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Biomedical subjects

H Rushforth

Publications and source records attributed to H Rushforth.

12 recordsLinked to original sources
PubMed2000

A pilot randomised controlled trial of medical versus nurse clerking for minor surgery.

BACKGROUND: Nurse led clerking is currently practiced in a growing number of UK centres, but there is a paucity of evidence to underpin the safety of this innovation. AIM: To assess the safety of nurse led clerking in paediatric day case and minor surgery. METHODS: Children aged 3 months to 15 years were randomly assigned to clerking by either a nurse or a senior house officer (SHO) (resident). All children were then independently reassessed by a specialist registrar anaesthetist to provide a "gold standard" against which practitioner performance could be judged. RESULTS: In 60 children studied, nurses identified a significantly greater proportion of the detectable abnormalities present in the sample (p = 0.16). This difference is attributable to nurses' greater accuracy in history taking (p = 0.04); no conclusions regarding the comparability of nurses' and SHOs' skills in physical examination can be derived from the current study. CONCLUSION: Evidence attests to the likelihood of nursing having superior skills in history taking to SHOs. Exploration of nursing safety in undertaking physical examination, however, requires the conduct of a large scale equivalence study. Only then can conclusions be drawn as to whether nurse led physical assessment offers children a standard of care equivalent to that which they currently receive from SHOs.

Adolescent↗
PubMed1999

Practitioner review: communicating with hospitalised children: review and application of research pertaining to children's understanding of health and illness.

There is growing recognition amongst child health care practitioners of children's rights to be informed about their condition and treatment, and to be actively involved in decisions pertaining to their care. In order to facilitate such understanding, there is a need to explore the ways in which such concepts can best be communicated, in particular to younger children whose conceptual ability may be regarded as limited. Consideration of the literature on how children's conceptualisation of health and illness develops reveals diverse perspectives, with seminal work heavily influenced by the work of Piaget (1929), and a belief that the understanding of younger children may be minimal. However, more contemporary theorists refute such beliefs, suggesting that children may have far more potential to understand complex illness concepts than they have previously been given credit for. The work of Carey (1985) and Vygotsky (1962) offers alternative developmental theories congruent with this perspective, which might more appropriately underpin current practice. A variety of clinical situations are then explored in the light of this debate, including preparation of children for hospitalisation, their competence to consent, their views of pain and death, and approaches to child health promotion. Guidelines are offered to practitioners throughout, with the aim of enhancing children's understanding of their conditions, and their active participation in care, which in turn has the potential to optimise care delivery.

Adolescent↗
PubMed1997

Fit for whose purpose? The contextual forces underpinning the provision of nurse education in the UK.

This paper explores the implications of the contextual forces currently underpinning nurse education. It challenges the notion of a model of education which is principally founded on the concept of 'fitness for purpose'. Open acknowledgement is made that the driving forces impacting on the purchasers and providers of nurse education are different, and may be in conflict. The central tenet of this debate is based upon a growing awareness that the notion of practitioners being fit for purpose is increasingly being dictated and articulated by local purchasers. Their views may reflect financial expedience and short-term goals, arguably to the detriment of a longer term vision. Tensions also exist between purchasers' locally driven agendas and the reality that practitioners receive a nationally and internationally recognized qualification. The importance of manpower planning is also central to the debate. Solutions are offered which consider guidelines offered by a range of recent policy documents. Their contribution to the debate is assessed. Recommendations are made which recognize the need to equip practitioners with skills that have currency at point of registration, but argue that dominance must be given to the longer term goals of the educational enterprise.

Curriculum↗
PubMedDate not supplied

Nursing physical assessment skills: implications for UK practice.

The physical assessment skills of inspection, palpation, percussion and auscultation currently have only minimal recognition in UK nursing practice. Authors attest to perceived benefits in terms of continuity of care, holistic care delivery, rapidity of emergency intervention and reduction in junior doctors' hours and workload. However, the use of such skills by nurses has been subject to little in the way of formal outcome-based evaluation, and there is a clear need for such research to be carried out within the UK. Important guidelines exist within the literature to underpin educational programmes in physical assessment; these are reviewed and their implications for UK practice are considered. It is concluded that while generation of a UK evidence base is required, there is a persuasive argument to underpin continued development of physical assessment skills within UK nursing practice.

Clinical Competence↗
PubMedDate not supplied

Implications of nursing role expansion for professional practice.

The topic of nursing role expansion has caused much heated debate in the nursing press in recent years. The contemporary relevance of the debate is heightened by the current recruitment and retention crisis in nursing, and continued pressures to reduce junior doctors' hours and workload. This article re-examines the 'expanded role debate' by putting current concerns in an historical framework. The perceived benefits of role expansion are discussed, and balanced against continued concerns expressed by practitioners regarding possible detrimental effects on care delivery. The potential erosion of 'caring' as the heart of nursing practice is acknowledged, and challenges are made to the belief that nursing has the 'monopoly on caring'. The issue of 'nursing time', perhaps the major barrier to continued role expansion, is also explored. The future division of labour within healthcare delivery is seen as pivotal to this aspect of the debate, and a pragmatic vision for the future is offered. Finally, the issue of the paucity of the evidence base underpinning role expansion is considered and a plea is made for future developments to be soundly underpinned by research.

Evidence-Based Medicine↗