Evaluation of the Succession Planning Development Pathway for Consultant Nurses, Midwives and Allied Health Professionals.

sch_nurpub954pu

Developing cartoons for long-term condition self-management information

Background: Advocating the need to adopt more self-management policies has brought with it an increasing demand for information about living with and making decisions about long-term conditions, with a significant potential for using cartoons. However, the purposeful use of cartoons is notably absent in many areas of health care as is evidence of their acceptability to patients and lay others. This paper outlines the process used to develop and evaluate cartoons and their acceptability for a series of self-management guidebooks for people with inflammatory bowel disease, irritable bowel syndrome, diabetes, chronic obstructive pulmonary disease and chronic kidney disease (CKD). Methods: Principles for a process to develop information and cartoons were developed. Cartoon topics were created using qualitative research methods to obtain lay views and experiences. The CKD guidebook was used to provide a detailed exemplar of the process. Focus group and trial participants were recruited from primary care CKD registers. The book was part of a trial intervention; selected participants evaluated the cartoons during in-depth interviews which incorporated think-aloud methods. Results: In general, the cartoons developed by this process depict patient experiences, common situations, daily management dilemmas, making decisions and choices and the uncertainties associated with conditions. CKD cartoons were developed following two focus groups around the themes of getting a diagnosis; understanding the problem; feeling that facts were being withheld; and setting priorities. Think-aloud interviews with 27 trial participants found the CKD cartoons invoked amusement, recognition and reflection but were sometimes difficult to interpret. Conclusion: Humour is frequently utilised by people with long-term conditions to help adjustment and coping. Cartoons can help provide clarity and understanding and could address concerns related to health literacy. Using cartoons to engage and motivate people is a consideration untapped by conventional theories with the potential to improve information to support self-management

Potential for reported needlestick injury prevention among healthcare workers through safety device usage and improvement of guideline adherence: expert panel assessment

A prospective survey was conducted over six months in order to estimate the proportion of reported occupational needlestick injuries sustained by National Health Service (NHS) Scotland staff that could have been prevented through either safety device introduction, improved guideline adherence, guideline revision or a combination of these. This survey involved the administration of a standard proforma to healthcare workers followed by an expert panel assessment. All acute and primary care NHS Scotland trusts, the Scottish Ambulance Service and the Scottish National Blood Transfusion Service were included. Proforma and expert panel assessment data were available for 64% of injuries (952/1497) reported by healthcare staff. These injuries were all percutaneous. The expert panel concluded that: 56% of all injuries and 80% of venepuncture/injection administration injuries would probably/definitely have been prevented through safety device usage, 52% of all injuries and 56% of venepuncture/injection administration injuries would probably/definitely have been prevented through guideline adherence and 72% of all injuries and 88% of venepuncture/injection administration injuries would probably/definitely have been prevented through either intervention. Multi-factorial analysis indicated that injuries sustained through venepuncture/injection administration were significantly more likely to be prevented through safety device usage [adjusted odds ratio (OR) 5.09, 95% confidence intervals (CI) 3.11-8.31 and adjusted OR 2.70, 95% CI 1.64-4.45, respectively], and significantly less likely to be prevented through guideline adherence (adjusted OR 0.26, 95% CI 0.11-0.60 and adjusted OR 0.31, 95% CI 0.12-0.78, respectively). Injuries sustained after completing procedures were significantly more likely to be prevented through safety device usage and guideline adherence. The study's findings support the need for improvements to staff's adherence to needlestick injury guidelines and appropriate implementation of safety devices for venepuncture and injection administration

Health professionals\u27 attitudes toward caring for people with hepatitis C

An estimated 170 million people worldwide have hepatitis C, which is a significant cause of morbidity and mortality. Therefore, health professionals (HPs) are likely to care for people with hepatitis C at some stage in their careers. However, little is known about HPs\u27 attitudes towards treating people with hepatitis C. An analytical, cross-sectional survey was conducted to explore the inter-relationship among HPs\u27 hepatitis C knowledge and attitudes towards treating people with hepatitis C and their self-reported clinical behaviour: Self-administered questionnaires were distributed to 3675 complementary therapists, dentists, medical practitioners, nurses, pharmacists, undergraduate medical and nursing students and people with hepatitis C in Victoria, Australia. Forty-six per cent responded (n = 1510). Only HP (complementary therapists, dentists, medical practitioners, nurses and pharmacists) data is presented (n = 1347).Most HPs demonstrated adequate hepatitis C knowledge, but some displayed intolerant attitudes toward people with hepatitis C. Their self-reported compliance with infection control practices indicated that they frequently treated people with hepatitis C differently from other patients by using additional infection control precautions while treating patients with hepatitis C. In addition, fear of contagion and disapproval of injecting drug use emerged as barriers to their willingness to treat people with hepatitis C.The results suggest that focusing education strategies on changing HPs\u27 attitudes toward people with hepatitis C, injecting drug users, and infection control guidelines rather than concentrating solely on medical information might ultimately improve patient care.<br /

Practice development \u27without walls\u27 and the quandary of corporate practice

Aim. The context of this study is a group of clinical nurse specialists from across a Trust seeking accreditation as a practice development unit. The university was asked to facilitate the accreditation process via 11 2-hour learning sessions (including a one-hour focus group). During initial discussions between the university and practice development unit, the overarching research question for this study was set as: \u27what are the main roles and responsibilities of clinical nurse specialists?\u27 Background. Although there is no known study of a practice development unit based beyond a ward or speciality, the central tenet of the practice development unit literature is that units must demonstrate their worth if they are to survive and harness senior management support in doing so. Design and methods. Data gleaned from the transcribed audio tape-recordings of the learning sessions were studied at least three times to ensure transcription accuracy and produce detailed charts. Ethical approval was granted by the appropriate Local Research Ethics Committee and written informed consent obtained from clinical nurse specialists. The study lasted 30 months and ended in October 2004. Results. The four crucial statements that give meaning to specialist practice are: quality care giver; expert; information giver and initiator of change. Further analysis reveals the area of corporate and political practice as being missing from this and other lists of clinical nurse specialist attributes found in the literature. Clinical nurse specialists characterize their relationship with the Trust in terms of dichotomy – differing agendas and perceptions of value. Conclusions. The specialist role requires professional development in the areas of corporate and political acumen and professional business management. Relevance to clinical practice. While the findings of this study relate to one Trust and a group of 16 clinical nurse specialists, with careful application they may be transferable to other settings and groups of senior nurses