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EBN Journal Chat #ebnjc

Treating pain during pregnancy and breast feeding

16 Apr, 17 | by josmith

This week’s EBN Twitter Chat on Weds 19th April at 8-9pm UK time will focus on pain during pregnancy, how important and difficult is to treat pain during pregnancy and breast feeding.

The Twitter Chat will be hosted by Dr Massimo Allegri, Assistant Professor in Anesthesia Intensive Care and Pain Medicine at the University of Parma (Italy),@allegri_massimo. Participating in the Twitter chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward, You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ and add #ebnjc (the EBN chat hash tag) at the end of your tweet, this allows everyone taking part to view your tweets.

The Pain Department of University Hospital of Parma is one of the biggest pain clinic in Italy and it is the most important research centre about acute ad chronic pain in Italy and one of the most important in Europe.

Furthermore, next year a new PhD Position in Pain will be settled up together with Alborg University and Prof Lars Arendt Nielsen about chronic pain and central sensitization. Furthermore, University of Parma organizes one of the most important translational pain meeting in the world: SIMPAR (www.simpar-pain.com).

Pain affects 20% of adult population worsening not only quality of life, but also outcome of patients who refer it. Unfortunately, pain continues to being undertreated and under-recognized. Chronic pain is not just a symptom but it is a real disease that needs an accurate diagnosis and appropriate therapy against the pain generator pathophysiology.

This problem is even more important during pregnancy and breastfeeding. The fear to give drugs that can hurt foetus/neonate can drive the physician to a “wait and see” approach that cannot solve the problem to the mother. Furthermore, during pregnancy there are several physiological changes that can worsen previous pain or generate new one. Finally, all the drugs are obviously off label and it is difficult to know exactly their real toxicity.

On Wednesday 19th April during the twitter chat we will continue the conversation to consider how to drive the therapy for patients during pregnancy and breastfeeding. We will discuss all together which multidisciplinary approach could be useful and how important is to diagnose the right pathophysiological mechanism that triggers the acute or chronic pain:

  • Which are the classifications of the drugs that could drive clinicians to use the drugs to alleviate pain?
  • When is more harmful to use some specific drugs?
  • Which concerns do we have to consider when we give a drug to a breastfeeding mother?
  • How to perform the right pathophysiological diagnosis?
  • Do we have to stop some drugs if the women would like to become pregnant

Please join us to discuss this important medical, nursing and public health challenge.

References

1 Coluzzi F, Valensise H, Sacco M, Allegri M Chronic pain management in pregnancy and lactation. Minerva Anestesiol. 2014 Feb;80(2):211-24.

2  Narayan B, Nelson-Piercy C. Medical problems in pregnancy. Clin Med (Lond). 2016 Dec;16(Suppl 6):s110-s116.

3 Tepper D. Pregnancy and lactation–migraine management. Headache. 2015 Apr;55(4):607-8.

Dementia Awareness Training with a Difference

3 Apr, 17 | by hnoble

Karen Galway and Catherine Monaghan, School of Nursing and Midwifery, Queen’s University Belfast, Medical Biology Centre, 97 Lisburn Road, Belfast Northern Ireland. BT9 7BL

 

This week’s EBN Twitter Chat on Wednesday 5th April between 8-9 pm (UK time) will focus on dementia, how we can break the taboo and improve education in this area.

The Twitter Chat will be hosted by Dr Karen Galway a Lecturer in Mental Health nursing At the School of Nursing and Midwifery, Queens University Belfast. Participating in the Twitter chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward, You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ and add #ebnjc (the EBN chat hash tag) at the end of your tweet, this allows everyone taking part to view your tweets.

The School of Nursing and Midwifery at Queen’s University Belfast has been championing improvements in dementia care through continuing professional development training over the past two decades.  The increasing prevalence of dementia, which has been referred to as the dementia tsunami, means that healthcare professionals need more training, support and resources to help alleviate symptoms and maximise quality of life. There is a clear need for specialised training as we continue to learn more about how to prevent, diagnose and treat the condition.

We teamed up with AFTAThought Training Consultants, to take our programme of training to a new level. AFTAThought was formed in 1988, and has been inspiring people to think differently ever since. “We’re passionate about what we do, delivering training through drama to bring issues, policies and legislation to life and we’ve trained just shy of a million people.”  Topics addressed in this inaugural partnership training included; public awareness, effective management, role of primary care, person centered care, communication challenges, identity, capacity and caregiving.

Approximately 300 students, researchers, statutory sector and voluntary sector health and social care professionals attended the event and we received some remarkable feedback indicating a strong and healthy appetite for this type of dementia training.  Many of those who provided feedback related the awareness training to their own personal experience with dementia, as a carer or as a professional.

Gary Mitchell, Research Coordinator at Four Seasons Healthcare commented on the training session; “You’re really filling a gap with this training. It is much needed.”

The awareness training was based on a local policy document (Dementia Learning Development Framework, 2016) and peer reviewed publications we have produced 1–4. The format was based a number of scenarios including; initial recognition of a problem by an individual, reactions from their family and the GP, disclosing a diagnosis and managing family dynamics, capacity to make decisions, transitions to nursing and residential care and hospital admissions. The session ended with a touching account of how it feels to be a family member caring for someone with dementia. There wasn’t a dry eye in the house, this training hit home and you could hear a pin drop.

We were thrilled to receive spontaneous feedback via email and from some students in subsequent classes. Some of these are quoted below;

“I just wanted to send an email to say what a fantastic experience and incredible insight the dementia lecture was. I lost my father to vascular dementia 18 months ago and was delighted to see that the experiences of family and the person living with dementia was so realistically and sensitively portrayed.”

“I was a student of yours way back in 2013. I attended the dementia awareness session yesterday & just wanted to get in touch to let you know I thoroughly enjoyed it. It was a very powerful and emotive experience.”

“Fantastic training! Really enjoyed the experience and a great insight to dementia. Puts things into perspective and creates a better way of thinking. Very overwhelming performance, it was brilliant.”

“That was the best lecture I’ve ever had”

On Wednesday 5th April during the twitter chat we will continue the conversation to consider these dementia questions that we have yet to answer;

  1. What are the best ways to break the taboo of dementia?
  2.  How can we best help people discuss and share their concerns, thoughts and feelings and maybe seek help earlier?
  3. What way should education be delivered, to allow all disciplines of health care professionals to access training that will increase the quality of dementia care?

Please join us to discuss this important medical, nursing and public health challenge.

References

1           Carter G, van der Steen J, Galway K, Brazil K. GPs’ perceptions of the barriers and solutions to good quality palliative care in dementia. Dement Int J Soc Res Pract 2015; In Press.

2           Brazil K, Carter G, Galway K, Watson M, van der Steen JT. General practitioners perceptions on advance care planning for patients living with dementia. BMC Palliat Care 2015; 14: 1–6.

3           Mitchell G, McCollum P, Monaghan C. The personal impact of disclosure of a dementia diagnosis: a thematic review of the literature. Br J Neurosci Nurs 2013; 9: 223–8.

4           Mitchell G, McCollum P, Monaghan C. Disclosing a diagnosis of dementia: A background to the phenomenon. Nurs Older People 2013; 25: 16–21.

Desert Island Discs and the role of the health care professional in addressing child health inequalities….

12 Mar, 17 | by atwycross

Blog written by Kath Evans 

This week’s EBN Twitter Chat on Wednesday 15th March between 8-9 pm (UK time) will focus on the role of the health care professional in addressing child health inequalities. The Twitter Chat will be hosted by Kath Evans (@kathevans2) a children’s nurse who works at NHS England and leads on improving experiences of care in maternity, infant, children and young people’s services and Professor Alison Twycross (@alitwy) – editor of Evidence Based Nursing. This Blog provides some context for the Chat.

Participating in the Twitter chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward, You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ and add #ebnjc (the EBN chat hash tag) at the end of your tweet, this allows everyone taking part to view your tweets.

I love listening to Desert Island discs as I run (admittedly at a pretty slow pace) around my local park, it was Dame Carol Black and her desert island discs that got me running again back in February 2016. She’s still running in her 70s, and as I’m in my 40s I didn’t think I had any excuse not to lace up my running shoes and get plodding!

However it was Sir Michael Marmott’s  desert island discs podcast (who published ‘Fair Society, Healthy Lives’  ‘The Marmot Review’  )  that got me thinking that we now know so much about child health inequalities and the reasons for them, and yet they continue to exist.

As health care professionals we also see child health inequalities day in day out on our wards, in schools, A&E or Urgent Care centres in fact anywhere where healthcare is delivered. The infant brought in dead having suffocated after co-sleeping, the 4 year old drinking cola from a bottle whilst being admitted for dental extractions due to tooth decay, the obese five year old, the 8 year old awaiting a child protection medical so malnourished and with hair so matted and infested that the play specialist and nurse spend hours bathing and treating her with such kindness that shines a light on compassion in practice and exemplifies the non-judgemental attitude of health care professionals, whilst knowing the social deprivation many of the children are facing. more…

Do Nurse-Led Programs Make a Difference?

26 Feb, 17 | by rheale

This week’s EBN Twitter Chat is on Wednesday 1st of March, between 8-9 pm (UK time) and will be hosted by Roberta Heale (@robertaheale) Associate Editor at EBN.

The Twitter chat this week will focus on a commentary about a nurse-led exercise program for hemodialysis patients. Nursing care very often incorporates health promotion and disease prevention programming, particularly related to chronic disease management. In fact, the development and implementation of health programs are somewhat unique skills to nursing; that often go unrecognized. In this age of fiscal accountability, it’s important to highlight and evaluate nurse-led programs to offer evidence to both improve and sustain them. It’s even more important to determine positive patient outcomes from these programs. We’ll explore the prevalence of nurse-led programs along with facilitators and barriers. How are programs evaluated and what recommendations do nurses who have participated in a health program have for those of us thinking about developing one?

To read the commentary, please click on this link: http://ebn.bmj.com/content/19/1/12

Participating in the Twitter chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account, contributing is straightforward. You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ and add #ebnjc (the EBN Twitter chat hash tag) at the end of your tweet, this allows everyone taking part to view your tweets.

Questions to consider prior to the Twitter Chat:

  1. What are your experiences with nurse-led programs? What were the outcomes?
  2. What do you think are important considerations for nurse-led programs?
  3. What are the facilitators and barriers to nurse-led programs?

 

 

Living with paediatric chronic illness: What are the developmental challenges?

12 Feb, 17 | by atwycross

 

Abbie Jordan (@drabbiejordan), University of Bath and Line Caes (@LineCaes5), University of Stirling will be leading this week’s EBN Twitter Chat (#ebnjc) on Wednesday 15th February between 8-9pm UK time focusing on the developmental challenges of living with a paediatric chronic illness.

 

 

 

Participating in the Twitter Chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward:

  • Go to your Twitter account
  • Follow the discussion by searching for #ebnjc once linked to the discussion, click “all tweets” to keep up-to-date with recent tweets
  • Add the EBN chat hash tag (#ebnjc) to your tweets to join in, this allows everyone taking part to view your contribution

Chronic illness in childhood is common, with figures estimating as many as one in four families in the US reporting caring for a child or adolescent with an ongoing health condition (Compas et al., 2012).  As noted by Christie and Katun (2012), receiving a diagnosis of a chronic condition marks the start of a long and challenging journey for children and their families. This journey may change along the way as children grow up and develop new skills. To explore this, research has focused on exploring what it is actually like for children and their families to live and grow up with a chronic condition (Compas et al., 2012; Palermo et al., 2014).  In addition to the challenges associated with managing a chronic illness (e.g. repeated hospital appointments, daily treatment requirements), a substantial number of children who live with a chronic illness experience emotional and social difficulties. Not only the child, but their entire family is affected, with some parents and siblings reporting emotional distress and poor relationship functioning (Knecht et al., 2015; Palermo and Eccleston, 2009).

more…

The power of reflection in nursing

30 Jan, 17 | by dibarrett

Lizzie Ette. Lecturer in Nursing, The University of Hull

This week’s EBN Twitter Chat is on Wednesday 1st February between 8-9 pm (UK time).

The chat will be led by Lizzie Ette (j.ette@hull.ac.uk ), Lecturer in Pre-registration Nursing, The University of Hull.

Participating in the Twitter chat requires a Twitter account; if you do not have one you can create an account at www.twitter.com. Once you have an account, contributing is straightforward. You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ adding #ebnjc (the EBN Twitter chat hash tag) to your tweet, this allows everyone taking part to view your tweets

The power of reflection in nursing

As is so often the case, professional and personal lives are intricately related, and the recent experience of losing our family cat Reggie, following a road traffic accident at Christmas, really got me to reconsider the power of reflection on a personal level, and this got me thinking deeply about how important reflection is in my professional capacity, as a nurse.

  Reggie: 2000-2017

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Using Technology to Support Learning – confident, terrified or indifferent?

15 Jan, 17 | by josmith

 

This week’s EBN Twitter Chat on Wednesday 18th January between 8-9 pm (UK time) will be lead by Kirsten Huby, Lecturer in Children’s Nursing, University of Leeds, @KirstenHuby focussing on learning technologies. Participating in the Twitter chat requires a Twitter account; if you do not have one you can create an account at www.twitter.com. Once you have an account, contributing is straightforward. You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ adding #ebnjc (the EBN Twitter chat hash tag) to your tweet, this allows everyone taking part to view your tweets.

We are surrounded by technology that assists us in every aspect of our life and education is no exception. It has never been easier to access information and learning resources on an almost infinite number of topics. We can collaborate and attend conferences in virtual spaces and share ideas in real time or whenever we have a minute spare! Our learning can incorporate teacher-led instruction, be led by our own interest and desire to learn or a combination; what is becoming apparent is that social learning in digital forums is enhancing learning by bringing interested parties together (Simon Nelson 2017). As health professionals continually learning and demonstrating how this learning has occurred in the digital world is opening doors and making digital learning easier. Whilst digital learning enables us to be flexible in our learning it also requires a degree of digital literacy. This has been defined by the European commission (2010) as “the confident critical use of ICT for work, leisure, learning and communication”. Digital literacy is a wider concept than just being able to use specific tools it also encompasses the ability to find, manage and evaluate the information that is available and understand how data is stored and shared in order to remain safe in virtual spaces. Ultimately educational technology is there to help improve education and facilitate student learning (Forest, 2015), the educational goals should be identified first but we need to be able to engage with the technology if we are to enhance our learning.

Within the Twitter chat I would like to explore:

  1. What technologies you currently use to support your learning and how effective you think they are?
  2. The reasons why you would choose or not choose to learn using technology?
  3. The facilitators that help you to engage with learning using technology?
  4. The barriers you have encountered to engaging with learning using technology?
  5. And finally the one app, device or program that you wouldn’t want to be without!

For those that feel they would like to learn more about working and learning in digital ways FutureLearn (a digital platform that hosts courses produced by educational institutions, organisations and businesses) offer a number of free online courses to get you started. https://www.futurelearn.com/courses?utf8=%E2%9C%93&filter_category=online-and-digital&filter_availability=new-and-upcoming

European Commission, 2010. Digital Literacy European Commission Working Paper and Recommendations from Digital Literacy High-Level Expert Group. [online]. [Accessed 12 January 2017]. Available from: http://www.ifap.ru/library/book386.pdf

Forest, E., 2015. Educational technology: An Overview. 18 November. Educational technology [online]. [Accessed 12 January 2017]. Available from: http://educationaltechnology.net/educational-technology-an-overview/

Nelson, S. 2017. DigiFest Keynote – Simon Nelson, CEO, FutureLearn. Student Education Conference and Digital Festival, 5 January, Leeds.

‘Loosing the child’s voice’ and ‘the captive mother’- an inevitable legacy of family-centred care?

2 Jan, 17 | by josmith

This week’s EBN Twitter Chat on Wednesday 4th January between 8-9 pm (UK time) in conjunction with @WeCYPnurses will focus on child & family cunknown-3unknownentred care.

The chat wll be lead by Professor Linda Shields (@lshields50), Charles Stuart University, Australia; Professor Philip Darbyshire (@PDarbyshire), global healthcare consultant; Sarah Neil (@SarahNeill7) University of Northampton, UK; and Dr Joanna Smith
IMG_0206(@josmith175) theUniversity of Leeds, UK.unknown-2

Participating in the Twitter chat requires a Twitter account; if you do not have one you can create an account at www.twitter.com. Once you have an account, contributing is straightforward. You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ adding #ebnjc (the EBN Twitter chat hash tag) to your tweet, this allows everyone taking part to view your tweets.

Professor Linda Shield’s recent publication (Shields Linda (2016) (Family-centred care: the ‘captive mother’ revisited, Journal of the Royal Society of Medicine; 109; 4: 137-140 (http://jrs.sagepub.com/content/109/4/137.full.pdf+html) revisited Roy Meadow’s acclaimed article ‘The captive mother’ (Arch Dis Child 1969; 44: 362–367), where he eloquently described the “captive mother” who was forced to accompany her school aged child to hospital when in reality they would spend little time together. Family-centered care has evolved since that time is espoused as the dominant philosophy underpinning care in children’s hospitals around the world. We postulate that that although family-centered care is embedded within most health services policies for children, it is largely untested. Evidence suggests problems with the implementation of family-centred care, with some parents feeling resentful that they have to undertake some of their child’s care. We postulate that Meadow may have been right & that expecting a mother (or other carer) should stay with a hospitalized school aged child, we are not operating within the ethos of family-centred care, potentially compromising the care given.

screen-shot-2016-12-10-at-16-56-52

 

The article is already generating debate: with suggestions that concepts such as the ‘captive patient’ and ‘family-centred care’ are no longer relevant in today’s world of personalised care and offering care delivery choices (http://jrs.sagepub.com/content/109/11/408.1.full). The child must be treated as an individual, with rights & choices having a voice in their cared.

This Twitter chat provides a chance for nurses to discuss their experiences of working with children & families, & identify some of the common challenges of embedding child & family-centred care into practice such as:

  1. Is family-centred care relevant within contemporary healthcare contexts?
  2. Does family-centred care marginalise the voice of the child?
  3. Given that evidence of its effectiveness is not available, is it ethical to continue pushing for family-centred care?

The importance of public health in the nursing curriculum

12 Dec, 16 | by dibarrett

 

Lizzie Ette – Lecturer in Nursing, University of Hull

It’s easy to imagine that public health is falling out of favour in the UK in the current era of austerity, which has ushered in cuts for local authorities, who are now predominantly responsible for the public health of their local population. With the Local Government Association (LGA) itself expressing concern and disappointment in the government’s approach to the funding of this essential remit, it would be easy to believe that improvements to public health are a fading aspiration.

However, the NHS’s own Five Year Forward Plan commits to ‘getting serious about prevention’, and cites examples of integrated models of care which are aimed at addressing health needs and promoting better health.

So what does this mean for nurses?  And what kind of nurse education do we need to deliver to ensure that future nurses are as equipped as possible to embrace and contribute to this challenging future?

determinants-of-health

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Fields of nursing: do we need them, what should they be and when should nurses choose theirs?

10 Nov, 16 | by dibarrett

Dr David Barrett, Director of Pre-Registration Nurse Education, Faculty of Health and Social Care, University of Hull

One of the perennial issues faced by nurse education and the nursing workforce is the formalisation of different categories of Registered Nurse. Whether called ‘fields’, ‘branches’ or ‘specialties’, there is continual discussion about what constitutes a standalone area of nursing and at which point in a nurse’s career specialisation should take place.

Discussion of this issue is particularly lively within the UK. Currently, there are four fields of nursing – Adult, Children, Learning Disabilities and Mental Health – with student nurses selecting their chosen field at the time of application to University, and then completing a degree (or higher) level programme of study focused on that field (albeit with some shared elements across fields).

However, this structure is under review and likely to change. The publication of ‘Raising the Bar’ – a review of nurse education in England – challenged the current model. The review suggested that current system of a three-year, field-specific programme of study did not produce flexible practitioners with the transferable skills necessary to work with patients and clients in a range of settings (Willis, 2015). The review proposed a more generic model, specifically suggesting that students complete two-year ‘whole-person’ education, before specialising in the final year of their programme and first year post-registration.

 

raising-the-bar

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