Background: The concept that critical care is a service rather than a location has been increasin... more Background: The concept that critical care is a service rather than a location has been increasingly highlighted. However, there is limited information regarding nurses' perceptions of caring for critically ill patients outside of high dependency areas. Aim: The aim of this study was to explore the factors that influence the experiences of trained nurses caring for critically ill patients within a general ward setting. Method: This was an exploratory, descriptive study combining an interview and questionnaire methodology. A purposive sample of seven trained nurses reflecting a range of grades and experience, from one medical ward were selected. A semi-structured interview combined with an attitudinal scale was utilised. Results: Following analysis five key themes emerged: clinical environment, professional relationships, patient assessment, nurse's feelings and educational needs. Conclusion: Whilst the findings of this study cannot be generalised, analysis of the data has provided an insight into the complex factors that effect care delivery. In order to respond to this study's findings, there are resource implications. Educational requirements and communication skills will need to be developed.
To examine the contribution of the Healthcare Assistant (HCA) as the recogniser, responder and re... more To examine the contribution of the Healthcare Assistant (HCA) as the recogniser, responder and recorder of acutely ill patients within the general ward setting. Concerns have been highlighted regarding the recognition and management of the acutely ill patient within the general ward setting. The contribution of the HCA role to this process has been given limited attention. A postal survey of HCAs was piloted and conducted within two district general hospitals. Open and closed questions were used. Results suggest that on a regular basis HCAs are caring for acutely ill patients. Contextual issues and inaccuracies in some aspects of patient assessment were highlighted. It would appear normal communication channels and hierarchies were bypassed when patients' safety was of concern. Educational needs were identified including scenario-based learning and the importance of ensuring mandatory training is current. HCAs play a significant role in the detection and monitoring of acutely ill patients. Acknowledgement is needed of the contextual factors in the general ward setting which may influence the quality of this process. The educational needs identified by this study can assist managers to improve clinical supervision and educational input in order to improve the quality of care for acutely ill patients.
The effectiveness of pre-hospital thrombolysis (PHT) in reducing mortality following ST segment e... more The effectiveness of pre-hospital thrombolysis (PHT) in reducing mortality following ST segment elevation myocardial infarction (STEMI) is well established. In England, PHT is provided to around 17% of STEMI patients, and responsibility for treatment rests largely with paramedics rather than physicians as in some other countries, but little is known about how paramedics perceive their role, or whether age or experience influence such perceptions. To describe paramedics' perceptions of PHT. Questionnaire survey to all 106 paramedics working within a single ambulance service in England. 60 (56.6%) paramedics responded. Overall, there were few significant differences by age or length of service in responses given. However, paramedics who had administered PHT gave more positive responses compared to those who had not, in relation to duty of care, professional image, individuals' influence on paramedic role development, and preparedness for practice. Paramedics hold a range of views and perceptions of their role in delivering PHT; some of which appear to be related to age and length of experience, and actual administration of PHT. The vast majority view PHT as a positive step to providing patient care that is evidence based.
Background: The concept that critical care is a service rather than a location has been increasin... more Background: The concept that critical care is a service rather than a location has been increasingly highlighted. However, there is limited information regarding nurses' perceptions of caring for critically ill patients outside of high dependency areas. Aim: The aim of this study was to explore the factors that influence the experiences of trained nurses caring for critically ill patients within a general ward setting. Method: This was an exploratory, descriptive study combining an interview and questionnaire methodology. A purposive sample of seven trained nurses reflecting a range of grades and experience, from one medical ward were selected. A semi-structured interview combined with an attitudinal scale was utilised. Results: Following analysis five key themes emerged: clinical environment, professional relationships, patient assessment, nurse's feelings and educational needs. Conclusion: Whilst the findings of this study cannot be generalised, analysis of the data has provided an insight into the complex factors that effect care delivery. In order to respond to this study's findings, there are resource implications. Educational requirements and communication skills will need to be developed.
To examine the contribution of the Healthcare Assistant (HCA) as the recogniser, responder and re... more To examine the contribution of the Healthcare Assistant (HCA) as the recogniser, responder and recorder of acutely ill patients within the general ward setting. Concerns have been highlighted regarding the recognition and management of the acutely ill patient within the general ward setting. The contribution of the HCA role to this process has been given limited attention. A postal survey of HCAs was piloted and conducted within two district general hospitals. Open and closed questions were used. Results suggest that on a regular basis HCAs are caring for acutely ill patients. Contextual issues and inaccuracies in some aspects of patient assessment were highlighted. It would appear normal communication channels and hierarchies were bypassed when patients' safety was of concern. Educational needs were identified including scenario-based learning and the importance of ensuring mandatory training is current. HCAs play a significant role in the detection and monitoring of acutely ill patients. Acknowledgement is needed of the contextual factors in the general ward setting which may influence the quality of this process. The educational needs identified by this study can assist managers to improve clinical supervision and educational input in order to improve the quality of care for acutely ill patients.
The effectiveness of pre-hospital thrombolysis (PHT) in reducing mortality following ST segment e... more The effectiveness of pre-hospital thrombolysis (PHT) in reducing mortality following ST segment elevation myocardial infarction (STEMI) is well established. In England, PHT is provided to around 17% of STEMI patients, and responsibility for treatment rests largely with paramedics rather than physicians as in some other countries, but little is known about how paramedics perceive their role, or whether age or experience influence such perceptions. To describe paramedics' perceptions of PHT. Questionnaire survey to all 106 paramedics working within a single ambulance service in England. 60 (56.6%) paramedics responded. Overall, there were few significant differences by age or length of service in responses given. However, paramedics who had administered PHT gave more positive responses compared to those who had not, in relation to duty of care, professional image, individuals' influence on paramedic role development, and preparedness for practice. Paramedics hold a range of views and perceptions of their role in delivering PHT; some of which appear to be related to age and length of experience, and actual administration of PHT. The vast majority view PHT as a positive step to providing patient care that is evidence based.
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