Cross-section Of Staff Research Articles

Assisted Decision Making in the Acute Hospital Setting – Staff Experiences of Working with Older Adults

Abstract Background The Assisted Decision Making (Capacity) Act 2015 was fully implemented in April 2023. This brought changes to how health and social care staff work with patients who may lack decision making capacity for certain decisions. The most significant group impacted by these changes in the acute hospital context is Older People with cognitive impairment. Staff working with these patients have been navigating the complex balance between embracing the guiding principles of the Act, testing the practical requirements of the Act on behalf of patients who require formal decision supports, all in the context of continued demand on unscheduled care. Methods The newly developed role of Principal Social Worker for Assisted Decision Making and Adult Safeguarding has enabled regular access to frontline staff working across 11 hospitals in a large hospital group. Both formal and informal feedback was gathered from a cross section of staff via focussed discussion at local implementation meetings and via individual qualitative interviews with key stakeholders from a broad range of professions. Results Staff were generally very positive about the introduction of the Act and its rights-based approach to providing health and social care. Themes which emerged from the interviews included the need for further education and training, continued forums for case discussion and review, clarity re roles and responsibilities and improved pathways for patients requiring support. Conclusion The enactment of the Assisted Decision-Making Act did not, as many feared, bring the healthcare system to a standstill. However, its impact on resources and time should not be underestimated. Increased investment in staffing, training and supports are needed to ensure continued integration of the Act in the acute hospital setting.

Containment? An investigation into psychoanalytic containment in the NHS in relation to someone with a diagnosis of personality disorder

This research investigated the psychoanalytic idea of containment in the context of NHS staff responses to a person diagnosed with personality disorder. The aim was to identify what, if any, containment was provided by staff for someone diagnosed with personality disorder by recording staff responses to an assessment and analysing the discourse. The research was undertaken with participants selected to represent a cross section of staff in the organisation.The discourse analysis of the interviews examined defences against containment such as splitting, projective identification and idealisation and the positions people occupied in relation to the material and the researcher, as well as looking for examples of containment. Reflexivity was a key part of the methodology, forms a significant part of the thesis and is used to contribute to the discussion. Reflexivity, findings from the review of the literature and the analysis of the interviews form the basis of the discussion and conclusions.The research showed that containment, in its psychoanalytic sense, is often avoided and defended against. Key difficulties with developing the capacity for containment were found to be conflict between the personal and professional in staff and anxiety in relation to the power of others in the organisation.

EFFECTIVE PERFORMANCE MANAGEMENT SYSTEM FOR ENHANCING GROWTH AT ACCRA TECHNICAL UNIVERSITY

Performance management supports and offers a structure for employees to develop the skills they need to achieve organisation’s strategic goals. The key features of PMS involve setting objectives, monitoring, motivation, giving timely feedback and measurable performance. There are regular day-to-day meetings as well as periodic feedback meetings with subordinates. An unbiased annual evaluation of performance based on specific assessable targets set at the beginning of the corporate year is carried out. During these end-of-year appraisal face-to-face meetings, achievements and non-achievements of targets are discussed objectively. Necessary steps are then taken to either recognize or improve performance, enhance career development, promote, reward and compensate as deemed fit. The objective of this study is to propose the introduction of Performance Management System in Accra Technical University that would enhance performance and effective growth. A semi structured questionnaire was used and interviews were conducted to gather information from a cross-section of staff in the institution. In all, about 30 questionnaires were distributed and retrieved from both senior and administrative junior staff. PMS manual was designed based on information gathered. The manual spells out the step-by-step procedure or guideline for a successful implementation of PMS. The study concludes and recommends among other things that efforts should be made by the Institution to ensure that staff are given the requisite training in the area of target setting and implementation, recognition of employees’ effort and enhance career development which would go a long way to achieve institutional strategic goals and competitive advantage for Accra Technical University

Measurable improvement in patient safety culture: A departmental experience with incident learning

PurposeRigorous use of departmental incident learning is integral to improving patient safety and quality of care. The goal of this study was to quantify the impact of a high-volume, departmental incident learning system on patient safety culture. Methods and materialsA prospective, voluntary, electronic incident learning system was implemented in February 2012 with the intent of tracking near-miss/no-harm incidents. All incident reports were reviewed weekly by a multiprofessional team with regular department-wide feedback. Patient safety culture was measured at baseline with validated patient safety culture survey questions. A repeat survey was conducted after 1 and 2 years of departmental incident learning. Proportional changes were compared by χ2 or Fisher exact test, where appropriate. ResultsBetween 2012 and 2014, a total of 1897 error/near-miss incidents were reported, representing an average of 1 near-miss report per patient treated. Reports were filed by a cross section of staff, with the majority of incidents reported by therapists, dosimetrists, and physicists. Survey response rates at baseline and 1 and 2 years were 78%, 80%, and 80%, respectively. Statistically significant and sustained improvements were noted in several safety metrics, including belief that the department was openly discussing ways to improve safety, the sense that reports were being used for safety improvement, and the sense that changes were being evaluated for effectiveness. None of the surveyed dimensions of patient safety culture worsened. Fewer punitive concerns were noted, with statistically significant decreases in the worry of embarrassment in front of colleagues and fear of getting colleagues in trouble. ConclusionsA comprehensive incident learning system can identify many areas for improvement and is associated with significant and sustained improvements in patient safety culture. These data provide valuable guidance as incident learning systems become more widely used in radiation oncology.

Views of professionalism: a veterinary institutional perspective

In many western countries, there has been a marked change in the demographic profile of those entering the veterinary profession, with a shift from a predominantly male to a predominantly...

Nutritional care in care homes: experiences and attitudes of care home staff

Background: The Food Award Barnsley (FAB) is organised for care homes that meet nutritional criteria based on national recommendations. Research (Thompson, 2003) highlighted that meeting FAB criteria is not an assurance that residents are receiving adequate nutrition. This is supported by studies demonstrating multiple individual/organisational factors influencing rates of malnutrition in care establishments (Abbasi & Rudman 1994; Health Advisory Services, 2000). To develop a training intervention to support FAB, an understanding of the role, perceptions and attitudes of care staff in the process of nutritional care was required. The main research aims were to describe staff's experiences of nutritional care of service users, to explore staff's attitudes towards nutritional care of service users and to highlight issues relating to nutritional care which could be considered when developing training programmes or provide the basis for future research. Methods: A care home that held the silver FAB, offered nursing and residential care and had more than 20 beds was chosen. Maximum variation sampling was used to select a cross-section of staff in terms of position, level of education and length of service. Twelve semi-structured interviews were recorded, transcribed and analysed using the template approach as developed by King (1998). The process from which the conclusions of the study were drawn was made clear through documentation. The audit trail within the final report demonstrates dependability and confirmation and hence the rigour of the study. Results: In general staff felt they were effective in identifying and addressing issues of malnutrition. However, from a dietetic perspective there was a fragmented approach to nutritional care. At all levels ‘confused role expectations’, lack of clear action planning, poor communication and attitudes towards malnutrition represented a significant barrier to good nutritional care within the home. Despite using a nutritional screening tool, staff relied more heavily on their own subjective judgement to identify residents who they thought were malnourished. Care home staff at all grades considered a poor appetite to be a ‘normal’ part of ageing and some felt that in conditions such as Parkinson's Disease it was expected that residents would lose weight. Portion sizes were reduced regardless of the need for compensation for reduced nutritional intake. Discussion: The lack of a coherent approach to nutritional care coupled with poor communication at all levels resulted in the risk that residents were not receiving appropriate nutritional care. Staff relied on their own judgement, not an objective measure; to identify residents they thought were at risk of malnutrition. These problems were compounded by attitudes of staff at all levels to nutrition, weight and ageing which resulted in lack of intervention in residents who were malnourished or at risk of malnutrition. Conclusion: This study highlights barriers to changing the process of nutritional care within the home which should be addressed through training, whilst ensuring national nutritional standards for provision of food are met. References Abbasi, A. & Rudman, D. (1994) Under nutrition in the nursing home: Prevalence, consequences, cause and prevention. Nutr. Rev. 52, 113–122. Health Advisory Services. (2000) “Not Because they are Old”. An Independent Inquiry into the Care of Older People on Acute Wards in General Hospitals. London: Health Advisory Services. King, N. (1998) Template analysis. In Qualitative Methods and Analysis in Organisational Research. eds C. Cassell & G. Symons, pp. 118–134. London: Sage. Thompson, L. (2003) Nutritional Perceptions among Staff Working in a Care Home for Elderly People and the Potential for Nutrition Education. BSc thesis, Leeds Metropolitan University.

Current Practice in the Allocation of Academic Workloads

AbstractSignificant factors within UK higher education include explicit competition, regulatory demands and pressures to maintain student numbers despite tuition fee increases. Universities have responded by more actively managing finances and quality but seemingly not staff time. This paper sets out findings on the processes and practices surrounding academic workload allocation (WLA) in universities, based on 59 detailed interviews from a cross section of staff. The main findings from this research are that there are a huge variety of different practices surrounding WLA and much potential for improvement. The approaches observed can be seen to work in a continuum from informal to partial, to the more comprehensive. Although many felt the disciplinary context to be very important to the process chosen, the findings of the research reveal that this is not the case.

Factors Affecting the Use of MIS as a Tool for Informing and Evaluating Teaching and Learning in Schools

This study looks at the way in which Management Information Systems (MISs) are being used in Primary Schools in Birmingham. Analysis was from data collected through a questionnaire, to a 50% sample of schools in May 1999 and semi structured interviews with a cross section of staff at 20 schools, conducted during the period September 1999 until September 2001. The findings indicate that despite an overwhelming acceptance of the value of such systems, they are generally being used to provide specific statutory returns and administrative type functions. This is as opposed to use as a constant monitoring tool for self-evaluation, performance management, alerting and feedback, which is then used to inform the teaching and learning process. The paper goes on to propose a hypothesis as to why this is occurring and makes suggestions as to how the situation may be remedied. The research and its findings are part of the LEAs continuous evaluation of the use of ICT in its schools and the remedies which follow are part of its planning for the future.