Anita Green

Therapists’ and clients’ perceptions of routine outcome measurement in the NHS: A qualitative study

Abstract Primary objective: This is the first qualitative study that elicited the perceptions of both psychological therapists and their clients in the use of Clinical Outcomes in Routine Evaluation with computer software (CORE-Net), where instant visual feedback for session tracking was given on a computer screen in the therapy room at each therapy session. The study also examined how therapists viewed its potential value in supervision and provides suggestions for improving training. Research design: The study adopted a convenience sample of four therapists in a primary care counselling setting (PCC – General Practitioner referrals) who were experienced in using CORE-Net, and five therapists in an NHS employee/occupational support counselling service (OH) who had just begun to use CORE-Net for session tracking with 10 of their clients. Method: A qualitative methodology was used and interview data were collected from the therapists via focus groups; the clients were interviewed individually face to face....

Provision of continued professional development for non-medical prescribers within a South of England Strategic Health Authority: a report on a training needs analysis.

AIMS This paper reports on a Training Needs Analysis for Non-Medical Prescribers commissioned by a south of England Strategic Health Authority. BACKGROUND The aim of the TNA was to inform future policy, educational provision and practice development and provide nurse managers with significant information on the perceived Continuing Professional Development (CPD) needs of the non-medical prescribers. METHODS Data were collected from a sample of 270 non-medical prescribers using an in-depth questionnaire, and telephone interviews with a purposive sample of 11 key stakeholders. RESULTS The findings report: * The qualifications that non-medical prescribers possess. * The level of confidence described by the non-medical prescribers in their role. * What non-medical prescribers identify as their present and future CPD requirements in relation to prescribing. * What education and training provision non-medical prescribers have attended in relation to their prescribing role since qualifying. CONCLUSIONS The findings suggest, first that short courses that were specific to the non-medical prescribers role were considered to be the most popular and useful. However, courses needed to be advertised well in advance. Second, training gaps were identified. IMPLICATIONS FOR NURSING MANAGEMENT Pharmacology and prescribing are rapidly changing and require regular CPD in order to keep up to date with the latest developments. Non-medical prescribing is a comparatively new innovation to the NHS, therefore those who are not medically qualified need mentorship from experienced prescribers, as well as the encouragement from nurse managers to be confident prescribers themselves and enhance patient care.

Experiential learning and teaching — a critical evaluation of an enquiry which used phenomenological method

Experiential teaching methods have been recommended as the most effective medium for students to acquire the interpersonal skills and self-awareness required for the mental health nurse. This enquiry developed from the premise that there is potential for students to learn effectively in experiential teaching sessions. The authors experience of teaching in mental health gave focus to the question as to whether nurse teachers consider, and then use, a particular experiential learning framework when facilitating experiential teaching methods. The enquiry was an individual case study of one nurse teacher, and the data were collected through non-participant observation and focussed, non-directive interviewing. The philosophical perspective and methodology was phenomenological with the data analysed using phenomenological guidelines. This was used as it concentrated on the nurse teachers understanding of experiential learning as a phenomenon. The results concluded that the nurse teacher had a clear understanding of experiential learning and aspects of her interpretation manifested themselves within the classroom as part of experiential teaching. When compared with the literature there were commonalities with the meaning of experiential learning held by the nurse teacher studied. The focus of this paper is to report briefly on the enquiry, and then offer a detailed critical description and evaluation of the methodological approach used.

Cannabis use in palliative care - an examination of the evidence and the implications for nurses.

AIM AND OBJECTIVE Examine the pharmaceutical qualities of cannabis including a historical overview of cannabis use. Discuss the use of cannabis as a clinical intervention for people experiencing palliative care, including those with life-threatening chronic illness such as multiple sclerosis and motor neurone disease [amyotrophic lateral sclerosis] in the UK. BACKGROUND The non-medicinal use of cannabis has been well documented in the media. There is a growing scientific literature on the benefits of cannabis in symptom management in cancer care. Service users, nurses and carers need to be aware of the implications for care and treatment if cannabis is being used medicinally. DESIGN A comprehensive literature review. METHOD Literature searches were made of databases from 1996 using the term cannabis and the combination terms of cannabis and palliative care; symptom management; cancer; oncology; chronic illness; motor neurone disease/amyotrophic lateral sclerosis; and multiple sclerosis. Internet material provided for service users searching for information about the medicinal use of cannabis was also examined. RESULTS The literature on the use of cannabis in health care repeatedly refers to changes for users that may be equated with improvement in quality of life as an outcome of its use. This has led to increased use of cannabis by these service users. However, the cannabis used is usually obtained illegally and can have consequences for those who choose to use it for its therapeutic value and for nurses who are providing care. RELEVANCE TO CLINICAL PRACTICE Questions and dilemmas are raised concerning the role of the nurse when caring and supporting a person making therapeutic use of cannabis.

A utilisation-focused evaluation of a clinical supervision programme for nurses and health visitors in one national health service trust

The implementation of clinical supervision in the practice setting presents a major challenge for the nursing profession. There have been numerous reports and papers promoting its importance, and providing the impetus for this challenge (Department of Health, 1993; Butterworth F Kohner, 1994). Clinical supervision has been well established as part of social work, counselling, psychotherapy and psychoanalytic practice, and in the nursing specialities of mental health and midwifery (Swain, 1995). Its utilisation by nurses and health visitors is clearly important and should be seen as integral to professional practice. This enquiry evaluated a programme purchased by a south coast of England Trust. The programme aimed to provide the knowledge and skills required for nurses and health visitors to practice as supervisors and supervisees in their clinical areas. This report forms the final stage of the evaluation of the programme. The evaluation process is guided by the work of Patton (1986, 1990) ...

Issues in the application of self-assessment for the diploma of higher education/registered nurse mental health course

This paper examines some of the issues in the application of self assessment in nurse and higher education. It argues that if student-centred learning methods are being advocated, that this also gives a clear indication that self-assessment in some form should be introduced into the present assessment procedures. This paper suggests that the process of using self-assessment can be an effective assessment strategy, both formative and summative, and can successfully satisfy both the professional and statutory requirements of nursing and be accepted and used within the academic arena. This paper also suggests that with nurse education and higher education institutions collaborating, there is now an opportunity to develop new methods of assessment including self-assessment.

Student Nurses’ Experience of Experiential Teaching and Learning: towards a phenomenological understanding

ABSTRACT This paper reports on the use of a phenomenological research methodology to investigate the influence on clinical practice of pre‐ and post‐registration nurse education which makes explicit use of experiential teaching and learning approaches. The primary aims of the research were: first, to examine the learners’ understanding of experiential teaching and learning, and, secondly, to examine the claims made for the use of experiential teaching and learning approaches in both pre‐ and post‐registration nurses courses. A rationale is provided for the selection of a phenomenological approach indicating its compatibility with the focus of the enquiry. Data collection has involved focused non‐directive interviews with nine members of a BSc Nursing Studies and MSc/DipHE Mental Health Branch courses. The data have been analysed using a technique developed by Giorgi. The findings are presented and discussed In the context of other studies from both nurse and higher education. Previous experiences of exper...

Transcultural knowledge and skills transfer: issues arising from evaluation processes

The transfer of knowledge, policy and practice between nations increasingly involves knowledge of the theory and practice of evaluation. This article examines issues arising from the transcultural evaluation of a drug and alcohol misuse knowledge and skills transfer programme for nurses, nurse teachers and medical staff in the narcology service in St Petersburg, Russia that ran between 1995 and 2004. The programme is contextualized and described prior to an account of the evaluation activities. Issues arising from the evaluation process are discussed, including ethnocentricity, cultural biases and the local generation of meaning, and the use of interpreters in interviewing and transcription The article suggests that undertaking transcultural evaluations enables more sensitive and effective domestic evaluations and that the approaches to evaluation favoured by Western funding agencies encourage ethnocentricism. The paper concludes with a recommendation for enhancing transcultural evaluations by setting them within a conceptual framework that facilitates the analysis of policy and practice ‘borrowing’ and transfer.

Evaluating the impact of a partnership for creating change in substance misuse practice in St. Petersburg, Russia

This paper reports on an evaluation of an innovative education and training programme for nurses and narcologists in St. Petersburg, Russia. The aims of the evaluation were: first, to evaluate the effect of the education and training programme on the clinical practice of doctors and nurses who have had direct contact with the programme and, second, to evaluate the influence of the education and training programme on city-wide drug and alcohol policy and practice. Brief contextual information regarding the programme is provided prior to an account of the qualitative methodology. Particular attention was paid to the work of Patton [Utilisation-focused evaluation, second ed., Sage, London, 1986; Qualitative research and evaluation methods, third ed., Sage, London, 2002] for the theoretical framework and to Hantais and Mangen [Cross-national research methods in the social sciences, Pinter, London, 1996] regarding the methodological issues that surround international and cross-cultural research projects. Data collection was carried out in St. Petersburg and in the United Kingdom, which involved key participants in the programme. The data analysis followed Miles and Huberman [Qualitative data analysis. An expanded sourcebook, second ed. Sage, Thousand Oaks, 1994] which yielded six major themes: rehabilitation, the role and continuing professional development of the trained nurse; the status of the nurse training-college and the staff, small scale projects and their significance; sharing experiences/networking/face-to-face meetings; and, lack of resistance. The findings are discussed and recommendations for further involvement are identified.

Providing a motivational interviewing (MI) informed intervention in conjunction with a cannabis drug urine screening for PICU service users: a feasibility project

Purpose – The purpose of this paper is to provide a description of a small, early-stage feasibility project that used a motivational interviewing (MI) informed intervention on a psychiatric intensive care unit (PICU). Design/methodology/approach – The paper describes a MI informed intervention implemented on a PICU for service users who use cannabis. The intervention was evaluated using a feedback questionnaire post intervention. Due to the small number of service users (n=5) in the first cohort there is limited narrative and quantitative data available. Findings – The project raised awareness for staff of the potential usefulness of applying MI informed interventions in a PICU setting. All participants stated the intervention should continue to be offered after the project. The intervention needs to be further developed with the possibility of it being used on an acute open ward environment with a larger cohort and consider the use of a randomised-controlled trial approach to validate the results. Resear...