bluuebunny/crossref_metadata_2025 huggingface dataset:
The effect of online point-of-care testing on patient waiting times in A&E
Authors: Fink Richard , Gilkar Ashfaq , Eardley Phillip , Barron Catriona
Published: May 2014

The point-of-care testing (POCT) team was constructed at the start of 2012 to implement the POCT project, which aims to define and test the hypothesis that interfacing POCT devices to a clinical electronic order communications system reduces patient waiting times in an NHS accident and emergency department. The Sysmex XS 1000i haematology analyser and the Abbott I-Stat analyser were selected for evaluation, offering a wide test profile. To assess the true effect of POCT on patient waiting times, the analysis was confined to cases associated with POCT only (n = 217). A control population (n = 229) was randomly selected from the clinical laboratory database. The interval between requesting a test and receiving the results for POCT tests was 23 minutes—60 minutes for laboratory tests. The patient waiting times were 167 minutes for the POCT group and 208 minutes for the clinical laboratory group—a difference of 41 minutes. The project confirmed that interfaced (online) POCT has many advantages with respect to the quality and safety of data management. Benefits include reliable identification of the requesting clinician and patient, and the assurance that the right result is allocated to the right patient. This study also demonstated that the quality of results produced by the POCT devices met the requirements of the clinical environment.
Changes during hospital treatment in patients with SMI
Authors: Bonsaksen Tore
Published: May 2014

Severe mental illness (SMI) is associated with low levels of functioning, severe symptomatology, and low levels of physical activity and quality of life. This study explores changes in these variables during hospital treatment in a sample with SMI. Participants were 11 patients with SMI who completed assessments at admission and discharge from hospital. Changes with regard to physical activity levels, global functioning, psychiatric symptoms, and quality of life during treatment were investigated with non-parametric tests for related samples. Participants achieved higher functional status and experienced reduced depression during treatment. There was a trend of increased quality of life during treatment, but no changes were detected on other measures. Physical activity levels were unchanged from admission to discharge. Efforts to increase physical activity levels among patients with SMI should have a long-term perspective, as significant changes may not occur during hospital treatment.
Redefining rehabilitation from spinal cord injury: A process–outcome model
Authors: Pellatt Glynis Collis
Published: May 2014

Rehabilitation is a key component of the National Service Framework for Long-Term Conditions, yet rehabilitation is a concept that is difficult to define. The aim of this study was to identify patients and professionals′ definitions of spinal cord injury rehabilitation. A qualitative approach was adopted using ethnographic techniques. Purposive sampling was used to select informants in a spinal cord injury unit in England. The sample comprised 30 professionals (14 nurses, 5 doctors, 3 occupational therapists, 5 physiotherapists, 1 discharge planning coordinator, 2 clinical psychologists) and 20 patients (8 who had been injured for between 16 and 44 years and 12 who had been recently injured). Data were collected using semi-structured interviews. Analysis was iterative, involving identification of themes according to a variant of the constant comparison method.

It was found that participants defined rehabilitation in three ways: ‘toolbox’ (where physical and psychosocial skills are provided); ‘picking up ones life again’ and ‘empowerment’. It is proposed that these three definitions form a process-outcome model that is neither static nor hierarchical, enabling patients to move back and forth in the model throughout their lives as their situation changes. An understanding of this rehabilitation model may help professionals provide rehabilitation that meets individuals′ needs and goals.
Tracheostomy management in the neurosciences: A systematic, multidisciplinary approach
Authors: Hunt Katharine , McGowan Susan
Published: May 2014

The use of tracheostomies is becoming increasingly common in intensive care and on wards. This article examines the indications for tracheostomy and the evidence base for the tracheostomy weaning regimens that are used today. The systematic, multidisciplinary approach to tracheostomy management which has been implemented at the National Hospital for Neurology and Neurosurgery is described and the results of an audit of this approach are discussed. It is argued that a multidisciplinary, systematic approach to tracheosotomy care, provided by a dedicated team, can result in fewer complications during weaning.
The use of interferon beta-1b (Betaferon) in multiple sclerosis and the MS nurse's role
Authors: Burgess Megan
Published: May 2014

Multiple sclerosis (MS) is a progressive and incurable disease. Disease-modifying therapies were the first medications to have an impact on the course of MS and interferon beta was the first to be licensed as Betaferon in 1995. Interferon beta is a high-dose, high-frequency medication which has been shown to reduce relapse rates and lesion load in active, relapsing-remitting MS. Interferon beta-1b is the only disease-modifying therapy to be licensed for use with certain secondary progressive patients, showing a small but significant slowing of disability progression. All the disease-modifying therapies are given by self-injection requiring support and training from an MS nurse, and research shows that adherence is significantly increased with nurse support. Interferon beta does not represent a cure for MS and cannot help everyone who suffers from MS but it can make a difference to daily living, removing much of the uncertainty which is normally so much a part of living with MS.
Research Round-Up
Authors: Eberhardie Christine
Published: May 2014

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
Patients' experience of nurses' informational support after diagnosis with a brain tumour
Authors: O'Donnell Caroline
Published: May 2014

Patients newly diagnosed with a brain tumour embark on a journey with an uncertain destination, laden with stress, uncertainty and fear. Although the literature presents the informational needs of patients with cancer, brain tumour patients have often been neglected in these studies. Patients with brain tumours, whether benign or malignant, are at risk of developing cognitive and physical deficits and even death. The purpose of the present study was to explore patients' experience of receiving information after diagnosis of brain tumour, with specific focus on information given by nurses. A qualitative approach was used to gain an insight into the patients' lived experience using semi-structured interviews. Eight patients diagnosed and treated in a regional neurosurgical unit participated, and two of them took part in a pilot study. The findings reveal that informational support is essential to enhance a patient's ability to cope with the diagnosis. This study also highlights the need for improvement in the accuracy of information given to patients in wards.
A vision for quality improvement: The NSF for long-term conditions
Authors: Hopcutt Beverley
Published: May 2014

The National Service Framework for Long-term Conditions was published in 2005 with a 10-year implementation period. This article furnishes an overview of the NSF focusing on the 11 quality requirements which cover the patient pathway from diagnosis to the end of life. There are many perceived barriers to implementation, including the lack of national milestones or targets, and ring-fenced funding. An exploration of how the NSF can help NHS organizations meet their existing targets is undertaken, and other possible levers for implementation are identified. Support available at national level is outlined, and practical resources to support implementation are highlighted. Neuroscience nursing has an important role in implementation, and individuals are encouraged to consider how they engage with implementation at a local level.
Stroke rehabilitation for the young: Age-specific rehabilitation
Authors: Burgess Mike , Mooney Emma
Published: May 2014

Mike Burgess and Emma Mooney discuss why younger people with stroke would benefit from an age-appropriate rehabiltation environment during their recovery.
The need to understand ethics
Authors: Woodward Sue
Published: May 2014

Many of you will have seen a BBC news report on 20 November about a 53-year-old woman who was to be prescribed zolpidem to try to wake her up from a persistent vegetative state (PVS) against her family′s wishes (BBC, 2006). Zolpidem is a GABA agonist, normally used to treat insomnia, which has been reported to have roused three patients from PVS (Clauss and Nel, 2006). The family is in favour of withdrawing the woman′s enteral feed and allowing her to die, rather than to be left with the potential of serious disability, even if the drug has an effect in her case.
Effect of sleep-wake rhythm on consciousness disturbance in cerebrovascular patients
Authors: Yamauchi Noriko , Ito Keiichi , Imajo Kaoru , Fujita Yoshiyuki , Mogi Junichi , Iseki Hiroshi
Published: May 2014

Objective

: The purpose of this study was to examine the effect of sleep-wake rhythm on improvements in level of consciousness disturbance for patients with cerebrovascular disease who received sensory stimulation care.

Methods

: The sample comprised four patients (3 men, 1 woman) with cerebrovascular disease who were hospitalized. Using sleep-stage analysis by means of 24-hour continuous electroencephalography by polysomnogram, the relationship between the establishment of sleep-wake rhythm and change in level of consciousness disturbance was examined.

Results

: Some measurements indicated that the establishment of the sleep-wake rhythm may be effective for improving the level of consciousness of patients who are receiving the sensory stimulation. However, it was difficult to verify this hypothesis because it was impossible to control the effects of other variables considered to contribute to the regulation of consciousness

Conclusions

: These findings provide a useful basis for future research using a more precise method.
CORRESPONDENCE
Authors: McArdle Kate , Bennett Beverley
Published: May 2014

I thought readers might be interested to know of work which is being undertaken through the European Association of Neuroscience Nurses (EANN).
Knowledge of epilepsy in schools needs improvement
Authors: Anderson Elizabeth
Published: May 2014

Epilepsy Action is campaigning for better support for schoolage children with epilepsy during National Epilepsy Week (14-20 May). Elizabeth Anderson explains.
Returning to normal: The role of eating in recovery from a critical illness
Authors: Segaran Ella
Published: May 2014

Much emphasis is placed on proactive early establishment of nutrition support during critical illness. Eating on an intensive care unit (ICU), on the other hand, is a more infrequent occurrence and is often overlooked, as is the social aspect of eating or the inability to eat. Currently there is a dearth of published work investigating any aspect of eating during the critical care phase; patients' experiences of eating at this time and the importance they place on it is not known. This qualitative study aims to explore and accurately describe patients' experiences of eating in a critical care environment. It is intended to seek out the essence of what eating and drinking following a critical illness signifies to those who have experienced it.

Eight participants were recruited from the neuro-critical care unit at the National Hospital for Neurology and Neurosurgery, and engaged in tape- recorded in-depth interviews. Sampling was undertaken using purposive sampling and findings were analysed to create themes using Colazzi's phenomenological (1978) approach to qualitative analysis. All interviews were conducted, transcribed and analysed by the researcher. Following data analysis, examination of the phenomena revealed commonalities in experiences, which were organized into four key themes: perceptions of eating, returning to normality, eating with a tracheostomy, eating in critical care.

This study suggests that eating and drinking played a fundamental role in the psychological wellbeing of the participants by helping provide a positive milestone to identify that recovery is possible. The overwhelming emotions expressed by patients were derived from their desire to return to normality. The critical care environment also influenced the ability to eat and drink, with most participants depicting a period of adaptation to the environment. After this period of adjustment, patients felt that the environment no longer mattered and that other emotions took precedence.
BOOK REVIEW
Authors: Ward Nicki
Published: May 2014

In the current climate of a rapid evolution in multiple sclerosis (MS) management, this book is an essential read for all those involved in the care and support of people with MS. The fundamental value of this textbook lies in the fact that it is up to date and is reliant on evidence-based medicine; this means that the material provided is predominantly based on the medical model of care, but the information it contains is an excellent resource that is not equalled in other MS texts.
Cannabis: The new aspirin?
Authors: Woodward Sue
Published: May 2014

News coverage in May of the attributes of cannabis for pain relief followed the publication of a paper by researchers from Imperial College, London, reporting the effects of a cannabis extract for post-operative pain relief (Holdcroft et al, 2006). This adds to a long-running debate about whether cannabis should be legalized for medical purposes.
Assessment of obstructive sleep apnoea/hypopnoea syndrome and its role in preventing stroke
Authors: Eberhardie Christine
Published: May 2014

To date stroke prevention has concentrated mainly on weight reduction, healthy diet, control of cholesterol levels and increased exercise. Obesity also contributes to obstructive sleep apnoea/hypopnoea syndrome (OSAHS), a sleep disorder which can be treated effectively with nasal continuous positive airway pressure (CPAP). It is a disorder which is now being recognized more often in general practice and respiratory medicine. Although it is not proven unequivocally that OSAHS causes stroke, some of the symptoms would suggest that it may be a contributory factor. Both general and specialist nurses play a role in the prevention of stroke and those in hospital care are uniquely placed to observe sleeping patterns, respond to patients' questions and work with other professionals to ensure that OSAHS is treated successfully. Therefore an understanding of the recognition and management of OSAHS and its possible association with stroke is important for nurses working on medical wards and in general practice as well as specialist respiratory nurses and neuroscience nurses.
The effects of ageing and decline after spinal cord injury
Authors: Williams Sue
Published: May 2014

The NHS Improvement Plan and the NHS and Social Care Model for supporting people with long-term conditions (2005) require health service providers to develop a systematic, collaborative approach to improving the care of people with long-term conditions. Twenty years ago a spinal cord injury would not have been considered a long-term condition, but, as a result of advances in both acute and rehabilitative care, it is possible that the longevity of a person with a spinal cord injury can be equal to that of his/her fellow citizens.

Studies into ageing with spinal cord injuries are beginning to accumulate (Gerhart et al, 1997; Go et al, 1995; Thompson, 1999; Kemp and Thompson, 2002). These authors provide greater insight into the problems and complications that people with a spinal cord injury may acquire as they age.

The Department of Health (2005) has called for case management training for all health professionals to improve understanding of neurological conditions among generalist staff. The aim of this paper is to raise awareness of the issues related to ageing with a spinal cord injury, by exploring how ageing impacts on the individual with spinal cord injury. It is hoped that this investigation will guide nurses in addressing some of the issues and help them prevent or minimize the extent of the problems through earlier interventions and improved educational strategies.
Quantifying the role of nurse specialists in epilepsy: Data from diaries and interviews
Authors: Higgins Sue , Lanfear Judith , Lewis Shelia , Goodwin Melesina
Published: May 2014

Aim:

Previous research has identified that a clinical nurse specialist in epilepsy (CNSE) plays a key role in the management of people with epilepsy (Goodwin et al, 2004). However, there remains a lack of research that focuses on the clinical knowledge and skill base of an individual CNSE working at an advanced level of practice. The aim of this research study is to meet that void.

Methods:

Nine CNSEs participated in this study. Prospective data on their daily clinical and non-clinical activity over a period of 20 days using a self-completion diary was collected. Following quantitative collation of the data, the researchers obtained qualitative data from the nine respondents using structured interviews to clarify the initial data.

Results:

Respondents were highly autonomous in nurse-led clinics, and 40% of their time was spent on the clinical aspects of care, which included epilepsy assessment, ordering investigations and drug management. Time spent on non-clinical activities included teaching, education and research was 60%.

Conclusion:

This study demonstrates the advanced level of practice of the CNSE. As advanced nurse practitioners, the nine participants demonstrated an ability to make independent and complex decisions about patient care using clinical judgment and their unique and expert knowledge base.
CORRESPONDENCE
Authors: Cosgrave Rebecca
Published: May 2014

I am writing to you to raise awareness about a very important issue related to the care of patients with debilitating neurological conditions such as motor neurone disease: communication. It is, in my mind, one of the most important skills in nursing but one which many of us neglect. I would also like to appeal for more articles relating to this disease, not only for my personal interest but because I feel that nurses working in the field of neurology would really benefit from more information about this relatively rare, but extremely cruel, disease. Your journal is extremely informative but I do feel that motor neurone disease has been rather neglected over the last few months.
RESEARCH ROUND-UP
Authors: Woodward Sue
Published: May 2014

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
Building a business case for the specialist nurse: Making the NICE guideline a reality
Authors: Heisters Daiga
Published: May 2014

The national guideline for the diagnosis and management of Parkinson's disease was published for NICE in June 2006 by the Royal College of Physicians. This guideline sets out five recommendations which strengthen the case for an important role for the Parkinson's disease specialist nurse in the care provided to individuals with a diagnosis of Parkinson's. This article explores how Parkinson's disease nurse specialists can help make the NICE guideline a reality and can build a business case to ensure the long-term future of their posts.
The management of neuromuscular respiratory failure: A review
Authors: Garner Anne , Amin Yogen
Published: May 2014

Respiratory failure remains a common cause of morbidity and mortality among patients with neuromuscular disorders. Medical optimization of neuromuscular conditions and detection of early respiratory impairment is of primary importance in the prevention of the disease and respiratory deterioration. A multidisciplinary approach should be taken; these patients need regular physiotherapy, optimal nutrition and vigilance for the early signs of new infections. Non-invasive and invasive ventilation both have defined roles in the management of acute and chronic respiratory failure.

The management of chronic progressive neuromuscular disorders often involves difficult decisions to implement, withhold or withdraw life-sustaining interventions. The use of advance directives has become accepted practice in recent years, although assisted death at present remains illegal in the UK. With appropriate care and attention this difficult patient group can show significant improvements in quality of life.
BOOK REVIEWS
Authors: Aubeeluck Aimee
Published: May 2014

In this useful handbook, Steve Smith provides a thorough application of the Roper Logan and Tierney Model of Nursing to caregiving in Huntington's disease.
Time for nurses to debate euthanasia
Authors: Leyshon Stephen
Published: May 2014

Stephen Leyshon explains why the debate on legalizing assisted dying for the terminally ill is likely to be reignited and why nurses should speak up.
‘An ailment not to be treated’: Tracing the development of spinal cord injury management
Authors: Collis Pellatt Glynis
Published: May 2014

Spinal cord injury was first described by the Ancient Egyptians who concluded that it was ‘an ailment not to be treated’. This attitude to spinal cord injury continued through succeeding centuries as a number of physicians described the pathology and consequences. Nursing input was not a feature of spinal cord injury management. In the 20th century the foundations of modern spinal cord injury care were laid out by pioneers such as Donald Munroe in the USA and Sir Ludwig Guttmann in the UK, during the Second World War. The nursing role in spinal cord injury care has developed since those days, but there is scope for nurses to develop that role further as new challenges are presented.
BOOK REVIEWS
Authors: Mestecky Ann-Marie
Published: May 2014

This book is a compilation of neuroscience articles that have been published by the British Journal of Nursing since 2004. The aim of the book was to bring together the best of the articles so as to provide an essential reference for nurses working with people with neurological problems.
Prevention and management of injection site reactions during therapy with glatiramer acetate
Authors: Colhoun Samantha
Published: May 2014

The increasing use of disease-modifying therapies by people with multiple sclerosis (MS) has brought new challenges for MS nurses. All of the four currently available therapies need to be self-administered by injection. All of the therapies can cause injection site reactions, which are usually minor in nature, but may cause distress and anxiety. Glatiramer acetate is one of the four available disease-modifying therapies for MS. It is self-administered by subcutaneous injection once daily. A group of MS specialist nurses has considered the question of self-injection of glatiramer acetate on the basis of published information and their own experience. This group has produced best practice guidelines for the use of glatiramer acetate, which encompass the initial training of people starting disease modifying MS therapy and practical advice to help with the resolution of minor problems.
Research Round-Up
Authors: Preece Anne
Published: May 2014

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
Report demonstrates need for national dementia strategy
Authors: Doeg Rachael
Published: May 2014

A new report published by the Alzheimer's Society has revealed some alarming findings about the cost and prevalence of dementia in the UK. The Dementia UK report puts the financial cost of dementia at £17 billion, and the number of people with the disease at 700 000. That figure is predicted to rise sharply to over 1 million in the next 20 years.
A toolkit to help MS nurses secure their fi nancial future and contribution to patient care
Authors: Matthews Victoria
Published: May 2014

The multiple sclerosis (MS) specialist nurse is pivotal to the care and support of patients with MS, often taking the lead for service provision and development. However, in the current financial climate in the NHS, MS nurses are having to justify their positions in economic terms. The MS Trust has developed a business plan toolkit to help MS nurses plan and review the financial aspects of their work and justify their contribution in economic terms. The MS nurse ensures that information and support is both appropriate and timely in the care of people with MS. To secure that precious resource for the future, those principles have to be applied to the ‘business’ of caring.
Hearing ‘the unutterable sigh’
Authors: Winter George
Published: May 2014

Despite advances, headache continues to elude attempts to describe it and find new ways to treat it. George Winter reflects on one of the commonest neurological conditions
Book Review
Authors: Treacy Colm
Published: May 2014

‘Person-centred care’ is a term frequently used by organizations to describe the aims and objectives of dementia care but, in reality, the term is often misused and ill-defined because the care for people with dementia, especially long-term care, is anything but person-centred. The traditional overemphasis on pathologizing dementia, based on physical brain changes and hitherto task oriented approaches, often overlooks the unique and personal human experiences and ignores the important infl uence of social and physical environments in the care and management of patients. The development of patient-centred care, in its true sense, has therefore led to a new culture in the way we look at the needs of people with dementia.
Research Round-Up
Authors: Cook Neal
Published: May 2014

This section presents a synopsis of a selection of recently published research articles of interest to those nurses working in the field of the neurosciences. The aim of this round-up is to provide a brief overview, rather than a detailed critique, of the research papers selected. A full reference is provided for those who wish to look at the research in further detail.
Gaining understanding from patients' stories to inform neuroscience nursing practice
Authors: Bennett Bev
Published: May 2014

Patients' stories are achieving recognition as significant sources of knowledge about the illness experience and are being increasingly acknowledged as important aspects of evidence on which to base health-care interventions. Patients often recount their stories as a way of offering information and support for others in similar situations, but their stories can also provide nurses with insights to enhance their understanding of the effects of illness on a patient and those closest to them. In this paper, key sources of first-hand accounts of the illness experience are outlined, before introducing the potential uses and limitations of patients' stories in neuroscience nursing. Future discussions could identify the most effective ways of incorporating patients' stories into the planning and delivery of health-care services at all levels.
Acting to improve understanding of migraine
Authors: Manning Karen
Published: May 2014

The Migraine Action Association is a registered membership-based charity that offers information and support to anyone affected by migraine and other headache disorders, by bridging the gap between the medical world and the sufferer.
Exploring the evidence for the emotional response to stroke: Sociological research sources
Authors: Bennett Bev
Published: May 2014

In an earlier article, the contribution of biomedical research to understanding and responding to the emotional experience of stroke was described. However, it was questioned whether biomedical sources of evidence alone are sufficient to inform psychosocial interventions, and it was suggested that more diverse sources of evidence should be explored. Accordingly, in this second article, sources of sociological evidence and ‘grey literature’, which focus on the lived experience of stroke, are considered together with the difficulties that researchers might face in both locating and using them. The conclusion is reached that although biomedical and sociological research are grounded in different philosophical traditions, by combining these research perspectives a more holistic therapeutic approach to promoting the emotional wellbeing of a person affected by a stroke can be achieved.
Care for the person with dementia, 2: How to know what the person needs or wants
Authors: Beart Kirsty
Published: May 2014

The aim of this series of articles is to question the traditional view that the devastation of dementia is all that is left of a person and offer readers a resource for helping individuals and their carers live with dementia. A social disability model allows insights into ways to help maintain a person′s individuality by accepting that everyone needs emotional attachment, even those who cannot clearly communicate that need, and carers can learn how to interpret the meaning of apparently unrecognizable comments or behaviours. The care pathway for the person with dementia and assessment of individual needs are discussed in this second article.
Art and vision
Authors: Winter George
Published: May 2014

George Winter wonders about the grounding that the powers of the imagination often have in scientific theory.
Addressing erectile problems in Parkinson's disease
Authors: Hallam-Jones Ruth , Clegg Mary
Published: May 2014

Ruth Hallam-Jones and Mary Clegg look at the assessment and management of erectile dysfunction in Joseph, a 57-year-old man with Parkinson's disease
Getting back-up for fun and confidence
Authors: Byle Samantha
Published: May 2014

The Back-Up Trust has so much to offer patients with spinal cord injuries.Samantha Byles describes these unique experiences
Lyme disease: Rising incidence and risk
Authors: Preece Anne
Published: May 2014

Anne Preece discusses changes in the epidemiology of Lyme disease and explains its diagnosis and treatment
Presidential depression
Authors: Winter George
Published: May 2014

George Winter wonders whether clarity of thought has much to do with mental health
CORRESPONDENCE
Authors: Hassall Mandy , Matthews Vicki
Published: May 2014

Three years on from the long-term conditions NSF and where are we now?
Stem-cells: Prospects for treating dementia
Authors: Ekonomou Antigoni , Cedar SH , Ballard Clive G , Minger Stephen L
Published: May 2014

Antigoni Ekonomou, SH Cedar, Clive G Ballard and Stephen L Minger consider the potential of stem-cell research to improve the treatment of Alzheimer′s disease
Does underpinning evidence influence the frequency of neurological observations?
Authors: Mavin Claire
Published: May 2014

To date the evidence that has underpinned the practice of neurological observations of patients with traumatic head injury in the UK has been anecdotal. Although national guidance from the Scottish Intercollegiate Guidelines Network (SIGN) and the National Institute for Health and Clinical Excellence (NICE) exist in the UK to direct practice in the care of patients in the first 72 hours following a head injury, guidelines on the frequency of neurological observations are not research based.

A number of studies have been undertaken to review the frequency of conducting vital signs observations, particularly in the postoperative period. Many of these indicate that the frequency of observing vital signs is based on tradition and expert opinion, rather than on research evidence. It is possible that this is also the case for neurological observations.
The ERICA eye gaze system versus manual letter board to aid communication in ALS/MND
Authors: Harris Donna , Goren Mark
Published: May 2014

Communication is essential to providing individuals with effective health care, but degenerative neurological conditions such as amyotrophic lateral sclerosis or motor neurone disease (ALS/MND) impair patients' physical ability to communicate to get their needs met. New technologies are giving people with motor disabilities alternative means of communicating with caregivers and health professionals.

Aim: The aim of this study was to determine whether ERICA, a hands-free, eye-tracking communication device, is practical for use by people with ALS/MND. The ERICA eye gaze system was compared with a manual letter board and evaluated for speed and ease of use.

Method: Six patients were asked to spell out a simple sentence with the assistance of a caregiver, first using a manual letter board, then using the ERICA eye gaze system.

Results: Four out of the six patients communicated more quickly using the manual letter board but four out of the six patients rated the ERICA eye gaze system as less difficult to use.

Conclusions: It is recommended that health professionals use both low-tech and high-tech solutions to address the loss of speech experienced by people with ALS/MND during disease progression.
Exploring the lived experience of palliative care for people with MS, 3: Views of group support
Authors: Embrey Nikki
Published: May 2014

This is the third article in a series exploring patients' experiences of palliative day-care services for people with long-term conditions such as multiple sclerosis. In the first article, a literature review of palliative care services for non-cancer patients supported an argument for palliative care services being rolled out for neurological conditions across the UK (Embrey, 2008). Subsequent articles in this series report the findings of three themes to emerge from interviews with nine patients at a palliative day-care service for MS in North Staffordshire. A ‘grand-tour’ approach was adopted for the interviews and the data were analysed using a phenomenological approach.

The second article (Embrey, 2009) examined patients' views of therapeutic interventions encountered at the day-care service and indicated the holistic benefits of palliative day-care therapies on physical, psychological and social aspects of life with MS. In this article, patients' views on the benefits of group support from the palliative day-care service are described. The final article will discuss the relevance of information networking in MS care.

Further research is recommended to evaluate the effect of hospice-based palliative day-care programmes, with a view to improving MS services at the palliative care end of the disease spectrum, and to identify changes in current clinical practice which will benefit patients with advanced disease.
Taking a closer look at the role of the coroner
Authors: Urpeth David
Published: May 2014

The role of the coroner carries great responsibility, requiring a sympathetic but fearless approach. David Urpeth discusses his role of coroner investigating work-related deaths.
Apathy: A common neurobehavioural problem
Authors: Braine Mary E
Published: May 2014

Apathy is a common behaviour in many neurological conditions, yet it lacks a consensus on its definition. Furthermore, there is a lack of validated standardized assessment tools for detecting apathy and assessing its severity. In this article, apathy will be further discussed to increase neuroscience nurses' knowledge and understanding of this common problem, and call attention to the concept of apathy in the neuroscience setting. The definition of apathy and the assessment tools to quantify and characterize apathy will be reviewed. The evidence underlying this pathophysiology will be considered along with its relation to associated conditions such as traumatic brain injury, Parkinson's disease and Alzheimer's disease. Finally a consideration of the treatment options will highlight the need for future research into this important phenomenon.
The management of dysphagia after stroke
Authors: Clarkson Katrina
Published: May 2014

This article provides an overview of the management of dysphagia (a swallowing disorder) after stroke. It includes an examination of the normal swallow, what can go wrong with the swallow after a stroke, current national guidelines on best practice during the acute phase, screening for swallow impairments, instrumental assessment including videofluoroscopy and fibreoptic evaluation, both compensatory and direct rehabilitation of the impaired swallow and the prognosis for recovery of swallow function in people who have experienced a stroke.
Contributing factors to burden in Turkish MS caregivers
Authors: Whitehead Bridget
Published: May 2014

Bridget Whitehead provides a synopsis and brief review of a selection of recently published research articles of interest to neuroscience nurses, highlighting the key points to keep you up to date. A full reference is provided for those who wish to read the research in more detail.
Nurse fellowship to Barrow Neurological Institute
Authors: Preece Anne
Published: May 2014

Anne Preece discusses her visit to the Barrow Neurological Institute, the work the BANN and the Society of British Neurological Surgeons have been doing and introduces two more members of the BANN board.
Spiritual support and its role in end-of-life care
Authors: Chapman Simon
Published: May 2014

Spiritual support is recognized as one of the core components of palliative care; however, the spiritual support needs of people approaching the end of life, and those close to them, are often not assessed or met.
National Institute for Health Research leading the way for neuroscience research
Authors: Rhymes Christopher
Published: May 2014

This article describes the role of the National Institute of Health Research and the development of the clinical research networks. The work of the networks and the nervous system disorders research portfolio is discussed. It describes the benefits for patients, researchers and organizations in participating in NIHR portfolio research and how working with your local network can help you unblock the blocks in getting your study open and recruiting. The article demonstrates the significant increase into nervous system disorder research studies since the inception of the networks.
Rehabilitation for primary brain tumours
Authors: Eberhardie Christine
Published: May 2014

Christine Eberhardie provides a synopsis and brief review of a selection of recently published research articles of interest to neuroscience nurses, highlighting the key points to keep you up to date. A full reference is provided for those who wish to read the research in more detail.
Warfarin-induced intracerebral haemorrhage and the importance of urgent reversal of coagulopathy
Authors: Khadjooi Kayvan , Fowler Barbara , Kenton Anthony
Published: May 2014

Increasing use of warfarin for primary or secondary prevention of ischaemic stroke has led to an increased incidence of warfarin-induced intracerebral haemorrhage (WICH) in recent years. Patients on warfarin have a higher likelihood of having intracerebral haemorrhage, and the morbidity and mortality of WICH are higher than for spontaneous intracerebral haemorrhage. Focal neurological signs in an anticoagulated patient— especially if accompanied by altered consciousness, headache, nausea and vomiting—warrant an urgent brain computerised tomography (CT) scan. WICH is a medical emergency and patients can deteriorate very rapidly. Warfarin reversal should therefore start as soon as possible, as any delay can have catastrophic consequences. Infusion of prothrombin complex concentrates together with intravenous vitamin K is the current recommended treatment for reversal of the anticoagulant effect of warfarin in WICH. The aim of this paper is to increase the awareness of nursing staff regarding this medical emergency and its management.
Nurses' perspectives on their specialist stroke roles in London
Authors: Brooke Joanne , Walia Surinder
Published: May 2014

Aim:

This paper is a report of a study exploring nurses' perspectives on their developing roles in specialist stroke care in London.

Method:

Nine paired semi-structured interviews with nurses working across the stroke care pathway in London were completed in 2011, recorded and transcribed verbatim. The data was analysed using interpretative phenomenological analysis.

Results:

The emergent themes included receiving support from fellow nurses, good communication but minimal involvement with the multidisciplinary team, unclear career pathways, and a positive ethos among the nurses. The nurses' responses indicated that they remain passionate and caring. They expressed interest in being more closely involved with the decision-making process within the multidisciplinary team.

Conclusion:

An understanding of the complex nursing roles within the new London stroke care pathway has emerged. Clear pathways of progression from band 5 to band 6 are being developed.
Prion diseases and device reprocessing: a time gone or a time bomb?
Authors: McDonnell Gerald
Published: May 2014

Prions are the protein-based, transmissible causative agents of a group of diseases known as transmissible spongiform encephalopathies (or prion diseases). These are considered rare, although Creutzfeldt–Jakob disease and a variant form of this disease (vCJD) have been a notable concern over the past 20 years. Prion diseases present unique risks to neurosurgery but may also be a concern for a wider range of surgical and medical procedures. They are not considered contagious but are transmissible via tissues and reusable device surfaces, as well as being highly resistant to decontamination. Understanding these diseases is important in the development of facility policies to reduce patient and staff risks. Examples include controls on tissue transplantation, the handling of waste and decontamination of reusable medical devices from surgical and other procedures. There is also debate over standard precautions in surgical practice against prion and potentially other protein-precipitating diseases. As our knowledge of these diseases improves there may be a need to consider a greater risk to patient safety, for example blood transfusions and ward-based procedures such as lumbar punctures. This article briefly considers what prions are, their associated diseases and risks with reusable devices that are reprocessed between patients.
Current trends in the medical management of Parkinson's disease: implications for nursing practice
Authors: Magennis Brian , Lynch Tim , Corry Margarita
Published: May 2014

To successfully educate and advocate on behalf of people with Parkinson's disease and their family members and caregivers, nurses and other health professionals need a working knowledge of current trends in the medical management of Parkinson's. The goal of treatment is to gain control over the symptoms of the disease and promote the best possible quality of life for patients and their families. This paper provides an overview of current approaches to the medical management of Parkinson's. It explores the challenges encountered when treating people with young-onset Parkinson's and those who experience medication side effects, in particular the increasingly recognised impulsive/compulsive behavioural disorders associated with some classes of medication. The key role of the nurse in symptom monitoring and promoting compliance with medication regimens is emphasised.
The importance of cardiotocographs
Authors: Symon Andrew
Published: May 2014

Cardiotocography is an aspect of clinical care which has attracted considerable attention in legal cases, particularly those concerning cerebral palsy. While its level of use may be debated, those midwives who use this form of monitoring must be adequately trained in its interpretion.
Part 1. Woman's memories of homebirth 3-5 years on
Authors: Ogden Jane , Shaw Adrienne , Zander Luke
Published: May 2014

Twenty-five women who had had a homebirth between 3-5 years ago were interviewedin 1995 about the experience in terms of their memories of the homebirth itself, the processes involved in deciding to have a homebirth and their beliefs about the impact of the homebirth on their lives subsequently. This article reports the results from the first component of the study. The women provided rich and detailed accounts of the birth and described the experience interms of factors such as normality, theatmosphere, the role of professionals, pain control and sharing. The memories provide insights into the experience of having a birth at home.
Part 3. A decision with a lasting effect
Authors: Ogden Jane , Shaw Adrienne , Zander Luke
Published: May 2014

In the third part of this homebirth supplement women described the impact of the birth in terms of their perception of themselves as a woman, their reinterpretation of past negative events such as previous births, and their understanding of subsequent experiences such as relationships with others and future decisions about birth.
Planning antenatal services to meet women's psychological needs
Authors: Clement Sarah , Sikorski Jim , Wilson Jennifer , Das Sarah
Published: May 2014

This article considers alternative ways of providing antenatal services, and discusses how well these alternatives might meet women's psychological needs in pregnancy. These alternatives include individualized or flexible antenatal visit schedules, drop-in clinics, telephone advice, targeted care, antenatal groups and home visits. The alternatives are examined in the light of findings from the Antenatal Care Project (a randomized controlled trial comparing two schedules of antenatal visits). Finally, the question of whether reducing the quantity of antenatal visits would increase in quality is addressed.
Midwifery education: Part 5 The North West region
Authors: Bazell Jean
Published: May 2014

Midwifery education in the North West of England, like elsewhere in England, has undergone amalgamation and downsizing in recent years. Before the 1990s in the old Mersey Region Health Authority alone there were seven schools of midwifery. By 1996, these had been subsumed into four institutions of higher education University of Central Lancashire, Edge Hill University, University College Chester and Liverpool John Moores University.
Essential stress relief: the use of oils to treat tension
Authors: Lim Pauline
Published: May 2014

High levels of stress are linked with many phsiological and psychological symptoms. Unfortunately it is becomin a common phenomenomamong health professionals. This article explores some avenues for stress relief, illustrating this with examples of this with some essential oils and their usage. Some other potential self-help remedies are also discussed. Caution is advised for self-treatment without prior consultation with a qualified therapist.
Midwives access to the higher award: a management or supervision issue?
Authors: Thomas B Gail
Published: May 2014

The English National Board (ENB) framework to the higher award has become an option for continuing professional education throughout Britain. At a colege of health studies based in north London, the first students indexed in September 1994. The college research unit and the team of teachers Involved in the planning and Implementation of the process decided to be proactive in evaluating the success of this approach to education for qualified nurses and midwives. Therefore a number of small research projects were set up to be conducted over the first few years In order to examine the complexities of the implementation process as well as the effectiveness of the education provided. This report describes the findings of one of those small projects; one which considered the way that midwives would access the higher award — through managers or supervisors of midwives?