The complexities and challenges of introducing electronic Ongoing Achievement Records in the pre-registration nursing course using PebblePad and hand-held tablets

This paper reports on a small pilot study aimed at eliciting the lecturer and student experience of using PebblePad to record the students' Ongoing Achievement Record (OAR) using hand-held tablets, at one university in England. Android tablets were purchased and attempts were made to transfer the OAR into the PebblePad system in an attempt to enhance the student experience of feedback from their via PebblePad, embed PebblePad learning technology in the practice component of the curriculum, enable the student to more readily engage in reflection and feedback with their personal tutor, practice education link and mentor, develop skills in the use of PebblePad and pilot the use of PebblePad in developing the Ongoing Achievement Record. Focus groups were carried out with students nurses (n=6) and lecturers (n=5) where participants were asked to discuss the successes and challenges of using PebblePad for the Ongoing Achievement Record, and suggest ways in which this strategy may be implemented more widely. Through a thematic analysis of the focus groups three broad themes of 'timing', 'technology literacy' and 'the technology' were identified. The findings from the study indicated that whilst this was not a positive experience on the whole for a number of reasons, there are lessons that can be learnt when attempting to introduce new ways of engaging with technology to enhance the student experience. Recommendations for implementing such an approach in the future are also presente

Care transitions for frail, older people from acute hospital wards within an integrated healthcare system in England: a qualitative case study

Introduction: Frail older people experience frequent care transitions and an integrated healthcare system could reduce barriers to transitions between different settings. The study aimed to investigate care transitions of frail older people from acute hospital wards to community healthcare or community hospital wards, within a system that had vertically integrated acute hospital and community healthcare services.Theory and methods: The research design was a multimethod, qualitative case study of one healthcare system in England; four acute hospital wards and two community hospital wards were studied in depth. The data were collected through: interviews with key staff (n =17); focus groups (n = 9) with ward staff (n = 36); interviews with frail older people (n = 4). The data were analysed using the framework approach. Findings: Three themes are presented: Care transitions within a vertically integrated healthcare system, Interprofessional communication and relationships; Patient and family involvement in care transitions.Discussion and conclusions: A vertically integrated healthcare system supported care transitions from acute hospital wards through removal of organisational boundaries. However, boundaries between staff in different settings remained a barrier to transitions, as did capacity issues in community healthcare and social care. Staff in acute and community settings need opportunities to gain better understanding of each other’s roles and build relationships and trust