• End of life care planning - why it is everyone’s concern?

      Brown, Michelle; University of Derby (University of Derby, 2017-05-08)
      To mark Dying Matters Awareness Week (May 8-14), Michelle Brown, Deputy Head of Department for Healthcare Practice, explains why everyone – young or old – should make sure they know what end of life care planning involves. What is end of life care planning?
    • End of life care.

      Brown, Michelle; University of Derby (Sage, 2015)
    • Enhancing the student experience through values based personal tutoring

      Kilduff, Alison; Harris, Betty; Collins, Guy; University of Derby (Nurse Education Today, 2013-09)
      A values based approach is relational and has positive working relationships and good communication as the heart of its focus. The personal tutor relationship is often thought to be one of the key areas which can foster a sense of belonging to a higher education institution which is a key part of the widening participation agenda (HEFCE 2012), whose aim is “to promote and provide the opportunity of successful participation in higher education to everyone who can benefit from it”. This poster details the subject area approach to values based personal tutoring along the student journey.
    • Evaluating interprofessional simulation in the operating theatre

      Naylor, Sarah; Foulkes, Denise; Sheffield Hallam University (2017-06)
      The operating theatre is an area of practice that newly qualified Diagnostic Radiographers find challenging. Interprofessional education (IPE) and simulation are becoming widely used in healthcare education in order to prepare students for practice. Failures in interprofessional communication are well-documented with poor communication an established cause of medical error and negative health outcomes. Socio-historical issues like imbalances in power and status are particularly prevalent in the operating theatre environment, and add complications to interprofessional working. As part of an action research study to develop and pilot an interprofessional simulation experience for Operating Department Practitioner (ODP) and Diagnostic Radiography (DRAD) students. Diagnostic Radiography students took part in a simulation in the mock operating theatre on the university campus with an ODP student, ODP and Diagnostic Radiography lecturers. A purposive convenience sample of 48 second year Diagnostic Radiography students participated in the simulation. Following the simulation students were asked to evaluate the session using Padlet and later reflect on the impact of the experience on practice. The simulation was a positive experience. The timing and organisation of the simulation is important for the students to get the most out of the experience. There are benefits of being immersed in a high fidelity simulation and the realism plays a role in preparing students for real life experiences.
    • Evaluating the role of patient facing pharmacists in a GP practice setting.

      Lewis, Rachel; Giles, David; University of Derby (2018-07-10)
    • Evaluation of the efficacy and safety of single dose iron infusion in clinical practice

      Grant, Claire; Scott, Robert; Mortimore, Gerri; Austin, Andrew; University of Derby (BMJ Publishing Group Ltd., 2013-06-08)
      Introduction Total dose iron (TDI) infusion therapy has been utilised for several years in our hospital but has previously necessitated multiple admissions or an overnight stay. Shorter duration agents have been introduced to try to alleviate this significant cost burden. Aims/Background Having recently introduced a short duration TDI infusion (Monofer©) as first-line parental iron therapy in our hospital, we undertook an audit to examine its efficacy and safety. Method We audited the notes of those who had received short duration TDI since its introduction. TDI doses had been calculated by an experienced pharmacist from baseline haemoglobin (Hb), ideal body weight and target Hb according to SPC guidance. Results Efficacy Data 40 consecutive patients received a TDI between May 2012 and January 2013. Pre-infusion Hb was 9.50 [8.75–10.1] (median [IQR]). For the 25 patients who had an Hb taken at 3–5 weeks post infusion, Hb was 11.6 [10.6–12.1], significantly higher than prior to infusion (p<0.001), with an increment of 1.8 [1.35–2.70].⇓ Figure 1 Figure 1 Safety Data Of the 40 patients who received Monofer, 4 had adverse reactions within 5 minutes of commencement which led to discontinuation of the infusion (10%). 3 patients experienced an allergic-type reaction with facial swelling and dyspnoea. 1 patient experienced profuse vomiting and diarrhoea. No delayed reactions were observed. Conclusion Utilisation of Monofer in our clinical practice has shown a sub-optimal attainment of Hb target. Furthermore, the frequency of adverse reactions was much higher than expected from those reported in the product SPC or previous studies in renal patients. In light of these observations, we no longer use Monofer®.
    • 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.
    • The experiences and meanings of recovery for Swazi women living with ‘Schizophrenia’

      Nxumalo Ngubane, Siphiwe; McAndrew, Sue; Collier, Elizabeth; University of Salford (Wiley, 2019-05-01)
      Globally, twenty-four million people live with schizophrenia, 90% living in developing countries. While most Western cultures recognise service user expertise within the recovery process this is not evident in developing countries. In particular, Swazi women diagnosed with schizophrenia experience stigma from family, community and care providers, thus compromising their recovery process. This study aimed to explore the experiences and meanings of recovery for Swazi women living with schizophrenia Interpretive Phenomenological Analysis was used. Fifteen women were recruited from Swaziland National Psychiatric Hospital out patients’ department, and face to face interviews were conducted. Four super-ordinate themes were identified: (1) The emotionality of ‘illness of the brain’; (2) Pain! Living with the illness and with others; (3) She is mad just ignore her; and (4) Being better. Discussion focuses on the findings of this study and a number of positive and negative implications emanating from them; labelling, stigma and the roles of family, culture and religious beliefs on the process of recovery. This study provides practitioners with insight into the importance of the socio-cultural context of the lives of women diagnosed with schizophrenia and how, in understanding this, mental health care could be improved.
    • Experiences of integrated care for dementia from family and carer perspectives: A framework analysis of massive open online course discussion board posts

      Robertshaw, David; Cross, Ainslea; University of Derby (Sage, 2017-07-18)
      Background Integrated Care for dementia is an increasingly popular approach to supporting people with dementia, bringing services together to form a single cohesive provision for service users. This approach is still in its infancy but has the potential to improve the management of dementia, social care and to enhance the patient experience. Aims To understand views and experiences of integrated health and social care for dementia from the perspective of carers, families, healthcare professionals and researchers. Methods Crowdsourcing views and experiences from 'Bridging the Dementia Divide', a massive open online course at the University of Derby, provide a rich source of qualitative data from carers, families and healthcare professionals. We analysed 847 massive open online course discussion board posts using a Framework Analysis approach. Results Participants described how Integrated Care for dementia should be person-centred and holistic, involving a multidisciplinary team of health and social care practitioners, as well as the patient, the family and the wider community. The establishment of Integrated Care for dementia was viewed positively.
    • An exploration into the curricular development of a master's programme designed to support advanced nurse practitioner education

      Reynolds, Julie; Mortimore, Gerri; University of Derby (2017-03-21)
      With such fluidity within the NHS, the need to provide provision for health care to the general population is a challenge for government, professionals and the structures that support that development. This has necessitated a need to consider the current workforce and how it can be expanded and adapted to meet these expectations without compromise to patient safety and satisfaction. As nursing is one of the largest professions within the NHS this has meant that advanced nurse practice has grown to meet that demand, but without a consistent and clear framework for the underpinning educational development. Whilst this is certainly under current review and there is much local and national activity to address this issue, debate continues as to what educational provision should be in place. - The development of competencies by professional and governmental bodies is offering a national perspective on the skills and knowledge required by advanced practitioners. However, these competencies are left to be interpreted at a local level whilst trying to map to the proposed national view. The development of an educational programme is influenced by these external forces, with the additional need to accommodate the students’ professional standards of practice and acquisition of characteristics conducive with academic study at master’s level. - Agreeing what an educational curricular should entail in light of the fore mentioned complexities may prove problematic and result in a plethora of titles with differing underpinning knowledge and skills and as such a worrying lack of consistency. - Aim - To develop a programme which meets the academic requirement offering a systematic understanding of knowledge and critical awareness within the field of advanced practice. - Objectives - Establish the knowledge and skills required to support advanced practice - To constructively align the students’ acquisition of knowledge and skill development within the curricular design - To support the development of a practitioner who can demonstrate safe, autonomous practice and problem solving skills in complex and unpredictable situations.
    • An exploration of family in the context of head injury: a narrative understanding of change

      Secretary, SRR; whiffin, charlotte; Bailey, Christopher; Ellis-Hill, Caroline; Nikki, Jarrett; Peter, Hutchinson J.; University of Derby; University of Nottingham; Bournemouth University; University of Portsmouth; et al. (SAGE Publications, 2020-02-13)
      Traumatic brain injury is potentially devastating. Families commonly respond by supporting the injured individual and their recovery. However, family members are at risk of negative psychological outcomes and family functioning has emerged as a key variable post injury. What is less understood are the subjective changes experienced by families and the impact these have post injury. A longitudinal narrative case study using in-depth narrative qualitative interviews. Data were collected a one, three and 12 months post injury. Nine non-injured family members from three families were recruited from an acute neurosurgical ward. Five interwoven narrative threads were identified: trauma, recovery, autobiographical, suffering and family. The narrative approach emphasized that the first-year post-head injury was a turbulent time for families, who were active agents in the process of change. Families’ stories of illness from a nonpatient perspective need recognition and validation in their own right. understanding this experience in terms of biographical narratives helps to recognize the vacillation between change and continuity. Adopting a narrative approach to rehabilitation may be more positive than adopting a model of loss. Change is not limited to the injured person and family members need help to understand that they too are changing as a result of their experiences. In addition, it is proposed that there be a shift in the discourse in research and practice literature away from loss and towards transition, with greater recognition of the role that uninjured family members play in making sense of change post injury.
    • An exploration of service user involvement in the assessment of students

      Naylor, Sarah; Harcus, J.; Elkington, M.; Sheffield Hallam University (Elsevier BV, 2015-02-25)
      This paper is an exploration of service user involvement in assessing first year diagnostic radiography students' ability to practise and interact with the public safely prior to attending placement. Service users took the role of patients during a simulation exercise undertaken in a general X-ray room. In recent years the importance of involving service users in all aspects of healthcare has been promoted; this includes being involved in the education of healthcare workers. The evaluation of service user involvement in the education of healthcare workers is limited, as is any literature about service user involvement outside nursing, mental health, and social work. Feedback was obtained via email and face to face via a focus group from academic staff, service users and students using open questions. The benefits of service user involvement were that it made the exercise more relevant and meaningful. It was perceived as a valuable exercise for the students to interact with service users in terms of developing, and for assessing, patient care, communication and positioning skills. The service users valued the experience. Issues highlighted include travel to the venue and the physical demands on the service user. Concerns highlighted by previous authors of preparation of the service users for their role, and remuneration had been addressed prior to the exercise. There is increasing diversity in the ways in which service users are involved in education. Service user involvement as patients in a simulation exercise for student assessment was deemed successful in this setting.
    • 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.
    • Exploration of volunteers and support workers initiation of quality of life conversations in hospice palliative day care

      Watson, Sharan; Hembrow, Alison; University of Derby and Treetops Hospice Care (BMJ, 2019-03-01)
      Treetops Hospice, in partnership with University of Derby have commenced a research project exploring the outcomes of developing volunteers, in initiating conversations around quality of life. As a pilot site work for NHS England for Personal Health Budgets (PHB’s), Treetops discovered that the ‘conversations’ around what’s important right now to the patient/carer can be just as important, than the outcome of the PHB. This is a vital piece of work which directly could impact on improving individual’s wellbeing, the new approach focuses around the mnemonic L.I.S.T.E.N (developed by Treetops Hospice). Policy drivers have acknowledged that there is a much greater need and demand for person centred care than professionals in health and social care can meet, the barriers around developing these conversations, possibly relate to lack of time and clarity to whose role it is. Volunteers and support workers may be advantageous in having these conversations with the right support and development.
    • Exploring the transition from student to practitioner in diagnostic radiography

      Naylor, Sarah; Ferris, C.; Burton, M.; Sheffield Hallam University (Elsevier BV, 2015-10-20)
      This study explores the expectations and experiences of newly qualified diagnostic radiographers during their transition into practice. This was a longitudinal study using interpretative phenomenological analysis methodology. Data were gathered from four students who participated in a focus group. This informed semi structured interviews with a further eight students who were interviewed prior to starting work and three times over the following twelve months. Themes generated from the data included; experience, fitting in, and identity. This study brings to light the experiences of newly qualified diagnostic radiographers. The findings are open to theoretical generalizability and raise issues that may be used by academic staff in the preparation of students and managers who support newly qualified staff members.
    • Exploring the use of student-led simulated practice learning in pre-registration nursing programmes.

      Brown, Jo; Collins, Guy; Gratton, Olivia; University of Derby; Derbyshire Community Health Services (Royal College of Nursing, 2017-09-20)
      Simulated practice learning is used in pre-registration nursing programmes to replicate situations that nursing students are likely to encounter in clinical practice, but in a safe and protected academic environment. However, lecturer-led simulated practice learning has been perceived as detached from contemporary nursing practice by some nursing students. Therefore, a pilot project was implemented in the authors’ university to explore the use of student-led simulated practice learning and its potential benefits for nursing students. Aim To evaluate the effectiveness of student-led simulated practice learning in pre-registration nursing programmes. The authors specifically wanted to: enhance the students’ skills; improve their critical thinking and reflective strategies; and develop their leadership and management techniques. Method A literature review was undertaken to examine the evidence supporting student-led simulated practice learning. A skills gap analysis was then conducted with 35 third-year nursing students to identify their learning needs, from which suitable simulated practice learning scenarios and sessions were developed and undertaken. These sessions were evaluated using debriefs following each of the sessions, as well as informal discussions with the nursing students. Findings The pilot project identified that student-led simulated learning: developed nursing students’ ability to plan and facilitate colleagues’ practice learning; enabled nursing students to develop their mentoring skills; reinforced the nursing students’ self-awareness, which contributed to their personal development; and demonstrated the importance of peer feedback and support through the debriefs. Challenges included overcoming some students’ resistance to the project and that some lecturers were initially concerned that nursing students may not have the clinical expertise to lead the simulated practice learning sessions effectively. Conclusion This pilot project has demonstrated how student-led simulated practice learning sessions could be used to engage nursing students as partners in their learning,enhance their knowledge and skills and promote self directed learning.
    • The feasibility of nurse-delivered, low-intensity cognitive behavioural therapy for irritable bowel syndrome.

      Dainty, Andrew; Hunt, Melissa; Holtham, Elizabeth; Kinsella, Philip; Timmons, Stephen; Fox, Mark; Callaghan, Patrick; University of Derby; University of Pennsylvania; University of Nottingham; et al. (Mark Allen Group, 2017-11-16)
      Introduction: This study assessed the feasibility of nurse-delivered cognitive behavioural therapy (CBT) for the treatment of irritable bowel syndrome (IBS). Methods and analysis: A mixed-method design was used, and 20 participants were randomly allocated to high-intensity CBT (n=5), guided self-help (n=5), self-help only (n=5) or treatment as usual (n=5). Ten intervention participants completed semi-structured interviews. Quantitative data were analysed using descriptive statistics; qualitative data were analysed using group thematic analysis. Results: Barriers to the interventions were lack of therapist contact, negative preconceptions about treatment and factors relating to supporting materials. Treatment facilitators included therapist-facilitated relaxation, narratives located within self-help materials and social support mechanisms. Conclusion: Further development of the low-intensity interventions in collaboration with service users is required to improve intervention acceptability and relevance.
    • Feeling unsafe in the healthcare setting: patients' perspectives

      Kenward, Linda; Whiffin, Charlotte Jane; Spalek, Basia; University of Derby; University of Cumbria (Mark Allen Healthcare, 2017-02-09)
      This literature review aimed to discover the factors that contribute to patients feeling unsafe in the healthcare setting. Electronic searches were undertaken using three databases to examine publications from 2002 to 2016. The design used a modified Cooper's (1982) five-stage integrative review method. Fourteen articles were identified, producing seven themes: information and communication, loss of control, staff presence, impersonal care, patients' vulnerable emotional and physical state, not being taken seriously, and the patient perception of of a lack of staff experience, knowledge, proactivity and interest. The findings suggest that, in maintaining a quality service for patients, nurses can contribute to the reduction of patients' feelings of being unsafe and vulnerable. Patients do not just feel unsafe when errors occur, but also when service quality is noticeably poor. Where lack of quality is perceived as an indication of potential threat, this lack may contribute to patients feeling unsafe within the healthcare setting
    • FibroScan: assessing cirrhosis and advanced fibrosis with vibration-controlled transient elastography

      Mortimore, Gerri; University of Derby (Mark Allen, 2016-12)
      There are many causes of liver disease that can lead to progressive fibrosis and cirrhosis of the liver; chronic liver disease is the third most common cause of death for people under 65 in the UK. Advanced fibrosis and cirrhosis can be asymptomatic, making diagnosis difficult without the aid of the ‘gold standard’ biopsy to assess liver architecture. However, there are many disadvantages associated with this invasive procedure, and so researchers, over the past 15 years, have developed and patented a noninvasive device for measuring liver stiffness and scarring called a FibroScan. This device uses vibration-controlled transient elastography to send sound waves through the liver, from which a reading is taken. A higher reading correlates with an increased likelihood of fibrosis and cirrhosis. This technology is efficient, easy to use and provides immediate results. It allows clinicians to estimate the degree of liver damage, aiding management, treatment and prognosis. It is also an effective monitoring tool that allows liver health to be checked at allotted periods.
    • Gallstone disease.

      Mortimore, Gerri; University of Derby (National Institute for Health and Care Excellence (NICE), 2015-12)