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Biomedical subjects

Karen Bryan

Publications and source records attributed to Karen Bryan.

10 recordsLinked to original sources
PubMed2005

Delayed transfers of older people from hospital: Causes and policy implications.

Health and social care agencies in the UK. have been under pressure for some time to reduce delayed transfers of older people from hospital because they absorb scarce health service resources and incur a human cost through inappropriate placement. A local study based on an analysis of records and interviews with managers showed that delays reflect the complex needs of older people, and arise from financing and organisational problems at both the planning and implementation stages of a discharge. Family resistance may also be a factor. Budgetary constraints result in delays in confirming public support for some clients. Shortages of professional staff and care assistants limit the provision of domiciliary packages. The contraction of the residential sector has reduced the availability of beds and increased the cost of care home placements. Scope exists for expediting administrative aspects of transfers by coordinating health and social services. More recent legislation that imposes fines on social service departments for delayed transfers does not address underlying causes.

Aged↗
PubMed2005

Clinicians and dyslexia--a computer-based assessment of one of the key cognitive skills involved in drug administration.

AIMS: This research investigates the relationship between dyslexia traits and nurse performance on a laboratory task designed to assess one of the key cognitive skills involved in drug administration. The potential moderating role of perceived performance control was also assessed, based on previous work demonstrating the importance of self-belief as a facilitator of vocational success. BACKGROUND: Dyslexia within the health care professions has been the subject of wide and emotionally charged debate but has not yet been scientifically examined. Those who fear clinicians with dyslexia do so because of a presumed or potential risk to patient health and safety posed by dyslexia-induced performance error (e.g. problems with drug administration). DESIGN, SAMPLE AND METHODS: 46 nurses (40 student nurses and 6 qualified nurses) volunteered to complete a battery of computerised tasks assessing for dyslexia traits (using four accuracy tasks measuring different types of literacy skill), a paired association task designed to measure one of the key cognitive skills involved in drug administration) and a self-report questionnaire (Learning Styles Questionnaire, self-reported reading difficulty and a history of educational support, perceived control over performance). The performance criterion measure was constructed after detailed job analysis (involving analysis of official documentation, in-depth interviews and field observation across a variety of clinical settings) and involved matching drug names to patient names and vice versa. RESULTS: The results showed that the dyslexia indicators (objective and self-report) were significantly correlated with performance on the paired association task. Contrary to expectation however, the perceived control variable was not associated with performance. CONCLUSION: The findings provide tentative support for the idea that some tasks might be problematic for the clinician with dyslexia. Taken in isolation however, it would be inappropriate to conclude that this will necessarily translate into true performance errors without taking into consideration the entire performance context. Suggestions are made for replicating and extending the study to provide a more solid and constructive basis for intervention (e.g. support measures, a built-in checking process).

Adaptation, Psychological↗
PubMed2005

Developing an interprofessional learning culture in primary care.

This paper discusses the concept of interprofessional learning based on empirical data from an evaluation of an interprofessional learning project that was set in a British primary health care centre. A process evaluation methodology was chosen to collect the data using semi-structured interviews and focus groups with stakeholders and staff to gather their experiences and views of the project and documentary data from records written over the lifetime of the project. The paper argues that an interprofessional learning culture requires time to become embedded in everyday practice and to achieve such a culture, shared values, aims and clear communication are essential. The data suggest that there is a need to recognize responsibility for one's own learning as individuals as well as learning as teams of work colleagues if interprofessional learning is to be successful. However, even when these pre-requisites of interprofessional learning are agreed and acknowledged openly in the workplace, participants in the development of a learning culture need to recognize that there are structural controls which influence and constrain such developments which are external to participants and beyond their immediate control.

Community Health Nursing↗
PubMed2005

Clinical leadership in health care: a position statement.

PURPOSE: This paper aims to briefly review leadership within the contemporary UK National Health Services (NHS) including Department of Health and Royal College of Nursing (RCN) initiatives. DESIGN/METHODOLOGY/APPROACH: It is argued that the concept of clinical leadership is a viable and important one, and is theoretically consistent with the contemporary social psychological literature on the importance of "local" leadership to effective organizational functioning. Field theory proposes that local influences (e.g. local management) on attitudes and behaviour will to a large extent mediate the impact of the organization (e.g. organisational structure and values) on (in this instance) health care delivery. FINDINGS: The reality of clinical leadership must involve a judicious blend effective management in the conventional sense with skill in transformational change in order to make real difference to the care delivery process. PRACTICAL IMPLICATIONS: For leadership initiatives to become truly culturally embedded into the "way we do things around here", they require more than just individual training and development. ORIGINALITY/VALUE: A view is offered for the practical interpretation of the clinical leadership concept in relationship terms. This will involve management of the relationship between health care professionals, between health care professionals and the "organizations" to which they are accountable and between health care professionals and service users.

Delivery of Health Care↗
PubMed2004

An analysis of information available to relatives in intensive care.

The Comprehensive Critical Care Review published by the Government in 2000 acknowledges that patients are part of family units and critical illness has an extended impact. It outlines information that should be provided to relatives and suggests recommendations be implemented within 3-5 years. The aim of this study was to gauge an overall view of provisions available across general Intensive Care Units in England for relatives, by conducting an analysis of information available and unit policies, and to see the extent that government guidelines have been adhered to. Two hundred and ten units were approached for copies of policy documents and leaflets. There was a 56% response rate. Results were collated and analysed for basic descriptive statistics using software package SPSS version 11.5. The Gunning's Fog Index was performed on 20% of leaflets to measure readability. All leaflets measured above the recommended level. Sixteen percent of units do not have a leaflet and therefore do not comply with the Department of Health recommendations. Huge variation exists nationally over the amount and quality of information that relatives have access to and receive. Only 9% of units had an official policy on how to deal with relatives. The implications of this are discussed.

England↗
PubMed2004

An evaluation of dependency assessment: experiences of staff, patients and carers in a UK hospice.

AIM: To evaluate the experiences of health-care professionals, service users and carers of service users from a UK hospice in relation to dependency assessment. DESIGN: Qualitative evaluation. SAMPLE: Purposive, convenience sample of hospice staff, patients receiving hospice services and carers of patients receiving hospice services. METHODS: Focus group interviews with hospice staff and carers of hospice service users. Individual interviews with patients. RESULTS: Staff felt the tool used produced inaccurate results, in part because of omissions in content. They did not perceive the data produced affected working practice, e.g. staffing levels. Patients described unobtrusive assessment and stated their needs were met. Carers reported feelings of isolation. They also described differing information and support needs from the patients. CONCLUSION: Further research is required to improve the validity of dependency data collection. Further investigation of carer assessment is also justified.

Aged↗
PubMed2003

Variant Creutzfeldt-Jakob disease: need for mental health and palliative care team collaboration.

People with a dementia syndrome and a superimposed terminal illness are increasingly being referred to palliative care services. Creutzfeldt-Jakob disease (CJD) is a dementia syndrome in the early stages of which people experience a variety of psychological symptoms that may lead to them being admitted to psychiatric services. People with CJD have died in psychiatric units. There is clearly a need for collaboration between mental health and palliative care services in providing care for people with CJD and other dementia syndromes. An inductive qualitative study of one case of variant CJD (vCJD) was carried out to explore issues that were raised in providing care for a young person with the disease who had died in a hospice unit. The study, which was a pilot for a larger study, highlights some of the complexities of providing care for people with an end-stage dementia and identifies the need for the development of education initiatives to increase knowledge and understanding of the end-of-life needs of people with CJD and other dementia syndromes, and their families.

Adaptation, Psychological↗
PubMedDate not supplied

Preliminary study of the prevalence of speech and language difficulties in young offenders.

BACKGROUND: There are no systematic surveys of the UK prison population, but data from several sources suggest that a significant number of prisoners might have limitations in their speech, language and communication abilities. AIM: To examine the hypothesis that compared with the general population, a significantly larger number of the prison population has speech, language and communication difficulties. METHODS & PROCEDURES: A survey of 10% of the young offenders within one young offender's institution was conducted. Tests of naming, picture description, grammatical competency and comprehension were used. OUTCOMES & RESULTS: Forty-three per cent of participants scored at a level significantly lower than the limits acceptable for their age on the Boston Naming Test; 73% scored significantly below the acceptable limits for their age on grammatical competency; 23% scored significantly below the acceptable limits for their age on language comprehension; 47% of participants received more than one rating of moderate impairment on picture description. CONCLUSION: It was confirmed that high levels of speech, language and communication difficulties are found among the young offender population. The implications for the management of young offenders, the limitations of the study and indications for further research are discussed.

Adolescent↗
PubMedDate not supplied

Relatives' experiences of critical care.

This exploratory study investigates relatives' overall experiences of the critical care environment and how staff perceived these experiences. Traditionally, research in Critical Care concentrated on patients' psychological well-being or relatives' immediate needs. There is little research that addresses the relative's overall experience of events. Critical Care Units are possibly the most daunting units in hospitals. Having a family member admitted to a Critical Care Unit could qualify as a traumatic-enough stressor to induce post-traumatic stress symptoms in relatives. A convenience sample of eight relatives and five staff participated in the study. The study used qualitative methods and drew on techniques of grounded theory. While staff perceived relatives' experiences accurately; issues arose, from both staff and relatives perspective, with regard to accurate dissemination of information. Further research into the communication processes used within Critical Care Units is required in addition to developing best practice in this area.

Adaptation, Psychological↗