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2036 research outputs found
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Bridging barriers to evidence-based practice and knowledge utilisation: Leadership strategies in acute care nursing
Full text linkThe implementation of evidence-based practice (EBP) is crucial for improving patient outcomes and healthcare delivery, yet it faces significant challenges in acute care settings due to organisational barriers, resource limitations, and leadership complexities.
This study explores how ward managers (WMs) facilitate knowledge utilisation (KU) and promote EBP adoption in these environments. A longitudinal qualitative case study was conducted over eight months in two acute care hospitals in the East Midlands, England.
Data were collected through semi-structured interviews with 23 WMs, nonparticipant observations, and document analysis. Thematic analysis was used to identify key findings.
Six themes emerged: navigating leadership challenges, overcoming organisational and re-source barriers, sustaining EBP through learning networks, integrating technology, tailoring EBP to patient-centred care, and providing emotional support for staff. Hybrid leadership strategies, combining directive and collaborative approaches, were critical in addressing barriers, fostering engagement, and embedding EBP into workflows. Mentorship and resource management also played pivotal roles. The study highlights the need for tailored leadership strategies, innovative resource utilisation, and sustainable learning networks to overcome systemic challenges and promote EBP. These findings provide actionable insights for fostering evidence-informed care environments in resource-constrained acute care settings
“Shifting goalposts” and “fishing expeditions”: police case preparation and the application of the full code test in cases of RASSO
Full text linkPurpose: Despite recent increases, the low level of convictions in cases of rape and serious sexual offences (RASSO), aligned with the subsequent lack of victim satisfaction with the process, has highlighted the various challenges and barriers throughout the criminal justice process. Whilst understanding the shortcomings of criminal justice processes in cases of RASSO requires a holistic approach, this paper focuses on case preparation and the application of the Full Code test. Its purpose is to explore the application of this test and preceding case preparation in police decision-making around submitting cases for charging decision, following the recommendations of the first year of Operation Soteria Bluestone.
Design/methodology/approach: This study adopted a mixed-method approach, combining both interviews and case reviews of selected RASSO cases across five forces in England and Wales.
Findings: This research found a shift towards “threshold thinking”, whereby officers arguably no longer try to predict a prosecutor’s decision and instead focus on meeting the requirements for the application of the test. In terms of case preparation, the research demonstrates a move away from “fishing expeditions”, with a preference for more focused approaches to collecting evidence.
Originality/value: To the best of the authors’ knowledge, this is one of the first studies looking at the use of full code test principles in police decision-making in RASSO cases
Lived experiences of adolescents and young adults receiving inpatient psychiatric care
Full text linkBackground: Adolescents and young adults in low-and middle-income countries (LMICs), face multiple barriers to accessing quality mental health care, shaped by cultural expectations, systemic gaps, and widespread stigma. In Nigeria, little is known about how these factors intersect within psychiatric inpatient settings. This study explored the lived experiences of adolescents and young adults receiving inpatient psychiatric care to inform more culturally responsive, family-engaged, and psychologically supportive models of care. Methods: Using an Interpretative Phenomenological Approach, we conducted in-depth semi-structured interviews with 28 participants aged 13 to 28 years, all receiving care at a public psychiatric hospital in South-Eastern Nigeria. Participants were purposively sampled and represented a range of diagnostic categories. The hospital, serving a diverse catchment area, reflects a hybrid system of biomedical and traditional models of care. Interviews were conducted over nine months and analysed through iterative, reflexive engagement, supported by member checking to enhance credibility and contextual grounding. Results: Participants described a range of emotionally charged experiences, with stigma emerging as a major theme. Several reported social withdrawal, strained family dynamics, and shifts in how they were perceived by others. Relationships with peers in hospital varied, offering both connection and tension. Personal coping strategies, such as prayer, art, music, and peer dialogue were commonly described. Despite these efforts, many expressed a desire for consistent psychological support and greater engagement from staff. Hospital environments were viewed as both protective and limiting, with concerns raised about overcrowding, lack of privacy, and emotional neglect. Conclusion: While the findings cannot be generalised, they offer important insights into the mental health journeys of young people within a Nigerian inpatient setting. Participants called for greater emotional and relational support, staff communication, and culturally sensitive care. These perspectives highlight areas for further research and service improvement in youth mental health provision across similar contexts
A service evaluation of the North East Essex Diabetes Service (NEEDS)
Full text linkImproving outcomes and the integration of diabetes care for adults is a National Health Service ambition. In north east Essex, United Kingdom, an innovative interprofessional community-based diabetes service (North East Essex Diabetes Service (NEEDS)) was developed to provide a single point of access and continuity of care across an integrated, interprofessional care pathway. The aim was to evaluate how NEEDS was embedded into Primary Care, and gain insight into how it works from the perspective of staff delivering the service and from those receiving care. A mixed methods approach was used. Retrospective data from GP surgeries involved in NEEDS were analyzed. Online surveys (n = 21) and focus groups (workforce n = 23; service users n = 6) were conducted. A clear pathway of diabetes care across an integrated, interprofessional care system was demonstrated. Standard care processes and patient outcomes were higher than those recorded for other GP surgeries across England. Service users reported that they received support with more control over their care. The workforce reported a reduction in bureaucracy, blurring of professional boundaries, and thus autonomy to develop the service. The “virtual ward” provided a true interprofessional team approach. Patients and the workforce reported feeling empowered, demonstrating a holistic high-quality approach to patient care
The perceptions of male accessibility to the fields of nursing practice by those studying or teaching nursing in England: cross-sectional survey
Full text linkAims: Investigate the perception of male accessibility to the fields of nursing practice by those studying or teaching nursing in England. Design: Cross‐sectional survey. Methods: Online questionnaire with three closed‐scale questions and two open‐text questions designed to elicit perceptions on the accessibility of men to the fields of nursing practice. The questionnaire was distributed to the staff and students at 61 nursing schools in England. Inferential and descriptive statistics were used to analyse the closed questions data and inductive content analysis was used to analyse open‐text questions data. Results: Students (n = 52) and staff (n = 51) responded to the survey. Adult (Mdn = 6, IQR = 2) and mental health (Mdn = 6, IQR = 2) were perceived as the most accessible fields of nursing practice to men, and child (Mdn = 4, IQR = 2) the least. Specialised practice areas in acute and emergency (Mdn = 6, IQR = 2), education (Mdn = 6, IQR = 2), leadership (Mdn = 7, IQR = 1), prison services (Mdn = 7, IQR = 1), and research (Mdn = 7, IQR = 2) were rated the most accessible to men and neonatal care (Mdn = 3, IQR = 3) the least. Societal stereotyping and stigma were seen as barriers to men entering the nursing profession. The perception that nursing is a feminised profession persists and a distrust of men is associated with child nursing. Men were viewed as progressing to leadership roles with greater ease than women. Conclusion: Societal level stereotyping and stigma are perceived as prevalent in nursing practice areas considered less accessible to men entering the nursing profession. Impact: This study adds insight into the gendered nature of nursing and highlights the barriers to men entering a profession with a workforce crisis. Reporting Methods: STROBE cross‐sectional studies guidelines. COREQ guidelines for content analysis. Patient or Public Contribution: No patient or public contribution
Review of Polumi Basu, Always Coming Home, Focal Point Gallery
No full textThis article reviews Poloumi Basu's important solo exhibition showing at Focal Point Gallery in Southend, exploring how its themes of displacement are tackled through its complex array of objects and mediums
Balloon Pulmonary Angioplasty for Chronic Thromboembolic Pulmonary Hypertension results of an international multicenter prospective registry
Full text linkBackground
Chronic thromboembolic pulmonary hypertension results from mechanical obstruction of major pulmonary artery lumina with fibrotic tissue. Main treatment has been pulmonary endarterectomy, a complex surgical procedure removing vascular obstruction. However, at least 40% of patients are not candidates for pulmonary endarterectomy because of technical inoperability, comorbidities, or limited access to surgery. Balloon pulmonary angioplasty (BPA) has emerged as an interventional treatment for these patients.
Objectives
The International BPA Registry (NCT03245268) was designed to investigate BPA practice across 18 established centers in the United States, Europe, and Japan.
Methods
A total of 500 patients were prospectively and consecutively enrolled between March 2018 and March 2020, with follow-up until March 2022. Of these, 484 patients were included in the analysis set.
Results
Regional differences were seen in patient characteristics (fewer patients with prior pulmonary endarterectomy and more elderly women in Japan) and procedural details (less medical pretreatment, more jugular access, more segments and more occlusive lesions treated per session and patient, less conscious sedation, less contrast and less radiation, shorter intervals between BPA sessions in Japan). Female sex, procedure in Europe/United States, pulmonary hypertension medications at any time, and higher baseline pulmonary vascular resistance (PVR), calculated as transpulmonary pressure gradient divided by cardiac output, emerged as independent predictors of complications during BPA. After a median of 5 (Q1-Q3: 3-6) BPA sessions per patient within a median time of 4.9 months (Q1-Q3: 1.7-11.0 months), a 15-mm Hg (38%) decrease in mPAP, a 332 dynes/s/cm−5 (57%) decrease in PVR, and a 3.2% increase in arterial saturation (medians; P < 0.001) were observed, and there were significant improvements in functional class, 6-minute walk distance, serum levels of N-terminal probrain natriuretic peptide, and Borg dyspnea index. BPA complications occurred in 11.3% of sessions and 33.9% of patients and were mostly hemoptyses. No patient died within 30 days of BPA.
Conclusions
Our data are in line with previous reports on changes of clinical and hemodynamic parameters and complication rates of BPA. Centers with more experience providing BPAs were more likely to achieve a higher percentage decrease in PVR
Interview on BBC local radio re: new book
No full textInterview with Heidi Secker broadcast on three local radio stations - BBC Radio Suffolk, BBC Radio Norfolk, BBC Radio Cambridgeshire. Part of the feature Music Sounds Better with You
Scenes from a place called world - in conversation with artist Rebecca Riess and Dr. Susan Barnet
No full textArtist Rebecca Riess joins Dr. Susan Barnet to discuss her recent exhibition ‘Scenes From A Place Called World’ at The Art Station 2025. From her Pick ‘N’ Mix style to her “Adventure of Process,” Riess reflects on life during lockdown and how her work captures her world within the world she lives in