Trauma-Informed Care: Essential Elements for Pediatric Health Care.

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Catheter-associated urinary tract infection: signs, diagnosis, prevention.

Catheter-associated urinary tract infection (CAUTI) is one of the most prevalent healthcare-associated infections (HAIs) in the UK and can have implications for both the patient and the health service. This article highlights those at risk, the signs and symptoms of CAUTI, diagnosis, methods of prevention and treatment. It highlights current guidance available to nurses to help ensure they are following the most recent recommendations for best practice.

Selecting an intermittent self-catheter: key considerations.

This article explores the factors that must be considered when assessing patients for intermittent self-catherisation (ISC). It discusses the various types of intermittent catheters and their properties. Key considerations for the health professional when making product recommendations are covered and emphasis is placed on teaching patients the ISC technique. The article also highlights what patients value in terms of product choice and the importance of ongoing support. It concludes by introducing the GentleCath Glide, a new product that incorporates FeelClean™ technology, which leaves less residue on the hands and clothes.

Lower urinary tract infections in women.

In her lifetime, a woman is highly likely to develop at least one lower urinary tract infection. Early detection and treatment are key. Being aware of predisposing factors for infection and understanding appropriate diagnosis and treatment regimens will help nurses in both primary and acute care manage these patients correctly. This will not only benefit patients but will also help prevent incorrect antimicrobial management and avoid unplanned admissions. This aim of this article is to provide nurses with the information they need to best advise both colleagues and patients on how to manage lower urinary tract infections in women.

Developing a research-active clinical environment within the emergency department: a case study.

Historically, nursing research undertaken in the clinical setting has been problematic. Problems included small samples, weak methodology, poorly designed tools, limited analyses, and little dissemination. These issues have made it difficult to apply some of the research within an evidence-based framework. A visiting scholar program was developed to link experienced researchers with clinicians for them to undertake more rigorous nursing research in the clinical setting. An example of the application of the visiting scholar program within an emergency department setting illustrates positive research outcomes for both clinical staff and academic scholars.

The effect of aromatherapy massage with music on the stress and anxiety levels of emergency nurses: comparison between summer and winter.

AIMS AND OBJECTIVES: This research aimed to evaluate the use of aromatherapy massage and music as an intervention to cope with the occupational stress and anxiety that emergency department staff experience. The study also aimed to compare any differences in results between a summer and winter 12-week massage plan. BACKGROUND: Emergency nurses are subjected to significant stressors during their work and it is known that workloads and patient demands influence the role stress has on nurses. The perception that winter months are busier for emergency departments has long been held and there is some evidence that people with cardiac and respiratory dysfunction do present more frequently in the winter months. Massage has been found to decrease staff anxiety. DESIGN: The study used a one-group pre-test, post-test quasi-experimental design with random assignment. METHOD: Staff occupational stress was assessed pre- and post- 12 weeks of aromatherapy massage with music and anxiety was measured pre and post each massage session. Sick leave was also measured. Comparisons of summer and winter data were undertaken. RESULTS: A total of 365 massages were given over two 12-week periods, one during summer and the other during winter. Analysis identified that aromatherapy massage with music significantly reduced anxiety for both seasonal periods. Premassage anxiety was significantly higher in winter than summer. No differences in sick leave and workload were found. There was no difference in the occupational stress levels of nurses following the two 12-week periods of massage. CONCLUSION: Emergency nurses were significantly more anxious in winter than summer but this cannot be attributed to increased sick leave or workloads. Aromatherapy massage with music significantly reduced emergency nurses' anxiety. RELEVANCE TO CLINICAL PRACTICE: High levels of anxiety and stress can be detrimental to the physical and emotional health of emergency nurses and the provision of a support mechanism such as on-site massage as an effective strategy should be considered.

Geographic variation, physician characteristics, and diabetes care disparities in a metropolitan area, 2003-2004.

Quality improvement begins with quality measurement. Quality improvement continues by examining variation in patient standards of care. Diabetes is a complex chronic disease requiring aggressive care to improve and prolong life. Identifying and determining what factors explain care variation-including physician office location, physician characteristics, practice factors, and the translation of knowledge over time-is an area of important research. Determining physician practice characteristics' impact on these diabetes measures is an important step in understanding diabetes care in greater Kansas City. Aggregated diabetes HEDIS data from numerous private insurance plans from greater Kansas City, and associated practice factors from these same providers serves as a large and representative source of information to evaluate the impact of these factors on diabetes care. Using both multivariate and logistic methods, we find that the variation in care is largely explained by physician office location, but there is statistical explanatory significance for physician age on A1c testing rates. Also, nephropathy screening rates are positively related to whether a physician is a member of a group or a solo practice. The location of a practice has significant effects for diabetes care because physician office location approximates to some extent patient characteristics. This is not to say that physician practice factors are unimportant, rather that diabetes care is complex, and requires a fruitful interaction between physician and patient. Quantifying the interaction between an informed, activated patient and a prepared, proactive physician is difficult to observe and measure, and evaluating testable hypotheses about this interaction is correspondingly difficult.

Standards for education and training for interagency working in child protection in the UK: implications for nurses, midwives and health visitors.

This article presents a discussion of key issues for the education of nurses, midwives and health visitors following the completion of a Department of Health funded project, managed by the General Social Care Council and conducted jointly by two research centres; Salford Centre for Social Work Research and Salford Centre for Nursing, Midwifery and Collaborative Research. The work was initiated in response to Lord Laming's report on the circumstances leading to the death of Victoria Climbié. The project was conducted in relation to specified professions and occupational groups: doctors; health visitors; midwives; nurses; police; teachers, and social workers. It was undertaken in two stages. The first stage mapped existing material about standards in relation to education and training for interagency working. The second stage engaged in an extensive consultation exercise through which a model and a set of proposed standards for interagency education and training for interagency work were developed. The former is detailed fully in this report, while nine examples of standards are presented. The project final report was presented seven months after commencement.

What is a 'normal' midwife?

When you look through job advertisements these days, there are many different titles for midwifery roles. From Consultant to Research & Development Midwife, breastfeeding specialist to Sure Start ... it makes me wonder what has happened to the 'normal' midwife. Last year (June 2001) we had a focus on Normal Birth--this time we are asking, what is a 'normal' midwife? What skills does she/he have? What does she/he do to keep things 'normal'? A clinical midwife, a researcher, an educationalist and a consumer give us their views.