• 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.
    • 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.
    • 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.
    • Preceptorship support is an effective way to invest in NQNs

      Whitehead, Bill; University of Derby (EMAP, 2018-12-03)
    • 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.
    • 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.
    • Apprenticeships

      Baker, Denise; University of Derby (2018-11)
    • 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.
    • Evaluating the role of patient facing pharmacists in a GP practice setting.

      Lewis, Rachel; Giles, David; University of Derby (2018-07-10)
    • Exploration of support workers and volunteers initiation of advance care planning and quality of life conversations in palliative care.

      Watson, Sharan; Hembrow, Alison; University of Derby; Treetops Hospice Care (2018-07-10)
      Treetops Hospice Care, in partnership with University of Derby are commencing a research project exploring the outcomes of developing support workers and volunteers, in initiating conversations around quality of life. Treetops Hospice are a pilot site for NHS England for Personal Health Budgets (PHB’s), their work has began to explore not only if PHB’s have been awarded, but in addition to this, discovering that the “conversations” around what’s important right now to the patient / carer and what can make a difference right now toward end of life, can be just as important. Volunteers and support workers may be advantageous in having these conversations with the right support and development. This is a current ongoing research project being developed with the support of SEED Funding from University of Derby.
    • ‘Am I a student or a Health Care Assistant?’ A qualitative evaluation of a programme of pre-nursing care experience.

      Whiffin, Charlotte Jane; Baker, Denise; Henshaw, Lorraine; Nichols, Julia J.; Pyer, Michelle; University of Derby; University of Northampton; Senior Lecturer in Nursing; College of Health and Social Care; University of Derby; Head of Allied Health and Social Care; College of Health and Social Care; University of Derby; Head of Post-Graduate Health Care; College of Health and Social Care; University of Derby; Senior Lecturer in Nursing; Faculty of Health and Society; University of Northampton; Senior Researcher; Faculty of Health and Society; University of Northampton (Wiley, 2018-07-10)
      Aim To examine the experiences of pre‐nursing Health Care Assistants during a six‐month programme of pre‐nursing care experience. Background Care experience prior to commencing programmes of nurse education is broadly considered to be advantageous. However, it is not clear how formal care experience prior to nurse education has an impact on the values and behaviours of the aspirant nurse. Design A longitudinal prospective qualitative study using focus group discussions. Methods Data were collected from 23 pre‐nursing health care assistants during September 2013 ‐ February 2014. Three focus groups were held at the beginning, middle and end of the programme of care experience at each of the participating hospitals. A thematic analysis was used to analyse data sets from each hospital. Findings from each hospital were then compared to reach final themes. Results Five major themes were identified in the analysis of qualitative data: personal development; positioning of role in the healthcare team; support and supervision; perceived benefits; and advice and recommendations. These themes were underpinned by deep aspirations for better care and better nurses in the future. Conclusions Pre‐nursing care experience can positively prepare aspirant nurses for programmes of nurse education. The benefits identified were confirmation of aspiration (or otherwise) to pursue nursing; learning opportunities and aspiration to improve patient experience. Risks for the programme included poor supervision; role ambiguity or confusion; demotivation through a deteriorating view of nursing and poor treatment by others. The longer‐term impact on values and behaviours of this cohort requires further evaluation.
    • Genetic haemochromatosis.

      Mortimore, Gerri; Woodward, Amelia; University of Derby (2018-07-10)
      Genetic Haemochromatosis (GH) is the most common inherited disorder in Caucasians affecting 1:200 in the UK. GH causes the body to absorb too much iron from the diet which over times can lead to systemic iron overload. Treatment involves weekly removal of blood termed venesection. There is little research that examines patients thoughts and feelings of being diagnosed with this life long disease which requires life long treatment in the form of venesections. Exploring the patients symptoms prior to and after venesection has not been fully studied
    • Leadership in nursing: default not design.

      Mortimore, Gerri; University of Derby (2018-06-01)
      Discussing nursing over the last 3 decades, touching on bullying within the work place and development opportunities. Developing short term and long term goals.
    • We may unknowingly consume dangerous levels of alcohol.

      Mortimore, Gerri; University of Derby (EMAP publishing limited, 2018-05-31)
      Alcohol is the main cause of liver disease and associated death. By raising awareness and offering brief interventions, not only to patients but also to family and friends, nurses can potentially save lives.
    • Is drinking becoming socially unacceptable?

      Mortimore, Gerri; University of Derby (University of Derby, 2018-05-21)
    • Dying matters - Why we need to talk about death.

      Watson, Sharan; University of Derby (University of Derby, 2018-05-17)
      How many of us are touched by the death of a loved one, friend or colleague? How many of us feel able to talk openly about our own future death? Sharan Watson, Lecturer in Post Graduate Health Care Practice, Award Leader for PG Certificate in Palliative Care, and Chair of Derbyshire Alliance for End of Life Care, explains why it’s important to talk – and plan – for death.