Aims and Objectives
To establish consensus on items to be included in an instrument to measure person‐centred teamwork in a hospital setting. The objective was to identify the items through a ...methodological literature review. Refine the items and obtain consensus on the items.
Background
A definition and related attributes of person‐centred teamwork have been agreed upon. An instrument is needed to measure and monitor person‐centred teamwork in hospital settings.
Design
Consensus, electronic Delphi design.
Methods
Items were identified through a methodological literature review. These items were included in three electronic Delphi rounds. Using purposive and snowball sampling, 16 international experts on person‐centred care, teamwork and/or instrument development were invited to participate in three electronic Delphi rounds via Google Forms. Descriptive statistics were used to demonstrate their agreement on the relevance and clarity of each item. Items were included if consensus was 0.75. Content analysis was used to analyse written feedback from experts.
Results
The response rate was 56% (n = 9/16). Nine experts participated over an 8‐week period to reach consensus on the items to be included in an instrument to measure person‐centred teamwork in hospital settings. The experts' responses and suggestions for rephrasing, removing and adding items were incorporated into each round.
Conclusion
A Delphi consensus exercise was completed, and experts reached agreement on 38 items to be included in an instrument that can be used to evaluate person‐centred teamwork in hospital settings.
Relevance to clinical practice
We engaged with nine international experts in the academic and clinical field of person‐centeredness, teamwork and/or instrument development. An online platform was used to allow the experts to give input into the study. The experts engaged from their own environment with full autonomy and anonymity. Person‐centred teamwork, aimed at improving practice is now measurable. Person‐centred teams improve outcomes of patients. Person‐centred teamwork was specifically developed to assist low compliance areas in hospitals.
Effective health care relies on person-centeredness and teamwork, which are known to improve outcomes. These two concepts have been defined individually, but we could not find a definition of the ...combined concept. A preliminary definition was developed through a concept analysis; however, consensus on the concept has not been reached.
The aim of this study was to reach consensus on the definition and attributes of person-centered teamwork.
A consensus design allowed experts to collaborate and share their experience and wisdom to refine and reach consensus on the definition and attributes of person-centered teamwork. An e-Delphi was used to engage the experts.
Three rounds of online engagement with 12 experts were needed to reach consensus on the definition and attributes of person-centered teamwork. The attributes reached consensus of 82% after the first round. The definition had 82% consensus after the three rounds. The definition had been adjusted and refined according to the expert input. The newly adjusted definition was established.
We successfully used the e-Delphi method to obtain consensus on the attributes and definition of person-centered teamwork. The definition of person-centered teamwork can be further developed and included in clinical practice to guide improved clinical outcomes. The consensus definition of person-centered teamwork provides a clear understanding of the meaning thereof, which may in turn enrich the usability thereof in clinical practice. Person-centered teams improve outcomes for persons receiving care in hospitals. Building person-centered teams are now better understood and the foundation of building these teams defined. We engaged with 12 experts in the academic and clinical field of person-centeredness and teamwork. The use and value of the Delphi method to obtain consensus is now better understood and can assist future research development.
M.Com. (Business Management)
Background Best cost country sourcing is a relatively new concept and not many organisations are utilising this specific process nor are they optimising this as their ...sourcing strategy. Best cost country sourcing is one of the most profound sourcing processes available, and it has the ability to increase an organisation’s efficiency and effectiveness if implemented correctly. Purpose The purpose of this study is to determine if best cost country sourcing should be used as an alternative to local sourcing. It includes aspects of the best cost country sourcing process as well as its risks and advantages. Research method The dissertation analyses the process of best cost country sourcing and the effect it has on an organisation’s sourcing strategy. To achieve this understanding it is necessary to do a qualitative investigation, which is the reason a qualitative research was used as the research methodology in this dissertation. Conclusion Pursuing the process of best cost country sourcing requires a lot of dedication and implementation time. It is a complicated process and no two situations will be alike. Each organisation would need to determine the advantages, risks and challenges which they will encounter with best cost country sourcing. Organisations would also need to determine the best cost countries, as well as the criteria they would need to use in selecting potential suppliers.
BackgroundBest cost country sourcing is a relatively new concept and not many organisations are utilising this specific process nor are they optimising this as their sourcing strategy. Best cost ...country sourcing is one of the most profound sourcing processes available, and it has the ability to increase an organisation’s efficiency and effectiveness if implemented correctly.PurposeThe purpose of this study is to determine if best cost country sourcing should be used as an alternative to local sourcing. It includes aspects of the best cost country sourcing process as well as its risks and advantages.Research methodThe dissertation analyses the process of best cost country sourcing and the effect it has on an organisation’s sourcing strategy. To achieve this understanding it is necessary to do a qualitative investigation, which is the reason a qualitative research was used as the research methodology in this dissertation.ConclusionPursuing the process of best cost country sourcing requires a lot of dedication and implementation time. It is a complicated process and no two situations will be alike. Each organisation would need to determine the advantages, risks and challenges which they will encounter with best cost country sourcing. Organisations would also need to determine the best cost countries, as well as the criteria they would need to use in selecting potential suppliers.
A research report submitted to the;
Faculty of Health Sciences, University of the Witwatersrand, Johannesburg,;
in partial fulfilment of the requirements for the degree;
of;
Master of Science in ...Nursing;
Johannesburg, 2014
The preceptorship model is widely used in both undergraduate and postgraduate nursing education. Primarily, preceptors engage in preceptorship to share knowledge, obtain recognition and achieve job satisfaction. However, the same preceptors are facilitating integration of newly hired staff in Intensive Care settings and these experiences are relatively unknown. Preceptors are highly qualified and valued staff, who undertake this role in addition to their nursing responsibilities and the risk of burnout exists if asked to assume additional obligations without appropriate rewards and support. Consequently, needs and expectations necessitate understanding so that preceptors, preceptees and clinical facilities may benefit from such programmes.;
Purpose. The purpose of the study was to examine the relationships amongst preceptors’ perceptions of benefits, rewards, supports and commitment to the preceptor role.;
Method. A non-experimental, descriptive, correlational and quantitative survey design and a non-probability purposive sampling method were applied and used in this study. The setting for the research is the Intensive Care Units (n=13) of four major academic hospitals, including public and private sector, in Gauteng Province. The sample comprised of 80 (n=80) Intensive Care registered nurses, employed throughout the Intensive Care Units (n=13). Data was collected by means of a self-administered questionnaire (Dibert & Goldenberg, 1995) and participants were asked to rate all the items independently on a 4-point Likert scale.;
Findings. Data analysis determined the incidence of preceptor’s perceptions of the benefits, rewards, support and commitment to the preceptor role. Preceptors perceive there are benefits for the preceptor in preceptorship. The commitment of preceptors, if;
rewarded and part of a beneficial goal, was seen with a positive response. The study indicated that if preceptors perceive there to be support for their role, their commitment to the role of preceptorship increases. Years of experience, age and gender had no significant role in the preceptor commitment.;
Conclusion. Preceptors are committed to their role. It is the responsibility of the nursing education, health care institutions and nursing practice to provide benefit, rewards and support to sustain this role. Research in qualitative and quantitative studies on preceptorship is needed on this topic.
Osteoarthritis is a disease characterized by an increase in the production of reactive oxygen species (ROS) in afflicted joints. Excess iron, due to its role in the production of ROS and crystal ...deposition in the joints, is implicated in the disease progression of osteoarthritis. Ferritin is a major regulator of the bioavailability of iron, and its functions are determined largely by the combination of H- and L-subunits present in its outer protein shell. The purpose of the study was to investigate the expression of the H- and L-subunits of ferritin in bone marrow macrophages of osteoarthritis patients. The cytokine profiles were assessed as cytokines play an important role in the expression of the ferritin subunits. The H-subunit of ferritin in the bone marrow macrophages was significantly higher (P value = 0.035) in the osteoarthritis patients compared with the controls (107.84; 69.25-167.94 counts/μm(2); n = 7 versus 71.07; 58.56-86.26 counts/μm(2); n = 19). A marginally significant increase (P value = 0.059) was shown for the expression of the L-subunit in the osteoarthritis patients compared with the controls (133.03; 104.04-170.10 counts/μm(2); n = 7 versus 104.23; 91.53-118.70 counts/μm(2); n = 19). The osteoarthritis and control groups had comparable C-reactive protein, as well as proinflammatory and anti-inflammatory cytokine concentrations. The major exception was for transforming growth factor-β (TGF-β), which was higher (P value = 0.014) in the plasma of the osteoarthritis patients (16.69; 13.09-21.28 ng/mL; n = 7 versus 8.60; 6.34-11.67 ng/mL; n = 19). Up-regulation of the ferritin subunits decreases the levels of bioavailable iron and provides protection against the unwarranted production of ROS and crystal deposition. A role for TGF-β in the up-regulation of the expression of the H-subunit, and possibly the L-subunit, of ferritin is postulated in osteoarthritis.
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