• 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.
    • Implementing real talk: interprofessional education intervention enabling clinicians to develop confidence in open and honest conversations about dying

      Watson, Sharan; Whittaker, Becky; University of Derby; Loughborough University (BMJ, 2020-03-18)
      National reports highlight the need to break down the barriers between the evidence to practice gap in talking with patients about dying. Our programme of research incorporates evidence and video clips from UK hospice consultations. Real Talk is designed to fit into existing communication skills training, disseminated across diverse interprofessional groups/settings, aiming to promote confidence and competence. Real Talk holds great promise because: practicalities of short video clips ensure flexibility for practitioners to engage in detailed conversation and debate, enhancing the learning potential in any environment; the depth of evidence underpinning our resources helps demystify complex communication strategies, promoting confidence when talking about dying; clinicians using the resources span diverse professional groups and clinical settings helping promote talk in broaching dying and planning ahead with diagnostic uncertainty.
    • Improving recognition and support for women experiencing the menopause

      Collier, Elizabeth; Clare, Alicia; University of Derby; BlueSCI Wellbeing Service (RCN, 2021-11-09)
      Menopause most commonly occurs in women aged 45-55 and may last for many years. The experience of menopause is a very individual one though many common symptoms are reported such as insomnia, hot flushes, anxiety and poor memory. Many workplaces have no recognition of the disabling effects that menopause can have nor any supportive infrastructure. Nor do workplaces have well informed managers or staff, unsurprising when women themselves often cannot recognise menopause. In addition, symptoms can be interpreted as mental illness. Medical research tends to conceptualise the psychological effects of menopause as psychiatric disorder, but this is not necessarily helpful when treatments for menopause will alleviate experiences rather than the potential inappropriate prescribing of antidepressants for example. Professional awareness is poor generally but there are many actions that can be taken to improve recognition and support; evaluate your services, introduction of specific assessment and information resources for staff and patients and also provide reasonable adjustments. Taking individual responsibility for improving knowledge and skills in this area will mean we can all contribute to a better and more effective environment for women where they feel that their needs are addressed, without having to wait for access to ‘specialist’ services, if available.
    • An initiative for student nurses to practise clinical skills at home

      Whitehead, Bill; Ansell, Helen; University of Derby (EMAP, 2021-02-15)
      This article describes an initiative for students to practise clinical skills in their own homes using university-supplied instructions and equipment, implemented as a response to the restrictions to on-campus teaching during the coronavirus pandemic. It includes recommendations for future use, concluding that it would also be a useful adjunct to traditional training methods following the end of the pandemic.
    • Innovative learning from simulated patient complaints

      Collins, Guy; Brown, Jo; University of Derby (NET - Networking for Education in Healthcare, 2015-09-09)
      Repeated inquiries have highlighted issues with patient safety, communication and the exploration of complaints, emphasising the interplay between each in securing the optimum patients’ journey through health and social care provision (Francis 2013, Keogh 2013). The Care Quality Commission (2014) highlighted that every concern or complaint is an opportunity to improve. A complaint may signal a problem, with the potential to help save lives, and well-handled concerns can help to improve the quality of patient care. Despite these potential benefits there is a wide variation in how complaints are handled or the fostering of an open culture where all complaints are welcomed and learnt from. The University of Derby in delivering pre-registration nursing education utilises simulation to explore patient complaints in order to facilitate recognition of the value they offer, providing transferability to enhance nursing practice and improve patient safety. The simulated experience consists of examining the reasons for complaints; impacts upon service users; lessons for nurses and other health professionals; means of address and preventing repetition of similar incidents;enhancements for practice and lessons for organisations. As part of this process the inclusion and effects of Human Factors are explored from the inception of the simulation experience. Students’ simulate three phases: root cause analysis; the development of a response letter; and a proposal for practice enhancement. These are all subsequently explored via a simulated Boardroom experience. This consists of a panel of allocated ‘experts’ to which the students’ present their findings and recommendations to enhance potential future patient experience and safety. Robust exploration of students’ thought processes and actions are incorporated within this experience via questioning, observation and reflections of the panel. Resulting from this simulation, students develop key transferrable skills: critical thinking; team working; leadership; knowledge of systems and processes; communication skills; customer care; quality assurance, governance and promoting patient safety that are mapped against the competencies outlined in the Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education. This experience and feedback is recorded within each students practice document. This is used for subsequent review by their practice mentor, and can be used as part of their practice assessment at the applicable progression point. Learning from service user complaints is high on the agendas of commissioners and healthcare providers. This simulated experience has the potential to be transferred in to not only nursing practice but also any other healthcare professional pre-registration education and continued professional development. References Care Quality Commission (2014) Complaints Matter. Newcastle Upon Tyne: CQC. Francis, R. (2013) Report of the Mid Staffordshire NHS Foundation Trust Public Inquiry, London: The Stationery Office. Keogh, B. (2013) Review into the Quality of Care and Treatment Provided by 14 Hospital Trusts in England: An overview report. London: The Stationary Office. Nursing and Midwifery Council (2010) Standards for Pre-registration Nursing Education. London: NMC. Key words: • simulation • complaints • patient safety • enhancing practice. Bullet points that indicate how your work contributes to knowledge development: • innovative approaches to teaching and learning through the application of simulated complaints • enhancement of patient safety and the quality of care • development of transferable competence for nursing practice.
    • Interventions in exclusive breastfeeding: a systematic review

      Bevan, Gillian; Brown, Michelle; University of Derby (Mark Allen Healthcare, 2014-02)
      Now recognised as a worldwide public health issue, the significance of promoting and encouraging exclusive breastfeeding (EBF) has been acknowledged by the World Health Organization (WHO) and the United Nations Children's Fund (UNICEF). Documented policies about the importance of facilitating the support of breastfeeding women is currently receiving worldwide recognition (WHO, 2011; WHO and UNICEF, 2003). This literature review will examine provision of support mechanisms for breastfeeding mothers, focusing on peer support in encouraging the starting and maintaining of EBF. Consideration will also be given to any barriers that may prevent higher success rates, as cultural and educational factors may have a significant impact on the starting and maintaining of EBF. These factors must be considered when starting support groups, networks or activities that aim to address this significant public health issue.
    • Intrapartum ultrasound assessment of cervical dilatation and its value in detecting active labor.

      Wiafe, Yaw A.; Whitehead, Bill; Venables, Heather; 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.
    • An investigation into the effects of clinical facilitator nurses on medical wards

      Whitehead, Bill; University of Nottingham (2010-10-29)
      This thesis investigates the effects of clinical facilitator nurses on medical wards in hospitals. These staff are the current culmination of recent attempts to situate nurse education in the field of clinical practice rather than merely the lecture room. Therefore, the work sets out to gain an understanding of the clinical and educational needs perceived by policy makers; the methods chosen by local managers to fulfil these needs; and the practical manifestation of these initiatives at the bedside. The thesis commences with a literature review consisting of historical context studies and a focused analysis of recent research literature. The context studies are of adult and nurse education. The review of clinical facilitator literature uses search criteria to identify and critically analyse previous research related to similar roles in the United Kingdom. The researcher uses a modified grounded theory approach as a methodological framework for collection and use of data. The data is obtained primarily by field observations; semi-structured interviews with practising clinical facilitators; and from questionnaires completed by nursing students. In addition to this generated data, information harvested from official and academic sources is used to produce theory. The discussion chapter explores the contestation that the themes generated indicate that the introduction of educationally focussed staff, into the area dominated by clinical need, is both problematic and essential. Problematic, as conflicts of role and leadership create misunderstanding and hardship for educators and clinicians. Essential, because in acute wards, where nursing skill is literally a matter of life or death for patients, a large proportion of nursing staff are in need of focussed educational support. The study proposes a model of managerial support for the introduction of educationally focused nurses in the clinical area which enables these clinical facilitators to operate in a valued and protected position.
    • Is drinking becoming socially unacceptable?

      Mortimore, Gerri; University of Derby (University of Derby, 2018-05-21)
    • 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.
    • 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.
    • 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.
    • 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.
    • 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.
    • Liver disease

      Mortimore, Gerri; University of Derby (National Institute for Health and Care Excellence (NICE), 2017-06)
    • 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
    • Liver ultrasound scans.

      Mortimore, Gerri; Mayes, JP; University of Derby (Mark Allen Group, 2019)
      Ultrasound scans can be used in a variety of settings to examine internal organs, muscle, joints, tendons and lesions or to monitor foetal growth and development during pregnancy. Ultrasound, is arguably the most frequently requested form of imaging especially within the gastroenterology department. However, to elucidate a cause of abdominal pain, distension, jaundice, abnormal liver function tests; abdominal ultrasound is one of the easiest, quick and cost-effective ways to do so. In addition, ultrasound can assist the practitioner to rule out other considered differential diagnoses. Since the advent of advanced clinical practitioner roles, nurses are increasingly taking on advanced clinical roles within the field of gastroenterology. With these advanced roles, nurses and other allied health professionals, can act autonomously in the assessment, diagnosis and treatment of patients, which includes the ability to order different tests and investigations, which can comprise of radiological and ultrasound requests. However, it is not just the ordering and requesting of radiological and ultrasound scans, but the requirement to understand the scan report and the ability to deal with the findings in an appropriate and timely fashion, that is vital for improving patient care. This article will focus on abdominal ultrasound, with emphasis on liver ultrasound scans. It will discuss what an ultrasound scan is, and some of the terminology used in liver ultrasound reports. In addition, it will compare ultrasound images of normal liver to abnormal and explore the importance of background information which should be presented on the request form, to aid the sonographer or radiologist in their interpretation of the scan.
    • Ludwig's angina: a multidisciplinary concern.

      Parker, Emma; Mortimore, Gerri; University of Derby (MA Healthcare, 2019-05-09)
      Although relatively uncommon, Ludwig’s angina is a potentially life-threatening infection of the floor of the mouth and neck. There is a danger of airway obstruction by swelling in the area and displacement of the tongue, and patients are at risk of deterioration. There are many factors thought to place patients at an increased risk of developing the condition. These include recent dental treatment, dental caries or generally poor dentition, chronic disease such as diabetes, alcoholism, malnutrition, and patients with compromised immune systems (eg AIDS, organ transplantation). This article examines the aetiology of Ludwig’s angina and considers the presentation, diagnosis and treatment of a patient who presented to an out-of-hours streaming area of a local emergency department, with an emphasis on the importance of a multidisciplinary approach. It also considers the need for ongoing education and awareness of health professionals to ensure the successful diagnosis, management and treatment of this condition, particularly in the context of patients with poor access to dental care presenting first to the emergency department.
    • Making sense of complexity: A qualitative investigation into forensic learning disability nurses’ interpretation of the contribution of personal history to offending behaviour

      Lovell, Andrew; Skellern, Joanne; University of Chester; University of Derby (Wiley, 2020-04-01)
      There is growing recognition that an individual's personal history can be extremely influential in shaping their future experience, though there has been a limited exploration in the context of learning disability and offending behaviour. Research questions related to participant interpretation of offending behaviour and individual and service responses. A series of focus groups comprising learning disability forensic nurses were conducted across all secure settings, high, medium and low. Three themes were produced: interpreting offending behaviour; the impact of personal history; responding therapeutically. The difficulties relating to understanding the relationship between offending behaviour and personal history significantly informed the construction of the most effective therapeutic relationships. An increased focus on the impact of someone's background might inform nursing as it seeks to deliver care to individuals with increasingly complex needs in a time of service transition.
    • Making the link between critical appraisal, thinking and analysis

      Whiffin, Charlotte Jane; Hasselder, Alison; University of Derby; University of Suffolk (Mark Allen Group, 2013-09-27)
      Nursing has become an all-graduate profession; as such, student nurses must develop their skills of critical analysis. The need to develop critical analytical thinking has been identified as the single most important skill in undergraduate education and reaching the academic requirements of level six study. In degree-level healthcare programmes, students are frequently asked to complete a structured critical appraisal of research. This paper examines how critical appraisal activities can be an opportunity for students to develop transferable critical thinking skills. Critical appraisal teaches objectivity, reflection, logic and discipline, which encourage students to think critically in both theory and practice.