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Nursing

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

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End date: 2019Has files: No

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Now showing 1 - 10 of 185
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    Person-centred community nursing
    (Wiley-Blackwell, 2016-07) Dickson, Caroline; McCormack, Brendan; McCance, Tanya
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    Fingermark recovery from riot debris: Bricks and stones
    (Elsevier, 2015-02-13) Davis, Lisa; Fisher, Ruth
    During the UK riots in August 2011, large volumes of bricks and stones were used as weapons or projectiles in acts of violence or to gain illegal entry to properties. As a result, it has been emphasised that it is necessary to determine suitable chemical treatment(s) that will enable the development of fingermarks on such items in order to identify those involved. This study has undertaken the task of attempting to develop latent fingermarks on common house bricks, limestone and sandstone using current techniques including ninhydrin and fluorescence. Results produced have shown that, with fluorescent fingerprint powder, silver nitrate and superglue providing the best results, it is now possible to enhance fingermarks that were previously left undeveloped. In addition, Isomark T-1 Rapid Grey High Resolution Forensic Impression Material has proved extremely effective as an alternative method of recovering fingermarks developed with fluorescent fingerprint powder.
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    New care home admission following hospitalisation: How do older people, families and professionals make decisions about discharge destination? A case study narrative analysis
    (Wiley, 2018-03-24) Rhynas, Sarah J.; Garcia Garrido, Azucena; Burton, Jennifer K.; Logan, Gemma; MacArthur, Juliet
    Aims and objectives: To gain an in-depth understanding of the decision- making pro-cesses involved in the discharge of older people admitted to hospital from home and discharged to a care home, as described in the case records.Background: The decision for an older person to move into a care home is significant and life-changing. The discharge planning literature for older people highlights the integral role of nurses in supporting and facilitating effective discharge. However, little research has been undertaken to explore the experiences of those discharged from hospital to a care home or the processes involved in decision- making.Method: A purposive sample of 10 cases was selected from a cohort of 100 individu-als admitted to hospital from home and discharged to a care home. Cases were se-lected to highlight important personal, relational and structural factors thought to affect the decision- making process. Narrative case studies were created and were thematically analysed to explore the perspectives of each stakeholder group and the conceptualisations of risk which influenced decision-making.Results: Care home discharge decision- making is a complex process involving stake-holders with a range of expertise, experience and perspectives. Decisions take time and considerable involvement of families and the multidisciplinary team. There were significant deficits in documentation which limit the understanding of the process and the patient’s voice is often absent from case records. The experiences of older people, families and multidisciplinary team members making care home decisions in the hospital setting require further exploration to identify and define best practice.Implications for practice: Nurses have a critical role in the involvement of older peo-ple making discharge decisions in hospital, improved documentation of the patient’s voice is essential. Health and social care systems must allow older people time to make significant decisions about their living arrangements, adapting to changing medical and social needs.
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    Decisions affecting discharge from hospitals directly to care homes
    (EMAP, 2017-05-31) Harrison, Jennifer Kirsty; MacArthur, Juliet; Garcia Garrido, Azucena; Logan, Gemma; Rhynas, Sarah J.; MacLullich, Alasdair M. J.; Shenkin, Susan
    Admission to care homes following acute hospital admission is common, despite being contrary to UK health policy. Care home admission from hospital is also a care trajectory that is under-researched and poorly understood. A retrospective cohort study reviewed the case notes of 100 people who had experienced this transition, what happened during their hospital stay, and what led to the life changing decision to discharge them to a care home. Only 37% of individuals were documented as having been involved in the decision-making process. This article describes the study methods, highlights some salient results, and makes recommendations for practice.
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    New institutionalisation following acute hospital admission: A retrospective cohort study
    (Oxford University Press, 2016-10-15) Harrison, Jennifer Kirsty; Garcia Garrido, Azucena; Rhynas, Sarah J.; Logan, Gemma; MacLullich, Alasdair M. J.; MacArthur, Juliet; Shenkin, Susan
    Background: institutionalisation following acute hospital admission is common and yet poorly described, with policy documents advising against this transition. Objective: to characterise the individuals admitted to a care home on discharge from an acute hospital admission and to describe their assessment. Design and setting: a retrospective cohort study of people admitted to a single large Scottish teaching hospital. Subjects: 100 individuals admitted to the acute hospital from home and discharged to a care home. Methods: a single researcher extracted data from ward-based case notes. Results: people discharged to care homes were predominantly female (62%), widowed (52%) older adults (mean 83.6 years) who lived alone (67%). About 95% had a diagnosed cognitive disorder or evidence of cognitive impairment. One-third of cases of delirium were unrecognised. Hospital stays were long (median 78.5 days; range 14–231 days) and transfers between settings were common. Family request, dementia, mobility, falls risk and behavioural concerns were the commonest reasons for the decision to admit to a care home. About 55% were in the acute hospital when the decision for a care home was made and 44% of that group were discharged directly from the acute hospital. Conclusions: care home admission from hospital is common and yet there are no established standards to support best practice. Decisions should involve the whole multidisciplinary team in partnership with patients and families. Documentation of assessment in the case notes is variable. We advocate the development of interdisciplinary standards to support the assessment of this vulnerable and complex group of patients.
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    Clinical judgment and decision-making in wound assessment and management: Is experience enough?
    (Mark Allen, 2015-04-17) Logan, Gemma
    The assessment and management of wounds forms a large proportion of community nurses' workload, often requiring judgment and decision-making in complex, challenging and uncertain circumstances. The processes through which nurses form judgments and make decisions within this context are reviewed in this article against existing theories on these subjects. There is variability in wound assessment and management practice which may be attributed to uncertainties within the context, a lack of knowledge in appropriate treatment choices and the inability to correctly value the importance of the clinical information presented. Nurses may be required to draw on intuition to guide their judgments and decision-making by association with experience and expertise. In addition, a step-by-step analytical approach underpinned by an evidence base may be required to ensure accuracy in practice. Developing an understanding of the different theories of judgment and decision-making may facilitate nurses' abilities to reflect on their own decision tasks, thereby enhancing the care provided.
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    Human factors in student paramedic practice
    (Mark Allen, 2019-01-02) Matheson, Rose
    Human factors affect paramedic practice and training. However, although there are frequent references to human factors in the literature, little evidence on this is available on those that influence student paramedic development. A personal experience as a student paramedic highlighted certain human factors unique to the role, most notably how interactions between students and mentors can affect a student's practice. Following this, the awareness and effect of human factors within the student paramedic role were investigated. Discussions regarding human factors that influence a student paramedic's development on practice placements remain in their infancy. The student paramedic role is unique and challenging, and involves developing a level of resilience that continues post registration. Because of the role's emotive nature, students need to increase their awareness and management of human factors to prevent them from affecting their practice. Equally, educators need to have a greater focus on encouraging and teaching coping strategies. Practitioners who work with students do so whether they choose to be a mentor or not and many may feel unprepared for the role. Interactions between students and clinician mentors are complicated and future research will be required to determine the best approach to aid student development in the placement environment.
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    Initial treatment of burns
    (Bailliere Tindall, 1989-08) Coull, Alison