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Biomedical subjects

M Mallik

Publications and source records attributed to M Mallik.

15 recordsLinked to original sources
PubMed2000

An exploration into the role of the teacher/lecturer in practice: findings from a case study in adult nursing.

Against a background of increasing concern over the widening theory practice gap and research evidence of problems in providing quality practice education, the English National Board (ENB) commissioned an 18 month study into the role of the teacher/lecturer in practice. This article, after providing a brief overview of the background, literature and methods, outlines the results from the Adult Case Study stage of the research. Documents, individual and focus group interviews of lecturers (n = 76), practitioners (n = 46) and students (n = 131) in five schools of nursing and midwifery provided data for analysis. A role labeled as 'link lecturer' was the most common approach acknowledged by all respondent groups. Despite overt commitment to the practice role by schools of nursing and midwifery, findings indicate that lecturers are unprepared, unsupported and unmonitored. Students and practitioners had very variable experiences and expressed a strong need for a better-organized approach which would provide them with consistent and sustained support in the practice setting. Overall the study highlighted a lack of strategic management of the practice role by university schools of nursing and midwifery. Convergence of findings from midwifery and the other branches of nursing provides strong research evidence for recommendations for more active management of the practice curriculum to be implemented as part of any future proposed reforms for nurse education in the UK.

Adult↗
PubMed2000

Diffusion of the concept of patient advocacy.

PURPOSE: To examine the growth and diffusion through the USA and UK literature of nurses claims to patient advocacy. DESIGN: A bibliometric analysis of articles cited under the key descriptor "patient advocacy" in the International Nursing Index (INI) was undertaken. Analysis included output in 5-year accumulations from 1976 to 1995, and was focused on quantity of output and exposition of concerns through interpretation of the titles. Citation mapping was undertaken to trace dominant influences in the diffusion process. METHODS: Titles and countries of origin of the journal along with year of publication were organized into a database to provide quantitative material on comparative output from the USA and the UK. Citation profiles of key influencing authors were examined. FINDINGS: A role in patient advocacy was proposed in the American nursing literature in the late 1970s and in the British literature a decade later. Support for the role was evident in its use in professional organizations and schools. The pattern of dissemination illustrates the influence of American nursing on the professional role of nurses in the UK. CONCLUSIONS: On the basis of a stages model for diffusion of an innovation, patient advocacy has reached only preliminary stages of acceptance as an innovation in nursing.

Humans↗
PubMed1998

The role of nurse educators in the development of reflective practitioners: a selective case study of the Australian and UK experience.

The potential to improve patient/client care, stimulate the personal and professional growth of the practitioner and help close the theory practice gap has provoked much discussion in the nursing literature on the benefits of reflection on practice. In order to examine recent developments in this area, a study tour, supported by the Florence Nightingale Foundation, was conducted in Australia and the UK during the spring and summer of 1995. Using an illuminative case study approach, data collected demonstrated that although reflective practice was fully endorsed by the nursing profession in Australia, and there were excellent examples of reflective practice in use, the continued growth of the reflective practice movement appeared to be threatened by the rationalization of both clinical and theoretical education in the universities. Issues around methods of encouraging reflection in students focused on ethical use of journals, the levels of reflection developed and the outcome effectiveness of reflective learning. Although it is recommended that the nursing profession continue to endorse developments in reflective practice in the UK, it is also necessary to encourage both process and outcome evaluations of its effects on the development of the individual nurse and on the ensuing quality of health care delivery.

Australia↗
PubMed1998

Role extension or expansion: a qualitative investigation of the perceptions of senior medical and nursing staff in an adult intensive care unit.

The Scope of Professional Practice (UKCC 1992) has significantly altered the interpretation of nurses' roles, emphasizing individual professional accountability and clinical decision-making. However, 5 years after the issue of the document, uncertainties remain regarding interprofessional legal accountability between medicine and nursing. To investigate issues surrounding role extension or expansion in intensive care nursing, a small qualitative study was conducted centred on one intensive care unit (ICU) within a large teaching hospital. Data were collected by semi-structured interviews from a purposive sample of five senior intensive care nurses and three consultant anaesthetists. Four major categories emerged, identified as: interpretation confusion; education for change; struggles for power and task versus autonomy. The findings revealed that the senior critical care nurses identified themselves as independent, autonomous practitioners involved in clinical decision-making. However, there was evidence of a reluctance to empower more junior staff to perform extended or expanded roles. Medical respondents viewed extended or expanded roles as taking on mechanical tasks for which anyone could be trained to perform. In conclusion, it is argued that although nursing is maturing in its growth towards professionalization, broader issues such as the legal quagmire, failure to adopt the philosophy of role expansion and the existence of sacred boundaries intra- and inter-professionally need to be addressed.

Adult↗
PubMed1998

A comparative study of differences in the referral behaviour patterns of men and women who have experienced cardiac-related chest pain.

Survival and long-term prognosis after a myocardial infarction are directly related to the individuals's decision to seek medical help. Early medical intervention is imperative if thrombolytic therapy is to be effective. Emerging research has indicated that women frequently have longer pre-hospital delays than men. Incorporating a comparative descriptive design, this research compared the pre-hospital admission behaviour patterns of women and men, following the onset of acute chest pain. A convenience sample of 12 women and 12 men were selected following admission to a local coronary care unit. Structured interviews and the examination of medical notes/relevant documentation provided the data. Findings were examined and compared through the use of content analysis and descriptive statistics. Severity of symptoms proved to be the strongest influence in shortening pre-hospital delay. Despite this, overall, men were admitted to hospital more quickly than women. Men were more ready than women to believe that they might be having a heart attack and this belief led them to seek treatment promptly. In order to improve female mortality and morbidity following a myocardial infarction, it is recommended that there is an urgent need to target women, through health promotion and media interventions.

Adult↗
PubMed1998

Advocacy in nursing: perceptions and attitudes of the nursing elite in the United Kingdom.

In recent years, patient advocacy has been claimed as an integral part of the nurse's role in health care delivery in the United Kingdom (UK). Support from the nursing leadership/elite is seen as important in the promulgation and diffusion of any 'new' role in nursing. This paper explores the perceptions and attitudes of nurse leaders in the UK to the adoption of the patient advocate role as an 'innovation' in nursing. Using a qualitative methodology, semi-structured interviews with six of nursing's 'elite' were conducted over a period of 5 months. Results revealed contradictions and paradoxes within the views of the elite. Although leaders recognized patient advocacy as a role integral to the moral value system in nursing enhanced by the nurse-patient relationship, they objected to the professionalization of the role, seeing an exclusive claim to patient advocacy as intensifying interprofessional conflicts in health care. It is argued that unless professionalized, the individual nurse will continue this potentially risky activity without adequate authority or support systems. The results overall question the role of the nursing leadership in the diffusion of innovations in nursing.

Attitude of Health Personnel↗
PubMed1997

Advocacy in nursing--a review of the literature.

Patient/client advocacy has been claimed as a new role for the professional nurse. This paper presents a critical review of the literature on advocacy in nursing. After briefly outlining the conditions which may have instigated the need for patient advocacy, meanings and models of advocacy are discussed. It is argued that although there are many examples of the advocacy role in health care, models proposed for the nurse as advocate are indeterminate which leads to multiple interpretations and lack of clarity in operationalizing advocacy. Much of the literature focuses on justification arguments for claiming the advocacy role. Key themes are outlined and include: patient advocacy as a traditional role, nurses are in the best position in the health care team, nurses have the knowledge to advocate and finally nurses and patients can be partners in advocacy. However, critical examination reveals many counter-arguments to the above claims and finally concludes that advocacy is a potentially risky role to adopt. It is argued that support systems are inadequate except in low-risk situations and ultimately acts of advocacy remain a moral choice for the individual nurse. Finally the need to conduct research into the interpretation of the patient advocate role by nurses in the United Kingdom is highlighted.

Career Choice↗
PubMed1997

Advocacy in nursing--perceptions of practising nurses.

This paper reports on a qualitative study which examined the interpretation of patient advocacy by practising nurses. Focus group interviews, which allowed respondents to recount and share their particular 'stories' of patient advocacy, were used to collect data. Results indicate that a triadic model of advocacy predominated which involved the nurse in a conflict/potential conflict situation. The patient's requests, the patient's fear, the patient's vulnerability or threats to the patient's human rights provoked an advocacy response in the perceptive nurse. The nurse was sustained in the role through patient recognition, the nurse-patient relationship, emotional strength, moral justification and knowledge/expertise legitimacy. The nurse used direct and indirect means to protect the patient against incompetent/inappropriate practice and/or represent patient/family choice, the advocacy activity resulting in positive or negative outcomes. In conclusion it is argued that if the triadic conflict model of advocacy outlined by this research is to be sustained by practising nurses, the potential risks involved should be recognized. Professionalization of the role may be the only way forward if the ethical code (United Kingdom Central Council, 1992) continues to make patient advocacy a mandatory activity for the professional nurse.

Attitude of Health Personnel↗
PubMed1991

Real-time sensing of tooth position for dental digital subtraction radiography.

Dental digital subtraction radiography requires accurate repositioning of the patient and X-ray source in order to facilitate correct diagnostic of bone loss. Present mechanical repositioning systems do not allow radiography of posterior teeth, and are uncomfortable for the patient. A new repositioning system that utilizes a six degrees of freedom position sensor and a robot arm with X-ray source is proposed. A mathematical model for the system is given, and the robot arm solution is obtained based on patient position. An error analysis is performed in order to determine the influence of sensor and robot errors on system accuracy. A series of experiments to determine sensor noise and accuracy are described. These tests showed relatively small errors over the work envelope of the sensor. Further tests showed that there is no adverse effect due to the presence of metal work in the patient's mouth. The high bandwidth of the sensor may allow real time tracking of small movements of the patient's head.

Alveolar Bone Loss↗
PubMedDate not supplied

Patient representatives: a new role in patient advocacy.

Patient representatives advocate the consumer interests of hospital patients. The initiation and development of this role in hospitals in the USA during the mid-1970s is now being mirrored in the UK. Patient representatives in both countries have been supported by powerful hospital associations, receive their authority to act through hospital management and deal with similar patient issues. Occupational boundary disputes have occurred with other healthcare professionals who feel that they are the patient's advocate. It is important to differentiate between this new full-time professional role and other claims to patient advocacy made by the nursing profession.

Humans↗