Background Continuity of mentorship is central to students' clinical placement experience. Despite a plethora of studies investigating student-mentor relationships and how it affects grading, limited attention has been paid to the extent to which a lack of continuity of mentorship affects placement experience. Aims To explore the importance of mentor continuity on labour ward for pre-registration midwifery students. Methods A database search was conducted using the terms: ‘student midwives’, ‘continuity’, ‘mentor’, ‘preceptor’, ‘mentorship’, ‘labour ward’, ‘delivery suite’ and ‘experiences.’ Findings Continuity of mentorship enhances learning and improves clinical practice experience. Conclusions A lack of continuity affects all aspects of student midwives’ experiences of the labour ward. Good mentor practice should focus on continuity and the introduction of co-mentoring, where a student is mentored by at least 2 midwives, in order to reduce the strain on mentors while retaining the feeling of belonging that student midwives value.
An earlier article in the Innovations on the Internet Series introduced the Database Access Project (DAPs) at Southmead Health Services NHS Trust, which piloted the introduction and use of EMBASE via the Internet and NHSnet. This follow-up article assesses the results of the Project, and reports on its findings. In particular, it considers the usefulness of EMBASE in terms of coverage and content for different groups of NHS users and aspects of take-up in terms of access arrangements and patterns of usage. It also considers the likely impact on the library and information service in terms of providing training and user support and meeting related demands, for example the acquisition of full-text articles as a result of increased levels of searching. The value of retaining access to EMBASE was recognized by the majority of those who participated in the Project, despite its acknowledged overlap with other databases. The coverage of the database was identified as being relevant by a majority of users; both its expanded European coverage and its coverage of drug-related and mental health literature were identified as important aspects. The project identified a clear preference for remote access to the database, although there was still a need to visit the library for retrieval of full text. Lack of time both for training and for actual database use, and lack of confidence in applying search skills and in appraising research were identified as key challenges to database searching. The authors highlight the special role of information professionals in providing training and support for NHS professionals in the acquisition of search skills and critical appraisal skills in order to encourage effective database use.
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Paediatric intensivists frequently use the cumulative fluid intake minus output ratio (FIMO) calculated by PICU nurses. Aims: To determine prospectively correlation and concordance between FIMO and body weight (BW) changes and to compare timecost and convenience between these two methods of FB assesment. Methods: Study approved by local Ethics Committee (CPP Ile de France III -Avis AT 130). Measurements of BW, with tall-adapted and systematically tared scales, were performed during the first 12 hours following admission and exactly 24 hours later in 60 consecutive PICU patients (median age and weight of 304 days (39;1565) and 9.2 kgs (4.4;17.8) respectively) from 1 st June 2011 to 16 th August 2011. Every 12h, nurses in charge of the patient and not aware of his BW calculated FIMO and adjusted FIMO, including insensible respiratory losses (AFIMO). Duration and convenience of each procedure were systematically recorded using an analogic scale. Results: Correlation and Bland-Altman agreement (r 2 ; absolute mean difference ± standard deviation) between BW changes and FIMO were poor (0.52 ; 0.381 L ± 0.450) and slightly better between BW changes and AFIMO (0.55 ; 0.301 L ± 0.447). No statistical difference were found in timecost and convenience between the two methods (Wilcoxon test ; p=0.13 and p=0.84 respectively). Conclusions: In a general PICU, either nurse-registred FIMO or AFIMO did not agree with BW changes observed during the first day after admission and these two methods showed no difference in timecosts and convenience.Background and aims: Described as being similar to a chain of 'Chinese Whispers', handover of information between health professionals is internationally recognised as a necessary but potentially risky aspect of patient care. Consequently, the WHO called for a standardised handover approach. Effecting a change in healthcare has been identified as a challenge and an increased use of participative change management methodologies is emerging in response. Aims: The aim was, by use of a participative approach, to optimise the quality and efficiency of nursing shift handover in the PICU at Red Cross Children's Hospital. Methods: Ethics approval was gained and an action research approach was applied. Nurses from the study setting, together with the researcher, worked in action research cycles to diagnose existing handover practice and plan, implement and evaluate appropriate optimisation strategies. Results: The study concentrated on the bedside and unit handover. Analysis of the bedside handover identified challenges related to content and process which led to a handover information form being developed and conversations to optimise the time window for handover. Analysis of the unit handover also emphasised difficulties with process and so was converted to an electronic handover presentation. A standard operating procedure was proposed to make the optimal bedside and unit handover practice explicit. Conclusions: Evaluation of optimisation strategies demonstrated potential to optimise the pre-exis...
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