Papers by Stephen Timmons
Global Journal of Health Science, 2013
During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to s... more During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to stay out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Previous literature shows controversial belief whether or not a family member should be present during resuscitation of their relative. Some worldwide association such as the American Heart Association supports family-witnessed resuscitation and urge hospitals to develop policies to ease this process. The opinions on family-witnessed resuscitation vary widely among various cultures, and some hospitals are not applying such policies yet. This study explores family members' needs during resuscitation in adult critical care settings. This is a part of larger study. The study was conducted in six hospitals in two major Jordanian cities. A purposive sample of seven family members, who had experience of having a resuscitated relative, was recruited over a period of six months. Semi-structured interview was utilised as the main data collection method in the study. The study findings revealed three main categories: families' need for reassurance; families' need for proximity; and families' need for support. The need for information about patient's condition was the most important need. Updating family members about patient's condition would reduce their tension and improve their acceptance for the end result of resuscitation. All interviewed family members wanted the option to stay beside their loved one at end stage of their life. Distinctively, most of family members want this option for some religious and cultural reasons such as praying and supplicating to support their loved one. This study emphasizes the importance of considering the cultural and religious dimensions in any family-witnessed resuscitation programs. The study recommends that family members of resuscitated patients should be treated properly by professional communication and involving them in the treatment process. The implications concentrate on producing specific guidelines for allowing family-witnessed resuscitation in the Jordanian context. Finally, attaining these needs will in turn decrease stress of those witnessing resuscitation of their relative.
Emergency Medicine Journal, 2016
The combination of constrained resources, patient complexity and rapidly increasing demand has me... more The combination of constrained resources, patient complexity and rapidly increasing demand has meant that healthcare productivity constitutes a significant problem for emergency medicine. However, healthcare productivity remains a contentious issue, with some criticising the level of professional engagement. This paper will propose that productivity improvements in healthcare could occur (and be sustained) if professionals' perceptions and views of productivity were better understood. An 8-month ethnographic study was conducted in a large UK ED, using semistructured interviews with healthcare professionals (HCPs) (n=26), a focus group and observation. Thematic analysis of the data was undertaken based on an interpretivist philosophy. The data demonstrate that HCPs accept productivity improvement as part of their contemporary professional role. In particular, their understanding of productivity is focused around five key domains: the patient; the professional; the culture; the process of work and the economic. By exploring how these HCPs experienced and made sense of productivity improvement and productive healthcare, the data reveals how HCPs may reconcile a culture of caring with one of efficiency. Understanding healthcare productivity from this perspective has potential implications for service improvement design and performance measurement.
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Global Journal of Health Science, Dec 1, 2013
Background: During cardio-pulmonary resuscitation, family members, in some hospitals, are usually... more Background: During cardio-pulmonary resuscitation, family members, in some hospitals, are usually pushed to stay out of the resuscitation room. However, growing literature implies that family presence during resuscitation could be beneficial. Previous literature shows controversial belief whether or not a family member should be present during resuscitation of their relative. Some worldwide association such as the American Heart Association supports family-witnessed resuscitation and urge hospitals to develop policies to ease this process. The opinions on family-witnessed resuscitation vary widely among various cultures, and some hospitals are not applying such polices yet. This study explores family members' needs during resuscitation in adult critical care settings.
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ABSTRACT Automated external defibrillators are becoming ubiquitous in public space, with a wide v... more ABSTRACT Automated external defibrillators are becoming ubiquitous in public space, with a wide variety of organisations adopting this technology as a way of dealing with the risk of cardiac arrest to staff or users of the organisation. In this article, we examine why organisations had purchased defibrillators. We explore how organisations perceive their responsibilities to staff and visitors in an emergency, and why organisations believe a defibrillator is an appropriate technology. This article draws on data from a qualitative, interview-based study of five large public-sector organisations (universities) in the United Kingdom, in 2011–2012. We found that the organisations perceived the risk of cardiac arrest to be substantial, though the available epidemiological evidence did not support this. They perceived the defibrillator to be an effective technology for managing this risk, as part of a wider first aid system. Instances where a cardiac arrest had occurred in the organisation were likely to persuade them to adopt the defibrillator. Our study indicated that the organisations were unaware of (or chose to ignore) the available ‘scientific’ evidence, which cast doubt on both of the scale of the risk of cardiac arrest and the effectiveness of the defibrillator in dealing with it. In this case, the symbolic power of the defibrillator to address a risk perceived to be serious enough to warrant substantial expenditure was sufficient to persuade organisations to adopt it.
The Clinical Teacher, 2015
Manikins and simulated patients (SPs) are commonly used in health care education and assessment. ... more Manikins and simulated patients (SPs) are commonly used in health care education and assessment. SPs appear to offer a more realistic experience for learners than 'plastic' manikins, and might be expected to engender interactions that approximate real clinical practice more closely. The analyses of linguistic patterns and touch are methodologies that could be used to explore this hypothesis. Our research aims were: (1) to compare verbal interactions and the use of procedural touch by health care workers (HCWs) in scenarios with SPs and with manikins; and (2) to evaluate the methodologies used to inform a large-scale study. We conducted a pilot preliminary comparative study on conversations and touch in two scenarios in emergency care training, each performed using an SP and a high-fidelity manikin. The setting was a simulation centre. Two scripted acute-care scenarios (chest pain and acute breathlessness) were performed using both an SP and a high-fidelity manikin. Audiovisual recordings were subsequently analysed. Two teams comprising a clinician (medical student), a senior nurse and a clinical support worker took part in the study. The linguistics research methodology integrated a multimodal corpus-based approach and discourse analysis. Simulated patients appear to offer a more realistic experience for learners than 'plastic' manikins RESULTS: Overall, HCWs had far more interactions with the SPs than with the manikins, and the utterances and behaviours were more akin to what one would expect in real clinical practice. HCWs used procedural touch without the patient's permission much more frequently with the manikin. These methodologies offer opportunities for further research projects studying interactions with SPs, manikins and real clinical practice.
Nurse Education Today the Journal For Health Care Educators, 2005
Part of evidence-based practice is an ability to appraise research. Studies have shown that under... more Part of evidence-based practice is an ability to appraise research. Studies have shown that understanding the statistical components of a study is an area some nursing students struggle with. This paper reports the implementation and evaluation of a web-based statistics test to teach statistics to post-registration nursing students. The evaluation used both the data from the web-based statistics test, to measure students' learning, and from a survey completed after the module, to examine students' attitudes. The survey included some qualitative elements. The evaluation demonstrated that this is a valid and acceptable method of improving knowledge and understanding of statistics within this group of students.
British Journal of Infection Control, 2008
... Email: [email protected] 3. Clinical Audit, Nottingham University Hospitals NH... more ... Email: [email protected] 3. Clinical Audit, Nottingham University Hospitals NHS Trust, Nottingham *Corresponding author ... Marshall et al (2004) conclude that healthcare workers are not aware of the basic effective measures required to contain MRSA. ...
There is some debate in the resuscitation literature about whether training lay people in the use... more There is some debate in the resuscitation literature about whether training lay people in the use of an Automatic External Defibrillator (AED) is actually necessary. Certain models of AED implementation have successfully been used where no formal training has been provided. This paper reports on a qualitative, interview-based study of lay people who had been trained to use an AED. The data suggests that the training event, and especially the faceto-face contact with the trainers, plays an important part in persuading people to trust the AED, and to use it, if and when an emergency occurs. Thus the training event may have a value in addition to teaching lay people the skills of using an AED.
Journal of Emergency Primary …, 2007
There is some debate in the resuscitation literature about whether training lay people in the use... more There is some debate in the resuscitation literature about whether training lay people in the use of an Automatic External Defibrillator (AED) is actually necessary. Certain models of AED implementation have successfully been used where no formal training has been provided. This paper reports on a qualitative, interview-based study of lay people who had been trained to use an AED. The data suggests that the training event, and especially the faceto-face contact with the trainers, plays an important part in persuading people to trust the AED, and to use it, if and when an emergency occurs. Thus the training event may have a value in addition to teaching lay people the skills of using an AED.
Using an actor-network theory approach, this paper analyses two technologies used in resuscitatio... more Using an actor-network theory approach, this paper analyses two technologies used in resuscitation medicine to try to improve outcomes from cardiopulmonary resuscitation, which remain an ongoing disappointment to resuscitation practitioners. The technologies are mechanical chest compression, and the use of automatic external defibrillators in hospital. In both cases, the actor network that performs resuscitation is being rebalanced away from humans and in favour of machines. Despite these efforts, outcomes from resuscitation continue to be worse than resuscitation medicine would like. This paper analyzes why there has been such persistence (in one of the cases for over 40 years) with apparently 'failed' technologies, concluding that it is a way of ensuring medical control over the process.
The British journal of theatre nursing: NATNews: the official journal of the National Association of Theatre Nurses
Journal of perioperative practice
This paper reports a prospective audit, against an existing baseline standard, for intermittent p... more This paper reports a prospective audit, against an existing baseline standard, for intermittent pneumatic compression (IPC) in the prophylaxis of asymptomatic deep vein thrombosis (DVT). This was done via a structured questionnaire, using the methodology of total population sampling, encapsulating all theatre staff within one NHS trust. With regards to the standard, performance is good, as IPC is DVT prophylaxis of choice in the perioperative area and is used frequently on most patients. The findings of the audit do, however, highlight the need for appropriate local DVT risk assessment guidelines, essential to ensure that prophylaxis is administered to the correct at risk groups, as prevention may be unjustified in low risk groups and possibly inappropriate for the same regimen to be used for all patients.
Paediatric nursing
High levels of noise in the hospital environment can have an impact on patients and staff increas... more High levels of noise in the hospital environment can have an impact on patients and staff increasing both recovery time and stress respectively. When our seven-bedded paediatric intensive care unit (PICU) is full, noise levels seem to increase significantly. This study measured noise levels at various times and places within a PICU using Tenma sound level meter which simulates the subjective response of a human ear. Noise levels were often excessive, exceeding international guidelines. Staff conversation was responsible for most of the noise produced; medical equipment, patient interventions, telephones, doorbell and the air shoot system were also responsible for causing high levels of noise. More can be done to reduce noise and its effects on patients and staff.
British journal of perioperative nursing: the journal of the National Association of Theatre Nurses
This article examines the organisational culture in theatres, specifically the doctor-nurse relat... more This article examines the organisational culture in theatres, specifically the doctor-nurse relationship, based on the literature and the experience of one author (Anika Reynolds) on placement in theatres. The initial motivation for the study was noticing how well these doctors and nurses got on in a friendly, informal and efficient atmosphere. This relationship between the multidisciplinary team was especially surprising when compared with the experience of hospital wards. Why did such a difference exist?
Nursing times
C difficile is the most important cause of infectious healthcare acquired diarrhoea and risk of i... more C difficile is the most important cause of infectious healthcare acquired diarrhoea and risk of infection is a public concern. Many acute and primary care trusts are working to further reduce rates of C difficile and targets have been set. Global reduction strategies include prudent antibiotic prescribing and intensive cleaning programmes. While risk assessment tools for C difficile exist, they are not easy to use in hospital. This article introduces an inexpensive and easy to use assessment tool and outlines how nurses can apply a reduction strategy using it to identify patients who are at risk on admission and then target interventions to reduce this risk.
Journal of Contemporary Religion
... DOI: 10.1080/13537903.2011.616040 Stephen Timmons * & Aru Narayanasamy pages 451-465. ...... more ... DOI: 10.1080/13537903.2011.616040 Stephen Timmons * & Aru Narayanasamy pages 451-465. ... They also oppose physician-assisted dying (Sorbye, Sorbye and Sorbye) and the termination of pregnancy (Marshall, Gould and Roberts). ...
Nursing times
Uniforms are thought to hold personal significance for those who wear them and act as powerful sy... more Uniforms are thought to hold personal significance for those who wear them and act as powerful symbols representing the profession's identity and image. To gain an insight into the influence of uniform on self image and professional identity among student nurses. Fourteen qualitative, semi structured interviews were carried out with pre registration nurses on diploma and degree programmes at a university in England. Uniform raised issues in a number of areas including gender, equality, power and identity. Pride, combined with a strong self image and professional identity, lead to enhanced confidence and, therefore, better performance in clinical practice. Since this study shows the importance of uniform to students, uniforms need to balance a professional and modern image while retaining an appreciation for nursing's heritage. This will project a realistic image to the public and help nurses to form a positive professional identity.
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Papers by Stephen Timmons