Practice Staff Research Articles

Remembered childhood mealtime experiences influence on early childcare and education staff

Parent feeding styles, behaviors, beliefs, and practices are associated with developing children's eating behaviors. However, many children spend considerable time in childcare; thus, are exposed to child-feeding practices of other adults, e.g., early care and education (ECE) staff. Limited research exists on how and whether current classroom feeding practices of ECE staff associate with their own childhood experiences. The About Feeding Children survey, conducted in 2005, examined self-reported feeding practices and beliefs and personal characteristics of ECE staff in Western United States. An exploratory factor analysis of questions related to childhood experiences (N = 1189), revealed two Mealtime Factors: Remembered Adult Control and Remembered Child Autonomy Support. Structural equation modeling was conducted to examine the hypothesis that these remembered experiences would be associated with current feeding practices (Structural Mealtime Strategies, Verbal Mealtime Strategies, and Beliefs about Mealtimes). For each outcome, models had good to moderate fit. Across models, Remembered Autonomy Support was associated with less control, bribing, autonomy undermining, and concern-based control beliefs and greater support at meals and autonomy promoting beliefs in teachers' classroom feeding practices. More research is called for to consider whether reflection on remembered childhood experiences might be beneficial to consider during ECE staff training related to feeding young children.

A Novel Pediatric Surgery Division Incentive Program Engaging Faculty, Advanced Practice Providers and Staff Around a Single Financial Growth Target

BackgroundProductivity-based financial incentive programs for faculty are common. We implemented a novel Division wide clinical productivity incentive sharing professional fee collections across faculty, nurses, and staff with half of bonuses reserved to be given out proportionally to achievement of the annual growth target. MethodsA novel bonus plan was formulated to incentivize collection of professional fees to achieve a 15% annual growth target. The 15% was divided equally between the clinical provider, the responsible provider's center(s) of excellence, and all Division members. 50% of the bonus pool was paid out monthly and the remaining 50% was held for an end of the year payout proportional to achievement of the Divisional professional fee collection annual growth target. Principal findingsDuring the initial year of the program, overall Division collections and charges grew 30% and 17%, respectively. Average monthly bonuses paid through the new incentive program for faculty, advanced practice providers, and staff were $1,700, $700, and $200, respectively. The program cost $525,000 in additional bonuses over the previous year while the Division saw an increase of 2 million dollars in collections over the previous year. ConclusionA clinical productivity incentive program based upon professional fee collections distributed across faculty, nurses, and staff was feasible and successful in its first year. Collections increased by a significantly higher percentage than charges, we believe collections incentive including support staff will be most useful in practices with lower rates of charge collection. Further study is needed to measure the effects of different components of the program. Level of EvidenceLevel IV. Study TypeCost Effectiveness Study.

P08 Preventing and managing urinary tract infections: using thematic analysis to explore interventions and strategies implemented by NHS commissioning organizations in English primary care, 2017–22

Abstract Objectives To identify and explore strategies, interventions and activities used by English Clinical Commissioning Groups (CCGs) to improve prevention and management of urinary tract infections (UTIs) from 2017–22. Methods Online questionnaires were sent to primary care chief nurses and medicines optimization leads via regional infection prevention control (IPC) and antimicrobial stewardship (AMS) leads August–September 2022. Qualitative data were mapped to the Theoretical Domains Framework. Results Response rate was 14.1% (56/397 participants approached), with representation from 29.2% (31/106) English CCGs. Respondents provided 201 examples of UTI interventions. Themes identified included: (i) populations and settings; (ii) aspects of UTI targeted; (iii) types and functions of interventions and activities; (iv) resources, tools and policies; and (v) implementation strategies. Education and training were the most used type of intervention, while changing the environment to facilitate ideal behaviours was the least used intervention type. Most interventions targeted general practice staff and patients accessing primary care, followed by care home staff and residents and their families. The most used success measures included reduction in antibiotic prescribing (54.5%, 97/178 intervention examples); positive feedback from stakeholders (42.1%, 75/178); and increased adherence to national diagnostic guidelines (32.6%, 58/178). However, 48.8% (20/41) stated their team’s UTI activities had not been evaluated, indicating that success was determined using informal data or perceived outcomes. Barriers to implementation of UTI interventions included: lack of resources and time; low staff engagement, inaccurate data due to lack of clinical coding; inconsistent systems and processes; and lack of dedicated roles. Facilitators to implementation included: availability of tools; financial incentives; multidisciplinary collaboration; sharing of information; staff motivation; embedding resources into systems; digitalization; and dedicated roles. Conclusions Multidisciplinary teams and cross-sector collaboration are key facilitators for implementation of UTI interventions. Although some teams are already using robust success measures, there is a need to improve how interventions are evaluated to inform resource allocation and planning. Education and training interventions should address or leverage the barriers and facilitators identified, including clinical coding skills, embedding resources and tools into existing systems and auditing adherence to diagnostic and antibiotic prescribing guidance. There may be missed opportunities for intervention types that are less widely used e.g. changing environmental factors.

Protocol for the feasibility and implementation study of a model of best practice in primary care led postdiagnostic dementia care: PriDem

IntroductionCare is often inadequate and poorly integrated after a dementia diagnosis. Research and policy highlight the unaffordability and unsustainability of specialist-led support, and instead suggest a task-shared model, led by...

Nursing Staff Practices Towards Computerization and Computer Use in a Teaching and Referral Hospital, Nairobi Kenya

The use and dependence on information technology have recently become increasingly widespread in healthcare and nursing care delivery. The purpose of this study was to assess practices among nursing staff in relation to computerisation and computer use in a tertiary referral hospital. This was a cross-sectional study comprising qualified nurses from all departments. A sample size of 291(100%) nurses participated in the study. Data were collected using questionnaires. Data were analysed using a statistical package for social sciences software version 22. A p-value < 0.05 was considered statistically significant. The majority of the respondent’s age were in the category 40-49 years 112(38.5%); senior nursing officers were 132(45.4%); majority participants used computers for ordering supplies 160(55%), nursing notes 41(14.1%), billing 64(22%) and communication 26(8.9%). Two hundred and fifty-nine (89%) had the ability to type using the computer keyboard, while 32(11%) had difficulties. Use of a computer mouse, typing on the keyboard, use of a word processor, having an email, ability to prepare power-point presentations, and formal training were statistically significant (p-value <0.0001). Regarding communication, 50(17.2%) used electronic mails while 241(82.8%) did not. Evidently, nurses’ practices on computerisation and computer use have an important bearing on the uptake and utilisation of computer systems in the workplace

Knowledge, attitude, and practice of nurse aids and service staff about nosocomial infection control: A case study in Iran

Background: Hospital-acquired infection (HAI) or nosocomial infection is a major public health concern. In this study, the status of knowledge, attitude, and practice (KAP) of service staff and nurse aids in reference to HAI was investigated. Methods: This descriptive-analytic study was carried out to investigate KAP in two steps design and measurement. Twenty-five hospitals were included in this study. To collect data, a questionnaire comprised of 8 divisions and 45 questions was designed and validated, and the three sections of KAP were listed. The questionnaire was distributed to 405 nurse aids and service staff to determine their level of KAP towards HAI. The data were analyzed using SPSS 18. Results: The mean±standard deviation values of KAP of the included staff were 7.07±1.97, 23.08±4.38, and 35.83±8.25, respectively. A statistically significant difference was observed in the level of KAP of personnel among different hospitals (P<0.001). The type of employment status and education was found to be significantly influential on knowledge (P=0.027, P<0.001) and level of education. Marital status, education and career experience were found to be significantly influential on attitude (P=0.034, P=0.004 and 0.045). Level of education, job category, career experience, and gender were the significant influential factors on practice (P<0.05). Conclusion: The knowledge and practice levels were low in many nurse aids and service staff. An educational plan and compiled programs in hospital infection control seem to be necessary to effectively control the major concern of HAI in hospitals in Iran.

Effects of Herder-farmer Conflict on Output of Food Crops among Households in the Niger Delta Region, Nigeria

The study examined the effects of herder-farmer conflict on output of food crops among respondents. A sampling technique applied was multistage sampling in selection of respondents. Data were collected through administration of questionnaire for 768 respondents out of which 648 respondents were found useful for the work. Data were analysed with the use of likert scale, regression models and descriptive statistics. The study revealed that farmer-herder conflict, hired labour, amount of money spent on seed, amount of money spent on fertilizer, age, farming experience, amount of money spent on weeding, farm size, household size and contact with extension agent have positive differential coefficient, hence, positive relationship exist between the aforementioned variables and production output. The study therefore recommends that Nigeria‘s government should invest in the security area by consistently providing the security personnel with upgraded security gadgets and adequate security funding for training and equipping security staff in best global security practices and defensive intelligence gathering.

Occupational Health and Safety Practices Among Frontline Medical Laboratory Staff in the Covid-19 Testing Centres in the Bono Region of Ghana

Background: Medical laboratory personnel are exposed to various occupational risks, especially during the COVID-19 pandemic. Their role in testing COVID-19 patients puts them at risk of contracting the virus while handling specimens. This study aimed to assess the occupational health and safety practices of frontline medical laboratory staff in COVID-19 testing laboratories in Ghana's Bono region. Methods: A cross-sectional study was conducted using purposive sampling among medical laboratory staff at five COVID-19 testing centers in the Bono region. Checklists, interview schedules and structured questionnaires were used for data collection. Data analysis was performed using SPSS 20.0. Results: The study included 137 participants, with 85 (62.0%) aged between 21 and 30 years. Males constituted 96(70.1%) whiles females constituted 41(29.9%) of the study participants. Among the respondents, 55% reported having been infected with COVID-19 before vaccination, 30% after vaccination, and 15% both before and after immunization. The majority of participants (93%) emphasized the importance of adhering to occupational health and safety procedures. Furthermore, 97% believed that standard operating procedures should be regularly reviewed, and 91% agreed that rewards should be provided for following safety protocols. Conclusion: The study revealed a positive attitude toward adherence to occupational health and safety protocols among frontline medical laboratory staff in COVID-19 testing centers in the Bono region of Ghana.

Role delineation of advanced practice nursing: A cross-sectional study.

To identify the roles and activities of nurses, including advanced practice nursing (APN), and to determine nursing practice patterns across health facilities in Saudi Arabia. A descriptive cross-sectional design was used to collect data from 207 nurses working in the Saudi health sector between November 2021 and March 2022 through an online questionnaire. The Advanced Practice Role Delineation tool was used to measure and delineate nursing practice patterns and activities. Data were analysed using descriptive statistics and analysis of variance. The study followed the Strengthening the Reporting of Observational Studies in Epidemiology reporting guidelines. Findings showed that participants, regardless of their current role, reported high scores across all domains of practice. The highest average score was obtained for the Clinical Care domain. Except for the leadership domain, findings showed that those reported working as advanced practice nurses had higher average scores across all domains than those working as staff nurses or being in managerial/administrative positions. There were significant differences in the average Clinical Care scores between advanced practice nurses and staff nurses. Advanced practice nursing roles and activities are being practised in Saudi Arabia; however, there is no clear delineation of these roles and activities according to a unified and national-level APN scope of practice. Advanced practice nursing roles are evolving in Saudi Arabia; however, no study has examined the existing patterns of APN activities in Saudi Arabia. This study highlights the practice patterns of advanced practice nurses and adds to the international evidence base on the need for delineating APN activities under a unified scope of practice. The findings of this study are beneficial to practitioners, researchers, and stakeholders as well as the legislative and regulatory bodies. No patient or public contribution.

Development of theoretically informed audit and feedback: An exemplar from a complex implementation strategy to improve asthma self-management in UK primary care.

Audit and feedback is an evidence-based implementation strategy, but studies reporting the use of theory to guide design elements are limited. Within the context of a programme of research aiming to improve the implementation of supported asthma self-management in UK primary care (IMPlementing IMProved Asthma self-management as RouTine [IMP2 ART]), we aimed to design and develop theoretically-informed audit and feedback that highlighted supported asthma self-management provision and areas for improvement in primary care general practices. Aligned with the Medical Research Council (MRC) complex intervention framework, the audit and feedback was developed in three phases: (1) Development: literature and theory exploration, and prototype audit and feedback design; (2) Feasibility: eliciting feedback on the audit and feedback from general practice staff (n = 9); (3) Prepiloting: delivering the audit and feedback within the IMP2 ART implementation strategy (incorporating patient and professional resources and an asthma review template) and eliciting clinician feedback (n = 9). Audit and feedback design was guided by and mapped to existing literature suggestions and theory (e.g., Theoretical Domains Framework, Behaviour Change Technique Taxonomy). Feedback on the prototype audit and feedback confirmed feasibility but identified some refinements (a need to highlight supporting self-management and importance of asthma action plans). Prepiloting informed integration with other IMP2 ART programme strategies (e.g., patient resources and professional education). We conclude that a multistage development process including theory exploration and mapping, contributed to the design and delivery of the audit and feedback. Aligned with the MRC framework, the IMP2 ART strategy (incorporating the audit and feedback) is now being tested in a UK-wide cluster randomised controlled trial.

Routine developmental screening in Australian general practice: a pilot study

BackgroundParents’ Evaluation of Developmental Status, (PEDS), is a validated screening tool designed for primary health care clinicians to assess child development. Despite widespread use by local government child-nurse services, PEDS has not been tested in Australian general practice. We examined the effect of an intervention that aimed to use PEDS to improve documented assessment of child developmental status during routine general practice consultations.MethodsThe study took place in a single general practice in Melbourne, Australia. The intervention included training of all general practice staff regarding PEDS processes and provision of PEDS questionnaires, scoring and interpretation forms. Mixed methods incorporated audits of clinical records of young children (1 to ≤ 5 years) before and after the intervention, and written questionnaires and a focus group (informed by the Theoretical Domains Framework and COM-B model) with receptionists, practice nurses and general practitioners.ResultsDocumented developmental status more than doubled after the intervention with almost one in three (30.4%) records documenting the PEDS tool. Overall, staff responses to questionnaires indicated that PEDS processes had been successfully implemented, half of the staff felt PEDS had developed their professional skills and clinicians expressed confidence using the tool (71%). Thematic analysis of the focus group transcript revealed divided reactions to PEDS screening with most barriers arising from general practitioners’ motivation to use PEDS tools and perceptions of environmental constraints.ConclusionsA team-practice intervention that applied PEDS training and implementation, more than doubled documented rates of child developmental status during routine visits. Solutions to underlying barriers could be incorporated into a revised training module. Future studies need to test the tool in more methodologically robust studies that include analysis of the outcomes of developmental surveillance and long-term sustainability of PEDS use in practices.

Knowledge, Attitudes, and Practices (KAP) of inpatient nursing staff regarding bowel preparation before colonoscopy: A cross-sectional study

Knowledge, Attitudes, and Practices (KAP) of inpatient nursing staff regarding bowel preparation before colonoscopy: A cross-sectional study

Effect of a Health Education Intervention on Practices of Hospital Laboratory Staff; A Quasi-Experimental Study

Background: The incidence of Laboratory acquired infections is on the rise despite the existence and continuous upgradation of infection prevention protocols. The objective of this study was to determine the practice of lab staff before and after carrying out an intervention in the form of health education intervention based on WHO protocols for infection prevention. Methods: This is a Quasi-experimental study carried out in three hospitals in Rawalpindi. A total of n=38 technical and non-technical lab staff participated in the study. Laboratory practices were observed by the researchers themselves for a week. Then an education session was conducted for the staff regarding the World Health Organization (WHO) standard protocols for infection control. The post-intervention data were collected after about two weeks of health education sessions. Data were analyzed using SPSS version 22. Paired t-test was applied to compare the mean scores of pre- and post-interventional data. Results: The laboratory staff participated in the study mostly 19(50%) belonging to the age(years) range of 20-27. The percentage of respondents having good practice of infection prevention protocols before intervention was 7.5%, after the intervention this increased to 57.9%. Paired t-test showed that the difference in practice mean score of pre- and post-interventional data was statistically significant (CI=21.55-15.33 p-value=0.001). Conclusion: Pre-intervention data showed that the practice of the staff was not completely in accordance with WHO infection prevention. After delivering the education session on WHO infection prevention protocols, there was a significant improvement in the practices of laboratory staff.

The relationship between research activity and quality of care in English general practice: a mixed methods study.

There is evidence showing that healthcare organisations that take part in research demonstrate better performance. However, most evidence derives from hospital settings and these findings may not extend to general practice. The relationships between research activity and outcomes across general practices in England were explored. To assess whether levels of research activity in general practice are associated with a range of organisational and patient-reported outcomes, and to explore possible mechanisms that might explain those associations. Analysis of national data on research activity and outcomes (including QoF, GPPS, prescribing, GP retention, and hospital utilisation) between 2008 and 2019 from practices in England, combined with qualitative interviews with general practice staff, patients, and wider stakeholders. In cross-sectional analyses, research activity was associated with a number of outcomes, including clinical quality of care, patient-reported experience, and hospital use. The associations were generally modest in magnitude. However, longitudinal analyses did not generally support a causal relationship. Practice staff reported that the most likely benefits of research activity would be on professional wellbeing. Similar to hospital settings, general practice research activity is associated with a range of positive outcomes, although it is difficult to claim that research is causing those improvements. This study identified no negative impacts, suggesting that research activity is something that high-quality practices are able to deliver alongside their core responsibilities. There is a need to explore ways by which additional impacts of research can be maximised.

The Unique Practice of the Clinical Nurse Specialist.

The Unique Practice of the Clinical Nurse Specialist.

Pharmacist and pharmacy staff knowledge, attitude and practice of wound care in the community setting: A cross-sectional survey

Pharmacist and pharmacy staff knowledge, attitude and practice of wound care in the community setting: A cross-sectional survey

180° view on general practitioners’ leadership skills: practice-level comparisons of leader and staff assessments using data from the cluster-randomised controlled IMPROVEjob study

ObjectivesStrong primary care leaders are needed to assure high quality services for patient populations. This study analysed general practitioners’ (GP) leadership skills comparing practice-level self and staff assessments based on...

Knowledge and Practices of Dialysis Unit Staff Regarding the Care and Management of Vascular Access Infections

Background: Vascular access infections among dialysis patients are becoming the major concerns that contribute to a significant morbidity and mortality across the globe. Proper management and care must be planned according to the standard protocols for the prevention of these infections. Objective: The objective of the study was to assess the knowledge and practices of dialysis staff regarding vascular access infection control in tertiary care hospitals of Peshawar, Pakistan. Methodology: A cross-sectional study was conducted on dialysis staff including nurses and technicians (n=58). All hemodialysis staff (Nurses and Technician) was included in the study who were regularly working in dialysis unit and had at least 6 months of dialysis unit experience. Data was collected through a self-administered questionnaire and checklist with its proper validation. Data was analyzed through SPSS Version-20 for its proper presentation. Results: The finding of the study showed that around 44.94% of the questions were corrected by the nurses and technician on the knowledge assessment questionnaire while looking into their practices 28.5% of the correct practices were followed by them. Additionally it was found that private sector hospital nurses and technician scored more than public sector hospitals in knowledge and practices. Practical implication: It is one of the main responsibilities of the dialysis unit staff to have knowledge regarding vascular access infections. So based on their knowledge, they will maintain the aseptic protocol while practicing, which will ensure a low infection rate and prevent the patient from complications that will improve the patient's experience and reduce the length of stay. Conclusion: It is concluded from the research findings that nurses and technician knowledge and practices are not sufficient to prevent the vascular access infections; therefore they must be trained for the provision of best possible care among the dialysis patients. Keywords: Knowledge, Practice, Vascular Access, Infections, Dialysis, Nurse, Technicians

Assessment of Biomedical Waste Management Practices and Paramedical Staff Knowledge and Attitude at Healthcare Facilities in Lahore, Pakistan

Healthcare waste refers different natures of wastes, biological, and non-biological which are useless& do not desired to re-use again. Healthcare (Biomedical) waste can be defined that all waste generates from healthcare settings. Objective: To analyze the awareness, attitudes & Para medical’s work practically related to the management of BMW at Public, Private, DHQ and THQ Hospitals, RHC and BHU of Lahore, Punjab. Methods: The methodology was cross-sectional and consisted on the data (survey based) and talk to the heads of the Institutions, persons concerned with waste (handling and transportation). The data about medical waste management were taken from ten HCFs. Results: The results showed that <50% has knowledge about categories, color coding and different wastes that are not included in Biomedical Waste Management Rules, 2016. Attitude shows good results. >50% has faulty practice regarding bio medical waste. The findings about the awareness & practice about the management of waste among Intern Nurses and sanitary workers were poor, periodic training and their evaluation is mandatory for better outcome. Total percentage of the knowledge items was 57%. The attitude percentage was 44%. The overall level of practice was considered unsafe because only 9.4% respondent who practice always during waste management. Conclusions: Research revealed the improper practices, irregularities, and shortcomings in the overall system of the WM. The study found inconsistencies during waste management in hospitals are generally because of low amount of financial resources, poor awareness & trainings at the administrative level.

Use of video group consultations by general practice staff during the COVID-19 pandemic

Background: Video group consultations (VGCs) are one approach to delivering care using a virtual platform for a group of patients with the same or similar health conditions. However, little is known about the use and uptake of VGCs in the UK.Aim: To describe the use and uptake of VGCs by UK general practice staff during the coronavirus disease 2019 pandemic.Method: A cross-sectional design using an online questionnaire. Data analysis adopted the principles of content analysis and demographic data were analysed descriptively.Findings: A total of 36 participants completed the questionnaire across nine UK regions and representing 36 general practices. A lack of standardisation regarding the use and uptake of VGCs across UK general practices was identified, hindering implementation, scale-up and delivery.Conclusion: While the VGC model looks promising, further research is needed to demonstrate its use and uptake, developing a more robust evidence base for implementation.