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Biomedical subjects

Annette Richardson

Publications and source records attributed to Annette Richardson.

9 recordsLinked to original sources
PubMed2006

How long do patients spend weaning from CPAP in critical care?

The purpose of this project was to audit clinical practice and to investigate the time taken to wean patients using continuous positive airway pressure (CPAP) as a method of respiratory support prior to the introduction of a weaning protocol. Data was collected over a two-month period and 43 patients were included in the audit. Criteria for inclusion were that each patient had previously received mechanical ventilation and was subsequently weaned with the aid of CPAP or had received CPAP and was weaning from CPAP alone. The average time taken to wean was 95 hours (3.96 days) and ranged from one to 41 days. There was no correlation between the length of weaning time and the patient's APACHE II Score or the length of time spent on invasive ventilation prior to weaning on CPAP. However, there was a consistency in the time spent on CPAP as a percentage of the total weaning time. The audit identified large variations in the process and time taken to wean patients from CPAP. This might suggest that CPAP is used in a routine or arbitrary manner rather than a selective response to patients' specific needs.

APACHE↗
PubMed2003

New horizons: the motives, diversity and future of 'nurse led' care.

This article identifies the reasons for the accelerated development of nurse led services and attempts to define and discuss the diversity, risks and future that lies ahead. Evidence was collected and analysed using a literature review, reflection on practice and results of a local survey. It is suggested that nurse led developments are influenced by NHS policy, the practice environment, local need 'service gap' and provision of resources. No clear definition of a nurse led service is revealed, but six key features can be linked to common activities. Partnership with doctors is important and three levels of practice with differing degrees of autonomy and independence are identified and linked to the six common activities. Current scope and future opportunities for services are considered, highlighting the need for good preparation and supervised practice to minimize the risk of isolation. It is suggested that 'low risk' or tightly defined areas of practice may be most suited to this type of development. Our view is that nurse led services may not have reached their full potential and contribute to the future delivery of modern health care. It is concluded, that greater emphasis on education, training and support for nurses delivering this type of service is required to maximize potential opportunities and foster competence.

Attitude of Health Personnel↗
PubMedDate not supplied

Critical care staff rotation: outcomes of a survey and pilot study.

Staff rotation is defined as a reciprocal exchange of staff between two or more clinical areas for a predetermined period of time. The rationale for introducing a 'Critical Care Nurse Rotation Programme' includes important issues such as improving nurses' knowledge and skills, providing development opportunities, networking, the ability to recruit and retain nurses and the provision of a more versatile and flexible workforce. To gain the understanding of nurses' views and opinions on critical care rotation programmes, evidence was collected by means of questionnaires involving 153 critical care nurses and by undertaking semi-structured interviews with four nurses. On the basis of the responses, a pilot of three Critical Care Nurse Rotation Programmes was introduced. An evaluation of the pilot project assessed participants, supervisors and senior nurses' experience of rotation and revealed very positive experiences being reported. The benefits highlighted included improving clinical skills and experience, improving interdepartmental relationships, heightened motivation and opportunities to network. The disadvantages focused on the operational and managerial issues, such as difficulties maintaining supervision and providing an adequate supernumerary period. Evidence from the survey and pilot study suggests that in the future, providing rotational programmes for critical care nurses would be a valuable strategy for recruitment, retention and developing the workforce.

Attitude of Health Personnel↗
PubMedDate not supplied

Twelve-hour shift on ITU: a nursing evaluation.

This paper describes the introduction and subsequent evaluation of a 12-h shift system in a large ITU in the northeast of UK. To date, only a small number of studies has evaluated nurses working the 12-h shifts in critical care areas. To evaluate the level of staff satisfaction, data were collected by means of a questionnaire involving 41 nurses, at 3 months following the introduction of the 12-h shifts. The responses from the evaluation advocated the continuation of 12-h shifts with alternative shift patterns for nurses who felt dissatisfied with the current system. Twelve-hour shifts can be seen as a flexible system for nurses working in intensive care and may assist with staff satisfaction and improving nurse recruitment and retention.

Attitude of Health Personnel↗
PubMedDate not supplied

An evaluation of critical care lecturer practitioners.

The aim of this study was to evaluate the educational value and impact upon staff of critical care lecturer practitioners. Data were collected through three staff focus groups (n=21) and a questionnaire completed by 70 members of trust or university staff. A majority of respondents felt that the lecturer practitioner roles had considerable effect upon adult critical care services. Six main categories of findings were derived from analysis and integration of both focus group and questionnaire data--development of knowledge; staff support; being a teacher; developing and maintaining the workforce; role improvement plus removal of the lecturer practitioner role. Many of these findings concur with the limited quantity of evaluative literature on the lecturer practitioner role. The authors produced a report recommending continued funding for existing lecturer practitioner posts; introduction of more lecturer practitioner posts should be considered, and further role evaluation should be conducted at both a local and national level.

Attitude of Health Personnel↗
PubMedDate not supplied

Ward nurses' evaluation of critical care outreach.

Following the recommendation to introduce critical care outreach, two different models on two hospital sites were introduced within a large teaching Trust. To establish ward nurses' views and opinions of important components of the two outreach models, a questionnaire survey was undertaken involving 134 ward nurses on the awareness of outreach, accessibility of outreach and usage of outreach. The results identified a high level of user satisfaction amongst ward nurses. Awareness of critical care outreach and how to access the service within a hospital site was good, with little differences between the two different models. Outreach was found to provide ward nurses with better skills, more knowledge, advice and support. Providing a 24-h service and continual critical care education and training opportunities are the suggested ways to improve outreach in the future.

Attitude of Health Personnel↗
PubMedDate not supplied

Utilizing audit to evaluate improvements in continuous veno-venous haemofiltration practices in intensive therapy unit.

Continuous veno-venous haemofiltration (CVVH) is used regularly in the management of acute renal failure in intensive therapy unit (ITU). A three-staged approach was undertaken involving two audits of practice to improve CVVH record keeping in a 15-bedded cardiac ITU. An initial baseline audit identified a number of areas for improvement in practice. The areas for improvement were implemented then a second audit was repeated. The improvements and practice changes included the dissemination of audit findings to the multidisciplinary team, redesigning the prescription chart to a more user-friendly format and the development of a competency-based CVVH workbook. This nurse-led project demonstrated how positive outcomes and improvements could be achieved with record keeping across the multidisciplinary ITU team.

Attitude of Health Personnel↗