The Faculty of Health and Social Care is one of the major providers of Health and Social Care education in the North West and offers a wide range of programmes at both undergraduate and postgraduate levels.

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  • Building the future workforce through indirect supervision

    Knight, Kate H.; Simpson, Angela; Hay, Jonathan; University of Chester (MA Healthcare, 2024-02-08)
  • Errors in diabetic insulin therapy and the vitality of proper precautions in Bangladesh: Real-life insights from the developing world

    Tulsan, Suresh K.; Laila, Rona; Patel, Harshkumar; Dave, Vyapti; Mary, Rabeya M.; Sham, Sunder; Anjali, FNU; Jaladi, Soumya; Kumar, Sanjay Kirshan; Singhania, Priya; et al. (Medknow, 2024-02-08)
    Background: Insulin therapy errors can have life-threatening consequences in patients with diabetes. Given the increasing prevalence of diabetes and insulin therapy in Bangladesh, it is crucial to identify and prevent these errors. This study uses case-based clinical experiences to thematically analyze insulin therapy errors and propose preventive measures. The study aims to provide valuable insights into the challenges faced in managing insulin therapy in a developing country setting and the importance of involving various stakeholders. Materials and Methods: This is a qualitative research that used a case study approach to identify and analyze errors in insulin therapy in diabetic patients who had experienced adverse clinical consequences. The cases were thematically analyzed to generate insights into current global health problems resulting from erroneous insulin therapy. Results: The two case studies highlight potential risks of errors in insulin therapy, including poor glycemic control, complications, and death. The analysis also highlights the importance of careful monitoring, checks, and communication among health-care providers, patients, and pharmacists to prevent such errors. In addition, it emphasizes the need for education and awareness among patients and health-care providers to ensure safe and effective insulin therapy. Conclusion: Accurate insulin therapy is crucial for diabetes management and preventing adverse outcomes. Identified themes emphasize improved communication, education, and monitoring to minimize therapy errors. Insights from this study can inform policies and practices for better patient outcomes. Further research can identify the root causes and develop interventions to prevent errors, leading to improved quality of life for diabetics.
  • Managers' Perspectives of an Effective Health and Social Care Worker in the Independent Sector: An Ethnographic Study

    Templeman, Jenni; Barton, Janet; Kendall-Corry, Raymond J. (University of Chester, 2023-08)
    Aim: This thesis presents an ethnographic investigation into the perceptions of managers in the independent health and social care sector regarding the characteristics of effective health and social care workers. The study investigates the managerial perspective of the values, skills, knowledge, and functional behaviours regarded essential for providing high-quality care services to adults who may be at risk. Using an ethnographic methodology, the study seeks to glean rich and nuanced insights from managers who play a central role in moulding and supervising the Health and Social Care workforce. Background: Health and social care workers require a variety of skills and knowledge for them to be perceived as effective by their managers. The skill and behavioural requirements range from the practicalities of supporting people with their daily living tasks, including clinical support, to high levels of emotional intelligence to support the sociological, psychological, and emotional wellbeing of people who access health and social care services. Health and social care frontline workers require a sophisticated level of emotional intelligence with positive, personal attributes such as patience, kindness, empathy, and compassion. Methodological approach: An interpretive, ethnographic design was adopted for the study incorporating symbolic interactionism with social constructionism as a lens with which to analyse the outcomes from the research question. Individual, semistructured ethnographic interviews were conducted with ten managers (n=10), and 18 two focus groups were held in which participants were asked to identify the characteristics that, in their opinion, constitute an effective frontline worker. The leadership focus groups included eleven managers in total (n=5 + n=6) therefore twenty-one participants in total (n=21) plus field notes thus achieving triangulation. The data was analysed using Ricoeur’s thematic analysis framework. Findings: Communities of practice are naturally inherent in well performing teams. On a service level this is brought about through the behaviours of effective frontline workers, creating cultures of effective communication and continual, shared learning to enhance the lives of their service users. One may suggest a culture of experiential learning begins through the metamorphic, liminal experience of integrating staff members into the organisational culture. Liminality is present in the experience of individual workers, teams and the ‘living organisation’. It is a catalyst, in which processes happen spontaneously, leading to consideration of 21st century healthcare and compassion in caring; essential for the transformative, person-centred healthcare required in contemporary practice. Recommendations: Recommendations included the development of a professional identity through communities of practice, an educational push towards enhancing staff self-actualisation, and the cultivation of organisational culture, all of which would lead to compassionate care with a focus on facilitating service user safety and happiness.
  • Understanding the contribution of intellectual disabilities nurses. Paper 4 of 4 - Impacts of intellectual disability nursing interventions

    Mafuba, Kay; Chapman, Hazel M.; Chester, Rebecca; Kiernan, Joann; Kudita, Chiedza; Kupara, Dorothy; University of West London; University of Chester; Berkshire Healthcare NHS Foundation Trust; Edge Hill University; Alder Hey Children’s Hospital (SAGE Publications, 2024-01-18)
    Internationally, there is a wide variety of roles and expectations for intellectual disabilities nurses, and the range of nursing interventions they undertake in this field has not been clearly identified. In this paper we report the impacts of intellectual nursing interventions from an online survey of intellectual disability nurses. An online survey, using voluntary response sampling was used to collect case study examples from 230 participants from seven countries. We identified 13 themes of the impacts, and 23 broad groups of case examples of intellectual disability nursing interventions with, pregnant women, children, adults, older adults, and people at the end of life. Awareness of the roles of intellectual disability nurses and their importance in addressing health inequalities and facilitating the use of mainstream services for people with intellectual disabilities will enable improved healthcare experience and healthcare outcomes for people with intellectual disabilities.
  • Evaluating the NMC proficiencies framework: perspectives of students and educators 5 years on

    Whaley, Viki; Cooper-Caiger, Lee; Hay, Jonathan; Stone, Jacqueline; University of Chester (MA Healthcare, 2024-01-09)
    It is now half a decade since the Nursing and Midwifery Council (NMC) launched Future Nurse: Standards of Proficiency for Registered Nurses. Applicable nationally, this proficiencies framework dictates specific elements of nursing praxis that all pre-registrants must achieve in order to qualify as registered nurses, before going on to gain employment in either the NHS or adjacent healthcare providers. The NMC proficiencies framework is subdivided into seven proficiencies and two annexes, each of which contains multiple specific criteria detailing the skillset pre-registrants must demonstrate, in order to be signed off by a qualified educator. Subsequently, in the last 5 years the standards have brought about significant alterations to the delivery of nursing programmes at UK higher education institutions. This article reports the results of a pair of service evaluations, which gathered feedback from both pre-registrant students and educators in relation to their direct experiences of the NMC's proficiencies framework. The authors compare the contemporary perspectives collated here against earlier academic appraisals of the guidance framework, in order to outline its past and present reception at the level of delivery.
  • Determining current approaches to the evaluation of the quality of healthcare simulation-based education provision: a scoping review

    Pogson, Rachel; Henderson, Helen; Holland, Matt; Sumera, Agnieszka; Sumera, Kacper; Webster, Carl A.; Keele University; Robert Gordon University; Library and Knowledge Service for NHS Ambulance Services in England; University of Chester; European Pre-Hospital Research Network, Nottingham; East Midlands Ambulance Service NHS Trust; Nottingham Trent University (Taylor & Francis, 2023-10-05)
    Background: With an increase in simulation being used in healthcare education, there is a need to ensure the quality of simulation-based education is high. This scoping review was conducted to answer the question: What are the current approaches to the evaluation of the quality of health-care simulation-based education provision? Methods: Databases PubMed, Cochrane, ERIC, CINAHL and Medline were searched in March 2023 to retrieve peer-reviewed healthcare research and review articles written in the English language within the last 20 years. All data were extracted from six studies, themed and presented in the main text and in tabular form. Results: Two scoping reviews, one systematic review and three research articles were included. Three main themes were found: adherence to existing design frameworks, lack of validation of these frameworks and lack of evaluation frameworks, and a proposed evaluation framework. Many of the excluded articles focussed on gaining participant feedback to evaluate simulation activities, rather than evaluating the quality of the design and implementation of the simulation. Conclusions: Benchmarking of current United Kingdom (UK) healthcare simulation against UK and international simulation standards is required to increase its quality, therefore, an agreed UK template framework to evaluate simulation packages is recommended.
  • CPR Quality Officer role to improve CPR quality: A multi-centred international simulation randomised control trial

    Sumera, Kacper; Ilczak, Tomasz; Bakkerud, Morten; Lane, Jon D.; Pallas, Jeremy; Ortega Martorell, Sandra; Sumera, Agnieszka; Webster, Carl A.; Quinn, Tom; Sandars, John; et al. (Elsevier, 2024-01-02)
    Background: An out-of-hospital cardiac arrest requires early recognition, prompt and quality clinical interventions, and coordination between different clinicians to improve outcomes. Clinical team leaders and clinical teams have high levels of cognitive burden. We aimed to investigate the effect of a dedicated Cardio-Pulmonary Resuscitation (CPR) Quality Officer role on team performance. Methods: This multi-centre randomised control trial used simulation in universities from the UK, Poland, and Norway. Student Paramedics participated in out-of-hospital cardiac arrest scenarios before randomisation to either traditional roles or assigning one member as the CPR Quality Officer. The quality of CPR was measured using QCPR® and Advanced Life Support (ALS) elements were evaluated. Results: In total, 36 teams (108 individuals) participated. CPR quality from the first attempt (72.45%, 95% confidence interval [CI] 64.94 to 79.97) significantly increased after addition of the CPR Quality role (81.14%, 95% CI 74.20 to 88.07, p = 0.045). Improvement was not seen in the control group. The time to first defibrillation had no significant difference in the intervention group between the first attempt (53.77, 95% CI 36.57–70.98) and the second attempt (48.68, 95% CI 31.31–66.05, p = 0.84). The time to manage an obstructive airway in the intervention group showed significant difference (p = 0.006) in the first attempt (168.95, 95% CI 110.54–227.37) compared with the second attempt (136.95, 95% CI 87.03–186.88, p = 0.1). Conclusion: A dedicated CPR Quality Officer in simulated scenarios improved the quality of CPR compressions without a negative impact on time to first defibrillation, managing the airway, or adherence to local ALS protocols.
  • Exploring engagement: A Constructivist grounded theory study of pregnant woman’s engagement with antenatal care health services in rural India

    Speed, Shaun; Roberts, Taniya; Chaudhary, Diksha (University of Chester, 2023-11)
    Background: Safe motherhood, a woman experiencing a healthy pregnancy experience, with a positive outcome and healthy living of women and newborns are an integral concern for global public health (WHO, 2016). The estimated global maternal mortality rate is 211 deaths per 100 000 live births and approximately 810 mothers died each day worldwide in 2017 from preventable maternal complications (WHO et al., 2019). Only 52% of women reported to have attended at least four ANC visits as per NFHS 4 (2015-16), along with 17% of Indian women who never contacted health facilities for visits (NFHS4a, 2017). Methodology: The research study has adopted Kathy Charmaz’s Constructivist Grounded Theory methodology. Methods: In-depth semi-structured interviews were conducted with eight initial purposive samples of pregnant women. The data was simultaneously analysed to gather preliminarily concepts which further guided the theoretical sampling of sixteen pregnant women and eight healthcare workers. All 32 interviews were audio-recorded with the permission and consent of the participant. The three stages of coding in Constructivist Grounded Theory methodology, Initial coding, Focused coding, and Theoretical coding were followed for data analysis. Findings: The core category consists of interrelated sub-categories; perceived Benefits and importance of Antenatal care health services; pregnant women and Health worker interaction and structural factors as a barrier to antenatal care. Pregnant women especially for a full and partial ANC, perceived ANC as an opportunity to gain assurance about their well-being. Family presence is crucial in women's ANC decision-making. A positive relationship with healthcare providers significantly influences ANC engagement. ASHA community health workers act as a crucial bridge between the community and the health system is one of the important social processes which encourage women. Women preferred the Ultrasound over complete ANC services and recognized it as a core component to reassure both the baby and the woman. Family members especially elder female strongly influenced women’s decision-making. Health worker-pregnant women interaction is pivotal, fostering trust and encouraging ANC acceptance. Conclusion: The study reveals varying perceptions of ANC among full, partial, and non-attenders, shaped by diverse factors influencing their engagement. A prevalent theme is the predominant view of ANC as curative rather than preventive care, reflecting a significant social process. Pregnancy is often seen as a normal, healthy event, affecting decision-making. Lack of autonomy emerged as a significant predictor for ANC utilization, highlighting the need for women-cantered care.
  • Understanding the contribution of intellectual disabilities nurses. Paper 1 of 4 -Scoping literature review

    Mafuba, Kay; Chapman, Hazel M.; Forster, Marc; Chester, Rebecca; Kiernan, Joann; Kupara, Dorothy; Kudita, Chiedza; University of West London; University of Chester; Berkshire Healthcare NHS Foundation Trust; Edge Hill University; Alder Hey Children’s Hospital (SAGE Publications, 2023-12-11)
    The objective of this scoping review was to summarise evidence on the contribution of intellectual disabilities nurses to improve the health and well-being of children, adults and older people with intellectual disability, now and for the future. The Preferred Reporting Items for Systematic Reviews and Meta-Analysis (for Scoping Reviews) (PRISMA-ScR) process and Joanna Briggs Institute (JBI) guidance was used. We included 54 publications. We identified 154 interventions undertaken by intellectual disability nurses. We categorised the intellectual disability nursing interventions into three themes: effectuating nursing procedures, enhancing impact of services, and enhancing quality of life. Findings point to high quality research being essential in determining the impact and effectiveness of intellectual disability nursing interventions across the lifespan. We recommend that a searchable online compendium of intellectual disability nurse interventions be established and regularly updated. This will provide opportunities to engage more effectively in evidence-based practice.
  • Transitional support interventions for care leavers: A scoping review

    Feather, Julie; Allen, Dan; Crompton, Rhian; Jones, Zoey; Christiansen, Angela; Butler, Gavin (Wiley, 2023-12-09)
    The purpose of this scoping review was to identify and map knowledge on different types of transitional support interventions currently available to support transition to independent living for care leavers. An extensive search using four research databases was undertaken, resulting in 36 relevant articles for inclusion. Findings were organised thematically into four broad areas: (1) Extended care; (2) A Helping Relationship; (3) Family; and (4) Employment, Education and Training. Findings show that offering a combination of targeted interventions can contribute to a more successful transition. Effective relationship‐based practices are critical to the success of transitional support interventions.
  • Acquired brain injury (ABI) survivors’ experience of occupation and activity during their inpatient stay: a scoping review

    Cottrell, Katy; Chapman, Hazel M.; Countess of Chester Hospital NHS Trust; University of Chester (Taylor & Francis, 2023-11-20)
    This review aimed to characterise and map: (1) what type of evidence and what dominant study characteristics are available regarding acquired brain injury (ABI) survivors’ experience of occupation and activity in hospital? (2) How are occupation and activity conceptualised in the literature? (3) How are ABI survivors experiencing occupation and activity while in hospital? (4) What factors create barriers or opportunities for engagement in occupations or activity in hospital? (5) Are there any knowledge gaps identified? Materials and methods A scoping review was conducted examining literature published between 2017 and 2022. Relevant studies were systematically retrieved from electronic databases. Results Thirty-four publications were included. There were more quantitative studies (n = 18). Much of the research has been conducted outside of the UK. The populations studied were principally stroke (n = 22). The concept of activity rather than occupation predominates. Patients spend their time alone and inactive. Structural and contextual barriers for engaging in activity are identified. Qualitative study designs exclude ABI survivors with communication or cognitive impairment. Conclusions There is a paucity of research with ABI survivors in hospitals in the UK. Alternative methodological approaches such as ethnography would ensure those with communication or cognitive impairment are not excluded from research. Implications for rehabilitation Rehabilitation professionals, especially occupational therapists, need to lead acquired brain injury (ABI) research in acute hospital settings in the UK. Conceptualisation of meaningful activity and occupation needs a clearer focus in ABI research. Qualitative studies frequently exclude participants with cognitive or communication impairments so methodologies that are more inclusive and representative of brain injury survivors are needed. Keywords: Brain injuryexperiencehospitaloccupationrecoveryscoping review Acknowledgements The authors thank for Doctorate supervision provided by Dr H. M. Chapman and Dr A. Keen. This review forms part of a thesis towards a Professional Doctorate in Health and Social Care for the lead author. Disclosure statement No potential conflict of interest was reported by the authors. Additional information Funding Support has been provided by the Elizabeth Casson Trust and the Hospital Trust where the first author works.
  • Understanding the contribution of intellectual disability nurses. Paper 2 of 4 - Survey

    Mafuba, Kay; Kiernan, Joann; Chapman, Hazel M.; Kupara, Dorothy; Kudita, Chiedza; Chester, Rebecca; University of West London; Edge Hill University; Alder Hey Children’s Hospital; University of Chester; Berkshire Healthcare NHS Foundation Trust (SAGE Publications, 2023-11-13)
    The objective was to identify ID nursing interventions and their impact on the health and healthcare of people with IDs. Data was collected using an online survey questionnaire from a voluntary response and snowball sample of 230 participants. Thematic, descriptive statistical, and inferential statistical analyses were undertaken. We identified 878 interventions that could be undertaken by ID nurses from 7 countries. We categorised the interventions into five themes: effectuating nursing procedures, enhancing impact of ID services, enhancing impact of mainstream services, enhancing quality of life, and enhancing ID nursing practice. Findings demonstrate that ID nurses play important roles in improving the health and healthcare experiences of people with IDs.
  • Designing a toolkit intended to safeguard and protect older adults and staff in the care sector: the findings from a scoping review

    McSherry, Robert; Blain, J.; Kumah, E.; Liverpool School of Tropical Medicine, Department of International Public Health; University of Chester
    The article aims to highlight the emerging themes following a comprehensive scoping review exploring the effectiveness of co-creation in developing and designing instruments to safeguard and protect older people and staff in care homes leading to the development of the PROTECToolkit. The article provides a summary of the six key themes making up the PROTECToolkit people, resources, other, team, environment, and care; highlighting why they are deemed critical to safeguard and protect staff, residents, and others within the care sector. Some essential points are provided to enable sharing and learning for the future.
  • The impact of rotational models on workforce stability in UK clinical settings

    Whaley, Viki; Hay, Jonathan; Knight, Kate; Rooney, Cath; University of Chester (MA Healthcare, 2023-12-04)
    Background/Aims: To ensure that the NHS workforce remains engaged and productive, rather than leaving the profession, underlying factors that cause attrition must be addressed, and strategies implemented to strengthen retention rates and workforce sustainability. This study aimed to assess the impact of models that allow staff to rotate through different roles and organisations on workforce stability. Methods: Project leads employed by organisations within NHS Cheshire and Merseyside integrated care system who had conducted a rotational model were recruited via purposive and snowball sampling. A total of 11 project leads took part in semi-structured interviews about their experiences of the rotational models. Results were analysed using thematic analysis. Results: Respondents identified considerable benefits of the rotational models, both for staff and their organisations. Rotational pathways enhanced the transferability of the workforce, with staff developing the knowledge and skills to work across boundaries. Conclusions: The broader implementation of rotational models could help to mitigate the recruitment and retention challenges that healthcare organisations such as the NHS are currently experiencing.
  • Views about Euthanasia and Dementia: Exploring Perceptions Utilising Evidence from the Mass Observation Archive

    Blain, Janet; Stevens, Dean; Taylor, Louise; Kingston, Paul; Watts, Geoffrey; University of Chester (MDPI, 2023-09-15)
    This paper contributes to the ongoing discussion in the United Kingdom regarding euthanasia and assisted dying, using data specifically related to individuals with dementia. A qualitative approach was taken with data captured via a set of written questions in the form of a Mass Observation Archive Directive. The respondents, known as Observers, provided written responses; there was no limit to the length of the responses and the Observers were able to provide as much or as little detail as they chose. The data were analysed thematically utilising NVivo software. One-hundred and seven responses were received, representing a range of beliefs, and with opinions regarding euthanasia and dementia with pro, anti, and uncertain views being expressed. Five main themes emerged during our data analysis: capacity, legislation, agency and personal philosophies, disquietude, and incumbrance. Consistent with previous research capturing public views regarding euthanasia and assisted dying for people with dementia, the findings suggest policy makers may wish to consult the British public regarding legislation regarding euthanasia and dementia.
  • Establishing a guidance toolkit for assessment of proficiencies in students

    Whaley, Victoria; Caiger, Lee; Hay, Jonathan; Knight, Kate; University of Chester (MA Healthcare, 2023-10-13)
    Our development of the GAP toolkit sought to enhance quality practice learning experiences across the pre-registration learning journey, with an intent that the toolkit would help mitigate student concerns around meeting the requirements in the NMC annexes. This toolkit outlines roles and responsibilities, alongside listing the requirements for student supervision, and providing the documentation of learning and experience, particularly in regard to the more challenging proficiencies.
  • Rare mental health conditions showing cultural concepts of distress

    Mitchell, Andrew E. P.; University of Chester (Qeios, 2023-09-29)
    It is important to note that certain mental health disorders are classified as rare conditions, and they have their own ‘cultural concepts of distress’ as defined in the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM5). Cultural concepts of distress are a recent attempt to understand psychological distress influenced by culture, separate from biomedical diagnoses that require equal attention and support for individuals and their families, both physically and emotionally.
  • Editorial: Equality, diversity and inclusive research for diverse rare disease communities

    Mitchell, Andrew E. P.; Galli, Federica; Butterworth, Sondra; University of Chester; Sapienza University of Rome; Swansea University (Frontiers Media, 2023-09-19)
    Rare diseases affect< 5 per 10,000 individuals, based on the European Union’s definition (European Union, 2000). The Department of Health and Social Care (DHSC, 2021) published the UK Rare Diseases Framework, highlighting the government’s dedication to enhancing the lives of the 3.5 million individuals affected by rare conditions in the UK (Rare Disease UK, 2000). A new framework has been established across the United Kingdom with four key priorities. These priorities include helping patients receive a final diagnosis quickly, increasing rare disease awareness among healthcare professionals, better coordination of care, and improving access to specialist care, treatments, and drugs (DHSC, 2021). The implementation must incorporate five supporting themes: patient voice, national and international collaboration, pioneering research, digital, data, technology, and broader policy alignment.
  • Development of online cancer resources to support pre-registration nurses and allied health professionals

    Armoogum, Julie; Taylor, Vanessa; Cruickshank, Susanne; Donaldson, Jayne; Wyatt, Debbie; Tanay, Mary; Holdsworth, Fiona; Cook, Florence; McNamara, Joanna; Job, Claire; et al. (MA Healthcare, 2023-09-22)
    Cancer rates are increasing, and more people are living with cancer and its consequences. Healthcare students will be caring for people affected by cancer in all clinical contexts. However, pre-registration programmes can include limited cancer education and not all students will have the opportunity for a clinical placement in a cancer setting. This can result in healthcare students feeling unprepared to care for people affected by cancer. To address this need, nine e-learning modules, collectively called The Foundations of Cancer Care, have been developed to support students' knowledge, understanding and confidence about cancer. This article outlines the development and peer review of The Foundations of Cancer Care. The resultant modules are freely available to all those with an Open Athens account or NHS or UK university email address via the NHS Learning Hub ( ).
  • Key changes to NMC programme standards: an opportunity for progress

    Garrow, Amanda; Borwell, Juliet; Knight, Kate; Wright, Karen; Whaley, Victoria; Roberts, Deborah; Monks, Rob; Leigh, Jacqueline; Kenny, Amanda; Liverpool John Moores University; Health Education England (South East); University of Chester; University of Central Lancashire; Edge Hill University; La Trobe University; University of Lincoln (MA Healthcare, 2023-09-22)

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