Critical Care Nurses' Views and Experiences of Preanalytical Factors Influencing Point-of-Care Testing A Qualitative Study

The main users of point of care testing devices placed outside the central laboratory are clinicians, predominantly nurses. Understanding the factors influencing sample accuracy is important to ensure appropriate clinical decision making. Previous studies focus on the analysis process, however, errors can also occur during the pre-analytical phase, linked to user knowledge, skills and other factors associated with the wider context of care. This study explored adult critical care nurses’ views about point of care testing, the challenges they experience and their suggestions on how the pre-analytic phase might be improved. Using a qualitative design, four focus group discussions took place with 60 critical care nurses studying at two London based Universities between April and July 2019. Anonymized and verbatim-transcribed focus group data were uploaded into NVivo11 and underwent a standard process of inductive thematic analysis. Findings suggest that nurses’ concerns focus on three key areas: Training and competence; Sample frequency and volume; and impacts on patients, relatives and staff. Critical care nurses view POCT as a necessary task, which aids timely patient management. However, the process can detract nurses from performing other care duties. Being able to draw less blood was identified as an important way to increase patient comfort and to reduce risks. Collaborative working is key to ensure that improvements made to the pre-analytical process reflect users’ needs. Ensuring best use of nurses’ time by streamlining preanalytical processes and ensuring equipment is readily available for use is important to ensure other clinical priorities can be achieved

Design and Bench-Scale Hydrodynamic Testing of Thin-Layer Wavy Photobioreactors

In a thin-volume photobioreactor where a concentrated suspension of microalgae is circulated throughout the established spatial irradiance gradient, microalgal cells experience a time-variable irradiance. Deploying this feature is the most convenient way of obtaining the so-called flashing light effect, improving biomass production in high irradiance. This work investigates the light flashing features of sloping wavy photobioreactors, a recently proposed type, by introducing and validating a computational fluid dynamics (CFD) model. Two characteristic flow zones (straight top-to-bottom stream and local recirculation stream), both effective toward light flashing, have been found and characterized: a recirculation-induced frequency of 3.7 Hz and straight flow-induced frequency of 5.6 Hz were estimated. If the channel slope is increased, the recirculation area becomes less stable while the recirculation frequency is nearly constant with flow rate. The validated CFD model is a mighty tool that could be reliably used to further increase the flashing frequency by optimizing the design, dimensions, installation, and operational parameters of the sloping wavy photobioreactor

Recognition and management of critical illness by midwives: implications for service provision

This is the pre-peer reviewed version of the following article: Bench, Suzanne (2007) Recognition and management of critical illness by midwives: implications for service provision. Journal of Nursing Management, 15 (3). pp. 348-356. which has been published in final form at 10.1111/j.1365-2834.2007.00759.x.This article may be used for non-commercial purposes in accordance with Wiley Terms and Conditions for Self-Archiving. Aim  The aim of this study was to explore midwives’ recognition and management of critical illness in obstetric women in order to inform service provision. Background  Critical illness is not confined to Intensive Care. Limited published work was located examining factors affecting critical care provision by midwives. Methods  A multi-method design incorporating a paper and pencil simulation (n = 11) and in-depth interviewing (n = 5) was conducted with midwives from a large London National Health Service Trust. This study details and discusses the findings. Results  Findings indicated that frequency and type of critical illness experience impact upon midwives’ critical care knowledge and skills. Midwives, especially those who were more junior, expressed anxiety regarding this aspect of practice, and considered the support of senior midwives, medical and nursing staff as crucial to effective client management. Conclusion  This study has yielded important insights into midwives’ management of critical illness. Possible mechanisms to enhance the quality of service provision, and midwife support in this area are highlighted

Clinical skills: assessing and treating shock: a nursing perspective

This document is the Accepted Manuscript version of a Published Work that appeared in final form in British Journal of Nursing copyright © MA Healthcare, after peer review and technical editing by the publisher. To access the final edited and published work see http://www.magonlinelibrary.com/doi/abs/10.12968/bjon.2004.13.12.13260 This article outlines the pathophysiology associated with hypovolaemic, cardiogenic and distributive shock, and discusses how each of these might present clinically in the patient. Nursing assessment of a patient in shock is explored, and the use of tools such as the pulse oximeter are examined. The evidence base for a variety of interprofessional interventions is analysed, including fluid therapies such as blood transfusion, the use of crystalloids and colloids, and drug therapies such as the use of inotropic and vasoactive agents. The nursing role in managing the patient in shock is considered throughout. The importance of recognizing the clinical presentation of shock is highlighted, with an emphasis on understanding the pathophysiology and potential systemic effects. Treatment is discussed and covers: providing optimal oxygen therapy, appropriate patient monitoring and location of care, using effective communication skills, assisting with activities of living, psychological support, and working collaboratively to maximize the overall quality of patient care delivered

Born and Raised - Native Nevadans

This Fact Sheet highlights population shifts and investigates the adult population of Nevada counties. Data from a 2017 GOVERNING report details Nevada’s counties and their populations

Chmura Economic Diversity Index: Nevada Counties and Southwest Metros

This Fact Sheet highlights Nevada and Mountain West data from the 2018 Economic Diversity Index (EDI), prepared by Chmura Economics & Analysis the economic diversity data details the disparities within counties in Nevada. The tables below show the different levels of economic diversity that exist in Nevada’s counties and other relevant metropolitan statistical areas (MSAs)