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Friday, 26 August 2016
Thursday, 25 August 2016
Revalidation, Reflection, Reconsider
Faced with completing your Nurse Revalidation documentation ...
Been a while since you had any advice on how to undertake Reflection ...
Reconsider your needs.
Do you need training in:
Been a while since you had any advice on how to undertake Reflection ...
Reconsider your needs.
Do you need training in:
- finding good evidence
- critically appraising evidence
- reflective writing
You can book a customised training session, delivered at a place and time convenient to you and your team by emailing: mcardle.library@nhs.net
Infection Control Information
Need to know more about Infection Prevention and Control?
Need to know about specific Infections e.g. MRSA, Clostridium difficile, or Carbapenemase- Producing Enterobacteriaceae (CPE)?
Your Library & Knowledge Service can help.
Email: mcardle.library@nhs.net
Need to know about specific Infections e.g. MRSA, Clostridium difficile, or Carbapenemase- Producing Enterobacteriaceae (CPE)?
Your Library & Knowledge Service can help.
Email: mcardle.library@nhs.net
Monday, 22 August 2016
WUTH publication: Critical care in the Emergency Department: organ donation
Citation: Emergency Medicine Journal. 2017, 34(4), 256-263
Author: Gardiner DC, Nee MS, Wootten AE, Andrews FJ, Bonney SC, Nee PA
Abstract: Organ transplantation is associated with improved outcomes for some patients with end-stage organ failure; however, the number of patients awaiting a transplant exceeds the available organs. Recently, an extended role has been proposed for EDs in the recognition and management of potential donors. The present review presents an illustrative case report and considers current transplantation practice in the UK. Ethical and legal considerations, the classification of deceased donors and future developments promising greater numbers of organs are discussed.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
KEYWORDS: clincial management; emergency department; forensic/legal medicine; intensive care
Link to PubMed record
Author: Gardiner DC, Nee MS, Wootten AE, Andrews FJ, Bonney SC, Nee PA
Abstract: Organ transplantation is associated with improved outcomes for some patients with end-stage organ failure; however, the number of patients awaiting a transplant exceeds the available organs. Recently, an extended role has been proposed for EDs in the recognition and management of potential donors. The present review presents an illustrative case report and considers current transplantation practice in the UK. Ethical and legal considerations, the classification of deceased donors and future developments promising greater numbers of organs are discussed.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
KEYWORDS: clincial management; emergency department; forensic/legal medicine; intensive care
Link to PubMed record
WUTH publication: HELPING PARENTS/CARERS TO GIVE MEDICINES TO CHILDREN IN HOSPITAL
Citation: Archives of disease in childhood. 2016, 101(9), e2
Author: Williams L, Caldwell N, Collins E
Abstract: BACKGROUND: Medicines given to children in hospital are often prepared, checked and administered by two-registered nurses. Children are more likely to accept medicines given by a parent/carer1 but many hospital policies do not support such practice. Indeed the Trusts Medicines Management Policy allows single person medicines administration, except for children, but does not specify how medicine preparation and administration should take place or who should witness this. Our aim was to identify ways of increasing parent/carer involvement in giving medicines to children in hospital.
OBJECTIVES: ▸ Measure time delays with the current administration process▸ Identify obstacles that may prevent parent/carer involvement in giving medicines▸ Identify how to overcome potential/perceived problems with parent involvement▸ Determine parent/carer opinions of their involvement in giving medicines▸ Assess single nurse checking and parent administration of medicines
METHOD: Drug rounds were observed to identify time delays in medicines administration. A list of nineteen low risk medicines was proposed for parent administration with single nurse preparation. Focus groups were conducted, using structured questions, to get healthcare professionals perspective on the proposed changes and to approve a list of low risk medicines. Parents/carers were invited to complete a questionnaire regarding their involvement. Following Drug and Therapeutics Committee approval, parents/carers administered medicines with single nurse preparation during a trial period.
RESULTS: Administration of twenty-one medicines was observed under current practice. Delays were observed in all cases: average delay 6.5 minutes. Delays of 10 minutes were observed due to children fighting against having medicines administered by a nurse. Delays in 28% of cases were due to getting another nurse to check the preparation and seventeen of the twenty-one medicines observed where not in the medicines locker. Such delays often lead to parents administering medicines, despite the current policy not allowing such practice. Three focus groups, involving 12 staff, identified several problems and potential solutions to single nurse checking of medicines. The main concern was the risk of errors with dose calculations. Questionnaires were completed by 30 parents/carers and 97% wanted to be involved in administering medicines. The only parent/carer who did not, quoted: "My child will not take any medicine from me, this is part of the reason she has been admitted". Most parents/carers (80%) felt their child would be more at ease if they give the medicine. During the trial eight medicines were administered by parents and carers and no delays were observed.
CONCLUSION: Children often receive late medicines in hospital. Parents/carers want to be involved in giving their child medicines. They suggest children would be more at ease. Parents/carer would also gain experience to help when administering medicines at home. Nurses support parent's being more involved in giving medicines. Focus groups suggest that medicines requiring dose calculations should be removed from a list of low risk medicines and parents be encouraged to administer medicines.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
KEYWORDS: Abstract; Oral
Link to PubMed record
Author: Williams L, Caldwell N, Collins E
Abstract: BACKGROUND: Medicines given to children in hospital are often prepared, checked and administered by two-registered nurses. Children are more likely to accept medicines given by a parent/carer1 but many hospital policies do not support such practice. Indeed the Trusts Medicines Management Policy allows single person medicines administration, except for children, but does not specify how medicine preparation and administration should take place or who should witness this. Our aim was to identify ways of increasing parent/carer involvement in giving medicines to children in hospital.
OBJECTIVES: ▸ Measure time delays with the current administration process▸ Identify obstacles that may prevent parent/carer involvement in giving medicines▸ Identify how to overcome potential/perceived problems with parent involvement▸ Determine parent/carer opinions of their involvement in giving medicines▸ Assess single nurse checking and parent administration of medicines
METHOD: Drug rounds were observed to identify time delays in medicines administration. A list of nineteen low risk medicines was proposed for parent administration with single nurse preparation. Focus groups were conducted, using structured questions, to get healthcare professionals perspective on the proposed changes and to approve a list of low risk medicines. Parents/carers were invited to complete a questionnaire regarding their involvement. Following Drug and Therapeutics Committee approval, parents/carers administered medicines with single nurse preparation during a trial period.
RESULTS: Administration of twenty-one medicines was observed under current practice. Delays were observed in all cases: average delay 6.5 minutes. Delays of 10 minutes were observed due to children fighting against having medicines administered by a nurse. Delays in 28% of cases were due to getting another nurse to check the preparation and seventeen of the twenty-one medicines observed where not in the medicines locker. Such delays often lead to parents administering medicines, despite the current policy not allowing such practice. Three focus groups, involving 12 staff, identified several problems and potential solutions to single nurse checking of medicines. The main concern was the risk of errors with dose calculations. Questionnaires were completed by 30 parents/carers and 97% wanted to be involved in administering medicines. The only parent/carer who did not, quoted: "My child will not take any medicine from me, this is part of the reason she has been admitted". Most parents/carers (80%) felt their child would be more at ease if they give the medicine. During the trial eight medicines were administered by parents and carers and no delays were observed.
CONCLUSION: Children often receive late medicines in hospital. Parents/carers want to be involved in giving their child medicines. They suggest children would be more at ease. Parents/carer would also gain experience to help when administering medicines at home. Nurses support parent's being more involved in giving medicines. Focus groups suggest that medicines requiring dose calculations should be removed from a list of low risk medicines and parents be encouraged to administer medicines.
Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/
KEYWORDS: Abstract; Oral
Link to PubMed record
Monday, 15 August 2016
WUTH publication: Initial UK experience with transversus abdominis muscle release for posterior components separation in abdominal wall reconstruction of large or complex ventral hernias: a combined approach by general and plastic surgeons
Citation: Annals of the Royal College of Surgeons of England. 2017, 99(4), 265-270
Author: Appleton ND, Anderson KD, Hancock K, Scott MH, Walsh CJ
Abstract: INTRODUCTION Large, complicated ventral hernias are an increasingly common problem. The transversus abdominis muscle release (TAMR) is a recently described modification of posterior components separation for repair of such hernias. We describe our initial experience with TAMR and sublay mesh to facilitate abdominal wall reconstruction. METHODS The study is a retrospective review of patients undergoing TAMR performed synchronously by gastrointestinal and plastic surgeons. RESULTS Twelve consecutive patients had their ventral hernias repaired using the TAMR technique from June 2013 to June 2014. Median body mass index was 30.8kg/m2 (range 19.0-34.4kg/m2). Four had a previous ventral hernia repair. Three had previous laparostomies. Four had previous stomas and three had stomas created at the time of the abdominal wall reconstruction. Average transverse distance between the recti was 13cm (3-20cm). Median operative time was 383 minutes (150-550 minutes) and mesh size was 950cm2 (532-2400cm2). Primary midline fascial closure was possible in all cases, with no bridging. Median length of hospital stay was 7.5 days (4-17 days). Three developed minor abdominal wall wound complications. At median review of 24 months (18-37 months), there have been no significant wound problems, mesh infections or explants, and none has developed recurrence of their midline ventral hernia. Visual analogue scales revealed high patient satisfaction levels overall and with their final aesthetic appearance. CONCLUSIONS We believe that TAMR offers significant advantages over other forms of components separation in this patient group. The technique can be adopted successfully in UK practice and combined gastrointestinal and plastic surgeon operating yields good results.
KEYWORDS: Hernia; Transversus abdominis muscle; Ventra
Link to PubMed record
Author: Appleton ND, Anderson KD, Hancock K, Scott MH, Walsh CJ
Abstract: INTRODUCTION Large, complicated ventral hernias are an increasingly common problem. The transversus abdominis muscle release (TAMR) is a recently described modification of posterior components separation for repair of such hernias. We describe our initial experience with TAMR and sublay mesh to facilitate abdominal wall reconstruction. METHODS The study is a retrospective review of patients undergoing TAMR performed synchronously by gastrointestinal and plastic surgeons. RESULTS Twelve consecutive patients had their ventral hernias repaired using the TAMR technique from June 2013 to June 2014. Median body mass index was 30.8kg/m2 (range 19.0-34.4kg/m2). Four had a previous ventral hernia repair. Three had previous laparostomies. Four had previous stomas and three had stomas created at the time of the abdominal wall reconstruction. Average transverse distance between the recti was 13cm (3-20cm). Median operative time was 383 minutes (150-550 minutes) and mesh size was 950cm2 (532-2400cm2). Primary midline fascial closure was possible in all cases, with no bridging. Median length of hospital stay was 7.5 days (4-17 days). Three developed minor abdominal wall wound complications. At median review of 24 months (18-37 months), there have been no significant wound problems, mesh infections or explants, and none has developed recurrence of their midline ventral hernia. Visual analogue scales revealed high patient satisfaction levels overall and with their final aesthetic appearance. CONCLUSIONS We believe that TAMR offers significant advantages over other forms of components separation in this patient group. The technique can be adopted successfully in UK practice and combined gastrointestinal and plastic surgeon operating yields good results.
KEYWORDS: Hernia; Transversus abdominis muscle; Ventra
Link to PubMed record
Wednesday, 10 August 2016
WUTh publication: Rare case of gallbladder agenesis presenting with pancreatitis
Citation: BMJ Case Reports. 2016, Aug 8.
Author: Thornton L, Goh YL, Lipton M, Masters A
Abstract: Gallbladder agenesis (GA) is a rare congenital abnormality with an incidence of 0.01-0.09%. Majority of GA exist alone although it can be associated with other systemic malformations involving the gastrointestinal, genitourinary, cardiovascular and skeletal systems. It is thought that biliary and pancreatic pathologies coexist and this is the second case reported in the literature of GA presenting with pancreatitis.
Link to PubMed record
Author: Thornton L, Goh YL, Lipton M, Masters A
Abstract: Gallbladder agenesis (GA) is a rare congenital abnormality with an incidence of 0.01-0.09%. Majority of GA exist alone although it can be associated with other systemic malformations involving the gastrointestinal, genitourinary, cardiovascular and skeletal systems. It is thought that biliary and pancreatic pathologies coexist and this is the second case reported in the literature of GA presenting with pancreatitis.
Link to PubMed record
Tuesday, 9 August 2016
Upcoming webinar
NIHR will be hosting a live one hour webinar on ‘Writing for Publication’ on Tuesday 23 August at 2pm, which may be of interest to you.
This webinar aims to introduce tips for getting published in both academic, practice-led journals and other peer-reviewed publications. Whether you have written for publication before, or are just getting started, this session will provide valuable tips and will introduce the process from submission and peer review, through to, hopefully, acceptance. It is aimed at current and aspiring NIHR trainees who would like to learn more about writing for publication.
The webinar will cover:
· Why/where/what do you want to publish?
· Structuring the paper
· Hints and tips on getting your article into print
· A live Q&A session
The webinar will be presented by Jennifer Chubb, a researcher at the University of York studying for a PhD in the Department of Education. Jenn has 10 years’ experience delivering training and development opportunities for researchers nationally and internationally and has published in a range of medium.
As this is a live webinar, attendees will be able to send questions in to the speakers and we will try to answer as many as possible during the webinar. We encourage you to send your question in advance, please email tcc@nihr.ac.uk with the subject: ‘Writing for Publication webinar question’
You can register for the webinar via the following link: http://bit.ly/writingforpublicationwebinar
Please share this information with any colleagues that may be interested in attending.
Anyone with issues around registering for the event should email tcc@nihr.ac.uk
Thursday, 4 August 2016
WUTH publication: An ethical dilemma: malignant melanoma in a 51-year-old patient awaiting simultaneous kidney and pancreas transplantation for type 1 diabetes
Citation: The British Journal of Dermatology. 2016, 175(1), 172-4
Author: Kirby LC, Banerjee A, Augustine T, Douglas JF
Abstract: Malignant melanoma is a high-risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after melanoma diagnosis. However, in young patients with end-stage organ failure and malignant melanoma, complex ethical and moral issues arise. Assessment of the true risk associated with transplantation in these patients is difficult due to lack of prospective data, but an autonomous patient can make a decision that clinicians may perceive to be high risk. The national and worldwide shortage of available organs also has to be incorporated into the decision to maximize the net benefit and minimize the risk of graft failure and mortality. The incidence of malignant melanoma worldwide is increasing faster than that of any other cancer and continues to pose ethically challenging decisions for transplant specialists evaluating recipients for solid organ transplantation
Link to PubMed record
Author: Kirby LC, Banerjee A, Augustine T, Douglas JF
Abstract: Malignant melanoma is a high-risk skin cancer that, in potential transplant recipients, is considered a substantial contraindication to solid organ transplantation due to significant risk of recurrence with immunosuppression. Current guidelines stipulate waiting between 3 and 10 years after melanoma diagnosis. However, in young patients with end-stage organ failure and malignant melanoma, complex ethical and moral issues arise. Assessment of the true risk associated with transplantation in these patients is difficult due to lack of prospective data, but an autonomous patient can make a decision that clinicians may perceive to be high risk. The national and worldwide shortage of available organs also has to be incorporated into the decision to maximize the net benefit and minimize the risk of graft failure and mortality. The incidence of malignant melanoma worldwide is increasing faster than that of any other cancer and continues to pose ethically challenging decisions for transplant specialists evaluating recipients for solid organ transplantation
Link to PubMed record
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