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1
Makin, Thomas. "Legionellae and the hospital environment". Thesis, University of Liverpool, 1995. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.261833.
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This thesis investigates the distribution of legionellae in water systems in the Royal Liverpool University Hospital (RLUH) and examines some of the factors that affect colonisation by these organisms. The effect of persistent contamination of the domestic water system on immunocompromised patients was monitored, and the envirorunental control of legionellae by various methods was assessed. A fluorescent monoclonal antibody (DFA) was evaluated for its ability to detect L. pneumophila in domestic and cooling water, and was highly sensitive and specific for this purpose. DFA detected non-culturable L. pneumophila in the cold water system (CWS) that were not recovered following heat shock procedures. Legionellae were not isolated from air conditioning humidifiers, and were rarely detected in cooling towers despite treatment with inadequate concentrations of biocide. A high pH assisted in preventing legionella colonisation. Calorifier sediment contained legionellae and high levels of insoluble copper oxides. Culture media and a low pH, released Cuions from sediment which were markedly inhibitory to legionellae. Low concentrations of Cuions were detected in domestic hot water. At temperatures below 60°C legionellae were detected in the hot water supply to the wards, and calorifiers were regularly re-seeded by legionellae returning from contaminated peripheral parts of the system. Legionellae were not detected in the HWS when 60°C was achieved. L. pneumophila sgps 6, 12 and L. bozemanii predominated in domestic water. L. pneumophila sgp 1 was detected on one occasion only in a cold water storage tank and a calorifier, and did not colonise any of the water systems. L. pneumophila sgps 6 and 12 were isolated from three nosocomial cases of Legionnaires' disease. Endemic legionellae prepared as yolk sac antigens, detected significant titres of legionella antibodies (~ 1 :64) in samples from six subjects which did not react ( < 1: 16) with the PHLS L. pneumophUa sgp 1 yolk sac antigen. Most raised titres were to L. pneumophila sgp 12, and the highest titre in heterologous responses identified the infecting serogroup of L. pneumophila. Routine culture of respiratory samples from susceptible patients. detected only one undiagnosed case of Legionnaires' disease. Legionellae were not detected in water from showers that were regularly flushed or irradiated with UV light. Re-colonisation of showers by legionellae was closely associated with the reappearance of amoebae. A trace heating element was effective at maintaining dead-legs at 50°C (± 1.5) and reduced legionellae in these sites. Legionellae proliferated where pipes and heating element were not adequately insulated. Re-circulating the HWS through dead-legs eradicated legionellae from this site but resulted in heavy colonisation of adjacent mixer valves. Automatic drain valves failed to prevent legionellae from colonising shower hoses and mixer valves, and hyperchlorination of shower hoses and water strainers had only a short term effect. Showers heated electrically at point of use were not colonised by legionellae entering in the CWS, or by wild strains of legionellae introduced with calorifier sediment. This appeared to be due to rapid throughput of water, extensive use of copper, and pasteurisation of calorifier contents following discharge of heat from the heating elements, after the shower ceased operating.
2
Radant, Kimberly Lynn Belec. "PATIENT-STAFF PERCEPTIONS OF A REAL AND IDEAL WARD TREATMENT ENVIRONMENT". Thesis, The University of Arizona, 1985. http://hdl.handle.net/10150/275271.
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Bishop, Katherine G. "From their perspectives: Children and young people's experience of a paediatric hospital environment and its relationship to their feeling of well-being". Thesis, The University of Sydney, 2008. http://hdl.handle.net/2123/3962.
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This study was conducted to increase our understanding of children and young people’s experience of a hospital environment and to identify the salient attributes of the physical environment in their experience. There were three specific aims: to describe children and young people’s experience of a hospital environment and identify what constitutes a supportive paediatric environment; to examine the role of the physical environment in patients’ feeling of well-being; and to highlight the capacity of participatory research with children and young people to inform evidence-based paediatric design. At this stage, there has been very little healthcare design research carried out with populations of children and young people. Well-being research with children and young people in paediatric environments that identifies the potential supportive attributes in this environment is also very limited. Historically research on children’s health and well-being has been dominated by a focus on the prevalence of disorders, problems and disabilities. More recently, in response to the change to health promotion, positive attributes have been included in well-being and satisfaction measures. At this stage, there are still many fewer positive measures. Within the body of literature that exists in healthcare, healthcare design research, and well-being research, there are only a small number of participatory studies that focus on children and young people’s experience of hospitalisation, and an even smaller number that include children and young people’s experience of hospital environments. The picture that is created by the research that exists is patchy. There is a need for a more holistic understanding of children and young people’s experience of hospitalisation and of hospital environments from their own perspectives. Based on these gaps in current knowledge, two research questions were developed. The first was concerned with describing children and young people’s experience of the sociophysical environment of a paediatric hospital. The second question was concerned with understanding the role of the physical environment in children and young people’s feeling of well-being in a hospital environment. In addressing these questions, the intention was to identify attributes within the hospital setting which collectively comprise a supportive environment for children and young people and which contribute to children and young people’s feeling of well-being in a paediatric setting. The current study was conducted as an exploratory qualitative case study and carried out at the Children’s Hospital at Westmead, in Sydney, Australia. Using participatory research techniques, the sequence of the study included two pilot studies and the main study. The focus was on understanding the experiences of longer-term patients of a paediatric hospital environment. In the main study 25 children and young people, aged between 9-18 years, who had been in hospital for at least a week completed semi-structured interviews in which they talked about their response to the environment of the hospital and their experience of hospitalisation. Data analysis was completed using a combination of concept mapping and thematic analysis techniques. Preliminary findings were used as the basis of a further member-checking task carried out with a further six children and young people before conclusions were reached. The findings reveal that children and young people’s experience of a paediatric setting involves a number of major areas of influence including their personal situation, their social experience, their interaction with the physical environment, opportunities and characteristics of the organisation, and the effect of time. The findings also reveal that children’s feeling of well-being within this experience is linked to their ability to feel comfortable in the environment, to maintain a positive state of mind, and to remain positively engaged with the experience and the environment. This research reveals a dynamic relationship between children and young people and a paediatric environment that children and young people actively manage and shape. It reveals some of the key considerations in children and young people’s experience of hospitalisation. It also reveals why these considerations are important and what role they play in patients’ experience and feeling of well-being. These findings provide the basis for further research and they have implications for future design and research practice in paediatric healthcare settings.
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Bishop, Katherine G. "From their perspectives children and young people's experience of a paediatric hospital environment and its relationship to their feeling of well-being /". University of Sydney, 2008. http://hdl.handle.net/2123/3962.
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Doctor of Philosophy (PhD)This study was conducted to increase our understanding of children and young people’s experience of a hospital environment and to identify the salient attributes of the physical environment in their experience. There were three specific aims: to describe children and young people’s experience of a hospital environment and identify what constitutes a supportive paediatric environment; to examine the role of the physical environment in patients’ feeling of well-being; and to highlight the capacity of participatory research with children and young people to inform evidence-based paediatric design. At this stage, there has been very little healthcare design research carried out with populations of children and young people. Well-being research with children and young people in paediatric environments that identifies the potential supportive attributes in this environment is also very limited. Historically research on children’s health and well-being has been dominated by a focus on the prevalence of disorders, problems and disabilities. More recently, in response to the change to health promotion, positive attributes have been included in well-being and satisfaction measures. At this stage, there are still many fewer positive measures. Within the body of literature that exists in healthcare, healthcare design research, and well-being research, there are only a small number of participatory studies that focus on children and young people’s experience of hospitalisation, and an even smaller number that include children and young people’s experience of hospital environments. The picture that is created by the research that exists is patchy. There is a need for a more holistic understanding of children and young people’s experience of hospitalisation and of hospital environments from their own perspectives. Based on these gaps in current knowledge, two research questions were developed. The first was concerned with describing children and young people’s experience of the sociophysical environment of a paediatric hospital. The second question was concerned with understanding the role of the physical environment in children and young people’s feeling of well-being in a hospital environment. In addressing these questions, the intention was to identify attributes within the hospital setting which collectively comprise a supportive environment for children and young people and which contribute to children and young people’s feeling of well-being in a paediatric setting. The current study was conducted as an exploratory qualitative case study and carried out at the Children’s Hospital at Westmead, in Sydney, Australia. Using participatory research techniques, the sequence of the study included two pilot studies and the main study. The focus was on understanding the experiences of longer-term patients of a paediatric hospital environment. In the main study 25 children and young people, aged between 9-18 years, who had been in hospital for at least a week completed semi-structured interviews in which they talked about their response to the environment of the hospital and their experience of hospitalisation. Data analysis was completed using a combination of concept mapping and thematic analysis techniques. Preliminary findings were used as the basis of a further member-checking task carried out with a further six children and young people before conclusions were reached. The findings reveal that children and young people’s experience of a paediatric setting involves a number of major areas of influence including their personal situation, their social experience, their interaction with the physical environment, opportunities and characteristics of the organisation, and the effect of time. The findings also reveal that children’s feeling of well-being within this experience is linked to their ability to feel comfortable in the environment, to maintain a positive state of mind, and to remain positively engaged with the experience and the environment. This research reveals a dynamic relationship between children and young people and a paediatric environment that children and young people actively manage and shape. It reveals some of the key considerations in children and young people’s experience of hospitalisation. It also reveals why these considerations are important and what role they play in patients’ experience and feeling of well-being. These findings provide the basis for further research and they have implications for future design and research practice in paediatric healthcare settings.
5
London, Nancy Hubertina Hendrikus Joyce. "Antibiotic resistance in the non-hospital environment". Maastricht : Maastricht : Rijksuniversiteit Limburg ; University Library, Maastricht University [Host], 1995. http://arno.unimaas.nl/show.cgi?fid=6645.
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Choi, Young-Seon. "The physical environment and patient safety: an investigation of physical environmental factors associated with patient falls". Diss., Georgia Institute of Technology, 2011. http://hdl.handle.net/1853/45974.
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Patient falls are the most commonly reported "adverse events" in hospitals, according to studies conducted in the U.S. and elsewhere. The rate of falls is not high (2.3 to 7 falls per 1,000 patient days), but about a third of falls result in injuries or even death, and these preventable events drive up the cost of healthcare and, clearly, are harmful outcomes for the patients involved. This study of a private hospital, Dublin Methodist Hospital, in Dublin, Ohio analyzes data about patient falls and the facility's floor plans and design features and makes direct connections between hospital design and patient falls. This particular hospital, which was relatively recently constructed, offered particular advantages in investigating unit-layout-related environmental factors because of the very uniform configuration of its rooms, which greatly narrowed down the variables under study.
This thesis investigated data about patients who had suffered falls as well as patients with similar characteristics (e.g., age, gender, and diagnosis) who did not suffer falls. This case-control study design helps limit differences between patients. Then patient data was correlated to the location of the fall and environmental characteristics of the locations, analyzed in terms of their layout and floor plan. A key part of this analysis was the development of tools to measure the visibility of the patient's head and body to nurses, the relative accessibility of the patient, the distance from the patient's room to the medication area, and the location of the bathroom in patient rooms (many falls apparently occur during travel to and from these areas).
From the analysis of all this data there emerged a snapshot of the specific rooms in the hospital being analyzed where there was an elevated risk of a patient falling. While this finding is useful for the administrators of that particular facility, the study also developed a number of generally applicable conclusions. The most striking conclusion was that, for a number of reasons, patients whose heads were not visible from caregivers working from their seats in nurses' stations and/or from corridors had a higher risk of falling, in part because staff were unable to intervene in situations where a fall appeared likely to occur. This was also the case with accessibility; patients less accessible within a unit had a higher risk of falling. The implications for hospital design are clear: design inpatient floors to maximize a visible access to patients (especially their heads) from seats in nurses' stations and corridors.
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Karnas, Diana Maria Girardi. "The psychology of the environment in children's health care setting : James Whitcomb Riley Hospital for Children - Cancer Unit". Virtual Press, 1992. http://liblink.bsu.edu/uhtbin/catkey/845987.
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Hospitals are constantly evolving to keep pace with the latest medical technologies. Whether it is a refurbishment of an existing facility or the addition of a new unit, the design process usually focuses on the technological requirements rather than the human elements of such an undertaking. The Riley Hospital for Children in Indianapolis presents an architectural opportunity to incorporate psychology of the environment into the design and construction of a new Cancer Unit. By balancing the technological requirements with the physical and psychological needs of the pediatric bone marrow transplant and hematology/oncology patients, one can create a healing environment more conducive to a rapid recovery.Department of Architecture
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Chan, Dominic S. "Assessing nursing students' perceptions of hospital learning environment". Thesis, Curtin University, 1999. http://hdl.handle.net/20.500.11937/2351.
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Nursing is essentially a practical discipline and as such, clinical practice plays an important part in the nursing curriculum. Clinical education is a vital component in the curricula of pre-registration nursing courses and provides student nurses with the opportunity to combine cognitive, psychomotor, and affective skills. Clinical field placement is an integral element in the overall pre-registration nursing program. Clinical practice enables the student to develop competencies in the application of knowledge, skills, and attitudes to clinical field situations. However, the time allocation for the clinical component of pre-registration nursing courses can be rather limited. It is, therefore, vital that the short but valuable clinical time be utilised effectively and productively.One of the objectives of this study was to develop and validate an instrument, the Clinical Learning Environment Inventory (CLEI), to assess nursing students' perceptions of hospital learning environment during clinical practice. Data were collected from 138 second year nursing students in a major university school of nursing in South Australia. Both quantitative and qualitative data were collected. The study confirmed the reliability and validity of the CLEI for use in the hospital learning environment.A second objective was to investigate associations of the CLEI with outcomes. Students' perceptions of the outcome of their clinical placement were found to be strongly associated with all five scales of the CLEI namely; Individualisation, Innovation, Involvement, Personalisation, and Task Orientation. The quantitative and qualitative findings reinforced each other. A third objective was to determine whether there were any differences in students' perceptions of the actual learning environment provided and that preferred by students. It was found that there were significant differences in students' perceptions of the actual clinical learning environment and their preferred clinical learning environment. Findings from the study suggested that students preferred a more positive and favourable clinical environment than they perceived as being actually present.
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Chan, Dominic S. "Assessing nursing students' perceptions of hospital learning environment". Curtin University of Technology, Science and Mathematics Education Centre, 1999. http://espace.library.curtin.edu.au:80/R/?func=dbin-jump-full&object_id=9844.
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Nursing is essentially a practical discipline and as such, clinical practice plays an important part in the nursing curriculum. Clinical education is a vital component in the curricula of pre-registration nursing courses and provides student nurses with the opportunity to combine cognitive, psychomotor, and affective skills. Clinical field placement is an integral element in the overall pre-registration nursing program. Clinical practice enables the student to develop competencies in the application of knowledge, skills, and attitudes to clinical field situations. However, the time allocation for the clinical component of pre-registration nursing courses can be rather limited. It is, therefore, vital that the short but valuable clinical time be utilised effectively and productively.One of the objectives of this study was to develop and validate an instrument, the Clinical Learning Environment Inventory (CLEI), to assess nursing students' perceptions of hospital learning environment during clinical practice. Data were collected from 138 second year nursing students in a major university school of nursing in South Australia. Both quantitative and qualitative data were collected. The study confirmed the reliability and validity of the CLEI for use in the hospital learning environment.A second objective was to investigate associations of the CLEI with outcomes. Students' perceptions of the outcome of their clinical placement were found to be strongly associated with all five scales of the CLEI namely; Individualisation, Innovation, Involvement, Personalisation, and Task Orientation. The quantitative and qualitative findings reinforced each other. A third objective was to determine whether there were any differences in students' perceptions of the actual learning environment provided and that preferred by students. It was found that there were significant differences in ++students' perceptions of the actual clinical learning environment and their preferred clinical learning environment. Findings from the study suggested that students preferred a more positive and favourable clinical environment than they perceived as being actually present.
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Sutton, Kathleen Rose Creagh, i res cand@acu edu au. "A Study of the Mater Children’s Hospital Tile Project". Australian Catholic University. School of Arts and Sciences, 2005. http://dlibrary.acu.edu.au/digitaltheses/public/adt-acuvp105.11092006.
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This thesis examined the relationship between children’s visual art and hospital contexts. It specifically focused on children’s art in the Tile Project within the Mater Children’s Hospital, Brisbane, Queensland, Australia. This ethnographic study consisted of interviews with the creators of the Tile Project as well as interviews and a survey with parents, staff, and children within the Mater Children’s Hospital. The interviews were informed by a review of literature in the areas of art in health settings. The study made observations of the community interacting with the tiles and collected images of the tiles used in the hospital and employed the framework of Bourdieu’s (1993) fields of cultural production and Abbs’s (1987) aesthetic field and dimensions, as well as the aesthetic dimensions of Beardsley (1982), Eisner (1985), and Csikszentmihalyi (1990). The study investigated the aesthetic characteristics of the tiles and their health outcomes in relation to the hospital community. This study is significant because the Mater Children’s Hospital Tile Project was a project that reflected art in healthcare settings involving Community Arts, art in design, and art in public buildings. The research identified the unique nature of the Tile Project which saw the hospital as a children’s space with artworks for children by children. The study reflected on the value of the tiles in having a healing and distracting quality for parents and children alike and that engagement with the tiles through touch, imagination, and playful games improved the atmosphere of the hospital.
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Sherman, Sandra Anne. "Healing effects of the built environment". Diss., Connect to a 24 p. preview or request complete full text in PDF format. Access restricted to UC campuses, 2008. http://wwwlib.umi.com/cr/ucsd/fullcit?p3321036.
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Thesis (Ph. D.)--University of California, San Diego and San Diego State University, 2008.Title from first page of PDF file (viewed Aug. 1, 2008). Available via ProQuest Digital Dissertations. Vita. Includes bibliographical references (p. 120-127).
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Malawski, Jeffrey Richard. "Satisfaction of interdisciplinary team members in a hospital based environment". Online version, 2000. http://www.uwstout.edu/lib/thesis/2000/2000malawskij.pdf.
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Pettersson, Tobias. "A Study of Production Planning in a Hospital Environment". Thesis, Högskolan i Borås, Institutionen Ingenjörshögskolan, 2011. http://urn.kb.se/resolve?urn=urn:nbn:se:hb:diva-20786.
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Nixon, Michal. "Burnout, work environment, and coping in surgical hospital nurses". Master's thesis, University of Cape Town, 1996. http://hdl.handle.net/11427/14059.
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Summary in English.Bibliography: leaves 145-152.
This study examined the extent of burnout (as conceptualized by Maslach and Jackson (1981): emotional exhaustion, depersonalization and diminished personal accomplishment) being experienced by nurses in a South African state hospital, and its associations with a range of work environment variables and the ways in which nurses generally cope with their stress. This exploratory study took the form of a cross-sectional, correlational field survey, in which both quantitative and qualitative data were collected from surgical hospital nurses by means of self-report questionnaires. Quantitative measures included were the Maslach Burnout Inventory (MBI; Maslach & Jackson, 1981), the Work Environment Scale (WES; Moos, 1986) and the Coping Orientations to Problems Experienced Scale (COPE; Carver, Scheier & Weintraub, 1989). Additional quantitative measures of personal control, support, sense of appreciation and job satisfaction were obtained from visual analogue rating scales. The qualitative data comprised a frequency analysis of themes evident in the content of subjects' written responses to four open-ended questions posed in the questionnaire. On each of the three burnout subscales, respondents' scores were categorized into low, moderate or high levels of burnout. Apart from correlational and ANOVA analyses, performed in order to examine relationships between variables and differences in terms of demographics, nursing categories, and nursing specialities, discriminant analyses were performed in order to identify those variables which were experienced differently by nurses reporting different levels of burnout. A number of significant predictors of burnout were identified. Of the work environment variables examined in the study, higher levels of work pressure, diminished physical comfort, and lack of peer cohesion predicted higher levels of emotional exhaustion. Lack of physical comfort and perceived lack of supervisor support were strongly associated with higher levels of depersonalization. Generally, lower levels of perceived autonomy and supervisor support were associated with a diminished sense of personal accomplishment. Regarding coping, frequent use of the problem-focused strategy of planning was found to be associated with lower levels of emotional exhaustion and depersonalization. Frequent use of the emotion-focused strategies of positive reinterpretation, seeking emotional social support, and acceptance were related to higher levels of personal accomplishment, whereas increased use of the emotion-focused strategy of denial was strongly associated with diminished personal accomplishment. Regarding palliative/avoidant coping strategies, frequent behavioural disengagement was associated with higher levels of emotional exhaustion and depersonalization, and mental disengagement and focusing/venting of emotions were related to higher levels of emotional exhaustion.
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Rice, Stephanie C. "The greening of an Adelaide hospital and caring for the environment : perceptions of the environment and changing environmental awareness of staff /". Title page, contents and abstract only, 1996. http://web4.library.adelaide.edu.au/theses/09ENV/09envr497.pdf.
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Leung, Hiu-sum. "Healing environment in hospitals : improving and redesigning the outdoor areas in the Haven of Hope Hospital /". View the Table of Contents & Abstract, 2005. http://sunzi.lib.hku.hk/hkuto/record/B34609702.
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Leung, Hiu-sum, i 梁曉心. "Healing environment in hospitals: improving and redesigning the outdoor areas in the Haven of Hope Hospital". Thesis, The University of Hong Kong (Pokfulam, Hong Kong), 2005. http://hub.hku.hk/bib/B45009648.
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Rooke, C. N. "Improving Wayfinding in old and complex hospital environments". Thesis, University of Salford, 2012. http://usir.salford.ac.uk/27358/.
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Many hospitals have developed over a number of years in a piecemeal fashion. This has resulted in complex environments made up of long and confusing corridor systems with bends, turns, and confusing signs. Such settings challenge and frustrate those who visit them. The importance of wayfinding to building use, costs and safety and the growth in terms of theories, principles, guidelines, and methodologies over the years does not appear to have made an impact on wayfinding performance in complex hospitals. Thus, there remains a need to find more effective wayfinding solutions to the problems that continue to occur in complex hospitals. This research aims at improving methods for developing wayfinding systems and strategies in old and complex hospital environments. The study adopts a design science research approach informed by uniquely adequate observations of how wayfinders make sense of wayfinding information embedded in the complex built environments they have to navigate. The approach includes an extensive review of literature on wayfinding supported by that of the fields of knowledge management, design (architectural and industrial), and production and operations management. The research brings together the disciplines of design and knowledge management to sensitise designers to the varied needs and knowledge levels of wayfinders when designing wayfinding systems. Drawing on findings from both the review of literature and extensive ethnographic fieldwork the research has produced prescriptive and evaluative wayfinding frameworks to aid the design of effective and efficient wayfinding systems and strategies. The outcome of successfully applying the design science research approach to researching the problems of wayfinding and mapping the approach research process with the unique adequacy approach is the Wayfinding Conceptual framework. It represents a methodological contribution, aimed at helping to mitigate the problem of relevance often associated with academic management research.
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Sultanic, Indira SULTANIC. "Medical Interpreter Training and Interpreter Readiness for the Hospital Environment". Kent State University / OhioLINK, 2018. http://rave.ohiolink.edu/etdc/view?acc_num=kent153250300759496.
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Yee, Janice L. "The design and manufacture of a female clothing system for the hospital environment". Thesis, University of Leeds, 1988. http://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.329200.
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Pimpão, Isabel Cristina Pelado. "Perceção da qualidade do serviço da consulta externa hospitalar: contributos para a validação da escala SHEDS". Master's thesis, Universidade de Évora, 2021. http://hdl.handle.net/10174/30105.
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A Teoria de Design de Suporte de Ulrich (1991; 2001), tem gerado um interesse acrescido, dentro das comunidades científica e hospitalar devido à sua relevância e impacto no bem-estar e stress dos utentes (e.g. Andrade et al., 2017; Morais et al., 2015). Neste contexto, pretende-se contribuir para a validação da Escala de Perceção do Design de Suporte do Ambiente Hospitalar (SHEDS) desenvolvida com base na Teoria do Design de Suporte de Ulrich e adaptada para o contexto de sala de espera por Catrapona (2019). Este estudo realizou-se no Hospital Distrital de Santarém numa amostra de 129 utentes. Confirmou-se a estrutura fatorial de Catrapona (2019). Assim, após Análise Fatorial Exploratória, a escala ficou com 15 itens, 3 fatores e consistência interna forte. Dos resultados estatísticos, as Distrações Positivas confirmaram-se como preditor significativo da Perceção de Qualidade Geral do serviço; Abstract:
Ulrich's Theory of Supportive Design (1991; 2001) has created increased interest within the scientific and hospital communities due to its relevance and impact on users' well-being and stress (e.g. Andrade et al., 2017; Morais et al., 2015). In this context, this dissertation intends to be a contribute to the validation of the Supportive Hospital Environment Design Scale (SHEDS) developed based on Ulrich's Theory of Supportive Design and adapted to the waiting room context by Catrapona (2019). This contributive validation was carried out in a sample of 129 patients of the Hospital Distrital de Santarém. We confirmed the factorial structure from Catrapona (2019). After Exploratory Factor Analysis, the scale ended with 15 items, 3 factors, with strong internal consistency. From the results of the statistical analysis, Positive Distractions were confirmed as a predictor of the Perception of General Quality of the service.
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Lundström, Caroline, i Sara Hedberg. "Coordinating transportation services in a hospital environment using Deep Reinforcement Learning". Thesis, Uppsala universitet, Avdelningen för datalogi, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-355737.
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Artificial Intelligence has in the recent years become a popular subject, many thanks to the recent progress in the area of Machine Learning and particularly to the achievements made using Deep Learning. When combining Reinforcement Learning and Deep Learning, an agent can learn a successful behavior for a given environment. This has opened the possibility for a new domain of optimization. This thesis evaluates if a Deep Reinforcement Learning agent can learn to aid transportation services in a hospital environment. A Deep Q-learning Networkalgorithm (DQN) is implemented, and the performance is evaluated compared to a Linear Regression-, a random-, and a smart agent. The result indicates that it is possible for an agent to learn to aid transportation services in a hospital environment, although it does not outperform linear regression on the most difficult task. For the more complex tasks, the learning process of the agent is unstable, and implementation of a Double Deep Q-learning Network may stabilize the process. An overall conclusion is that Deep Reinforcement Learning can perform well on these types of problems and more applied research may result in greater innovations.
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Koelemeijer, Dorien. "The Design and Evaluation of Ambient Displays in a Hospital Environment". Thesis, Malmö högskola, Fakulteten för kultur och samhälle (KS), 2016. http://urn.kb.se/resolve?urn=urn:nbn:se:mau:diva-23601.
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Hospital environments are ranked as one of the most stressful contemporary work environments for their employees, and this especially concerns nurses (Nejati et al. 2016). One of the core problems comprises the notion that the current technology adopted in hospitals does not support the mobile nature of medical work and the complex work environment, in which people and information are distributed (Bardram 2003). The employment of inadequate technology and the strenuous access to information results in a decrease in efficiency regarding the fulfilment of medical tasks, and puts a strain on the attention of the medical personnel. This thesis proposes a solution to the aforementioned problems through the design of ambient displays, that inform the medical personnel with the health statuses of patients whilst requiring minimal allocation of attention. The ambient displays concede a hierarchy of information, where the most essential information encompasses an overview of patients’ vital signs. Data regarding the vital signs are measured by biometric sensors and are embodied by shape-changing interfaces, of which the ambient displays consist. User-authentication permits the medical personnel to access a deeper layer within the hierarchy of information, entailing clinical data such as patient EMRs, after gesture-based interaction with the ambient display. The additional clinical information is retrieved on the user’s PDA, and can subsequently be viewed in more detail, or modified at any place within the hospital.In this thesis, prototypes of shape-changing interfaces were designed and evaluated in a hospital environment. The evaluation was focused on the interaction design and user-experience of the shape-changing interface, the capabilities of the ambient displays to inform users through peripheral awareness, as well as the remote communication between patient and healthcare professional through biometric data. The evaluations indicated that the required attention allocated for the acquisition of information from the shape-changing interface was minimal. The interaction with the ambient display, as well as with the PDA when accessing additional clinical data, was deemed intuitive, yet comprised a short learning curve. Furthermore, the evaluations in situ pointed out that for optimised communication through the ambient displays, an overview of the health statuses of approximately eight patients should be displayed, and placed in the corridors of the hospital ward.
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Moeller, Michael M. Jr. "Noise environment characterization in military treatment facilities". Thesis, Georgia Institute of Technology, 2012. http://hdl.handle.net/1853/48995.
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Hospital sound environments are complex and hard to understand. One of the most important factors in these environments is the effective communication between staff members in regards to patient care and successful communication depends in part on the hospital’s sound environment. In this study, objective sound measurements as well as occupant perceptive data were collected at three hospitals. Sound pressure levels; including maximum, peak, minimum and equivalent levels were recorded in these hospitals, in addition to active impulse response measurements. Acoustic descriptors of the sound environment such as spectral content, level distributions, energy decay and temporal patterns were examined. The perception of the hospital soundscape (sound environment) was evaluated through surveys of the staff, patients and visitors to units. It was found that noise levels in all patient rooms and work areas were significantly higher than guidelines laid out in previous literature and by professional organizations. This work contributes to the field by broadening the metrics used to quantify hospital acoustic environments. In addition, this work added to the field by providing the most rigorous acoustic field measurement set published to date. This was done to create an accurate portrayal of the hospital soundscape environment.
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Brandenburg, Claudia Angelique. "A transaction cost analysis of Dutch hospital care : contacting between hospital and health insurance companies in a deregulated environment /". Rotterdam, 2008. http://opac.nebis.ch/cgi-bin/showAbstract.pl?sys=000253128.
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De, Villiers Brooks Geoffrey Robert. "Competitive environment, competitive strategy and performance : a study of the hospital industry /". Ann Arbor, MI : UMI Dissertation Information Service, 1992. http://aleph.unisg.ch/hsgscan/hm00092823.pdf.
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Söderström, Patrik. "Mobile Communication within Healthcare Environment : A Case Study at Danderyds University Hospital". Thesis, KTH, Industriell Management, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-211063.
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Organizations within the healthcare industry are under a constant pressure with a continuousgrowth, resulting in a larger number of patients in need of attention and an increased demandfor healthcare services. The pressure put on the different departments at hospitals challengesthe communication channels within the organization. This in turn prevents the employeesfrom driving change efficiently where a perceived lack of information flow and fragilecommunication is the cause. To facilitate a transition, ICT is acting as a fundamental driverfor a transformation, where emerging technologies are changing the workflow inorganizations. It has contributed with mobile applications to work as solutions to enhancecommunication by improving connectivity and facilitating information flow. Therefore, thepurpose of the report was to investigate how a mobile application could help to enhance theinternal communication in the healthcare sector.For the master thesis, the investigation has been realized by conducting a descriptive casestudy at the infectious disease department. Findings were derived from observations, threeinterviews with representatives from the management and a pilot study consisting of thirteenpeople. The process was to observe existing communication channels, obtain a needs analysisfrom the management regarding improvement factors as well as implement and evaluate amobile application as a new communication channel based on their requirements.From the initial observations and interviews it was possible to identify a gap between themanagement’s information distribution and the employees’ information receiving. This wasaddressed by implementing, testing and evaluating a mobile communication channel in orderto make the information more accessible. It was discovered that by dividing employees intosmaller groups with their own specific purpose, it was possible to direct information andprevent information overload. By establishing a mobile communication channel the workflowat the department could be improved with a facilitation of transmitting information as a result.
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Skytte, Joakim. "Feasibility Study of Indoor Positioning in a Hospital Environment Using Smartphone Sensors". Thesis, Linköpings universitet, Reglerteknik, 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:liu:diva-145172.
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This thesis is a feasibility study of contemporary indoor positioning approaches in an hospital environment using sensor available on Android phones together with Wi-Fi fingerprintingand map information. The purpose is to determine the resolution of pedestrian indoor positioning and whether it is sufficient for room level accuracy. Accurate and robust positioning for outdoor applications based on mobile networks and satellite systems, such as the Global Positioning Service (GPS), has been around for many years. However these systems are not suitable for positioning inside buildings due to a high level of signal degradation. Through the years various pedestrian indoor positioning methods have been proposed.A simple algorithm for suppressing random movement of the mobile phone is tested. Two versions of the Extended Kalman Filter (EKF) are compared for fusing the Inertial Navigation System (INS) measurements during Pedestrian Dead Reckoning (PDR). The TRIAD algorithm is tested for suppressing the effects of large magnetic disturbances. Wi-Fi fingerprinting using two combinations of positioning algorithms and radio maps is tested. The EKF is tested for fusing PDR and Wi-Fi fingerprint position estimations. The Particle Filter (PF) is tested for combining PDR with Wi-Fi fingerprint positioning with a geometrical map. Static Received Signal Strength Indication (RSSI) measurements are carried out to detect variable Wi-Fi transmission power. The results show that adding more informations sources improves the positioning performance. Also fusion using PF outperforms the EKF in more complex indoor environments and movement patterns.En starkt växande tillgång och kapacitet hos trådlösa nätverk i kombination med explosionen inom mobiltelefoni, i synnerhet vad gäller smartphones, har lett till ett enormt ökat intresse för och utveckling inom området inomhuspositionering. Det har under många år funnits lösningar för positionering i utomhusmiljöer, exempelvis GPS och triangulering med mobila basstationer, men inga av dessa system lämpar sig för inomhuspositionering eftersom signalerna tappar alldeles för mycket i intensitet när användaren befinner sig inomhus. Under årens lopp har flera olika lösningar för inomhuspositionering föreslagits. I denna uppsats testas olika lösningar för inomhuspositionering med smartphones i en sjukhusmiljö. Testen baserar sig på de sensorer som finns i en smartphone med operativsystemet Android i kombination med Wi-Fi triangulering och en digital planlösning över testområdet. Syftet är att undersöka om noggrannheten kan bli såpass så bra att en upplösning på rumsnivå uppnås. En enkel algoritm för att kompensera för slumpartade och oplanerade rörelser hos mobiltelefonen testas. Två versioner av det utökade Kalmanfiltret testas för tröghetsnavigering. TRIAD algoritmen testas för att motverka magnetiska störningar. Två kombinationer av radiokartor och positioneringsalgoritmer provas för att genomföra Wi-Fi positionering. Ett utökat Kalmanfilter används för att kombinera resultaten av tröghetsnavigeringen med Wi-Fi positioneringen. Ett partikelfilter används för att utföra sensorfusionen av tröghetsnavigeringen, Wi-Fi positioneringen och den digitala planlösningen. Resultaten visar att ju mer information som tillförs under positioneringen desto större blir noggrannheten samt att partikelfiltret ger en bättre noggrannhet i en komplex inomhusmiljö i kombination med komplicerade rörelsemönster än det utökade Kalmanfiltret.
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Zalgaonker, Mustafa. "Intravenous fluid resuscitation : surveillance of penetrating injury in the pre-hospital environment". Thesis, Cape Peninsula University of Technology, 2018. http://hdl.handle.net/20.500.11838/2738.
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Thesis (Master of Emergency Medical Care)--Cape Peninsula University of Technology, 2018.Physical injury is a major cause of premature death and disability worldwide (WHO, 2015). Mortality statistics for South Africa indicate that approximately half of all injury-related deaths were intentionally inflicted, often as a result of sharp-force injuries (Donson 2009). Cape Town is reputed to be a violent city (Nicol et al., 2014). Pre-hospital emergency care providers are often the first medical contact for injured patients. Previously, it was understood that high volume crystalloid administration would improve survival and was standardised in the management of shock (Santry & Alam 2010). However, over-administration of crystalloid fluid can cause patient harm by potentially worsening injuries and can be detrimental to a patients survival. Current evidence supports the practice of lower volume crystalloid intravenous fluid administration- permissive hypotension. Little is known about pre-hospital emergency care providers intravenous fluid management practices for penetrating injury. Injury surveillance data for victims of penetrating injury is also scarce with the majority of current data taken from mortality sources. Surveilling pre-hospital cases may yield opportunities for prevention from premature mortality and morbidity. The aim of this study is to undertake surveillance of penetrating injury and related intravenous fluid resuscitation in the pre-hospital emergency care environment. A prospective observational descriptive survey was conducted in the Cape Metropole1. Over three consecutive months, emergency care providers documented parameters related to mechanism of injury, scene vital signs, hospital vital signs, intravenous fluid resuscitation and basic patient demographic information for patients with penetrating injury. A predetermined inclusion and exclusion criteria was used to sample patients.
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Shepherd, P. A. "The effects of a hospital ward eating environment on patients' mealtime experience". Thesis, Bournemouth University, 2011. http://eprints.bournemouth.ac.uk/19253/.
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The provision of adequate nutritional care to hospital patients continues to be an international problem, despite numerous initiatives and attempts by interested parties over several decades to make improvements. The focus of this research was to critically evaluate the effects a hospital ward eating environment can have on patients’ foodservice experience and to establish if providing an enhanced dining environment could improve outcomes. A case study approach was employed on two Orthopaedic wards in an Acute Care Hospital which considered the variables that concurred in the contextual environment of the foodservice provision, to provide an in depth appreciation of Orthopaedic patients’ dining experience. The study used a mixed methods, sequential, exploratory, research process, consisting of four phases incorporating; semi structured interviews with patients, patient questionnaires, exploratory interviews with stakeholders and measurement of patients’ food intake and mood. Following the empirical processes this study has engaged in, theoretical contributions have been made which include; (1) A conceptual model for factors affecting patients’ foodservice experience developed from a synthesis of literature and theories with regard to the provision of hospitality, mealtime experiences and nutritional care provision for patients; (2) A questionnaire to measure hospital patients’ overall food experiences has been developed; (3) An explanatory model for factors influencing hospital patients’ foodservice experience has been developed; (4) A comparison of the patients’ mean, daily, nutritional intakes with the recommended levels, provided updated evidence of poor nutrition in the research setting, whilst factors influencing reduced food intakes were established; (5) The provision of an enhanced group dining experience for the patients, established positive outcomes for patients and stakeholders; (6) A theoretical model was developed that establishes a hierarchy of factors influencing Orthopaedic patients’ foodservice experience and food intake. This research study makes a contribution to our understanding of how sociological and environmental factors can enhance patients’ dining experience which may ultimately lead to improved nutritional intake.
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SÖDERSTRÖM, PATRIK. "Mobile Communication within Healthcare Environment : A Case Study at Danderyds University Hospital". Thesis, KTH, Skolan för industriell teknik och management (ITM), 2017. http://urn.kb.se/resolve?urn=urn:nbn:se:kth:diva-232485.
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Miller, Sharon Carleton University Dissertation Canadian Studies. "Power and powerlessness; an examination of nurses' experiences within the hospital environment". Ottawa, 1994.
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Porter, Marilyn J. "The study of the key components of a work order process within a hospital environment". Online version, 2000. http://www.uwstout.edu/lib/thesis/2000/2000porterm.pdf.
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Zhang, Lei. "Uncompensated Care Provision and the Economic Behavior of Hospitals: the Influence of the Regulatory Environment". Diss., unrestricted, 2008. http://etd.gsu.edu/theses/available/etd-02242009-152847/.
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Thesis (Ph. D.)--Georgia State University, 2008.Title from file title page. Paul G. Farnham, committee chair; Patricia G. Ketsche , Douglas S. Noonan (Ga. Tech.), Shiferaw Gurmu, Karen J. Minyard, William S. Custer, committee members. Description based on contents viewed June 11, 2009. Includes bibliographical references (p. 146-153).
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Garcia, Mariana Ferreira Martins. "Diretrizes projetuais para humanização hospitalar: Hospital de Clínicas da Universidade Federal do Triângulo Mineiro". Universidade de São Paulo, 2016. http://www.teses.usp.br/teses/disponiveis/102/102131/tde-10102016-133942/.
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O Hospital de Clínicas da Universidade Federal do Triângulo Mineiro (HC UFTM) foi inaugurado em 1982 na cidade de Uberaba - MG e é, atualmente, o único hospital público do Triângulo Mineiro que oferece atendimento terceirizado de alta complexidade. Os critérios técnicos exigidos em normas rígidas para esses ambientes hospitalares dificultam o processo de humanização hospitalar como forma de atender os usuários satisfatoriamente e proporcionar espaços apropriados para o exercício dos profissionais da saúde e para auxiliar na cura dos pacientes. Sendo assim, o objetivo deste trabalho é propor diretrizes projetuais com a finalidade de melhorar o desempenho térmico e lumínico das alas de clínicas médica (CM) e cirúrgica (CC) do HC da UFTM. Para isso, a metodologia proposta consiste, inicialmente, num levantamento de dados dos aspectos projetuais e construtivos das alas estudadas. Posteriormente, foi feito um levantamento bioclimático de Uberaba dos últimos 10 anos junto a uma caracterização do edifício através dos cálculos das propriedades térmicas dos materiais e do uso das estratégias passivas no projeto. Para verificar a eficiência destas estratégias realizaram-se as análises dos métodos de Mahoney e Givoni. Além disso, o desempenho térmico e lumínico das alas de CM e CC foi analisado através das medições das temperaturas internas e externas, da umidade relativa do ar e dos níveis de iluminância. Depois, foram comparados com as recomendações de Mahoney e Givoni e à norma de iluminação NBR 8995-1. Os resultados encontrados indicaram que das estratégias passivas, a ventilação é a mais favorecida pela implantação do edifício, mas o resfriamento evaporativo e a alta inércia térmica não estão presentes. Além disso, os cálculos das 2 propriedades térmicas dos fechamentos verticais e horizontais e as medições das variáveis ambientais não apresentaram índices ideais de conforto e sim, altas transmitâncias, baixas inércias térmicas e, consequentemente, altas temperaturas no interior das alas, gerando um grande desconforto térmico praticamente o tempo todo. Além disso, os níveis de iluminância encontrados não estão adequados às normativas e, aliados a ambientes sem identidade visual desfavorecem ainda mais a percepção que os usuários/pacientes têm dos mesmos. Promover espaços ajardinados, melhorar o desempenho dos fechamentos através da utilização de isolantes térmicos e rever a concepção visual e os níveis mínimos de iluminação do HC são possibilidades eficientes e utilizadas em diversos hospitais para melhorar o conforto térmico e visual dos pacientes durante suas internações e assegurar qualidade no desempenho das tarefas dos funcionários.In 1982, the teaching hospital (Hospital de Clínicas - HC) of the Triângulo Mineiro Federal University (UFTM) was opened in Uberaba, in Minas Gerais state in Brazil. Currently, it is the only public hospital in the Triângulo Mineiro area to offer third party high complexity services. Technical requirements in strict regulations for hospital environments make it harder to humanize them and satisfactorily assist users, provide health professionals with adequate working spaces and help the healing process. Therefore, this document aims to propose design guidelines to improve thermal and lighting performance in the medical clinic (clínica médica CM) and surgery clinic (clínica cirúrgica - CC) wings of the HC of UFTM. In order to achieve this, there was initially some data collection regarding design and building aspects related to the aforementioned hospital wings. Afterwards, it was necessary to gather data on the bioclimatic profile of Uberaba for the last ten years and relate it to the building using an estimate of the thermal properties of its materials and of the use of passive strategies in its design. To verify how effective the plans were, analyses based on Mahoney and Givonis methods were carried out. Furthermore, measurement of internal and external temperatures, of relative humidity and of illuminance levels were used to analyze thermal and visual performance of CM and CC wings. Then, the results were compared to Mahoney and Givonis recommendations and to lighting regulation NBR 8995-1. These results showed that regarding passive strategies, ventilation benefits the most from the building orientation, while evaporative cooling and high thermal inertia are absent. Moreover, thermal property figures of the vertical and the horizontal openings and measurements of environmental variables did 4 not present ideal comfort ratings, but high transmittance, low thermal inertia and, consequently, high temperatures inside the wings creating great thermal discomfort almost all the time. In addition, illuminance levels registered did not comply with regulations and, while associated with a lack of visual identity in rooms, caused users/patients to negatively perceive those rooms. Fostering green areas, improving insulation by using thermal insulation materials and revising the visual concept and the minimum illuminance levels in the HC are effective possibilities used in several hospitals to improve patients thermal and visual comfort while under treatment and to ensure quality to staff performance.
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Kwok, Yi Lin. "The design of garments for premature infants to wear in a hospital environment". Thesis, University of Leeds, 1992. https://ethos.bl.uk/OrderDetails.do?uin=uk.bl.ethos.725257.
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Williams, Levonne. "The relationship between the two levels of patient education program implementation within the hospital environment and the impact of selected hospital attributes /". The Ohio State University, 1987. http://rave.ohiolink.edu/etdc/view?acc_num=osu1487586889186837.
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Linden, Andrew. "Measuring hospital efficiency using DEA an investigation into the relationship between scale and efficiency within the South African private hospital environment". Master's thesis, University of Cape Town, 2013. http://hdl.handle.net/11427/5811.
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Includes abstract.Includes bibliographical references.
This paper investigates the relationship between scale and efficiency through the application of Data Envelopment Analysis (DEA) to a set of South African private hospitals over the three year period from 2007 to 2009. As part of the investigation, this paper provides a description of the current research into scale and efficiency with a focus on definition and measurement. It also provides an introduction to DEA as a tool for measuring the relationship between hospital scale and efficiency. Based on the underlying set of private hospitals, this investigation found that scale efficiency improvements are likely to be possible.
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Marques, Cristina Maria Alves. "Mudança organizacional em contexto hospitalar: Um projecto de planeamento de altas". Master's thesis, Instituto Superior de Psicologia Aplicada, 2005. http://hdl.handle.net/10400.12/643.
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Dissertação de Mestrado em Comportamento OrganizacionalA aprovação da nova Lei de gestão hospitalar veio configurar uma nova realidade para o sector hospitalar português. É uma oportunidade para desenvolver novas competências de gestão, recompensar o bom desempenho e premiar a maior eficiência. Neste contexto de mudança vários foram os objectivos traçados pela Unidade de Missão, bem como as estratégias para os atingir, entre os quais o projecto de planeamento de altas, que é uma das iniciativa chave na redução dos internamentos por motivos de natureza social, sendo para tal necessário o empenhamento de toda a equipa multidisciplinar, incluindo o doente/elemento cuidador. A necessidade de diminuir o tempo de internamento que hoje vigora nos hospitais, na perspectiva da optimização económica de recursos, colide frequentemente com os interesses dos familiares e dos doentes hospitalizados, podendo mesmo atropelar a qualidade dos cuidados que estes merecem. Neste seguimento, este estudo teve por base este projecto, implementado num serviço hospital central de Lisboa, recentemente tornado sociedade anónima. Pretende-se assim contribuir para a compreensão, num contexto de mudança, do conceito de planeamento de altas na continuidade dos cuidados de saúde e na sua estruturação, no sentido de perceber como podem levar a cuidados mais centrados no doente. Este serviço é caracterizado por recursos humanos altamente especializados e os seus clientes têm habitualmente déficit de saúde, mais concretamente na área da respiratória. São assim portadores de doenças crónicas, de alguma forma limitativas, obrigando-os, com alguma frequência, a dirigirem-se ao hospital. O facto da alta do doente não ser planeada atempadamente, torna-se com frequência num momento de ansiedade, tanto para o doente, como para a família/elemento cuidador, não o deixando de ser também para a equipa multidisciplinar. É frequentemente no momento de alta que é transmitida toda uma quantidade de informações e conselhos importantes para a vida futura dos mesmos, o que se houvesse planeamento, poderia ter sido feito de uma forma gradual e sistemática. Pretende-se estudar o impacto deste projecto e para tal analisou-se o impresso implementado aos doentes internados, durante um mês consecutivo, perfazendo um total de 51. Por esta análise ter sido inconclusiva, recorreu-se a entrevistas aos lideres dos grupos profissionais envolvidos. Trata-se de um trabalho exploratório, uma vez que procura conhecer melhor os fenómenos em estado, quer através de novas questões ou novas explicações, ou simplesmente tentando indagar as características dos acontecimentos ou situações. Concluímos de uma forma geral que realmente não se ganhou a aposta da mudança pretendida inicialmente, mas acabou por ficar incutido no seio da equipa determinadas alterações à sua rotina, que permitiram uma melhoria futura contínua dos cuidados, sendo necessário que todos se sintam motivados e envolvidos. Com este projecto aconteceram evoluções muito significativas no processo de cuidados e no modo de estar dos profissionais. Pensa-se e fala-se na alta precocemente e é registada mais informação relativa ao processo de alta para garantir a continuidade de cuidados e do investimento de cada grupo profissional. A família é mais "chamada" a participar nos cuidados e "ensina-se" mais cedo, para obterem mais segurança e confiança na capacidade para lidar com as "novas dependências" do seu doente. Há uma maior solicitação, melhoria do diálogo e maior esforço de articulação entre os vários grupos profissionais (os envolvidos no projecto e os nutricionistas e psicólogos), nomeadamente em situações com necessidade de apoio domiciliário. Rompeu-se com algumas formas de pensar e agir, dominantes no início do projecto, havendo agora argumentos e fundamentos para poderem negociar tempos para orientação do doente/família/elemento cuidador. A postura da equipa é mais activa e dinâmica na procura de soluções para o doente e família, sendo a comunicação mais horizontal. Sendo que actualmente a equipa deste serviço conhece de outro modo a pessoa, que por estar doente vive este período da sua existência, precisando da sua ajuda e da sua competência. Sugere-se o alargamento deste estudo aos doentes e elementos cuidadores, de uma forma mais activa.
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RANGEL, MÁRCIA MOREIRA. "COLOR AND ERGONOMICS IN BUILD ENVIRONMENT: AN INVESTIGATION ABOUT SPATIAL ORIENTATION IN A HOSPITAL". PONTIFÍCIA UNIVERSIDADE CATÓLICA DO RIO DE JANEIRO, 2011. http://www.maxwell.vrac.puc-rio.br/Busca_etds.php?strSecao=resultado&nrSeq=17927@1.
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Os hospitais estão entre as maiores e mais complexas instalações da sociedade contemporânea, pois além da arquitetura, dos tipos, e da quantidade de serviços oferecidos, tem-se a dinâmica da medicina que impõe constantes mudanças no campus hospitalar. E também devem ser mencionados os estados de estresse físico e psicológico que dificultam a relação do humano com seu entorno. A partir do entendimento de que esse cenário que se forma ao redor do indivíduo é fruto da articulação entre todos os seus elementos e de inter-relações desses com a cor e com os sujeitos, esta pesquisa focou a participação da cromática do ambiente na orientação espacial dos usuários de uma unidade hospitalar. Foi realizado um estudo de caso, utilizando o método Índice de visibilidade (VI) para analisar o layout e a sinalização do hospital, além de questionários com os usuários e entrevistas com funcionários e arquitetos da instituição. Buscou-se verificar como a informação cromática contida nos elementos do ambiente é percebida e, mais precisamente, em que medida é utilizada como informação norteadora das rotas que configuram as atividades vinculadas aos deslocamentos dos usuários do ambiente em questão. Os dados obtidos evidenciam que o projeto cromático se planejado no sentido de conferir organização espacial auxilia aos indivíduos a obter senso de lugar, fundamental em seus deslocamentos. Sob o olhar da ergonomia foram formuladas recomendações que visam contribuir com o trabalho dos arquitetos e designers para a projetação de ambientes, cada vez mais, adequados às necessidades reais de seus usuários.Hospitals are among the biggest and more complex installations in our contemporary society, because, besides its architecture, types and offered services, it has the medicine dynamic that imposes continuous chances in the hospital campus. And also we must mention that are the physical and psychological mood that difficult the relationship between the human being and the environment. From understanding this scenario that takes place relating the human and his articulation among elements and inter-relationship between color and subjects, this research focused on the chromatic participation in wayfinding in a hospital environment . It was carried out a case study, using tools as visibility index (VI) to analyze layout and signaling system of the hospital, user´s questionnaires and interviews with employees and architects of that institution. It was aimed to verify how the chromatic information in the elements are perceived and more precisely, how it is used as information for routes that configure activities of the users in this space. Obtained data point out that the chromatic design - if well planned - could help individuals to has sense of pertinence, important for displacements. Some recommendations from ergonomic point of view that could contribute with architects and designers work when designing environments, more adequate to real necessities of its users.
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Raij, Katariina. "Toward a profession : clinical learning in a hospital environment as described by student nurses". Helsinki : University of Helsinki, 2000. http://ethesis.helsinki.fi/julkaisut/kas/kasva/vk/raij/.
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Lundberg, Pontus, i Kohl Marcus Svenningsson. "Människan påverkas av miljön". Thesis, Hälsohögskolan, Högskolan i Jönköping, HHJ, Avd. för omvårdnad, 2018. http://urn.kb.se/resolve?urn=urn:nbn:se:hj:diva-39741.
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Bakgrund: Nightingale förespråkade vikten av vårdmiljön och dess betydelse för patienten på senare halvan av 1800-talet. Hennes teori bygger på att patienten skall ha en trivsam miljö vid sjukhusvistelse och att den är avgörande för patientens återhämtning. En god och trivsam miljö har visat sig förkorta återhämtningstiden och ökat patientens välmående och dennes positiva upplevelse av att vistas på sjukhus. Syfte: Att beskriva patienters upplevelse av vårdmiljön på sjukhus. Metod: En kvalitativ litteraturöversikt med induktiv ansats genomfördes. Resultat: Det framkom två huvudkategorier; Den visuella miljöns influens med underkategorierna “Färgens betydelse”, “Behovet av ljus och utsikt” och “Inredningens påverkan” samt Vårdrummets inflytande med underkategorierna “Betydelsen av rummets egenskaper” och “Behovet av god komfort”. Upplevelserna hos patienterna gällande vårdmiljön på sjukhus var varierande ifall den var tillfredsställande eller inte. Patienterna nämnde flertalet faktorer som ökade deras positiva upplevelse av att vara inlagd på sjukhus, exempelvis färger, fönster och utrymme. Det framkom även faktorer som hade en negativ påverkan på deras upplevelse, exempelvis obekväma möbler och oljud. Slutsats: Resultatet visade att vårdmiljön har sina brister runt om i världen. Studien visar också att de problem som Nightingale handskades med fortfarande förekommer idag.Background: In the second half of the 17th century, Nightingale advocated the weight of the hospital environment and its effect on the patient. Her theory was built on the patient encountering a pleasant environment during hospitalization and its critical impact for the patients well-being and health. A pleasant environment has shown to counteract prolonged hospital stays and leads to a shortened recovery process. Aim: To describe patients experience of the hospital environment. Method: A qualitative literature review with an inductive approach was conducted. Results: Two main categories were revealed; The visual environmental influence, with the sub categories “The meaning of colours”, “The need of light and view” and “Impact of the interior”. The second main category found was; The hospital wards impact, with the sub categories “The importance of the rooms characteristics” and “The need of good comfort”. The patients experience of the hospital environment varied between being satisfying or not. The patients mentioned several isolated components that had a positive effect on their experience during hospital stays, such as colours, windows and space. Components that had a negative effect were also mentioned. Conclusion: The result sheds light on the flaws and deficiencies in the physical hospital environment that exists internationally. The study conducts the fact that the problems that Nightingale dealt with still exists to this day.
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Su, Shiuan-Ru. "Perceived Control in Outpatients Departments of Taiwanese Hospitals from the Patient's Perspective: A Qualitative Study". Thesis, The University of Sydney, 2020. https://hdl.handle.net/2123/21907.
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The lack of control that patients in hospitals often feel over customary tasks and over the environment around them is widely recognised. Indeed, previous research has shown that a patient’s lack of sense of control in health care environments can increase stress, and affect recovery and overall well-being. Yet few studies have examined the process by which numerous factors influence the development of a patient’s perceived control from the time they decide to go to a hospital, and little is known about how sense of control changes throughout patients’ experiences in the outpatient department (OPD). The research reported in this thesis focuses on the needs of a sample of patients and their experiences of perceived control in the outpatient departments of hospitals in Taiwan. Through thematic analysis of in-depth interview transcripts, the factors that affected patients’ sense of control in the OPD environment were identified and a model of patients’ sense of control was developed. The findings showed that patients’ perceived control in a health care setting is the result of interactions between external situational/environmental factors and internal psychological processes. The multi-dimensional conceptual model based on these findings describes the manner in which patients’ needs invoke their desire for control and motivate them to seek control in five distinct areas - procedure, spatial, physical, information and privacy - and these define the five major needs that emerged from analysis of interviews with outpatients. The model of patients’ sense of control also recognises the role of three fundamental processes that mediate the sense of control - the environment/situation perception process, the cognition of control process, and the reaction and outcome process. From this model, three strategies to enhance patients’ sense of control were identified. These were: improving patients’ environmental perception process; improving patients’ cognition of control; and improving individual physical, behavioural and coping abilities. Examples based on the field data are provided to illustrate how these aspects could be addressed in practice, recognising local concerns (events or environments) to improve patients’ sense of control, and helping to create a more supportive hospital environment.
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Cintra, Cynthia Leonis Dias. "AMBIENTE HOSPITALAR: análise da estrutura físico-funcional da UTI de um Hospital Universitário". Universidade Federal do Maranhão, 2008. http://tedebc.ufma.br:8080/jspui/handle/tede/1068.
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Previous issue date: 2008-10-27This paper deals with the physical and functional structure of an Intensive Care Unit (ICU) of the Maternal Child Hospital in the Federal University of Maranhão. The conceptual and theoretical aspects on health policies are discussed as well as the historical aspects of the hospital building, one of the most complex structures that exist, where activities are developed having as objective the prevention, the cure and the rehabilitation of human beings in their training Initial life. It is a surrender of legal instruments for the normalization of Establishments Assistance of Health, with emphasis on the resolution of Collegiate Directors n º 50/Agencia Nacional de Vigilância Sanitária (ANVISA), which is an important tool for the organization of these environments, regarding the function-flow. Addresses on the hospital's point of view of architecture by presenting the hospital types, the evolution of this area and the influence of new technologies, the environmental comfort and employment of medical gases in that context. After that, it is discoursed on the university hospitals in Brazil up to the Neonatal Intensive Care Unit (NICU) itself, and its peculiarities. In conclusion, with the recognition of the importance of this unit, are some final considerations that point to a study on the environmental quality of the University Hospital of the University of Maranhao.
O presente trabalho trata sobre a estrutura físico-funcional da Unidade de Terapia Intensiva (UTI) do Hospital Materno Infantil da Universidade Federal do Maranhão. São abordados os aspectos conceituais e teóricos sobre as políticas de saúde, além dos aspectos históricos do edifício hospitalar, uma das mais complexas estruturas que existem, onde são desenvolvidas atividades que têm como objetivo a prevenção, a cura e a reabilitação do ser humano no seu estágio inicial da vida. Faz-se um resgate dos instrumentos legais para a normalização dos Estabelecimentos Assistenciais de Saúde, com destaque para a Resolução de Diretoria Colegiada n º 50/Agencia Nacional de Vigilância Sanitária (ANVISA), que se mostra um importante instrumento para a organização desses ambientes, no tocante à função-fluxo. Aborda-se sobre o ambiente hospitalar do ponto de vista da arquitetura, apresentando-se as tipologias hospitalares, a evolução desse espaço e a influência das novas tecnologias, do conforto ambiental e do emprego dos gases medicinais nesse contexto. Em seguida, discorrese sobre os hospitais universitários do Brasil até chegar-se a UTI neonatal, propriamente dita, e suas particularidades. Na conclusão, com o reconhecimento da importância dessa unidade, são apresentadas algumas considerações finais que apontam para um estudo quanto à qualidade ambiental do Hospital Universitário da Universidade Federal do Maranhão.
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Peacock, Joy M. "The relationships between job characteristics, professional practice environment and cardiovascular risk in female hospital nurses". Thesis, Kingston, Ont. : [s.n.], 2008. http://hdl.handle.net/1974/1314.
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Luna, Marcos. "The biomedicalization of public health and the marginalization of the environment a policy history from the environment to the hospital and back again /". Access to citation, abstract and download form provided by ProQuest Information and Learning Company; downloadable PDF file, 437 p, 2007. http://proquest.umi.com/pqdweb?did=1362525181&sid=39&Fmt=2&clientId=8331&RQT=309&VName=PQD.
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Crane, Melissa R. "Synchronous Online Training Employing Practice and Feedback in the Hospital Environment| A Basic Qualitative Study". Thesis, Capella University, 2017. http://pqdtopen.proquest.com/#viewpdf?dispub=10617124.
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The purpose of this basic qualitative study was to determine practice and feedback strategies used by instructional designers when creating synchronous online instruction. Practice and feedback have survived through many modes of learning including classroom, asynchronous online learning, and synchronous online learning. The research design consisted of open-ended questions administered during a telephone interview. A pre-qualifying questionnaire was posted on social media to recruit participants to determine the sample population; the qualifying survey produced 14 participants who met the requirements to participate in a telephone interview. The participants answered nine questions during the phone interview. The interviews were recorded, transcribed, and coded. Based on the participant responses, five themes emerged. The results of the study contribute to the field of instructional design by providing suggestions of the current use of practice and feedback in synchronous online instruction and how they use motivation strategies to encourage adult learner participation. Similarities were found between the results and reviewed literature. This study was limited by only interviewing instructional designers who work, or have worked, in a hospital environment. Suggestions for future research would be to repeat this study on a larger scale by recruiting more participants that work in different work environments as an industry, higher education, and computer technology.
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Woldehawariat, Negat. "Experiences of operating room nurses in their work environment at a state hospital in Ethiopia". Thesis, Nelson Mandela Metropolitan University, 2012. http://hdl.handle.net/10948/d1008177.
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Operating room nursing skills are some of the most demanding skills in the nursing profession. At the moment nurses trained in operating room technique are in very short supply in Ethiopia, due to the exodus of nurses to better working environments with more reasonable payment. This is especially noticeable in one of the state hospitals in Addis Ababa, Ethiopia, as emerged in conversations with the head nurse of the operating room in this hospital about the high turnover rate, as well as the high absenteeism rate amongst the nurses working in the operating room. Nurses working in the operating room also expressed unhappiness in their work environment which could cause them to look for other jobs or to be absent from duty. The nurses were facing numerous problems in their work environment such as work overload due to staff shortage, stress due to shortage of supplies because they are not able to do their job as much as the need requires. The researcher identified the need to explore the challenges that the operating room nurses are experiencing in their work environment. The researcher used the following questions to meet the research objectives: What are the experiences of the operating room nurses in their work environment?; What potential assistance would such nurses need to better cope with the problems they experience in their work environment? The research study aimed to explore and describe the experience of operating room nurses in their work environment and on the basis of the findings to develop guidelines to assist the operating room nurses in coping more effectively with their work environment. The researcher used a qualitative approach with an explorative, descriptive and contextual design. Fifteen registered nurses were selected using purposive sampling. Informed consent was obtained from the participants and permission from the Ethics Committee of the Nelson Mandela Metropolitan University, as well as Yekatit 12 Hospital. Data were gathered using face to face interviews and field notes were taken to determine the experiences of the participants. Data were analyzed using Tesch's method of descriptive data analysis (in Creswell, 2003:13). Two main themes with two sub-themes related to the experience of the registered nurses working in the operating room of the state hospital were identified. Main theme one focused on the non-conducive work environment and it focused on the lack of support from management and the problems experienced in the environment. It was found that OR nurses had good working relationships among the nursing staff. Main theme two focused on the limited training opportunities in OR techniques. The sub-themes described the limited exposure to new technology and the quality of nursing education which the participants felt was not taken seriously in Ethiopia. Based on the identified themes guidelines were formulated to assist the registered nurses working in the operating room of a state hospital in Ethiopia. Utilization of these guidelines should assist the registered nurses to cope more effectively with their work environment. Recommendation were made, further research and limitations identified.
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Andrews, Diane. "THE EFFECT OF JOB STRAIN IN THE HOSPITAL ENVIRONMENT: APPLYING OREM'S THEORY OF SELF CARE". Doctoral diss., University of Central Florida, 2006. http://digital.library.ucf.edu/cdm/ref/collection/ETD/id/2234.
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The purpose of this research was to evaluate the causal relationships between job strain, the practice environment and the use of coping skills in order to assist in the prediction of nurses who are at risk for voluntary turnover. It was conducted at the level of the individual nurse employee in order to better understand the health consequences associated with job strain, the factors in the professional practice environment which may contribute to the propensity to leave and the influence of coping behaviors in response to workplace stressors. It was undertaken with the intention of identifying intervention strategies which will promote a healthy workforce and the retention of nurses in the workplace. An exploratory cross-sectional survey of 1235 staff nurses employed on the intensive, progressive and general medical-surgical nursing units of seven hospitals associated with a major Central Florida healthcare network tested a client-centered model in an effort to identify nurses vulnerable to the health consequences of job strain using structural equation modeling. Human subject protection was assured. An 82 item questionnaire was used to collect demographic data and measure responses to items associated with the constructs of health status, autonomy, collaboration, decentralization, coping, satisfaction, absenteeism and intent to leave. A variety instruments that were previously demonstrated as valid and reliable were used in the construction of the instrument. Subjects were also given the option of including additional written comments. A total of 325 surveys were returned, of which 308 met inclusion criteria, for a response rate of 25%. Data analysis determined that the measurement of job strain as a function of self-assessed generic health status was predictive of propensity to leave (ã = -.21). The experience of job strain shared a strong association with indicators of mental health status. Job strain was significantly influenced by coping behavior (ã = .56) which targeted activities associated with sustaining and balancing. Anecdotal remarks suggested that the need for balance influenced perceptions regarding stressors in the workplace. The professional practice environment was associated negatively with the propensity to leave (ã = -.58). Those staff nurses who experienced higher levels of autonomy expressed a greater degree of satisfaction and lower intent to leave. The variables of collaboration and decentralization contributed minimally to the construct of professional practice. Anecdotal remarks suggested that the low contribution of collaboration and decentralization contributed to a sense of powerlessness and frustration with work related circumstances. The influence of job strain, coping and the professional practice environment upon staff nurses suggests that health promotion strategies, efforts to enhance coping behavior and promotion of a professional practice environment will increase employee satisfaction and reduce intent to leave. Adoption of policies and procedures which support the health and well-being of individual staff members will benefit employees, strengthen the organizations in which they practice and promote the overall retention of nurses in the face of looming nurse shortages.Ph.D.
Health and Public Affairs
Public Affairs: Ph.D.
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Morelli, Agneta. "Implications of Nursing Station Design on Nurses's Psychosocial Health and Work Behavior". Thesis, University of Gävle, Department of Technology and Built Environment, 2007. http://urn.kb.se/resolve?urn=urn:nbn:se:hig:diva-280.
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The purpose was to investigate design factors in nursing station work environments, to explore and compare outcomes of centralized and decentralized designs on nurses’ psychosocial health, work behaviors and indirect hospital economic implications. Six nursing units in three US hospitals participated in the study. A triangulation method was used. The approach included a literature review, hospital statistical data, observations, a survey and two focus groups. Results showed small variations in comparable hospital statistics. Observations revealed office type duties as an ongoing activity. Sound levels exceeded those recommended in all nursing stations. Nurses in the decentralized stations experienced lower sense of control. Four design themes emerged from the focus groups; nurse specific support, sense of control, professional privacy and requirements to stay separate but connected. In conclusion there was no evidence suggesting that either type of nursing station design could be regarded as better in terms of nurses’ psychosocial health and work behavior.