8,413 research outputs found
Nursing education and regulation: international profiles and perspectives
No full textThis review of nurse education and regulation in selected OECD countries forms part of ongoing work on contemporary nursing careers and working lives, based at the National Nursing Research Unit, King’s College London. The review was commissioned by the Department of Health to inform their work in considering the UK’s position in relation to the Bologna declaration and changes that may emanate from the implementation of Modernising Nursing Careers (DH 2006). While much of the information in the review was obtained from publications and websites, we also contacted key personnel in most of the countries included for an up-to-date review of developments in their country and would like to thank them all for providing this information
Involving users in the development of effective critical care discharge information: a focus group study
No full textBackground Discharge from critical care to a general care unit is a difficult period, and more effective information is needed to support patients and their families at this time.Objectives This study sought the views of patients, relatives and health care staff on (1) the most effective methods of delivering critical care discharge information, (2) the required information content of any proposed strategies, (3) the benefits and limitations of any existing strategies, and (4) potential resource implications.Methods In this qualitative focus group study, 11 adult patients, 8 family members, and 23 health care staff in Eng-land took part in 8 focus group interviews at 2 hospitals. The computer software program NVIVO7 was used for thematic analysis of the data.Results Three key themes were identified from the data: (1) considerations related to effective discharge information, (2) goals of critical care discharge information, and (3) resource implications.Conclusions This focus group study provides unique user insight into what influences successful and unsuccessful information giving. Based on real experiences, it adds to the limited international body of current evidence. Findings will be of value in designing future critical care discharge information and identifying the related resource implications
An assessment of failure to rescue derived from routine NHS data as a nursing sensitive patient safety indicator (report to Policy Research Programme)
No full textObjectives: This study aims to assess the potential for deriving 2 mortality based failure to rescue indicators and a proxy measure, based on exceptionally long length of stay, from English hospital administrative data by exploring change in coding practice over time and measuring associations between failure to rescue and factors which would suggest indicators derived from these data are valid.Design: Cross sectional observational study of routinely collected administrative data.Setting: 146 general acute hospital trusts in England.Participants: Discharge data from 66,100,672 surgical admissions (1997 to 2009).Results: Median percentage of surgical admissions with at least one secondary diagnosis recorded increased from 26% in 1997/8 to 40% in 2008/9. The failure to rescue rate for a hospital appears to be relatively stable over time: inter-year correlations between 2007/8 and 2008/9 were r=0.92 to r=0.94. No failure to rescue indicator was significantly correlated with average number of secondary diagnoses coded per hospital. Regression analyses showed that failure to rescue was significantly associated (p<0.05) with several hospital characteristics previously associated with quality including staffing levels. Higher medical staffing (doctors + nurses) per bed and more doctors relative to the number of nurses were associated with lower failure to rescue. Conclusion: Coding practice has improved, and failure to rescue can be derived from English administrative data. The suggestion that it is particularly sensitive to nursing is not clearly supported. Although the patient population is more homogenous than for other mortality measures, risk adjustment is still required
The Concept of Genius in D. A. Granin’s Work (Based on the Novel “Evenings with Peter the Great”)
No full textThe article deals with D. A. Granin’s concept of history as presented in the novel “Evenings with Peter the Great”. The author of the novel argues that historical process is driven and streamlined by people endowed with rare gifts and deep urge to create such as the first Russian emperor Peter the Great
The role of pilot testing for a randomised control trial of a complex intervention in critical care
No full textRandomised controlled trials (RCTs) involving diverse population groups in complex health care settings can be difficult to successfully undertake and pose practical and methodological challenges. For this reason, undertaking a pilot study is recommended by the Medical Research Council prior to conducting a definitive trial. This paper reports a pragmatic review of the challenges encountered by the research team during a single centre pilot RCT and discusses how feasible it was to deliver and evaluate a complex intervention in practice. The psycho-social intervention designed for this trial was a ‘user-centred critical care discharge information pack’. The pack was designed to support patients and their families during and after their discharge from a critical care unit. It consisted of two written booklets, one for the patient and one for the family member. In total, 221 patients met our inclusion criteria, of whom 158 (71%) were recruited. The pilot RCT identified important lessons for the design of future trials. Challenges included those associated with the recruitment of potential participants, assessing capacity and obtaining informed consent. Problems with attrition, intervention delivery and the choice of data collection tools and time-points were also apparent. Our findings demonstrate that the evaluation of complex interventions is feasible in clinical practice. The importance of adhering to a robust research protocol, maintaining efficient and effective communication between researchers and clinical staff is emphasised. Findings further support the importance of conducting a pilot study prior to embarking on a definitive RCT.</p
Providing critical care patients with a personalised discharge summary: A questionnaire survey and retrospective analysis exploring feasibility and effectiveness
No full textObjectives: This paper reports on the potential value and feasibility of providing patients with a personalised discharge summary of their critical care stay. Design and methods: Fifty-one patient discharge summaries, written by nurses during a randomised controlled trial, were retrospectively analysed for readability, structure and quality. A questionnaire survey completed by trial patients (n= 42), their relatives (n= 21) and nurses (n= 170) explored user experience and feasibility. Quantitative questionnaire data were analysed descriptively and inferentially; qualitative data were subjected to content analysis. Results: Most completed summaries achieved at least an average readability score and were of an acceptable quality. Motivation, time constraints and competing priorities were identified as key barriers to writing an effective summary; however, in the majority of cases, writing them had taken less than 15. minutes. Questionnaire data support that patient discharge summaries can help patients, relatives and ward nurses better understand and patients accept, what happened in critical care. Conclusion: Patient discharge summaries are likely to be a useful adjunct to existing discharge information, but further work is required to determine when and how they should be provided. With appropriate training and support, it is feasible for nurses to write discharge summaries in a busy critical care environment.</p
User centred critical care discharge information to support early critical illness rehabilitation; development and evaluation using the Medical Research Council’s complex interventions framework
No full textObjectives: this paper reports on an intervention designed during an ongoing 2 phase project aimed at improving early critical illness rehabilitation. It focuses specifically on the justification for a newly developed critical care discharge information pack: ‘User Centred Critical care Discharge Information Pack’(UCCDIP). The intervention is described in detail and the chosen research methods are discussed. Background: discharge from critical care to a ward is a difficult time for patients and relatives. Research suggests that effective information has the potential to reduce relocation stress and optimize recovery. Methods: using the Medical Research Council framework for the development and evaluation of complex interventions, a phase I focus group study and collaboration with service users/carers informed the development of a new critical care discharge information pack, currently being evaluated in a phase II Randomised Controlled Trial. Conclusion: UCCDIP acknowledges the patients’ need to understand what they have been through and the progress they have made. It provides for the different information needs of patients and relatives, recognising their physical and psychological vulnerability. Through its use of reflection and participation, UCCDIP has the potential to optimise support of adult patients and their families during early critical illness rehabilitation
Video game addiction: past, present and future
No full textGaming addiction has become a topic of increasing research interest. The last decade has witnessed a significant increase in the number of empirical studies examining various aspects of problematic video game play and video game addiction. This paper begins with a brief past history of how research into video game addiction has changed over the last three decades (i.e., the 1980s, 1990s and 2000s). It then examines more thoroughly the contemporary research literature by analyzing the (i) prevalence of problematic video game use and video game addiction, (ii) negative consequences of excessive video game use, (iii) factors associated with problematic video game use and video game addiction, and (iv) the treatment of problematic video game use and video game addiction. The paper concludes by looking at the trends in the field and a somewhat theoretical examination of what the future of video game addiction might be.Mark D. Griffiths, Daria J. Kuss and Daniel L. Kin
Zechariah 9-14 as the substructure of 1 Peter’s eschatological program
No full textThe principal aim of this study is to discern what has shaped the author of 1 Peter to regard Christian suffering as a necessary (1.6) and to-be-expected (4.12) component of faithful allegiance to Jesus Christ. Most research regarding suffering in 1 Peter has limited the scope of inquiry to two particular aspects—its cause and nature, and the strategies that the author of 1 Peter employs in order to enable his addressees to respond in faithfulness. There remains, however, the need for a comprehensive explanation for the source that has generated 1 Peter’s theology of Christian suffering. If Jesus truly is the Christ, God’s chosen redemptive agent who has come to restore God’s people, then how can it be that Christian suffering is a necessary part of discipleship after his coming, death and resurrection? What led the author of 1 Peter to such a startling conclusion, which seems to runs against the grain of the eschatological hopes and expectations of Jewish restoration ideology?
This thesis analyzes the appropriation of shepherd and fiery trials imagery,
and argues that the author of 1 Peter is dependent upon Zechariah 9-14 for his
theology of Christian suffering. Said in another way, the eschatological program of
Zechariah 9-14, read through the lens of the Gospel, functions as the substructure
for 1 Peter’s eschatology and thus its theology of Christian suffering.
In support of this hypothesis, this study highlights the fact that Zechariah 9-
14 was available and appropriated in early Christianity, in particular in the Passion
Narrative tradition; that the shepherd imagery of 1 Pet 2.25 is best understood
within the milieu of the Passion Narrative tradition, and that it alludes to the
eschatological program of Zechariah 9-14; that the fiery trials imagery found in 1
Peter 1.6-7 and 1 Pet 4.12 is distinct from that which we find in Greco-Roman and OT
wisdom sources, and that it shares exclusive parallels with some unique features of
the eschatological program of Zechariah 9-14; that Zechariah 9-14 offers a more
satisfying explanation for the modification of Isa 11.2 in 1 Pet 4.14, the transition
from 4.12-19 to 5.1-4, why Peter has oriented his letter with the term διασπορά,
and why he has described his addresses as οἶκος τοῦ θεοῦ; and finally that 1 Peter
contains an implicit foundational narrative that shares distinct parallels with the
eschatological program of Zechariah 9-14.
We can conclude that 1 Peter offers a unique vista into the way in which at
least one early Christian witness came to understand and to communicate the fact
that Christian suffering was a necessary feature of faithful allegiance to Jesus Christ
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