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Biomedical subjects

S Cowman

Publications and source records attributed to S Cowman.

15 recordsLinked to original sources
PubMed2005

Wound cleansing for pressure ulcers.

BACKGROUND: Pressure ulcers (also called pressure sores, bed sores and decubitus ulcers) are areas of tissue damage that occur in the very old, malnourished or acutely ill, who cannot reposition themselves. Pressure ulcers impose a significant financial burden on health care systems and negatively affect quality of life. Wound cleansing is considered an important component of pressure ulcer care. OBJECTIVES: This systematic review seeks to answer the following question:What is the effect of wound cleansing solutions and wound cleansing techniques on the rate of healing of pressure ulcers? SEARCH STRATEGY: We searched the Specialised Trials Register of the Cochrane Wounds Group (up to August 2005), and the Cochrane Central Register of Controlled Trials (The Cochrane Library Issue 3, 2005). We searched bibliographies of relevant publications retrieved. We contacted drug companies and experts in the field to identify studies missed by the primary search. SELECTION CRITERIA: Randomised controlled trials (RCTs) comparing wound cleansing with no wound cleansing, or different wound cleansing solutions, or different cleansing techniques, were eligible for inclusion if they reported an objective measure of pressure ulcer healing. DATA COLLECTION AND ANALYSIS: Two authors extracted data independently and resolved disagreements through discussion and reference to the Cochrane Wounds Group editorial base. A structured narrative summary of the included studies was conducted. For dichotomous outcomes, relative risk (RR), plus 95% confidence intervals (CI) were calculated; for continuous outcomes, weighted mean difference (WMD), plus 95% CI were calculated. Meta analysis was not conducted, because of the small number of diverse RCTs identified. MAIN RESULTS: No studies compared cleansing with no cleansing. Two studies compared different wound cleansing solutions: a statistically significant improvement in Pressure Sore Status Tool scores occurred for wounds cleansed with saline spray containing Aloe vera, silver chloride and decyl glucoside (Vulnopur) compared to isotonic saline (P value = 0.025), but no statistically significant change in healing was seen when water was compared to saline (RR 3.00, 95% CI 0.21, 41.89). One study compared cleansing techniques, but no statistically significant change in healing was seen for ulcers cleansed with, or without, a whirlpool (RR 2.10, 95% CI 0.93 to 4.76). AUTHORS' CONCLUSIONS: We identified only three studies addressing cleansing of pressure ulcers. One noted a statistically significant improvement in pressure ulcer healing for wounds cleansed with saline spray containing Aloe vera, silver chloride and decyl glucoside (Vulnopur) when compared with isotonic saline solution. Overall, there is no good trial evidence to support use of any particular wound cleansing solution or technique for pressure ulcers.

Humans↗
PubMed2001

An examination of the role and function of psychiatric nurses in clinical practice in Ireland.

AIM OF THE STUDY: The aim of the study was to describe the role and function of all grades of psychiatric nurse in clinical practice so as to clarify the nature and scope of psychiatric nursing services. BACKGROUND AND RATIONALE: The psychiatric nursing role in Ireland and the United Kingdom (UK) in recent years has undergone a period of great change. There is a new emphasis on health promotion, early intervention, community development, with nursing being provided closer to where people live and work as well as making access to services easier for vulnerable groups of the population. Role ambiguity and the difficulty with defining psychiatric nursing work is a constant theme in the psychiatric nursing literature and this leaves the profession of psychiatric nursing rather vulnerable during this period of intense change. DESIGN AND METHODS: A descriptive qualitative research design with a multimethods approach to data collection was utilized involving three disparate but complimentary methods. RESULTS AND FINDINGS: Following data analysis, nine categories of nursing role were identified; these included both independent and interdependent roles. Clearly psychiatric nursing occupied a pivotal role in all mental health care settings. A major proportion of psychiatric nursing related to caring interactions and this appears to be a central nursing element. The assessment and maintenance of patient's safety was also important as mental health problems may place the patient or others in a position where their physical safety is threatened. CONCLUSION: It is concluded that Irish psychiatric nurses have been innovative and initiated many new services in response to emerging needs. Our understanding of psychiatric nursing is far from complete and the immediate challenge is to determine the knowledge and skills base required for independent therapeutic roles in response to changing mental health care needs.

Documentation↗
PubMed1998

The approaches to learning of student nurses in the Republic of Ireland and Northern Ireland.

In recent years during a period of change in nurse education, there has been an increased interest in educational theory and nurse educators have examined and questioned the fundamental principles upon which the system of education is constructed. In nurse education it is likely that no single theory of learning can account for all aspects of learning and there are reflections of many learning theories in the nursing curriculum. The literature in the area of student learning is complex and wide ranging and is poorly represented in the nurse education literature. In recognition of a lack of understanding and clarity on learning approaches in nurse education during a period of unprecedented change in Irish and United Kingdom (UK) nurse education, this paper aims to highlight the importance of understanding student nurse learning. A study is described which investigated the approaches to learning of student nurses from the Republic of Ireland, who were receiving a traditional apprenticeship training, and student nurses from Northern Ireland in a Project 2000 programme. On comparative statistical analysis significant differences were identified between the two groups in their approaches to learning. It is concluded that students' constructs of learning in nurse education are primarily dependent on their interpretation of the demands of the task, on assessment, teaching and the learning environment. The study provides nurse educationalists with important evaluative information from the students' perspective. It suggests that the way forward is to identify the significant contextual factors influencing student learning and to incorporate them into the nursing curriculum. Such an approach will serve to focus the system on variability in the quality of learning rather than on stability in human attributes.

Adolescent↗
PubMed1996

Student evaluation: a performance indicator of quality in nurse education.

This study, which forms part of a doctoral thesis, is derived from the increasing demand for economic models of nurse education as a process within a wider economic agenda which converts inputs (e.g. training costs) into outputs (e.g. registered nurses). In such a climate the pursuance and determination of quality in nurse education should be of fundamental concern to the nursing profession. The development of models for evaluation and measurement of quality must take due cognisance of the stakeholders' interests and concerns, and student nurses, as the consumers of nurse education, must be regarded as major stakeholders. This paper describes the use of the course experience questionnaire, an instrument designed to investigate the students' perspective on teaching and learning. The study incorporates a comparative analysis between Project 2000 students in Northern Ireland and students in the apprenticeship programme in the Republic of Ireland, from general, psychiatric, sick children's and mental handicap nursing. This comparative analysis does provide the nursing profession with a level of feedback on which to make decisions in the interest of quality. Nurse teachers should examine potential reasons why their programmes are poorly or highly rated and the actions that may be required to remedy imperfections on the one hand and the actions that may be taken to promote excellence on the other. As nurse education continues to forge links with universities, nurse teachers, by adopting student evaluation as a performance indicator, can maximize an essential element in the web of public accountability.

Adolescent↗
PubMed1995

The teaching/learning preferences of student nurses in the Republic of Ireland; background issues and a study.

Teaching and learning in all forms of education is being increasingly reviewed in a climate of educational accountability. The literature generally displays a certain irrationality about nurse education; on the one hand teachers are espousing student-centred ideologies while on the other hand, students are expressing preferences for teacher-structured approaches. The research on nurse education generally concludes that the roles of teacher and student operate around a mechanistic view of man with the teacher being viewed as the front of all knowledge and the students the passive recipients of that which was given. This paper reports on related background issues, and a study of the teaching/learning preferences of student nurses from general, psychiatric, sick children's and mental handicap nursing. Whilst students reflected preferences for more teacher-structured strategies, significant differences were identified between the preferences of the four groups of student nurses. It is concluded that any insistence on a doctrinaire approach to teaching and learning would be unnecessarily restrictive to the whole process of nurse education. Nurse tutors therefore need to reflect on what they do, particularly that which influences the relationship between the students and what they learn. It is then the responsibility of nurse tutors to act on what they have learned about that relationship and their part in it.

Attitude↗
PubMed1993

Triangulation: a means of reconciliation in nursing research.

The nursing profession has adopted many of its theoretical foundations, including research approaches, from other academic disciplines. This has resulted in the acceptance of one epistemological perspective to the exclusion of others. In this context, the evolution of nursing research reflects a rather conservative approach. The quantitative approach was the dominant paradigm of the 1950s, 1960s and during the 1970s and 1980s the research approach has been increasingly located in the qualitative paradigm. It is noted that each research perspective has several inherent differences which give rise to a specific type of research endeavour. Within the literature there is general support for the separateness of the quantitative qualitative paradigm. However in accepting the inherent differences between the two methods, nurse researchers have been concerned that neither method in isolation from the other will truly provide an understanding of human beings and of their health-related needs, problems or nursing care. Triangulation as a research strategy represents a means of integrating the two research approaches. Triangulation, first used in 1959, is defined as a combination of multi methods in a study of the same object or event to depict more accurately the phenomenon being investigated. The literature exploring the merits of triangulation is incomplete. However, it is reported that triangulation, by reconciling the paradigmatic assumptions inherent to quantitative and qualitative methods, provides rich and productive data. Triangulation does offer an alternative to the bi-polar quantitative and qualitative approaches and a means of reconciling the two methodological encampments.

Data Collection↗