| 1. |
- Abrahamsson, Sten, 1953-, et al.
(författare)
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Integrated Management Systems : testing a model for integration
- 2011
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Ingår i: 14th Toulon-Verona Conference. - Alicante : University of Alicante. - 9788890432712 ; , s. 22-35
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Konferensbidrag (refereegranskat)abstract
- Management systems are widely used for creating order, minimising risks and for assuring performance. Management systems are in many occasions integrated since this has been found to be beneficial. In this paper a model for a fully integrated management system (IMS) based on the three axes of level, extent and scope of integration is tested for relevance. The studied system permits the integration of all relevant process dimensions. The research is only in a pilot stage, but the initial results are promising and indicate that there are advantages in using the process view as a base for identifying critical aspects to be managed. A review of the current situation for system integration is studied and the model is subjected to some tests using Sweden as a case. The background study shows that system integration still is limited, especially when comparing with a fully integrated IMS. The feedback from the organisations interviewed is positive and supports continued work with development of the model.
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| 2. |
- Abrahamsson, Sten, 1953-, et al.
(författare)
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Integrated Management Systems : advantages, problems and possibilities
- 2010
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Ingår i: 13th Toulon-Verona Conference. - 9789729344046 ; , s. 1-12
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Konferensbidrag (refereegranskat)abstract
- Effective management in the globalized world requires an effective, efficient and flexible management system. Effective could be interpreted as addressing all relevant stakeholder concerns in a context of Corporate Social Responsibility (CSR). Efficient would mean that it does the job with low resource use. Flexibility requires that changed conditions and new requirements easily can be included. Many organizations are already working with Integrated Management Systems (IMS). Interesting questions are to what extent current integration covers the above mentioned needs and if not what changes are needed. This conceptual paper looks at the advantages and problems of integration. Possibilities for development of fully integrated management systems are studied from the perspective of managing stakeholder needs, with the forthcoming ISO 26000 – “Guidance on social responsibility”, as inspiration. Results show that there are advantages in integration, but that the scope and level of integration often is limited. A conceptual model for integrating all stakeholder needs in value networks is presented.
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| 3. |
- Aldenbratt, Annika, et al.
(författare)
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Estimation of kidney function in patients with primary neuromuscular diseases : is serum cystatin C a better marker of kidney function than creatinine?
- 2021
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Ingår i: JN. Journal of Nephrology. - : Springer Science and Business Media LLC. - 1121-8428 .- 1724-6059. ; 35:2, s. 493-503
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Using serum creatinine leads to an overestimation of kidney function in patients with primary neuromuscular disorders, and reduced kidney function may remain undetected. Cystatin C (CysC) could provide a better estimation.AIM: To evaluate the precision, accuracy, and bias of two creatinine-, one cystatin C-based and one combined equation to estimate glomerular filtration rate (eGFR) in patients with primary neuromuscular disease.PATIENTS AND METHODS: Of the 418 patients initially identified at the out-patient clinic, data on kidney function was obtained for 145 adult patients (age 46 ± 14 years, BMI 26 ± 6 kg/m2) with primary neuromuscular disease. Kidney function was measured by iohexol clearance, and blood samples for serum creatinine and CysC were drawn simultaneously. Bias was defined as the mean difference between eGFR and measured iohexol clearance, and accuracy as the proportion of eGFRs within ± 10% (P10) of measured clearance.RESULTS: Kidney function (iohexol clearance) was 81 ± 19 (38-134) ml/min/1.73m2. All equations overestimated kidney function by 22-60 ml/min/1.73m2. eGFR CysC had the lowest bias overall 22 (95% CI 20-26) ml/min/1.73m2 also at all levels of kidney function we evaluated (at 30-59 ml/min/1.73m2 bias was 27 (95% CI 21-35), at 60-89 it was 25 (95% CI 20-28) and at ≥ 90 it was 12 (95% CI 7-22)). eGFR CysC also had the best accuracy in patients with reduced kidney function (P10 was 5.9% at 30-59 ml/min/1.73m2).CONCLUSIONS: Cystatin C-based estimations of kidney function performed better than creatinine-based ones in patients with primary neuromuscular disease, but most importantly, all evaluated equations overestimated kidney function, especially in patients with reduced kidney function. Therefore, kidney function should be measured by gold-standard methods when precision and accuracy are needed.
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| 4. |
- Amouzgar, Kaveh, 1980-, et al.
(författare)
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An approach towards generating surrogate models by using RBFN with a priori bias
- 2014
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Ingår i: Proceedings of the ASME International Design Engineering Technical Conferences & Computers and Information in Engineering Conference, 2014, Vol. 2B. - New York, USA : ASME Press. - 9780791846322
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Konferensbidrag (refereegranskat)abstract
- In this paper, an approach to generate surrogate modelsconstructed by radial basis function networks (RBFN) with a prioribias is presented. RBFN as a weighted combination of radialbasis functions only, might become singular and no interpolationis found. The standard approach to avoid this is to add a polynomialbias, where the bias is defined by imposing orthogonalityconditions between the weights of the radial basis functionsand the polynomial basis functions. Here, in the proposed a prioriapproach, the regression coefficients of the polynomial biasare simply calculated by using the normal equation without anyneed of the extra orthogonality prerequisite. In addition to thesimplicity of this approach, the method has also proven to predictthe actual functions more accurately compared to the RBFNwith a posteriori bias. Several test functions, including Rosenbrock,Branin-Hoo, Goldstein-Price functions and two mathematicalfunctions (one large scale), are used to evaluate the performanceof the proposed method by conducting a comparisonstudy and error analysis between the RBFN with a priori and aposteriori known biases. Furthermore, the aforementioned approachesare applied to an engineering design problem, that ismodeling of the material properties of a three phase sphericalgraphite iron (SGI) . The corresponding surrogate models arepresented and compared
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| 5. |
- Arakelian, Erebouni, 1973-, et al.
(författare)
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I Stay : Swedish Specialist Nurses in the Perioperative Context and Their Reasons to Stay at Their Workplace
- 2019
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Ingår i: Journal of Perianesthesia Nursing. - : Elsevier BV. - 1089-9472 .- 1532-8473. ; 34:3, s. 633-644
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Tidskriftsartikel (refereegranskat)abstract
- Purpose To investigate why nurse anesthetists and operating room nurses choose to stay in the same workplace.Design Qualitative design.Methods Individual interviews were conducted with 15 nurse specialists from four hospitals in Sweden. Two men and 13 women aged between 43 and 63 participated. Data were analyzed with systematic text condensation according to Malterud.Findings Three themes were identified. (1) Organizational stability contributed to low staff turnover, with good spirits between colleagues, representing everyone’s equal value and resulting in a feeling of homelikeness. (2) Sustained development in one’s own profession. (3) A humane head nurse who was at hand, who was a facilitator, who knew staff members, and eliminated obstacles for them.Conclusions In a nonhierarchical and stable organization with a head nurse with caritative leadership skills, a welcoming working environment with opportunities for professional development is created. Thus, nurse specialists choose to stay, contributing to organizational development.
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| 6. |
- Arakelian, Erebouni, 1973-, et al.
(författare)
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Managerial challenges faced by Swedish nurse managers in perioperative settings : a qualitative study
- 2021
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Ingår i: BMC Nursing. - : Springer Science and Business Media LLC. - 1472-6955 .- 1472-6955. ; 20:1, s. 1-10
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Tidskriftsartikel (refereegranskat)abstract
- BACKGROUND: Nurse managers need to create cultures that are worthy, not only of the commitment of everyone who comes to work but also of the trust of everyone who comes to be served. The aim of our study was to describe the challenges faced by Swedish nurse managers in a perioperative setting.METHODS: A qualitative study was conducted. The participants were chosen by convenience sampling, and individual in-depth interviews were conducted. Data were analysed by Systematic Text Condensation. The COREQ checklist was consulted throughout the study to optimise the quality.RESULTS: Nineteen nurse managers (all women) participated. Six themes were identified: "striving to treat employees with consideration and solicitude"; "the obligation to take care of each employee's individual needs"; "convincing others was an uphill battle", "finding solutions when things seem impossible"; "staff recruitment, allocation, and management"; "working with constantly changing planning".CONCLUSIONS: The nurse managers faced challenges because of the overwhelming amount of work tasks, with almost no time for reflection. Having carefully chosen tasks and a realistic time schedule for each work task, plus time to find one's own path to inner peace, are essential for nurse managers. Organisations that provide these prerequisites show that they care about their nurse managers. The results of this study indicate the need for time to reflect, as well as support from superior managers and from the human resources department.
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| 7. |
- Arakelian, Erebouni, 1973-, et al.
(författare)
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Nurse managers in perioperative settings and their reasons for remaining in their jobs : A qualitative study
- 2020
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 28:6, s. 1191-1198
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Tidskriftsartikel (refereegranskat)abstract
- AIM: The study describes what helps nurse managers maintain the strength to keep going as leaders.BACKGROUND: Good leadership is important for the quality of patient care, patient satisfaction in care and efficiency. Many nurse managers stay on despite challenges at work.METHODS: Twelve nurse managers were interviewed. Data were analysed by systematic text condensation according to Malterud.RESULTS: The results were as follows: A-Walking side by side with my employees; B-Knowing that I mean something to my employees; C-Talking to myself-asking myself tough questions; D-Having someone to talk to, to decrease the feeling of being alone; E-Leading and managing in my own way-the fear of not succeeding is my motivation.CONCLUSION: The nurse managers built their own strategies to get through and get on when difficult situations arose. In order to succeed in leading their employees, the nurse managers gathered their inner strength through moving caritatively back and forth between the 'secret room' and the 'staff room' in the house of leadership.IMPLICATIONS IN NURSING MANAGEMENT: The manuscript gives insights into where nurse managers found sources of strengths in their everyday work. To realize their employees' strengths and motivation made a difference for nurse managers as a driving force. By having someone to talk to and by asking themselves tough questions, they were prepared for the challenges that came.
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| 8. |
- Arakelian, Erebouni, 1973-, et al.
(författare)
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Reaching a tipping point : perioperative nurse managers' narratives about reasons for leaving their employment - a qualitative study.
- 2021
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Ingår i: Journal of Nursing Management. - : Hindawi Limited. - 0966-0429 .- 1365-2834. ; 29:4, s. 664-671
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Tidskriftsartikel (refereegranskat)abstract
- AIM: To describe reasons why nurse managers in perioperative settings decide to leave their employment.BACKGROUND: Current literature has shown that perioperative nurse managers' reasons to leave their positions are formed through an interaction of factors.METHODS: Individual in-depth interviews were performed with seven nurse managers, all women, in perioperative settings in Sweden. Data were analysed using Systematic Text Condensation.RESULTS: Five key themes were identified: a- To end where I started, as a front-line nurse; b- I wanted to develop further to the next level in my career; c- I ran out of ideas; d- I lost trust in my head manager and did not believe in the new organization, and e- I had had enough of being offended by my superior manager and my employees.CONCLUSION: Nurse managers experienced feeling forced into a decision to leave because of being offended by their superiors or their employees. Furthermore, the findings indicate that nurse managers should be offered support from superior managers and the organization together with time for discussions.IMPLICATIONS IN NURSING MANAGEMENTS: The most essential element should be the influence of caritative leadership and the obvious expectation of being treated with dignity, respect, and appreciation.
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| 9. |
- Arakelian, Erebouni, 1973-, et al.
(författare)
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The meaning of person-centred care in the perioperative nursing context from the patient's perspective : an integrative review
- 2017
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Ingår i: Journal of Clinical Nursing. - : Wiley. - 0962-1067 .- 1365-2702. ; 26:17-18, s. 2527-2544
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Tidskriftsartikel (refereegranskat)abstract
- AIMS AND OBJECTIVES: To determine the meaning of person-centred care from the patient's perspective and in the context of perioperative nursing. BACKGROUND: Person-centred care (PCC) is used but not defined in the perioperative context. The concept indicates an interest in the patient's own experience of health, illness, needs and preferences. As with many terms that are frequently used, there is a tendency for person-centred care to mean different things to different people in different contexts. METHODS: A two-part search strategy was employed; firstly, a computerized database search of PubMed and CINAHL, using Medical Subject Headings and free terms to search articles dating from 2004 to 2014, and secondly, a hand-search of those articles' reference lists was performed. Twenty-three articles were selected and an integrative review was conducted. RESULTS: Four themes were discovered: 'Being recognized as a unique entity and being allowed to be the person you are', 'Being considered important by having one's personal wishes taken into account', 'The presence of a perioperative nurse is calming; prevents feelings of loneliness and promotes wellbeing, which may speed up recovery', and 'Being close to and being touched by the perioperative nurse during surgery'. CONCLUSIONS: PCC means respecting the patient as a unique individual, considering the patient's particularities and wishes, and involving the patient in their own care. PCC also implies having access to one's own nurse who is present both physically and emotionally through the entire perioperative process and who guides the patient and follows up postoperatively, guaranteeing that the patient is not alone. RELEVANCE TO CLINICAL PRACTICE: By having a common understanding of the concept of PCC, the nurse anaesthetists' and theatre nurses' caring actions or concerns will be directed towards the patient', resulting in personalization of care rather than simply defining the concept. This article is protected by copyright. All rights reserved.
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