The evidence-base for stroke education in care homes

<b>Summary.</b> <b>Research questions:</b> 1. What are registered care home nurses’ educational priorities regarding stroke care? 2. What are senior care home assistants’ educational priorities regarding stroke care? 3. How do care home nurses conceive stroke care will be delivered in 2010? <b>Study design:</b> This was a 2-year study using focus groups, stroke guidelines, professional recommendations and stroke literature for the development of a questionnaire survey for data collection. Workshops provided study feedback to participants. Data were collected in 2005–2006. <b>Study site:</b> Greater Glasgow NHS Health Board. <b>Population and sample:</b> A stratified random selection of 16 private, 3 voluntary and 6 NHS continuing care homes from which a sample of 115 trained nurses and 19 senior care assistants was drawn. <b>Results:</b> The overall response rate for care home nurses was 64.3% and for senior care assistants, 73.6%. Both care home nurses and senior care assistants preferred accredited stroke education. Care home nurses wanted more training in stroke assessment, rehabilitation and acute interventions whereas senior care assistants wanted more in managing depression, general stroke information and communicating with dysphasic residents. Senior care assistants needed more information on multidisciplinary team working while care home nurses were more concerned with ethical decision-making, accountability and goal setting. <b>Conclusions:</b> Care home staff need and want more stroke training. They are clear that stroke education should be to the benefit of their resident population. Guidelines on stroke care should be developed for care homes and these should incorporate support for continuing professional learning in relation to the resident who has had a stroke

Let's think operationally

Reports of appalling nursing care cause shame, bewilderment, and anger. Failure to care is an act of betrayal. Delamothe's editor's choice prompted much discussion among nurses completing their MScHC at the University of Glasgow. 1 These nurses hold nursing to be a caring profession with clinical expertise, good communication, and compassion as the cornerstones of practice

Patient safety in Europe: medication errors and hospital-acquired infections

The Report was commissioned by the European Federation of Nurses Associations (EFN) in November 2007 in order to support its policy statements on Patient Safety (June 2004). In that statement the EFN declares its belief that European Union health services should operate within a culture of safety that is based on working towards an open culture and the immediate reporting of mistakes; exchanging best practice and research; and lobbying for the systematic collection of information and dissemination of research findings. This Report adressess specifically the culture of highly reliable organisations using the work of James Reason (2000). Medication errors and hospital-acquired infections are examined in line with the Reprt´s parameters and a range of European studies are used as evidence. An extensive reference list is provided that allows EFN to explore work in greater detail as required

Experience of cardiac rehabilitation after coronary artery surgery: effects on health and risk factors

Objective:Cardiac rehabilitation (CR) programs are provided to support the recovery process following acute myocardial infarction and coronary artery bypass grafting (CABG). Attendance varies. We related attendance following CABG to severity of cardiac symptoms, general health status (Short Form-36) and prevalence of modifiable coronary artery disease (CAD) risk factors. METHODS: 209 patients due to undergo CABG were recruited and assessed preoperatively as well as at a mean of 16.4 months postoperatively. General health status was measured using the Short Form-36 questionnaire. Severity of cardiac symptoms was assessed on a visual analogue scale. Modifiable coronary artery disease risk factors (smoking, body mass index, hypertension and elevated cholesterol) and social deprivation index were noted

Stroke education for healthcare professionals: making it fit for purpose

<b>Research questions:</b> 1. What are healthcare professionals’ (HCPs) educational priorities regarding stroke care? 2. Do stroke care priorities vary across the primary and secondary sectors? 3. How do HCPs conceive stroke care will be delivered in 2010? <b>Study design:</b> This was a two-year study using focus groups and interviews for instrument development, questionnaires for data collection and workshops to provide study feedback. Data were collected in 2005–06. <b>Study site:</b> One Scottish health board. <b>Inclusion criteria:</b> All National Health Service healthcare professionals working wherever stroke care occurred. <b>Population and sample:</b> Participants were drawn from 4 university teaching hospitals, 2 community hospitals, 1 geriatric medicine day hospital, 48 general practices (GPs), 12 care homes and 15 community teams. The sample comprised 155 doctors, 313 nurses, 133 therapists (physiotherapists, occupational therapists, speech and language therapists), and 29 ‘other HCPs’ (14 dieticians, 7 pharmacists, 2 podiatrists and 6 psychologists). <b>Results:</b> HCPs prefer face-to-face, accredited education but blended approaches are required that accommodate uni- and multidisciplinary demands. Doctors and nurses are more inclined towards discipline-specific training compared to therapists and other healthcare professionals (HCPs). HCPs in primary care and stroke units want more information on the social impact of stroke while those working in stroke units in particular are concerned with leadership in the multidisciplinary team. Nurses are the most interested in teaching patients and carers. <b>Conclusions</b> Stroke requires more specialist stroke staff, the upskilling of current staff and a national education pathway given that stroke care is most effectively managed by specialists with specific clinical skills. The current government push towards a flexible workforce is welcome but should be educationally-sound and recognise the career aspirations of healthcare professionals

Breakdown of Particle-Hole Symmetry in the Lowest Landau Level Revealed by Tunneling Spectroscopy

Tunneling measurements on 2D electron gases at high magnetic field reveal a qualitative difference between the two spin sublevels of the lowest Landau level. While the tunneling current-voltage characteristic at filling factor $\nu = 1/2$ is a single peak shifted from zero bias by a Coulomb pseudogap, the spectrum at $\nu=3/2$ shows a well-resolved double peak structure. This difference is present regardless of whether $\nu =1/2$ and $\nu = 3/2$ occur at the same or different magnetic fields. No analogous effect is seen at $\nu = 5/2$ and 7/2 in the first excited Landau level.Comment: 5 pages, 4 figure

Disordered Hubbard Model with Attraction: Coupling Energy of Cooper Pairs in Small Clusters

We generalize the Cooper problem to the case of many interacting particles in the vicinity of the Fermi level in the presence of disorder. On the basis of this approach we study numerically the variation of the pair coupling energy in small clusters as a function of disorder. We show that the Cooper pair energy is strongly enhanced by disorder, which at the same time leads to the localization of pairs.Comment: revtex, 5 pages, 6 figure