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Biomedical subjects

Dinah Gould

Publications and source records attributed to Dinah Gould.

17 recordsLinked to original sources
PubMed2004

Examining the validity of pressure ulcer risk assessment scales: a replication study.

Risk assessment scales (RASs) intended to identify patients most at risk of developing pressure ulcers have been widely used for many years. Numerous studies have evaluated their predictive validity but potential bias has been inherent in the design of all. To overcome these problems a simulation study was conducted in which clinical nurses were asked to identify the degree of risk experienced by four patients employing the three RASs discussed most frequently in the literature (Norton, Braden and Waterlow Scores). These findings were compared with nurses' clinical judgment rated on a visual analogue scale. The simulations consisted of high-resolution photographs accompanied by case studies of the patients. The nurses' scores were compared to estimates of risk generated by an expert panel. Nurses' clinical judgment agreed much more closely with expert opinion than any of the RASs. A replication study was undertaken to confirm these findings. One hundred and fifteen nurses participated in replication. Again the nurses' clinical judgment matched expert opinion much more closely than the results of the RASs. Replication also drew attention to a number of methodological issues which deserve consideration when using simulation to test the effectiveness of clinical tools and the need to establish adequate measures of external validity whenever use of this method is contemplated.

Bias↗
PubMed2004

Training needs analysis. A literature review and reappraisal.

Training needs analysis is the initial step in a cyclical process which contributes to the overall training and educational strategy of staff in an organisation or a professional group. The cycle commences with a systematic consultation to identify the learning needs of the population considered, followed by course planning, delivery and evaluation. Although much has been written about training needs analysis in relation to post-registration nursing education, there is disagreement concerning its impact on the training cycle and its potential to influence service delivery. This stimulated the literature review presented below. Initial searches of nursing databases identified 266 works. Twenty three (8.6%) contained empirical findings relating to post-registration nursing education in which assessment of training needs was presented as the major aim. Most of these accounts were concerned with the training needs of nurses in more than one organisation and were classified as macro-level training needs analysis. However, seven studies were concerned with a single, specific organisation (micro-level training needs analysis). Despite their smaller scale and more limited scope, micro-level training needs initiatives demonstrated greater methodological rigour, were more likely to consider the stakeholder perspective, to generate findings which could positively influence the rest of the training cycle and showed the greatest potential for influencing service delivery and quality of patient care. The review drew attention to the similarities between the training cycle and the audit cycle and resulted in the development of a model which could be used to evaluate the effectiveness of the process and outcomes of future training needs analysis initiatives.

Data Collection↗
PubMed2004

The impact of commissioning processes on the delivery of continuing professional education for cancer and palliative care.

Educational commissioning was introduced into nursing and non-medical education in the mid 1990s. However, little research has been undertaken to explore its effect on continuing professional education despite early concerns that it could have a negative impact, especially in relation to more specialist provision such as that required by nurses delivering cancer and palliative care. The in-depth, qualitative study reported in this paper examined the commissioning process and how it was perceived by key stakeholders in one Workforce Development Confederation and the two universities which provided the education for practitioners throughout a local Cancer Network. The study identified failure to address educational needs accurately because too little attention was given to training needs analysis at the level of National Health Service Trusts. Commissioning was dominated by the need to demonstrate value for money at the expense of educational innovation and there was scope for improving communication between stakeholders. In addition scope existed for better collaboration between the two provider universities. Although all respondents voiced the similar criticisms, lecturers, service managers and Trust education leads were more able to suggest solutions to problems than education managers because of their awareness of service needs and the requirements of individual practitioners. The findings of this study cannot be generalised beyond the Cancer Network in which it took place. However, they clearly indicate possible weaknesses in the commissioning process which should be explored in greater depth, in relation to continuing professional education for specialist and non-specialist areas of practice.

Attitude of Health Personnel↗
PubMed2002

Using replication studies to enhance nursing research.

As an emerging academic profession, nursing suffers from a lack of rigorously tested evidence to support clinical practice. The author proposes that in some areas of nursing, research replication studies might be the best way to build up evidence, on which to base high-quality patient care.

England↗
PubMed2002

Establishing the validity of pressure ulcer risk assessment scales: a novel approach using illustrated patient scenarios.

Preventing pressure ulcers is an important nursing goal and over the years a number of risk assessment scales (RASs) have been developed to expedite clinical judgement. The aim of this study was to examine the validity of the three most commonly used RASs compared to nurses' own clinical judgement. Patient simulations were presented to 236 clinical nurses. Nine hundred and forty one assessments were completed and compared to the ratings from a panel of tissue viability experts. Clinical judgement exactly matched expert opinion (69.1%) more often than assessment with any of the RASs. The Waterlow Score matched exactly in 20% of cases, the Braden Scale in 8.5% of cases and the Norton Score in 4.6% of cases. Thus none of these RASs can be considered valid, assuming that the expert panel genuinely reflected the 'gold standard' in terms of the external criterion. The implications for clinical practice are far-reaching considering the extent to which RASs are currently used to reach important clinical decisions relating to the deployment of expensive pressure-relieving aids and nursing time.

Humans↗
PubMed2002

Learning preferences of paediatric intensive care nurses.

AIM: This paper reports the views of students on the teaching and learning strategies used in paediatric intensive care nursing courses. STUDY METHODS: Qualitative methods of data collection and analysis were used. A case study of one paediatric intensive care nursing course was carried out, followed by group interviews with students from a further seven courses. Local ethics committee protocols were followed. Data were analysed using constant comparative analysis. STUDY FINDINGS: Qualified nurses undertaking paediatric intensive care nursing courses seek a specific knowledge base, relevant to their clinical practice. Their preferred way of learning in this situation is teaching by knowledgeable experts who are also prepared to discuss issues that arise. Although in some instances student centred or self-directed approaches were considered acceptable, Students still require clear guidance and structure in their learning. Students did not summarily oppose student centred approaches to teaching and learning, however, time considerations and whether this would reduce the amount of study time provided by their employers were important factors. There was evidence that students do not necessarily have one specific learning preference. LIMITATIONS: This study explored only paediatric intensive care nurse education, and was not intended to be generalizable beyond this field. CONCLUSION: The findings from this study indicate that no single educational approach is universally seen as the most attractive for PICU nurses. The major considerations in designing and implementing PICU nursing courses should be that content is clearly rated to the clinical speciality, theory is clearly linked to practice, and that the time constraints for students who are additionally in full time employment are taken into account.

Attitude of Health Personnel↗
PubMedDate not supplied

Occupational irritant contact dermatitis.

This article raises awareness of the risks of irritant contact dermatitis among different occupational groups, especially healthcare professionals, and suggests strategies to aid prevention.

Allied Health Personnel↗
PubMedDate not supplied

Legionnaires' disease.

This article describes the environmental sources and transmission of Legionella pneumophila, outlines the factors that place certain groups of patients at particular risk, documents a number of outbreaks of legionellosis that have received media attention and explains the most important preventative strategies currently employed in the UK. Implications for the nurse's role, plus individual and public health are addressed.

Cross Infection↗
PubMedDate not supplied

Endometriosis.

Endometriosis is a common condition that causes pain and distress to many women. A variety of medical and surgical treatment options exist, and the nursing role is mainly one of information-giving and support.

Endometriosis↗
PubMedDate not supplied

Training needs analysis: an evaluation framework.

Training needs analysis (TNA) is the first step in the training and educational strategy of an organisation and is crucial to meeting the continuing professional development needs of the healthcare workforce and service. TNA must be carefully planned, conducted and have clear outcomes to ensure that training interventions are implemented effectively and that they lead to meaningful changes in service delivery. However, there is a death of literature on approaches to critique TNA. This article describes a framework developed specifically to evaluate the effectiveness of TNA. The framework combines approaches that have been used to evaluate conventional research studies and audit.

Attitude of Health Personnel↗
PubMedDate not supplied

Healthcare assistants: the new registration route.

A number of locally organised schemes now exist to help healthcare assistants access programmes leading to qualified nursing status. Although some schemes have been operating for some time, little has been done to evaluate their effectiveness. However, drawing on the literature that has addressed indicators of successful completion among entrants taking a more conventional route into nursing, it is possible to predict which individuals are most likely to complete courses and course-related factors that encourage successful completion.

Career Mobility↗
PubMedDate not supplied

Bacterial infections: antibiotics and decontamination.

Infectious disease is caused by bacteria, viruses, fungi, protozoa and micro-organisms including the mycoplasmas, rickettsiae and chlamydiae. Most of the infections commonly encountered in the UK are caused either by bacteria or viruses. This article describes bacterial structure and function to explain how antibiotics work and the processes of decontamination such as cleaning, disinfection and sterilisation, which are important in infection control.

Anti-Bacterial Agents↗
PubMedDate not supplied

Systematic observation of hand decontamination.

Meticulous infection control precautions are required to prevent healthcare-associated infection, with particular attention to hand hygiene and universal precautions. A detailed observation study undertaken in the early 1990s still has clear messages for infection control today. To prevent the spread of infection in clinical settings, nurses need adequate time and resources to comply with infection control protocols. Pressure of work and staff shortages still mitigate against safe practice today despite greater awareness of the importance of infection control.

Attitude of Health Personnel↗
PubMedDate not supplied

Hand decontamination.

Hand decontamination is the most effective, and certainly the most cost-effective, method of preventing health-related infection (HRI). However, research has shown that health professionals, including nurses, do not decontaminate hands as often as they should. It has become apparent that hand decontamination does not always follow those activities which will probably result in the most heavy soiling, and the technique used to decontaminate hands is often poor.

Anti-Infective Agents, Local↗
PubMedDate not supplied

Preventing cross-infection.

Using hand decontaminants correctly is a skilled activity that all health professionals need to learn and practise. All health professionals need to acquire an appropriate technique at the beginning of their careers, with continuing professional development to update them and inform them of new advances in research and technology.

Cross Infection↗
PubMedDate not supplied

Benign ovarian neoplasms.

Benign ovarian neoplasms have the capacity to undergo malignant change and are difficult to diagnose in the early stages. Although rarely life-threatening, they can cause patients considerable physical and psychological distress. This article explains the structure and function of the ovaries and why they sometimes undergo benign neoplastic change.

Adult↗