Ward housekeepers in mental health environments

Purpose – In the year 2000, the UK Government promoted the concept that hospital services be shaped around the needs of the patient to make their stay in hospital as comfortable as possible. In recognition of this, the Government advocated the introduction of a Ward Housekeeper role in at least 50 per cent of hospitals by 2004. This is a ward-based non-clinical role centred on cleaning, food service and maintenance to ensure that the basics of care are right for the patient. Much of the guidance for the ward housekeeper role has focussed on its development and implementation in an acute hospital setting. The aim of this research is to illustrate how the role has been adopted and implemented successfully in mental health environments and the subsequent impact for patient services. Design/methodology/approach – Four case studies were undertaken in a variety of mental health settings, the principle method of data collection was qualitative semi-structured interviews. Findings – Common themes were identified from the case studies relating to experiences of developing and implementing the ward housekeeper role. This paper suggests models of best practice which relate to six main areas of: role, recruitment, induction, training, integration and management. It also demonstrates that the role has been successful and is highly valued by nursing staff. Research limitations/implications – The study was largely qualitative based and therefore the results do not lend themselves to be generalisable across the NHS.</p

Describing Pediatric Hospital Discharge Planning Care Processes Using the Omaha System

Purpose Although discharge planning (DP) is recognized as a critical component of hospital care, national initiatives have focused on older adults, with limited focus on pediatric patients. We aimed to describe patient problems and targeted interventions as documented by social workers or DP nurses providing specialized DP services in a children\u27s hospital. Methods Text from 67 clinical notes for 28 patients was mapped to a standardized terminology (Omaha System). Data were deductively analyzed. Results A total of 517 phrases were mapped. Eleven of the 42 Omaha System problems were identified. The most frequent problem was health care supervision (297/517; 57.4%). Three Omaha System intervention categories were used (teaching, guidance, and counseling; case management; and surveillance). Intervention targets are varied by role. Conclusion The findings provide a rich description of the nature of DP for complex pediatric patients and increase our understanding of the work of DP staff and the influence of the DP practice model

Child Health Care in Ireland

The Irish health care system is based on a complex and costly mix of private, statutory, and voluntary provisions. The majority of health care expenditure comes from the state, with a significant proportion of acute hospital care funded from private insurance, but there are relatively high out-of-pocket costs for most service users. There is free access to acute hospital care, but not for primary care, for all children. About 40% of the population have free access to primary care. Universal preventive public health services, including vaccination and immunization, newborn blood spot screening, and universal neonatal hearing screening are free. Major health challenges include poverty, obesity, drug and alcohol use, and mental health. The health care system has been dominated for the last 5 years by the impact of the current recession, which has led to very sharp cuts in health care expenditure. It is unclear if the necessary substantial reform of the system will happen. Government policy calls for a move toward a patient-centered, primary care-led system, but without very substantial transfers of resources and investment in Information and Communication Technology, this is unlikely to occur

Pediatric Nurses\u27 Perspectives on Medication Teaching in a Children\u27s Hospital

Purpose To explore inpatient pediatric nurses\u27 current experiences and perspectives on medication teaching. Design and Methods A descriptive qualitative study was conducted at a Midwest pediatric hospital. Using convenience sampling, 26 nurses participated in six focus groups. Data were analyzed in an iterative group coding process. Results Three themes emerged. 1) Medication teaching is an opportunity. 2) Medication teaching is challenging. Nurses experienced structural and process challenges to deliver medication teaching. Structural challenges included the physical hospital environment, electronic health record, and institutional discharge workflow while process challenges included knowledge, relationships and interactions with caregivers, and available resources. 3) Medication teaching is amenable to improvement. Conclusion Effective medication teaching with caregivers is critical to ensure safe, quality care for children after discharge. Nursing teaching practices have not changed, despite advances in technology and major changes in hospital care. Nurses face many challenges to conduct effective medication teaching. Improving current teaching practices is imperative in order to provide the best and safest care. Practice Implications This study generated knowledge regarding pediatric nurses\u27 teaching practices, values and beliefs that influence teaching, barriers, and ideas for how to improve medication teaching. Results will guide the development of targeted interventions to promote successful medication teaching practices

Focal Spot, Fall 1985

https://digitalcommons.wustl.edu/focal_spot_archives/1041/thumbnail.jp

Exploring the provision of high dependency care in children's wards

The aim of this qualitative research study was to explore the provision of high dependency care in children's wards in SW England and to identify and evaluate individual and organisational factors influencing this care. Concerns about paediatric intensive care have been reported, leading to the implementation of many changes in practice. High dependency care, which is usually provided on children's wards, is included in the organisational framework for critical care, but has received far less attention. Definitions and recommendations lack clarity, which could lead to difficulties in determining the most appropriate environment, staffing and equipment for care provision.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

Supporting experienced hospital nurses to move into community matron roles

Report of a study to examine the key knowledge and support required by nurses, experienced in the management of patients with long term conditions, to work in primary care contexts in undertaking community matron roles. Commissioned by the Department of Health (England) 200