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Biomedical subjects

B McCormack

Publications and source records attributed to B McCormack.

At least 19 recordsLinked to original sources
PubMed2002

Side rails as physical restraints in the care of older people: a management issue.

This article explores the use of side rails within the context of physical restraint in gerontological practice. It is debated that side rails can be considered as a form of physical restraint if the individual cannot voluntarily remove/lower the device if he/she wishes to do so. The value of side rails as a protective medium is debated with regard to their association with injuries sustained as a result. Side rails should be used with caution and within a risk management context. Frailty should not be an indicator for the use of side rails, an individualized approach to determine patient's suitability to side rails is advocated.

Aged↗
PubMed2002

Ingredients for change: revisiting a conceptual framework.

Finding ways to deliver care based on the best possible evidence remains an ongoing challenge. Further theoretical developments of a conceptual framework are presented which influence the uptake of evidence into practice. A concept analysis has been conducted on the key elements of the framework--evidence, context, and facilitation--leading to refinement of the framework. While these three essential elements remain key to the process of implementation, changes have been made to their constituent sub-elements, enabling the detail of the framework to be revised. The concept analysis has shown that the relationship between the elements and sub-elements and their relative importance need to be better understood when implementing evidence based practice. Increased understanding of these relationships would help staff to plan more effective change strategies. Anecdotal reports suggest that the framework has a good level of validity. It is planned to develop it into a practical tool to aid those involved in planning, implementing, and evaluating the impact of changes in health care.

Delivery of Health Care↗
PubMed2001

The experience of practice development: an exploratory telephone interview study.

Practice development is a widely used term within British nursing. However, there is a lack of consistency and clarity in the way that the term is used. A small-scale qualitative telephone interview study was therefore conceived to explore practitioners' views of practice development. Qualitative telephone interviews were carried out with 26 nurses working in a range of settings and roles around the UK. Informants reported varying degrees of awareness of practice development roles and activities ranging from little awareness to being closely involved. Most informants seemed to place more emphasis on issues of personal development and educational aspects of practice development than is found in the literature. Practice development staff were seen as having a range of functions ranging from working with individual practitioners to the co-ordination of education and training within an organization. The credibility of practice development staff was closely related to their clinical experience and ability.

Attitude of Health Personnel↗
PubMed2001

Side rails as physical restraints: the need for appropriate assessment.

Side rails are commonly used in the care of the older person. They can be classified as a physical restraint if they restrict the movement of an individual and also if the individual has an inability to have them removed/lowered at will. Advanced age should not be an indicator for side rail use and an individualized approach in patient assessment is advised.

Accidental Falls↗
PubMed2000

Polysialic acids: potential in improving the stability and pharmacokinetics of proteins and other therapeutics.

Naturally occurring polymers of N-acetylneuraminic acid (polysialic acids) are biodegradable, highly hydrophilic and have no known receptors in the body. Following intravenous injection, polysialic acids exhibit long half-lives in the blood circulation and have therefore been proposed as carriers of short-lived drugs and small peptides. In addition, shorter-chain polysialic acids can be used as a means to increase the circulatory half-life of proteins and thus serve as an alternative to the nonbiodegradable monomethoxypoly(ethylene glycol). Recent work has shown that covalent coupling of a low molecular weight polysialic acid (colominic acid) to catalase and asparaginase leads to a considerable increase of enzyme stability in the presence of proteolytic enzymes or blood plasma. Comparative studies in vivo with polysialylated and intact asparaginase revealed that polysialylation significantly increases the half-life of the enzyme. The highly hydrophilic and innocuous nature of polysialic acids renders them suitable as a means to prolong the circulation of peptides and proteins.

Animals↗
PubMed2000

Creating an adult learning culture through practice development.

The development of a learning culture is becoming a dominant theme in the strategic plans of health care organisations. This is arising through a drive to improve standards of practice, bridge the perceived theory-practice gap and create means of integrating learning with practice. There have been many initiatives to create such a change, including continuous professional development, reflective practice, clinical supervision and work based learning. This paper presents an account of a practice development strategy that aimed to create a learning culture as a sub-element of the overall programme of work. Working with individual project leaders, the intention was to shift the emphasis away from classroom based education, to learning at and from work. This was achieved through a combination of action research, the application of adult learning theory and facilitation. The paper describes the context of the development strategy, the facilitation processes adopted including the theoretical underpinnings and some 'tentative' outcomes achieved.

Adult↗
PubMed2000

Future directions for gerontology: a nursing perspective.

This paper discusses the contribution nursing has made to the development of person-centred services, and the influence of gerontology upon such developments. It examines traditional attitudes to medicine and nursing, when curing was all-important and caring treated as secondary and the shift away from this attitude to a more holistic approach to nursing, where the dignity of the patient is an important issue. It argues that good practice utilizes different sources of knowledge, including intuitive knowledge, and discusses the integrated programme of policy, development, research and education activities that the Royal College of Nursing is developing. The options currently available to anyone wishing to study gerontology are discussed, and the pros and cons of the current emphasis on broad-based clinical and educational experience prior to specialization analysed. The key aim of the RCN is to develop the specialism of gerontological nursing and the quality of care experienced by older people. With this end in view, this paper describes the education programme being developed by the RCN, leading to the award of Gerontological Nurse Specialist--a person able to demonstrate knowledge of rehabilitation, clinical assessment, health care assessment and a holistic knowledge of the ageing process.

Aged↗
PubMed1999

Vaccine entrapment in liposomes.

The use of liposomes as carriers of peptide, protein, and DNA vaccines requires simple, easy-to-scale-up technology capable of high-yield vaccine entrapment. Work from this laboratory has led to the development of techniques that can generate liposomes of various sizes, containing soluble antigens such as proteins and particulate antigens (e.g., killed or attenuated bacteria or viruses), as well as antigen-encoding DNA vaccines. Entrapment of vaccines is carried out by the dehydration-rehydration procedure which entails freeze-drying of a mixture of "empty" small unilamellar vesicles and free vaccines. On rehydration, the large multilamellar vesicles formed incorporate up to 90% or more of the vaccine used. When such liposomes are microfluidized in the presence of nonentrapped material, their size is reduced to about 100 nm in diameter, with much of the originally entrapped vaccine still associated with the vesicles. A similar technique applied for the entrapment of particulate antigens (e.g., Bacillus subtilis spores) consists of freeze-drying giant vesicles (4-5 microm in diameter) in the presence of spores. On rehydration and sucrose gradient fractionation of the suspension, up to 30% or more of the spores used are associated with generated giant liposomes of similar mean size.

Bacteria↗
PubMed1999

Determining older people's need for registered nursing in continuing healthcare: the contribution of the Royal College of Nursing's Older People Assessment Tool.

This paper presents an overview of the work of the Royal College of Nursing (RCN) in developing an assessment tool to determine the need for registered nursing by older people in continuing care. In the past, healthcare has been provided free and social care 'means-tested'. The erosion of the NHS's responsibility for continuing care provision through the development of eligibility criteria has resulted in the majority of older people having their care services means-tested, including their nursing care. The RCN has argued that older people have inter-related health and social care needs, that nursing care is an integral component of healthcare provision and that therefore older people should not have to pay for nursing care. This paper describes the work undertaken by the RCN to develop a tool for use in assessing older people's need for registered nursing--'The RCN Nursing Older People Assessment Tool'. The underpinning theoretical framework is outlined and the process of constructing the tool is described. In addition, the stages of assessment using the tool are outlined. A pilot study in seven nursing homes managed by three different companies was undertaken to test the reliability and acceptability of the tool. 178 paired assessments were completed (89% of the intended sample). The results of the pilot study demonstrated that the tool has a high degree of reliability and acceptability.

Aged↗
PubMed1999

Towards practice development--a vision in reality or a reality without vision?

This paper describes the development of a conceptual framework for practice development. Drawing on the authors' combined experiences of facilitating developments in practice, a conceptual framework is proposed. It is argued that much practice development in health care today lacks a systematic approach and is often undertaken by individual practitioners who are poorly prepared for their roles. A short history of practice development is outlined to contextualize current development activities. The proposed framework is located in a critical social science philosophy and it is suggested that such a philosophy enables individual growth and development, empowerment of practitioners and the generation of cultural change that sustains continuous growth and innovation in practice. An example of the framework in use is described and recommendations proposed to enable organizations to embrace a systematic approach to practice development.

Clinical Competence↗
PubMed1998

Femoral cementing techniques in total hip replacement.

Clinical studies have shown that second-generation femoral cementing techniques at total hip replacement result in a superior fixation of the femoral stem. In an effort to determine what benefits further developments in cementing techniques would provide, we compared the morphology of the cement mantles produced by traditional finger-packing and gun-insertion techniques. The porosity of the cement mantles was quantified using computerised image analysis. The finger-packing technique caused large air inclusions that resulted in large pores in the substance of the cement mantle, whereas the cement-gun technique did not result in any individual pore with an equivalent diameter greater than 3 mm. The mean porosity of cement mantles prepared using the finger-insertion technique was 8.3%, whereas the mean porosity in gun-prepared mantles was 1.7%. The use of a cement gun significantly reduced the porosity of femoral cement mantles (P = 0.02). Reduction of defects in the substance of the cement mantle may account for the increased survival of femoral prostheses inserted when second-generation techniques were used. Further reduction of the porosity of the cement mantle could not be expected to produce as dramatic a clinical improvement in prosthesis fixation.

Arthroplasty, Replacement, Hip↗