A survey of registered nurses’ activities in British orthopaedic pre-operative assessment clinics

This small-scale exploratory survey was designed to provide an indication of the range of activities undertaken by registered nurses within British pre-operative assessment clinics. Twenty-seven out of 41 postal questionnaires were returned, and the results showed that nurses were involved in 79 different activities, most notably information giving and clinic coordination. There was a lack of uniformity across Britain in the nursing role within such clinics. The results raised questions about the appropriateness of certain activities for registered nurses, and the need for nurses to identify effective and appropriate roles. Implications for practice and suggestions for future research are made.     

Where is family in the family nurse practitioner program? Results of a U.S. family nurse practitioner program survey

Though recent progress in family nursing science can serve the family nurse practitioner (FNP) to intervene in the regulation of family health, whether those advances are taught to FNP students has been unclear. All 266 FNP programs in the United States were invited to participate in a survey to assess the content and clinical application of family nursing theories in the curriculum. The majority of FNP programs frame family as the context of care for the individual. Though FNP students receive a foundation in family nursing theory in core courses, they are not usually expected to use family assessment methods in clinical practicum courses or to plan interventions for the family as the unit of care. The authors challenge educators to consider family nursing science as an essential component of the FNP program as the Doctor of Nursing Practice (DNP) evolves and becomes requisite for entry into advanced practice.     

A national survey of nurse practitioners’ patient satisfaction outcomes

BackgroundThe research findings about nurse practitioner (NP) patient experiences (satisfaction) are limited to small sample sizes from local community clinics. No national studies with large sample sizes were found.PurposeTo analyze responses from the Consumer Assessment of Healthcare Providers and Systems survey and compare the patient experiences from four different provider categories.MethodsSecondary data analysis was completed on survey responses from 53,885 patients.FindingsIn the sample, medical doctor providers were disproportionately represented in greater number than NPs, doctor of osteopathy, or physician assistant. Further analysis comparing patient experiences between providers revealed NP to be rated significantly higher than their colleagues.DiscussionRecognizing the factors associated with patient satisfaction with their providers can lead to improvements in patient-provider interactions that can result in increased quality of care.ConclusionPolicy makers should find opportunities to employ NP in primary care settings and achieve greater patient satisfaction that can influence outcomes associated with patient-centered care initiatives.     

Nurses’, physicians’ and radiographers’ perceptions of the safety of a nurse prescribing of ionising radiation initiative: A cross-sectional survey

BackgroundA new initiative was introduced in Ireland following legislative changes that allowed nurses with special training to prescribe ionising radiation (X-ray) for the first time. A small number of studies on nurse prescribing of ionising radiation in other contexts have found it to be broadly as safe as ionising radiation prescribing by physicians. Sociological literature on perceptions of safety indicates that these tend to be shaped by the ideological position of the professional rather than based on objective evidence.ObjectivesTo describe, compare and analyse perceptions of the safety of a nurse prescribing of ionising radiation initiative across three occupational groups: nursing, radiography and medicine.DesignA cross-sectional survey design.SettingsParticipants were drawn from a range of clinical settings in Ireland.ParticipantsRespondents were 167 health professionals comprised of 49 nurses, 91 radiographers, and 27 physicians out of a total of 300 who were invited to participate. Non-probability sampling was employed and the survey was targeted specifically at health professionals with a specific interest in, or involvement with, the development of the nurse prescribing of ionising radiation initiative in Ireland.MethodsComparisons of perspectives on the safety of nurse prescribing of ionising radiation across the three occupational groups captured by questionnaire were analysed using the Kruskal–Wallis H test. Pairwise post hoc tests were conducted using the Mann–Whitney U test.ResultsWhile the majority of respondents from all three groups perceived nurse prescribing of ionising radiation to be safe, the extent to which this view was held varied. A higher proportion of nurses was found to display confidence in the safety of nurse prescribing of ionising radiation compared to physicians and radiographers with differences between nurses’ perceptions and those of the other two groups being statistically significant.ConclusionThat an occupational patterning emerged suggests that perceptions about safety and risk of nurse prescribing of ionising radiation are socially constructed according to the vantage point of the professional and may not reflect objective measures of safety. These findings need to be considered more broadly in the context of ideological barriers to expanding the role of nurses.     

Midwives’ perspectives of the challenges in mentoring students: A qualitative survey

ProblemNational professional standards dictate that all practitioners should provide mentorship to students, however students often report a lack of interest from many mentors while on placement.BackgroundIt is important that academic researchers investigate issues that can inform us of how the student/mentor relationship is facilitated and supported.AimThe aim of the project was to explore the perspectives of midwifery mentors who had experienced challenges with mentoring students, to determine what the challenges are, and what support they need, as mentors.MethodsAn online anonymous survey containing qualitative questions was used to identify the challenges faced by mentors, and asked them to provide recommendations for improving their delivery of mentorship. Three themes emerged; challenges of providing mentorship – student related; challenges of providing mentorship – work related; and what needed to be done to improve mentoring.DiscussionMentors shared their experiences of mentoring students and the issues they had faced.ConclusionsRecommendations are made that acknowledges the important role of midwifery mentorship and suggest the introduction of preparation for mentorship training for midwives working with students.     

A survey on the use of outcome measures by musculoskeletal physiotherapist’s in India

Abstract

In recent times, there has been great pressure on physiotherapists to become accountable for their practices and to provide evidence for effectiveness of their treatment. Therefore, it has become necessary to integrate standardised outcome measures (OMs) into clinical practice and boost evidence-based practice. The aim of this study was to determine the extent of use of outcome measures among physiotherapists in India and to identify the commonly used measures. A survey was conducted using a questionnaire consisting of 23 closed-ended questions. It was administered face-to-face and via email to Indian physiotherapists working with musculoskeletal patients. The response rate was 54% (n?=?81). The results indicated 80% of the respondents used OMs with impairment-based measures being the most commonly used. Education qualifications, years of work experience and workplace setting were not significantly associated with utilisation of OMs. Various benefits and barriers to use of OMs were also identified. The findings of this study give insight into possible changes that could be incorporated in clinical practice and educational system for developing a standardised level of assessing patients and to tailor future implementation strategies.     

A survey of Canadian cancer patients’ perspectives on the characteristics and treatment of breakthrough pain

Objective

Breakthrough pain is defined as a transient exacerbation of pain that occurs spontaneously or in response to a trigger despite stable and controlled background pain. The purpose of this study was to explore Canadian patients’ awareness of and experience with breakthrough pain in cancer (BTPc).

Methods

Four Canadian cancer centers participated in a non-interventional survey recruiting cancer patients who experienced breakthrough pain. These patients were asked about their pain, its impact on functioning, current management and interest in new treatments of BTPc.

Results

Ninety-four Canadian cancer patients participated in this study, with 96 % stating that cancer pain impacted their daily living with over half unable to go to work or shopping. Fifty percent of patients said that an episode of BTPc lasted greater than 60 minutes, with the pain score being on average 7.8/10, impacting normal work (7.2/10) and general activity (7.1/10). Only 35 % of patients were very satisfied with the speed of relief of their medications. Those who did not take their breakthrough pain medication for every episode stated that was because the pain was not always severe (37 %), or they were afraid of becoming tolerant (23 %) or addicted (12 %). Patients stated that the most important features of a new treatment for BTPc were the ability to relieve pain completely (47 %), and quickly (43 %). Patients expressed willingness to try transmucosal products (80 %) or nasal products (59 %).

Conclusion

Breakthrough cancer pain in Canadian cancer patients greatly impacts their daily lives. There is room for improvement in the management of BTPc, and the majority of patients would be willing to try new treatments.     

Summative clinical competency assessment: A survey of ultrasound practitioners’ views

Clinical competency and the assessment of core skills is a crucial element of any programme leading to an award with a clinical skills component. This has become a more prominent feature of current reports on quality health care provision. This project aimed to determine ultrasound practitioners’ opinions about how best to assess clinical competency. An on-line questionnaire was sent to contacts from the Consortium for the Accreditation of Sonographic Education and details distributed at the British Medical Ultrasound Society conference in 2011. One hundred and sixteen responses were received from a range of clinical staff with an interest in ultrasound assessment. The majority of respondents suggested that competency assessments should take place in the clinical departments with or without an element of assessment at the education centre. Moderation was an important area highlighted by respondents, with 84% of respondents suggesting that two assessors were required and 66% of those stating some element of external moderation should be included. The findings suggest that respondents’ preference is for some clinical competency assessments to take place on routine lists within the clinical department, assessed by two people one of which would be an external assessor. In view of recent reports relating to training and assessment of health care professionals, the ultrasound profession needs to begin the debate about how best to assess clinical competence and ensure appropriate first post-competency of anyone undertaking ultrasound examinations.     

The impact of debriefing modalities on nurse practitioner students’ knowledge and leadership skills in managing fatal dysrhythmias: A pilot study

Acute care nurse practitioners (ACNPs) require special training and educational preparation to meet their role expectations. Using high fidelity simulation with debriefing modalities is considered one of the innovative learning strategies in graduate nursing. No studies have investigated debriefing modalities in nurse practitioner programs specially ACNPs leadership skills. The purpose of this study was to examine the difference in students' knowledge, code team leader skills and self-efficacy using two debriefing modalities. A two group, pretest-posttest quasi-experimental design was used. Students were divided into video-assisted debriefing group vs. verbal debriefing following a simulation scenario of managing emergency codes. There were no significant differences between the two groups in knowledge acquisition/retention, leadership skills, and self-efficacy, but there was a significant difference in self-efficacy in both groups between two-time points. There was a general improvement in teams' performance. Students preferred verbal debriefing over video-assisted debriefing. The debriefing session plays an important role in graduate nursing education. Acute care nurse practitioners are lacking a formal leadership training to meet their advanced role. Nurse Educators, and simulation/debriefing leaders may benefit from our study results to develop a structured, formal curriculum and educational instruction focusing on acute care nurse practitioners’ role change especially leading a resuscitation team.     

Nursing degree students’ clinical placement experiences in Australia: A survey design

AimThis study aimed to evaluate Australian nursing students’ views of placements at seven tertiary education institutions with the use of the Placement Evaluation Tool (PET).BackgroundClinical placements are a core element of healthcare education programs around the world (Chuan and Barnett, 2012) with undergraduate nursing students required to complete a prescribed number of hours as part of their degree. The quality of nursing clinical placements varies with a range of positive and negative learning experiences.DesignA survey design was used with a contemporary survey tool– the Placement Evaluation Tool (PET). Using Qualtrics software (Qualtrics, 2005) the on-line survey was distributed to approximately 6265 undergraduate nursing students at six Australian universities and one Technical and Further Education (TAFE) college where Bachelor of Nursing degree students were enrolled. Three Australian States were covered. Sites were selected where a project team member was employed.MethodsA total of 1263 nursing students completed the Placement Evaluation Tool (PET) − 19 items (rated 1–5), one global rating (rated 1–10) − following placement in three Australian States (July 2019−February 2020). Most - 618 (48.9%) completed a placement in acute care with placements positively rated overall.ResultsThe total PET mean score was 78.3% with 29.8% being ‘extremely satisfied’ (10 out of 10 – Item 20). However, 11.0% were dissatisfied with global ratings of four or less, whilst ratings between States differed significantly (p = <0.001). One third of respondents answered a free text statement relating to placement experiences, with significantly more comments from older students (p = <0.001) and from those with ratings in the lower range (p = <0.001). Three core themes emerged: 1. Staff Attitudes to Students, 2. Environment and 3. Lifestyle.ConclusionsWhilst students’ clinical experiences in Australia tend to be positive a minority reported exposure to negative staff attitudes, in unsafe environments, with lifestyle detriments. Further work is required to understand and enhance student experiences.     

Thrombotic thrombocytopenic Purpura: A nurse’s perspective on a decade of treatment in Sheffield,United Kingdom

TTP is a rare, life threatening condition, with an annual incidence of 3-11 cases per million people. A deficiency of a vWF multimer cleaving protein, ADAMTS13 is the cause of the condition. Quick & accurate diagnosis is crucial in the safe & effective treatment of individuals presenting with this condition. First line treatment is the removal of the resulting ulta-large vWF multimers left in the circulation by the lack of ADAMTS13 & immunosuppression of antibodies against ADAMTS13. In the last 3 years, introduction of a targeted therapy called Caplacizumab has seen a change in treatment. This paper provides an overview of the experience of the Sheffield, UK treatment team in the changes in TTP treatment pathways in the region. Finally exploring the impact introducing Caplacizumab into routine management has had on patient care & outcomes from a local nurse's perspective.     

A survey of surgical audit in Australia: whither clinical governance?

A postal survey was undertaken to determine the extent of surgical audit in Australian public hospitals in the context of clinical governance. Participants were 88 surgical units from 74 Australian public hospitals in 1998 with more than 70 beds. The main outcome measures were performance of audit, methods used, frequency, documentation and perceived adequacy of resources and comparison of performance with Royal Australasian College of Surgeons requirements for re-certification. The main findings were that most units performed audit, but over two-thirds declared that they had insufficient resources to conduct audit according to College requirements, while a substantial proportion did not comply with other published guidelines for the conduct of audit meetings. The conclusion from this survey is that surgical audit will be unable to play its part in quality initiatives inherent in the clinical governance concept unless appropriately resourced.     

Resources for education on pain and its management: A practitioner’s compendium

Knowing enough information about pain and its management to adequately care for people in pain may seem challenging, especially for primary care providers who provide the bulk of pain management services in the United States. Few, if any, primary care providers received training beyond the names of a few analgesics and the rudiments of pain assessments. Fortunately, many national and international societies provide health care practitioners with pain-related education, resources, and tools. Education may be tied to pain certification or specialization, or provided solely for the benefit of practitioners. Due in large part to the World Wide Web, much information about pain is readily available online.     

Use of herbal medicines: Pilot survey of UK users’ views

Increasing sales of medicinal plants as supplements or health foods continue to indicate widespread self-medication. We conducted a survey on users’ views on obtaining information on herbal medicines and their experiences and opinions about their use. Responses over one-year period (01.08.2015–31.07.2016) were analysed.157 participants took part (87% aged 45–64y, and 13% >65y). 80% participants used medicinal plants for multiple health benefits [i.e. health protection (74%), disease prevention (38%) and treatment (49%]). 95% believed in the medicinal powers of plants. Information regarding use of medicinal plants was predominantly based on books (57%), the internet (53%), friends, colleagues or neighbours (51%) and health practitioners (42%). 51% of participants felt herbs were safe (51%) with less side effects (55%) than pharmaceutical medicines. 24% of medicinal plant users informed their medical doctor, with majority of informed medical professional (47%) accepting the use of medicinal plants.This pilot survey provides new and valuable information for use in designing future more comprehensive surveys to provide essential information about the use of herbal medicines by the general population and health care providers’ attitudes in the UK.