Celebrating a ground breaking year in music from Limerick Print Facebook Emma Langford shortlisted for RTE Folk Award and playing a LIVE SHOW!!! this Saturday Advertisement Twitter Previous articleFoley speaks of “Joy” at new roleNext articleAdams tribute to the women of King’s Island Alan Jacqueshttp://www.limerickpost.ie Watch the streamed gig for Fergal Nash album launch TAGSCllr Joe LeddinLimerick city councilLimerick County CouncilMungret CollegeMusic LimerickOpera Centre LIMERICK City and County Councils have become “major players” in the purchase of strategic sites throughout the region, according to Labour Party city councillor Joe Leddin.And he says that this should benefit the proper redevelopment and provision of suitable infrastructure in Limerick.Sign up for the weekly Limerick Post newsletter Sign Up “From a time when the Council played little or no role in the purchase of sites and buildings of importance, it is now a serious player in the local and regional property market,” claimed Cllr Leddin.“Over recent years, the Council has acquired sites including the derelict ‘Opera Centre‘ on Patrick Street, the Granary Building and adjacent lands on Michael Street, the former Texaco garage on Parnell Street, and, more recently, a 200-acre site including the former Mungret College,” he said.According to Cllr Leddin, these acquisitions, along with a number of buildings including No 2 Pery Square, home to the City of Culture team, have provided the Council with considerable opportunities to redevelop these sites in partnership with suitable private or public sector agencies.The new Local Government Bill 2013, he said, also provides local councils with additional powers to become more actively involved in enterprise and community development projects as the local enterprise boards are amalgamated into existing Council structures.“The publication of the GVA 2030 document outlines the real potential that Limerick has to offer if proper sustainable development in key areas such as retail, conference, and tourism are delivered.“Ownership of and the purchase of additional key sites is essential to delivering the vision set out in the 2030 document while simultaneously delivering thousands of new jobs into the region,” he concluded. Email NewsLocal NewsCouncil is ‘major player’ in Limerick property marketBy Alan Jacques – February 20, 2014 803 #SaucySoul: Room 58 – ‘Hate To See You Leave’ #HearThis: New music and video from Limerick rapper Strange Boy Linkedin WhatsApp RELATED ARTICLESMORE FROM AUTHOR Concerns raised over Punches Cross student development
Comments are closed. Previous Article Next Article Is the way you practice based on sound research, or is it just the way it’salways been done? Nurses are increasingly expected to keep abreast of currentresearch, by Greta Thornbory The fact that you are reading this article indicates that you are interestedin improving practice and care, which is what continuing professionaldevelopment is all about. However, occupational health practice, by its very nature, is often isolatedfrom other healthcare practice. So how do OH practitioners know that what theyare doing is the right thing? How do they keep up to date with the latestpractice? And how do they know what they are doing is the most efficient andeffective way to practice? What is evidence-based practice? This article aims to explore and discuss what ‘evidence-based practice’really means, how it fits into clinical effectiveness and the steps that areneeded in order to ensure that OH nursing practice is evidence based. Althoughthere has been a move towards evidence-based practice. It does have itslimitations. Pearson, cited by Johnson and Griffiths1, cautions that it is nota cure for all nursing ills and McKenna et al2 demolishes some of the mythssurrounding the concept. Today’s nurses are expected to care for their patients, identify theiractual and potential problems, and develop research-based strategies “toprevent, ameliorate and comfort” so says Dicenso et al3. They go on to say that nurses are also expected to take on worktraditionally done by doctors and to be highly educated empatheticcommunicators. They need to be critical thinkers and keep abreast of importantresearch findings. Traditionally, nursing has been derived from knowledge basedon anecdote and tradition1. Think back to your own training – why did you dowhat you did? Was it because sister or staff nurse told you to – and why didthey do it? There have been some classic examples of ‘habit-based practice’such as salt in the bath. The evidence-based healthcare movement has developed rapidly over the past10 years4 and is thought to have originated in Canada as “…theconscientious, explicit and judicial use of current evidence in makingdecisions about the care of individual patients”. Such a definition does not necessarily suit OH nursing because manypractitioners do not have individual patients – but rather clients – and it maybe populations of employees on which decisions about care are being made.However, Dicenso et al3 say that research utilisation has been defined as the useof research findings in all aspects of work as a nurse and they believe thatthis is the same as the definition for evidence-based nursing. But is all this known under another name and as part of ‘clinicaleffectiveness’ defined by the RCN5 as “doing the right thing in the rightway at the right time for the right patient”? The RCN goes on to say thatclinical effectiveness, of which evidence-based practice is part, is aboutmaking sure that you offer the best care possible for an individual patient orfor a population. Fennessy6 says that the concepts of evidence-based practiceand evaluation, or clinical audit, are brought together into a coherent modelfor improving clinical practice and as such form the parts of clinicaleffectiveness. The steps for clinical effectiveness and evidence-based practice require anenquiring mind, and an ability to look at and criticise one’s practice. Recent questions about health assessment that have been asked on one of theOH Websites indicate that nurses still cannot justify why they are undertakingcertain screening procedures for pre-employment health assessment. Further questioning by expert practitioners indicates that they have notconsidered the evidence base for their practice and cannot give an explanation fortheir actions; rather their practice is based on habit. If occupational healthnurses are to move forward with clinical effectiveness and evidence-basedpractice perhaps this is one area with which to start. The first steps requirelooking at practice and developing a questioning attitude to day-to-daypractice5. Information gathering The next step is to gather the ‘evidence’, to search for and gather relevantinformation and to look for the best available knowledge5,6. The problem hereis in deciding which evidence is ‘good’ and how to go about finding it in thefirst place. According to Evans and Pearson7 the demand for evidence to support practiceis growing, but finding the best evidence is becoming increasingly difficult.They go on to say that the need for evidence on which to base care is growingas a result of many factors such as: – the expectation of high quality services – the demand for redress and compensation – the existence of many new technologies, procedures and products OH practitioners are answerable to both employers and employees who allexpect a high quality of service. This is especially so because they are payingfor the OH service. OH practitioners must therefore be able to justify theiractions and give explanations for them. Pre-employment health assessment is an example of OH nursing practice thatneeds to be evidence based. What screening is actually undertaken during healthassessments and why? Does research indicate that one-off screening tests, suchas blood pressure measurements and urinalysis, are effective indicators of aperson’s health status and fitness to work? Despite much research into the best ways to measure blood pressure thereremains considerable controversy8. Urinalysis may detect early signs of disease,but research undertaken in 1992 showed that only 0.9 per cent of a sample wereundiagnosed diabetics9. Research-based evidence is available and it is apractitioner’s duty to ensure that he or she finds it, reads it and acts uponit, as nurses are personally accountable for their practice10. These examples are only the tip of the iceberg and a thorough search ofnursing literature is necessary to ensure that all aspects of any topic areexplored. Information is available in a variety of forms and it is important to beclear about what you want to know or find out and to be aware of how to accessall forms of information. With the advance of technology and the Internet, moreand more resources are available and searching for information can be fun ratherthan a chore. Types of evidence There are a number of different types of evidence: – Primary research – Systematic reviews – Meta-analysis – Clinical guidelines – Textbooks – Expert opinion Each has its own place and significance in evidence-based practice and thefirst four will be discussed, highlighting their relevance to OH nursingpractice. A thorough literature search is necessary to identify what evidenceis available. Primary research Primary research is usually published in professional journals. The bestevidence comes from ‘randomised controlled trials’ and results from suchresearch are ranked highly11. However, such research is not always ethicallypossible with regard to nursing practice1. Finding best evidence is becoming increasingly difficult7 and it is notenough just to find relevant research, the work needs to be closely examined toassess and decide on its quality and worth. This is where ‘critical appraisal’skills are needed. Critical appraisal means checking that research was doneproperly, that the method was suitable and that its findings are relevant toyour area of practice. It is worthwhile looking for a course to help withdeveloping these skills. Further information is given at the end of thearticle. Systematic reviews To make life easier for evidence-based practice and to find a way around thevast quantity of research, a system called ‘systematic review’ has beendeveloped. Evans and Pearson7 describe systematic reviews as the ‘gatekeepers’ ofnursing knowledge and argue that they represent the ‘gold standard’ in researchsummaries. Along with Johnson and Griffith1 they found that most researchregarded as credible in the healthcare sector depend on randomised controltrials and agree that such methods do not do justice to nursing research. Their paper discusses the issues that need to be considered and addressedfor more appropriate systematic reviews of nursing research. They also say theaim of a systematic review is to provide reliable summaries of past researchand this is exactly what OH practitioners need. Magarey4 defines a systematic review as “the application of scientificstrategies that limit bias to the systematic assembly, critical appraisal andsynthesis of all relevant studies on a specific topic”. In other words itdoes the work for you. It is worth reading more about this topic and thereferences given in this article are available free online to RCN members.Systematic reviews can be found on a number of databases and in specialistjournals (see the list at the end of this article). It is also worth looking atsome reviews to get a clear idea of how they work and what they say. Meta-analysis Briefly, meta-analysis is a process of pooling together a number of, oftenconflicting, small research studies on the same topic to give one overallpicture. It is necessary to be cautious about the results of this process, andto understand it properly, before accepting the results on which to base or makechanges to practice. Clinical guidelines Clinical guidelines are developed by professional organisations, such as theroyal colleges or at local levels by large healthcare providers. In OH they mayhave been developed by specific companies with large OH services. They shouldbe based on up-to-date and suitably appraised evidence and give guidelines forpractice and management, helping to set an overall standard. Clinicalguidelines are being developed on a number of topics at a national level and itis worth looking at an example for OH practice, such as the UK Guidance on BestPractice in Vaccination Administration12, available from the RCN. Don’t forgetthat guidelines should be: – Based on valid and reliable research – Prepared by a multi-disciplinary panel – Not past their use by date5 Implementation It has been said, anecdotally, that to go from research to a change inpractice takes 10 years. To ensure that your practice is evidence based takestime and a questioning mind. Nurses may not have the time or resources toundertake searches or read research, reviews or guidelines. They may feelthreatened or anxious about making changes. But some will want to make changesto practice for the benefit of their clients and the organisation they work for.Changes can be made if they are handled carefully and evidence of the benefitscan be shown. Working with a committed team helps, but if you work on your own it may takemore courage. Discussing this with a respected colleague, even in anotherorganisation, may help. The RCN5 suggests the following key points forintroducing change: – Decide on priorities for change – Don’t take on too much – Be realistic – Don’t try and do it on your own – Involve your colleagues – Remember, change can be difficult – Don’t expect things to change over night – And don’t forget to build in some evaluation, or clinical audit. References 1. Johnson M, Griffiths R (2001) Developing evidence-based clinicians.International Journal of Nursing Practice 7: 109-118 2. McKenna H, Cutliffe J, McKenna P (2000) Evidence based practice:Demolishing some myths. Nursing Standard 5 January, 14(16): 39-42. 3. Dicenso A et al (2000) Introduction to evidence basednursing.www.cebm.utoronto.ca 2002. 4. Magarey J M (2001) Elements of systematic review. International Journalof Nursing Practice 7:376-382. 5. Royal College of Nursing (1999) Doing the right thing; clinicaleffectiveness for nurses. London: RCN. 6. Fennessy G (1999) What’s the evidence? Clinical effectiveness. NursingUpdate Unit 87, Nursing Standard Nov 11, 3(8). 7. Evans D, Pearson A (2001) Systematic Reviews: gatekeepers of nursingknowledge. Journal of Clinical Nursing 10: 593-599. 8. Beever M (1998) On the way up: hypertension. Nursing Update Unit 80, Nursing Standard 18 March, vol 12(26). 9. Worral G, Moulton N (1992) The ratio of diagnosed to undiagnoseddiabetics in patients 40 yrs and older. Canadian Journal of Public Health83(5): 379-381. 10. UKCC (1992) The Scope of Professional Practice. London: UKCC. 11. Belsey J, Snell T (1997) What is Evidence-Based Medicine? HaywardMedical Communications Ltd. 12. Driver C et al (2001) UK Guidance on Best Practice in VaccinationAdministration, Shire Hall Communications. Critical Appraisal11 Critical appraisal is the method ofassessing and interpreting the evidence by systematically considering itsvalidity, results and relevance to the area of work being considered.Questions to ask – Do you know why you do what you do?– Can you give an explanation as to why you are doing it?– Are you up to date or is your practice based on habit?Sources of information for evidence-based practiceJournalswww.nursing-standard.co.ukRegister and you can access Nursing Standard’s archive and download researcharticles and CPD articles from all the RCN journalswww.personneltoday.comThe site for Occupational Health journalwww.freemedicaljournals.comThis site concentrates primarily on medical journals but it isgood for some specialist information. Beware, as some of the journals are onlyfree for a trial period after which you will need to subscribewww.nursingtimes.co.ukwww.heapro.oupjournals.orgThis is the site for Health Promotion International with leads to HealthEducation Research and many other relevant journalswww.nursing-libraries.org.ukA new site aimed at nurses in Wales but will be expanding to cover the rest ofthe UK. This site outlines where nurses can access libraries and whichfacilities are availablehttp://omni.ac.uk/An extremely useful site which provides a gateway to biomedical resources. Itincludes some free access to Medline and other databaseswww.nursingnet.org/American site with links to electronic journals and someinteractive featureswww.jr.ox.uk/bandolier/For research systematic reviewswww.cochrane.hcn.netFor research on systematic reviews -the gold standard!Nursing and health information siteswww.rcn.org.ukIf you are an RCN member you can register, log on and download several journals(www.blackwell-synergy.com) as well as join BNI (British Nursing Index), whichgives you access to search facilities www.nmap.ac.ukAn extremely informative site containing a lot of information relevant tonursing practice including lots of links to other useful siteswww.nelh.nhs.ukPart of the Government’s information for health strategy. This site is stillbeing developed but is worth visiting. A series of branch libraries is beingdeveloped; the first includes Primary Care Groups and Mental Healthwww.man.ac.uk/rcnLinked to the RCN Research and Development Co-ordination Centre at ManchesterUniversity. This website enables you to search according to geographicareawww.shef.ac.uk/~nhcon/nuuk.htmAn extremely informative site containing a lot of informationrelevant to nursing practice including links to other useful siteswww.healthcentre.org.uk/hc/default.htmThis site acts as a signposting service, providing information for patients andcarers as well as a separate staff room for healthcare professionalswww.healthgate.comA useful site providing information for patients, carers and health careworkers. Includes separate healthcare centres for women’s health,men’s health, mental health, alternative health, etc. Also includes detailed research facilitieswww.ukcc.org.ukwww.enb.org.ukwww.had-online.org.uk (replaces HEA)www.health-news.co.ukVery useful site for up-to-date health care news of all sortswww.who.dkWorld Health Organisation Europewww.icn.chInternational Council of NursesOccupational health siteswww.jiscmail.ac.ukThis site allows you to join the mailing list for OH professionals – go tomedicine and health and then scroll down to occupational health – click on andjoin up. NB – there are other specialties on this site – go to healthand pick your own topic areaCritical appraisal course informationwww.phru.org.ukOxford Critical Appraisal Programme Old Road, Headington, Oxford,OX3 7LF 01865 226968Government siteswww.statistics.gov.ukA site for all the statistics you wantwww.hse.gov.ukwww.hsebooks.co.ukwww.doh.gov.ukwww.cdc.govAmerican communicable diseases centre www.eoc.org.ukThe site of the Equal Opportunities Commission Related posts:No related photos. Evidence of successOn 1 Mar 2002 in Personnel Today
In a year filled with questions about the future of the program, Wisconsin women’s basketball head coach Bobbie Kelsey landed the highest-ranked recruiting class of her tenure.Wednesday marked the first day recruits could sign letters of intent, and Wisconsin fans should be excited about some of the prospects arriving on campus next fall.The class consists of six recruits, three of whom are ranked in the top 100 nationally, who should inject some new blood into the struggling program and ease some of the pressure on Kelsey’s hot seat.Gabby Gregory, a 5-foot-8 guard from Irving, Texas, who should become an impact player the minute she steps on campus, headlines the class. Both ESPN and Blue Star Basketball rank Gregory in the top 60, and her dynamic talent should bolster coach Kelsey’s growing pipeline into Texas.“We are definitely looking for her to come in and do big things for our program,” Kelsey said. “Gabby is a hard-nosed point guard that shoots the ball extremely well, has great ball handling and playmaking skills to boot. She elevates those around her to play at the highest level because of her love for the game, competitive nature and will to be the best.”Wisconsin also added size to its frontline by signing 6-foot-3 forward Abby Laszewski from Hartford, Connecticut. Laszewski is a top 75 recruit and should be a familiar name to Wisconsin die-hards. Her father, Jay, played for the men’s basketball team from 1983-86.“Abby will have the distinct honor of continuing the legacy of being a Badger basketball player as she follows in the footsteps of her father,” Kelsey said. “We had the good fortune to see her play early last year and decided that she had just the right skill set and pedigree to join our program.”Another name that might ring a bell with fans is Suzanne Gilreath, sister of football player David Gilreath, out of Brooklyn Park, Minnesota. Gilreath was a lights-out scorer in high school and averaged 28.3 points en route to becoming one of the most decorated 3-point shooters in Minnesota state history.Joining Gilreath from Minnesota is Courtney Fredrickson from Excelsior. The Star Tribune named her to the 2015 all-state team and she played for the North Tartan basketball program — one of the most competitive AAU teams in the Midwest.Lastly, at the foundation of any strong Badger team is a strong in-state backbone; the Badgers kept two players inside their borders this cycle. Grace Mueller from Verona and Alona Johnson from Milwaukee should help bolster Wisconsin’s depth next season and be integral parts of the team as upperclassmen.“Two Wisconsin natives in the 2016 class shows our commitment to keep Wisconsin players here in Wisconsin,” Kelsey said.