Setting up a successful nurse-led intravitreal injections service: pearls from Swindon

2020 ◽  
Vol 29 (20) ◽  
pp. 1178-1185
Author(s):  
Hani Hasan ◽  
Sunil Mamtora ◽  
Nimish Shah
Keyword(s):  
Nurse Practitioners ◽  
Positive Impact ◽  
Training Model ◽  
Training Programme ◽  
Intravitreal Injections ◽  
Nurse Training ◽  
Financial Benefits ◽  
Hands On ◽  
Number Of Injections

The demand for performing intravitreal injections has increased in recent years, prompting the need for more nurse training in their administration. The Great Western Hospitals NHS Trust in Swindon has developed a structured nurse training programme and now has 8 independent nurse injectors trained to undertake injections independently; nurse practitioners now contribute upwards of 85% of the total number of injections. The authors have also demonstrated the financial benefits of using injection assistant devices and shown the positive impact such devices have on training. In September 2019, the authors organised the first course to offer nurses and doctors hands-on experience in administering injections, using the Swindon training model to provide participants with a structured approach to learn how to perform intravitreal injections safely. Nurses made up 96% of participants; the remainder were doctors and managers; 6% had never performed an intravitreal injection; of units where they had, disposable drapes and a speculum were used in 71% of these. The number of injections performed per session at participants' units at the time they attended the course was: 17 or more injections=46%, 13–14=39%, and 11–12=15%. The course was rated 8.9/10 overall for content, with 85% very likely to recommend it to colleagues. All participants indicated that using the Swindon model made them feel confident to deliver injections safely. The authors demonstrated that using a structured training protocol and intravitreal assistant device improves the quality of nurse training and increases confidence in administering intravitreal injections.

Improving the organization of modern postgraduate studies: system approach

2020 ◽  
pp. 49-61
Author(s):  
Nonna Antonovna Morozova
Keyword(s):  
Graduate Students ◽  
Graduate School ◽  
Academic Writing ◽  
Systematic Approach ◽  
Positive Impact ◽  
Postgraduate Education ◽  
Training Programme ◽  
Practice Research ◽  
Postgraduate Studies

The article deals with the problems of training scientific and pedagogical personnel in Russia at the present stage of postgraduate education, which caused the need to discuss them, both at the level of the country’s leadership, and at the level of the scientific and University community. The directions of improving the organization of modern postgraduate studies in the context of a systematic approach are proposed. The directions of improving the training of postgraduates and the organization of the modern Russian postgraduate school in the context of its two types - scientific and University with the organization of different types of practice: research and teaching. The most significant among the directions proposed in the article are the following: improving the quality of recruitment of applicants to graduate school on the example of a pre-admission system of two-stage training of applicants in the system of professional development of the Research center for problems of quality of training of specialists; the implementation of master’s training programme “graduate student researcher” and “student-expert” on the basis of the principle of continuity of training programs for “masters-postgraduate” and implementation of the program and the model of problem-designresearch teaching academician I.A. Zimnyaya; formation of academic literacy in the process of formation of communicative competence of graduate students by means of educational disciplines «Academic writing» / «Scientific text», «Academic speech»; improving the organization of classroom and extracurricular independent work of postgraduates and its material and technical support; financing of postgraduate education; and a number of others. Along with the actualization of a systematic approach to improving the organization of modern graduate school activities, personal-activity, convergent and scenario approaches to improving the training of graduate students are identified. The proposed ways to solve the existing problems of the organizational plan of the postgraduate school in some of the indicated areas can have a positive impact on its improvement.

scholarly journals Hands-on nursing and carepaths: a commentary

2001 ◽  
Vol 24 (4) ◽  
pp. 14 ◽  
Author(s):  
Fiona Middleton
Keyword(s):  
Patient Care ◽  
Positive Impact ◽  
Quality Of Patient Care ◽  
Hands On

From a nursing perspective, the introduction of carepaths has been an important practical advance, having a positive impact on the quality of patient care. Like most other nurses, I suspect, I am as enthusiastic as Pearson and Macintosh (2001) about the benefits.

Improving the Quality of Care in the Specialization: The Benefits of “Hands-on” Courses for Learning Neuromuscular Ultrasound

2017 ◽  
Vol 48 (S 01) ◽  
pp. S1-S45
Author(s):  
A. Schroeder ◽  
S. Berweck ◽  
K. Vill ◽  
L. Gerstl ◽  
C. Jansen ◽  
...  
Keyword(s):  
Quality Of Care ◽  
Hands On

Strategic Role of Zakat in Multidimensional Quality of Life in Sijunjung, Indonesia

2018 ◽  
Vol 15 (1) ◽  
pp. 55-72
Author(s):  
Herlin Hamimi ◽  
Abdul Ghafar Ismail ◽  
Muhammad Hasbi Zaenal
Keyword(s):  
Quality Of Life ◽  
Positive Impact ◽  
Wealth Distribution ◽  
Absolute Poverty ◽  
Before And After ◽  
The Status ◽  
Being There ◽  
The Impact

Zakat is one of the five pillars of Islam which has a function of faith, social and economic functions. Muslims who can pay zakat are required to give at least 2.5 per cent of their wealth. The problem of poverty prevalent in disadvantaged regions because of the difficulty of access to information and communication led to a gap that is so high in wealth and resources. The instrument of zakat provides a paradigm in the achievement of equitable wealth distribution and healthy circulation. Zakat potentially offers a better life and improves the quality of human being. There is a human quality improvement not only in economic terms but also in spiritual terms such as improving religiousity. This study aims to examine the role of zakat to alleviate humanitarian issues in disadvantaged regions such as Sijunjung, one of zakat beneficiaries and impoverished areas in Indonesia. The researcher attempted a Cibest method to capture the impact of zakat beneficiaries before and after becoming a member of Zakat Community Development (ZCD) Program in material and spiritual value. The overall analysis shows that zakat has a positive impact on disadvantaged regions development and enhance the quality of life of the community. There is an improvement in the average of mustahik household incomes after becoming a member of ZCD Program. Cibest model demonstrates that material, spiritual, and absolute poverty index decreased by 10, 5, and 6 per cent. Meanwhile, the welfare index is increased by 21 per cent. These findings have significant implications for developing the quality of life in disadvantaged regions in Sijunjung. Therefore, zakat is one of the instruments to change the status of disadvantaged areas to be equivalent to other areas.

Exercise Capacity in Chronic Heart Failure

2012 ◽  
Vol 9 (1) ◽  
pp. 57-60 ◽  
Author(s):  
Gina G Mentzer ◽  
Alex J Auseon
Keyword(s):  
Quality Of Life ◽  
Heart Failure ◽  
Exercise Training ◽  
Exercise Capacity ◽  
Positive Impact ◽  
Pharmacologic Therapy ◽  
The Past ◽  
Diagnosis And Prognosis ◽  
Future Therapy

Heart failure (HF) affects more than 5 million people and has an increasing incidence and cost burden. Patients note symptoms of dyspnea and fatigue that result in a decreased quality of life, which has not drastically improved over the past decades despite advances in therapies. The assessment of exercise capacity can provide information regarding patient diagnosis and prognosis, while doubling as a potential future therapy. clinically, there is acceptance that exercise is safe in hf and can have a positive impact on morbidity and quality of life, although evidence for improvement in mortality is still lacking. specific prescriptions for exercise training have not been developed because many variables and confounding factors have prevented research trials from demonstrating an ideal regimen. Physicians are becoming more aware of the indices and goals for hf patients in exercise testing and therapy to provide comprehensive cardiac care. it is further postulated that a combination of exercise training and pharmacologic therapy may eventually provide the most benefits to those suffering from hf.

Why Is Safe Science Good Science?

2018 ◽  
Author(s):  
Camilla Kao ◽  
Che-I Kao ◽  
Russell Furr
Keyword(s):  
Decision Making ◽  
Design Thinking ◽  
Good Science ◽  
Safety Issues ◽  
Safety Requirements ◽  
The Arts ◽  
Hands On ◽  
Obvious Benefit ◽  
New Ideas

In science, safety can seem unfashionable. Satisfying safety requirements can slow the pace of research, make it cumbersome, or cost significant amounts of money. The logic of rules can seem unclear. Compliance can feel like a negative incentive. So besides the obvious benefit that safety keeps one safe, why do some scientists preach "safe science is good science"? Understanding the principles that underlie this maxim might help to create a strong positive incentive to incorporate safety into the pursuit of groundbreaking science.<div><br></div><div>This essay explains how safety can enhance the quality of an experiment and promote innovation in one's research. Being safe induces a researcher to have <b>greater control</b> over an experiment, which reduces the <b>uncertainty</b> that characterizes the experiment. Less uncertainty increases both <b>safety</b> and the <b>quality</b> of the experiment, the latter including <b>statistical quality</b> (reproducibility, sensitivity, etc.) and <b>countless other properties</b> (yield, purity, cost, etc.). Like prototyping in design thinking and working under the constraint of creative limitation in the arts, <b>considering safety issues</b> is a hands-on activity that involves <b>decision-making</b>. Making decisions leads to new ideas, which spawns <b>innovation</b>.</div>

scholarly journals One Song, Many Voices: Dementia and The Power of Music

2020 ◽  
Vol 4 (Supplement_1) ◽  
pp. 775-775
Author(s):  
Debra Sheets ◽  
Stuart MacDonald ◽  
Andre Smith
Keyword(s):  
High School Students ◽  
Social Inclusion ◽  
Positive Impact ◽  
Social Connections ◽  
Social Connection ◽  
School Students ◽  
Choral Singing ◽  
Novel Approach ◽  
Care Partners

Abstract Choral singing is a novel approach to reduce dementia stigma and social isolation while offering participants a sense of purpose, joy and social connection. The pervasiveness of stigma surrounding dementia remains one of the biggest barriers to living life with dignity following a diagnosis (Alzheimer Society of Canada, 2018). This paper examines how a social inclusion model of dementia care involving an intergenerational choir for people living with dementia, their care partners and high school students can reduce stigma and foster social connections. Multiple methodologies are used to investigate the effects of choir participation on cognition, stress levels, social connections, stigma, and quality of life. Results demonstrate the positive impact of choir participation and indicate that this socially inclusive intervention offers an effective, non-pharmacological alternative for older adults living with dementia in the community. Discussion focuses on the importance of instituting meaningful and engaging dementia-friendly activities at the community level.

scholarly journals Healthcare Provider Perspectives on Bipolar I Disorder Screening and the Rapid Mood Screener (RMS), a Pragmatic, New Tool

CNS Spectrums ◽  
2021 ◽  
Vol 26 (2) ◽  
pp. 181-183
Author(s):  
Michael E. Thase ◽  
Stephen M. Stahl ◽  
Roger S. McIntyre ◽  
Tina Matthews-Hayes ◽  
Mehul Patel ◽  
...  
Keyword(s):  
Depressive Symptoms ◽  
Nurse Practitioners ◽  
Primary Care Physicians ◽  
Screening Tool ◽  
Positive Impact ◽  
Screening Tools ◽  
Predictive Values ◽  
Bipolar I Disorder ◽  
Provider Perspectives ◽  
Patient Reported

AbstractIntroductionAlthough mania is the hallmark symptom of bipolar I disorder (BD-I), most patients initially present for treatment with depressive symptoms. Misdiagnosis of BD-I as major depressive disorder (MDD) is common, potentially resulting in poor outcomes and inappropriate antidepressant monotherapy treatment. Screening patients with depressive symptoms is a practical strategy to help healthcare providers (HCPs) identify when additional assessment for BD-I is warranted. The new 6-item Rapid Mood Screener (RMS) is a pragmatic patient-reported BD-I screening tool that relies on easily understood terminology to screen for manic symptoms and other BD-I features in <2 minutes. The RMS was validated in an observational study in patients with clinically confirmed BD-I (n=67) or MDD (n=72). When 4 or more items were endorsed (“yes”), the sensitivity of the RMS for identifying patients with BP-I was 0.88 and specificity was 0.80; positive and negative predictive values were 0.80 and 0.88, respectively. To more thoroughly understand screening tool use among HCPs, a 10-minute survey was conducted.MethodsA nationwide sample of HCPs (N=200) was selected using multiple HCP panels; HCPs were asked to describe their opinions/current use of screening tools, assess the RMS, and evaluate the RMS versus the widely recognized Mood Disorder Questionnaire (MDQ). Results were reported by grouped specialties (primary care physicians, general nurse practitioners [NPs]/physician assistants [PAs], psychiatrists, and psychiatric NPs/PAs). Included HCPs were in practice <30 years, spent at least 75% of their time in clinical practice, saw at least 10 patients with depression per month, and diagnosed MDD or BD in at least 1 patient per month. Findings were reported using descriptive statistics; statistical significance was reported at the 95% confidence interval.ResultsAmong HCPs, 82% used a tool to screen for MDD, while 32% used a tool for BD. Screening tool attributes considered to be of the greatest value included sensitivity (68%), easy to answer questions (66%), specificity (65%), confidence in results (64%), and practicality (62%). Of HCPs familiar with screening tools, 70% thought the RMS was at least somewhat better than other screening tools. Most HCPs were aware of the MDQ (85%), but only 29% reported current use. Most HCPs (81%) preferred the RMS to the MDQ, and the RMS significantly outperformed the MDQ across valued attributes; 76% reported that they were likely to use the RMS to screen new patients with depressive symptoms. A total of 84% said the RMS would have a positive impact on their practice, with 46% saying they would screen more patients for bipolar disorder.DiscussionThe RMS was viewed positively by HCPs who participated in a brief survey. A large percentage of respondents preferred the RMS over the MDQ and indicated that they would use it in their practice. Collectively, responses indicated that the RMS is likely to have a positive impact on screening behavior.FundingAbbVie Inc.

scholarly journals Engaging community pharmacists in quality improvement (QI): a qualitative case study of a partnership between a Higher Education Institute and Local Pharmaceutical Committees

2021 ◽  
Vol 10 (1) ◽  
pp. e001047
Author(s):  
Asam Latif ◽  
Nargis Gulzar ◽  
Fiona Lowe ◽  
Theo Ansong ◽  
Sejal Gohil
Keyword(s):  
Quality Improvement ◽  
Focus Groups ◽  
Qualitative Methodology ◽  
Positive Impact ◽  
Community Pharmacists ◽  
Educational Institute ◽  
Collaboration And Communication ◽  
Improve Service Quality ◽  
The Impact

BackgroundQuality improvement (QI) involves the use of systematic tools and methods to improve the quality of care and outcomes for patients. However, awareness and application of QI among healthcare professionals is poor and new strategies are needed to engage them in this area.ObjectivesThis study describes an innovative collaboration between one Higher Educational Institute (HEI) and Local Pharmaceutical Committees (LPCs) to develop a postgraduate QI module aimed to upskill community pharmacists in QI methods. The study explores pharmacist engagement with the learning and investigates the impact on their practice.MethodsDetails of the HEI–LPCs collaboration and communication with pharmacist were recorded. Focus groups were held with community pharmacists who enrolled onto the module to explore their motivation for undertaking the learning, how their knowledge of QI had changed and how they applied this learning in practice. A constructivist qualitative methodology was used to analyse the data.ResultsThe study found that a HEI–LPC partnership was feasible in developing and delivering the QI module. Fifteen pharmacists enrolled and following its completion, eight took part in one of two focus groups. Pharmacists reported a desire to extend and acquire new skills. The HEI–LPC partnership signalled a vote of confidence that gave pharmacists reassurance to sign up for the training. Some found returning to academia challenging and reported a lack of time and organisational support. Despite this, pharmacists demonstrated an enhanced understanding of QI, were more analytical in their day-to-day problem-solving and viewed the learning as having a positive impact on their team’s organisational culture with potential to improve service quality for patients.ConclusionsWith the increased adoption of new pharmacist’s roles and recent changes to governance associated with the COVID-19 pandemic, a HEI–LPC collaborative approach could upskill pharmacists and help them acquire skills to accommodate new working practices.

scholarly journals Benefits of EPAs at risk? The influence of the workplace environment on the uptake of EPAs in EPA-based curricula

2021 ◽  
Author(s):  
Karsten Arthur van Loon ◽  
Linda Helena Anna Bonnie ◽  
Nynke van Dijk ◽  
Fedde Scheele
Keyword(s):  
At Risk ◽  
Postgraduate Medical Education ◽  
Training Programme ◽  
Workplace Environment ◽  
Medical Specialists ◽  
Professional Activities ◽  
National Training ◽  
Local Medical Care

Abstract Introduction Entrustable Professional Activities (EPAs) have been applied differently in many postgraduate medical education (PGME) programmes, but the reasons for and the consequences of this variation are not well known. Our objective was to investigate how the uptake of EPAs is influenced by the workplace environment and to what extent the benefits of working with EPAs are at risk when the uptake of EPAs is influenced. This knowledge can be used by curriculum developers who intend to apply EPAs in their curricula. Method For this qualitative study, we selected four PGME programmes: General Practice, Clinical Geriatrics, Obstetrics & Gynaecology, and Radiology & Nuclear Medicine. A document analysis was performed on the national training plans, supported by the AMEE Guide for developing EPA-based curricula and relevant EPA-based literature. Interviews were undertaken with medical specialists who had specific involvement in the development of the curricula. Content analysis was employed and illuminated the possible reasons for variation in the uptake of EPAs. Results An important part of the variation in the uptake of EPAs can be explained by environmental factors, such as patient population, the role of the physician in the health-care system, and the setup of local medical care institutions where the training programme takes place. The variation in uptake of EPAs is specifically reflected in the number and breadth of the EPAs, and in the way the entrustment decision is executed within the PGME programme. Discussion Due to variation in uptake of EPAs, the opportunities for trainees to work independently during the training programme might be challenging. EPAs can be implemented in the curriculum of PGME programmes in a meaningful way, but only if the quality of an EPA is assessed, future users are involved in the development, and the key feature of EPAs (the entrustment decision) is retained.

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