Repository logo
 

Nursing

Permanent URI for this collectionhttps://eresearch.qmu.ac.uk/handle/20.500.12289/24

Browse

Author: search.filters.author.Smith, Margaret CoulterHas files: Yes

Search Results

Now showing 1 - 10 of 15
  • Thumbnail Image
    Item
    The response from Scottish health boards to complaint investigations by the Scottish Public Services Ombudsman: A qualitative case-study
    (Cambridge University Press, 2023-05-04) McBurnie, Gavin; Williams, Jane; Smith, Margaret Coulter
    This article explores how complaint investigations undertaken by health ombudsman contribute to the improvement of the healthcare system. Using a qualitative case-study approach, semi-structured interviews were conducted with participants form the Scottish Public Services Ombudsman (SPSO) and three health boards within its jurisdiction. Health board participants were frustrated by complaints process used by the SPSO, in particular the lack of communication during an SPSO investigation especially when there were differences in clinical judgment. Using Braithwaite’s typologies of motivational postures and Hertogh’s models of administrative control it was found that a sense of capitulation was the primary determinant in ensuring health board compliance with SPSO recommendations and that the relationship between SPSO and health boards was predominantly coercive in nature. For the SPSO to be more effective in contributing to system improvement requires it to review its role and means of conducting complaint investigations.
  • Thumbnail Image
    Item
    Obesity matters: The skills that strengthen midwifery practice when caring for obese pregnant women
    (Mark Allen Group, 2021-05-02) Greig, Yvonne; Williams, Anne F.; Smith, Margaret Coulter
    Obese pregnant women (BMI>30 kg/m²) are at an increased risk of developing complications during pregnancy, labour and birth. Furthermore, their offspring are at risk of short- and long-term health complications. Midwives are ideally situated to inform women about risks and to support them in optimising their health. How midwives raise and maintain dialogue with women about this health issue is not well understood. A qualitative research study was conducted drawing on the principles of social constructionism to explore how midwives practiced and maintained dialogue with women about the risks of living with obesity. Data were analysed thematically, three themes emerged: ‘situational context of practice’, ‘constructing partnerships with women’, ‘midwife as a public health agent’. Midwives appeared to have learnt their communication skills informally ‘on the job’ but utilised institutional questionnaires as a mechanism for opening ‘sensitive’ conversations. This approach appeared to guide appointment dialogue and risked providing woman-centred care to individuals while concurrently inhibiting development of professional autonomy. Providing educational opportunities for midwives with respect to consultation education in midwifery curricula may strengthen midwifery practice with respect to discussing sensitive topics.
  • Thumbnail Image
    Item
    Being conductor of the orchestra: An exploration of district nursing leadership
    (Mark Allen, 2020-05-07) Dickson, Caroline; McVittie, Chris; Smith, Margaret Coulter
    The purpose of the present study was to gain insight into how district nurses understand their leadership role. Data were generated through interviews and audio-journals and analysed using interpretive phenomenological analysis. Findings suggested that district nurses managing teams and caseloads experienced a burden of responsibility. Being creative problem solvers, they adopted facilitative ways of engaging with patients but directive approaches to team management. District nurses sharing leadership with multidisciplinary colleagues did not appear to experience this burden. Their leadership drew on their facilitative approaches to care-giving. If nurses enabled, rather than directed teams, they could create a context for developing autonomy and growth, easing the burden of responsibility.
  • Thumbnail Image
    Item
    Innovative application of a MOOC (Massive Open Online Course) within the Lydia Osteoporosis Project (LOP 3), an action research, process evaluation and implementation project
    (2019-12-05) Smith, Margaret Coulter; Pearson, Claire; Roberts, Denny
    Background This presentation focuses on the design, implementation and evaluation of a Massive Open Online Couse (MOOC), a complex online learning intervention within an action research, process evaluation and implementation project (The Lydia Osteoporosis Project 3).
  • Thumbnail Image
    Item
    Coproduction of knowledge for practice through a participatory action research and process evaluation project (Lydia Osteoporosis Project 2, LOP 2)
    (BioMed Central, 2018-08-17) Smith, Margaret Coulter; Schrag, Anthony; Kelly, Fiona; Pearson, Claire; Bacigalupo, Alison
    Background - Participatory action research (PAR) is active, collaborative and seeks to develop knowledge from everyday occurrences (Reason and Bradbury 2013). A creative movement workshop developed from the Lydia Osteoporosis PAR Project 2 (LOP 2) and enabled volunteer local research collaborators and participants to articulate new practice knowledge.
  • Thumbnail Image
    Item
    A nurse‐led FibroScan® outreach clinic encourages socially deprived heavy drinkers to engage with liver services
    (Wiley, 2018-09-05) Matthews, Karen; MacGilchrist, Alastair; Smith, Margaret Coulter; Jones, Jacklyn; Cetnarskyj, Roseanne
    Aims and objectives To determine whether a portable FibroScan® device can be an acceptable screening tool for chronic liver disease in a community alcohol support service, through recording uptake, determining apparent prevalence of undiagnosed fibrosis/cirrhosis in participants and report engagement following referral to specialist liver services of those individuals referred because of a FibroScan® reading ≥ 7.1 kilopascals (kPa). Background Alcohol‐related liver disease, including cirrhosis, is a major cause of death in the UK. Liver disease is silent and usually presents late. Socially deprived patients with alcohol‐related liver disease are a “hard to engage” population and at higher risk of death than less deprived. A FibroScan® device is a non‐invasive tool for measuring liver stiffness. A result of ≥7.1 kPa can indicate possible chronic liver disease. Design Prospective observational study. Method Individuals who self‐identified as harmful drinkers were recruited. Consented individuals attended for a liver FibroScan®. Those with a reading ≥7.1 kPa were referred to a nurse‐led liver clinic for further investigations, results of which determined referral to a liver specialist in secondary care. Participants referred were monitored for compliance over a 6‐month period. Results Seventy‐nine consented individuals participated, an uptake of 67% of those informed of the study. Of the 79 scans performed, three were unreliable leaving 76 participants. After scanning, 20/76 (26%) had a FibroScan® ≥7.1 kPa requiring referral on to the nurse‐led clinic. All 20 (100%) engaged in further assessment. Of those, 12 required onward referral to specialist services. Subsequent compliance with specialist services in this sample (n = 12) was ≥90%. Conclusion A nurse‐led FibroScan® outreach clinic encourages socially deprived drinkers to engage with liver services. Relevance to clinical practice A 67% uptake suggests a nurse‐led FibroScan® service in a community alcohol service is acceptable. High engagement gives potential for early intervention and improved health outcomes. What does this paper contribute to the wider global clinical community? Findings from this study should instil confidence in centres planning to deliver early intervention through nurse‐led screening for chronic liver disease with a portable FibroScan® device in community settings. These findings should inform future research in this area.
  • Thumbnail Image
    Item
    Leadership and excellence in the early recognition of critical illness
    (Elsevier, 2015-04) Smith, Margaret Coulter; Lyte, Geraldine
    The ICCN Editorial Board has great pleasure in presenting this special issue, which focuses on leadership and excellence in the early recognition of critical illness. A stimulating range of topics and methodological approaches are included as follows:
  • Thumbnail Image
    Item
    Evaluation of Education for Senior Healthcare Support Workers (SCQF Level 7) and Assistant Practitioners (SCQF Level 8) in Children and Young People-s Health with Optional Pathways
    (Queen Margaret University, 2010-07) Smith, Margaret Coulter; O'May, Fiona; Mountain, Kristina; Riddell, Helen; Balaam, Martina
  • Thumbnail Image
    Item
    Pain management and satisfaction in post-surgical patients
    (2012-08) Rodgers, S.; Tocher, J.; Smith, Margaret Coulter; Watts, D.; Dickson, L.
    Aims and objectives. To examine the relationship between patient satisfaction and the incidence of severe and enduring pain through a health board wide hospital satisfaction questionnaire. Background. The incidence and management of acute postoperative pain and its relationship to patient satisfaction have been of great interest to clinicians over the last 20 years. Evidence suggests that despite many moves to address this problem with the advent of acute pain nurse specialists and dedicated pain teams, severe and enduring pain continues to be a problem. However, patients appear to report high satisfaction levels. Design. The study design was a postal questionnaire the results of which were analysed statistically. Methods. The postal questionnaire was sent to patients who had been discharged from acute hospitals in one health board in the previous two weeks. A total of three large acute hospitals were included. The data were analysed to produce descriptive statistics for all patients on the pain questions and then for patients with severe and enduring pain on the variables of age, gender, ethnic group, responses to pain questions and type of admission. Results. Twenty-six percent of patients reported having pain all or most of the time. Patients suffering from severe and enduring pain were younger females. Conclusion. Acute postoperative pain continues to be a problem, although patients continue reporting moderate satisfaction levels. Relevance to clinical practice. Acute postoperative pain is an ongoing issue for postsurgical patients. It is crucial to understand and recognise issues that can adversely contribute to increased pain severity.
  • Thumbnail Image
    Item