Simulation on sensory impairment in older adults:nursing education

Sensory impairments are identified as the most common chronic and disabling conditions of later life impacting significantly on the quality of life and safety of older adults. Hospitals and care environments can present significant challenges to older adults with sensory impairments to negotiate. Therefore, it is important to raise awareness on sensory and cognitive impairments with all healthcare professionals and nurses in particular, both to help develop an empathetic awareness on the impact of impairment and to minimize risk of adverse events. This article reports on a pedagogical innovation on the development and use of a simulation resource primarily on sensory impairments in older adults with first year nursing students within an undergraduate nursing programme in a Scottish university. The article also reports on students' reflections on their experience of participating in this simulation

An action research inquiry exploring the transfer of pain knowledge from a continuing education course into practice

Acute and chronic pain conditions have a significant impact on the individual who is experiencing pain and resolution of pain continues to present a challenge to nurses and other health care professionals. It is widely accepted that pain education for nurses is necessary if nurses are to deliver effective, evidenced based pain care. Although it has been shown that participation in pain education improves nurses’ pain knowledge, very little is known about the way in which nurses use their improved pain knowledge in their practice or about the conditions that promote application of that pain knowledge. The aims of this study are (a) to explore the transfer of pain knowledge from a continuing education nursing course into practice, and (b) to investigate the impact that the nurses’ participation in action research has on their ability to improve aspects of their pain practice. Participants are 14 registered nurses who successfully completed two accredited pain course units as part of their BSc / BN degree in Nursing. The nurses formed two groups of inquiry, who used both their participation in the pain course and in action research to investigate and change aspects of pain assessment and management practices within their clinical areas. The inquiry groups were located in two different Health Board locations in Scotland. Following involvement in a pain course, the strategies used by the participating nurses to enhance their pain assessment and management practices are examined. Qualitative data was obtained through individual and group interviews, and analysis of significant incidents. An action research approach contributes to an understanding of conditions that promote application of pain knowledge into practice following participation in the course, and focuses on the possibilities for action and improvement of pain care. The findings from this study demonstrate how nurses develop a more patient-centred approach to pain care and become more accountable for their pain practice. The research also identifies a range of strategies used by nurses to improve collaborative working practices with their colleagues that help to reduce some of the obstacles to delivery of effective pain care. From the outcomes of the inquiry, it is evident that these nurses’ participation in action research has increased the possibilities of their involvement in pain practice interventions. Conditions are created through pain course participation and involvement in action research, which supports nurses’ transfer of pain knowledge into practice Additionally, findings demonstrate the potential action research has for identifying problems with pain care and its potential for helping to develop relevant and workable solutions for improving aspects of care. The findings from this study are significant because they inform teaching and learning approaches which can be used with pain education that helps to prepare nurses to deliver more effective pain care within their health care settings

Community Nurse Workforce Planning Project

The purpose of this project was to explore the potential for developing a flexible and innovative approach to community workforce planning that took account of the synergies between community health needs and the expertise and skill sets of community nurses. Workshops were held with community nurses in three localities within NHS Highland in 2010 and at the beginning of 2011. Information that emerged from the workshops provided a picture of the responsibilities and activities that community nurses are engaged in, as well as some of the challenges of delivering a service across the diverse localities in NHS Highland. In May 2011 a wider stakeholder workshop was held, facilitated by one of the NMSH CHP general managers. The workshop considered the findings of the project to date, and proposed some changes. These changes were incorporated into the final report

An Evaluation of the Impact of Sight and Hearing Support Services: Western Isles Sensory Project

This report presents an evaluation of the Western Isles Sensory Centre (WISC). The Centre provides advice, assessment, referrals and practical interventions to people with sensory impairments who live in the Western Isles. The report details the evaluation findings from a survey and in-depth interviews carried out with WISC clients and their carers. The views of clients and experience of the service offered by the WISC was explored initially by the use of a postal survey (n=49). Following this, a number of in-depth interviews (n=12) were conducted with clients that further explored the impact that attending the Centre had on their impairment. The views of WISC staff who support service provision for people with sensory impairments were also sought. Additionally, perspectives about the service were sought from health, social care and third sector professionals who are involved in the care and support of people with sensory impairments

Raising awareness of sensory impairment among community nurses: a brief intervention in a remote island setting

Introduction: The prevalence of sensory impairment that includes, sight and/or hearing impairment is projected to rise worldwide given the strong correlation between sensory impairment, older age, and the demographic structure of the global population. Sensory impairment and associated disability is thus a significant global health concern. The prevalence rates for sensory impairment in Scotland are significant as more people live into older age and as the age distribution in rural areas is markedly different with a higher proportion of older people, the extent of sensory impairment in the rural population will increase proportionally.  In rural areas community nurses have a key role in recognising sensory impairment and signposting people to sensory services to reduce the debilitating impact of sensory impairment. However, there is limited evidence about the utility of educational interventions to enhance healthcare professionals’ knowledge, skills and attitudes about sensory impairment and subsequent impact on referral practices. The aim of this study was to evaluate the impact of a brief educational intervention with community nurses. The educational intervention was a training workshop that included simulation practice, information on assessment and referral pathways. The study was conducted in a remote, island community health setting in the Western Isles of Scotland. The study evaluated nurses’ perceptions of the training on their knowledge, attitudes and practice.  Methods: Mixed method, longitudinal design implemented in three phases. Phase 1: Pre and post workshop questionnaire; Phase 2: Postal questionnaire three months post workshop; Phase 3: Qualitative focus group interview six months post workshop. Kirkpatrick’s (1) model of training evaluation provided a framework for data evaluation.  Results: 41 community based healthcare professionals who were mostly nurses participated in the study. Participants described increased awareness of the potential for their patients to have a sensory impairment, greater understanding and empathy with patients who experience sensory impairment, more robust patient assessment to identify impairment, and increased likelihood to inform of, and refer to, sensory services.  Conclusions: Community nurses are often well placed to identity disabilities and patients at risk of injury because of sensory impairment. Participation in simulation training can help to develop greater awareness of the impact of that sensory impairment. Knowledge of specialist services will increase the opportunities for referral to services and impact positively on the lives of older people living in rural settings. Provision of accessible education on sensory impairment for health and social care professionals can enhance care delivery to older people

Seeking, accepting and declining help for emotional distress in cancer: A systematic review and thematic synthesis of qualitative evidence

Many individuals affected by cancer who experience emotional distress report not wanting help. This review aims to understand why individuals affected by cancer seek, accept or decline help for emotional distress and what influences these actions. A systematic review and thematic synthesis of the qualitative literature was conducted. Using pre-defined search terms, four electronic databases were searched from January 2000 to May 2016. Pre-determined inclusion and exclusion criteria were then applied. Identified papers were quality appraised. In total, 32 papers were included in the synthesis. Four themes emerged from data synthesis: attaining normality—the normality paradox; being emotionally literate; perceptions of help; needs-support gap. Attaining normality is ideographic, context dependent and temporally situated; some individuals maintain normality by not seeking/declining help whereas others seek/accept help to achieve a new normality. Thus, attaining normality paradoxically functions to explain both why individuals sought/accepted help or did not seek/declined help. Data indicate that a context dependent, systems thinking approach is merited to enhance psychosocial care. In particular, clinicians must actively explore the personal context of an individual's distress to ensure that help desired and help offered are mutually understood. Further research must address the limitations of the current evidence base to advance theoretical understanding

Evaluating the impact of nursing and midwifery sensitive clinical quality indicators on practice

This narrative literature review aimed to examine the literature that identified clinical quality indicators (CQIs) in nursing and midwifery and that also measured the impact of nursing and midwifery practice on CQI implementation and outcome. Specifically, the review objectives were to: (a) examine the evidence that reviewed how quality indicators are being used to influence care delivered by nursing and midwifery practitioners, and (b) from the evidence reviewed, identify the quality indicators that are most readily applied to nursing and midwifery practice in NHS Highland. Nurse and midwifery sensitive CQIs are quantitative measures which reflect professional care standards that monitor and evaluate particular aspects of care for which nurses and midwives have key responsibility. This narrative literature review considered the nurse and midwifery CQIs that have been implemented in NHS Scotland and identified themes from these indicators which reflect the nurse or midwives' distinct professional contribution to CQI outcomes. Additionally, factors have been identified that have been shown to support successful implementation of nurse and midwife sensitive CQIs into clinical practice

A review of the prevalence of physical activity in health professional undergraduate, postgraduate, pre qualification courses and Continuous Professional Development activities

'Let's Make Scotland More Active' was published in 2003 by the then Scottish Executive and sets out the recommendations for increasing levels of physical activity (PA) within the population. One of the key strategy recommendations was that all patients coming into contact with primary care professionals should be offered screening and appropriate counselling for PA tailored to individual needs (paragraph 142). NHS Health Scotland has a range of existing and planned learning products and services aimed at influencing knowledge, attitudes and behaviour in the area of physical activity among the practitioner and wider health improvement workforces. These resources and services seek to encourage health professionals to increasingly deliver PA brief advice as an intervention in the care of their patients. However, it is not clear whether they are being used, or indeed the extent to which physical activity and its benefits are being taught to health professionals during undergraduate, post graduate and CPD training