Biomedical subjects

Tina Day

Publications and source records attributed to Tina Day.

3 recordsLinked to original sources

PubMed2003

Developing a competency framework for critical care to match patient need.

UNLABELLED: The competency framework developed by the critical care education group of the London Standing Conference aims to serve every grade and level of practitioner. It is neither time specific nor static. The patient is the central focus of the framework and the elements of competence reflect patient need at any critical care level [Comprehensive Critical Care: A Review of Adult Critical Care Services, The Stationary Office, London]. A group of expert nurses have developed the competency framework, with widespread consultation and collaboration. This approach intended to develop consistency for critical care education and practice. It is envisaged that this will reduce pockets of repeated activity, which places huge demands on limited resources. The critical care competency framework was developed using the method of functional analysis. A plan for the future has been identified, including continued collaboration and consultation with Trusts and Higher Educational Institutions and the development of an online manual to support the competency framework. KEY POINTS: 1. Critical care delivery has been under close scrutiny and a number of key contemporary drivers have led to the development of this competency framework. 2. The development of a consistent pan-London approach to critical care education has been identified. 3. The patient is the focus of critical care delivery and therefore patient need is central to the critical care competency framework. 4. Wider collaboration is needed with other agencies and groups to prevent the repetition of work already carried out.

Clinical Competence↗

PubMed2002

Suctioning: a review of current research recommendations.

Effective suctioning is an essential aspect of airway management in the critically ill. However, there are many associated risks and complications. These range from trauma and hypoxaemia to cardiac dysrhythmias and, in extreme cases, cardiac arrest and death. This paper identifies the current research recommendations for safer suctioning practices. The literature is reviewed in three parts: prior to suctioning; during suctioning; and post-suctioning. The recommendations prior to suctioning include patient assessment, patient preparation and hyperoxygenation. The recommendations during suctioning include appropriate catheter selection, depth of insertion, negative pressure, duration of procedure and number of suction passes. Measures for maintenance of asepsis, such as hand-washing, wearing gloves, goggles and aprons are other essential considerations, which must not be overlooked. The recommendations post-suctioning include reconnection of oxygen, patient assessment, reduction of oxygen to baseline level, and providing patient reassurance. In order to improve standards of care, it is imperative that nurses are aware of current research recommendations. This will enable nurses to make informed decisions about their own suctioning practices, based on the individual needs of the patient.

Clinical Nursing Research↗

PubMed2002

Tracheal suctioning: an exploration of nurses' knowledge and competence in acute and high dependency ward areas.

BACKGROUND AND RATIONALE: With an increasing demand for intensive care beds more nurses in acute and high dependency wards will be expected to care competently for patients with tracheostomy tubes. Tracheal suctioning is an essential aspect of effective airway management. However, this has many associated risks and complications, ranging from trauma and hypoxaemia to, in extreme cases, cardiac arrest and death. It is imperative that nurses are aware of these risks and are able to practice according to current research recommendations. Aims. This study was designed to explore nurses' knowledge and competence in performing tracheal suctioning in acute and high dependency ward areas and to investigate discrepancies between knowledge and practice using method triangulation. METHODS: Twenty-eight nurses were observed using nonparticipant observation and a structured observation schedule. Each subject was interviewed and questioned about their tracheal suctioning practices, and subsequently completed a knowledge-based questionnaire. Scores were allocated for knowledge and practice. FINDINGS: The findings demonstrated a poor level of knowledge for many subjects. This was also reflected in practice, as suctioning was performed against many of the research recommendations. Many nurses were unaware of recommended practice and a number demonstrated potentially unsafe practice. In addition, there was no significant relationship between knowledge and practice. However, during the interviews, many nurses were able to provide a rationale for specific aspects of practice that were perhaps not based on current research recommendations. CONCLUSIONS: The study raised concern about all aspects of tracheal suctioning and has highlighted the need for changes in practice, clinical guidelines and focused practice-based education.

Clinical Competence↗