The purpose of this research was two‐fold: first, to compare staff and patient perceptions of two new wards in a medium‐secure unit with perceptions obtained previously for a unit…
Abstract
The purpose of this research was two‐fold: first, to compare staff and patient perceptions of two new wards in a medium‐secure unit with perceptions obtained previously for a unit that has since closed, and second, to compare staff and patient perceptions of the new ward with their ideal ward environment. The results obtained from patients indicated that there were differences between perceptions of the new treatment unit and the former treatment unit. The results obtained from patients also indicated that there was a difference between perceptions of the new treatment unit and the ideal ward environment. Results obtained from staff could not be analysed because of a low response rate.
In the year 2000, the UK government promoted the concept that hospital services be shaped around the needs of the patient to make their stay in hospital as comfortable as possible…
Abstract
In the year 2000, the UK government promoted the concept that hospital services be shaped around the needs of the patient to make their stay in hospital as comfortable as possible and advocated the introduction of a ward housekeeper role in at least 50 per cent of hospitals by 2004. This is a ward‐based non‐clinical role centred on cleaning, food service and maintenance to ensure that the basics of care are right for the patient. In 2002 the Facilities Management Graduate Centre at Sheffield Hallam University completed a series of six case studies looking at the role within different NHS Trusts. These were developed through interviews and observations with the facilities manager, ward housekeepers and nursing staff and also by collecting documentary evidence such as job descriptions, financial details and training information. Common themes were identified, relating to experiences of developing and implementing the ward housekeeper role. This paper suggests models of best practice relating to role, recruitment, induction, training, integration and management.
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Gerard Lambe, Niall Linnane, Ian Callanan and Marcus W. Butler
Ireland’s physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this…
Abstract
Purpose
Ireland’s physicians have a legal and an ethical duty to protect confidential patient information. Most healthcare records in Ireland remain paper based, so the purpose of this paper is to: assess the protection afforded to paper records; log highest risk records; note the variations that occurred during the working week; and observe the varying protection that occurred when staff, students and public members were present.
Design/methodology/approach
A customised audit tool was created using Sphinx software. Data were collected for three months. All wards included in the study were visited once during four discrete time periods across the working week. The medical records trolley’s location was noted and total unattended medical records, total unattended nursing records, total unattended patient lists and when nursing personnel, medical students, public and a ward secretary were visibly present were recorded.
Findings
During 84 occasions when the authors visited wards, unattended medical records were identified on 33 per cent of occasions, 49 per cent were found during weekend visiting hours and just 4 per cent were found during morning rounds. The unattended medical records belonged to patients admitted to a medical specialty in 73 per cent of cases and a surgical specialty in 27 per cent. Medical records were found unattended in the nurses’ station with much greater frequency when the ward secretary was off duty. Unattended nursing records were identified on 67 per cent of occasions the authors visited the ward and were most commonly found unattended in groups of six or more.
Practical implications
This study is a timely reminder that confidential patient information is at risk from inappropriate disclosure in the hospital. There are few context-specific standards for data protection to guide healthcare professionals, particularly paper records. Nursing records are left unattended with twice the frequency of medical records and are found unattended in greater numbers than medical records. Protection is strongest when ward secretaries are on duty. Over-reliance on vigilant ward secretaries could represent a threat to confidential patient information.
Originality/value
While other studies identified data protection as an issue, this study assesses how data security varies inside and outside conventional working hours. It provides a rationale and an impetus for specific changes across the whole working week. By identifying the on-duty ward secretary’s favourable effect on medical record security, it highlights the need for alternative arrangements when the ward secretary is off duty. Data were collected prospectively in real time, giving a more accurate healthcare record security snapshot in each data collection point.
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Benjamin Thomas Gray, Matthew Sisto, Renee Conley and India Sisto
The purpose of this paper is to explore the bias of psychiatrists and other healthcare staff’s perception of “presenting psychosis”. The purpose of this paper is twofold: first…
Abstract
Purpose
The purpose of this paper is to explore the bias of psychiatrists and other healthcare staff’s perception of “presenting psychosis”. The purpose of this paper is twofold: first, to suggest that psychosis, rather than residing in the individual, can be triggered by a hostile ward environment (e.g. very loud emergency alarms) as well as the negative attitudes of staff and friction with other service users; second, to argue that psychosis is not just in the person’s mind but interpreted and negatively labelled by psychiatrists and other healthcare professionals.
Design/methodology/approach
This paper is based on the lived experience of Ben, who was first diagnosed with schizophrenia in 2003 (when he spent two years in and out of a mental health unit). Ben had a relapse in 2013 and spent six full months in the same unit. Ben has been working as a peer worker on the same ward he was on as a patient for the last 17 months. This paper is informed by participant observation as a patient and peer worker, particularly reflecting on the general ward environment, ward reviews and punitive action faced by Ben and other service users. The title of this paper is based on occasions when Ben has been told that he cannot interact or take service users on leave off the ward, because they were “presenting psychosis”.
Findings
Ways of judging whether someone is presenting psychotic behaviour sounds straightforward enough but in fact can be quite complex. Whether someone is presenting psychotic behaviour is open to interpretation. Psychotic behaviour is perceived as latent or inherent within the individual by psychiatry. This paper makes the case that presenting psychotic behaviour is in fact a construct or interpretation by psychiatrists that works to limit people’s freedom, coerce them, take away their leave off the ward and voice, and which expresses power imbalances between staff and service users. The impact for service users of psychiatrists and staff’s decision-making can lead to service users being angry and upset, a negative ward environment and feelings of unfreedom. A good example is that service users present psychotic behaviour due to a hostile and frightening ward environment, with loud emergency alarms (like sirens) and the threat of restraint, restrictive practice and seclusion in de-escalation rooms being used as a threat.
Originality/value
People with mental illness, particularly schizophrenia like Ben, can be stereotyped as psychotic, aggressive and dangerous or a risk to themselves and others. While this can sometimes be the case the majority of people with mental illness that Ben has interacted with for over 20 years could be described as “broken” and in need of care, fixing and giving them hope in their recovery. This paper is of value because it draws on over twenty years of experience of the lived experience of Ben and his diagnosis of the harmful label of schizophrenia. It describes the added value of peer work in an in-patient mental health unit. It also introduces the new idea of “clemency”.
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Tori Wolfendale and Angella Musaabi
The purpose of this paper is to provide an overview of the implementation of a peer support volunteer scheme in a high secure setting and to explore the peer support volunteer’s…
Abstract
Purpose
The purpose of this paper is to provide an overview of the implementation of a peer support volunteer scheme in a high secure setting and to explore the peer support volunteer’s experiences conducting this role, based predominantly on an assertive rehabilitation ward.
Design/methodology/approach
This paper has outlined the implementation of the peer support volunteer scheme in a high secure setting and has explored the peer support volunteer’s experiences conducting this role and has explored the views of newly transferred patients who have accessed this scheme. The peer support scheme is based predominantly on an assertive rehabilitation ward. The data have been collected through the completion of detailed questionnaires that have been disseminated to participants through the clinical team.
Findings
This paper has outlined the implementation of a peer support scheme on an assertive rehabilitation ward within a high secure forensic mental health setting. This paper has explored the role and experiences of a peer support volunteer on an assertive rehabilitation ward and has explored the experience from a service recipient’s perspective also through the completion of questionnaires. This paper has explored the overall benefits of peer support within mental health services to both the volunteer, staff members and to a patient newly admitted to the ward, and has identified the skills that the volunteer is able to develop following contribution in to the peer support scheme.
Practical implications
This paper has acknowledged that there have been challenges introducing this particular scheme into mental health service teams. Challenges have included establishing appropriate boundaries and dilution of the role due to power imbalances, both between the peer support volunteer and the service recipient, but also between the clinical team that supervises the overall peer support scheme (Christie, 2016). The clinical team within this particular ward have been mindful with regards to the approach that has been utilised and has therefore, included the service users within the overall development of the scheme to encompass the recovery principles, but have continued to review the progression as a team and have taken into consideration all aspects of relational security.
Originality/value
The paper relating to the implementation of the peer support volunteer scheme in a high secure setting has not been published before and is not under consideration for publication with another journal.
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Purpose: This chapter examines how two basic rights, freedom of expression, and the right to equality based on one’s dignity, reputation, and honor, were balanced in a case…
Abstract
Purpose: This chapter examines how two basic rights, freedom of expression, and the right to equality based on one’s dignity, reputation, and honor, were balanced in a case involving a stand-up comedian and an adolescent suffering from Treacher Collins syndrome. Methodology/Approach: The case is contrasted with Jürgen Habermas’ concept of the public sphere and with the intrinsic and utilitarian values that Canadian courts have attributed to free speech. Findings: Because the case was dealt with first in a human rights tribunal and then by a court of appeal, a number of considerations were overlooked in court proceedings: how laughter occurs; the broadening of Ward’s audience and its consequences; and Ward’s publicity strategy. These aspects are explored here to give a more complete picture of the case beyond the court decisions. Originality/Value: In Canada, freedom of expression is usually dealt with ordinary courts. A whole new avenue for dealing with this right is human rights bodies and tribunals. Contesting free speech in the name of defamation is being replaced by rights entrenched in human rights charters, such as the right to equality based on the preservation of one’s dignity, reputation, and honor.
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Purpose – Extant studies have shown immigration does not lead to higher crime rates, yet this fallacy persists. The aim of this chapter is to explore the relationship between…
Abstract
Purpose – Extant studies have shown immigration does not lead to higher crime rates, yet this fallacy persists. The aim of this chapter is to explore the relationship between crime and the presence and growth of the Latino and the foreign-born populations in Washington DC's City Council Wards.
Methodology/approach – This chapter draws on Uniform Crime Reports data and Census information to compare and contrast crimes rates, the presence and growth of the Latino and foreign-born populations, and socioeconomic indicators across Washington DC.
Findings – Violent and property crimes rates have decreased consistently since the mid-1990s despite the growth of the Latino and the foreign-born populations. While there are significant differences between crimes rates at the Council Ward level, they appear to be associated with persistent structural inequality – not the presence or growth of either group.
Research limitations – This work is largely exploratory and descriptive. Results should be interpreted with caution. Future research should employ multivariate methods to systematically identify factors that most significantly and strongly explicate crime rates within and across DC Wards.
Social implications – Preliminary findings suggest policy makers should shift attention away from scapegoating immigrants for social ills and focus on improving social and economic opportunities and the life outcomes of racialized subordinate group members throughout the United States.
Originality – Little empirical research exists focusing on the relationship between immigration and crime in the nation's capital. This is a significant gap in the literature considering the recent rapid growth of the foreign-born and Latino populations in Washington DC.
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Francis O. Uzuegbunam, Fynecountry N. Aja and Eziyi O. Ibem
This research aims to investigate the influence of building design on the thermal comfort of occupants of naturally ventilated hospital (NVH) wards to identify the aspects with…
Abstract
Purpose
This research aims to investigate the influence of building design on the thermal comfort of occupants of naturally ventilated hospital (NVH) wards to identify the aspects with the most significant influence on the thermal comfort of hospital buildings during the hot-dry season in the hot-humid tropics of Southeast Nigeria.
Design/methodology/approach
Field measurements, physical observations and a questionnaire survey of 60 occupants of the wards of the Joint Presbyterian Hospital, Uburu in Ebonyi State, Nigeria were undertaken. The data were analysed using Humphreys' neutral temperature formula, descriptive statistics and multiple regression analysis.
Findings
The results revealed that the neutral temperature for the wards ranges from 26.2 °C to 29.9 °C, the thermal condition in the wards was not comfortable because it failed to meet the ASHRAE Standard 55 as only 65% of the occupants said the thermal condition was acceptable. The number and sizes of windows, building orientation, the presence of high-level windows and higher headroom significantly influenced the occupants' thermal comfort vote.
Practical implications
This research is valuable in estimating comfort temperature and identifying aspects that require attention in enhancing the capacity of NVH wards to effectively meet the thermal comfort needs of occupants in the hot-humid tropics of Southeast Nigeria and other regions that share similar climatic conditions.
Originality/value
To the best of the authors’ knowledge, this is the first study of this nature that provides valuable feedback for building design professionals on the performance of existing hospital buildings in meeting users' thermal comfort needs in the hot-dry season of the hot-humid tropics in Southeast Nigeria.
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Lesley Jones, Nicky Cullum, Ruth Watson and John Keady
This study aims to address this need. In the UK, people with dementia admitted to National Health Service mental health in-patient dementia assessment wards [dementia assessment…
Abstract
Purpose
This study aims to address this need. In the UK, people with dementia admitted to National Health Service mental health in-patient dementia assessment wards [dementia assessment wards] present as complex and experience a number of changed behaviours, such as excessive walking, agitation and aggression. The complexity of the presentation of dementia has been identified as underpinning pre-and post-admission to these care environments, but limited study has so far been conducted to explore the boundaries and meaning of complexity and its relationship to dementia assessment ward practice.
Design/methodology/approach
An online electronic survey of UK-based national dementia leaders was conducted in 2018. Nineteen completed questionnaires were returned, and mental health nurses comprised the largest sub-sample. Qualitative data of the free-text responses were analysed using manifest content analysis.
Findings
Four routes to admission to a dementia assessment ward were identified. Multiplicity of needs and interconnectedness were seen as important domains in uncovering the meaning of complexity. The importance of life story and formulation approaches were highlighted. Challenges uncovered included, better understanding changed behaviour and its relationship to complexity, the need for understanding the boundaries of complexity and making visible care practices on these specific wards.
Originality/value
Findings can be used to produce a heightened awareness about the meaning and function of complexity in dementia assessment wards. Policymakers and researchers need to increase the emphasis on this area of mental health and dementia care. Further training for the multidisciplinary team on formulation approaches could help to improve the evidence-base for practice.