Reflections on setting up a nursing preceptorship programme

2020 ◽  
Vol 29 (11) ◽  
pp. 627-631
Author(s):  
Sharin Baldwin ◽  
Tracey Coyne ◽  
Claire Hynes ◽  
Patricia Kelly
Keyword(s):  
First Year ◽  
North West ◽  
Protected Time ◽  
The Uk ◽  
Similar Programme ◽  
Roll Out

It is now common practice for preceptorship programmes to be offered to newly qualified nurses within the NHS. The Nursing and Midwifery Council expects newly qualified nurses to be given protected time for learning in their first year of qualified practice and to access support from a preceptor. This article discusses a preceptorship programme that has been implemented in a large integrated NHS Trust in north-west London and shares reflections and learning to date, which can benefit others wanting to roll out a similar programme in the UK.

scholarly journals Quality improvement in general practice: what do GPs and practice managers think? Results from a nationally representative survey of UK GPs and practice managers

2021 ◽  
Vol 10 (2) ◽  
pp. e001309
Author(s):  
Jennifer Gosling ◽  
Nicholas Mays ◽  
Bob Erens ◽  
David Reid ◽  
Josephine Exley
Keyword(s):  
General Practice ◽  
Quality Improvement ◽  
General Practitioners ◽  
Service Improvement ◽  
Protected Time ◽  
Routine Work ◽  
Professional Interest ◽  
Quality And Outcomes ◽  
Nationally Representative ◽  
The Uk

BackgroundThis paper presents the results of the first UK-wide survey of National Health Service (NHS) general practitioners (GPs) and practice managers (PMs) designed to explore the service improvement activities being undertaken in practices, and the factors that facilitated or obstructed that work. The research was prompted by growing policy and professional interest in the quality of general practice and its improvement. The analysis compares GP and PM involvement in, and experience of, quality improvement activities.MethodsThis was a mixed-method study comprising 26 semistructured interviews, a focus group and two surveys. The qualitative data supported the design of the surveys, which were sent to all 46 238 GPs on the Royal College of General Practitioners (RCGP) database and the PM at every practice across the UK (n=9153) in July 2017.ResultsResponses from 2377 GPs and 1424 PMs were received and were broadly representative of each group. Ninety-nine per cent reported having planned or undertaken improvement activities in the previous 12 months. The most frequent related to prescribing and access. Key facilitators of improvement included ‘good clinical leadership’. The two main barriers were ‘too many demands from external stakeholders’ and a lack of protected time. Audit and significant event audit were the most common improvement tools used, but respondents were interested in training on other quality improvement tools.ConclusionGPs and PMs are interested in improving service quality. As such, the new quality improvement domain in the Quality and Outcomes Framework used in the payment of practices is likely to be relatively easily accepted by GPs in England. However, if improving quality is to become routine work for practices, it will be important for the NHS in the four UK countries to work with practices to mitigate some of the barriers that they face, in particular the lack of protected time.

The RUMA Alliance targets: an overview

Livestock ◽  
2021 ◽  
Vol 26 (4) ◽  
pp. 176-179
Author(s):  
Chris Lloyd
Keyword(s):  
Task Force ◽  
Animal Health ◽  
Antibiotic Use ◽  
Codes Of Practice ◽  
The Government ◽  
The Uk ◽  
Ongoing Support ◽  
The Impact ◽  
Insight Into ◽  
Roll Out

The Responsible Use of Medicines in Agriculture Alliance (RUMA) was established to promote the highest standards of food safety, animal health and animal welfare in the British livestock industry. It has a current focus to deliver on the Government objective of identifying sector-specific targets for the reduction, refinement or replacement of antibiotics in animal agriculture. The creation and roll out of sector specific targets in 2017 through the RUMA Targets Task Force, has helped focus activity across the UK livestock sectors to achieve a 50% reduction in antibiotic use since 2014. This has been realised principally through voluntary multi-sector collaboration, cross sector initiatives, codes of practice, industry body support and farm assurance schemes. This article provides an overview of RUMA's work to date providing insight into the methods used to create the targets, why they are so important, the impact they are having and how ongoing support and robust data are vital components in achieving the latest set of targets.

scholarly journals The role of accommodation environments in student mental health and wellbeing

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Joanne D. Worsley ◽  
Paula Harrison ◽  
Rhiannon Corcoran
Keyword(s):  
Mental Health ◽  
First Year ◽  
Student Mental Health ◽  
North West ◽  
Human Element ◽  
Health And Wellbeing ◽  
Physical Attributes ◽  
Attachment To Place ◽  
Pastoral Staff

Abstract Background Due to the increasing concern over student mental health and wellbeing, attention has turned to the matter of creating environments, communities, and institutions which enable students to flourish. Methods To explore the role of accommodation environments in first year student mental health and wellbeing, eight focus groups were conducted in two universities in North West England and analysed using thematic analysis. Results Three overarching themes were identified: ‘The betwixt space’; ‘Accommodations as vessels to cultivate friendships and communities’; and ‘The importance of accommodation-based pastoral staff’. As attachment to place and relationships with significant others are disrupted by the transition, this leaves young people vulnerable whilst they go through a process to re-attach to new people and a new environment, and loneliness and social isolation were keenly felt during this period. Physical attributes of place that prevent social cohesion further exacerbated feelings of loneliness. Conclusions As it is common for students to withdraw physically and psychologically when they do not form friendships within their flat, accommodation-based pastoral staff have an important role to fulfil. Although these findings demonstrate the importance of the human element within accommodation, designing places that facilitate community, a sense of we-ness, and belonging is crucial.

scholarly journals FRI0649-HPR HYDROXYCHLOROQUINE PRESCRIBING AND OPHTHALMOLOGY SCREENING WITHIN RHEUMATOLOGY DEPARTMENTS IN THE NORTH-WEST OF THE UNITED KINGDOM: A PROSPECTIVE REGIONAL AUDIT

2020 ◽  
Vol 79 (Suppl 1) ◽  
pp. 928.2-929
Author(s):  
S. Juman ◽  
T. David ◽  
L. Gray ◽  
R. Hamad ◽  
S. Horton ◽  
...  
Keyword(s):  
High Risk ◽  
Risk Group ◽  
Service Level ◽  
High Risk Group ◽  
North West ◽  
The North ◽  
The United Kingdom ◽  
The Uk ◽  
Treatment Dosage ◽  
Sd Oct

Background:Hydroxychloroquine (HCQ) is widely used in the management of rheumatoid arthritis and connective tissue disease. The prevalence of retinopathy in patients taking long-term HCQ is approximately 7.5%, increasing to 20-50% after 20 years of therapy. Hydroxychloroquine prescribed at ≤5 mg/kg poses a toxicity risk of <1% up to five years and <2% up to ten years, but increases sharply to almost 20% after 20 years. Risk factors for retinopathy include doses >5mg/kg/day, concomitant tamoxifen or chloroquine use and renal impairment. The UK Royal College of Ophthalmologists (RCOphth) 2018 guidelines for HCQ screening recommend optimal treatment dosage and timing for both baseline and follow-up ophthalmology review for patients on HCQ, with the aim of preventing iatrogenic visual loss. This is similar to recommendations made by the American Academy of Ophthalmology (2016).Objectives:To determine adherence to the RCOphth guidelines for HCQ screening within the Rheumatology departments in the North-West of the UK.Methods:Data for patients established on HCQ and those initiated on HCQ therapy were collected over a 7 week period from 9 Rheumatology departments.Results:473 patients were included of which 56 (12%) were new starters and 417 (88%) were already established on HCQ. 79% of the patients were female, with median ages of 60.5 and 57 years for new and established patients respectively. The median (IQR) weight for new starters was 71 (27.9) kg and for established patients, 74 (24.7) kg.20% of new starters exceeded 5mg/kg daily HCQ dose. 16% were identified as high risk (9% had previously taken chloroquine, 5% had an eGFR <60ml/min/m2and 2% had retinal co-pathology). Of the high-risk group, 44% were taking <5mg/kg. In total, 36% of new starters were referred for a formal baseline Ophthalmology review.In the established patients, 74% were taking ≤5mg/kg/day HCQ dose and 16% were categorized as high risk (10% had an eGFR less than 60ml/min/m2, 3% had previous chloroquine or tamoxifen use and 2% had retinal co-pathology). In the high-risk group, 75% were not referred for spectral domain optical coherence tomography (SD-OCT). 41% of patients established on HCQ for <5 years, and 33% of patients on HCQ for >5 years were not referred for SD-OCT. Reasons for not referring included; awaiting 5 year review, previous screening already performed and optician review advised.Since the introduction of the RCOphth guidelines, 29% patients already established on HCQ had an alteration in the dosage of HCQ in accordance with the guidelines. In the high-risk group, 16% were not on the recommended HCQ dose.Conclusion:This audit demonstrates inconsistencies in adherence to the RCOphth guidelines for HCQ prescribing and ophthalmology screening within Rheumatology departments in the North-West of the UK for both new starters and established patients. Plans to improve this include wider dissemination of the guidelines to Rheumatology departments and strict service level agreements with ophthalmology teams to help optimize HCQ prescribing and screening for retinopathy.Acknowledgments:Drs. S Jones, E MacPhie, A Madan, L Coates & Prof L Teh. Co-1st author, T David.Disclosure of Interests:None declared

scholarly journals An OSCE as part of the first-year SpR assessmentinent in ENT

2006 ◽  
Vol 88 (9) ◽  
pp. 310-312 ◽  
Author(s):  
A Drake-Lee ◽  
D Skinner ◽  
A Reid
Keyword(s):  
First Year ◽  
European Law ◽  
Senior Registrar ◽  
The Uk ◽  
Second Wave

The structure of postgraduate hospital training in the UK has changed in the last 20 years: the Calman report brought training in line with European law and the SpR post was created out of the registrar and senior registrar posts. Implementation of the new training was staggered across specialties. ENT was included in the second wave of implementation in October 1995. At the same time, consultant expansion was envisaged.

scholarly journals Caterpillars of the marsh fritillary butterfly Euphydryas aurinia can extend their life-cycle in Scotland

2021 ◽  
Author(s):  
Neil O. M. Ravenscroft
Keyword(s):  
Life Cycle ◽  
Conservation Status ◽  
Northern Europe ◽  
First Year ◽  
Winter Mortality ◽  
Closely Related Species ◽  
Euphydryas Aurinia ◽  
High Conservation ◽  
The Uk ◽  
Marsh Fritillary

AbstractThe marsh fritillary Euphydryas aurinia is declining across Europe and is of high conservation interest. Its ecology has been defined and its conservation status assessed primarily from the affinities and populations of young caterpillars in the autumn, before hibernation and high winter mortality. The possibility that caterpillars of E. aurinia can overwinter more than once was investigated on the Isle of Islay, Scotland after caterpillars were found to occur at some locations in the spring despite a pre-hibernation absence. Closely-related species in North America and Northern Europe can prolong larval development by diapausing for a year as does E. aurinia in Scandinavia. Measurements of development and manipulations of distribution confirmed that some caterpillars do extend the life-cycle in Scotland and may occur in areas devoid of larvae in their first year. Caterpillars attempting this life-cycle develop slowly in spring, attain the normal penultimate spring instar and then enter diapause while other caterpillars are pupating. They moult just before diapause, construct highly cryptic webs and on emergence the following spring are 5–6 times heavier than larvae emerging in their first spring, or the equivalent of a month or so ahead. They attain a final, extra instar as larvae in their first spring reach the penultimate instar. Knowledge of this life-cycle is confined in the UK to Islay but its occurrence in this mild climate implies that it is more widespread.Implications for insect conservation Conditions that permit long diapause are probably precise and may not be reflected in recognised qualities of habitat. The species may also be present despite a perceived absence in autumn, the standard period for monitoring. Assessments of the prevalence of the life-cycle and its contribution to the persistence of E. aurinia are required. Populations of E. aurinia are known to fluctuate greatly and do occur below the observation threshold for long periods.

Results from the first year as a major trauma radiology unit in the UK

2014 ◽  
Vol 69 (8) ◽  
pp. 812-821 ◽  
Author(s):  
E. Adiotomre ◽  
A. Chopra ◽  
A. Kirwadi ◽  
N. Kotnis
Keyword(s):  
Major Trauma ◽  
First Year ◽  
The Uk

Somatic dysfunctions in children of the first year of life: features of formation

2021 ◽  
pp. 34-44
Author(s):  
Yu. O. Kuzmina ◽  
E. S. Tregubova ◽  
E. S. Mokhova ◽  
Yu. P. Potekhina
Keyword(s):  
Statistical Significance ◽  
Statistical Processing ◽  
First Year ◽  
Term Infants ◽  
North West ◽  
Birth Canal ◽  
Pregnancy And Childbirth ◽  
Natural Birth ◽  
First Year Of Life ◽  
Physiological Childbirth

Introduction. The health status of children of the first year of life is primarily affected by the course of pregnancy and childbirth, as well as hereditary factors. During the newborn period, reversible disorders may occur, which can be estimated as somatic dysfunction (SD). The formation of SD in young children has its own causes and features, which have not been studied in detail until now.The goal of research — is to study the features of the osteopathic status in children of the first year of life with different patterns of pregnancy and delivery methods for their mothers.Materials and methods. Since 2015, for 5 years, a prospective multicenter study has been conducted to investigate the osteopathic status of children of the first year of life under a single protocol in 6 cities of Russia, organized by the Institute of Osteopathy (St. Petersburg) and the Department of Osteopathy of Mechnikov North-West State Medical University. A total of 360 full-term infants aged 1 to 12 months with perinatal hypoxic-ischemic lesions of the central nervous system, and practically healthy ones were examined. All children underwent an osteopathic examination, and a detailed history of pregnancy and childbirth was collected. Based on the results of the obstetric history analysis the following groups were selected: physiological course of pregnancy, ending in physiological childbirth through the natural birth canal — 62 people; physiological course of pregnancy, ending with operative delivery — 25 people; physiological course of pregnancy, ending in complicated labor through the natural birth canal — 20 people; pregnancy with complications, ending in physiological childbirth through the natural birth canal — 104 people. Statistical processing of the obtained results was carried out by nonparametric methods using the Statistica 10.0 software.Results. In children born by physiological childbirth with complicated pregnancy, a smaller number of local SD (p=0,04) and a larger number of global SD were detected, but the difference with the subgroup of the pregnancy physiological course did not reach the statistical significance. In children whose mothers had a physiological course of pregnancy, but childbirth proceeded with complications and required the use of obstetric assistance, the significantly more number of regional SD were revealed (p<0,0001) compared with children born in physiological childbirth. The latter had a greater number of local SD of the craniosacral system (p=0,035). In children born by caesarean section and in children born through the natural birth canal without complications, the number of global, regional and local SD did not differ statistically significantly. Osteopathic examination of children in the first year of life showed that the first three places in the structure of dominant SD were occupied by SD of the neck, head, and dura mater.Conclusion. Based on the data obtained as a result of the study, it can be assumed the presence of numerous factors that can lead to the formation of various SD in children of the first year of life during pregnancy and especially during childbirth. It is necessary to further study the features of the osteopathic state in children in the postnatal period.

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