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Biomedical subjects

B Moores

Publications and source records attributed to B Moores.

At least 19 recordsLinked to original sources

The changing composition of the British hospital nursing workforce 1962-1984.

The United Kingdom Central Council for Nursing, Midwifery and Health Visiting (UKCC) recently undertook a major project aimed at identifying the most appropriate future nurse staffing patterns. The results presented here were produced at the request of the UKCC in order that the recommendations stemming from their deliberations could be set against a wider backcloth. It proved possible to secure nurse staffing data from three of the countries of the United Kingdom, namely, England, Wales and Scotland. Most were secured from government publications but the appropriate government agencies also provided valuable assistance. The main trends emerging from a processing of the data are a steadily falling ratio of student nurses and midwives to their qualified counterparts and a steadily increasing contribution by state enrolled nurses. A number of other ratios are presented pictorially accompanied, where appropriate, by a commentary. The actual growth in whole time equivalent nurses is seen to be somewhat less than many people imagine when account is taken of the reduction in both the number of weeks and the number of hours per week worked. Indeed, there has been a levelling off of this last figure over the past few years.

Employment

What 1357 hospital inpatients think about aspects of their stay in British acute hospitals.

Following on a long series of interviews and pilot studies a substantial questionnaire was devised for soliciting the reactions of patients to their stay in hospital. With the cooperation of health authorities it was distributed to ex-patients in seven acute hospitals. A total of 1357 respondents returned a completed questionnaire. In this paper the responses to some 17% of the questions are presented. Most of these particular questions have been selected because they are concerned with nursing issues but a few others are included on account of their relevance. What comes across very clearly from the pattern of responses are the wide disparities between hospitals. Given that the questions were deliberately intended to be very specific a comparison of the results obtained in one institution with the overall averages does enable attention to be focused on areas where improvements are called for. In fact a number of health authorities, recognizing this feature, have since commissioned studies.

Attitude of Health Personnel

Patterns of nurse activity.

A major study was undertaken in three acute hospitals of how nursing staff occupied their time on the medical, surgical and orthopaedic wards, the observation technique adopted being systematic activity sampling. In addition all the interactions patients received from nurses were recorded, the categorization scheme for both sets of data being identical. This paper presents the overall results which emerged from the computer analysis of this material. One of the less expected results is the amount of nursing performed which is categorized as Basic.

Analysis of Variance

The relationship between the level of nurse staffing and the patterns of patient care and staff activity.

Data relating to patterns of nursing activity and all the interactions occurring between patients and nursing staff were obtained during observation periods of 1 week's duration on a total of 20 wards in three hospitals. When analysed these data reveal that in all wards there is a strong relationship between the nursing hours available and the various components of the nursing care provided. Indeed the linear relationship is so strong in some cases that it appears that these wards are a long way short of the staffing levels which produced the 'saturation' effect described by several American authors. The analysis of the interactions reveals, as one would suspect, that a disproportionate number of patients account for a large proportion of the interactions, but two further analyses will, it is hoped, shed a little more light on this aspect of the ward situation. The data are being subject to further examination to ascertain whether extra nursing staff leads to more or longer interactions and a longer term investigation is under way which is focused on patients with comparable diagnoses in different hospitals.

Humans

Resident characteristics and staff behavior in two hospitals for mentally retarded adults.

Results of part of a study aimed at evaluating the implications of different nurse staffing levels were reported. Two samples of 30 patients were observed in the two hospitals and measures were obtained of the proportion of time they were involved in adaptive and maladaptive activities, the frequency with which they interacted in particular ways with the nursing staff, and their Adaptive Behavior Scale scores. When these various measures were examined, we found that those patients who needed more attention received it but not necessarily of the appropriate type. While such results are understandable and even perhaps predictable, they do serve to reveal a situation deserving remedial attention. We in fact suggested that one possible means of countering this tendency to ignore the less attractive patients is for the nursing staff to be assigned much smaller groups of patients than is customary.

Adult

Public attitudes towards kidney transplantation.

A representative sample of 500 members of the public was interviewed about kidney transplantation. The survey showed that despite widespread awareness of the need for kidney donors only 4.4% of the respondents had completed a donor card. The small percentage holding kidney donor cards appears to reflect a failure to inform and motivate the general public. There was no evidence of any widespread objection to the procedures involved in obtaining cadaver kidneys, but there was strong objection to the introduction by law of an "opting out" system. The findings suggest how the numbers of potential donors could be increased without changing the law as regards consent to donation.

Attitude to Health

Nurses' expectations for accomplishment of mentally retarded patients.

As part of a larger study into the pattern of care delivered to hospitalized mentally retarded adults, an attitude survey was undertaken. Factor analysis on questionnaires returned by 696 nurses yielded a three factor solution. One factor, concerned with the expectations that nurses hold of the potential level of patient accomplishment, was examined. Different grades of staff were found to hold significantly different views on a scale ranging from "optimist" to "pessimist". Results from 30 hospitals showed that, after correcting for this grade effect, there were substantial institutional differences.

Achievement