Recent Submissions

  • Liver disease presentation and red flags in urgent, primary and community care

    Mortimore, Gerri; University of Derby (2019-03-06)
    Liver Disease Presentations & Red Flags in Urgent, Primary & Community Care- Gerri Mortimore, Advanced Practice Lecturer, ANP Specialist & Expert Advisor for NICE
  • Dying from liver disease: the importance of end-of-life discussions

    Watson, Sharan; Mortimore, Gerri; University of Derby; Post-Registration Lecturer, at the College of Health and Social Care, University of Derby; Lecturer, at the College of Health and Social Care, University of Derby (2018-12-21)
    Over the past 50 years, deaths from liver disease have risen dramatically, whereas deaths from many other major diseases have fallen. Liver disease is now the third largest cause of premature death in the UK, with alcohol-related liver disease accounting for nearly 40% of these deaths. With advanced liver disease comes the associated complications of varices, hepatic encephalopathy and ascites, and death from liver disease can be sudden and catastrophic. Supportive and palliative care needs in people with liver disease often go unrecognised and unaddressed. End-of-life care and wishes can be a difficult subject to broach to patients and their loved ones, but it is one that nurses are often best placed to undertake. Therefore, when considering the overall care of patients with liver disease, it is necessary to incorporate anticipatory and concordant end-of-life plans.
  • Literature review of post-traumatic stress disorder in the critical care population.

    Morrissey, Matthew; Collier, Elizabeth; University of Salford (Wiley, 2016-04-24)
    Aim To determine which factors relate to the development of posttraumatic stress disorder, in adult patients who are admitted to critical care units. Background Patient survival rates from critical care areas are improving each year and this has led to interest in the long term outcomes for patients who have been discharged from such environments. Patients typically require invasive and extensive treatment, which places a stress on physical and mental health. Prevalence estimates of posttraumatic stress disorder in the critical care discharge population vary from 5-63%, yet it remains unclear what the predisposing factors are. Design. A systematised review Method Subject heading and keyword searches were conducted in MEDLINE, CINAHL, PsycINFO and ScienceDirect, with 23 articles identified that examined the relationship between critical care and the development of posttraumatic stress disorder. Results Three main themes were identified; Critical Care Factors, Patient Factors and Experience Factors. Eight key and 3 potential causative factors were found: younger age, female, previous psychiatric history, length of ICU stay, benzodiazepine sedation, use of stress hormones, delusional memory and traumatic memory, delirium, GCS score of ≤9 on admission & use of mechanical restraint Conclusions Posttraumatic stress reactions can be strongly related to the development and presence of traumatic and delusional memories. Younger patients may exclude themselves from research to avoid their traumatic thoughts. The role of prior psychiatric illness is unknown. Distinction between ‘factual’ and ‘false’ or delusional memory as occurs in the literature maybe unhelpful in understanding trauma reactions. Relevance to clinical practice There are around 38,000 occupied critical care beds each year in England. The scale of the issue is therefore substantial. Risk factors can be isolated from available evidence and provide a rudimentary risk assessment tool to inform practice development in this area.
  • Growing older with post-traumatic stress disorder.

    Curran, Bernard; Collier, Elizabeth; University of Salford (Wiley, 2016-05-12)
    Ageing with mental illness is a neglected area of research and policy. People who grow older to later life with on-going mental health problems may not have their needs well understood. This understanding is important if mental health services are to ensure direct or indirect age discrimination is avoided. This paper discusses the issues of ageing with mental illness over a prolonged period of time with a focus on one person’s story, Bernard, of ageing with post-traumatic stress disorder in the UK. Implications for practice are discussed in the context of life course, recovery, self-help and preventing suicide. The narrative illustrates how time, memory and meaning interweave and how ageing with mental illness become part of a person’s ongoing identity.
  • The impact on relationships following disclosure of transgenderism: a wife’s tale.

    Watts, Carol; Collier, Elizabeth; Ashmore, Russell; Watts, Pippa; University of Salford (Wiley, 2017-05-19)
    What is known on the subject? • The experiences of transgender people are becoming increasingly more visible in popular culture, biographical literature and the media. • The topic has received little attention within the psychiatric and mental health nursing literature. • There is a paucity of literature exploring the impact on relationships following a disclosure of transgenderism. What does this paper add to existing knowledge? • A narrative account of the consequences for the wife of one transwoman and their relationships with friends and family following the disclosure of transgenderism. • The article identifies a range of issues that require further attention in relation to healthcare provision. These include the: mental health needs of partners and spouses; attitudes of healthcare professionals towards transgender issues; and the adequacy of the formal support offered to partners and spouses of transgender people. What are the implications for practice? • There is a need for healthcare practitioners to explore their understanding of transgender issues and how these may impact on the mental health of partners and spouses. • It is important that healthcare professionals provide a hopeful and supportive environment to enable couples to explore their relationships following disclosure of transgenderism.
  • A literature review exploring the preparation of mental health nurses for working with people with learning disability and mental illness.

    Adshead, Stephanie; Collier, Elizabeth; Kennedy, Sarah; University of Salford (Elsevier, 2015-01-23)
    The aim of this literature review is to explore whether mental health nurses are being appropriately prepared to care for learning disabled patients who also suffer from mental ill health. A systematic approach was adopted in order to identify relevant literature for review on the topic. Five electronic databases were searched; CINAHL, Medline, ERIC, PubMed and Scopus. Searches were limited to the years 2001-2013. A total of 13 articles were identified as relevant to the topic area for review. Three main themes were identified relating to (a) attitudes (b) practice and (c) education. There appears to be a lack of research that directly addresses this issue and the existing literature suggests that there are considerable deficits in the ability of mental health nurses to be able to provide appropriate care for those with both a learning disability and mental ill health. The findings of this review would suggest that this topic area is in urgent need of further investigation and research. Further research into this area of practice could possibly help to inform education regarding this subject at pre-registration and post qualifying levels, which could therefore in turn, improve the delivery of mental health nursing care to this particular client group.
  • Nurses' recognition of domestic violence and abuse.

    Byrom, Beth; Collier, Elizabeth; Rogers, Michaela; Salford University; Staff nurse, North Manchester General Hospital; Lecturer in mental health, University of Salford; Lecturer in social work, University of Salford (Mark Allen Healthcare, 2017-12-28)
    Most literature and discourse on domestic violence and abuse (DVA) focuses on women but there is a need to be cognisant of the broader population experiencing DVA and the wide-ranging impacts that can affect anybody whatever their identity or background. Mental Health nurses are in a good position to help people who experience DVA but they need to be able to recognise it first. This paper reports on a review which aims to address the question: How can mental health nurses recognise domestic violence and abuse (DVA)?. The databases CINAHL, Medline, PsychINFO and ASSIA were searched using key terms related to DVA and nursing and recognition. The term ‘nursing’ was used as the ‘mental health nursing’ search term found only two papers. Limits for the search were English language research only papers from 2002-2017. Fifteen papers were included in the review. Most of the located research focused on health care practitioners in multidisciplinary teams with nursing literature focused on adult health nurses rather than mental health nursing. The findings are presented in the categories: education, training and organisational support, and, screening, inquiry and the therapeutic relationship, with an additional category (given the original aim of the review) ‘mental health settings’. The experience of DVA has significant consequences for mental health yet we found only two research papers focused on mental health settings. We therefore discuss and extrapolate from reviewed literature the implications for practice in the context of mental health nursing.
  • Evaluation of the Good Life Festival: a model for co-produced dementia events

    Luxmoore, Beth; Marrett, Claire; Calvert, Lesley; Calvert, Sam; Foy, Pat; Smith, Emma; Collier, Elizabeth; Salford University (RCNi, 2018-03-05)
    This article presents an evaluation of the Good Life Festival, an event co-produced by people living with dementia, Salford University Dementia Institute, Alzheimer’s Society Salford and Salford Adventures. Co-production was a new way of working and was important because people living with dementia said they would like an event organised ‘for people with dementia by people with dementia’. A dementia-friendly evaluation form was circulated at the event. Of the 80 people who attended, 35 completed the evaluation form, all of whom said they enjoyed the event. Of these, 32 (91%) had learned something new and 27 (77%) left feeling more positive about living with dementia. Event attendees and organisers also provided qualitative feedback. Recommendations based on what we learned from planning and running the event are provided, which include having a media strategy in place and to send a follow-up letter to remind people about the information about resources/services advertised on the day.
  • A Literature Review on the Experience of Long-Term Mental Illness

    Collier, Elizabeth; Grant, Maria J.; Salford University; University of Salford, School of Health & Society, Salford, United Kingdom; University of Salford, School of Health & Society, Salford, United Kingdom (Taylor & Francis, 2018-02-13)
    Purpose To illuminate long-term experiences of mental illness from both research and autobiographical accounts. Design A literature review of English-language papers, 1950-2014, relating to the experience of long-term mental illness indexed in Ageinfo, AMED, ASSIA, British Nursing Index (BNI), CINAHL, MEDLINE, Psychextra and PsychInfo. Findings Twenty-five research papers and nine autobiographic accounts met the review criteria. All research papers were cross-sectional studies. Thematic analysis revealed nine themes: fear, explanation seeking, stigma, disability, coping strategies, control, support, change and learning, and life history. Specific gaps of note relate to age differences, acknowledgement of longevity of mental illnesses, and different cultural perspectives. Research implications There is an absence of longitudinal studies focused on experiences of long-term mental illness. The considerable length of time implicated in the experiences suggests that more individual life experience rather than illness focused studies are needed, enabling a holistic understanding. This includes studies from cultures other than the western world. Greater transparency is needed in justifying age inclusions or passive exclusion of older peoples’ perspectives. Practical implications Knowledge of long-term mental illness experiences is of great importance to mental health practitioners. Evidence based services cannot be provided if we do not have an holistic understanding of long term mental illness. The experience of older people in particular is not well understood due to the lack of evidence available. Social implications This review questions our ability to provide effective support when there is such a lack of evidence about the experience of long-term mental illness, in particular in relation to older people and different cultural perspectives Originality/value There appear to be no literature reviews that focus on the individual experience of long-term mental illness. It highlights the surprisingly small number of research studies available to inform mental health practitioners.
  • Potential implications of degree apprenticeships for healthcare education

    Baker, Denise; University of Derby (Emerald, 2018-12)
    Purpose The purpose of this paper is to critically reflect on evidence relating to the development and delivery of apprenticeships and its potential implications for pre-registration healthcare education. Design/methodology/approach An iterative review of English language literature published after 1995 to date relating to apprentices and apprenticeships was undertaken. In total, 20 studies were identified for inclusion. Only three related to the most recent apprenticeship initiative in the UK, and the majority were UK based. Findings Three key themes were identified: entering an apprenticeship, the learning environment and perceptions of apprenticeships. Successful completion of an apprenticeship relies heavily on both understanding the role the apprentice is seeking to inhabit, as well as well-structured and comprehensive support whilst on the programme. These findings are then discussed with reference to professional body requirements and pre-registration education in healthcare. Practical implications Appropriate work experience and support for learning are critical to apprenticeship success and apprenticeships should be given equal status to traditional healthcare education routes. Originality/value The introduction of the Apprenticeship Levy in April 2017 (Finance Act, 2016), acknowledgement that all National Health Service Trusts will be levy payers and the introduction of targets relating to apprenticeships for public sector employers have all contributed to growing interest in the apprenticeship agenda in health and social care.
  • Apprenticeships

    Baker, Denise; University of Derby (2018-11)
  • Literature review of clinical benefits and reasons to prescribe palliative oxygen therapy in non-hypoxaemic patients

    Collis, Steven P; University of Derby; Senior Lecturer, College of Health and Social Care, University of Derby, UK (Mark Allen Healthcare, 2018-11-20)
    Aims: to review current guidelines and studies available to health professionals in the UK and explore the literature to identify reasons for the prescription of palliative oxygen therapy in non-hypoxaemic patients. Background: oxygen therapy is often associated with the palliative treatment for breathlessness. Although prescription guidelines are available and the risks of oxygen therapy are known, the therapy is still prescribed for non-hypoxaemic patients. Design: a literature search was conducted using relevant databases. Cited evidence from published guidelines was also consulted. Results: the findings suggest that oxygen is no more effective than room air for treating dyspnoea for non-hypoxaemic patients, although two small studies of self-reported benefits from patients and carers indicate different perceptions of need. Conclusion: the findings suggest that there is a knowledge gap with regards understanding the reasons for the prescription of oxygen therapy for non-hypoxaemic patients.
  • Preceptorship support is an effective way to invest in NQNs

    Whitehead, Bill; University of Derby (EMAP, 2018-12-03)
  • Roles and responsibilities in integrated care for dementia.

    Robertshaw, David; Cross, Ainslea; University of Derby; School of Nursing and Professional Practice, University of Derby, Derby, UK; UDOL, University of Derby, Derby, UK (Emerald, 2018-12-07)
    PURPOSE Effective integrated healthcare systems require capable, trained workforces with leadership, shared governance and co-ordination. This study aimed to provide additional understanding of roles and responsibilities in relation to integrated care from the perspective of massive open online course (MOOC) participants. METHODOLOGY MOOC discussion board posts were analysed using Framework analysis consisting of transcription, familiarisation, coding, developing an analytical framework and application of the framework. FINDINGS Boundaries and key issues surrounding roles and responsibilities were highlighted and participants suggested a number of enablers that could remove barriers, thereby enhancing integrated care. ORIGINALITY/VALUE Enablers included introduction of shared communication and IT systems to support continuity of care. Awareness and understanding of dementia was seen as crucial to promote person centred care and care planning. The roles of education in, and experience of, dementia care were highlighted. Barriers affecting the roles and responsibility professionals exercise include funding, role conflicts, time constraints and time-consuming paperwork.
  • A qualitative study on cancer care burden: experiences of Iranian family caregivers.

    Hassankhani, Hadi; Eghtedar, Samereh; Rahmani, Azad; Ebrahimi, Hossein; Whitehead, Bill; Tabriz University, Iran; University of Derby (Lippincott, Williams & Wilkins, 2019-01-01)
    The aim of this study was to explore the experiences of Iranian family caregivers with regard to the burden of caregiving. This is in the context of illuminating and identifying the experiences of family members from different contextual perspectives. In this qualitative study, purposive sampling was conducted in 2016. Data were collected using semistructured interviews and were analyzed using content analysis. Data analysis identified 4 categories and 8 subcategories: (1) burnout (physical problems and psychoemotional stress), (2) role conflict (balancing caring roles and family responsibilities; failure in professional or educational roles), (3) health system tensions (inadequate support from health professionals; ignorance of family members in health structure), and (4) social challenges of cancer (economic burden; taboo of cancer). In conclusion, nurses need to provide individualized support and counseling that address the sources of burden. This highlights the benefit of training health care professionals to provide culturally sensitive support based on family caregivers' needs and circumstances.
  • Share your experience

    Mortimore, Gerri; University of Derby (University of Derby, 2018-10)
  • Management of ascites in patients with liver disease

    Mortimore, Gerri; University of Derby (Metropolis International, 2018-09-18)
    Ascites is a distressing symptom that requires demanding treatments such as taking diuretics, reducing dietary salt or fluid intake, and draining ascitic fluid out of the abdomen (paracentesis). It is also often a sign that liver cirrhosis has progressed from a stable to decompensated state - and patients with decompensated liver cirrhosis have a poor prognosis.Nurses in advanced roles deal with many aspects of ascites management, from eliciting patient consent and prescribing albumin to performing paracentesis and monitoring electrolytes. This article offers an overview of ascites, it's causes, diagnosis complications and management, with a focus on ascites due to liver cirrhosis.
  • Role of the consultant pharmacist in clinical practice.

    Lewis, Rachel; Mortimore, Gerri; University of Derby (Wiley, 2018-08-20)
    It is now 15 years since the Department of Health first announced its plans for the establishment of consultant pharmacist posts in the NHS. This article examines how the role is developing and how it differs from that of an advanced clinical pharmacist practitioner.
  • Intrapartum ultrasound assessment of cervical dilatation and its value in detecting active labor.

    Wiafe, Yaw A.; Whitehead, Bill; Venables, Heather K.; Dassah, Edward T.; Eggebø, Torbjørn M.; University of Derby; Kwame Nkrumah University of Science and Technology; Trondheim University Hospital; Norwegian University of Science and Technology; Stavanger University Hospital (Springer, 2018-07-28)
    Introduction We aimed to examine the agreement between ultrasound and digital vaginal examination in assessing cervical dilatation in an African population and to assess the value of ultrasound in detecting active labor. Method A cross-sectional study was conducted in a teaching hospital in Ghana between April and September of 2016. Anterior–posterior and transverse diameters of cervical dilatation were measured with ultrasound and the mean value was compared with digital vaginal examination in 195 women in labor. Agreement between methods was examined with correlation coefficients and with Bland–Altman plots. Active labor was defined when cervix was dilated ≥ 4 cm with vaginal examinations. ROC curve analysis was conducted on the diagnostic performance of ultrasound in detecting active labor. Results Data were analyzed in 175 out of 195 (90%) cases where ultrasound could clearly visualize the cervix. The remaining 20 cases were all determined by digital vaginal examination as advanced cervical dilatation (≥ 8 cm), advanced head station (≥ + 2), and with ruptured membranes. The Pearson correlation coefficient (r) was 0.78 (95% CI 0.72–0.83) and the intra-class correlation coefficient was 0.76 (95% CI 0.69–0.81). Bland–Altman analysis obtained a mean difference of − 0.03 cm (95% CI − 0.18 to 0.12) with zero included in the CI intervals, indicating no significant difference between methods. Limits of agreement were from − 2.01 to 1.95 cm. Ultrasound predicted active labor with 0.87 (95% CI 0.75–0.99) as the area under the ROC curve. Conclusion Ultrasound measurements showed good agreement with digital vaginal examinations in assessing cervical dilatation during labor and ultrasound may be used to detect active labor.
  • Haemochromatosis: what is it and could you have it?

    Mortimore, Gerri; University of Derby (University of Derby, 2018-07-26)
    Genetic haemochromatosis is the most common inherited genetic disorder among Northern Europeans, thought to affect 1:200 people in the UK. despite this, most people have never heard of the condition. Gerri Mortimore, lecturer in Post-registration \health Care at the \University of Derby, looks at the health implications of this disorder.

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