How do secondary school counsellors work with other professionals?

Counselling services based in secondary schools across the UK are becoming common place. Indeed, several of the home nations have national strategies and targets to introduce universal counselling into schools to address the mental health needs of young people more effectively. This study explores how secondary school counsellors work with other professionals within and outside schools in the delivery of services. Sixteen school counsellors from across the UK were interviewed, in four different focus groups - 2 in England (n=8) and 2 in Scotland (n=8). The findings indicate that the professional relationships counsellors have with other colleagues have a direct influence upon the quality of the service they feel able to offer. Time spent with colleagues when setting up services was viewed as highly beneficial, as was time spent building relationships and connections with colleagues within the school and from external agencies and organisations, as well as having a senior member of staff to liaise with. It is apparent that attending to relationships outside of the counselling room may influence the positive outcomes for the counselling service and its clients generally. Implications of these findings may influence the time counsellors are employed by commissioners, and how counsellors use their time allocation in schools to ensure that effective services are both achieved and maintained. The research also points to the need for future research into the processes and practices in the delivery of school counselling across the UK. Karen Cromarty and Kaye Richards British Association for Counselling and Psychotherap

Decreasing Seclusion and Restraint Events Among Clients Within an Inpatient and Crisis Stabilization Behavioral Health Facility

Background: Despite global shifts in behavioral health treatment, changes regarding use of seclusion and restraint (S/R) continues to be extremely slow. Local Problem: Increasing S/R events and subsequent staff injuries and financial burden. Methods: A quality improvement project providing education in trauma-informed care (TIC), sensory modulation (SM), and S/R debriefing (S/RD). Interventions: Education and training for S/RD, TIC, and SM using a variety of materials and methods over a 6 to 12-month period was provided to staff within a 16-bed inpatient adult psychiatric health facility (PHF) and a crisis stabilization unit (CSU). Because of positively affecting the use of S/R, utilizing evidence-based practices, the values of providing a culture of respect, dignity, and social responsibility align with the values of the University of San Francisco’s Jesuit tradition (University of San Francisco, n.d.). Measures: Project outcomes were assessed by pre- and post-project surveys (N=90), and S/R events and S/R debriefing comparisons. Regression analysis was used to test for intervention effect on TIC understanding and S/RD. Results: No significantly strong evidence was provided for the intervention [t987.1)=0.29, p=0.98). Increases were noted in SM understanding, and staff desire for a SM room. Conclusion: Multiple studies indicate education in TIC, SM, and S/RD present a viable avenue for decreasing S/R events. In our study, multiple confounds such as fluid leadership, staffing, project delays, and global events were strong contributors to outcomes; indicating further study is warranted in these areas. Keywords: seclusion, restraint, interventions, trauma informed care education, adult, inpatient, education, psychiatric, SM, debriefin

IMPROVING QUALITY AND EFFICIENT COMMUNICATION BETWEEN PROVIDERS AND NURSING - A PSYCHIATRIC SBAR TOOL (PSYCH)

IMPROVING QUALITY AND EFFICIENT COMMUNICATION BETWEEN PROVIDERS AND NURSING - A PSYCHIATRIC SBAR TOOL (PSYCH) Karen Richards University of San Francisco Abstract Effective communication is the cornerstone of providing safety and quality healthcare. However, nursing and providers often share information inequitably, as these disciplines are trained differently regarding communication. Providers are taught to be brief, accurate and focused while nurses are taught to be descriptive and holistic. These differences have led to disparity in the sharing of valuable patient information, subsequently leading to increased frustration, inefficiency, and medical errors. Multiple studies provide evidence that poor communication is a major contributor to preventable medical errors and subsequent increased hospital costs (Institute of Medicine, 1999; DeMeester, Verspuy, Monsieurs, & VanBogaert, 2013). Additionally, the gap between providers and nursing remains a strong intimidation factor for many younger nurses going into this field. These differences are inherent within units of C and D at a rural, not-for-profit, thirty-seven bed psychiatric hospital in Colorado. As a consequence, several of the six aims of healthcare quality which are safe, effective, patient centered, timely, efficient and equitable care as proposed by the Agency for Healthcare Research and Quality, 2016, have been implemented poorly. To address this gap, the goals of (1) increasing efficiency between providers and nursing; and (2) increasing reported quality of communication among staff will be realized by using a Psychiatric SBAR communication tool (PSYCH). Standardized communication tools have been shown to markedly increase the effectiveness of communication (The Joint Commission, 2012). This simple and cost effective intervention combined with the competencies of the Clinical Nurse Leader (CNL) such as educator, clinician and outcomes manager, shows promise regarding addressing several elements necessary for providing safe and quality care. The Psychiatric SBAR tool (PSYCH) can easily be further incorporated throughout the entire organization from new hire orientation to patient discharge. References Agency for Healthcare Research and Quality. (2016). The six domains of healthcare quality. Retrieved from http://www.ahrq.gov/professionals/quality-patient-safety/talkingquality/create/sixdomains.html De Meester, K., Verspuy, M., Monsieurs, K., & Van Bogaert, P. (2013). Clinical paper: SBAR improves nurse–physician communication and reduces unexpected death: A pre and post intervention study. Resuscitation, 84(9), 1192-1196. doi: 10.1016/j.resuscitation.2013.03.016 Institute of Medicine. (1999). To err is human: Building a safer health system. Retrieved from http://iom.nationalacademies.org/~/media/Files/Report%20Files/1999/To-Err-is-Human/To%20Err%20is%20Human%201999%20%20report%20brief.pdf The Joint Commission. (2012). Joint commission center for transforming healthcare releases targeted solutions tool for hand-off communications. Retrieved from http://www.jointcommission.org/assets/1/6/tst_hoc_persp_08_12.pd

A study of the special education administrator\u27s role related to secondary transition: Management and leadership dimensions

The primary purpose of this study was to explore the complex role of division level special education administrators relating to secondary transition services. Management and leadership dimensions of the role of special education administrators related to secondary transition services were explored by surveying all special education directors (133) in the Commonwealth of Virginia using a survey instrument specifically designed for this study.;Analyses of the data revealed significant overlap between the management and leadership components of the role suggesting that the two constructs can not be separated. The dimensions of management and leadership were highly correlated and ratings for importance of tasks related to both constructs fell between some extent and great extent on the survey scale.;There was, however, significant difference between special education administrators\u27 perceived ideal role and their real role. Transition related tasks were rated in importance between some extent and great extent , while ratings for the performance of those tasks in the real role fell between small extent and some extent .;Administrators identified enablers to their ability to administer transition services in their divisions as support of a committed knowledgeable staff, adult agencies, community, general education, and their own personal vision and knowledge. Primary barriers included lack of time, resources, knowledge, and community support. Comments on factors related to enablers and barriers seemed to be linked with both management and leadership tasks as defined by this study

Color As A Factor Of Product Choice In E-Commerce

An exploratory study was conducted to evaluate the effects of Web site background color on consumers’ attitudes toward selected product attributes and consumers’ likelihood of purchase using a mixed design factorial experiment. Simulated Web pages were created using fully saturated colors from a Web page software program. Seven levels of color, including neutral white, and three levels of product were used in the experiment.  Results indicated a trend for two of the three products to receive more positive attribute scores when featured on a blue or purple background

Agriculture, meteorology and water quality in Ireland: a regional evaluation of pressures and pathways of nutrient loss to water

peer-reviewedThe main environmental impact of Irish agriculture on surface and ground water quality is the potential transfer of nutrients to water. Soil water dynamics mediate the transport of nutrients to water, and these dynamics in turn depend on agro-meteorological conditions, which show large variations between regions, seasons and years. In this paper we quantify and map the spatio-temporal variability of agro-meteorological factors that control nutrient pressures and pathways of nutrient loss. Subsequently, we evaluate their impact on the water quality of Irish rivers. For nitrogen, pressure and pathways factors coincide in eastern and southern areas, which is reflected in higher nitrate levels of the rivers in these regions. For phosphorus, pathway factors are most pronounced in north-western parts of the country. In south-eastern parts, high pressure factors result in reduced biological water quality. These regional differences require that farm practices be customised to reflect the local risk of nutrient loss to water. Where pathways for phosphorus loss are present almost year-round—as is the case in most of the north-western part of the country—build-up of pressures should be prevented, or ameliorated where already high. In south-eastern areas, spatio-temporal coincidence of nutrient pressures and pathways should be prevented, which poses challenges to grassland management