Biomedical subjects
Publications and source records attributed to S Furlong.
An assessment tool was developed to measure patient dependency and staff skill mix in a child psychiatry inpatient unit. The authors discuss the results of a three-month pilot implementation. The implications for practice include adjustments in staff duty rotas, allocation of skill mix and the systematic assessment of patient dependency before inpatient admission.
Self-administration of medicine (SAM) programmes for hospital in-patients have become increasingly popular. Such programmes are considered to facilitate education and learning. A quasi-experimental, longitudinal study was carried out to examine and compare knowledge acquisition, drug compliance, and satisfaction between patients who self-administered their medications and those who did not. Improvements in knowledge and compliance with medication regimes could not be linked directly with a SAM programme. All patients had a high level of knowledge of their medications and appeared to be compliant with prescribed drug regimes. Study findings support the hypothesis that knowledge improves with time, regardless of how medications are administered, but do not support the hypothesis that patients who self-administrate are more knowledgeable about their medications than those who do not. Therefore, SAM programmes may improve patient knowledge but opportunities to obtain knowledge may not be unique to such programmes. The ward or unit philosophy may be such that other patients, who are less willing or able to participate directly in their own care, also have the opportunity to improve their knowledge.
To assess the impact of sumatriptan in clinical practice, we undertook a retrospective analysis of the government of Newfoundland and Labrador's prescription drug program data base for 35 consecutive patients prescribed sumatriptan. The number of doses of all drugs prescribed ranged from 121 to 18,874 on from 4 to 357 prescriptions per patient over 1 to 19 months. The mean number of doses of analgesic drugs prescribed before sumatriptan therapy was 56 per month and after initiation of sumatriptan was 46 per month. The prescribing of multiple analgesics was common; 79% received three or more different analgesics. Twenty-two (63%) patients were prescribed medications indicated for the prophylaxis of migraine concomitantly with drugs indicated for symptomatic treatment. Twenty-four (69%) patients were prescribed medication capable of inducing migraine. We conclude that sumatriptan did not have a major impact on the outcomes of these patients judged by their use of analgesics. The simplest explanation is that many of the patients were suffering from analgesic-induced headache rather than migraine. In addition, we conclude that there were deficiencies in prescribing practices including numbers, quantities, and choice of analgesics; the use of analgesics concomitantly with drugs indicated for migraine prophylaxis; and the use of drugs capable of inducing migraine. Further research is required to validate these findings.
The purposes of this study were twofold. The first was to determine the rationale behind the adoption of a self-care approach to nursing. The second, to determine how a self-care philosophy is applied in practice. The study was carried out from a phenomenological perspective, as it facilitated an understanding of nursing practice from the practitioners' perspective. The adoption of a self-care philosophy and approach to caring, appears to have evolved through patients need. This finding has implications for all practitioners.
The key characteristic of primary nursing is a flattening of the traditional nursing hierarchy. Therefore, it is essential that each practitioner of primary nursing fully understands both his/her own role and that of his/her co-workers. Few studies have examined how practitioners of primary nursing view their role and the roles of others.
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This article describes how a nursing development unit (NDU), through the evolution of a self-care philosophy, responded to the changing needs and demands of patients. Patients in the NDU appeared to want to be more informed and involved in their health care. In addition, decreased length of stay as a result of increased sophistication of medical techniques and the need to have a faster throughput of patients has meant that a philosophy is required which is focused around empowering patients to take ownership for their own health care. The application of this philosophy is demonstrated through a case study which describes the experience of a gentleman who was cared for within the NDU.
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There has been a rapid increase in the number of so-called new roles in nursing. These have tended to develop in a random way. Consequently, titles are not a good indicator of what the role entails. The qualifications required to undertake a particular role are not clear and tend to be locally defined. This paper discusses the implications of this situation. Two subsequent articles will examine issues around patient consent, care provided by nurses in new roles and legality and accountability.
The development of new nursing roles is set to continue. Patients may not always be aware that the person giving them care is a nurse. This paper explores some of the issues of ethics, equity and consent as nursing becomes involved in more invasive and independent areas of practice.
The accountability of health care professionals is determined by what can reasonably be expected from an appropriately qualified practitioner. The recent proliferation of new roles raises the issue of what can be expected from postholders when their practice is questioned. This paper discusses the legal implications of roles that blur the boundaries between established professional groups.