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Biomedical subjects

Paul Fulbrook

Publications and source records attributed to Paul Fulbrook.

8 recordsLinked to original sources
PubMed2005

Advancing the clinical perspective: a practice development project to develop the nurse practitioner role in an acute hospital trust.

AIMS: The aims of this project were to investigate awareness and foster understanding of the concept of the nurse practitioner and to facilitate and support the development of nurse practitioner roles within an acute hospital trust. BACKGROUND: A limited understanding of and minimal support for the development of the nurse practitioner (NP) role were identified within an acute hospital trust in the south of England. This was the impetus for pursuing the project outlined in this paper. THEORETICAL PERSPECTIVE: The project used practice development theory synonymously with action research methodology comprising of four action research cycles. METHOD: Data were collected in a variety of ways within the four overlapping cycles using formal and informal methods, which were analysed concurrently during the project. Techniques included questionnaires, semi-structured interviews, meetings, discussions and the project leader's field notes' diary. OUTCOMES: A better understanding of the concept and support for NP posts were enhanced across the trust. A Nurse Practitioner Development Group (NPDG) was established, which helped to facilitate the development of NP posts. An example of such a post was established within a NP-led gynaecology pre-operative assessment clinic, which was a pilot project and constituted Action Research cycle 3. CONCLUSION: It is concluded that the development of NP roles, with the support of a NPDG, within an agreed strategy offers a robust process for NP development within an acute hospital setting. RELEVANCE TO CLINICAL PRACTICE: This project demonstrated how practice development and action research might be used together as a systematic process for developing and supporting professional roles that aim to improve the quality of patient care and the effectiveness of health care services.

Acute Disease↗
PubMed2003

Why do student nurses leave? Suggestions from a Delphi study.

The high dropout rate of nursing students is a major concern. However, there is little research available about the reasons why students leave. Universities collect some information from 'exit' interviews but, due to ethical sensitivities, it is not made available for research analysis. The purpose of this study was to establish a consensus view of the reasons why student nurses leave their pre-registration education programme. The study was undertaken in two phases. Initially, an exploratory phase using focus groups and one-to-one interviews was used to gather multi-professional views about the reasons why students leave. In the second phase a questionnaire was developed from the themes arising from the data analysis in phase one. The questionnaire was administered to an expert panel of student nurses in the form of a three-round Delphi Study. The consensus level was set at 75%. It is important to clarify that, for reasons stated above, the views expressed in this paper are those of current students about others who had left the programme. From this study, it is apparent that, with the exception of academic failure, there was no single contributing factor that was thought to make students leave. However, there were a number of important issues identified as factors that may result in student nurses leaving. These include communication and operational factors between the university and clinical areas, feelings of not being valued, unmet expectations, and stress. These issues were of concern to students and appeared to have a cumulative effect that led them to question whether they should continue their education programme. On the basis of these findings, several recommendations are made to improve the student nurse experience.

Attitude of Health Personnel↗
PubMedDate not supplied

Developing best practice in critical care nursing: knowledge, evidence and practice.

Because the current drive towards evidence-based critical care nursing practice is based firmly within the positivist paradigm, experimentally derived research tends to be regarded as 'high level' evidence, whereas other forms of evidence, for example qualitative research or personal knowing, carry less weight. This poses something of a problem for nursing, as the type of knowledge nurses use most in their practice is often at the so-called 'soft' end of science. Thus, the 'Catch 22' situation is that the evidence base for nursing practice is considered to be weak. Furthermore, it is argued in this paper that there are several forms of nursing knowledge, which critical care nurses employ, that are difficult to articulate. The way forward requires a pragmatic approach to evidence, in which all forms of knowledge are considered equal in abstract but are assigned value according to the context of a particular situation. It is proposed that this can be achieved by adopting an approach to nursing in which practice development is the driving force for change.

Benchmarking↗
PubMedDate not supplied

Care bundles in critical care: a practical approach to evidence-based practice.

The care bundle is a new concept in critical care, which is currently being promoted by the National Health Service Modernisation Agency for Critical Care. Care bundles originated in North America and are described best as groups of evidence-based practice interventions. The theory behind care bundles is that when several evidence-based interventions are grouped together in a single protocol, it will improve patient outcome. Care bundles are relatively easy to develop, implement and audit, and provide practitioners with a practical method for implementing evidence-based practice. This article describes the care bundle and offers practical suggestions about how to develop, implement and audit them in practice.

Benchmarking↗
PubMedDate not supplied

Education for outreach: development of an interprofessional MSc in critical care.

This article describes the development of a new multi-professional Master's degree programme, which is aimed at supporting the education of practitioners in meeting the needs of Level 1 critically ill patients. The main drivers that influenced its development were Comprehensive Critical Care (Department of Health, 2000a) and the National Health Service Modernisation Agency for Critical Care. The programme was aimed primarily at junior doctors, senior ward nurses, senior physiotherapists and members of Outreach teams. The programme was designed to maximize work-based learning and is framed around two clinically focused units. The programme is informed by principles of quality improvement and aims to prepare practitioners to meet the needs of Level 1 patients 'at the point of need'.

Certification↗