Evaluation of the implementation of the alert issued by the UK National Patient Safety Agency on the storage and handling of potassium chloride concentrate solution

Objectives: To assess the effectiveness of the response of NHS hospital trusts to an alert issued by the National Patient Safety Agency designed to limit the availability of concentrated potassium chloride in hospitals in England and Wales, and to determine the nature of any unintended consequences. Design: Multi-method study involving interviews and a physical inspection of clinical areas. Setting: 207 clinical areas in 20 randomly selected acute NHS trusts in England and Wales between 31 October 2002 and 31 January 2003. Participants: Senior managers and ward based medical and nursing staff. Main outcome measures: Degree of staff awareness of and compliance with the requirements of the national alert, withdrawal of concentrated potassium chloride solutions from non-critical areas, provision of pre-diluted alternatives, storage and recording in accordance with controlled drug legislation. Results: All trusts required that potassium chloride concentrate be stored in a separate locked cupboard from common injectable diluents (100% compliance). Unauthorised stocks of potassium chloride were found in five clinical areas not authorised by the trust (98% compliance). All trusts required documentation control of potassium chloride concentrate in clinical areas, but errors were recorded in 20 of the 207 clinical areas visited (90% compliance). Of those interviewed, 78% of nurses and 30% of junior doctors were aware of the alert. Conclusions: The NPSA alert was effective and resulted in rapid development and implementation of local policies to reduce the availability of concentrated potassium chloride solutions. The success is likely to be partly due to the nature of the proposed changes and it cannot be assumed that future alerts will be equally effective. Continued vigilance will be necessary to help sustain the changes

What's the evidence that NICE guidance has been implemented? Results from a national evaluation using time series analysis, audit of patients' notes, and interviews

OBJECTIVES: To assess the extent and pattern of implementation of guidance issued by the National Institute for Clinical Excellence (NICE). DESIGN: Interrupted time series analysis, review of case notes, survey, and interviews. SETTING: Acute and primary care trusts in England and Wales. PARTICIPANTS: All primary care prescribing, hospital pharmacies; a random sample of 20 acute trusts, 17 mental health trusts, and 21 primary care trusts; and senior clinicians and managers from five acute trusts. MAIN OUTCOME MEASURES: Rates of prescribing and use of procedures and medical devices relative to evidence based guidance. RESULTS: 6308 usable patient audit forms were returned. Implementation of NICE guidance varied by trust and by topic. Prescribing of some taxanes for cancer (P <0.002) and orlistat for obesity (P <0.001) significantly increased in line with guidance. Prescribing of drugs for Alzheimer’s disease and prophylactic extraction of wisdom teeth showed trends consistent with, but not obviously a consequence of, the guidance. Prescribing practice often did not accord with the details of the guidance. No change was apparent in the use of hearing aids, hip prostheses, implantable cardioverter defibrillators, laparoscopic hernia repair, and laparoscopic colorectal cancer surgery after NICE guidance had been issued. CONCLUSIONS: Implementation of NICE guidance has been variable. Guidance seems more likely to be adopted when there is strong professional support, a stable and convincing evidence base, and no increased or unfunded costs, in organisations that have established good systems for tracking guidance implementation and where the professionals involved are not isolated. Guidance needs to be clear and reflect the clinical context

‘It’s not what it looks like. I’m Santa’: connecting community through film

The lived experiences of young people are becoming increasingly marginalised within the narrowly defined curricula of neoliberal contexts. Many young people are also cast within the media according to deficit discourses of youth, which contributes to the fragmentation of communities and the limitation of interaction between generations. This article describes a film project in which young people living in an ex-mining community in the Midlands of England worked in and with their community to create a representation of where they live. As part of the process, the young filmmakers did more than connect to other people’s memories as repositories of information; both as process and as product, their film can be seen to connect shared narratives of people and place, across time and space. We argue that this project offers a timely opportunity to reflect upon the ways in which we understand learning in and out of English classrooms

Winking at Facebook: capturing digitally-mediated classroom learning

In this article I present an innovative combination of methods, used in a study of the use of Facebook as an educational resource by five dyslexic students at a Sixth Form College in north-west England. Through a project in which teacher-researcher and student-participants co-constructed a Facebook group page about the students’ scaffolded research into dyslexia, the study examined the educational affordances of a digitally-mediated social network. Combining multiple data-collection methods including participant-observation, semi-structured interviews, video recordings, dynamic screen capture (Cox, 2007), protocol analysis (Ericsson & Simon, 1993) helped to capture in detail multiple perspectives on the learning that happened in the classroom over the five weeks of the research project's lifetime. Aggregating the resulting data in turn enabled meticulous, comprehensive analysis and rigorous theorising. The article presents and analyses excerpts from the data which help to illustrate the insights gained into one participant's learning trajectory. I argue that the combination of methods employed could be used with any range of research participants in other studies exploring learning through Facebook and other Web 2.0 spaces. The article concludes by suggesting further refinements to the methods used

Temporal aspects of polar bear occurrences at field camps in Wapusk National Park, Canada

Wapusk National Park, University of Manitoba, University of Saskatchewan, the Social Sciences and Humanities Research Council of Canada, Hudson Bay Helicopters, the Churchill Northern Studies Centre, and EarthRangers.Interaction between polar bears (Ursus maritimus) and people is a growing concern for both bear conservation and human safety in a warming Arctic climate. Consequently, the importance of monitoring temporal trends in the proximity of polar bears to people has become critical in managing human-polar bear conflicts. Such concerns are acute in Wapusk National Park in Manitoba, Canada on the Western Hudson Bay coast, where we deployed 18 camera traps at three remote field camps from 2010–2014 (~22,100 camera-days) to monitor the frequency and timing of bears’ visits to those facilities. Following seasonal breakup of Hudson Bay’s sea ice polar bear occurrences at these camps increased throughout the summer and into fall (low in May–July and increasing sharply through August–November and then approaching zero in December when Hudson Bay freezes). We quantified age and sex class and estimated body condition of bears visiting the camps: adult males were most prevalent at Nester One camp close to where adult males congregate at Cape Churchill, whereas the two camps farther south were visited more frequently by females with dependent young, likely traveling to and from a known maternal denning area. Few subadults were observed. As expected, body condition scores declined throughout the on-shore season. Our method of monitoring polar bear occurrence on shore is robust, cost-effective, and non-invasive, and so may provide an economical complement to data gathered through more conventional techniques

Growth or decline in the Church of England during the decade of Evangelism: did the Churchmanship of the Bishop matter?

The Decade of Evangelism occupied the attention of the Church of England throughout the 1990s. The present study employs the statistics routinely published by the Church of England in order to assess two matters: the extent to which these statistics suggest that the 43 individual dioceses finished the decade in a stronger or weaker position than they had entered it and the extent to which, according to these statistics, the performance of dioceses led by bishops shaped in the Evangelical tradition differed from the performance of dioceses led by bishops shaped in the Catholic tradition. The data demonstrated that the majority of dioceses were performing less effectively at the end of the decade than at the beginning, in terms of a range of membership statistics, and that the rate of decline varied considerably from one diocese to another. The only exception to the trend was provided by the diocese of London, which experienced some growth. The data also demonstrated that little depended on the churchmanship of the diocesan bishop in shaping diocesan outcomes on the performance indicators employed in the study

'You were quiet - I did all the marching': Research processes involved in hearing the voices of South Asian girls

This article is available open access through the publisher’s website at the link below. Copyright @ 2011 A B Academic Publishers.This article provides insights into the outcomes of reflection following two interview approaches used to explore narratives of the lived, individual experiences of South-Asian girls living in West London. In attempting to illuminate and re-present the cultural experiences as told by these girls, the choice of interview approach became critical in allowing the voices to be effectively heard (Rogers, 2005). This article therefore considers how a semi-structured interview approach offered valuable insights into the girls' experiences but became constraining for both researcher and participant in unveiling the complexity and depth of their lives. These constraints emerged through reflection by both participants and researcher. As a result of reflexivity during the research process, the researcher moved towards the use of research conversations during the second phase of the study. Ultimately the study revealed how the girls felt empowered by the opportunity to narrate their individual experiences and tell of their lives. In narrating their reflections on being part of the research, there was a clear recognition that the process facilitated the articulation of new voices and ‘multi-voicedness’ (Moen, 2006

Investigating pupils’ interactions around digital texts: a spatial perspective on the ‘classroom-ness’ of digital literacy practices in schools

This paper complements debates around use of new technologies and literacy in education by proposing a focus on “classroom-ness.” It highlights the significance of incidental, everyday and ephemeral practices associated with classroom technology-use. Using examples from a study of primary pupils’ interactions around digital texts, it argues that we must acknowledge the distinctiveness of technology-use in classroom contexts but also see the spaces associated with those contexts as continually constructed, relational and heterogeneous. This helps us look beyond binary distinctions – between in/out of school and global/local practices, on/off-screen and on/offline activity, material/virtual contexts and official/unofficial discourses – to recognise the complex and nuanced ways that children make meaning around new technologies. It is proposed that this theoretical lens – in recognising the complexity of classroom-ness – can help us better understand the barriers and opportunities associated with effective integration of new technologies in educational contexts