Care Skills (care + skill)

Distribution by Scientific Domains

Selected Abstracts

An integrative review and meta-synthesis of the scope and impact of intensive care liaison and outreach services

Ruth Endacott
Aim., To determine activities and outcomes of intensive care unit Liaison Nurse/Outreach services. The review comprised two stages: (1) integrative review of qualitative and quantitative studies examining intensive care liaison/outreach services in the UK and Australia and (2) meta-synthesis using the Nursing Role Effectiveness Model as an a priori model. Background., Acute ward patients are at risk of adverse events and patients recovering from critical illness are vulnerable to deterioration. Proactive and reactive strategies have been implemented to facilitate timely identification of patients at risk. Design., Systematic review. Methods., A range of data bases was searched from 2000,2008. Studies were eligible for review if they included adults in any setting where intensive care unit Liaison Nurse or Outreach services were provided. From 1423 citations and 65 abstracts, 20 studies met the inclusion criteria. Results., Intensive care liaison/outreach services had a beneficial impact on intensive care mortality, hospital mortality, unplanned intensive care admissions/re-admissions, discharge delay and rates of adverse events. A range of research methods were used; however, it was not possible to conclude unequivocally that the intensive care liaison/outreach service had resulted in improved outcomes. The major unmeasured benefit across all studies was improved communication pathways between critical care and ward staff. Outcomes for nurses in the form of improved confidence, knowledge and critical care skills were identified in qualitative studies but not measured. Conclusion., The varied nature of the intensive care liaison/outreach services reviewed in these studies suggests that they should be treated as bundled interventions, delivering a treatment package of care. Further studies should examine the impact of critical care support on the confidence and skills of ward nurses. Relevance to clinical practice., Advanced nursing roles can improve outcomes for patients who are vulnerable to deterioration. The Nursing Role Effectiveness Model provides a useful framework for evaluating the impact of these roles. [source]

Refugees and medical student training: results of a programme in primary care

Kim Griswold
Context, Medical schools have responded to the increasing diversity of the population of the USA by incorporating cultural competency training into their curricula. This paper presents results from pre- and post-programme surveys of medical students who participated in a training programme that included evening clinical sessions for refugee patients and related educational workshops. Methods, A self-assessment survey was administered at the beginning and end of the academic year to measure the cultural awareness of participating medical students. Results, Over the 3 years of the programme, over 133 students participated and 95 (73%) completed pre- and post-programme surveys. Participants rated themselves significantly higher in all 3 domains of the cultural awareness survey after completion of the programme. Conclusions, The opportunity for medical students to work with refugees in the provision of health care presents many opportunities for students, including lessons in communication, and scope to learn about other cultures and practise basic health care skills. An important issue to consider is the power differential between those working in medicine and patients who are refugees. To avoid reinforcing stereotypes, medical programmes and medical school curricula can incorporate efforts to promote reflection on provider attitudes, beliefs and biases. [source]

"Sim Wars": A New Edge to Academic Residency Competitions

Yasuharu Okuda
Introduction: Simulation training is an educational modality that is increasingly being utilized by emergency medicine programs to train and assess residents in core competencies. During a recent national conference, patient simulators were used in a competition to highlight multitasking, teamwork, and patient care skills. The combination of audience participation and an expert panel provided a creative forum for learning. Methods: the Foundation for Education and Research in Neurological Emergencies (FERNE) and the Emergency Medicine Residents' Association (EMRA) sponsored an innovative competition between emergency medicine residencies during the 2008 Scientific Assembly of the American College of Emergency Physicians (ACEP). This competition used high-fidelity simulations to create scenarios on neurologic emergencies. Six teams were selected to participate in the three-hour single-elimination competition. The three-member resident teams were then randomly paired against another institution. Three separate 10 minute scenarios were created for the initial round, allowing paired teams to compete on the same scenario. An expert panel provided commentary and insight on the management by each team. In addition, the experts provided feedback in the areas of communication and team training. Each round's winners were determined by the audience using an interactive system. Results: Based on the immediate feedback from participants, audience members and the expert panelists, this event was an entertaining and successful learning experience for both residents and faculty. Like the Clinical Pathological Cases (CPC) competitions, "Sim Wars" provides a showcase for residencies to demonstrate practice philosophies while providing a unique emphasis on teamwork and communication skills. The ability to expand this program to include regional competitions that lead to a national contest could be the framework for future exciting and educational events. [source]

Developmental care in the UK: a developing initiative

K E StC Hamilton
Abstract Aim:, To review developmental care over time in the UK. Methods:, Longitudinal study comprising two prospective observational studies of unit organization and developmental care activity collected in 2005 and 2008 in all UK neonatal units. Indices related to developmental care and an aggregated score are reported corresponding to year and level of care. Results:, In 2008, over 90% units had open visiting for parents and modified lighting and 80% modified noise, showing no change since 2005. Incubator cover usage increased from 75% to 95%. Rates of parental tube feeding dropped from 76% to 64% and kangaroo care increased from 50% to 80%. Proportions of units with developmental care personnel and staff trained in developmental care have almost doubled to 64% and 57%. Aggregated scores, reflecting eight basic indices of developmental care, were unchanged: the 2005 mean was 5.7 (SD = 1.5) and 6.2 (SD = 1.5) in 2008. Scores were significantly higher in larger units and in those with developmental care personnel or developmentally trained staff. Conclusion:, Despite a significant increase in developmental care skills and infrastructure, variable approaches persist, with limited improvements over time. These findings reflect a UK culture that is ambivalent towards developmental care, and enable comparison with other countries where developmental care is more fully supported. [source]

Primary eye care skills

Nigel Morlet FRACO
No abstract is available for this article. [source]