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Biomedical subjects

John Little

Publications and source records attributed to John Little.

5 recordsLinked to original sources
PubMed2005

Building an ECT service: an outcomes-equivalent approach.

OBJECTIVE: Specific guidelines, ongoing controversies in technique and audit reviews have made clinicians wary about continuing in electroconvulsive therapy (ECT). This paper attempts to reassure practitioners by incorporating such changes into a simple approach to ECT based on outcomes equivalence. METHOD: A selected compilation of the recent literature was used to describe a model for starting and/or continuing an effective ECT service. RESULTS: It was suggested that a useful way of approaching ECT service delivery is to focus on what is actually important, getting patients better, and to do so within the context and capability of each hospital. CONCLUSIONS: ECT is a changing field. Remaining true to the core principles of clinical practice, patient selection and technique, provides a basis for beginning, continuing and further developing an effective ECT service.

Attitude of Health Personnel↗
PubMed2004

Use of seclusion in a psychiatric acute inpatient unit.

OBJECTIVE: To examine the rate and characteristics of seclusion among a group of patients admitted to an adult acute psychiatric unit as a precursor to planning an audit cycle and quality improvement project. METHODS: A retrospective chart review of all inpatient admissions to an adult acute unit over a 12 month period was undertaken with the use of a specially developed proforma. A comparison of secluded and non-secluded patients was described, and, where possible, statistically analysed. RESULTS: Four hundred and fifty admissions occurred during the study period, resulting in 140 episodes of seclusion. This represented a seclusion rate of 31% per admission. In contrast to patients who were not secluded, those secluded were more likely to be young, admitted involuntarily and with a diagnosis of schizophrenia. The most common indicator of seclusion was risk to others (74%) followed by risk to self (61%) and risk of absconding (55%). Length of time in seclusion ranged from 1 to 49 h with a mean of 9 h. Thirty-nine per cent of secluded patients were secluded on two or more occasions. Interventions including counselling, time out and medication were used in 71% prior to seclusion; however, in 29% no intervention was documented. Seclusion was more likely to occur in the evenings, when staff/patient ratios were lower. CONCLUSION: Seclusion remains an important part of psychiatric practice. As expected, the use of seclusion in an adult acute unit reflected indirect measures of illness severity. Its use needs to be carefully reviewed and monitored, representing as it does the greatest restriction on a person's freedom.

Acute Disease↗
PubMed2003

Effectiveness of a training program for ECT nurses.

Electroconvulsive therapy (ECT) is a highly technical procedure requiring a team that consists of an anesthetist, a psychiatrist, a clinical nurse specialist, and recovery nurses. Traditionally, nursing education and training in the context of providing a safe and high standard of care has not been addressed. Ninety-two nurses from 42 different health agencies participated in a training program focusing on defibrillation, electrocardiogram (ECG) and electroencephalogram (EEG) monitoring, intubation, stimulus dosing, setting up the ECT equipment, and caring for the patient. A non-experimental, one-group, pretest-posttest research design was used in this study to evaluate the effectiveness of the training program for nurses working with ECT. Effective training for nurses was hypothesized to make a difference in the standards of practice and clinical effectiveness for patients undergoing ECT. Findings from this study indicated a major knowledge deficit in key components of ECT among nurses who have responsibilities in this area of nursing care. With effective training, nurses' confidence levels increased related to setting up the equipment, administering a double dose, helping with intubation, and using a defibrillator. If nurses are to effectively function as team members in the ECT procedure, they must receive the training necessary to prepare them for this important role. The results of this study support the recommendation of the Royal Australian and New Zealand College of Psychiatrists that ECT nurses should be appropriately trained in anaesthetic and resuscitation techniques and modern ECT practice.

Education↗
PubMedDate not supplied

Online support for medicine dosage calculations.

This article reports findings from a small project run within the Robert Gordon University that aims to provide nursing students with online support for medicine dosage calculations through formative assessment. The project motivation is discussed together with an evaluation of a subset of data from 177 student participants. This evaluation focuses on the 20 or so students who have engaged most with the project, and assesses the extent to which these students have been able to transfer benefits derived from formative assessment of their skills to summative assessment. Evidence is presented that shows: students who do well formatively do not seek individual tuition, those who truly engage with the formative online assessment subsequently pass their summative assessment, students agree or strongly agree that the formative assessment helped them pass their summative assessment and students making multiple attempts do not simply copy the correct answers given in feedback, but retry the assessment.

Computer-Assisted Instruction↗