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Introduction: This multi-professional programme was developed by the stroke team at Chelsea and Westminster Hospital (CWH) to support stroke survivors post discharge into the community. Approximately one third of patients have significant impairments post stroke;physical, cognitive, visual, or speech/language related. Most patients and carers suffer a period of adjustment post discharge. The psychological aspect of stroke can have a huge impact beyond the inpatient setting. Method(s): The programme aims to: - Provide a platform where patients and relatives can meet the stroke team, giving them opportunity to become more informed of their own experience and highlight on-going needs. - Strengthen alliances with community and voluntary services. - Empower patients to seek self-management strategies to monitor and progress their long-term condition. - Sign-post stroke survivors to community stroke help groups and charities. - Increase high quality rehabilitation in-line with the NHS Longterm Plan. - Build a network of stroke survivors that support each other during their recovery. Result(s): The programme was planned face-to-face yet due to the Covid Pandemic, our first session ran virtually on 20/09/21, followed by 4 sessions every 2 months. Further sessions will hopefully be face-to-face. Conclusion(s): Feedback from stroke survivor attendees has been extremely positive (100% recommend it). We presented our innovative programme at a Dragon's Den style Trust event in November 2021. Feedback was very complimentary and we were privileged enough to receive a 10,000 Grant funded by NHS England and CWH Charity. This Grant will go towards development of the programme, support our stroke unit and nurse training.
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Cancer has become one of the major causes of death in the growing world population, affecting people irrespective of their age, sex and culture. Cancer diagnosis and therapy is a distressing procedure and affects the physical, emotional and mental well-being of the patient. Many studies have reported that cancer has a long-term impact on patient's lives leading to mood dysfunction, heart problems and chemotherapy toxicity. Modern-day healthcare systems are moving towards a patient-oriented approach and are designed around the patient's well-being, needs and preferences. Oncology nurses form the fundamental part of this system and provide the patient with the much-needed care, support and hope for life. Oncology nursing has developed and evolved briefly in the recent few decades due to the advancement in treatment procedures. As cancer care continues to progress, nurses play a vital role in the field of oncology. Specialized oncology nurses are providing clinical care, or as nurse researchers leading revolutionary oncology research. The future of oncology nursing is optimistic. Nursing care for cancer patients not only requires guidance through medication and treatment, but also offers encouragement and motivation to the patients. The present review provides an insight into the nursing care of cancer patients, its brief history, advancements and the current practices of oncology nursing. Future prospects of oncology nursing have also been discussed in detail.Copyright © 2022, Kuwait Medical Association. All rights reserved.
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Aims To look at the individual experiences amongst paediatricians in DGH (District General Hospitals) with regards to the management of PIMS-TS (Paediatric Multisystem Inflammatory syndrome) over the last 2 years Methods A survey was sent to paediatricians via a survey link. The survey asked for multiple questions regarding the respondents' individual experiences in the management of children presenting with PIMS TS. Results 38 completed responses were obtained and analysed. Among the 38 respondents, each had seen between 2-20 patients with PIMS-TS over the last 2 years. 40% of the cases were predominantly cardiovascular, 30% were gastrointestinal and 30% were mixed. 50% of the respondents said that <25% of their patients were transferred to PICU, 22% said around 50% of patients were transferred, 18% said 90% of their patients were transferred and 10% of the respondents said 100% of their patients were transferred to PICU. 66% of respondents had no problems getting a PICU bed or retrieval services however 33% of the respondents agreed to some difficulties. 92% of the time patients were discussed with the infectious diseases (ID) team and 8% of the time this wasn't discussed with the ID team. 17% of the respondents used steroids in all their patients whereas the rest used in varying numbers. 40% of the respondents said they used IVIG in 75% of their patients whereas the rest used it in varying numbers. Inotropes were used in 25% of the patients whilst in DGH, on average 25% of the patients needed peripheral noradrenaline and no complications were reported. Comfort levels in the management of PIMS TS were in the moderate range amongst paediatricians in DGH. Around 60% of the patients had echocardiography within 48 hours of presentation. Some of the other difficulties encountered were nursing training in regards to administering noradrenaline, interpreting cardiac biomarkers, follow-up arrangements, and education. Conclusion PIMS TS is still a new clinical entity and often these patients present to District general hospitals in varying circumstances of clinical instability. Some of these patients need PICU transfer which can be challenging at times. Around 25% of these patients need inotropes predominantly noradrenaline with no reported complications. There are still wide variations in the management of these patients, and further education and clear guidelines would be helpful to ensure the management of these complex children is done safely & effectively.
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Introduction In recent years, endoscopy services throughout NHS Scotland were under substantial strain due to supply/ demand mismatch: these pressures were significantly exacerbated by the COVID-19 pandemic, which saw cessation of all routine and surveillance endoscopies. Cytosponge is a nonendoscopic diagnostic tool demonstrating good specificity and sensitivity for detection of Barrett's oesophagus and dysplasia in the trial setting. Cytosponge was introduced as a triage tool in a real world pilot across NHS Scotland in 2020 under closely audited conditions in response to the COVID-19 pandemic. This presents the initial results of this audit. Methods A national Cytosponge group was formed with representatives from all Scottish health boards and the Scottish government. The two indications for Cytosponge were: Barrett's oesophagus surveillance patients;and new referrals with reflux-predominant symptoms. Cytosponge was introduced in the secondary care setting following appropriate nurse training, with data collected from September 2020 to January 2022. Indications and cytology codes were obtained from Cyted Labs. Results During the study period, Cyted Labs received 3180 specimens from NHS Scotland;3020 of these were formally reported. Indication for Cytosponge was Barrett's surveillance in 2271 samples (75.2%) and reflux symptoms in 749 samples (24.8%). Within the Barrett's oesophagus cohort, 143 samples (6.3%) did not provide adequate cells for analysis. of the remaining 2128 patients, 246 samples (11.6%) demonstrated cellular atypia or aberrant p53 expression and 1425 samples (67.0%) showed simple Barrett's oesophagus. of interest, 457 samples (21.5%) in the Barrett's surveillance group did not demonstrate intestinal metaplasia. Full results for patients with reflux-predominant symptoms were available in 679 samples;70 samples (9.3%) did not yield adequate cells for cytology. Intestinal metaplasia was identified in 83 samples (12.2%), with an additional 23 specimens (3.4%) demonstrating atypia or aberrant p53 expression. Conclusions Cytosponge is a useful diagnostic tool to demonstrate pathology in cohorts of patients unable to access endoscopy during the COVID-19 pandemic due to service pressures. Our initial results give an indication of endoscopy resources required to support Cytosponge;with only 11.6% of Barrett's oesophagus surveillance patients and 15.6% of reflux patients requiring endoscopy to exclude adenocarcinoma or precursor lesions. This significantly reduces the burden on endoscopy services. The study does not describe patients undergoing endoscopy for reflux with other pathologies. However, early results suggest that Cytosponge, combined with nurse-led clinical assessment, is beneficial in these patient pathways.
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Introduction Bowel cancer screening age extension, 'faster diagnosis' and COVID-related backlog all increase demand on endoscopy services. A competent workforce is central to endoscopy delivery but service pressure, lack of dedicated training time, and poor/unrefined trainer skills may be barriers to effective staff training. Immersive training programmes have improved nurse training in other settings1 and achieved success in the training of endoscopists.2 We, therefore, instituted a novel 4-week immersive nurse training programme for new starters to prepare workforce members for tasks in diagnostic luminal endoscopy. Methods Newly appointed registered nurses in Endoscopy commenced a dedicated, ring-fenced 4-week hybrid programme of didactic and supported practical teaching for 3 days per week. Trainees completed pre-training, midpoint, end of training and post-training online questionnaires utilising Likert scales where appropriate. Recorded feedback included indicators on trainee knowledge of endoscopy, confidence, and anxiety level on caring for patients in admission, procedure room, recovery, and discharge. Results Due to staggered commencement dates, preceding time in endoscopy varied (62% no exposure, 38% some exposure in preceding 6 months). Pre-course 62.2% and 66.7% of responses showed low confidence levels in undertaking the tasks of admitting, room preparation, endoscopy assistant roles, recovery and discharge of gastroscopy and colonoscopy patients respectively. In contrast at completion 74.3% and 75.6% of responses showed confidence or high confidence in these competencies. Further data at 6 months post training noted confidence to be sustained with 98.5% of responses describing no anxiety undertaking above tasks and 1.5% minor anxiety. Additionally 60% of trainees felt able train others and all had commenced GI bleed on-call work. Conclusions Rapid and agile re-skilling of the workforce to meet staff learning needs and importantly patient safety outcomes is heralded by HEE in other nurse groups. Our pilot results indicate immersive training meets the learning needs of Endoscopy nurses and correlates with confidence in job roles. Further work will correlate JAG workforce competencies and look at implementation to a wider, multi-site training group.
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Background: Since 2019, we have experienced a terrible pandemic, COVID-19. Emerging countries, like Brazil, with logistical difficulties and lack of public policies, face a generalized collapse in health system. Rare Diseases Reference Centers are located distant from patients' houses. Thus, patients with lysosomal diseases, unable to travel and need to receive their recombinant enzyme replacement therapy (ERT) close to their homes. Infusion-related reactions (IRR) are uncommon;however, they can impair the treatment. Therefore, due to the impossibility of locomotion and unavailability of teams of allergists, RDD protocol were accomplished. The study aimed to describe remote points of training and protocols execution. Method: After appointments from treating lysosomal centers (TLC) diseases about adverse reactions, the following strategy was adopted: three online meetings between metabolic team and allergists to present the clinical case;lectures about adverse reactions to medications and RDD: video demonstrations off how to perform skin tests and nursing training for the use of. Two meetings were held with the families, terms of consent were applied, and a communication group was created on WhatsApp® with team leaders. Afterwards, the RDD was formulated and applied remotely, by Google Meet®. Finally, three infusions were followed up under the supervision of our center. Results:: Six patients presented immediate IRR to different recombinant enzymes: three patients with Fabry disease, one with MPS I, one with MPS II and one with MPS IV. The Allergy Center located in São Paulo, was composed of a team of allergology and health professionals with expertise in inborn errors of metabolism. The (TLC) were in the interior of São Paulo, Bahia, Pernambuco and Piauí, 300 to 1,800 miles apart. The protocols were carried out respecting the Standard 12-16 steps according to risk stratification. One of the patients, developed urticaria on the 11th step, despite the addition of premedication. Conclusion: The new Coronavirus' pandemic imposed a new reality, which include much more telecommunication. Barriers have been overcome, such as offering remote alternatives to the treatment of incurable diseases in countries with continental dimensions.
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This article describes nurse education with the Open University in Scotland (OUiS). Although there are problems with nurse recruitment and retention across the UK, in Scotland the landscape is somewhat different, with greater support for students required in remote and rural areas. Despite these challenges, the OUiS continues to recruit to the commissioned numbers of places. OUiS nursing students are primarily health care support workers who are a key group within the health and social care workforce but historically have faced many challenges in developing clear career pathways into nursing. At the heart of the OU is the fundamental recognition of distance online pedagogy, complemented by work-based learning support by employers. Partnership working between the OU, employers and education commissioners is crucial to its success.
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Education, Nursing , Universities , Education, Nursing/trends , Forecasting , Humans , ScotlandABSTRACT
Objective:To analyze the application of Kirkpatrick's model in the nurse training program among the emergency surgery department based on clinical demand during the COVID-19 (coronavirus disease-2019). To provide reference for the training of emergency surgical nurses during the outbreak of COVID-19.Design:Guided by Kirkpatrick's model, 35 nurses in the emergency surgery department were trained according to a program that resulted from the clinical demand during the pandemic. The trainees were observed in terms of their performance at reaction level and learning level.Results:At reaction level, the degree of satisfaction scored by nurses was relatively high, with its total score achieving (18.77 ± 3.09). At learning level, the differences between theoretical and operational scores of tested nurses before and after training proved to be statistically significant (p < 0.001).Conclusion:The application of Kirkpatrick's model based on clinical demand during the COVID-19 confirms to be effective for the training program of nurses in the emergency surgery department. It is also beneficial to improve nurses' knowledge and skills during the pandemic, which serves as a positive influence for clinical reference.