Browsing by Person "Coull, Alison"

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The analgesic effect of odour and music upon dressing change
(2004-10-01) Kane, Fiona M. A.; Brodie, Eric E.; Coull, Alison; Coyne, Lynne; Howd, Alison; Milne, Alan; Niven, Catherine C.; Robbins, Ruth
Vascular wounds may require frequent dressing changes over a long period of time, often involving pain, which may not be adequately controlled with conventional analgesia. Complementary analgesia may be beneficial as an adjunctive therapy. This pilot study presented eight patients with two odour therapies, lavender and lemon, two music therapies, relaxing and preferred music and a control condition, during vascular wound dressing changes. Although the therapies did not reduce the pain intensity during the dressing change there was a significant reduction in pain intensity for the lavender therapy and a reduction in pain intensity for the relaxing music therapy after the dressing change. This supports the use of these complementary therapies, which are inexpensive, easy to administer and have no known side-effects, as adjunctive analgesia in this patient population. Earlier administration before dressing change may enhance these effects. Further research is required to ascertain why certain complementary therapies are more effective than others at relieving pain.
Analysis of the impact of a national initiative to promote evidence‐based nursing practice
(Wiley, 2006-06-28) Ring, Nicola; Coull, Alison; Howie, Catherine; Murphy-Black, Tricia; Watterson, Andrew
Best Practice Statements (BPS) are designed to facilitate evidence‐based practice. This descriptive, exploratory study evaluated the impact of five of these statements in Scotland. A postal survey of 1278 registered nurses was undertaken to determine use of these statements and their perceived benefits (response rate: 42%). Use of the BPS differed across clinical sites and some statements were more likely to be used than others. Identified barriers and drivers to their use were similar to factors known to encourage or hinder evidence‐based practice generally. Although ≈ 25% of clinical respondents reported using the BPS, most respondents reported perceived benefits to patients usually through quality improvement. Results highlight the importance of facilitation and supportive contexts in encouraging clinical use of these statements. Findings suggest that variation in clinical implementation of the BPS need to be addressed locally and nationally if their benefits are to be maximized.
Ankle brachial pressure index of normal, healthy, younger adults
(Mark Allen Group, 2013-06-26) Niblo, Jane; Coull, Alison
Doppler ultrasound and ankle brachial pressure index (ABPI) calculations are used in the assessment of lower limb vascularity, specifically to determine arterial deficiency. ABPI is important as it is used as an indicator when deciding management options for the treatment of leg ulceration. This study aimed to investigate the range of ABPI measurement, using Doppler ultrasound and sphygmomanometry in 36 young healthy adults aged 18–55 years. The findings show a mean ABPI in the left leg of 1.19 and a mean ABPI of 1.17 in the right leg which, while within the normal range, are consistently in the upper range and significantly higher than the acknowledged ‘normal’ midpoint of 1.0. It would appear that younger people will have ABPIs within the upper aspect of the normal range and well above the established norm of 1.0.
Bandages and bandaging techniques for compression therapy
(Mark Allen Group, 2002-03-01) Coull, Alison
Bandaging skills are essential for community nurses not only as a method of supporting joints, or retaining a dressing, but as an important treatment of leg ulceration. It is important to be able to choose the correct type, size, and composition of bandage and then apply it safely using the most appropriate technique as incorrectly applied bandages may lead to pressure necrosis and subsequent limb amputation. Bandaging applications have changed little over the last 100years and the two most commonly used techniques are still the spiral and the figure-of-eight methods. There are advantages and disadvantages of both, and successful bandaging depends on choosing the correct product, and good technique, both in stretching the bandage to the correct tension, and ensuring proper overlap between layers.
Best practice statement for compression hosiery
(Wounds UK, 2005-05-01) Coull, Alison; Clark, Michael
The use of compression hosiery requires adequate knowledge on the part of the practitioner to enable the selection of appropriate products, and a working partnership with patients to promote concordance with treatment. A Best Practice Statement has been developed which sets out a number of key statements in order to guide the practitioner to the most appropriate compression hosiery products when preventing the occurrence and recurrence of venous leg ulcers. Here, an overview of the Best Practice Statement is given.
Class‐3c compression bandaging for venous ulcers: Comparison of spiral and figure‐of‐eight techniques
(Wiley, 2006-04-21) Coull, Alison; Tolson, Debbie; McIntosh, Jean
Aim. This paper reports a study to compare the differences in compression produced on a limb using a spiral and a figure‐of‐eight bandaging technique.
Dermatology for health professionals: A new distance learning course
(Scottish Primary Care, 2006-09-15) Coull, Alison; James, B.
The developing role of tissue viability nurses
(Strathayr Publishing, 2001-06) Ropper, R. A.; Coull, Alison; Gray, D.
Development of a specialist clinic for homeless people and injecting drug users
(Wounds UK, 2002-11) Coull, Alison
Development of a tissue viability nursing competency framework
(Mark Allen Group, 2003-03-01) Coull, Alison; Wilson, Alice
In 1999, a sub-group of the National Association for Tissue Viability Nurse Specialists (Scotland) agreed to lead the production of a competency framework. The aims were to define tissue viability specialist nursing, to provide a framework for tissue viability nurse specialists (TVNSs) that would form a basis for clinical supervision and mentorship, and to inform curricula for tissue viability education. Using a combination of models, a framework evolved which defines the multifaceted nature of the role. The framework lists competencies, which are further broken down into specific role elements, matched with measurable performance criteria for the TVNS. The competency statements that are provided within the publication describe the attitude, knowledge and skills required to fulfil the TVNS role. The document, ‘A Route to Enhanced Competence for Tissue Viability Nurse Specialists’, was published in June 2002. This initiative meets the national need for definition of specialist practice and provides a standard by which the public can be assured of quality care from TVNSs in Scotland.
Development of a web-based distance learning leg ulcer management course
(2003-11-12) Coull, Alison; Booth, S.; Williamson, S.
Education programmes preparing independent prescribers in Scotland: An evaluation
(Elsevier, 2013-02-19) Boreham, Nick; Coull, Alison; Murray, Ian; Turner-Halliday, Fiona; Watterson, Andrew E.
Background Nurse prescribing (NP) is part of the modernisation of the health care workforce and contributes to patient care by improving access to quality services and medication, through utilisation of advanced professional skills. Nurses and midwives need to complete additional education in order to prescribe. This paper explores pedagogical issues relevant to professional training programmes.
Effect of a national community intervention programme on healing rates of chronic leg ulcer: Randomised controlled trial
(SAGE, 2002-06-01) Scottish Leg Ulcer Trial Participants; Coull, Alison
Background and Objective: Chronic leg ulcer is a common cause of serious disability in the elderly. Healing rates of chronic leg ulcers of 50–75% at 3–6 months have been reported from clinical trials in which specialist nurses delivered the care. But most patients in the population are managed by community nurses in the home, where the results are largely unknown. The aims of this trial were to audit healing rates and to evaluate the effect of a national community-based intervention programme of nurse training. Design: Fifteen Community Healthcare Trusts and one Healthcare Division in 10 Health Board Areas in Scotland comprising a population of 2.65 million took part in a cluster randomised controlled trial in which geographically and administratively distinct localities averaging 53 000 population were randomised, at the time of dissemination of Scottish Intercollegiate (SIGN) guidelines, to a programme of nurse training (intervention) or no training (control). Data were provided by 649 district nurse Case Load Managers (CLMs) via 10 3-monthly censuses (6 months baseline, 21 months post-randomisation). SIGN guidelines were disseminated nationally and in the intervention areas an intensive training course in leg ulcer care and teaching methods was provided for 51 link nurses who cascaded training to community nurses, supported by regional workshops run by the project team. Training was evaluated at each stage. Findings: A total of 4984 ulcerated legs in 3949 patients were registered: 991 (25%) males and 2958 (75%) females, mean age 77 years. Response rates from CLMs were 99.4% at the first census and 100% for all subsequent censuses. Outcome data were obtained for 98.9% of all ulcerated legs entered into the study. Care was provided by 1700 community nurses, each of whom saw an average of 1.5 leg ulcer patients annually. There were 489 deaths and 65 amputations with identical rates between the two groups. The 3-month healing rate was 28% in the intervention and control groups at baseline and did not change in either during the following 2 years. The more chronic the ulcer the lower the healing rate. Interpretation: The 3-month healing rate of less than 30% throughout more than 2 years of study, together with the lack of any evidence of improvement following an intensive guideline-based community intervention programme, indicate that a radical reappraisal is required of how care for patients with chronic leg ulcer should be delivered.
Evaluating the introduction of nursing best practice statements in Scotland
(Tissue Viability Society, 2005-08) Coull, Alison
Evaluation of Non-Medical Nurse Prescribing within NHS Fife Addictions Services
(University of Stirling, 2011) Parkes, T.; Coull, Alison; Stoddart, B.; Gray, S.
An evaluation of the expansion of nurse prescribing in Scotland
(Scottish Government, 2009-09-25) Watterson, Andrew; Turner, Fiona; Coull, Alison; Murray, Ian
Nurse prescribers in Scotland can now prescribe a range of controlled drugs for specific medical conditions. This research project which is summarised below provides an evaluation of the extension of nurse prescribing following the introduction of new legislation in 2001.
The expansion of nurse prescribing in Scotland: An evaluation
(Mark Allen Group, 2013-05-01) Coull, Alison; Murray, Ian; Turner-Halliday, Fiona; Watterson, Andrew
Medicine prescribing by community nurses commenced in the UK in 1996. By 2001, nurse prescribing was extended to include more nurses and to cover a wider formulary. This research project provides an evaluation of the extension of prescribing powers to nurses in Scotland, following the introduction of legislation in 2001. It aimed to evaluate the impact of nurse prescribing powers on patients, nurses, prescribers, and other stakeholders. A range of methods were used, including two public surveys, stakeholder interviews, postal questionnaires and case studies.
The experience of an increase in the injection of ethylphenidate in Lothian April 2014–March 2015
(SAGE, 2016-05-12) Lafferty, Con; Smith, Linda; Coull, Alison; Shanley, Jim
Background and aims New psychoactive substances are causing increasing harm across the UK but the use of new psychoactive substance by injecting has become a significant problem within Lothian since the beginning of 2014. Data indicate a rapid rise in the number of existing drug injectors, particularly heroin injectors, moving to new psychoactive substance injecting. This paper reports the experiences within Lothian of a sudden increase in injecting of ethylphenidate over one year. A temporary class drug order was placed on ethylphenidate on 10 April 2015, and as yet the effects of this are unknown.
The experience of an increase in the injection of ethyphenidate in Lothian, April 2014 - March 2015 [Report]
(SMD NHS Lothian, 2015-05) Smith, Linda; Lafferty, Con; Coull, Alison; Shanley, Jim
An exploration of competency frameworks developed and implemented for Clinical Nurse Specialists in Community, Acute and Academic settings and their potential applicability to future specialist practice within Scotland
(2001-12-06) Coull, Alison