Professional development programmes for teachers moving from majority to minoritised language medium education:Lessons from a comparative study

Education through the medium of a minoritised language is widely regarded as a critical component of language revitalisation initiatives. Given the demographic and social position of many minoritised languages, however, it may not be easy to find teachers who are fluent and literate in the language, confident about using and teaching it, and prepared for the demands of working in classrooms where the language is the medium of instruction. This article presents findings from a comparative study of teacher education programmes adopted in Catalonia, the Basque Autonomous Community, Wales and New Zealand, to prepare teachers to teach through the media of Catalan, Basque, Welsh and Māori respectively. The research was conducted to inform new professional development initiatives in Scotland, designed to enable qualified teachers to transfer from English-medium to Gaelic-medium education. The findings have wider relevance for other contexts in which the recruitment, professional development and retention of teachers to work in minoritised language medium education represent a challenge

High frequency of potential entrapment gaps in beds in an acute hospital

Objective: dimensional guidelines for bedrails have been developed to minimise the risk of patient entrapment within the bed. We examined whether bedrails in a large Irish teaching hospital complied with these standards. Design and setting: survey of 60 accessible beds in six hospital wards. Methods: a specialised cone and cylinder tool that mimics the size and weight of a small adult neck and head was used to determine gaps in the four zones most associated with entrapment. Results: the number of failures for each zone was 15 beds for zone 1 (any space between the perimeters of the rail); 42 beds for zone 2 (the space under the rail); 41 beds for zone 3 (the space between the inside surface of the bedrail and the mattress) and 13 beds for zone 4 (the space between the mattress and rail at the end of the rail). Failures were more common with hydraulic adjusted than with electric profiling beds. Mattresses that were the wrong size (usually too narrow) or too soft and bedrails that were loose or were poorly maintained accounted for many failures. Conclusion: many beds used in our hospital did not comply with dimensional standards to minimise entrapment risks. This emphasises the need for careful selection of patients for whom bedrails are to be used as well as the need for monitoring and maintenance of bed systems

Prevalence and predictors of bedrail use in an acute hospital

Objective: to determine the prevalence and predictors of bedrail use in an acute hospital. Design and setting: overnight survey in a University teaching hospital. Subjects: Three-hundred and twenty-seven beds and patients in 14 wards. Methods: data were collected on bedrail use and on the bed system, ward and patient characteristics. Medical, nursing and physical therapy notes were examined and the night and day nurses and, if necessary, the doctors and therapists caring for the patient interviewed to determine patients\u27 diagnoses, functional and cognitive status. Results: there were 133 (40.7%) beds with one or more raised rails. Independent predictors of bedrail use were use of electric profiling beds, confusion, reduced alertness and any difficulty with transferring from bed. The most common reported indication for bedrail use was \u27to prevent rolling out of bed\u27 (59%); \u27to prevent getting out of bed\u27 was recorded in 11% of cases. Use of bedrails was judged inappropriate in 27/133 (20.3%) patients and in 14/43 (32.6%) patients with abnormal mental status; misuse was particularly common in those with confusion or agitation [13/34 (38.2%)]. Failure to use bedrails was potentially inappropriate in 32/194 (16.5%) of those without bedrails. Conclusion: this study using individual patient data shows that the use of electric profiling beds, abnormal mental states and difficulty transferring from bed are the main predictors of bedrail use in acute hospitals. Inappropriate use of bedrails is common in those with cognitive impairment or with agitation

High frequency of potential entrapment gaps in beds in an acute hospital

Objective: dimensional guidelines for bedrails have been developed to minimise the risk of patient entrapment within the bed. We examined whether bedrails in a large Irish teaching hospital complied with these standards. Design and setting: survey of 60 accessible beds in six hospital wards. Methods: a specialised cone and cylinder tool that mimics the size and weight of a small adult neck and head was used to determine gaps in the four zones most associated with entrapment. Results: the number of failures for each zone was 15 beds for zone 1 (any space between the perimeters of the rail); 42 beds for zone 2 (the space under the rail); 41 beds for zone 3 (the space between the inside surface of the bedrail and the mattress) and 13 beds for zone 4 (the space between the mattress and rail at the end of the rail). Failures were more common with hydraulic adjusted than with electric profiling beds. Mattresses that were the wrong size (usually too narrow) or too soft and bedrails that were loose or were poorly maintained accounted for many failures. Conclusion: many beds used in our hospital did not comply with dimensional standards to minimise entrapment risks. This emphasises the need for careful selection of patients for whom bedrails are to be used as well as the need for monitoring and maintenance of bed systems

Prevalence and predictors of bedrail use in an acute hospital

Objective: to determine the prevalence and predictors of bedrail use in an acute hospital. Design and setting: overnight survey in a University teaching hospital. Subjects: Three-hundred and twenty-seven beds and patients in 14 wards. Methods: data were collected on bedrail use and on the bed system, ward and patient characteristics. Medical, nursing and physical therapy notes were examined and the night and day nurses and, if necessary, the doctors and therapists caring for the patient interviewed to determine patients' diagnoses, functional and cognitive status. Results: there were 133 (40.7%) beds with one or more raised rails. Independent predictors of bedrail use were use of electric profiling beds, confusion, reduced alertness and any difficulty with transferring from bed. The most common reported indication for bedrail use was 'to prevent rolling out of bed' (59%); 'to prevent getting out of bed' was recorded in 11% of cases. Use of bedrails was judged inappropriate in 27/133 (20.3%) patients and in 14/43 (32.6%) patients with abnormal mental status; misuse was particularly common in those with confusion or agitation [13/34 (38.2%)]. Failure to use bedrails was potentially inappropriate in 32/194 (16.5%) of those without bedrails. Conclusion: this study using individual patient data shows that the use of electric profiling beds, abnormal mental states and difficulty transferring from bed are the main predictors of bedrail use in acute hospitals. Inappropriate use of bedrails is common in those with cognitive impairment or with agitation