Objectives To explore the challenges of secondary use of routinely collected data for analyzing nursing-sensitive outcomes in Austrian acute care hospitals.Method A convergent parallel mixed methods design was perform...Objectives To explore the challenges of secondary use of routinely collected data for analyzing nursing-sensitive outcomes in Austrian acute care hospitals.Method A convergent parallel mixed methods design was performed.We conducted a quantitative representative survey with nursing managers from 32 Austrian general acute care hospitals and 11 qualitative semi-structured interviews with nursing quality management experts.Both results were first analyzed independently and afterward merged in the discussion.Results On average,76%of nursing documentation is already electronically supported in the surveyed Austrian hospitals.However,existing nursing data is seldom used for secondary purposes such as nursing-sensitive outcome analyses.This is due to four major reasons:First,hospitals often do not have a data strategy for the secondary use of routine data.Second,hospitals partly lack the use of standardized and uniform nursing terminologies,especially for nursing evaluation.Third,routine nursing data is often not documented correctly and completely.Fourth,data on nursing-sensitive outcomes is usually collected in specific documentation forms not integrated into routine documentation.Conclusion The awareness of the possibilities for secondary use of nursing data for nursing-sensitive outcome analyses in Austrian hospitals is still in its infancy.Therefore,nursing staff and nursing management must be trained to understand how to collect and process nursing data for nursing-sensitive outcome analyses.Further studies would be interesting in order to determine the factors that influence the decision-making processes for the secondary use of nursing data for outcome analyses.展开更多
The Elekta Precise medical Linac is a typical modern high energy accelerator which uses advanced digital technology and gets acknowledged around the world. It provides both X rays and electrons at various megavoltage ...The Elekta Precise medical Linac is a typical modern high energy accelerator which uses advanced digital technology and gets acknowledged around the world. It provides both X rays and electrons at various megavoltage energies including two photon energies (6 and 15 MV) and several electron energies (e.g. 6, 9, 12, 15, 18 and 22 MeV). The commonly used dose rate for X rays is 500 MU/min, while that for electors is 400 MU/min. The accelerator is equipped with beam intensity modulation cm2. The width of MLC at 40 pairs of MLC for photon covering fields up to 40 × 40 the isocenter is 10 mm. The maximum leakage is less than 0.3%展开更多
The quality standard ISO 9001 helps and enables organizations, regardless of the sector where they exist, to implement the quality management properly. Recent years have attracted attention to the possibilities of imp...The quality standard ISO 9001 helps and enables organizations, regardless of the sector where they exist, to implement the quality management properly. Recent years have attracted attention to the possibilities of implementing this standard in the health sector and the economic viability of that long-term investment. Health care organizations are recognizing the value system that combines all the criteria for managing quality, including management of business, compliance and management of procedural steps, and most importantly, the total quality management. In general, the implementation of ISO 9001:2008 standard for quality in health care institutions is seen as an opportunity to improve the quality of health care, and the entire process is to be completed by reducing costs and improving services in the sector. The implementation of a quality standard is directed towards patients, medical staff, and management in order to achieve reduction and complete relief from the pain, correct and professional services, conducted services with an appropriate skilled and professional care to obtain results that are comparable to known standards, and protection services with appropriate insurance policies, and the management expects the implementation of a quality system to justify and return their investments. The methods used in this paper are based on the quality standard ISO 9001:2008--Quality Management System and the Guidelines for Improving Performance, developed based on ISO 9004:2000: Quality Management System-43uidelines for Continuous Improvement. These guidelines contain a big part of the text in ISO 9004:2000, but they are supplemented with specific guidelines for their implementation in the health sector. The implementation of the system and monitoring guidelines evidently contributes to the overall resolution and closure of problems in over 50% of cases. This not only results in saving money for the institution, but it also globally leads to reduced variations in the healing process. Expected benefits from implementing the system in the health care sector in the Republic of Macedonia relate to providing a substantial foundation for obtaining all the necessary facilities and reduction of the costs by reducing the inappropriate staff in exactly determined departments. Implementation of future accreditation processes can be accomplished in a much shorter period of time, especially when there is good communication and cooperation among the departments. Improved working systems, processes, and final results inevitably contribute to happy and healthy patients.展开更多
文摘Objectives To explore the challenges of secondary use of routinely collected data for analyzing nursing-sensitive outcomes in Austrian acute care hospitals.Method A convergent parallel mixed methods design was performed.We conducted a quantitative representative survey with nursing managers from 32 Austrian general acute care hospitals and 11 qualitative semi-structured interviews with nursing quality management experts.Both results were first analyzed independently and afterward merged in the discussion.Results On average,76%of nursing documentation is already electronically supported in the surveyed Austrian hospitals.However,existing nursing data is seldom used for secondary purposes such as nursing-sensitive outcome analyses.This is due to four major reasons:First,hospitals often do not have a data strategy for the secondary use of routine data.Second,hospitals partly lack the use of standardized and uniform nursing terminologies,especially for nursing evaluation.Third,routine nursing data is often not documented correctly and completely.Fourth,data on nursing-sensitive outcomes is usually collected in specific documentation forms not integrated into routine documentation.Conclusion The awareness of the possibilities for secondary use of nursing data for nursing-sensitive outcome analyses in Austrian hospitals is still in its infancy.Therefore,nursing staff and nursing management must be trained to understand how to collect and process nursing data for nursing-sensitive outcome analyses.Further studies would be interesting in order to determine the factors that influence the decision-making processes for the secondary use of nursing data for outcome analyses.
文摘The Elekta Precise medical Linac is a typical modern high energy accelerator which uses advanced digital technology and gets acknowledged around the world. It provides both X rays and electrons at various megavoltage energies including two photon energies (6 and 15 MV) and several electron energies (e.g. 6, 9, 12, 15, 18 and 22 MeV). The commonly used dose rate for X rays is 500 MU/min, while that for electors is 400 MU/min. The accelerator is equipped with beam intensity modulation cm2. The width of MLC at 40 pairs of MLC for photon covering fields up to 40 × 40 the isocenter is 10 mm. The maximum leakage is less than 0.3%
文摘The quality standard ISO 9001 helps and enables organizations, regardless of the sector where they exist, to implement the quality management properly. Recent years have attracted attention to the possibilities of implementing this standard in the health sector and the economic viability of that long-term investment. Health care organizations are recognizing the value system that combines all the criteria for managing quality, including management of business, compliance and management of procedural steps, and most importantly, the total quality management. In general, the implementation of ISO 9001:2008 standard for quality in health care institutions is seen as an opportunity to improve the quality of health care, and the entire process is to be completed by reducing costs and improving services in the sector. The implementation of a quality standard is directed towards patients, medical staff, and management in order to achieve reduction and complete relief from the pain, correct and professional services, conducted services with an appropriate skilled and professional care to obtain results that are comparable to known standards, and protection services with appropriate insurance policies, and the management expects the implementation of a quality system to justify and return their investments. The methods used in this paper are based on the quality standard ISO 9001:2008--Quality Management System and the Guidelines for Improving Performance, developed based on ISO 9004:2000: Quality Management System-43uidelines for Continuous Improvement. These guidelines contain a big part of the text in ISO 9004:2000, but they are supplemented with specific guidelines for their implementation in the health sector. The implementation of the system and monitoring guidelines evidently contributes to the overall resolution and closure of problems in over 50% of cases. This not only results in saving money for the institution, but it also globally leads to reduced variations in the healing process. Expected benefits from implementing the system in the health care sector in the Republic of Macedonia relate to providing a substantial foundation for obtaining all the necessary facilities and reduction of the costs by reducing the inappropriate staff in exactly determined departments. Implementation of future accreditation processes can be accomplished in a much shorter period of time, especially when there is good communication and cooperation among the departments. Improved working systems, processes, and final results inevitably contribute to happy and healthy patients.