Denise Blanchard

The Yerin Dilly Bag Model of Indigenist Health Research

In this article, we discuss indigenist approaches to health research, including indigenist knowledges, cultural proficiency, and core values. We also highlight the importance of conducting Indigenous research in ways that are congruent with the needs and interests of Indigenous peoples. The discussion includes consideration of how indigenist approaches can be utilized to generate new Indigenous knowledges, in culturally appropriate ways. We then introduce the Yerin Dilly Bag Model for indigenist health research, an approach that allows for indigenist knowledges to be employed and created by the research/er/ed within an Indigenous framework. Use of the Yerin Dilly Bag Model enables research/er/ed concordance, together with the privileging of Indigenous voices. This is achieved by guiding researchers to align their research with the core values of the researched, with the Yerin Dilly Bag a metaphor for the holder of these core values.

Ketamine and Other Glutamate Receptor Modulators for Depression in Bipolar Disorder in Adults

Bipolar disorder is a significant psychiatric condition comprising a recurring pattern of deterioration including signs and symptoms of mania, hypomania and major depression (McCloud et al., 2015). During periods of significant depression the risk of self-harm or suicide is heightened. Therefore treatments for acute depression are being researched. Glutamate receptor modulators are a group of drugs that show some promise in their ability to counter the acute phase of depression experienced during unipolar depression (Caddy et al., 2015), or the period of depression experienced during bipolar disorder. Ketamine, a glutamate receptor modulator, appears to have a rapid effect on acute depression. Although the effect is rapid, it is transient, hence repeated ketamine administration is required for enduring effect. The long-term use of ketamine for depression is cautioned as the adverse effects of long-term effects of repeated exposure to ketamine are unclear and cause for concern, and while not the focus of the review is important to keep in mind (McCloud et al., 2015; Zhang & Ho, 2016).

Circuit class therapy for improving mobility after stroke: A Cochrane review summary

After a stroke, people characteristically experience a loss of function. Reviewers (English et al., 2017) provide evidence-based insights into the value of instigating CCT into post-stroke rehabilitation. The review examines the effectiveness of CCT for people who have experienced stroke. The meta-analysis includes seventeen trials comprising 1297 participants. Results demonstrate that CCT is a worthwhile intervention to establish and support mobility post-stroke. The primary effect of CCT was to improve walking capacity, measured by a walk test. CCT improves gaining independence in activities of daily living.

Using First Rank Symptoms to Assess for Schizophrenia

Timely and accurate assessment and diagnosis of schizophrenia are important to prevent deleterious consequences and enhance recovery. Clinicians should be aware that using first rank symptoms (FRSs) is now a timeworn tool, first introduced by Schneider in 1959. There is some question concerning the accuracy of FRSs as an accurate tool that discerns schizophrenia from other psychotic conditions. Nurses are in clinical settings wherein reliance upon accurate assessment tools is an essential part of their practice, hence reviewing the worth of FRSs becomes critical to evidence-based practice. FRS includes symptoms that people with psychosis may experience, for example, hallucinations, hearing voices and thinking that other people can hear their thoughts.

Efficacy of non-invasive brain stimulation for people experiencing chronic pain

Background Healthcare practitioners regularly work with people who present with chronic pain. Using pain intensity measures and questioning the quality of life, the nurse assesses the experience of pain to action specific targeted care. Amid the myriad of treatment choices available, practitioners need accurate and up-to-date research on the efficacy of these treatments to help them select the most suitable approach. Treatment techniques include various devices used to stimulate the brain electrically to address and manage the experience of chronic pain. For this updated Systematic Review that only considered non-invasive stimulation therapies the primary outcome measure was the changes recorded in self-reported pain using validated measures of pain intensity such as visual analog scales, verbal rating scales or numerical rating scales. Four main non-invasive brain stimulation treatment types were the subject of the Systematic Review, and these treatment types included repetitive transcranial magnetic stimulation (rTMS), cranial electrotherapy stimulation (CES), transcranial direct current stimulation (tDCS) and reduced impedance non-invasive cortical electrostimulation (RINCE). The studies identified in the review demonstrated notable variation in the stimulation parameters applied and in the methodological quality of evidence from the studies. Importantly for nursing, this Systematic Review also extracted, when available, measures that may support healthcare professionals’ practice such as self-reported disability data, quality-of-life measures and the incidence/nature of adverse events. Unfortunately, no studies included in the Systematic Review explored and assessed these measures. Had these measures been assessed, this would allow practitioners to examine pain relief measures and lifestyle choices in collaboration with the patient who is experiencing chronic pain.

Health professionals’ perceptions of clinical leadership. A pilot study

Abstract Aim: To identify how clinical leadership was perceived by Health Professionals (HPs) (excluding nurses and doctors) and to understand how effective clinical leadership relates to initiating and establishing a culture of change and progression in the health services. Methodology: This pilot study used a mixed methods approach, although quantitative methodological principles dominated. An on-line (SurveyMonkey) questionnaire was distributed via email links to HPs throughout the Western Australian Department of Health. Qualitative data was analysed by Statistical Product and Service Solutions (Version 21). Results: A total of 307 complete surveys were returned. Participants represented 6.1% of the total WA HP workforce and a wide range of HP disciplines. The majority of respondents were female (86.5%), the median age was 38.9 years and the majority of respondents worked in acute hospital environments (59.9%) and in a metropolitan location (73.7%). Most participants (79.2%) saw themselves or were reportedly seen by others (76.2%) as clinical leaders. The main attributes associated with clinical leadership were; effective communicator, clinical competence, approachability, role model and supportive. The main attribute identified least with clinical leadership was “controlling”. Only 22.2% saw clinical leaders as managers, while the majority saw a clinical focus as important (85.3%). Clinical leaders were perceived as having an impact on how clinical care is delivered, staff support and leading change and service improvement. Many respondents (81.4%) suggested barriers hindered their effectiveness as clinical leaders. Conclusions: Improvements in clinical care and changes in practice can be initiated by clinical leaders.

Securement and Dressing Devices for Central Venous Catheters

Editors note: This is a summary of a nursing care-related systematic review from the Cochrane Library.

Conservative Management Following Closed Reduction of a Traumatic Anterior Dislocation of the Shoulder.

Emergency department and primary health nurses are most likely to encounter a patient presenting with an acute anterior dislocation. Conservative interventions following a closed reduction of the joint are the most likely interventions for this injury. Conservative interventions may include immobilization for a period of 3–4 weeks; rehabilitative interventions, for example, advice, education; active and passive mobilization; proprioception and stabilization exercises; scapular setting and trunk stability exercise or both. Unfortunately, it has been found that redislocation often occurs for one third of patients within the fi rst 3 months of the initial dislocation. This means that assessing the patient experience and resumption of preinjury activities following the intervention being applied is needed to identify the correct services required for the patient. The review also reminds that for middle-aged-elderly patients immobilization times may need shortening as this group is often susceptible to immobilization stiffness and frozen shoulder.

Respite care for people with dementia and their carers

QuestionFor people with dementia and their carers, will respite care (as compared with no respite care or polarity therapy) affect rates of institutionalization?Relevance to nursing careRespite care can be defined as a service or group of services designed to provide temporary periods of relief or r

Nurse practitioner work : a case study

Abstract Within any professional practice, knowledge developments to support service delivery and to understand roles inherent within that practice context are critical. The purpose of this article is to present findings from case study research that used the AUSPRAC Research Toolkit Interview Schedule and to propose an additional theme to the Interview Schedule. Case Study method was used to explore the role of a nurse practitioner (NP) within a specific context of practice in an Australian Healthcare institution. Three semi-structured interviews with a NP using the AUSPRAC Research Toolkit Interview Schedule and one additional interview were employed. Data was analysed where initial free coding, then theme generation contributed to knowledge development. The AUSPRAC Research Toolkit Interview Schedule generated knowledge about the NP role. Themes identified for interviews in the Schedule were: the organisation of care, team functioning and patient service. Analysis of data from these themes identified that information related to ongoing development of professional practice was not forthcoming from the participant. The authors recommend adding a fourth theme to the Interview Schedule to enable exploration of the professional elements of the NP role.