Improving recording and reporting of dementia and frailty via electronic patient record by ambulance staff in a single service (IDEAS)

Background: Dementia is common in older adults assessed by ambulance services. However, inconsistent reporting via the patient record may result in this diagnosis being overlooked by healthcare staff further down the care pathway. This can have a deleterious effect on subsequent patient care, increasing morbidity and mortality. We sought to understand how and where ambulance staff would like to record this finding on the electronic patient record (ePR).Methods: We designed and implemented a survey of ambulance staff in a single service to understand how they identify patients with dementia, how they record dementia on the ePR and how the ePR could be improved to better capture dementia. Scoping questions on frailty were included. The survey was tested using cognitive interviewing. Analysis was conducted using descriptive statistics for closed questions and thematic analysis for open questions as appropriate.Results: 131 surveys were completed; 60% of participants were paramedics and 40% were other grades of front line staff. Participants reported consulting electronic/paper sources, and individuals such as carers involved in the patients’ care, to establish whether dementia had been diagnosed. Frailty assessments were prompted by social context, reduced mobility, a fall or diagnosis of dementia. Staff reported documenting dementia in 20 different areas on the ePR and 46% of participants stated a preference for a designated area to record the information. However, 15% indicated it was not necessary to record dementia or that no ePR changes were required.Conclusions: We have highlighted the variation in ambulance staff practice in recording of dementia. Alterations to the ePR are required to ensure that dementia is recorded consistently and is easily retrievable. Clearer guidance on when to assess frailty may also enhance information provision to care staff in other sectors, resulting in more appropriate clinical and social care.

Collecting for New Zealand: Examining What the Museum of New Zealand Te Papa Tongarewa Should Collect

<p>Collecting for New Zealand explores two interconnected questions: how do history curators at the Museum of New Zealand Te Papa Tongarewa decide what to collect; and what do those curators and members of the public think Te Papa should collect. Te Papa’s status as a national museum is important to the context within which decisions are made and opinions formed about collecting. By detailing the actual acquisition process and including the views of museum users, this research makes an important contribution to the literature on museum collecting. This study draws on multiple sources of data to examine history collecting at Te Papa. Face-to-face interviews were conducted with current curatorial staff and focus group discussions were held with members of the public. Current and previous policy documents that influence collecting at Te Papa were also reviewed. These sources combine to develop a picture of collecting at Te Papa which encompasses both specific details of staff practice and a further understanding of what qualities people seek in museum collection items. This thesis provides vital details on the practice and implications of collecting using location, in this case New Zealand, as a selection guide. In examining how staff decide what to collect, concerns expressed in the existing literature about the power of individuals to shape what is acquired are also addressed. The extent to which the views of the general public and those of museum staff are shared is revealed. In developing a fuller understanding of what people think Te Papa should collect, this research contributes to the debate about how to collect in ways that are sustainable. Collecting for New Zealand concludes by reflecting on the importance of audience to Te Papa’s ongoing collecting activity.</p>

Collecting for New Zealand: Examining What the Museum of New Zealand Te Papa Tongarewa Should Collect

<p>Collecting for New Zealand explores two interconnected questions: how do history curators at the Museum of New Zealand Te Papa Tongarewa decide what to collect; and what do those curators and members of the public think Te Papa should collect. Te Papa’s status as a national museum is important to the context within which decisions are made and opinions formed about collecting. By detailing the actual acquisition process and including the views of museum users, this research makes an important contribution to the literature on museum collecting. This study draws on multiple sources of data to examine history collecting at Te Papa. Face-to-face interviews were conducted with current curatorial staff and focus group discussions were held with members of the public. Current and previous policy documents that influence collecting at Te Papa were also reviewed. These sources combine to develop a picture of collecting at Te Papa which encompasses both specific details of staff practice and a further understanding of what qualities people seek in museum collection items. This thesis provides vital details on the practice and implications of collecting using location, in this case New Zealand, as a selection guide. In examining how staff decide what to collect, concerns expressed in the existing literature about the power of individuals to shape what is acquired are also addressed. The extent to which the views of the general public and those of museum staff are shared is revealed. In developing a fuller understanding of what people think Te Papa should collect, this research contributes to the debate about how to collect in ways that are sustainable. Collecting for New Zealand concludes by reflecting on the importance of audience to Te Papa’s ongoing collecting activity.</p>

Organizational Vs Individual Efforts to Help Manage Stress and Burnout in Healthcare Professionals

Stress and burnout continue to impact the thoughts, behaviors, and careers of healthcare professionals. Solutions will require a multidimensional approach that focuses on both individual and organizational efforts geared to build resilience and help providers better adjust to the pressures of medical practice. Individual efforts can only go so far. Since most of the issues are system related, solutions will require an empathetic pro-active approach form the affiliated organizations in which staff practice to provide effective resources and support to help them succeed. The article outlines a series of suggested strategies designed to help staff better adjust to the pressures of medical practice.

Exploring new ways of thinking about and developing staff practice: the role of modes of thinking

Purpose Nobel Prize winner Daniel Kahneman’s work on modes of “thinking” provides a comprehensive text which is little explored in respect of work with people who have an intellectual or developmental disability. This paper aims to explore the potential of this work to change staff development and practice. Design/methodology/approach Key themes from Thinking Fast, and Slow (Kahneman, 2011) are described and applied to current staff practice. Findings Modes of thinking are relevant and important to understanding and improving manager and staff practice. Originality/value To the best of the authors’ knowledge, this is the first attempt to describe and understand staff thinking and practice using Kahneman’s ideas.

Commentary on “Exploring new ways of thinking about and developing staff practice: the role of modes of thinking”

Purpose The purpose of this paper is to provide a commentary on “Exploring new ways of thinking about and developing staff practice: the role of modes of thinking” written by Roy Deveau, John Ockenden and Petra Bjorne. Design/methodology/approach The commentary considers the consistency of Kahneman’s model of thinking fast and slow with brain research. Findings The thinking styles of staff undoubtedly influence their responses to people with learning disabilities. Although Kahneman’s model provides a heuristic approach to tackling prejudicial and biased thinking, it risks incomplete solutions through bypassing some of the factors contributing to staff behaviour. Originality/value This commentary concludes that Kahneman’s model is not completely consistent with knowledge about how the brain is organized. This should be regarded as a limitation of any model seeking to explain decision-making.

A guide to the NMC emergency standards for nurse education during the current deployment of student nurses

The Nursing and Midwifery Council (NMC) recognises the important contribution that nursing students are making to the national response to the COVID-19 pandemic. This article reports on the Greater Manchester Supervision and Delegation Framework, providing practical guidance for students and practice staff (practice supervisor/practice assessor and registered nurse) on how to support student nurses who have opted into a paid (deployed) healthcare role. The framework operationalises NMC emergency standards for Nursing and Midwifery education, enabling students to complete their pre-registration undergraduate or postgraduate nursing programme while also supporting the healthcare workforce ( NMC, 2020 ).

Criminology placements: work-based learning and organisational “buy in”

PurposeThis study aims to explore the views of criminal justice and allied sector organisations and agencies, of why they provide placements for the Applied Criminology programme at the University of Worcester, UK.Design/methodology/approachThe study took a qualitative approach to tease out the underlying contributory factors that featured in the decision to offer placements. It used semi-structured interviews of key personnel, and thematic analysis was subsequently undertaken on the data collected.FindingsSeveral themes emerged, in particular reciprocal learning, dynamism, employability and social investment. These appeared to be the most impactful on the organisation in relation to the future recruitment of staff as well as the enhancement of current staff practice.Research limitations/implicationsBased upon the scale of the research, the findings may have limited transferability.Practical implicationsThere is a hidden benefit to organisations, which could be capitalised upon as a reciprocal learning process, which enhances practice and therefore outcomes.Social implicationsStereotypes are challenged, resulting in students overcoming preconceived ideas about particular service user groups.Originality/valueWhilst research into work-based learning and the benefits of placements for students is not new, research enquiring as to why organisations are prepared to offer placements remains in its infancy.

Growing our own theatre staff: Practice development and education

Royal Bournemouth & Christchurch Hospitals NHS Foundation Trust engaged in a quality improvement project aimed at improving quality and safety in theatres. The improvements delivered were recruitment to full staffing template, reduction in agency staffing to zero, and creating a theatre coordinator role to ensure safe staffing. The Practice Education Team was increased fivefold with no extra investment as a result of these improvements. Student satisfaction results amongst ODPs and nurses have increased alongside staff morale and productivity.