Staff Publication

Introducing a realistic and reusable quinsy simulator (2016)

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Type of publication:
Journal article

Author(s):
*Giblett, N, *Hari, C

Citation:
The Journal of Laryngology and Otology, Feb 2016, vol. 130, no. 2, p. 201-203

Abstract:
An increasing number of inexperienced doctors are rotating through otolaryngology departments and providing care to ENT patients. Numerous acute ENT conditions require basic surgical or technical intervention; hence, effective and efficient simulation induction training has become paramount in providing a safe yet valuable educational environment for the junior clinician. Whilst simulation has developed over the years for numerous ENT skills, to date there has not been a realistic and easily reproducible model for teaching the skills to manage one of the most common ENT emergencies, a peritonsillar abscess or 'quinsy'. We have adapted the Laryngotech trainer, a well-established ENT simulation tool, to present a readily accessible, reusable and realistic simulation model. The model provides safe training for the drainage of quinsy.

Multidrug-resistant (MDR) Gram-negative bacteria information leaflets (2016)

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Type of publication:
Journal article

Author(s):
Brown C., Livermore D.M., Otter J.A., *Warren R.E., Jenks P., Enoch D.A., Newsholme W., Oppenheim B., Leanord A., McNulty C., Tanner G., Bennett S., Cann M., Bostock J., Collins E., Peckitt S., Ritchie L., Fry C., Hawkey P., Wilson A.P.R.

Citation:
Journal of Hospital Infection, January 2016, vol./is. 92/1(86-87)

 

Prevention and control of multiresistant Gram-negative bacteria: recommendations from a Joint Working Party (2016)

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Type of publication:
Journal article

Author(s):
Wilson, A P R, Livermore, D M, Otter, *J A, Warren, R E, Jenks, P, Enoch, D A, Newsholme, W, Oppenheim, B, Leanord, A, McNulty, C, Tanner, G, Bennett, S, Cann, M, Bostock, J, Collins, E, Peckitt, S, Ritchie, L, Fry, C, Hawkey, P

Citation:
The Journal of Hospital Infection, Jan 2016, vol. 92 Suppl 1, p. S1

 

Factors contributing to student nurses'/midwives' perceived competency in spiritual care (2016)

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Type of publication:
Journal article

Author(s):
Ross, Linda, Giske, Tove, van Leeuwen, René, Baldacchino, Donia, *McSherry, Wilfred, Narayanasam y, Aru, Jarvis, Paul, Schep-Akkerman, Annemiek

Citation:
Nurse education today, Jan 2016, vol. 36, p. 445-451

Abstract:
The spiritual part of life is importa nt to health, well-being and quality of life. Spiritual care is expected of nurses/midwives, but it is not clear how students can achieve competency in spiritual care at point of registration as required by regulatory bodies. To explore factors contributing to undergraduate nurses'/midwives 9; perceived competency in giving spiritual care. A pilot cross-sectional, multinational, correlational survey design. Questionnaires were completed b y 86% (n=531) of a convenience sample of 618 undergraduate nurses/midwive s from six universities in four countries in 2010. Bivariate and multivaria te analyses were performed. Differences between groups were small. Two fact ors were significantly related to perceived spiritual care competency: perc eption of spirituality/spiritual care and student's personal spiritual ity. Students reporting higher perceived competency viewed spirituality/spi ritual care broadly, not just in religious terms. This association between perceived competency and perception of spirituality is a new finding not pr eviously reported. Further results reinforce findings in the literature that own spirituality was a strong predictor of perceived ability to provide spiritual care, as students reporting higher perceived competency engaged in spiritual activities, were from secular universities and had previous healthcare experience. They were also religious, practised their faith/belief and scored highly on spiritual well-being and spiritual attitude/involvement . The challenge for nurse/midwifery educators is how they might enhance spi ritual care competency in students who are not religious and how they might encourage students who hold a narrow view of spirituality/spiritual care t o broaden their perspective to include the full range of spiritual concerns that patients/clients may encounter. Statistical models created predicted factors contributing to spiritual care competency to some extent but the picture is complex requiring further investigation involving a bigger and mor e diverse longitudinal sample.

Clinical Validation of the UKMS Register Minimal Dataset utilising Natural Language Processing (2016)

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Type of publication:
Poster presentation

Author(s):
Rod Middleton, Ashley Akbari, Hazel Lockhart-Jones, Jemma Jones, *Charlotte Owen, Stella Hughes, Richard Gain, David Ford

Citation:
IPDLNC 2016

Abstract:
Objectives
The UK MS Register is a research project that aims to capture real world data about living with Multiple Sclerosis(MS) in the UK. Launched in 2011, identified data sources were: Directly from People with MS (PwMS) via the internet, from NHS treatment centers via ‘traditional’ database capture and by linkage to routine datasets from the SAIL databank. Data received from the NHS, though ‘gold standard’ in terms of diagnosis, is dependent on clinical staff finding both time and information to enter into a clinical system. System implementations across the NHS are variable, as is clinical time. Therefore, we looked to other complementary methodologies.

Approach
The Clix enrich natural language processing (NLP) software was chosen to see if it could capture a portion of the MS Register minimum clinical dataset, the software matches clinical phrases against SNOMED-CT. 40 letters, from 2 NHS Trusts, from 28 patients were loaded. The letters were a mix of MS patients with differing disease subtypes and were dictated by Neurologists, Specialist General Practitioners and MS Specialist Nurses. 20 of the letters were in docx format and 20 as PDF.
The letters were parsed by a domain expert for clinical content, scored by data item for sensitivity and specificity. Next the output from the software was scored by another researcher to see if the 12 relevant clinical concepts from the Register dataset had been elicited. Lastly a ruleset was created to look for particular clinical concepts and scored in the same way.

Results
Of the 40 letters one failed to load, the rest were analysed for the specific data items. Date related items were clearly challenging, with only 7% of appointment dates being matched and 22% for date of diagnosis. MS Type (93.3%) and EDSS score (93.75%) were well recognised, additionally symptoms of MS that would be poorly reported in traditional databases were recognised, with fatigue being well highlighted (78.5%) and gait and walking issues (68.7%) Of concern, were a number of false positive results in DMT’s with 15% patients being identified as being on a DMT when this was just being ‘considered’.

Conclusion
The NLP pathway could be extremely useful for obtaining hard to capture clinical data for the Register. Further work is needed to reduce errors, even with the current minimal configuration, it's possible to ascertain MS Type, functional score of MS, current medication and potentially disabling symptomology within the condition.

Ultrasound guided musculoskeletal interventions: professional opportunities, challenges and the future of injection therapy (2015)

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Type of publication:
Journal article

Author(s):
Sue Innes, Mark Maybury, Alison Hall, *Gordon Lumsden

Citation:
Sonography (2015) 2(4): 84-91

Abstract:
The demand for ultrasound guided injections for musculoskeletal presentations has increased in recent years as practitioners and patients seek verification of needle position. Musculoskeletal management pathways regularly include injection therapy for pain relief and are sometimes indicated as a single intervention but may need to be supported by rehabilitation. Workload in radiology departments has expanded in volume and complexity as radiologists perform new interventional procedures that require medical expertise. Innovative responses are required to meet the demand for ultrasound guided musculoskeletal injections; one option is offering appropriate education to musculoskeletal sonographers, enabling them to extend their current scope of practice. The role of the extended scope physiotherapist in the United Kingdom provides evidence that role diversification can produce excellent patient outcomes whilst preserving financial resources. The professional, legal and clinical requirements of extending service provision to include new clinical staff presents challenges that have to be met with strong leadership and the provision of high quality education in ultrasound guided interventions. There are many indicators that the patient experience is enhanced by guiding musculoskeletal injections, and access to this service has impact on patients’ confidence in their treatment pathway.

Risk factors for treatment failure following cold coagulation cervical treatment for CIN pathology: a cohort-based study (2015)

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Type of publication:
Journal article

Author(s):
*Papoutsis D., *Underwood M ., *Parry-Smith W., *Panikkar J.

Citation:
Archives of Gynecology and Obstetrics, May 2015, vol./is. 292/6(1329-1337)

Abstract:
Purpose: To determine any risk factors for cytology recurrence in women after cold coagulation ablative treatment for cervical intraepithelial neoplasia (CIN). Methods: This was a retrospective observational study of a cohort of women having had cold coagulation between 2001 and 2011 in the colposcopy unit of an NHS hospital. We retrospectively collected data from our colposcopy unit database. Women with previous cervical treatment were excluded. Results: 559 eligible women we re identified with a mean age of 28.7 +/- 6.2 years. Nulliparous women were 66.3 % with smokers involving 35.3 %. Referral cytology, pretreatment cervical punch biopsies and colposcopy were high grade in 51.9, 71.9 and 45.8 % of women. Endocervical crypt involvement (ECI) on pretreatment cervical punch biopsy involved 9.7 % of women. Mean follow-up was 3.1 +/- 2.4 years. Overall cytology recurrence (mild/moderate/severe dyskaryosis) at 6 and 12 months follow-up was 7.4 and 5 %. High-grade cytology recurrence (moderate/severe dyskaryosis) involved 2.7 % of women over the entire follow-up period . Multiple regression analysis showed that ECI on pretreatment cervical pun ch biopsy was a risk factor for high-grade cytology recurrence (HR 3.72; 95 %CI 1.18-11.71; p = 0.024). There were no risk factors identified for overall cytology recurrence. However, when cytology tests with borderline nuclear changes at follow-up were pooled with mild/moderate/severe dyskaryosis cytology tests, then parity >2 was a risk factor for abnormal cytology (HR 1.71; 95 %CI 1.08-2.69; p = 0.022). Conclusions: Endocervical crypt involvement on pretreatment cervical punch biopsy and multiparity >2 are risk factors that increase the likelihood of abnormal cytology following cold coagulation. These two risk factors should be taken in consideration when performing cold coagulation cervical treatment for CIN pathology.

Practical Otolaryngology for Junior Doctors (2015)

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Type of publication:
Book

Author(s):
Thomas Frederick Charles Saunders, Editors: Alistair Mitchell-Innes and *Duncan Bowyer

Citation:
Doctors Academy Publications; 1st edition
ISBN-13: 978-9380573076

Abstract:

This book is designed to guide the junior doctor through an Otolaryngology (ENT) rotation from the first referrals to the practical procedures carried out on a daily basis. ENT departments throughout the world will have different ways of managing particular conditions; however, this book will give the user a framework to deliver good quality clinical care and develop skills with confidence wherever one is working. All information is presented in an easy to digest format to give a handy reference guide on how to manage the hugely varied conditions that are dealt with by Otolaryngology. This makes the book an ideal companion to keep in an on-call bag or clinic room. The advice provided in this book is practical and very clear, with good explanations about simple procedures for settling difficult situations. Information is also provided about looking after patients on the ward following common ENT/Head and Neck operations. An ENT junior doctor should feel more confident quickly after checking through this book for advice, as well as knowing when to escalate a problem to a more knowledgeable senior doctor, if the patient is not improving.