loss and 5.7% for bariatric surgery before hernia repair. A high-risk anaesthetic opinion was obtained in for 7.6% and 17% were deemed unfit. Conclusions Our initial experience and data highlight the feasibility of delivery of CAWR service at a non-tertiary unit in line with GIRFT principles. The initial follow-up indicates improved patient outcomes and experience.

Clinical governance implications of a Victorian coronial finding regarding contrast-related anaphylaxis for health services and private providers of radiology services.

What is known about the topic? Anaphylaxis is a rare but inherent risk of treatments and investigational agents. What does this paper add? Using a recent coronial finding in Victoria, this letter explores clinical governance responsibilities of health services and private providers of radiology services with respect to anaphylaxis recognition and management. What are the implications for practitioners? There is a strong case for health service and corporate governance teams (for stand-alone clinics) to ensure that all staff have recent, adequate training to recognise and initiate treatment of anaphylaxis. Reliance on an ambulance response is not enough.

Developing an intervention to improve the quality of childcare centers in resource-poor urban settings: a mixed methods study in Nairobi, Kenya.

Globally, 350 million under-5s do not have adequate childcare. This may damage their health and development and undermine societal and economic development. Rapid urbanization is changing patterns of work, social structures, and gender norms. Parents, mainly mothers, work long hours for insecure daily wages. To respond to increasing demand, childcare centers have sprung up in informal settlements. However, there is currently little or no support to ensure they provide safe, nurturing care accessible to low-income families. Here, we present the process of co-designing an intervention, delivered by local government community health teams to improve the quality of childcare centers and ultimately the health and development of under-5 children in informal settlements in Kenya. This mixed methods study started with a rapid mapping of the location and basic characteristics of all childcare centers in two informal settlements in Nairobi. Qualitative interviews were conducted with parents and grandparents (n = 44), childcare providers, and community health teams (n = 44). A series of 7 co-design workshops with representatives from government and non-governmental organizations (NGOs), community health teams, and childcare providers were held to design the intervention. Questionnaires to assess the knowledge, attitudes, and practices of community health volunteers (n = 22) and childcare center providers (n = 66) were conducted. In total, 129 childcare centers were identified -55 in Korogocho and 77 in Viwandani. School-based providers dominated in Korogocho (73%) while home-based centers were prevalent in Viwandani (53%). All centers reported minimal support from any organization (19% supported) and this was particularly low among home-based (9%) and center-based (14%) providers. Home-based center providers were the least likely to be trained in early childhood development (20%), hence the co-designed intervention focused on supporting these centers. All co-design stakeholders agreed that with further training, community health volunteers were well placed to support these informal centers. Findings showed that given the context of informal settlements, support for strengthening management within the centers in addition to the core domains of WHO's Nurturing Care Framework was required as a key component of the intervention. Implementing a co-design process embedded within existing community health systems and drawing on the lived experiences of childcare providers and parents in informal settlements facilitated the development of an intervention with the potential for scalability and sustainability. Such interventions are urgently needed as the number of home-based and small center-based informal childcare centers is growing rapidly to meet the demand; yet, they receive little support to improve quality and are largely unregulated. Childcare providers, and government and community health teams were able to co-design an intervention delivered within current public community health structures to support centers in improving nurturing care. Further research on the effectiveness and sustainability of support to private and informal childcare centers in the context of low-income urban neighborhoods is needed.

#5868 PREVALENCE AND MANAGEMENT OF CHRONIC COMPLICATIONS IN PATIENTS WITH DIABETES AND ADVANCED CHRONIC KIDNEY DISEASE: A RETROSPECTIVE AUDIT

Abstract Background and Aims Current guidelines recommend that all patients with Chronic Kidney Disease (CKD) stage 3b or higher should be monitored and treated for anaemia, mineral bone disorder (BMD) and metabolic acidosis. We audited the prevalence and management of these complications in a cohort of patients with diabetes and advanced CKD. Method A retrospective audit was undertaken using KDIGO guidelines as standard and necessary approvals were secured from the governance team at University Hospitals Birmingham. We included patients with (a) diabetes (b) eGFR 30 and 15 ml/min/1.73 m2) and (c) attending diabetes clinics as of 30/09/2022. Using electronic patient records, we collected: demographics, co-morbidities, complications, treatments, body weight, BMI, blood pressure and serial biochemistry (creatinine, Hba1c, cholesterol, UAlb/Creat ratio, bicarbonate, haemoglobin, vitamin D, parathyroid hormone (PTH). Following definitions were applied: anaemia as Hb <13 g/dl for men and <12 g/dl for women, BMD as vitamin D <40 nmol/l plus raised PTH, acidosis as bicarbonate <22 meq/l. Data was analysed using SPSS 26. Descriptive statistics (frequencies and cross tabulations) were used to estimate prevalence. Independent means test was used for continuous variables. Comparison between groups was undertaken using the Chi Square test and one way ANOVA test. Results Data for 192 subjects (110 European (EUR), 40 South Asian (SA), 42 African-Caribbean (AFC) /other) was analysed. Mean age (SD) was 73 (+/-11) years. There were no significant differences in general characteristics between the ethnic groups except for albuminuria which was greater in SA and AFC compared to EUR (193 v 133 v 95.5mg/mmol; p=.038). 47% of the cohort had at least one diabetes related complication. 63/192 (32.8%) had cardiovascular disease, 49/192 (25.5%) had retinopathy and 19/192 (9.9%) had neuropathy. Insulin was the most common prescribed glucose lowering agent 105/192 (55%) with proportionately more SA treated with insulin (65%). Anaemia was present in 171/183 (93.4%) of the patients. 82/101 (81.2%) had BMD, and 135/168 (82.8%) of patients had metabolic acidosis. 65/192 (33.9%) of patients had all 3 complications. Only 38/133 (22%) of those with anaemia were receiving treatment out of which only 36.8% were treated adequately with a Hb of >10g/l. Corresponding figures for BMD and metabolic acidosis were: BMD: 39/82 (47.6%) treated and 42% optimally corrected, metabolic acidosis: 54/135 (40%) treated and 53% optimally corrected. There were no significant differences between ethnic groups in prevalence or treatment of these complications. Conclusion The prevalence of CKD related complications is high. The management of these complications however, is suboptimal. Increased emphasis on the management of these complications is required to improve outcomes in patients with advanced CKD.

Nudging people to pay their parking fines on time. Evidence from a cluster-randomized field experiment

The timely payment of municipal parking fines signifies people's acceptance of parking regulations, reduces administrative enforcement costs, and prevents additional late-payment fees for individuals. However, public administrations face challenges in enforcing the timely payment of parking fines. A large group of people fail to pay their fines on time, which requires additional enforcement actions that can result in extra late-payment costs and payment-related stress. In this study we collaborate with the Belgian city of Mechelen and the Behavioral Insights Team of the Flemish regional government to test the compounded effects of three communicative nudges. i.e., simplification, explicit penalty, and social norm, on the timely payment of parking fines. In a cluster-randomized field experiment, parking offenders received either the original notification letter, a simplified notification letter, a simplified notification letter accompanied by an explicit reference to the potential penalties, or a simplified notification letter accompanied by an explicit penalty and a social norm message. The results indicate that people can be nudged to pay their fines on time, but only when multiple nudges are combined and used simultaneously.

Perception of Contractors about Different Sources of Coarse Aggregates Used in Selected Building Construction Projects with in Kathmandu Valley

Purpose: The study was focused to find out the perception of contractors about different Sources of Coarse Aggregates used in Selected Building Construction Projects within Kathmandu Valley. The demand for coarse aggregate is increasing rapidly in the Kathmandu Valley for the construction of building-related structures after the Maoist revolution and the devastating earthquake of April 2015. Aggregates from different quarry sites should meet the physical requirements prescribed by the Indian Standard (IS), the Department of Urban Development and Building Construction (DUDBC), the National Building Code (NBC), the Nepal Standard (NS-297), the Standard Specifications for Road and Bridge Works (SSRBW). The perceptions of people from both sources; source 1, dissatisfaction with the sources, problems in the local community not addressed by the local government and management team were both responded to with support for the closure of the plant. The majority of respondents from source 2 were satisfied with the responses, having few complaints.

Modeling the principal success factors for attaining systemic circularity in the building construction industry: An international survey of circular economy experts

To achieve zero waste and cumber the acute environmental effect of the building construction industry (BCI), circular economy (CE) implementation is pertinent. Such implementation requires the incorporation of certain actionable factors that are critical to its success. However, investigating these factors considering the individualistic variations of developed and developing economies is rarely conducted in the literature. Therefore, this study evaluated the critical success factors (CSFs) for attaining systemic circularity in the BCI of both developed and developing economies. The methodological framework adopted comprises a literature review and a questionnaire survey of 140 CE experts across 39 developed and developing economies. The data collected was analyzed using exploratory factor analysis (EFA), rank agreement analysis (RAA), and fuzzy synthetic evaluation (FSE) techniques. The EFA analysis revealed four principal success factors (PSFs): data-driven digital tools and circularity plan, capacity building and pre-demolition auditing, systemic circularity guidelines and commitment, and circular metric and secondary market development. The RAA results showed that consensus and non-consensus exist between the two groups (developed and developing economies) on the PSFs. The FSE method revealed that all the PSFs are paramount in achieving a successful CE implementation in the two economies. However, the top two in developed economies are systemic circularity guidelines and commitment, and circular metric and secondary market development, while data-driven digital tools and circularity plans, and capacity building and demolition monitoring are the top two in developing economies. The RAA findings underscore the need to be context conscious while adopting the CSFs for CE implementation in the BCI. The FSE findings and the PSF models developed would guide the government and management teams in resource allocation during CE implementation. This study contributes to existing knowledge by providing essential insights into the CSFs that would promote systemic circularity attainment in the BCI of developed and developing economies.

AGRICULTURAL MARKET INFORMATION GOVERNANCE: A CAPABILITY-ORIENTED NATIONAL FRAMEWORK FOR BENIN REPUBLIC

Information technologies are improving the Agricultural Market Information delivery to the beneficiaries. The conceptualizationof the governance of disseminatedinformation, used by stakeholders to take important decisions, has become urgent.Therefore, the aim of this work is to design an Agricultural Market Information Governance Framework (AMIGov) focusing on governance capabilities of Benin.The designedcapability-oriented Agricultural MarketInformation Governance frameworkextends the existing Governance model of the Harmonized Information System ofAgricultural Markets of Benin. AMIGov is a three capability vertical layers framework with described practices to support each capability layer for achieving the Governance vision. The noveltyof AMIGovlies in the use of three main principles: (i) differentiation of governance and management functions and roles (ii) horizontal interactions between key stakeholders (co-governance of the Market Informationwith the involvement of the public and private sectors) (iii) compliance assessments at different levels across the country. Three key governance roles are suggested to improve the Governance practices: theNational Agricultural Market Information Leadership Group, the Information Governance Committee and the Information Governance Team. TheInformation Governance Team is theofficial operational workforce responsible for performance evaluation, and various compliance assessments(risk, regulatory, deployment, information quality).This team controls the actions of the Information Managerson the basis of predefined criteria and Service level Agreement, and reports to the Governance committee. The proposed framework can be recommended for use in the countries with a low level of digital organizational culture or where the MarketInformation Governance is not standardized.

The Amazing Mechanism of the Standing for 700years of the Tall Masonry Stone Tower of 32m in height on Manmade Sandy High Mound by Shallow Direct Foundation, Bayon Temple, Angkor, Cambodia

Soils and foundation of Bayon temple of Angkor Thom has been studied since 1994 by Japanese Government Team for Safeguarding Angkor (JSA). The main tower of Bayon of 32m in height from the base foundation mound consists of manmade fill of 14 m in thickness. The foundation was studied and found as a simple shallow direct foundation. This is just like a 10 story RC building standing upon thick manmade sand fill without such a deep foundation as piling. At present, such a structure based upon thick sandy fill shall lose the foundation stability in the dry season under the monsoon climate of South-eastern Asia. The amazing mechanism, standing for 700 years, has been identified as the unsaturated characteristics of well compacted silty sand.

Interplay between cyber supply chain risk management practices and cyber security performance

PurposeThis study aims to examine whether the cyber supply chain risk management (CSCRM) practices adopted by manufacturing firms contribute to achieving cyber supply chain (CSC) visibility. Studies have highlighted the necessity of having visibility across interconnected supply chains. Thus, this study examines the extent of CSCRM practices enabling CSC visibility to act as a mediator in achieving CSC performance.Design/methodology/approachA survey method was used to obtain data from the electrical and electronics manufacturing firms registered with the Federations of Malaysian Manufacturers directory. Data from 130 respondents were analysed using IBM SPSS and PLS-SEM.FindingsThis study empirically proves a dedicated governance team's integral role in setting the security tone within its CSC. The result also confirms the significant role that CSC visibility plays in achieving CSC performance. As theorised in the literature, there is also a strong direct relationship between CSC visibility and CSC performance, assuring manufacturing firms that investments and policies devised to improve CSC visibility are fruitful.Originality/valueThe significance of supply chain visibility in an integrated supply chain is recognised and studied using analytical models, behavioural techniques and case studies. Substantial empirical evidence on the CSCRM practices which contributes towards achieving supply chain visibility is still elusive. This study's major contribution lies in identifying CSCRM practices that can contribute towards achieving CSC visibility, and the mediating role CSC visibility plays in achieving CSC performance.

Improving adherence to and effectiveness of a vancomycin continuous infusion protocol, a pilot quality improvement project

Abstract Introduction Vancomycin treats serious Gram-positive infections such as methicillin-resistant Staphylococcus aureus. In St George’s University Hospital’s (SGH) intensive care unit (ICU) settings, vancomycin is administered by continuous infusion. Steady-state serum concentrations are measured daily with a 20-25 mg/L target. Non-therapeutic concentrations are associated with adverse drug reactions/prolonged length of stay.1 A SGH service-evaluation conducted across all three ICUs, revealed variable adherence to/effectiveness of its vancomycin prescribing/administration/monitoring protocol.2 Consequently, multifaceted interventions were devised using the Institute-for-Healthcare-Improvement’s model Plan-Do-Study-Act (PDSA) cycles and piloted on General ICU (GICU). Aim (1) To improve adherence to/effectiveness of the vancomycin protocol. (2) To ascertain administration accuracy of paper-fluid-balance-charts compared to the electronic-prescribing-and-medicines-administration (ePMA) system to assist with identifying per protocol treated patients. Methods PDSA Cycle-1 was conducted over a 9-month period (09/2021-05/2021) in which a mix of system/person-focused interventions were implemented. Protocol dosing2 was revised, introducing a >90kg patient 2g loading dose, renal-function category revision and increased maintenance dose for creatinine clearance (CLCR) >90ml/min. Protocol accessibility was increased via integration into an ePMA prescribing interface, plus CliniBee/Microguide apps. Educational slides on relevant protocol aspects were incorporated into medical/nursing induction training. Data relating to vancomycin prescribing/administration/monitoring for all non-renal replacement patients was extracted retrospectively from the ePMA system between 09/2021-05/2022. This data was compared to baseline GICU data (07/2020-07/2021).2 The project and associated interventions were approved by Trust Clinical Governance and Audit Teams. Data was collected by pharmacists directly involved in patient’s care and stored/analysed on the Trust’s secure server in line with Data Protection Act principles. Due to local generalisability, ethics approval wasn’t required. Results Compared to baseline, the proportion of patients receiving per protocol prescribing/administration of loading/maintenance doses with daily monitoring, nearly doubled (39% (7/18) to 68% (15/22)). 48-hour vancomycin serum concentrations in all patients increased therapeutically by 21% (3/9 to 7/13). In per protocol treated patients, concentrations increased 15% (2/7 to 4/9) therapeutically, decreased 21% (3/7 to 2/9) supra-therapeutically and increased 4% (2/7 to 3/9) sub-therapeutically. Supra-therapeutic concentrations were associated with CLCR<50ml/min. Sub-therapeutic concentrations were associated with CLCR>90ml/min and obesity. Compared to the ePMA system, there was 36% (8/22) less paper-fluid-balance-charts recording both loading/maintenance doses. Maintenance dose administration times in 9% (2/22) of cases differed by >60 minutes. Discussion/Conclusion Staff-turnover periods were associated with decreased protocol compliance. Observations suggest further education is required around prescribing/administration of standardised infusion bags for maintenance dosing. Pharmacist integration into daily Microbiology ward rounds may increase protocol compliance. Higher 20mg/kg loading doses for obese patients and maintenance dose revision should be considered to reduce non-therapeutic concentrations.3 Limitations include heterogenous/small sample sizes due to data paucity and vancomycin requirement. This can be addressed by involving all ICU’s in PDSA Cycle-2. Due to disparities, both the ePMA system and paper-fluid-balance-charts should be used to identify protocol adherence. Utilisation of digital-infusion-pump data to quantify administration accuracy may offer a promising solution. Piloted multifaceted interventions were successful at improving adherence to/effectiveness of the vancomycin protocol. Findings have informed further interventions and data capture methods for PDSA Cycle-2 implementation across all ICUs.

Do corporate governance and top management team diversity have a financial impact among financial sector? A further analysis

Do corporate governance and top management team diversity have a financial impact among financial sector? A further analysis

Exploring the links between the use of NbS, mindshifts and transformative urban coalitions to promote climate resilience within an ongoing reurbanization process. The case of Villa 20, Buenos Aires

In recent decades, informal settlement upgrading and housing deficit in Latin America has been addressed through a variety of urban programs, usually structured around physical-spatial and social actions with an emphasis on the provision of basic infrastructure and services, improved accessibility and connectivity and new housing, mostly done by conventional means. In general, they fail to incorporate new frameworks that provide solutions with strong environmental roots, such as Nature-based Solutions (NbS), Blue-Green Infrastructure (BGI) or Ecosystem-based Adaptation (EbA). This article explores the potentiality of NbS/BGI in contributing to solve structural problems in marginal urban areas, the mindshifts and actor coalitions needed to support this and how it may promote equity and justice. This is analyzed in a particular setting: Villa 20, an informal settlement in the City of Buenos Aires that is undergoing a participatory urban upgrading process with a strong participatory platform made up of multiple spaces and devices for consensual decision-making on re-urbanization aspects. In Villa 20, several interrelated projects and programs are focusing on sustainability. In particular, the Transformative Urban Coalitions (TUC) of the International Climate Initiative (IKI) is connecting decarbonization with urban inequalities and urban justice. The article reflects on some of the initial outcomes of the TUC program that builds upon the ongoing participatory upgrading process. To discuss the links between the use of NbS, mindshifts and transformative urban coalitions we look into the social setting, methods and tools that promote mindset shift. We explore initial mindset changes in government teams; community leaders; and participants of an Urban Lab and the building up of a new transformative actor coalition. With this, we aim to better understand the possibilities and potential implications of implementing NbS in marginalized social contexts, contributing both to closing the knowledge gap and re-thinking future policies and programs.

Factors associated with instrumental support in transitional care among older people with chronic disease: a cross-sectional study

BackgroundInstrumental support, which is defined as practical, tangible, and informational assistance extended to patients, is crucial for older people in transition. However, little is known about instrumental support in transitional care. Thus, the aim of this study was to evaluate the instrumental support of older people in transitional care.MethodsThis cross-sectional study was conducted using the Questionnaire of Instrumental Support in Transitional Care (QISCT) to collect data from 747 older people in China from September to November 2020. Survey items consisted of a sociodemographic characteristics questionnaire and the QISCT. Multiple regression analyses were conducted to examine the association between independent variables and the QISCT scores.ResultsThe total score of the QISCT was 39.43 (± 9.11), and there was a significant gap between the anticipated support and received support. The satisfaction of instrumental support was low. Multiple regression analyses showed that educational level, the number of intimate relationships, monthly family income, monthly costs of transitional care, diabetes, and chronic obstructive pulmonary disease were associated with instrumental support in transitional care.ConclusionsTo cope with the burden caused by chronic disease, the government and transitional care teams should establish a demand-oriented transitional care service model and pay more attention to helping older people obtain adequate and satisfactory instrumental support.

Ground Up Inquiry: Questions and Answers About the Emergence and Development of a Northern Australian Tradition of Situated Research

Ground Up Inquiry is the name of a situated approach to researching used by the Contemporary Indigenous Knowledge and Governance (CIKG) team in CDU’s Northern Institute (Charles Darwin University, 2017a). The team partners with Indigenous researchers working under the authority of Elders in their home places. Many of our partner researchers offer research services through Indigenous Researchers Initiative (Charles Darwin University, 2017b). In the Northern Territory of Australia, Ground Up is often contract research and service delivery, but it is also increasingly recognised as an established research method where Indigenous and academic knowledge authorities work together as equals under the aegis of the modern university system. Composed as answers to questions, this paper revisits the origins of Ground Up, and gives an overview of this approach as situated research.

Understanding Thrombolysis: Improving Patient Care

<h3>Background Information</h3> Thrombolysis is a process used to break up abnormal blood flow in veins and arteries. Catheter-directed thrombolysis treats vascular blockages and improves blood flow by dissolving abnormal blood clots or by mechanically removing the clots using radiology imaging. Understanding the pathophysiology behind what is causing the thrombus in the patient is as important as managing the patient pre and post thrombolysis procedures. Catheter-directed thrombolysis is a minimally invasive endovascular treatment that is used as an adjunct to anticoagulation. This is a procedure that is performed in Interventional Radiology and the nurses that receive these patients need to understand how to manage them. These patients are often critical and need personalized care and close attention. <h3>Objectives of Project</h3> The purpose of this project is to educate nurses in Interventional Radiology (IR), Intensive Care Units (ICU), and other departments about the pathophysiology of the thrombolysis procedure, along with the preparation, management, and post-procedure care of patients undergoing thrombolysis. <h3>Process of Implementation</h3> The IR shared governance team recognized a gap in knowledge regarding Thrombolysis procedures and the care of patients post-procedure. Current evidence was reviewed and an educational Power Point was created. All members of the IR shared governance team reviewed and offered feedback. The IR Director also reviewed the Power Point for content. Education will be uploaded to the health system's education platform. <h3>Statement of Successful Practice</h3> At the conclusion of the education, learners will be able to describe thrombolysis and how the procedure is performed, define deep vein thrombosis and pulmonary embolism and several methods of treatment for both, and explain the care and management of the patient undergoing Thrombolysis. <h3>Implications for Advancing the Practice of Perianesthesia Nursing</h3> Nurses caring for these patients need to understand what to manage and report back to the physician such as changes in mental status, acute headache, nausea/vomiting, and any neurovascular changes. RNs also need to understand appropriate dosages and rates of thrombolytic agents as ordered by the physician in order to properly care for the patient.

Segregation Practices by Health Workers in Urban Hospitals - A Step Necessary to Achieve Minimization and Effective Biomedical Waste Management

Effective segregation practice of biomedical waste is a critical process in hospital waste management and maintenance of a ‘risk-free’ health care environment. Failure to appropriately identify and isolate infectious from non-infectious wastes could lead to a myriad of health and biomedical waste management issues, which include high risk of cross-contamination, high risk of infection, difficulty in the assessment of waste generation, categorization, and composition of hospital waste. The aim of this study is to assess the segregation practice among health workers in selected hospitals in Abuja towards achieving effective waste management. A descriptive and cross-sectional study was conducted among 430 participants from six hospitals in Abuja. Data were collected using a pretested, structured questionnaire and on-the-spot observation. Reliability analysis and descriptive statistics were employed for the analysis of data. Most of the respondents agreed to the segregation at the point of generation 366 (91.5%), majority of the respondents supported the use of color-coded bins for segregation. The Cronbach’s alpha α = 0.830, loading factor (0.601- 0.949) which indicates that the measuring tool was reliable and the items on the questionnaire showed co-relatedness and consistency. The study revealed that most of the respondents were sensitized and practiced the process of segregation. Although these practices were observed on the spot, they could later change thus, sustenance of these practices is expedient to maintain a lasting and workable waste management framework. Government and hospital waste management team to prioritize the segregation process through an adequate budget for supplies of segregation materials.

Prevalence of Induced Abortion and Contraceptive Use among University Students in a Tertiary Institution in Nigeria

Abortion can be defined as the termination of a pregnancy after, accompanied by, resulting in, or closely followed by the death of the embryo or fetus. The main point made by the majority of the definitions of abortion upholds the fact that pregnancy is not wanted. Throughout the world, female students are exposed to the risk of unplanned pregnancies as a result of ineffective or non-use of contraceptives. This may result in failure to complete their education, inability to maintain gainful employment, and inability to make independent marital decisions. Young students’ sexual activities are a communal, municipal, and public health concern. Objectives: The objective of this study was to determine the prevalence of induced abortion and contraceptive use amongst female undergraduate students of the University of Abuja. Methodology: The study was conducted at the University of Abuja in the Federal Capital Territory of Nigeria. A descriptive cross-sectional quantitative survey was used to assess the prevalence of induced abortion and contraceptive use amongst unmarried female undergraduate students, using a multistage sampling method. The sample size was calculated to be 289. The data was analyzed using Statistical Package for Social Sciences (SPSS) version 23, p-value of &lt;0.05 was considered statistically significant at a 95% confidence level. Results: A total of 325 questionnaires were shared and 318 were filled and adequately answered, giving a response rate of 97.8%. The mean age in this study was 21.8 ± 3.01 standard deviation. There was a prevalence of contraceptive use amongst the respondents in which more than half (165; 51.9%) of the respondents have practiced contraception at one point or the other in their reproductive years while 163 (48.1%) of the respondents said they did not practice any form of contraception. 90 (28.3%) of the respondents have had induced abortion at one point or the other while the remaining 228 (71.7%) have not. The majority (87; 52.7%) of the respondents who practice contraception have also had an induced abortion at one point or the other while about 78 (47.3%) of those who practice contraceptive use had no history of induced abortion. Conclusion: Remarkably, and in contrast to conventional understanding, these results showed that less contraception does not appear to be associated with a higher incidence of abortion. Similarly, more contraception does not appear to be protective against incurring a pregnancy. Recommendation: There should be frequent awareness campaigns and health education on the knowledge, attitude, and practice of contraception by the Students Union Government, school media and publicity team, and non-governmental and charitable organizations targeted on effective contraceptive practice as a means of preventing unintended pregnancies.