A pilot survey of physical activity in men with an intellectual disability

People with intellectual disability are reported as a sedentary population with increased risks of poor health due to an inactive and sedentary lifestyle. As the benefits of physical activity are acknowledged, measuring physical activity accurately is important to help identify reasons for low and high physical activity in order to assist and maintain recommended levels for optimal health. This paper reports a pilot study undertaken to validate the use of a physical activity monitor (Sensewear Armband) and the International Physical Activity Questionnaire (IPAQ) as instruments for measuring and exploring physical activity of men with intellectual disability. The design was a one group descriptive study and data were collected over a 7 day period from 17 men. The Sensewear Armband enabled continuous and long-term measurement of 14 objective physical activity metrics. The IPAQ examined details of physical activity reported over the 7 days. Equivalent results were found in both instruments indicating a positive correlation between the Sensewear Armband and the IPAQ. The results show 50% have low activity levels and the national recommended physical activity levels been achieved at a very low active intensity. No sustainable high physical activity intensity levels were recorded. The results confirmed the Sensewear Armband and the IPAQ as a practical means of measuring and understanding physical activity levels of men with intellectual disability

Guest editorial: Promoting cultural competency in the nursing care of LGBT patients

The file attached to this record is the author's final peer reviewed version. The Publisher's final version can be found by following the DOI link.none- editoria

English language skills requirements for internationally educated nurses working in the care industry: barriers to UK registration or institutionalised discrimination?

Editoria

Formative interventions and practice-development: A methodological perspective on teacher rounds

Highlights • We examine Rounds in education from a methodological perspective. • In doing so, we class Rounds as a formative intervention and compare it to another means of formative intervention—Developmental Work Research. • We raise three methodological issues about both types of formative intervention: the role of theory; the relationship between the individual and the collective; and the meaning of collaboration

A comparison of the management of venous leg ulceration by specialist and generalist community nurses: A judgement analysis

Venous leg ulcer management in the UK varies significantly. Judgements made by nurses contribute to this variability and it is often assumed that specialist nurses make better judgements than non-specialist nurses. This paper compares the judgements of community tissue viability specialist nurses and community generalist nurses; specifically, the ways they use clinical information and their levels of accuracy.To compare specialist and non-specialist UK community nurses' clinical information use when managing venous leg ulceration and their levels of accuracy when making diagnoses and judging the need for treatment.Judgement analysis.UK community and primary care nursing services.18 community generalist nurses working in district (home) nursing teams and general practitioner services and 18 community tissue viability specialist nurses.Data were collected in 2011 and 2012. 18 community generalist nurses and 18 community tissue viability specialist nurses made diagnostic and treatment judgements on 110 clinical scenarios and indicated their confidence in each of their judgements. Scenarios were generated from real patient cases and presented online using text and photographs. An expert panel made judgements, and reached consensus on the same scenarios. These judgements were used as a standard against which to compare the participants. Logistic regression models and correlational statistics were used to generate various indices of judgement "performance": accuracy, consistency, confidence calibration and information use. Differences between groups of nurses with different levels of characteristics linked to expertise were explored using analysis of variance.Specialist nurses had similar cue usage to the generalist nurses but were more accurate when making diagnostic and treatment judgements.It is not obvious why the tissue viability specialist nurses were more accurate. One possible reason might be the greater opportunities for 'deliberate practice' afforded to specialists. However, restricting aspects of practice only to specialist nurses is likely to hinder the judgement performance of generalists

A qualitative study of advanced nurse practitioners’ use of physical assessment skills in the community: shifting skills across professional boundaries

Aim To explore multiple perspectives on the use of physical assessment skills by Advanced Nurse Practitioners in the UK Background Physical assessment skills practices are embedded in advanced nursing practice roles in the UK. There is little evidence on how these skills are used by Advanced Nurse Practitioners' on the community. Design Case study Methodology and methods. A qualitative interpretative single-embedded case study of 22 participants from South of England. A framework method analysed interview data collected by the researcher between March and August 2013. Participants included nurses, doctors, nurse educators and managers Findings Physical assessment skills education at Universities are part of a policy shift to develop a flexible workforce in the UK. Shared physical assessment practices are less to do with role substitution and more about preparing practitioners with skills that are fit for purpose. Competence capability and performance with physical assessment skills are an expectation of advanced nursing practice. Conclusions These skills are used successfully by community Advanced Nurse Practitioners to deliver a wide range of services in response to changing patient need. The introduction of physical assessment skills education to undergraduate professional preparation would create a firm foundation to develop these skills in post-graduate education. Relevance to clinical practice. • Physical assessment education prepares nurses with the clinical competencies to carry out healthcare reforms in the UK • Shared sets of clinical assessment competencies between disciplines have better outcomes for patients • Levels of assessment competence can depend on the professional attributes of individual practitioners • Unsupportive learning cultures can hinder professional development of advanced nursing practic

Shall I tell my mentor? Exploring the mentor-student relationship and its impact on students’ raising concerns on clinical placement

Aims To explore student nurses' and nurse mentors' perceptions and experiences of raising concerns on clinical placement and the influence (if any) of their relationship on this process. A secondary aim is to consider the above, from a regulatory perspective in light of current literature and policy developments. Background Raising concerns whilst on clinical placement has been shown to be challenging for student nurses internationally. Registered nurses in the UK (in this case called “nurse mentors”) facilitate learning and assessment in practice. However, limited research exists on the influence of the relationship between the nurse mentor and student nurse on the raising concerns process. Design A qualitative approach was used to undertake secondary thematic analysis of interview data. The primary data set was generated during a PhD study, focusing on the mentor–student dynamic and the possible influence of this relationship on students' raising concerns. Methods 30 individual semi‐structured interviews were subjected to concurrent and thematic analysis. Interviews were undertaken with student nurses (n = 16) and nurse mentors (n = 14) between April 2016–January 2018. The COREQ 32‐item checklist was used during the preparation of this article. Findings The following three interrelated analytical themes were generated from the data, “developing a mentor‐student relationship," “keeping your mentor sweet” and “the mentor role in the raising concerns process.” Conclusion Our analysis of participants' experiences and perceptions offers an original contribution to understanding the factors associated with student nurses raising concerns in practice. Student nurses and most mentors believed that students should be encouraged and supported to raise concerns, but students' decisions were strongly influenced by their perceptions of the immediate interpersonal and educational context. Similar barriers to raising concerns have been shown to exist regardless of geographical boundaries, therefore the findings of this study are nationally and internationally relevant

The role of nurses in alcohol and drug treatment services: a resource for commissioners, providers and clinicians

Commissioners and providers of alcohol and drugs services need to respond to an increasingly complex need in the populations they serve1. This requires services to be competent in identifying and responding to a wide range of health and social care needs and be able to support people to access treatment for co-existing physical and mental health issues, to enable recovery. This resource has been written by the Royal College of Nursing, the Association of Nurses in Substance Abuse (ANSA), the National Substance Misuse Non-Medical Prescribing Forum, and Public Health England. It describes the many possible roles of nurses in alcohol and drug treatment in England. It is one of a series of PHE-supported briefings on the roles of professions working in alcohol and drug treatment services, in the community and in secondary care2,3,4 and should be read in conjunction with them. This resource is to assist commissioners and providers of specialist adult alcohol and drug treatment services to identify the right workforce to meet the needs of their local populations. It does not address the wider role of nurses across other areas of health and social care, such as midwives, who make a significant contribution to the care of people who misuse alcohol and drugs, and their families. It outlines: •the roles of nurses working in alcohol and drug treatment including the contribution they can make to health and social care outcomes•the added value nurses can bring to alcohol and drug treatment•the competencies and skills that should be expected of nurses working in alcohol and drug treatment •what is required to develop and maintain these competencies potential added value of nurses is determined by the level of experience and training. Experienced nurses will be able to provide advanced clinical interventions and respond to more complex physical and mental health needs. It is important that the roles of nurses are not considered in isolation, but as a key part of a multidisciplinary team, responding to locally identified need

The crisis of public sector trade unionism: evidence from the Mid Staffordshire hospital crisis

This article contends that there is a growing, if uneven, crisis in public sector trade unionism masked by relatively high membership figures that obscure a weakening of trade unions in the workplace, leaving hollowed out organisation vulnerable to further legislative and employer-led onslaughts. The weakening is not inevitable but to overcome it requires a refocusing of organising efforts on the everyday concerns of members such as understaffing and the provision of better public services. Only with an engaged membership will national issues and wider campaigns have material force. Having outlined a general argument, the article takes as illustrative the nature and performance of trade unions, and particularly UNISON, during the Mid Staffordshire hospital crisis