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Outreach Services (outreach + services)
Selected AbstractsAn integrative review and meta-synthesis of the scope and impact of intensive care liaison and outreach servicesJOURNAL OF CLINICAL NURSING, Issue 23 2009Ruth 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] The impact of an ICU liaison nurse: a case study of ward nurses' perceptionsJOURNAL OF CLINICAL NURSING, Issue 6 2005Wendy Chaboyer MN Aims and objectives., To provide a description of ward nurses perceptions of the intensive care unit liaison nurse role. Background., Critical care outreach services have become commonplace over recent years. In Australia, the intensive care unit liaison nurse, developed at a local level by healthcare providers, has emerged as a way of improving the continuity of care offered to this patient group. As a relatively new development in critical care services, evaluation of this role has been limited, particularly in relation to the perceptions of ward nurses who receive patients on discharge from intensive care unit. Design., Case study of one Australian hospital that utilizes an intensive care unit liaison nurse. Methods., Ten ward nurses were purposefully selected for their representativeness of the population and for their experience with the intensive care unit liaison nurse role. Each of these nurses participated in semi-structured in-depth interviews. Thematic analysis was used to analyse the data. Findings., Three major themes emerged from the interviews, highlighting role behaviours, contextual demands and outcomes associated with the intensive care unit liaison nurse role. The role behaviours of the liaison nurse included the professional characteristics of the individual and the primacy of clinical liaison as a role descriptor. Contextual demands were environmental characteristics relevant to providing patient, family and staff support. Outcomes of the role were perceived to include environmental preparation and education. Conclusions., This qualitative study has presented an overview of ward nurses perceptions of the intensive care unit liaison nurse role within one Australian hospital, illustrating the educative and empathic support that the liaison nurse role can provide to ward nurses. Relevance to clinical practice., Collaboration with ward nurses in developing specialist roles such as the intensive care unit liaison nurse is essential in ensuring improvements in patient and family care across the continuum. [source] The Court's Role in Promoting Comprehensive Justice for Pregnant Drug and Alcohol UsersJUVENILE AND FAMILY COURT JOURNAL, Issue 3 2008Tourine Johnstone ABSTRACT Drug use during pregnancy is an important social and medical issue. Legislatures and courts have offered a variety of responses, ranging from imprisonment to comprehensive service programs that are rehabilitative in nature. This article discusses the prevalence and effects of prenatal drug use, followed by a presentation of the scope of legal responses and treatment options. Some courts do not provide outreach services for drug-offending mothers, while others may offer a limited range of services. In contrast, a comprehensive justice approach would provide a wide range of health, employment, and social programs for the offender. This approach is based on philosophies of restorative justice, therapeutic jurisprudence, and procedural justice. Such a theory-based comprehensive justice program ultimately benefits mothers, children, and the community. Considerations are offered for judges who seek to implement a comprehensive justice approach to address this important problem. [source] Low vision service delivery: an audit of newly developed outreach clinics in Northern Ireland,OPHTHALMIC AND PHYSIOLOGICAL OPTICS, Issue 4 2004J. Lindsay Abstract Recent publications recommend that low vision services are multi-professional; easily accessible; freely available to all those with visual impairment; monitored by professional and patient groups, and responsive to user feedback. These standards were applied when developing low vision outreach services in Northern Ireland in 1999/2000. Results are reported of the complete clinical audit cycle, coupled with a patient satisfaction telephone questionnaire, which was used to evaluate the service. Of the 48 patients randomly selected from the list of clinic attendees, 28 (58%) were female, 27 (56%) over 80 years of age and 38 (78%) had a primary ocular diagnosis of age related macular degeneration (AMD). Of the 46 low vision aids issued at patients' first appointments, 30 (67%) were illuminated stand magnifiers and 29 (63%) had magnification levels of ×5 or less. A total of 46 (96%) patients reported that they had benefited from low vision services. [source] Postdeployment, Self-Reporting of Mental Health Problems, and Barriers to CarePERSPECTIVES IN PSYCHIATRIC CARE, Issue 4 2009Rosanne Visco PhD PURPOSE., This study explored the relationship between self-reported mental health symptoms and help-seeking behaviors of active-duty Air Force members. DESIGN AND METHODS., Mixed-methods approach reviewed 200 postdeployment surveys from active-duty members assigned to Eglin Air Force Base, Florida, USA. Chi-square analysis examined significance between self-reporting mental health problems and accessing treatment. FINDINGS., As the rate of self-reported mental health symptoms increased, active-duty members were less inclined to seek help. There were inconsistencies among gender for self-reporting and accessing services. PRACTICE IMPLICATIONS., Air Force psychiatric nurses need to be at the forefront of outreach services when treating combat-stressed troops. [source] A review of maternal deaths at Goroka General Hospital, Papua New Guinea 2005,2008AUSTRALIAN AND NEW ZEALAND JOURNAL OF OBSTETRICS AND GYNAECOLOGY, Issue 1 2010Karen SANGA Background:, Papua New Guinea is a developing country with a population of six million, facing significant geographical, cultural and economic barriers to the provision of antenatal and intrapartum care. The maternal mortality ratio (MMR) is an internationally regarded index of the quality of a country's maternity services; the most recently reported MMR for Papua New Guinea of 773 deaths per 100 000 births is one of the highest in the world. Aims:, To review information about women who died from pregnancy-related causes, both direct and indirect, in the Goroka General Hospital (GGH) during the period 1st January 2005 to 31st May 2008. Methods:, A retrospective review was undertaken of the charts of women recorded as dying in the Obstetrics and Gynecology (O&G) ward of GGH in the study period. Results:, The charts of 21 women who died from pregnancy-related causes were reviewed and information collated. Puerperal sepsis and sepsis complicating unsafe abortion were the most common causes of maternal death accounting for 48% deaths. Other causes included ectopic pregnancy and postpartum haemorrhage. Contributing factors included residence in a rural area, geographical and transport difficulties accessing care, non-use of family planning services, non-booking for antenatal care and late presentation in pregnancy or labour, and under-resourcing of services at GGH. The socio-economic status of most of the women was low, and where educational attainments were recorded these were also low. 71% of women identified themselves as practising Christians. Conclusions:, Better outreach services to provide health information and antenatal care, with specific counselling about the need for supervised delivery, are urgently required in the Eastern Highlands Province that GGH serves if numbers of maternal deaths are to be reduced. Working through churches in the region may be the most appropriate way to provide information and services to women because a majority of women adhere to Christianity and can be reached in this way. [source] Psychiatric morbidity and people's experience of and response to social problems involving rightsHEALTH & SOCIAL CARE IN THE COMMUNITY, Issue 6 2010Nigel J. Balmer BSc PhD Abstract Psychiatric morbidity has been shown to be associated with the increased reporting of a range of social problems involving legal rights (,rights problems'). Using a validated measure of psychiatric morbidity, this paper explores the relationship between psychiatric morbidity and rights problems and discusses the implications for the delivery of health and legal services. New representative national survey data from the English and Welsh Civil and Social Justice Survey (CSJS) surveyed 3040 adults in 2007 to explore the relationship between GHQ-12 scores and the self reported incidence of and behaviour surrounding, rights problems. It was found that the prevalence of rights problems increased with psychiatric morbidity, as did the experience of multiple problems. It was also found the likelihood of inaction in the face of problems increased with psychiatric morbidity, while the likelihood of choosing to resolve problems without help decreased. Where advice was obtained, psychiatric morbidity was associated with a greater tendency to obtain a combination of ,legal' and ,general' support, rather than ,legal' advice alone. The results suggest that integrated and ,outreach' services are of particular importance to the effective support of those facing mental illness. [source] | ||||||||||