An evaluation of a clinical competency toolkit for nurses and midwives

The National Council of Nurses and Midwives in Ireland Commissioned the School of Nursing and Midwifery, Trinity College Dublin, through an open tender process to develop and test a toolkit to assist service managers, nurse and midwife managers and nurses and midwives in clinical competency determination and competency development planning. This paper provides an overview of the development process of the toolkit and its links to existing competency frameworks for nurses’ and midwives’ and documents published by the National Council. The presentation will provide details on the evaluation process used to valuidate the toolkit in Ireland through teh use of a mixed-method approach in sixteen pilot sites. A purposive sample of 455 registered nurses or midwives were recruited to participate in the survey aspect of the pilot. In total 208 questionnaires were returned representing 46% of the total number distributed. The questionnaires sought experiences of using competencies, and opinions on the structure, content, relevance and utility of the toolkit, plus feedback on using the tools provided within the toolkit. Participants were also given the opportunity to provide opinions on how to improve the toolkit in an open response section, a demographic section was also included. In total, 45 people (73% response rate) also participated in six focus group interviews. A semi-structured interview schedule developed by the team was used to guide the discussion. The schedule addressed the areas of relevance, credibility, readability, helpfulness, and user friendliness

An evaluation of a clinical competency toolkit for nurses and midwives

The National Council of Nurses and Midwives in Ireland Commissioned the School of Nursing and Midwifery, Trinity College Dublin, through an open tender process to develop and test a toolkit to assist service managers, nurse and midwife managers and nurses and midwives in clinical competency determination and competency development planning.This paper provides an overview of the development process of the toolkit and its links to existing competency frameworks for nurses’ and midwives’ and documents published by theNational Council. The presentation will provide details on the evaluation process used to valuidate the toolkit in Ireland through teh use of a mixed-method approach in sixteen pilot sites. A purposive sampleof 455 registered nurses or midwives were recruited to participate in the survey aspect of the pilot. In total 208 questionnaires were returned representing 46% of the total number distributed. The questionnaires sought experiences of using competencies, and opinions on the structure, content, relevance and utility of the toolkit, plus feedback on using the tools provided within the toolkit. Participants were also given the opportunity to provide opinions on how to improve the toolkit in an open response section, a demographic section was also included. In total, 45 people (73% response rate) also participated in six focus group interviews. A semi-structured interview schedule developed by the team was used to guide the discussion. The schedule addressed the areas of relevance, credibility, readability, helpfulness, and user friendliness.</p

Characterization of pain-related behaviors in a rat model of acute-to-chronic low back pain: single vs. multi-level disc injury

IntroductionLow back pain is the most common type of chronic pain. We examined pain-related behaviors across 18 weeks in rats that received injury to one or two lumbar intervertebral discs (IVD) to determine if multi-level disc injuries enhance/prolong pain.MethodsTwenty-three Sprague-Dawley adult female rats were used: 8 received disc puncture (DP) of one lumbar IVD (L5/6, DP-1); 8 received DP of two lumbar IVDs (L4/5 &amp; L5/6, DP-2); 8 underwent sham surgery.ResultsDP-2 rats showed local (low back) sensitivity to pressure at 6- and 12-weeks post-injury, and remote sensitivity to pressure (upper thighs) at 12- and 18-weeks and touch (hind paws) at 6, 12 and 18-weeks. DP-1 rats showed local and remote pressure sensitivity at 12-weeks only (and no tactile sensitivity), relative to Sham DP rats. Both DP groups showed reduced distance traveled during gait testing over multiple weeks, compared to pre-injury; only DP-2 rats showed reduced distance relative to Sham DP rats at 12-weeks. DP-2 rats displayed reduced positive interactions with a novel adult female rat at 3-weeks and hesitation and freezing during gait assays from 6-weeks onwards. At study end (18-weeks), radiological and histological analyses revealed reduced disc height and degeneration of punctured IVDs. Serum BDNF and TNFα levels were higher at 18-weeks in DP-2 rats, relative to Sham DP rats, and levels correlated positively with remote sensitivity in hind paws (tactile) and thighs (pressure).DiscussionThus, multi-level disc injuries resulted in earlier, prolonged and greater discomfort locally and remotely, than single-level disc injury. BDNF and TNFα may have contributing roles

Persistent endotheliopathy in the pathogenesis of long COVID syndrome

Background: Persistent symptoms including breathlessness, fatigue, and decreased exercise tolerance have been reported in patients after acute SARS-CoV-2 infection. The biological mechanisms underlying this "long COVID" syndrome remain unknown. However, autopsy studies have highlighted the key roles played by pulmonary endotheliopathy and microvascular immunothrombosis in acute COVID-19.Objectives: To assess whether endothelial cell activation may be sustained in convalescent COVID-19 patients and contribute to long COVID pathogenesis.Patients and methods: Fifty patients were reviewed at a median of 68 days following SARS-CoV-2 infection. In addition to clinical workup, acute phase markers, endothelial cell (EC) activation and NETosis parameters and thrombin generation were assessed.Results: Thrombin generation assays revealed significantly shorter lag times (p Conclusions: Collectively, our findings demonstrate that sustained endotheliopathy is common in convalescent COVID-19 and raise the intriguing possibility that this may contribute to long COVID pathogenesis.</p