Decision-making in an emergency department: A nursing accountability model

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Introduction Nurses that work in an emergency department regularly care for acute patients in a fast-paced environment, being at risk of suffering high levels of burnout. This situation makes them especially vulnerable to be accountable for decisions they did not have time to consider or have been pressured into. Research objective The objective of this study was to find which factors influence ethical, legal and professional accountability in nursing practice in an emergency department. Research design Data were analysed, codified and triangulated using qualitative ethnographic content analysis. Participants and research context This research is set in a large emergency department in the Midlands area of England. Data was collected from 186 nurses using participant observation, 34 semi-structured interviews with nurses and ethical analysis of 54 applicable clinical policies Ethical considerations Ethical approval was granted by two research ethics committees and the National Health Service Health Research Authority. Results The main result was the clinical nursing accountability cycle model, which showed accountability as a subjective concept that flows between the nurse and the healthcare institution. Moreover, the relations amongst the clinical nursing accountability factors are also analysed to understand which factors affect decision-making. Discussion The retrospective understanding of the factors that regulate nursing accountability is essential to promote that both the nurse and the healthcare institution take responsibility not only for the direct consequences of their actions but also for the indirect consequences derived from previous decisions. Conclusion The decision-making process and the accountability linked to it are affected by several factors that represent the holistic nature of both entities, which are organised and interconnected in a complex grid. This pragmatic interpretation of nursing accountability allows the nurse to comprehend how their decisions are affected, while the healthcare institution could act proactively to avoid any problems before they happen

Evolución de los conjuntos urbanos y su influencia en el crecimiento poblacional y el desarrollo de los espacios periurbanos en Calimaya, Estado de México, de 1990 a 2015

Este trabajo tiene el propósito de analizar la evolución e influencia de la producción habitacional del sector privado en la expansión de la urbanización y crecimiento de la población en Calimaya, Estado de México, de 1990 a 2015, mediante el uso de técnicas cualitativas y cuantitativas, tomando como base información de la Secretaría de Desarrollo Urbano estatal y municipal, INEGI y los SIG. Los datos estadísticos, cartográficos, la observación y análisis del proceso de producción habitacional a través de conjuntos urbanos en Calimaya muestran, por un lado, su tendencia a extenderse sin control en las localidades de Calimaya de Díaz González, San Andrés Ocotlán y la Concepción Coatipac, sobre las áreas de vocación agrícola que las circundan, conformando un espacio periurbano residencial desordenado y disperso, y por otro, el crecimiento acelerado de la población y sus posibles impactos sociales y ambientales derivados de estos

Teaching based on the case method of building collective protection

One of the fundamental aspects in the adaptation of the teaching to the European higher education is changing based models of teacher education to models based on student learning. In this work we present an educational experience developed with the teaching method based on the case method, with a clearly multidisciplinary. The experience has been developed in the teaching of analysis and verification of safety rails. This is a multidisciplinary field that presents great difficulties during their teaching. The use of the case method has given good results in the competences achieved by student

Analysis of teaching experience based on teaching by the case method. Application to reinforcing wooden floors

The technique of reinforcement of wooden floors is a matter clearly multidisciplinary. The teaching of the subject using the "traditional" method, explaining the theory first and then proposing and solving problems has not been successful. This paper discusses the results of a teaching experiencie. It has been the teaching of the subject by the case method. The results are clearly superior to those obtained with the traditional methodology

Dificultades docentes en el estudio de forjados de madera reforzados mediante losa superior de hormigón

El refuerzo de forjados de madera mediante la conexión de una losa de hormigón superior es una técnica ampliamente utilizada en el sector de la rehabilitación de edificios antiguos. Sin embargo, la experiencia muestra que el análisis estructural de estos tipos de refuerzos se realiza en muchas ocasiones de una manera empírica, sin aportar justificaciones numéricas, sobre todo en dos cuestiones: el análisis de la resistencia de los elementos de madera y el cálculo de la conexión. El Grupo de Innovación Educativa de la Universidad Politécnica de Madrid Enseñanza del Hormigón Estructural (EHE) está desarrollando un Proyecto de Innovación Educativa (PIE) basado en la elaboración de casos prácticos. En este trabajo se estudia uno de ellos relativo al análisis de refuerzo de forjados de madera mediante la conexión de una losa superior de hormigón

Wind pumps for irrigating greenhouse crops

Agriculture is a major consumer of energy in many countries of the world. Only a few of these countries are self-sufficient in conventional energy sources, which are also exhaustible. Fortunately, there are other sources of energy, such as wind, which has experienced recent developments in the area of wind power generation. From irrigation projects to power supply in remote farms, wind power generation can play a vital role. A simple methodology for technical evaluation of windmills for irrigation water pumping has been developed in this study to determine the feasibility per unit amount of water supplied and the levels of daily irrigation demand satisfied by windmill irrigation system at various levels of risk (probability of failure). For this purpose, a series of three hourly wind-speed data over a period of 38 years at Ciego de Ávila, Cuba, were analyzed to compute the diurnal wind pump discharge at varying levels of risk. The sizes of reservoirs required to modulate fluctuating discharge and to satisfy the levels of irrigation demand, on function of crop development dates, cultivated area and water elevation height, were computed by cumulative deficit water budgeting. An example is given illustrating the use of the methodology on tomato crop Licopersicon esculentum Mill) under greenhouse

Planificador estratégico para operaciones de rescate mediante vehículos terrestres no tripulados

El despliegue de plataformas robóticas como apoyo a la gestión de situaciones de emergencia constituye un reto que persigue mejorar la eficiencia en misiones de búsqueda y rescate. Este artículo propone un planificador estratégico para el rescate de víctimas mediante un equipo de robots terrestres. Este sistema inteligente permitirá planificar las trayectorias para acceder a las víctimas de acuerdo con su ubicación y prioridad de asistencia médica (triaje). Para la planificación se propone una nueva variante del algoritmo “ fast marching method” (FMM). En este trabajo se ofrecen resultados preliminares mediante un ejemplo de aplicación en condiciones simuladas.Universidad de Málaga. Campus de Excelencia Internacional Andalucía Tech. Proyecto nacional DPI2015-65186-R. Ayuda BES-2016-077022 del Fondo Social Europeo FSE

Ethical, legal and professional accountability in emergency nursing practice: an ethnographic observational study

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.Introduction Accountability in nursing practice is a concept that influences quality care, decision-making, safety standards and staff values. Therefore, understanding accountability and how it affects nursing practice could improve patient care and nurses’ working conditions. Aim The aim of this study was to find factors that influenced ethical, legal and professional accountability in emergency nursing practice. Methods A qualitative ethnographic approach using participant observation through convenience sampling was employed as the data collection method, while ethnographic content analysis was used for data analysis. Results The factors linked to nursing accountability found were classified into four main themes: daily dynamics, work environment evolution, customs and routines and bioethics principles’ application. Discussion The long-term effect of chronic high workload and crowding, which affects nursing accountability, could promote burnout in a junior ED workforce. Changes in the nurses’ working conditions need to be implemented to limit the workload to which an ED nurse is subjected to. Conclusion ED nurses have to manage their accountability in difficult situations regularly, which followed patterns of four main themes across the majority of situations. Nonetheless, all those factors were influenced by nursing workload, an ever-present factor that was always considered by ED nurses during decision-making

Hipoactivación en el área parahipocampal durante una tarea de “codificación/ recuperación”: estudio diferencial mediante RMf de pacientes con EA y DCL

Vuitenes Jornades de Foment de la Investigació de la FCHS (Any 2002-2003