Digital times: Disseminating your work and networking

This fifth and final article in the Writing for Publication series aims to provide guidance on disseminating your work and increasing professional networks through the use of social media. We will outline a range of different ways in which nurses can write about their research via blogs, and use Twitter to both grow their professional networks, and disseminate their work. Increasingly, health professionals are using social media and online resources to communicate with each other; advantages include connecting with interested others worldwide, and being able to access an audience far beyond that which could be accessed locally or via conferences

Developing and producing a focused conference poster

This fourth article in the Writing for Publication series aims to provide guidance on developing and producing a poster presentation for a conference. Most academic conferences offer opportunities for health professionals to present their work as an oral presentation or a poster; an earlier paper in this series discussed the submission of abstracts to conference organisers for consideration. Planning, preparing and producing a poster presentation requires different skills from those used when giving an oral presentation. These are examined in this paper by outlining what is meant by a poster presentation, and discussing key issues to consider when planning and producing a poster, and when presenting it at a conference

South African critical care nurses' views on end-of-life decision-making and practices.

BACKGROUND: Care of patients at the end-of-life (EOL) may be influenced by the experiences, attitudes and beliefs of nurses involved in their direct care. AIM: To investigate South African critical care nurses' experiences and perceptions of EOL care. DESIGN: Cross-sectional survey. METHODS: South African critical care nurses completed a modified version of the 'VENICE' survey tool. Data were collected concerning: attitudes towards EOL care; involvement in EOL decision-making; and beliefs about EOL practices. RESULTS: Of 149 surveys distributed, 100 were returned (response rate 67%). Seventy-six percent stated that they had had direct involvement in EOL care of patients, but a minority (29%) had participated in EOL decision-making processes. Whilst most nurses (86%) were committed to family involvement in EOL decisions, less than two thirds (62%) reported this as routine practice. When withdrawing treatment, around half (54%) of the respondents indicated they would decrease the inspired oxygen level to room air, and the majority (84%) recommended giving effective pain relief. Continued nutritional support (84%) and hydration (85%) were advocated, with most nurses (62%) indicating that they were against keeping patients deeply sedated. Most respondents (68%) felt patients should remain in intensive care at the end of life, with the majority (72%) supporting open-visiting, no restriction on number of family members visiting (70%), and the practising of religious or traditional cultural EOL rituals (93%). CONCLUSIONS: The involvement of Johannesburg critical nurses in EOL care discussions and decisions is infrequent despite their participation in care delivery and definite views about the process. RELEVANCE TO CLINICAL PRACTICE: Use of formal guidelines and education is recommended to increase the nurses' involvement in and their confidence in participating in EOL decisions. Educators, managers, senior nurses and other members of the multi-disciplinary team should collaborate to enable critical care nurses to become more involved in EOL care

Low-dose intensive insulin therapy in patients with acute coronary syndrome accompanied by left ventricular failure: Audit of two UK hospitals

Aims & Objectives: To determine whether a low-dose intravenous insulin regimen reduces blood glucose levels at a timely rate and associated side effects among patients with Acute Coronary Syndrome and Left Ventricular Failure. Background: Induced hypoglycaemia and the associated risks have questioned the benefits of intensive insulin therapy in patients presenting with raised blood glucose levels and Acute Coronary Syndromes. Local audit data identified that patients with Acute Coronary Syndrome and Left Ventricular Failure experienced more hypoglycaemic episodes than those with Acute Coronary Syndrome alone. Consequently, a new regimen of low-dose insulin for this group was implemented and audited over 12 months.Design: AuditMethods: 36 consecutive patient notes with a diagnosis of Acute Coronary Syndrome and blood glucose of ≥10 mmol/L treated with a new insulin therapy regimen were analysed. Data were extracted using a standardised form and entered into Excel spreadsheet for analysis.Results: The mean age of the sample was 70 years with 66% of subjects being men and 50% presenting with Acute Coronary Syndrome and Left Ventricular Failure. The low dose regimen was effective in achieving normoglycaemia, (range 4-8mmol/L) for a consecutive six hour period. This was achieved in 72% of patients and within a median time of 13 hours. Conclusion: The audit suggests that a low-dose insulin regimen can effectively stabilise blood glucose in patients presenting with both Acute Coronary Syndrome and Left Ventricular Failure. The importance of regularly monitoring blood sugar levels is vital and highlights the role of nurses in minimising patient risk and promoting safety.Relevance to practice: Nurses are instrumental in the safe implementation of intensive insulin guidelines. Close monitoring of patients is essential, enabling timely adjustments to treatments and ensuring patient safety. Regular audits allow nurses to evaluate care provision and continue to drive practice forward

Family witnessed resuscitation - experience and attitudes of German intensive care nurses.

To explore German intensive care nurses' experiences and attitudes toward family witnessed resuscitation (FWR). The subject of FWR has fuelled much controversy among health professionals. Typically studies involving European critical and cardiac nurses' under-represent the perspective of individual countries. Arguably research exploring the experiences and attitudes of nurses by country may expand understanding and embrace cultural values. Descriptive survey. Three hundred and ninety-four German intensive care nurses attending a conference were invited to complete a 36-item questionnaire on their experiences and attitudes towards FWR. Participants were also invited to share, in writing, other thoughts relevant to the study. Data was analysed using descriptive statistics. A total of 166 (42.1%) questionnaires were returned completed. Seventy participants had experiences with family members being present and for 46 (65.7%) these were negative. Participants (68%) did not agree that family members should have the option to be with loved ones during resuscitation. Over half (56.0%) were concerned that family presence may adversely influence staff performance during resuscitation procedures. There was a lack of certainty about the outcomes of the practice, although 61% agreed that family presence could facilitate better understanding among relatives. Qualitative responses where characterized by four broad themes relating to individualized decision-making, supporting families, threats of violence and family involvement. German intensive care nurses have guarded attitudes towards FWR because of their experiences and concerns for the well-being of relatives and staff. Introducing this topic within nursing curricula, as part of resuscitation training and by wider professional debate will help challenge and resolve practitioner concerns and objections. Health professionals have anxieties about possible consequences of FWR, strategies involving education and simulation training may improve attitudes

A randomised controlled trial of student nurse performance of cardiopulmonary resuscitation in a simulated family-witnessed resuscitation scenario

© 2017 Elsevier Ltd This randomized controlled trial, conducted in a UK University nursing department, compared student nurses' performance during a simulated cardiac arrest. Eighteen teams of four students were randomly assigned to one of three scenarios: 1) no family witness; 2) a “quiet” family witness; and 3) a family witness displaying overt anxiety and distress. Each group was assessed by observers for a range of performance outcomes (e.g. calling for help, timing to starting cardiopulmonary resuscitation), and simulation manikin data on the depth and timing of three cycles of compressions. Groups without a distressed family member present performed better in the early part of the basic life support algorithm. Approximately a third of compressions assessed were of appropriate pressure. Groups with a distressed family member present were more likely to perform compressions with low pressure. Groups with no family member present were more likely to perform compressions with too much pressure. Timing of compressions was better when there was no family member present. Family presence appears to have an effect on subjectively and objectively measured performance. Further study is required to see how these findings translate into the registered nurse population, and how experience and education modify the impact of family member presence

Leadership course evaluation with patient and public involvement

Executive Summary1. This project had two components, the evaluation of a Developing and Enhancing Leadership and Management Skills programme delivered to 150 frontline supervisory and senior managers in North Bristol NHS Trust and the implementation of guidelines for Patient and Public Involvement (PPI) in research.2. Evaluation data were collected through three knowledge café events engaging 36 staff. These events were used to facilitate and record meaningful conversations that were focused around five questions. Follow-up interviews were conducted with a further 15 staff.3. The PPI guidelines were applied throughout the project and the experiences of the two service users involved were recorded through ongoing dialogue and review of guideline implementation.4. Data from the events and interviews suggested the programme had benefits for staff. These included the development of new insights and better understanding of the roles and experiences of other leaders in the Trust. Immediate and sustained outcomes were also reported for the individuals and organisation. Staff felt that they moved forward professionally and had insight into the “bigger picture”. They also welcomed delivery from external facilitators who had a refreshing approach.5. Staff were also able to demonstrate new learning. In particular the programme had changed their approach to handling leadership issues and their use of tools and skills. Managers reported taking a different approach to the management of more challenging situations, planning responses rather than reacting and encouraging problem-solving and reflection in staff.6. Staff reflected on a number of issues that affected their ability to apply learning in practice. They commented on the need for a learning culture, with a strategy to support the implementation of new learning. They felt senior managerial support with the implementation of change was crucial. Having the time to implement learning was important and access to ongoing support to implement change would also be helpful, through perhaps knowledge café events or supervision and coaching.7. The service users found their involvement in this research to be largely positive, though there is a need to ensure all academics are attuned to the needs of service users engaged in projects.8. A number of recommendations emerged, such as: continue to include a wide range of staff in the same programme to allow sharing of expertise; consider delivering to an even wider range of staff including team leaders; maintain external consultancy role in delivery; consider post-course follow-up and include this in the initial contracting. There was also a recommendation that the organisation undertake internal reflections that explore the current learning culture and identify ways of supporting staff to implement learning in practice.9. The UWE guidelines for PPI in research were evaluated as being fit for purpose and could usefully guide service user and carer involvement in a range of evaluation and research projects

Family presence during resuscitation: Validation of the risk–benefit and self-confidence scales for student nurses

© 2016, © The Author(s) 2016. Background. There is increasing debate about the advantages and disadvantages of family-witnessed resuscitation. Research about the views of healthcare providers depends upon reliable tools to measure their perceptions. Two tools have been developed for use with nurses (26-item cost-benefit tool, 17-item self-confidence tool). Objectives. Firstly, to validate these tools for use with student nurses in the UK. Secondly, to report on the perceived risks and benefits reported by student nurses, and their self-confidence in dealing with this situation. Methods. A sample of 79 student nurses were invited to complete the tools. Item-total correlations and Cronbach’s α were used to determine internal consistency. Factor analysis was computed to assess construct validity. The correlation between the two scales was explored. Results. 69 students completed a questionnaire. Very few had experience of family-witnessed resuscitation. Mean total scores were 3.16 (standard deviation 0.37; range 2.04–4.12) on the risk-benefit scale and 3.14 (standard deviation 0.66; range 1.94–4.82) on the self-confidence scale. Four of the original items were removed from the risk-benefit scale (Cronbach's α 0.86; 95% confidence interval ≥0.82). None were removed from the self-confidence scale (Cronbach's α 0.93; 95% confidence interval ≥0.91). There was a significant correlation between the two scales (r = 0.37, p = 0.002). Conclusions. There is growing evidence that these tools are valid and reliable for measuring student nurses’ perceptions about family-witnessed resuscitation

The Challenges facing midwifery educators in sustaining a future education workforce

Background national and international trends have identified concerns over the ability of health and social care workforces in meeting the needs of service users. Attention has increasingly been drawn to problems of recruiting and retaining professionals within higher education; however data in relation to the midwifery profession is scant. Aim to examine the perceptions and experiences of midwifery educators, in south-west England, about the challenges facing them sustaining the education workforce of the future. Design a mixed methodology approach was adopted involving heads of midwifery education and midwife educators. Methodology midwifery participants were recruited from three higher education institutions in south west England. Data collection comprised of self-administered questionnaires plus individual qualitative interviews with heads of midwifery education (n=3), and tape recorded focus groups with midwife academics (n=19). Numerical data were analysed using descriptive statistics. Textual data were analysed for themes that represented the experiences and perspectives of participants. Ethics approval was granted by one University Ethics committee. Findings demographic data suggests that within south-west England, there is a clear ageing population and few in possession of a doctorate within midwifery. The six identified sub-themes represented in the data describe challenges and tensions that midwifery academics experienced in their efforts to attract new recruits and retain those in post in a highly changing educational environment which demands more from a contracting workforce. Conclusion and implications for practice there remain some serious challenges facing midwifery educators in sustaining the future education workforce, which if unresolved may jeopardise standards of education and quality of care women receive. Active succession planning and more radical approaches that embrace flexible careers will enable educational workforce to be sustained and by a clinically credible and scholarly orientated midwifery workforce