An Exploratory Study of Patient Falls

Debate continues between the contribution of education level and clinical expertise in the nursing practice environment. Research suggests a link between Baccalaureate of Science in Nursing (BSN) nurses and positive patient outcomes such as lower mortality, decreased falls, and fewer medication errors. Purpose: To examine if there a negative correlation between patient falls and the level of nurse education at an urban hospital located in Midwest Illinois during the years 2010-2014? Methods: A retrospective crosssectional cohort analysis was conducted using data from the National Database of Nursing Quality Indicators (NDNQI) from the years 2010-2014. Sample: Inpatients aged ≥ 18 years who experienced a unintentional sudden descent, with or without injury that resulted in the patient striking the floor or object and occurred on inpatient nursing units. Results: The regression model was constructed with annual patient falls as the dependent variable and formal education and a log transformed variable for percentage of certified nurses as the independent variables. The model overall is a good fit, F (2,22) = 9.014, p = .001, adj. R2 = .40. Conclusion: Annual patient falls will decrease by increasing the number of nurses with baccalaureate degrees and/or certifications from a professional nursing board-governing body

Aggregate quasi rents and auditor independence : evidence from audit firm mergers in China

Using a sample of audit firm mergers in China\u27s audit market, this paper provides evidence on the way auditor independence can be improved following audit firm mergers as a result of a change in the aggregate quasi rents that are exposed to risk (i.e., the quasi rents at stake). This setting allows us to examine the relationship between auditor independence and the aggregate quasi rents at stake directly after controlling for the confounding effects of auditor competence, audit firm brand name, and the self-selection problem that may exist in previous studies. We hypothesize that auditors become more independent in the post-merger period only if the mergers increase the aggregate quasi rents at stake. Proxying audit quality by the frequency of modified audit opinions (MAOs) and using a \u27\u27difference-in-differences\u27\u27 research design, we conduct separate tests for two types of mergers under the institutional arrangements in China: one with an increase in the aggregate quasi rents at stake and the other with little change in these rents. Consistent with our hypothesis, we observe an improvement in auditor independence, but only for mergers that increase auditors\u27 aggregate quasi rents at stake. Moreover, the post-merger increase in the propensity for MAOs in this type of merger is positively associated with the magnitude of the change in the aggregate quasi rents at stake. Our empirical findings support the theory that auditor independence is a positive function of the aggregate quasi rents at stake

An Empirical Study of Operational Performance Parity Following Enterprise System Deployment

This paper presents an empirical investigation into whether the implementation of packaged Enterprise Systems (ES) leads to parity in operational performance. Performance change and parity in operational performance are investigated in three geographically defined operating regions of a single firm. Order lead time, the elapsed time between receipt of an order and shipment to a customer, is used as a measure of operational performance. A single ES installation was deployed across all regions of the subject firm\u27s operations.Findings illustrate parity as an immediate consequence of ES deployment. However, differences in rates of performance improvement following deployment eventually result in significant (albeit smaller than pre-deployment) performance differences. An additional consequence of deployment seems to be an increased synchronization of performance across the formerly independent regions

Inventory drivers in a pharmaceutical supply chain

In recent years, inventory reduction has been a key objective of pharmaceutical companies, especially within cost optimization initiatives. Pharmaceutical supply chains are characterized by volatile and unpredictable demands –especially in emergent markets-, high service levels, and complex, perishable finished-good portfolios, which makes keeping reasonable amounts of stock a true challenge. However, a one-way strategy towards zero-inventory is in reality inapplicable, due to the strategic nature and importance of the products being commercialised. Therefore, pharmaceutical supply chains are in need of new inventory strategies in order to remain competitive. Finished-goods inventory management in the pharmaceutical industry is closely related to the manufacturing systems and supply chain configurations that companies adopt. The factors considered in inventory management policies, however, do not always cover the full supply chain spectrum in which companies operate. This paper works under the pre-assumption that, in fact, there is a complex relationship between the inventory configurations that companies adopt and the factors behind them. The intention of this paper is to understand the factors driving high finished-goods inventory levels in pharmaceutical supply chains and assist supply chain managers in determining which of them can be influenced in order to reduce inventories to an optimal degree. Reasons for reducing inventory levels are found in high inventory holding and scrap related costs; in addition to lost sales for not being able to serve the customers with the adequate shelf life requirements. The thesis conducts a single case study research in a multi-national pharmaceutical company, which is used to examine typical inventory configurations and the factors affecting these configurations. This paper presents a framework that can assist supply chain managers in determining the most important inventory drivers in pharmaceutical supply chains. The findings in this study suggest that while external and downstream supply chain factors are recognized as being critical to pursue inventory optimization initiatives, pharmaceutical companies are oriented towards optimizing production processes and meeting regulatory requirements while still complying with high service levels, being internal factors the ones prevailing when making inventory management decisions. Furthermore, this paper investigates, through predictive modelling techniques, how various intrinsic and extrinsic factors influence the inventory configurations of the case study company. The study shows that inventory configurations are relatively unstable over time, especially in configurations that present high safety stock levels; and that production features and product characteristics are important explanatory factors behind high inventory levels. Regulatory requirements also play an important role in explaining the high strategic inventory levels that pharmaceutical companies hold

Serbia - public sector accounting review : report on the enhancement of public sector financial reporting

The government’s public financial management (PFM) Reform Program 2016-2020 foresees the gradual transition of public sector financial reporting from a cash basis to an accrual basis of accounting and the application of International Public Sector Accounting Standards (IPSAS). This will significantly improve the quality of financial information and should enable better informed decision-making, more efficient use of public funds and resources and improved fiscal performance. This Report on the Enhancement of Public Sector Financial Reporting is one output of the Serbia Public Sector Accounting Reform Technical Assistance project funded by the Swiss State Secretariat for Economic Affairs (SECO) through the Strengthening Accountability and Fiduciary Environment (SAFE) Trust Fund under the Public Sector Accounting and Reporting Program (PULSAR) which provides support for the development and implementation of public sector accounting standards. This report supports the development of a plan towards that goal by assessing the institutional framework for public sector accounting as well as the gap between Serbian public sector generally accepted accounting principles (PS GAAP) and IPSAS

Vertical specialisation indicator based on supply-driven input-output model

“Import content of exportsâ€, based on Leontief’s demand-driven input-output model, has been widely used as an indicator to measure a country’s degree of participation in vertical specialisation trade. At a sectoral level, this indicator represents the share of inter-mediates imported by all sectors embodied in a given sector’s exported output. However, this indicator only reflects one aspect of vertical specialisation – the demand side. This paper discusses the possibility of using the input-output model developed by Ghosh to measure the vertical specialisation from the perspective of the supply side. At a sector level, the Ghosh type indicator measures the share of imported intermediates used in a sector’s production that are subsequently embodied in exports by all sectors. We estimate these two indicators of vertical specialisation for 47 selected economies for 1995, 2000, 2005 using the OECD’s harmonized input-output database. In addition, the potential biases of both indicators due to the treatment of net withdrawals in inventories, are also discussed.Developing countries, Developed countries, Input-output tables, International trade, Vertical specialisation, Ghosh inverse, Supply-driven, Input-output

Just-in-case inventories - a cross-country analysis

The authors find that raw materials inventories in the manufacturing sector in the 1970s and 1980s were two to three times higher in developing countries than in the United States, despite the fact that in most developing countries real interest rates were at least twice as high. Those significantly high levels of inventories are a burden and an obstacle to country competitiveness and need to be addressed. Poor infrastructure and ineffective regulation, as well as deficiencies in market development, rather than the traditional factors used in inventory models (such as interest rates and uncertainty), are the main determinants and explain these differences. Cross-country estimations show that a one standard deviation worsening of infrastructure increases raw materials inventories by 11 percent to 37 percent, and a one standard deviation worsening of markets increases raw materials inventories by 18 percent to 37 percent. These findings are robust across a number of different proxies and specifications, including an industry-level specification that controls for fixed country effects.Banks&Banking Reform,Environmental Economics&Policies,Markets and Market Access,Economic Theory&Research,Labor Policies,Economic Theory&Research,Banks&Banking Reform,Environmental Economics&Policies,Access to Markets,Markets and Market Access

Market evidence on the opaqueness of banking firms' assets.

We assess the market microstructure properties of U.S. banking firms' equity, to determine whether they exhibit more or less evidence of asset opaqueness than similar-sized nonbanking firms. The evidence strongly indicates that large banks (traded on NASDAQ) trade much less frequently despite microstructure characteristics. Problem (noncurrent) loans tend to raise the frequency with which the bank's equity trades, as well as the equity's return volatility. The implications for regulatory policy and future market microstructure research are discussed.Bank stocks ; Bank assets

ECONOMICS OF SEQUESTERING CARBON IN THE U.S. AGRICULTURAL SECTOR

Atmospheric concentrations of greenhouse gases can be reduced by withdrawing carbon from the atmosphere and sequestering it in soils and biomass. This report analyzes the performance of alternative incentive designs and payment levels if farmers were paid to adopt land uses and management practices that raise soil carbon levels. At payment levels below $10 per metric ton for permanently sequestered carbon, analysis suggests landowners would find it more cost effective to adopt changes in rotations and tillage practices. At higher payment levels, afforestation dominates sequestration activities, mostly through conversion of pastureland. Across payment levels, the economic potential to sequester carbon is much lower than the technical potential reported in soil science studies. The most cost-effective payment design adjusts payment levels to account both for the length of time farmers are willing to commit to sequestration activities and for net sequestration. A 50-percent cost-share for cropland conversion to forestry or grasslands would increase sequestration at low carbon payment levels but not at high payment levels.Carbon sequestration, greenhouse gas mitigation, afforestation, conservation tillage, no-till, incentive design, leakage, carbon stock, permanence, Environmental Economics and Policy,