ÖZET:Bir kamu hastanesinde çalışan hemşirelerin kateter ilişkili üriner sistem enfeksiyonlarının önlenmesi hakkındaki bilgi durumları Amaç: Araştırma, İstanbul Şişli Hamidiye Etfal Eğitim ve Araştırma Hastanesi'nde çalışan hemşirelerin, üriner sistem enfeksiyonlarını önlemek üzere üriner kateter kullanımına ilişkin bilgi durumlarını değerlendirmek amacıyla yapılmıştır. Gereç ve Yöntem: Hastanede çalışan toplam 469 hemşirenin 111'i yoğun bakım, 271'i klinik hemşiresi olmak üzere %82'sine tanımlayıcı nitelikte anket uygulanmıştır. Veriler, hemşirelerin demografik özelliklerini, bilgi durumlarını belirlemeye yönelik 5 puanlı likert türünde hazırlanmış anket formu ile toplanmış, sayı, yüzde, aritmetik ortalama, tek yönlü Anova ve Kruskal Wallis testleri kullanılarak değerlendirilmiştir. Bulgular: Ön lisans düzeyinde eğitim seviyesinde, 30 yaş üstünde, bayan, mesleki deneyimi 11-15 yaş arasında olan hemşirelerin katater ile ilişkili üriner sistem enfeksiyonlarının önlenmesinde bilgi durumlarının diğer gruplara göre yüksek olduğu saptanmıştır. Yoğun bakım hemşirelerinin üriner kateterizasyonun endikasyonları ve kateteri olan hastada dikkat edilecek genel noktalar konusunda yeterli bilgiye sahip olmadıkları, üriner kateteri yerleştirme sırasındaki uygulamalara ilişkin bilgi durumlarının da yeterli olduğu belirlenmiştir. Sonuç: Araştırma, hemşirelerin eğitim durumunun, yaşının, cinsiyetinin ve mesleki deneyim sürelerinin kateter ile ilişkili üriner sistem enfeksiyonları önleme konusundaki bilgi durumlarını etkilediğini göstermiştir. Hemşirelerin kateter ilişkili üriner sistem enfeksiyonları hakkında yeterli eğitim almadıkları saptanmıştır. Üriner kateteri yerleştirme sırasındaki uygulamalara ilişkin bilgi durumlarının yeterli olduğu fakat kateter bakımı, idrar torbası kullanımı ve üriner kateterizasyonun endikasyonları konusunda yeterli bilgiye sahip olmadıkları saptanmıştır. Anahtar kelimeler: Enfeksiyonları önleme, hemşirelik girişimleri, üriner sistem infeksiyonu ABSTRACT:Level of knowledge of the nurses work in a public hospital about the prevention of catheter associated urinary tract infections Objective: To evaluate the level of knowledge of the nurses in Sisli Hamidiye Etfal Training and Research Hospital, Istanbul, about the use of a urinary catheter to prevent urinary tract infections. Materials and Method: A descriptive research was held in 82% of a total of 469 nurses, 111 of whom work in intensive care unit, and 271 work in the clinics and a survey was performed. Data was collected by using a five-point Likert type survey which was prepared to show demographic features and level of knowledge. The numerical values, percentages and the arithmetic mean were evalueted with Oneway Anova and Kruskal-Wallis tests. Results: The level of knowledge of nurses who have associate degree, older than 30 years, woman in gender, and have duration of professional experience of 11-15 years were found to be higher, compared to the others in prevention of catheter-associated urinary tract infections. ICU nurses have inadequate k...
University rankings are an essential source of comparisons between universities according to specific combinations of criteria. International or national rankings have an increasing impact on higher education institutions, stakeholders, and their environments. Thereby, on behalf of effective decision-making, university-ranking efforts should be a process involving some conflicting criteria and uncertainties in a more sensitive manner. This study presents a detailed university evaluation procedure under certain service criteria via multi-criteria decision-making (MCDM) methodologies and provides an appropriate clustering of universities according to teaching and research factors. A hierarchical cluster-based Interval Valued Neutrosophic Analytic Hierarchy Process (IVN-AHP) integrated VIKOR methodology that includes two stages, clustering and ranking, is proposed for the university evaluation problem. The hierarchical clustering method is performed using teaching and research factors in the first stage. The second stage addresses the determination weights of service criteria through IVN-AHP and the ranking of universities by using VIKOR according to service criteria under determined clusters. This study, in which the proposed methodology is applied to Turkish universities, is the most comprehensive in terms of the number of universities evaluated and participating students. Furthermore, the integration of IVN-AHP and VIKOR to solve MCDM problems is presented for the first time. This study differs from other studies in terms of novelties both methodological-based and application based. Moreover, categorizing universities with similar characteristics into groups using cluster analysis and ranking them with the MCDM methodology provide a more realistic and effective interpretation of the results.
Single-minute exchange of dies (SMED) is one of the most significant lean tools which reduces the required time for setup operations. The consideration of appropriate ergonomic interferences during the SMED implementation improves working conditions, productivity, and flexibility. The SMED literature has an opportunity for expansion with ergonomic assessment. Moreover, ergonomic assessment studies have various limitations in terms of a broad hierarchy of ergonomic factors and their weighting. Therefore, this study enriches the literature by providing the ergonomic assessment of the setup process through integrating multi-criteria decision-making (MCDM) into SMED. In this context, a wide hierarchy of ergonomic risk factors is compiled for ergonomic assessment. The Interval Valued Pythagorean Fuzzy Analytic Hierarchy Process (IVPF-AHP) method is used to determine the weights of factors. Then, Fuzzy Technique for Order Preference by Similarity to Ideal Solution (TOPSIS) is used to prioritize setup tasks in terms of ergonomic factors by using the Interval Valued Pythagorean Fuzzy Sets (IVPFSs). The proposed model was validated by applying it to a real-life manufacturing system in the white goods supplier industry. The application results justify the proposed model with a setup time reduction of 58% and an ergonomic improvement of 19%.
Purpose Autonomous maintenance (AM), one of the pillars of total productive maintenance (TPM), aims to achieve performance toward zero defects and zero breakdowns. AM system equipped with comprehensive lean tools provides continuous improvement during the AM activities. Despite its long duration, establishing a lean AM system with a robust guideline would provide significant benefits such as high quality and short lead time. Therefore, AM design approach should be provided in a holistic and detailed manner. This study aims to develop a framework for AM design, including preliminary, reactive, preventive and proactive steps using the axiomatic design (AD). Design/methodology/approach Requirements and technical parameters of the AM system are explored with AD. An extensive literature review and a real-life application are presented. Findings The proposed design was validated by adapting the proposed roadmap to a textile manufacturing system in Turkey. The application results justify the established AM system design with an average downtime improvement of 69.2% and the average elapsed time between two failures improvement of 65.1% for apparel department. Originality/value This study has the novelty of establishing an overall AM system design with all of its stages stepwise. It presents a comprehensive guideline in terms of integration of lean philosophy into AM design by generating maintenance-related use cases for lean tools. The developed approach facilitates creating and analyzing complex systems to improve maintenance implementations while reducing nonvalue-added operations.
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