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Page 1 of 20

  • Medical Emergency Equipment Medication (MEEM) Training: A Quality Improvement Project Focusing on Transforming the Emergency Response to Inpatient Psychiatric Medical Emergencies

  • David Prossor, Simona Constantinescu, Cem Stubbs, Neil Stewart, Fredrik Johansson
  • Journal:
    BJPsych Open / Volume 10 / Issue S1 / June 2024
    Published online by Cambridge University Press:
    01 August 2024, p. S171
    • Article
      • You have access
      • Open access
    • PDF
    • Export citation
  • Aims

    All medical staff working within NHS psychiatric hospitals in the UK are required to complete mandatory life support training. However, there is no such mandatory requirement for associated training around the effective use of the emergency medical equipment used during medical emergencies on inpatient psychiatric wards. This quality improvement project focused on developing a sustainable educational intervention aimed at all staff types within one London inpatient psychiatric hospital. Staff of all grades and roles encountered frequent difficulties and delays in relation to the emergency medical bags and equipment, including issues around skill and confidence.

    Methods

    A survey was initially sent to medical and nursing staff working on an inpatient psychiatric unit, which highlighted participants’ lack of confidence in using the equipment. It emerged that staff exclusively handled the emergency medical equipment during relatively rare emergencies. This resulted in unfamiliarity with the equipment and consequent difficulties in using it competently. A novel educational intervention dedicated to upskilling staff with emergency medical equipment was created, focusing on contents and use of individual equipment within the medical emergency bag. Pre- and post-intervention quantitative feedback regarding confidence and familiarity was obtained using feedback forms containing Likert scales. Qualitative feedback was also obtained.

    Results

    More than six training cycles, each consisting of at least five training sessions, have now been completed with both qualitative and quantitative measures of improvement captured. Individuals noted on average a 31.62% (±3.605%) improvement in self-reported confidence and familiarity with equipment. The most frequently identified positive themes were that the intervention familiarised staff with equipment and was educational, whilst the most frequent suggestion for improvement were requests for additional sessions. From single idea to sustainable quality improvement, the team broadened and gained stakeholder support including clinical and nursing directors, pharmacy, junior doctors, nurses, and matrons.

    Conclusion

    The intervention has achieved sustainability and is being explored in other partnership psychiatric hospitals. Despite reported increased confidence in handling the emergency equipment, there is ongoing need to develop, maintain and practice these skills, across both the nursing and medical staff, to achieve better outcomes for psychiatric inpatients. Trainee psychiatrists intend to develop the project further, and the training will be incorporated as a mandatory requirement. The project links to the quality standards for mental health point 12 of the Resuscitation council UK. Next stage developments of the project include linking to feedback from emergencies as well as incorporating into existing simulation training.

  • Chapter 13 - Letitia Elizabeth Landon, Chronicler of the 1830s

  • Edited by John Gardner, Anglia Ruskin University, Cambridge, David Stewart, Northumbria University, Newcastle
  • Book:
    Nineteenth-Century Literature in Transition: The 1830s
    Published online:
    30 May 2024
    Print publication:
    06 June 2024, pp 284-303

  • Summary

    Letitia Elizabeth Landon was one of the most prominent figures in the 1830s literary scene. She became known, and was often condemned, for a ‘fatal facility’: a tendency to write too easily and too frequently for a market that was itself so overproductive that its grasp on posterity’s regard has proved unstable. Landon’s work in the 1830s mirrors the decade in its variety, its speed of production, its dubiety about cultural status, and its self-conscious reflection on its own potential place in literary history. This chapter explores a wide range of Landon’s 1830s work, work that has typically been passed over by her critics. It explores her interactions with the market via such forms as Silver Fork fiction, short fiction, essays, literary criticism, and ‘hack’ journalism. Her work is shaped by her unstable place as both a literary celebrity and a worker for the press, a combination of identities that was especially difficult for a woman writer. She became the decade’s chronicler: her experiments in 1830s literary forms produce a mode of understanding the uncertain temporality of this unusually self-conscious decade.

  • Introduction

  • Edited by John Gardner, Anglia Ruskin University, Cambridge, David Stewart, Northumbria University, Newcastle
  • Book:
    Nineteenth-Century Literature in Transition: The 1830s
    Published online:
    30 May 2024
    Print publication:
    06 June 2024, pp 1-16

  • Summary

    The Introduction to this book offers an overview of the literary culture of the 1830s. It explores existing literary-critical approaches to the decade’s culture, and considers why the decade has proved so resistant to absorption in literary genealogies. This is a consequence of the decade’s own uncertainty about and self-conscious analysis of its literary temporality. The Introduction proposes that the 1830s are uniquely placed to direct the future interests of contemporary literary studies.

Nineteenth-Century Literature in Transition: The 1830s
  • Edited by John Gardner, David Stewart
  • Published online:
    30 May 2024
    Print publication:
    06 June 2024
  • This instalment in the Nineteenth-Century Literature in Transition series concerns a decade that was as technologically transitional as it was eventful on a global scale. It collects work from a group of internationally renowned scholars across disciplinary boundaries in order to engage with the wide array of cultural developments that defined the 1830s. Often overlooked as a boundary between the Romantic and Victorian periods, this decade was, the book proposes, the central pivot of the nineteenth century. Far from a time of peaceful reform, it was marked by violent colonial expansion, political resistance, and revolutionary technologies such as the photograph, the expansion of steam power, and the railway that changed the world irreversibly. Contributors explore a flurry of cultural forms to take the pulse of the decade, from Silver Fork fiction to lithography, from working-class periodicals to photographs, and from urban sketches to magazine fiction.

  • 1 - An Introduction to Healthcare Knowledge and Library Services

  • Edited by Geoff Walton, Frances Johnson, David Stewart, Gil Young, Holly Case Wyatt
  • Book:
    Introduction to Healthcare Knowledge and Library Services
    Published by:
    Facet
    Published online:
    22 February 2024
    Print publication:
    11 January 2024, pp 1-14

  • Summary

    Introduction

    Working in a health organisation can be a bewildering experience for new knowledge and library service (KLS) staff. Such organisations often have thousands of highly pressured clinical and managerial staff spread across multiple sites, with little time to explain how things work and what all the jargon means.

    The good news is that, as a knowledge and library professional, you are already equipped to do lots of finding out for yourself:

    • • Start digging, start a set of notes, start a glossary or a set of questions.

    • • If it helps, draw up organisational and staff structures. A visual representation works better for some people.

    • • Network with knowledge and library colleagues in other health care organisations.

    Our experience shows that these come in useful when you, in turn, are helping new staff understand the complex world they have just joined. One of the authors of this chapter used their diagram of the English National Health Service (NHS) as part of the induction for a finance director who had come from a non-health background, earning his gratitude and a friendly smile ever after.

    This chapter will help you structure your voyage of discovery as you work out what your new organisation is all about and how it fits into the wider healthcare system of your country. It will also get you thinking about health in its wider societal context.

    As we write, the COVID pandemic is an example of a worldwide issue, affecting every person in every country. Knowledge and library specialists play an important role in enabling fellow health staff, the public, patients, families and carers locate and, crucially, use high quality knowledge resources. The services provided by healthcare knowledge and library services ‘take the “heavy lifting” out of getting evidence into practice and give the “gift of time” to healthcare professionals’ (Economics by Design, 2020).

    A word on terminology before we get started. We will generally use knowledge and library specialist to mean a person qualified in librarianship to at least degree level, or someone who aspires to be. This term covers a broad spectrum of roles across healthcare including, but not limited to, librarian, information professional and knowledge specialist. Most of our examples will come from the NHS but we believe you will be able to take the questions we think you should ask, find the answers and then apply them in your own home setting.

Introduction to Healthcare Knowledge and Library Services
  • Edited by Geoff Walton, Frances Johnson, David Stewart, Gil Young, Holly Case Wyatt
  • Published by:
    Facet
    Published online:
    22 February 2024
    Print publication:
    11 January 2024
  • The range of roles in healthcare knowledge and library services are many and varied. From 'traditional' librarian roles to those that break new ground - including clinical, embedded and outreach librarians and knowledge managers - they are a vital ongoing support for this important sector.

    This work brings together health information practitioners and researchers with a variety of experience across health information work within knowledge and library services in the NHS. It provides a comprehensive, practitioner-focused introduction to all aspects of knowledge and library work in the health sector with a focus on NHS England. The book begins with an overview of the NHS and how knowledge and library work sit within it. It then addresses such critical areas as services supporting evidence-based practice, the developing area of health information literacy, reflective practice, collaborative working, demonstrating impact and employing digital technology. The book ends with an exploration of what the future might hold for healthcare knowledge and library services such as, the rapid advance of artificial intelligence/machine learning and how it might shape those services and knowledge specialist roles.

    Knowledge and library specialists offer a valuable gift to healthcare professionals - the 'gift of time' enabling them to make informed decisions which directly impact upon patient care. This timely book provides a valuable reference for anyone studying or looking to enter this relevant and diverse field.

  • 61 Network Segregation Predicts Processing Speed in the Cognitively Healthy Oldest-old

  • Sara A Nolin, Mary E Faulkner, Paul Stewart, Leland Fleming, Stacy Merritt, Roxanne F Rezaei, Pradyumna K Bharadwaj, Mary Kathryn Franchetti, Daniel A Raichlen, Courtney J Jessup, Lloyd Edwards, G Alex Hishaw, Emily J Van Etten, Theodore P Trouard, David S Geldmacher, Virginia G Wadley, Noam Alperin, Eric C Porges, Adam J Woods, Ronald A Cohen, Bonnie E Levin, Tatjana Rundek, Gene E Alexander, Kristina M Visscher
  • Journal:
    Journal of the International Neuropsychological Society / Volume 29 / Issue s1 / November 2023
    Published online by Cambridge University Press:
    21 December 2023, pp. 367-368
    • Article
      • You have access
    • PDF
    • Export citation
  • Objective:

    Understanding the factors contributing to optimal cognitive function throughout the aging process is essential to better understand successful cognitive aging. Processing speed is an age sensitive cognitive domain that usually declines early in the aging process; however, this cognitive skill is essential for other cognitive tasks and everyday functioning. Evaluating brain network interactions in cognitively healthy older adults can help us understand how brain characteristics variations affect cognitive functioning. Functional connections among groups of brain areas give insight into the brain’s organization, and the cognitive effects of aging may relate to this large-scale organization. To follow-up on our prior work, we sought to replicate our findings regarding network segregation’s relationship with processing speed. In order to address possible influences of node location or network membership we replicated the analysis across 4 different node sets.

    Participants and Methods:

    Data were acquired as part of a multi-center study of 85+ cognitively normal individuals, the McKnight Brain Aging Registry (MBAR). For this analysis, we included 146 community-dwelling, cognitively unimpaired older adults, ages 85-99, who had undergone structural and BOLD resting state MRI scans and a battery of neuropsychological tests. Exploratory factor analysis identified the processing speed factor of interest. We preprocessed BOLD scans using fmriprep, Ciftify, and XCPEngine algorithms. We used 4 different sets of connectivity-based parcellation: 1)MBAR data used to define nodes and Power (2011) atlas used to determine node network membership, 2) Younger adults data used to define nodes (Chan 2014) and Power (2011) atlas used to determine node network membership, 3) Older adults data from a different study (Han 2018) used to define nodes and Power (2011) atlas used to determine node network membership, and 4) MBAR data used to define nodes and MBAR data based community detection used to determine node network membership.

    Segregation (balance of within-network and between-network connections) was measured within the association system and three wellcharacterized networks: Default Mode Network (DMN), Cingulo-Opercular Network (CON), and Fronto-Parietal Network (FPN). Correlation between processing speed and association system and networks was performed for all 4 node sets.

    Results:

    We replicated prior work and found the segregation of both the cortical association system, the segregation of FPN and DMN had a consistent relationship with processing speed across all node sets (association system range of correlations: r=.294 to .342, FPN: r=.254 to .272, DMN: r=.263 to .273). Additionally, compared to parcellations created with older adults, the parcellation created based on younger individuals showed attenuated and less robust findings as those with older adults (association system r=.263, FPN r=.255, DMN r=.263).

    Conclusions:

    This study shows that network segregation of the oldest-old brain is closely linked with processing speed and this relationship is replicable across different node sets created with varied datasets. This work adds to the growing body of knowledge about age-related dedifferentiation by demonstrating replicability and consistency of the finding that as essential cognitive skill, processing speed, is associated with differentiated functional networks even in very old individuals experiencing successful cognitive aging.

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