Modelling a Foundation of Grade 4 by the Finite Element Method

Abstract

<p>In any given health care system where the incidence of disease is high and the outcome poor, the process of care should be examined to determine changes that can be made, which will lead to improved outcome. The hypothesis to be tested in this study is that carefully designed and administered continuing education programme for nurses will improve the process of care and improve the outcome in critically ill children who have been hospitalized because of measles, meningitis or tetanus. In other words, improved nursing education improve's quality of care. This thesis presents a randomized controlled trial to test the hypotheses.</p> <p>Issues in quality of care and quality assurance are discussed. An in-service education programme is developed for nurses who have no pediatric special case training but, because of shortage of medical personnel, are depended upon heavily to make judgements about care of critically ill infants.</p> <p>This educational programme is based on pathophysiological states which are designated indicator based on pathophysiological conditions. The quality of care studies done before and after the educational programme are based on nurses' management of infants with these indicator conditions. The use of pathophysiological states rather than specific diseases allows for a greater number of pediatric patients to be managed by nurses who have this in-service training since most of the infants admitted into the hospitals develop one or any combinations of these morbid states.</p> <p>A general hospital setting is chosen for this study for greater generalizability of the results since most of these infants are cared for in general hospitals; only a negligible number compared to the high incidence are admitted into teaching hospitals.</p> <p>To reiterate: the main questions that this thesis seeks to answer are:</p> <p>1. Did the nurses learn?</p> <p>2. Did they change their practice behaviour?</p> <p>3. If (1) and (2) had occurred, did the patients' health outcome change?</p>