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Biomedical subjects

John W Albarran

Publications and source records attributed to John W Albarran.

9 recordsLinked to original sources
PubMed2006

Paramedics' perceptions of their role in providing pre-hospital thrombolytic treatment: qualitative study.

BACKGROUND: The majority of ambulance services in England provide pre-hospital thrombolysis, following publication of the National Service Framework for Coronary Heart Disease. A meta-analysis has confirmed the effectiveness of pre-hospital administration in terms of all-cause mortality reduction and time saved. Little is known however, about how paramedics perceive their role in thrombolytic administration. AIMS: To describe ambulance paramedics' perceptions of their role in delivering thrombolytic treatment in the pre-hospital setting. METHODS: Twenty paramedics, based in one rural ambulance service in the South West of England participated in focus group interviews. RESULTS: Five key themes emerged: Perceptions of drivers for change; duty of care; perceptions of professional image; role expansion; and preparedness for practice. CONCLUSION: Paramedics' perceptions of their role in pre-hospital thrombolysis were mixed, encompassing professional and political issues including lack of ownership of the emerging national strategy, desire for national certification and financial reward. For successful development and implementation of new strategies within the ambulance service early engagement of paramedics and other staff is essential.

Attitude of Health Personnel↗
PubMed2005

Comparison of sequential and simultaneous breathing and pulse check by healthcare professionals during simulated scenarios.

BACKGROUND: Basic life support guidelines for healthcare professionals recommend a sequential breathing and carotid pulse check allowing up to 10 s for each assessment. Life support providers are sometimes taught to do a simultaneous assessment of breathing and pulse check for up to 10 s. It is not clear whether this assessment improves diagnostic accuracy. METHODS: We recruited 119 healthcare professionals. The SIM-Man was used to develop 10 simulated cases scenarios. To assess performance, 89 participants did 10 simultaneous assessments followed by 10 sequential assessments, and 29 participants did the assessment techniques in reverse order. The primary outcome of the study was the number of correct diagnoses made with each assessment method. RESULTS: There were more correct diagnoses with a sequential assessment; 48.2% (569 out of 1180) compared to 33.5% (395 out of 1180) for the simultaneous method. Only 26.3% (n=31) had more than five accurate diagnoses with a simultaneous assessment, compared to 44.1% (n=52) for sequential assessments. Those performing sequential assessment achieved a median score of 5/10 correct diagnoses compared to a median score of 2.5/10 for the simultaneous method (Wilcoxon Z=-4.63, p<0.001). Sensitivity for the pulse check was 99% for both assessments; specificity was 48.9% for a simultaneous assessment and 61.9% for the sequential approach. For breathing check, specificity, sensitivity and accuracy were also higher with the latter method (sensitivity 99.6%, specificity 70.6% and accuracy 88%) CONCLUSION: A sequential assessment of breathing and pulse by healthcare professionals has greater diagnostic accuracy in simulated case scenarios.

Cardiopulmonary Resuscitation↗
PubMed2004

Partners of ICD patients--an exploratory study of their experiences.

BACKGROUND: The experiences of partners who care for and support the needs of a loved one with an implantable cardiac defibrillator (ICD) remain largely unknown within Europe. AIMS: This study explored the nature of partner's experiences from the pre-ICD implantation phase up until a maximum of 20 months at home. METHODS: Eight partners cohabiting with a recipient of an ICD were interviewed using a semistructured schedule. All interviews were transcribed and content analysed for emerging categories and themes. FINDINGS: Four themes representing 11 categories conceptualised the partners' experiences, these included: Acknowledging the patient's need for the device, reactions to the device, safeguarding the patient, and returning to normality. CONCLUSION: This qualitative study suggests that partners of ICD recipients progress through various difficult and adaptive stages when learning how best to support the patient. A point is reached when most are able to assume control and normalise their lives. This transformation is slow; however, to improve this process and empower partners, nurses should provide relevant information and include them in decisions affecting the patient. Further research into the unique needs of partners, which includes international perspectives, would be significant in developing practice and theory in this area.

Activities of Daily Living↗
PubMed2003

Exploring the patient's experiences of learning to live with an implantable cardioverter defibrillator (ICD) from one UK centre: a qualitative study.

BACKGROUND: International expansion of indications for implantable cardioverter defibrillator (ICD) implant means increasing numbers of patients with devices worldwide. However, smaller numbers of patients with ICDs in the UK has meant that clinical expertise available to care for this specialized group is limited. Whilst North American patients' experiences of living with an ICD are well documented, European perspectives remain underrepresented. AIM: The aim of this study was to explore and describe patient's experiences around the time of their ICD device implant and after they returned home from one UK centre. METHODS AND RESULTS: Eligible patients were recruited from one regional cardiothoracic centre and interviewed in their own homes using semi-structured schedules. Analysis of data elicited three themes; non-individualised nature of information, adjustments to living with the device and future outlook. Unique findings identified were; (a) concealment of concerns and symptoms; (b) funding issues; and (c) unavailability of appropriate support and advice during and after time in hospital. CONCLUSION: Individualized care and support for these ICD patients appeared lacking according to respondents. Opportunities to discuss concerns appeared non-existent, which may indicate that UK patients are disadvantaged in the domain of psychological support compared with their European and North American counterparts. Findings remain tentative until explored with a larger, more representative and international sample.

Activities of Daily Living↗
PubMed2002

Automated external defibrillation as part BLS: implications for education and practice.

The latest Adult Basic Life Support (BLS) guidelines support the inclusion of the use of the automated external defibrillator (AED), as part of basic life support (BLS). Emphasis on the provision of early defibrillation as part of BLS acknowledges the importance of this manoeuvre in the successful termination of ventricular fibrillation. The ramifications of such changes for both first responders and organisations implementing the guidelines should not be underestimated. Issues relating to resourcing, content and duration of training and retraining, auditing and evaluation require further exploration. To consider these issues now seems particularly pertinent, given the recent launch of the UK Government's paper on public health, 'Saving Lives-Our Healthier Nation' which seeks to deploy AEDs in busy public places for use by trained members of the lay public. Additionally, defibrillation has been identified as one of the key competencies that all trained nurses and other health care providers should be able to undertake. This paper will consider the background to the current guideline changes, analyse the wider implications of translating the recommendations into practice, and offer possible solutions to address the issues raised. Whilst the analysis is particularly pertinent to the United Kingdom, many of the issues raised have international importance.

Automation↗
PubMed2002

Evidence-based practice in health and social care: where are we now?

This paper explores evidence-based practice (EBP) in health and social care in the UK from the individual perspectives of professionals in physiotherapy, midwifery, nursing and social care. The present interest in EBP emerges as a natural derivative of contemporary economic, social and political trends and concerns. There is optimism and broad acceptance of the overall philosophy of EBP and each profession demonstrates a concerted organisational attempt to bridge the research--practice divide. This includes the interpretation of research outcomes in the form of practice guidelines, protocols and standards. However, adherence to these is poor and resistance to EBP is growing. This is attributed to practical and philosophical tensions common to all of the professions. These include the continued dominance of randomised controlled trials (RCTs) in the hierarchy of evidence. RCTs often fail to capture the multi-faceted individualistic nature of health and social care interactions or the development of qualitative methodologies within the professions. Concern is expressed that professional autonomy and the art of practice will be eroded by the enforcement of guidelines and protocols. EBP is currently located within individual professions rather than the broader context of interprofessional practice. The future of EBP is dependent, at least in part, on educational initiatives, organisational commitment and support, patient/client involvement and the development of a broader interprofessional perspective.

Attitude of Health Personnel↗
PubMedDate not supplied

How to get published: seven easy steps.

As a professional group, nurses, whether as academics or practitioners, are increasingly expected to contribute to the development of quality nursing care and service provision by disseminating the findings of research, sharing innovations in clinical practice or examples of best practice. Yet, many individuals find it difficult to write informatively about their practice or to translate the outputs of academic studies into accessible publications. However, in most instances, a lack of confidence remains a key obstacle as is the lack of familiarity with processes required in preparing a paper for publication. The aim of this paper is to discuss a series of progressive steps that must be followed when preparing a paper for publication in a peer-reviewed journal. The main body of the paper provides a detailed analysis on the importance of deciding what to write about, selecting a suitable journal, organizing the content and structure of a paper and using appropriate language to make the article more accessible to the audience. The discussion also explores the concepts of authorship order, peer-review process and how to respond to written reviewer's comments once the paper has been returned by the publishers. The paper concludes by stressing that success requires undertaking the necessary preparatory work, time, commitment and enthusiasm.

Humans↗