An evaluation of eye movement desensitization and reprocessing therapy delivered remotely during the Covid–19 pandemic

Background In addition to having a negative impact on the physical and emotional health of the population, the global Covid–19 pandemic has necessitated psychotherapists moving their practice to online environments. This service evaluation examines the efficacy of Eye Movement Desensitization and Reprocessing (EMDR) Therapy delivered via the internet. Methods A real–world service evaluation was conducted from a self–selecting group of EMDR therapists that subscribe to either a JISCMail discussion list or either the UK or All Ireland National EMDR Associations. Author designed questionnaires were used to gather information on the efficacy of EMDR delivered online as well as client and therapist characteristics. Results Thirty-three therapists provided efficacy data on a total of 93 patients. Statistically significant and clinically meaningful reductions were found in all four-psychometrics used both in adult and children and young people populations. Client outcome was not related to therapist experience. Conclusions EMDR delivered via the internet can be an effective treatment for clients experiencing mental health issues.

Experiences and attitudes of registered nurses towards the implementation of quality improvement programmes at a government hospital in Eswatini

Quality improvement is becoming the cornerstone of effective and efficient delivery of quality healthcare services in recent times. Among other healthcare workers, nurses are the primary implementers of quality improvement programmes (QIPs). Their knowledge, understanding, attitudes and motivation determine the potential effects of the programmes. This study explored the experiences of registered nurses (RNs) towards the implementation of the QIP at a government hospital in Swaziland. The RNs’ attitudes toward the programme were also explored. Non-probability, purposive sampling was used to select the sample that comprised of eight RNs. Data were collected through in-depth, face-to-face interviews to explore and describe the RNs’ experiences and attitudes regarding the implementation of QIPs. A semi-structured interview guide was used to ask questions until data saturation was reached. Data analysis was conducted following Tesch’s method. Ethical considerations were adhered to. The results revealed both negative and positive experiences of the RNs towards QIPs. A negative attitude towards the programme developed due to the manner in which the programmes were introduced to the RNs and their perception of the programme as work overload. However, there was a positive outlook by the RNs towards the programme after they had undergone training on a QIP. The training improved their knowledge, job satisfaction and client outcome. They developed motivation, interest and commitment despite the challenges they encountered. The programme also enhanced the spirit of teamwork among the RNs and the support staff.

Clinical competencies of physical therapy interns in patients’ management skills

Introduction: Graduates of physiotherapy educational and training programs should be expected to work as a competent clinician. Studies carried out in different parts of the world show contradicting results. This study was designed to evaluate the competencies of physical therapy interns in patients' management skills. Material & Methods: A cross-sectional study was carried out from July, 2019 to December, 2019 on fifty two physical therapy interns who were working in different clinical settings. The sampling technique used for this survey was purposive sampling. Twenty clinical physical therapists assessed competencies of these interns using the modified version of Clinical Internship Evaluation Tool. SPSS version 20 was used for data analysis. Results: Clinical physiotherapists who assessed the competencies of the physiotherapy interns stated that the profeciency of all (n = 52, 100) participants in relation to patients management skills was satisfactory for their current educational level. Thirteen (25%) of the respondents had thinking that examination is an area of concern and more than a half (53.8%, n=28) mentioned that examination is an area of strength and 21.2% (n=11) of them gave no response about examination. Questions related to examination revealed that majority (n=45, 86.5%) respondents think that they obtain accurate history. Similarly, majority (n=47, 90.4%) of participants responded that they determine diagnosis for physical therapy management of the patients. On a scale from 0 to 10, the interns were compared to a competent clinician who is able to skillfully manage patients in an efficient manner to achieve effective patient/client outcome. About 44.2% (n=23) of the respondents gave 4 out of 10 rating, 51.9% (n=27) of them gave 5 number and 3.8 (n=2) of them were awarded 6/10 number of clinical competences. Conclusion: We concluded from the study that almost all the physical therapy interns were competent in regards to in-patients management skills.

KNOWLEDGE AND PRACTICE ON IV CANNULATION AMONG NURSES

ABSTRACT Background: PIVC (Peripherally Intravenous Cannulation) is common invasive procedure in all hospital settings and nurses had a vital role in performing PIVC. It is the only fastest way to deliver any medications to the body. For fruitful insertion of cannulation the trainers should have proper knowledge and practical skills to succeed this procedure with minimum complication and positive client outcome with treatment. The objective was to determine the level of knowledge and practice on IV cannulation and its association with selected demographic and clinical variables. Materials and methods: By using convenience sampling technique 54 participants were recruited based on inclusion criteria. The study was conducted in St. John’s Hospital, Idukki. After gaining informed consent, data was collected by using self-structured questionnaire consisting demographic and clinical characteristics, questions regarding knowledge on IV cannulation and observational checklist for identifying practical skills in IV procedure. Results: Data was statistically analysed using SPSS version 20. Samples of 33(68.8%) had average and 10 (20.8%) had poor knowledge on IVC. Regarding practical performance, 27(56.3%) had average, 16 (33.3%) had good skills in IVC. Whereas 5(10.4%) had very poor practical skills on IVC. This study concluded that knowledge and practical skills in IVC should be improved by attending induction classes which can promote standardised care. Key words: Intravenous cannulation, knowledge, practice, staff nurses.

A Global Measure of Patient-reported Outcomes After Injury – Life Back on Track

Background The study assessed the psychometric properties of the Life Back on Track (LBoT) measure, a new self-reported single-item global measure of the trajectory of wellbeing after a transport accident. Methods The data come from four waves of the Transport Accident Commission Longitudinal Study (n=1,556 in wave 1), and two repeated cross-sectional surveys– a Client Outcome Survey (n=5,238) and a Client Experience Survey (n=1,964) of individuals injured in a transport accident in Victoria. The conceptual basis of the measure was confirmed in a qualitative analysis of open-ended survey responses. The psychometric performance of the measure, including known-groups validity, test-retest reliability, sensitivity, and responsiveness was investigated. Results The LBoT measure was found to have a conceptual basis of recovery towards a normal life with domains of independence, control, happiness, work, social life, pain, physical function, cognitive function, work and leisure activities, income, anxiety, and depression. There were significant differences in the distribution of the LBoT scores based on the respondent’s depression, pain, return to work status, financial ability to get by, ability to cope, and ability to bounce back. The LBoT measure was a reasonable predictor of future work status and was moderately responsive to change. Conclusions LBoT is a valid measure to track the individual’s trajectory of subjective wellbeing in the context of recovery after a trauma, and it covers wider concepts than health-related quality of life. For use as a performance or tracking measure, however, further evidence is needed on its responsiveness.

Piloting the Adult Protective Services’ Identification, Services, and Outcomes Matrix: Focus Group Findings

The historical lack of outcomes-related data in Adult Protective Services (APS) has affected funding coming to the program. Without data quantifying the effectiveness of APS services, policymakers have been unable to justify budget increases to improve wages for workers or professionalize the field. For the first time in APS history, the U.S. Administration for Community Living sponsored a pilot project to implement a novel evidence-based assessment tool into APS electronic systems, called the Identification, Services, and Outcomes (ISO) Matrix. The goal was to improve APS’ ability to reduce harm of abuse and neglect and maintain client’s independence to live in the community. APS workers in San Francisco and Napa Counties were trained and phased into using the ISO Matrix over a six-month implementation period. This poster presents findings from six focus groups conducted between February 13 and March 28, 2019, with 34 San Francisco and Napa County APS workers and supervisors. Utilizing semi-structured, in-depth interviewing techniques, APS workers and supervisors expressed their views and experiences. Facilitators and barriers of implementing the ISO Matrix were assessed and opportunities for improvements were identified. Findings revealed a tension between their hopefulness that the ISO Matrix could modernize APS data-tracking and yield evidence of improved client outcome to bolster the field, and their frustrations about new burdens the ISO Matrix placed on their labor and workflow. Understanding frontline perspectives of APS workers and supervisors has practical and policy implications for adopting the ISO Matrix in other counties and states across the U.S.