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Biomedical subjects

Claud Regnard

Publications and source records attributed to Claud Regnard.

9 recordsLinked to original sources
PubMed2004

Evolving spinal analgesia practice in palliative care.

Intraspinal analgesia can be helpful in some patients with intractable pain. Over 15 years palliative care professionals evolved their spinals policy through a repeated series of evaluations, discussions and literature reviews. One hundred intraspinal lines were then reviewed. Notable changes in policy were the switch from epidurals to intrathecals, and the insertion of lines during working hours rather than as emergencies. Our efficacy, and frequency of adverse effects, is equal or better to published studies. Key issues in reducing adverse effects were the improved care of the spinal line exit site, a change from bolus administration to continuous infusions, and modifying line insertion techniques. Current policy is to use continuous infusions of diamorphine and bupivacaine in a 1:5 ratio through externalized intrathecal lines. The lines are effective in approximately two thirds of patients and can be kept in place for up to 18 months. The policy continues to be updated and common documentation is now in place.

Adult↗
PubMed2003

The effectiveness of palliative care education delivered by videoconferencing compared with face-to-face delivery.

As part of a four-year study into the use of videoconferencing in palliative care, the delivery of workshops on palliative care to community nurses was evaluated by the Open University. Twenty nurses were randomly allocated to alternating videoconferencing and face-to-face modes of presentation. The quantitative study measured the amount of learning that occurred in each workshop with pre-tests and post-tests, and the mode of presentation. Forty-nine workshop attendances were analysed. The qualitative study used observation and analysis of videorecordings to assess the activity and attention spans in interactive communication during workshops, while a combination of interviews and questionnaires was used to assess the participants' level of satisfaction with presentation. The results showed that the nurses' level of satisfaction with the instructional presentation was high in both modes of presentation. Despite difficulties at the start of the project in the videoconferencing presentation, there was little difference between the modes of presentation in achievement scores or the gain in achievement scores. Although the learners preferred face-to-face workshops, they learnt as much from a videoconferenced workshop. Videoconferencing was less suitable for psychological or emotional discussions, but this may have been due to the time constraints on the workshops. Some features of videoconferencing suggest it could be used effectively in helping learners discuss sensitive issues. The Current Learning in Palliative Care (CLiP) worksheets were found to be an effective means of delivering learning.

Attitude of Health Personnel↗
PubMedDate not supplied

A framework for making advance decisions on resuscitation.

Decisions about cardiopulmonary resuscitation (CPR) continue to cause difficulties for healthcare professionals. Current UK guidelines provide information on the underlying principles, but do not include a clear decision framework. The resulting confusion about when and who to ask about CPR can result in an inappropriate burden being placed on patients, partners or families. A simple clinical decision framework is presented, together with the underlying principles. This framework is offered as an aid for clinicians and patients in understanding the current ethical, clinical and legal guidance on decisions about CPR.

Advance Directive Adherence↗