bluuebunny/crossref_metadata_2025_split huggingface dataset:
Midwife documentation of a shoulder dystocia delivery
Authors: Stohl Hindi , Chen Judy , Jaque Jenny 
Published: May 2014

Introduction:The objective of this study is to describe and analyse certified nurse midwife delivery notes after a simulated shoulder dystocia using a standardised case presentation and simulation technique.Methods:Seven experienced midwives from a single academic institution in california, US, underwent a standardised simulated shoulder dystocia delivery. Delivery notes were collected and analysed according to pre-specified criteria to assess for accuracy and comprehensiveness.Results:Fifteen documentation elements were examined. The median score was 11 out of 15, with 71% of participants recording 10 or more of the key components. The time of delivery, the presence of the paediatrics team for delivery, and the correct order of the manoeuvres performed were recorded by all midwives. The least commonly recorded items were the identification of the anterior shoulder, presence/absence of an epidural, and the name of the on-call supervising obstetricianConclusion:Narrative shoulder dystocia documentation by experienced midwives contains many components of standard birth documentation but lacks certain critical elements.
Simulation-based learning: a case study, part 3
Authors: Dow Angela 
Published: May 2014

The purpose of this study, presented in this series of three articles, was to explore the concept of clinical simulation in the setting where it was applied, that is, the clinical environment. A case study approach, consisting of a purposive sample of midwifery lecturers, midwife mentors and student midwives was adopted and data were collected by qualitatively driven methods which included interviews and focus groups. Categorical aggregation of interview and focus group data provided the basis for developing the thematic analysis. In part 1 and part 2 of this series, data were presented relating to the role of clinical simulation in preparation for, and application to, clinical practice. This third article explores the influence of simulation on learning in the workplace, where it was found that simulation-based learning (SBL) had a positive impact, and that it perhaps offered an interface between the university and practice placement. There was also evidence to suggest that simulation facilitated the mentors’ teaching role.
Supporting smoking cessation in pregnancy
Authors: Edwins Jenny 
Published: May 2014

A large study by Bickerstaff et al (2012) has once again confirmed the association between smoking in pregnancy and poor outcomes for both women and their babies. they identify that ‘quitting smoking prior to conception is most desirable; however, there is also likely to be benefit in stopping smoking prior to the second trimester, and women should be encouraged and supported to do so.’ This review article aims to signpost a number of currently available resources to update midwives’ understanding of the complexities of smoking cessation. the main focus will be on the role of the midwife in promoting strategies that improve the likelihood of pregnant women stopping smoking and remaining smoke free. it is assumed that the reader is already aware of the adverse consequences of smoking in pregnancy and motherhood, for both women and their children.
COPD: criteria to assist in the identification of the palliative phase
Authors: Trueman Jacqui , Trueman Ian 
Published: May 2014

For people with chronic obstructive pulmonary disease (COPD), hospital admission can be associated with a poor prognosis. Consequently, the end stage of the illness needs to be recognized for timely palliative care to be initiated. Tools to enhance the palliative phase such as the Gold Standards Framework and the Liverpool Care Pathway rely on the recognition of the final phase of a person's life. The illness trajectory of cancer makes this recognition far easier than for COPD, as a result many patients and their families manage at home with limited support. Lincolnshire Respiratory Network has developed criteria to help recognize the end-stage COPD, which correlate well with recent recommendations from the Consultation on a Strategy for Services for COPD in England ( Department of Health, 2010 ). However, there needs to be appropriate training to assist practitioners in their confidence to refer patients with end-stage COPD to palliative care providers.
Do medicines OSCEs improve drug administration ability?
Authors: Meechan Ronnie , Valler-Jones Tracey , Jones Helen 
Published: May 2014

Aim: To examine the efficacy of the early introduction of a medicines management ‘objective structured clinical examination’ (OSCE) into an undergraduate adult nursing students' programme of education and to determine if the acquisition of applied drug/pharmacology knowledge and drug administration of medicines had improved prior to qualification. Methods: A longitudinal comparative design was selected for this study. A convenience random samples method of three cohorts of adult nursing students (N=90) undertaking a pre-registration nursing programme was used to identify participants. Participants were assessed at the following points during their preparatory educational programmes. Cohort one (N=30) had completed 8 months of their programme, cohort two (N=30) had completed 20 months of their programme and cohort three (N=30) had completed 30 months of education. Students were asked to undertake a drug administration simulated activity (DASA) to generate the data for this study and differences between the students' performance was compared against the criteria of the DASA. Results/Findings: There were statistical differences observed on almost every criteria of the DASA between the three groups of students. Students who had been previously exposed to medicines management OSCEs as an assessment method demonstrated superior medicines management skills and pharmacology knowledge than the control group (group three). Conclusion: The authors of this study conclude that early introduction of clinical examinations, namely OSCEs with an integrated approach to pharmacology and medicines management teaching, does facilitate and improve students drug administration and applied pharmacology ability.
The variance in distribution of cancer nurse specialists in England
Authors: Leary Alison , Mak Vivian , Trevatt Paul 
Published: May 2014

Background The role of the specialist nurse in the UK evolved in the 1970s. In cancer care, policy drivers have seen an increase in the number of, and an increase in the role of, the pathology‐based, or ‘site‐specific’, cancer clinical nurse specialists, and also an increase in the variety specialist cancer nursing roles; the recommendation being that every cancer patient has access to a specialist cancer nurse. Methods A census of the specialist cancer nursing workforce was undertaken in 2008. These data were then compared with cancer registry data (incidence) to give an indication of caseload and access to a clinical nurse specialist by patients. Results There is a wide variation in provision of clinical nurse specialists both geographically and by pathology across England. Conclusions Cancer specialist nursing is a pivotal part of cancer care. Given the uneven distribution of cancer clinical nurse specialists, it is unlikely that patients and families have equitable access across pathology or geography. In terms of a realistic workload, more research is needed into optimum caseload guidance.
Assessing the impact of breakthrough cancer pain
Authors: Burton Beth , Zeppetella Giovambattista 
Published: May 2014

Breakthrough pain is a transient exacerbation of pain that occurs either spontaneously or in relation to a specific predictable or unpredictable trigger despite relative stable and adequately controlled background pain. Breakthrough pain is a common and distinct component of cancer pain and is typically of rapid onset, severe in intensity, and generally self-limiting with an average duration of 30-60 minutes. Despite the self-limiting nature of breakthrough pain, it can place significant physical, psychological, and economic burdens on both patients and their carers. Patients with breakthrough pain are often less satisfied with their analgesic therapy, they have decreased functioning because of their pain, and may also experience social and psychosocial consequences, such as increased levels of anxiety and depression. Successful management of breakthrough pain is best achieved by a thorough assessment which includes determining the severity, pathophysiology, and aetiology of the pain and takes into account both background and breakthrough pains while considering whether the underlying disease, co-morbidities or precipitating events are amenable to interventions. The features of breakthrough pain and the challenges it presents to patients, their carers, and health professionals are illustrated with a case study.
Perceptions of the advanced nurse practitioner role in a hospital setting
Authors: Dalton Mark Anthony 
Published: May 2014

Aim: To explore perceptions of junior doctors, nurses and advanced nurse practitioners (ANP) in relation to the role of the ANP. Method: A qualitative cross-sectional design was used, embedded in an interpretative philosophy. A non-probability sample of six junior doctors, six ward nurses and six ANPs took part in focus groups and individual semi-structured interviews. A mixture of phenomenological and grounded theory approaches were used to collect the data. Findings: Four major themes were identified – diverse definitions of the ANP role between medical and surgical wards in the hospital at day compared to hospital at night work; role vagueness and ambiguity; communication and education needs; and constraints and barriers. The study found varied perceptions and understanding of the role of the ANP within the hospital at day. Conversely, the hospital at night concept seemed correctly perceived – the role appeared well-established, organised and orchestrated the appropriate responses as required in both medicine and surgery. During the hospital at day, nurses on medical wards were more inclined to use the medical staff as their first responders. The absence of the bleep filtering system in medicine during the day was identified as one of the main barriers. A definitive understanding of the role during the hospital at day has been recognised as the second main barrier. A constraint well known to the ANP team was the inability to provide a bleep filter system in medicine during the day. Conclusion: The study finds the need for improved education, clinical support and system management during the hospital at day, with more of an emphasis within medical wards.
Knowing Generation Y: a new generation of nurses in practice
Authors: Chung Stephanie M. , Fitzsimons Virginia 
Published: May 2014

Generation Y is commonly defined as those people born between 1980 and 2000, now aged in their 20s and 30s. Their grandparents experienced post-World War II reconstruction, their parents the economic boom of the 1980s. There are currently 81 million individuals in the Generation Y cohort in the USA, making it the second-largest, and possibly most influential, cohort since World War II ( Manion, 2009 ). Members of Generation Y are diverse, technologically advanced and vocal about their opinions. They tend to resist traditional hierarchy, want recognition/reward for achievements and distrust institutions. Knowing these characteristics is useful for nurse managers, preceptors and team members working with members of Generation Y. Studies have proven that Generation Y is challenging the nursing workforce through rapid turnover ( Cogin, 2012 ). This article explores a theoretical model that predicts retention and/or turnover of nurses in light of Generation Y behaviours and motivators—for example, moving from agency to agency rather than devoting many years to a single practice. Further research is needed to find out whether these behaviours and motivators are unique to Generation Y alone.
Adherence to medication and self-management in stroke patients
Authors: Chapman Beatrice , Bogle Vanessa 
Published: May 2014

Background: Stroke is the third most common cause of mortality and one of the leading causes of adult physical disability in England. Medical treatment is imperative for the management of stroke and the risk reduction of recurrent stroke. The success of a medical treatment is determined largely by adherence. However, research has shown that adherence to medication in patients who have had a stroke is often suboptimal. Self-management interventions have been shown to improve adherence in long-term conditions. The impact of self-management interventions specifically on adherence to stroke medication is unknown. Objective: To review systematically the impact that self-management interventions have on adherence to stroke medication. Method: The online databases that were systematically searched included PsychINFO, MEDLINE, EMBASE, Scopus, Cochrane Database of Systematic Reviews, CINAHL and Web of Science. Reference lists of retrieved studies were hand-searched. Results: Six studies met the criteria for inclusion in the systematic review. Self-management interventions for stroke patients were effective in improving adherence to stroke medication in the short term. However, in the longer term, these benefits were not maintained. Conclusions: Applying self-management interventions to improve medication adherence in stroke patients across integrated clinical settings shows promise. However, further development of such interventions and research is recommended, with more stringent methodologies and longer follow-up periods.
Current nursing practice by hospital-based stoma specialist nurses
Authors: Burch Jennie 
Published: May 2014

Introduction Nurses frequently care for patients who have stomas. A common complication is sore peristomal skin (skin around the stoma). Aims and objectives The study aim was to answer the research question: what is the current nursing practice for peristomal skin problems among UK stoma specialist nurses? The question was explored through investigation of descriptions, treatments and opinions of peristomal skin problems. Results were examined to ascertain if practice reflects the literature and if care was evidence-based. Methods A questionnaire was posted in September 2009 to the stoma care nurses in all UK NHS hospitals (n=596). Results The proportion of completed or partially completed questionnaires was 15% (89 of 596). Most of the responding nurses held a stoma-related qualification (86%), a degree (55%) and had specialised in stoma care for over 5 years (67%). Respondents used erythema to describe sore skin (80%). Stoma powder (98%) and convex appliances (98%) were the most commonly used treatments. The most common cause of sore skin was appliance leakage (61%). Conclusions The study population was deemed suitably qualified and experienced to answer the research question. Many responses were reflected in the literature (predominantly opinion articles), reflecting a degree of reliability and validity. It could be concluded that stoma specialist nurses can accurately assess and use stoma accessories to treat sore skin, but due to the paucity of research, the care cannot be defined as evidence-based. More research is needed to determine universally accepted definitions and treatments for sore peristomal skin.
Assessing the learning needs of students
Authors: Sherwin Sarah , Stevenson Liz 
Published: May 2014

The role of the practice teacher is pivotal in supporting the development of students undertaking Nursing and Midwifery Council (NMC) approved Specialist Community Public Health (SCPHN), School Nursing programmes. It is a mandatory requirement that students of school nursing are supported and assessed by a named practice teacher, who must have met the requirements defined within the practice teacher standard ( NMC, 2008 ). In the third article of this series Sarah Sherwin and Liz Stevenson discuss the role of the practice teacher in assessing the learning needs of students on placement with the school health team.
The role of physiotherapy in anorexia nervosa management
Authors: Mandy A , Broadbridge H 
Published: May 2014

There is disparate evidence within the current literature concerning the nature and level of involvement that physiotherapists have with patients suffering from anorexia nervosa. The study outlined in this article investigated such issues. Physiotherapists actively working with anorexic patients were targeted using a postal questionnaire. Results indicated that there is an active involvement of physiotherapists within the multidisciplinary team in the management of anorexia, and that the application of physical treatments were appropriate in a condition that is largely regarded as a psychiatric/psychological problem. In particular, physiotherapy was perceived as a useful application in the management of distorted body image, in programmes to control excessive exercise and in anxiety reduction.
NEW Solutions: an Australian health promotion programme for people with mental illness
Authors: Lloyd Chris , Sullivan Dan 
Published: May 2014

The prevalence of people who are overweight or obese is continuing to rise. This is a key risk indicator of preventable morbidity and mortality resulting from many diseases. The increase in the number of obese people is associated with dietary practices and a reduction in physical activity. There is a need to implement strategies for the reduction of obesity in at-risk groups. People with a mental illness are at high risk of many physical illnesses related to behavioural factors, which include poor diet and lack of exercise. Health promotion programmes need to be incorporated into mental-health services to improve the general health and wellbeing of people with a mental illness. An Australian psychiatric rehabilitation service developed and implemented a health promotion programme, NEW Solutions, which aimed to address issues related to weight gain, dietary practice and physical inactivity.
Pimobendan: its place in managing feline heart failure
Authors: Adamany Jessica L , Dhumeaux Marc PJ 
Published: May 2014

Pimobendan, a positive inodilator, has proven to bring an added benefit when used in combination with other routine medications in the treatment of canine heart failure. In 2009, the American College of Veterinary Internal Medicine Consensus Statement recommended the use of pimobendan for treatment of dogs with congestive heart failure secondary to degenerative mitral valve disease, while in 2012 the PROTECT (Pimobendan Randomised Occult DCM Trial to Evaluate Clinical symptoms and Time to heart failure) study advocated the use of pimobendan in asymptomatic Doberman Pinscher dogs with dilated cardiomyopathy. With pimobendan being the only canine approved positive inotrope in the UK, and with its success in increasing survival times in our canine patients with heart failure, use of pimobendan in cases of feline heart failure is now being investigated as a viable option when positive inotropic effects are required.
National audit of stoma complications within 3 weeks of surgery
Authors: Cottam Jude , Richards Karen 
Published: May 2014

The objectives of this audit were to:1. Identify the incidence of problematic stomas within the UK;2. Highlight any dissimilarity of incidence from centre to centre;3. Confirm the height of the stoma as being a predisposing factor to complications;4. Initiate research.Of the 256 hospital−based stoma care services within the UK, 93 registered for the audit, the final total being 3970 stomas with 1329 (34%) meeting the criteria of problematic, with a variance from centre to centre of 6−96%. The loop ileostomy was reported as the most problematic with a height of less than 20mm at time of fashioning. Problems are more likely to occur after emergency surgery. The major problem is retraction, accounting for 40% of the total problems. Men have more stomas raised than women yet report fewer complications. This audit provides some predisposing factors to problematic stomas: height of stoma, stoma type, patient gender and body mass index, and underlying disease.
Recurrent hyperparathyroidism caused by parathyromatosis
Authors: Evans CFM , Mansfield L , Sharma AK 
Published: May 2014

In 1987, an Indian lady, aged 62 years, first presented complaining of a 1 year history of weight loss, poluria, polydipsia and lethargy. On examination of the neck there was a palpable nodule arising from the lower aspect of the right thyroid lobe. Bloods revealed raised corrected calcium of 3.62 mmol/L (normal 2.18–2.47 mmol/L). Neck ultrasound scan showed a large nodule in the right lower lobe of the thyroid, thought unlikely to originate from the parathyroid glands due to its size. After failed conservative treatment the patient underwent cervical exploration. A bilobed nodule was removed from the right side with a total weight of 12.5 g. Two specimens were sent for frozen section and histology confirmed the diagnosis of a parathyroid adenoma (weights 0.91 g and 11.60 g respectively). The larger specimen was documented as partially encapsulated, cystic and degenerative. Post operatively normocalcaemia was achieved with resolution of preoperative symptoms. Fourteen years later, in 2001, the lady presented with low back pain. She was found to have hypercalcaemia (adjusted calcium of 2.93 mmol/L) and hyperparathyroidism (parathyroid hormone level 46.7 pmol/L, normal values 1.1–6.9 pmol/L). Initial investigations, including a neck ultrasound scan, sestamibi scan, magnetic resonance imaging (MRI) scan of the neck and chest and parathyroid venous sampling were unable to localize the source of the hyperparathyroidism. In 2003, as a result of increasingly problematic symptoms, further localisation studies were performed. Ultrasound showed an enlarged parathyroid gland inferior to the right lobe of the thyroid. The decision was then made to proceed to re-exploration of the right side of the neck. At the repeat exploration, aided by methylene blue localization, multiple nodules of parathyroid tissue were identified in the following areas: subcutaneous tissue (within the midline); superficial and lateral to left sternocleidomastoid muscle; Adherent to the right recurrent laryngeal nerve; within the left sternothyroid muscle; right paratracheal and paraoesophageal areas; bilaterally in the thymus glands. All macroscopic nodules were excised and bilateral cervical thymectomies performed with no visible residual disease remaining. Histology confirmed multiple well-circumscribed nodules of parathyroid tissue similar to that originally excised and a diagnosis of parathyromatosis was recorded. The patient's subsequent calcium levels have fallen, her symptoms have improved and she is currently well.