Dr. Frances O'Brien

Summary

Background: The term holistic care in nursing encompasses complete and comprehensive care requirements of the individual. This includes physical and mental health requirements. To achieve the delivery of mental health care in the acute care setting, nurses need to be adequately skilled to carry out mental health assessments and subsequently deliver appropriate interventions or identify the need for specialist referrals, as appropriate. A study conducted among oncology nurses in Ireland (Nash 2017) demonstrated that a range of mental health problems are encountered in practice. While nurses were equipped to handle some aspects of mental health care requirements, they generally felt that they were in need of additional information particularly in relation to complex conditions that extended beyond anxiety and depression. This question has not been raised among general nurses in the acute setting and therefore a decision was made to assess Registered General Nurses' needs in relation to supporting individuals with mental health problems in the acute care setting. In the United Kingdom, the National Service Framework for Mental Health (Department of Health 2000) recommended standards for planning and delivering mental health services in the UK. This is seen as an important issue for consideration in the Irish population also. Research question: What are the needs of Registered General Nurses in relation to supporting individuals with mental health problems in the acute setting? Study aim: To assess Registered General Nurses' needs in relation to supporting individuals with mental health problems in the acute care setting. Objectives: . To determine whether Registered General Nurses' feel adequately equipped to support individuals with mental health problems in the acute care setting. . If deficits are identified, this study seeks to ascertain the nurses' specific education and training needs that would help in supporting individuals with mental health problems in the acute care setting. . Based on the information collected, a needs analysis will be compiled and from this, a business and education plan will be proposed within the School of Nursing and Midwifery.

Funding Agency

Nursing Midwifery Planning and Development Unit

Programme

Research Grants €15,093

Project Type

Survey

Person Months

12

Summary

This study is being supported by two academics from the SNM, TCD since December 6th 2018. The project includes the heart efficiency team in Tallaght University Hospital and the study was funded in 2019 under the Heart Failure Service Integrated Care Project (Tallaght University Hospital).

Programme

Heart Failure Service Integrated Care Project

Project Type

Clinical - TCPHI

Summary

This study will evaluate the current internship programme and in doing so, will address practice requirements and make recommendations for change, or not. The clinical learning environment enables students to apply theory to practice and to achieve confidence and competence in clinical skills. The internship placement allows students who are facing registration to experience the "real world" as they combine their skills to care for patients independently, alongside their preceptor or clinical supervisor. In this "real world" of nursing, the students experience shift work, night duty and weekend work, all of which have been recognised as valuable experiences for nursing students (Nash et al. 2009). Final year nursing students have high expectations of themselves, as they approach the transition from the internship period to becoming newly qualified nurses (Edwards et al. 2015). They are often anxious about this transition and have reported feeling that they still had a lot to learn (Nash et al. 2009; Edwards et al. 2015). There is evidence to support the link between preceptorship, clinical supervision and the development of competence among nursing students. This link was demonstrated in a study that investigated newly qualified nurses' self-reported levels of competence (Kajander-Unkuri et al. 2014). The participants in this study identified that supervision was vital to their development of competence, and those who had received good quality supervision reported greater levels of competence (Kajander-Unkuri et al. 2014). Registered nurses and pre-registered nurses on internship placement, are under immense pressure to provide high quality care under demanding conditions, including bed shortages, increased patient-nurse ratios and an ageing patient population with complex care needs. Such factors can lead to increased stress levels for staff and students, as they strive to deliver care in challenging environments. It has been well documented that stressful experiences and anxiety can hamper learning at clinical level (Levett-Jones et al. 2007). Newly graduated nurses' experiences and perceived value of the 36-week internship period is important, given the current shortage of nurses in the Irish healthcare system. It is now 15 years since the internship period was initiated, yet the change its introduction has brought to clinical practice has never been evaluated nationally. In conclusion, nurses, as health service providers in Ireland are under increased pressure to deliver quality care with limited resources. For nursing students, the 36-week internship placement is crucial, as this time affords the student opportunities to rehearse the role of staff nurse in the "real world", under the supervision of a preceptor. During this time learning, decision-making skills and competence are further developed. For some nurses, these final weeks of clinical placement can determine their future career decisions, which is important given the shortages currently faces in the Irish healthcare system. This study will explore nursing students' experiences of the internship period and, from it may identify aspects of this programme that are successful and should be continued, while also addressing those aspects that might require reconsideration or alteration to enhance the programme.

Funding Agency

Meath Foundation

Programme

Research Grants

Project Type

All Ireland Survey

Summary

This Randomised Controlled Trial tested a brief educational intervention and examined its effect on pre-hospital delay in patients who had experienced an acute coronary syndrome. The secondary objectives included: to determine the impact of the educational intervention on knowledge, attitudes and beliefs about heart disease and ACS symptoms; to determine factors that influence pre-hospital delay; to compare GTN and ambulance use following an educational intervention; to elucidate the determinants of physical activity in the ACS population and how it changes post cardiac event; to determine intention to attend cardiac rehabilitation, subsequent attendance and the factors that influence this. Secondary analysis 2013-2017 a) : Longitudinal changes in physical activity in ACS patients. b) Is there a difference in ACS symptom presentation in the aged compared to younger cohorts.

Funding Agency

Health Research Board

Programme

General programmes grant

Project Type

Randomised Controlled Trial

Person Months

36

Summary

Temporary epicardial pacing wires are routinely inserted after cardiac surgery. Despite this, there are no national or international guidelines to on which to base best practice regarding insertion, use and removal of wires. In this study, data were collected on all patients (N=167) who underwent cardiac surgery, requiring cardiopulmonary bypass in a six month period in 2016/17. Of the sample, pacing wires were inserted in 164 patients, the majority of whom did not require pacing (74%). We categorised the group into aortic valve replacements (AVR) (n=42) and non-AVRs (n=122). Of the AVR group, 26% (n=11) used their wires, and of these, 9% (n=4) required permanent pacemakers. In accordance with unit policy, most patients had their temporary pacing wires removed by day 4. The only noted complication was delayed discharge, which was related to the non-removal of pacing wires at weekends. In conclusion, unused pacing wires are normally removed on day 4, but for 47% of patients, they remained in place longer, because of a policy of wire removal during business hours only, resulting in delayed patient discharge.

Project Type

Cross Sectional Study