bluuebunny/crossref_metadata_2025_split huggingface dataset:
Clinical skills series/4: nasogastric tube insertion
Authors: Peate Ian , Gault Christine 
Published: May 2014

This article discusses the use of nasogastric (NG) tubes and the care a person with NG tube in situ may require. The indications for NG tube placement are discussed, along with preparation of the person, as well as the insertion technique and methods of confirming the tube's position. A number of deaths have occurred and serious harm has been caused to people as a result of poor technique and misplaced nasogastric feeding tubes. It is essential therefore that if the healthcare assistant (HCA) and assistant practitioner (AP) are to provide safe and effective care, they must understand the reasons why some people may have an NG tube in situ, as well as the care that person may need, the various methods of insertion and the ways in which the position of the NG tube can be verified. This article also discusses the anatomy of the upper gastrointestinal tract.
Writing a reflective assignment as a student HCA in Ireland
Authors: Duffy Anita , Noone Eileen 
Published: May 2014

Over recent years in the Republic of Ireland, there has been a major transformation in the healthcare workforce, especially those caring for older people. With the prompt induction of healthcare assistants (HCAs) to residential care facilities and more specifically to home care organisations, there has been an increase in demand for HCAs in Ireland. Consequently, the number of students undertaking Further Education and Training Awards Council (FETAC) Level 5 training programmes for these positions has increased and the Irish Government is providing free training programmes for jobseekers to retrain as HCAs. One such programme is the CPL Momentum project, retraining job seekers to qualify as HCAs. Many students struggle with academic writing and, in particular, with writing reflective assignments. In this article, one CPL Momentum student HCA and her reflective critical friend and course co-ordinator attempt to demystify the reflective writing process to empower other HCA students to critically analyse their own practice through reflective writing.
Multiple personality disorder: an introduction for HCAs
Authors: Hayes Catherine 
Published: May 2014

The public perception of multiple personality disorder (MPD) is of a sudden, irreversible and severe change in mental health. In fact, MPD is usually slow of onset and, with the right care, people can go on to live fulfilling lives after an episode of MPD. Diagnosis is a long and complex process and it is reasonable for HCAs to raise issues of concern about patient behaviour with a qualified healthcare practitioner. A basic awareness of the 5 types of symptoms can improve how and why the HCA or AP interacts with people living with MPD; these signs and symptoms may differ significantly in intensity and pattern and vary over time.
Quality palliative care for the person with dementia
Authors: Nazarko Linda 
Published: May 2014

Although every one of us will die, death remains a taboo subject. People rarely discuss death, or their wishes in the event of life-threatening illness. When a person has dementia, end-of-life care planning is doubly difficult, because the taboo of discussing death combines with lack of understanding about dementia ( Alzheimer's Society, 2012a ). This reticence means that people with dementia may be subject to burdensome interventions at end of life and do not always benefit from high-quality end-of-life care ( Goldfeld et al, 2012 ). This article outlines the reasons why a palliative approach is required, the principles and benefits of palliative care, and how this should be discussed and provided.
Ward Stars—applauding HCAs working in mental health wards
Authors: Higham Nic 
Published: May 2014

The healthcare assistant (HCA) role plays a major part in inpatient mental health settings. HCAs are nowadays the staff who are able to offer the most direct patient care. Yet despite the significance of the HCA, evidence shows that the majority of HCAs receive little or no training or professional development for their complex role. Patients frequently comment that it is the foundational, human qualities and compassionate attitudes that matter most to them. Ward Stars is a new and free staff development scheme for mental health inpatient HCAs. The scheme aims to provide a helpful structure for professional development and validation and enhance the status and reputation of the role.
Understanding the debate on regulation of support workers
Authors: Vaughan Suzanne , Melling Karen , O'Reilly Lynn , Cooper Denise 
Published: May 2014

While much is written about the regulation of healthcare support workers (HCSWs), many authors and policy-makers do not distinguish between assumption and evidence. As calls for compulsory regulation of HCSWs grow louder, it is crucial that the evidence underpinning the debate on both sides is considered carefully and critically. The authors reviewed journal articles and policy documents with the specific aim of clarifying the arguments for and against further regulation from an evidence-based perspective. The majority of material recommended HCSW regulation; however, the mechanisms by which regulation would deliver better patient care were often missing and were rarely evidence-based. This article provides clear definitions of the key terms and processes needed to engage in the debate, followed by a summary of the arguments for and against the regulation of support workers.
Returning to work: nurses’ experiences surveyed
Authors: Blomfield Richard , Horne Carys 
Published: May 2014

One of the major obstacles to the implementation of The NHS Plan and modernisation of health care is the shortage of available nurses. This article considers the impact of the recent initiatives on the personal and professional circumstances of nurses who return to work. Are they in reality coming ‘back to the future’? What support will ‘nurse returners’ require for this movement to grow?
The assessment of mood after stroke: A need for improvement in the use of measurement tools
Authors: McGinnes Alison 
Published: May 2014

One third of stroke patients suffer from a mood disorder. The psychological wellbeing of patients should be explicitly assessed at key points in the patient's pathway (Intercollegiate Stroke Working Party, 2008). This review aims to examine and bring together the evidence in relation to the assessment of mood in stroke patients. An array of screening tools are used within stroke, three of which were analysed in this review. The review shows that health professionals have limited confidence and knowledge in detecting and managing the complications of depression and anxiety following stroke. Consideration should be given to ensuring that staff providing this type of care are adequately trained and supervised.
Sexual dysfunction and multiple sclerosis: part 2
Authors: Ward-Abel Nicki , Hall Joy 
Published: May 2014

Sexual dysfunction (SD) is a common but frequently overlooked symptom of multiple sclerosis (MS). It is identified as one of the most distressing aspects of living with MS for both the individual and their partner and can have a negative impact on quality of life. Partners can find living with the physical and/or psychological effects of MS difficult, especially if it affects their intimate relationship. Therefore, intimacy is a particularly important area of sexual interaction that needs to be encouraged, and the patient's understanding of the link between this and sexual desire and sexual activity needs to be explored. Patients want to be provided with the opportunity to discuss their sexual difficulties. Some nurses will never feel entirely comfortable discussing these sensitive issues, although developing a strong therapeutic relationship with the patient helps. Nurses need to source the sexual assessment tools that are available and that they feel comfortable with, as these can help initiate and develop conversations with patients. There is also the need to ensure that the language used within these discussions is appropriate and acceptable to the patient. This is the second of two articles that aim to demystify SD as experienced by those with MS. It will explore methods of communicating with the patient who is experiencing these distressing symptoms before describing specific assessment techniques that nurses can utilise in their practice. It aims to increase nurses’ knowledge and understanding of SD and provide them with a range of tangible treatment options that can be suggested to the patient. Sexual difficulties are important to many people affected by MS and it is essential that nurses do what they can to recognise, assess, treat and then enable the patient to self-manage them effectively.
Management of sleep disturbance in multiple sclerosis: a survey of current practice in the UK
Authors: Freeman Jennifer , Cowan Paula , Hourihan Susan , Johansson-Charles Ewa , McDowall Kay , Nock Alison , Rowlands Helen 
Published: May 2014

Purpose: This cross-sectional survey explored the management of sleep disturbance by multiple sclerosis (MS) nurses and therapists. Method: 256 MS professionals were invited to anonymously complete a survey to describe their current practice regarding management of sleep disturbance. Results: The 181 respondents (71% response rate) worked across a range of settings, typically within a multidisciplinary team (74%) and an MS (58%) or neurology (29%) environment; almost half (44%) had worked in this area for over 10 years. Although most (86%) considered sleep management part of their role, only 9% felt very confident in their knowledge. Relatively few used specific assessment instruments (33%). Varying interventions were used (e.g. advice, fatigue management programmes, exercise), typically on an individual basis (91%). Conclusions: This survey provides an initial understanding of practice by experienced MS nurses and therapists in the UK. It suggests that their knowledge about management of sleep disturbance, particularly assessment instruments, is limited. Verification of these findings is needed.
Students' perceptions of the OSCE: a valid assessment tool?
Authors: Jay Annabel 
Published: May 2014

This paper presents the results of a qualitative study into student midwives' perception of the Objective Structured Clinical Examination (OSCE). The study was conducted at the University of Hertfordshire in the summer of 2005 as part of the author's Masters Degree in teaching and learning. Ten volunteers from a sample cohort of 23 students were surveyed through the medium of semi-structured interviews. The findings show that OSCE is generally perceived by student midwives to be an acceptable, valid and fair means of assessing clinical skills in simulation. However, several aspects were highlighted for criticism, in particular the artificiality of the situation, poor equipment and unsatisfactory administration, all of which contributed to student anxiety. Many suggestions for improvement were offered, such as allowing interaction with assessors during workstations and having flexible time limits to complete each station. On balance, the author concludes that the student perception of OSCE is encouraging enough to justify its continued use.
Antenatal services for ethnic minority women in South Tyneside
Authors: Mastrocola Emma L , James Nwabineli Nwachukwu 
Published: May 2014

Black and Minority Ethnic (BME) women are identified as being a disadvantaged group, often prevented from accessing adequate antenatal care due to various barriers. This audit aimed to assess provision of antenatal services for BME women at South Tyneside District Hospital (STDH) and identify potential areas of change, to improve quality and accessibility of care. The audit retrospectively reviewed 60 sets of case notes of BME women booked between January and June 2007. Results showed that only 23.5% of women who needed an interpreter received one. All English-speaking women were given written information about antenatal care but documentation was absent regarding whether or not non English-speaking women had received information in their native languages. 82.4% of women had booked their pregnancies by 12 weeks gestation. It concluded that an adequate service is provided for BME women at STDH, although amendments could be made, with regards to the provision of interpreters and documentation of individual needs.
Women's worries about childbirth: making safe choices
Authors: Maier Belinda 
Published: May 2014

The aim of this research was to provide a qualitative account of a number of women's everyday worries about childbirth. This was facilitated by asking women about their worries and identifying their social and personal contexts. The central findings of this Australian study were that women worry about their own health and their baby's; normality and the effects of their pregnant and potential birthing behaviours. In addition the study showed that pain is linked with vulnerability and that women feel they are not valued for their individual selves. This study has implications for professionals offering health services for pregnant women. It challenges health providers to reconsider assumptions about what it is women worry about and what measures should be taken. Understanding the complex ways that women worry about childbirth within social and personal contexts can improve knowledge and practice, and the experience of pregnancy and childbirth for women.
Caring for parents following the death of a twin: A student's experience
Authors: Attia Linda , Nolan Ann 
Published: May 2014

Reflection encourages midwives to challenge their thoughts, feelings and beliefs, and, as a result, creates a questioning approach to existing knowledge. While reflection is part of best practice and improving care, when reflection involves dealing with birth and death at the same time, the challenge can be immense. This article is a reflective account of a student midwife's experience of caring for bereaved parents. It highlights the caring relationship that was built up between them. The student reflects on the bittersweet experience of a young couple's attempt to deal with the complexity of emotion experienced at the time of the birth and death of their twin daughter. As the account unfolds, the unique role of the midwife in facilitating parents' grieving at the time of childbirth can be clearly seen. The importance of parents spending time with their baby is highlighted. Discussion also focuses on the significance of creating mementos in the grieving process.
Factors influencing multiparous women to choose a home birth—an exploratory study
Authors: Ashley Sarah , Weaver Jane 
Published: May 2014

This is the second article in a two-part series exploring the factors that influence multiparous women to chose to birth at home after a previous hospital birth. The first article examined existing research in the area ( Ashely and Weaver, 2012 ). This paper will discuss a phenomenological study using tape-recorded semi-structured interviews with eight multiparous women who chose a home birth after a previous hospital birth. The transcribed data were analysed using a modified version of Colaizzi's (1978) seven-step phenomenological method. The factors that influenced women could be separated into four themes: the midwives' role, the experience of home birth, the consideration of risk associated with home, and issues regarding the control of birth. The decision to home birth is highly individualised and complex, with an extensive array of influencing factors, which include both positive and negative previous birth experiences, as well as life experience and the influence of others.
Confusion between maternal and fetal heart rate during the second stage of labour
Authors: Equy Véronique , Buisson Séverine , Heinen Mélanie , Schaal Jean-Patrick , Hoffmann Pascale , Sergent Fabrice 
Published: May 2014

To determine risk factors for confusion between maternal heart rate (MHR) and fetal heart rate (FHR) while pushing in the second stage of labour, a prospective historical cohort including 300 singleton birth at term was conducted at Grenoble University maternity clinic. Confusion between MHRandFHR occurred in 65% of cases. The median percentage of confusion was 34.5% of the pushing tracings. Three elements were significantly correlated to confusion: epidural analgesia, which lowers the percentage of confusion, maternal tachycardia and obesity, which both enhance the confusion percentage. No consequences of confusion with regards to the neonatal state could be established. The instrumental delivery rate was significantly lower when the percentage of confusion increased. FHR monitoring using external captors during pushing appears to be of limited help to assess the fetal wellbeing as the percentage of confusion with MHR remains high.
Attitudes of employees working in public places toward breastfeeding
Authors: Marsden Amy , Abayomi Julie 
Published: May 2014

Background: The benefits of breastfeeding are well documented but the UK has one of the lowest breastfeeding rates in Europe. Perceptions of social disapproval of breastfeeding in public is one of the main reasons ( Acker, 2009 ; Dyson et al, 2010 ) why women may choose to bottle feed instead of breastfeeding, or why they may cease breastfeeding early. To better understand the social attitudes toward breastfeeding in public that women may face, the aim of this study is to explore these attitudes and opinions among employees working in public places. Methods: Nine semi-structured interviews were carried out with employees from public places with and without baby-friendly facilities or a breastfeeding policy. Interviews were audiotaped and transcribed verbatim. Transcripts were analyzed qualitatively by sorting and coding data into common themes. Findings: Breastfeeding is viewed as good and natural; however, public breastfeeding still makes some people feel uncomfortable, particularly younger and childless people. Most employees were supportive of women breastfeeding on their premises and their opinions seem unrelated to the facilities offered. Most employees thought breastfeeding facilities should be more widely available but that women should be able to choose whether to use these facilities or not. Breastfeeding education may help to normalize breastfeeding in society and make women feel more comfortable about breastfeeding in public. Conclusions: Most people view public breastfeeding positively; however, there is still a perception that breastfeeding women may feel uncomfortable breastfeeding in public, and private facilities may help to alleviate their anxieties.
Simulation-based learning: a case study, part 2
Authors: Dow Angela 
Published: May 2014

For several years, simulation-based learning (SBL) has been applied in academic settings in the acquisition of professional knowledge and skills ( Cioffi et al, 2005 ). In midwifery education, clinical simulation promotes learning by providing an opportunity for students to experience a realistic learning experience in a simulated, safe environment within the theoretical setting without harming the mother or baby. However the effectiveness of clinical simulation in preparing student midwives for the reality of clinical practice and the application of simulated skills to the workplace is uncertain. This second of three articles presents the findings from a case study, which explored the application of clinical simulation to clinical practice. Findings indicate that it was mainly the practical skills developed from simulation which were transferred and applied in practice. There was also evidence to suggest that context-dependent memory played a role in effective recall of the sequencing of practical skills in an environment similar to the university.
Acute coronary syndrome: social support and coping ability on admittance
Authors: Almerud S , Baigi A , Hildingh C , Jogre J , Lyrström L , Fridlund B 
Published: May 2014

Aim: To compare social support and coping ability in acute coronary syndrome patients at the time of the cardiac event with a healthy community-based sample, with regard to age, sex, education and marital status. Method: The study comprised 241 patients and 316 healthy controls. The participants answered a self-administered questionnaire that included three well-established scales. Multiple logistic regression was used in the analysis to compare the health situation between the patients and controls. Results: Persons suffering from acute coronary syndrome rated emotional support significantly lower than the healthy controls. However, there were no differences between the two groups in terms of socio-demographic variables. Conclusion: This study indicates that social support may be a predictor of acute coronary syndrome.
The lived experiences of newly qualified children's nurses
Authors: Hollywood Eleanor 
Published: May 2014

Aim: This paper reports a study that explored the lived experiences of newly qualified registered children's nurses (RCN) in their transition from postgraduate student nurse to staff nurse. Research question: What are the experiences of newly qualified RCNs in their transition from postgraduate student nurse to staff nurse? Methods: A qualitative phenomenological approach was chosen for the study and six newly qualified RCNs were interviewed. Data analysis was based on the work of Coliazzi (1978) who devised a seven-step approach to assist the analysis within phenomenological inquiry. Results: Findings indicate that support is the most important aspect of the transition experience for these nurses. Mentorship and preceptorship programmes facilitate support during the transition period and previous experience prescribes the amount of support required by the newly qualified RCN. Conclusion: In highlighting the experiences of newly qualified RCNs in their transition from postgraduate student nurse to staff nurse, this study raises awareness among children's nurses, children's nurse educators and children's nursing managers about this unique group of nurses.
Introducing a new skin-are regimen for the incontinent patient
Authors: Geraghty Jemell 
Published: May 2014

Maintaining skin integrity and preventing skin breakdown and moisture lesions in the incontinent patient is an everyday challenge for nurses in the acute setting. The management of incontinence is often a socially or culturally prohibited topic Fletcher (2008) ; it is frequently attributed to ill health, the aging process or hospitalization, and often overlooked. The concept of cleansing should be commonplace, but it is complicated by the ritualism that underpins this ordinary yet fundamental aspect of patient care ( Voegeli, 2010 ). The use of traditional methods of cleansing with soap and water in the management of skin integrity consumes significant amounts of nursing time. However, this procedure conflicts with infection control measures and predisposes the patient to further skin breakdown. This article looks at the use of an evaluation of a skin-cleansing emollient product in an elderly-care setting to provide evidence enabling an innovation that would lead to a change in practice. It highlights the importance of the implementation of a skin-care regimen as part of basic nursing care for the incontinent patient within the acute setting, and challenges ritualistic practice with evidence-based care.