Changing operating lists on the day of surgery: a service evaluation.

This study aims to explore how often the operating list is changed on the day of surgery and the reasons why this may occur. The purpose was to analyse the wider potential impact that changing the list on the day of surgery may have on patient safety, patient satisfaction and theatre efficiency. Survey data was collected across a multi-specialty elective operating department. The findings demonstrated that a significant change in operating lists occurred in 37.3% of sessions, for a variety of potentially avoidable reasons. We concluded that improved organisation and communication before the planned session could reduce the occurrence of changes, thereby increasing patient safety, theatre efficiency and potentially reducing incidents.

Managing type 2 diabetes: new policy and interventions.

This paper presents a critical discussion of the recent developments in diabetes services and concurrent patient care, which have a significant impact on the way that community nurses provide care to people with diabetes. The current prevalence and rising incidence of type 2 diabetes is discussed, mentioning how this trend will impact on community nursing practice. New interventions and management guidelines are presented and discussed, with a focus on patient-centred care as the main driver for these changes. New pharmacological interventions (Byetta) and biochemical outcome measures are discussed which will have an impact on patient care, delivered by nurses working in the community.

Clinical networks for nursing research.

As a central feature of national research and development strategies, clinical effectiveness emphasizes the importance of rigorous experimental research in nursing. It is naïve to assume that over-worked practitioners, with little research training and supervision, can undertake this type of research. Traditional approaches to research support rely on the practitioner registering for a higher degree and academic supervision. This assumes that the responsibility for research lies with practice, with higher education adopting a reactive stance in supporting research and development in nursing. The literature demonstrates a growing number of innovative models for facilitating nursing research. These, however, tend to focus on single appointments with limited and predefined access to clinical areas and patient populations. This article details a new initiative from the Clinical Nursing Practice Research Unit (CNPRU) that aims to support programmatic research in nursing practice through Clinical Networks for Nursing Research. Our research strategy is to contribute to the development of nursing science by facilitating effective collaboration between clinicians and higher education in core clinical specialties, including stroke rehabilitation, diabetes, mental health and community nursing. Each researcher has developed networks with a number of clinical areas, locally, regionally or nationally, through seminars, conferences or newsletters, to link practitioners and generate answerable research questions. Network communications also rely heavily on the establishment of interactive websites. This strategy has resulted in a number of collaborative, evaluative studies including clinical trials in rehabilitation, diabetic nursing and primary care.

Forced externalization of control in people with diabetes: a qualitative exploratory study.

AIM: The purpose of this study was to explore and describe the patients' perceptions of the Diabetic Disease State and its complications using an ethnographic method. BACKGROUND: Diabetes mellitus is an extensively researched and studied disease, however, relatively little attention has been given to the lived experience of chronic illness. METHODS: A purposive sample of 18 people with diabetes was derived from a diabetes register database. Data were collected by semistructured interviews, which were tape-recorded and transcribed. The transcripts were analysed together with the researchers' observational notes, using open coding procedures to identify main categories. Discussion of the results is made in the theoretical context of the locus of control (LOC) framework. FINDINGS: Three main categories emerged from the data: information-knowledge of illness; the psychological burden of diabetes; rationalizing. A further subcategory, reality avoidance, was identified. The findings showed that these people with diabetes experience and describe complex psychological effects and coping mechanisms in having a chronic illness. CONCLUSIONS: The findings also suggested that participants in this study might have felt that the control of their chronic condition had been externalized to the health care professionals responsible for their care.