Sara Morgan

image of nursing students in a emergency care simulation scenario

Emergency care drills are vital in preparing nursing students for practice

Simulations help make transition from student to qualified practitioner smoother

Using functional assessments to involve service users in their positive behaviour support plan

Functional assessments to involve service users in a positive behaviour support plan

Evaluating a functional assessment for people with an LD and behaviour that challenges

Recognition and management of autonomic dysreflexia in patients with a spinal cord injury

Recognition and management of autonomic dysreflexia in patients with spinal cord injury

It is important that ENs are aware of the symptoms and management of autonomic dysreflexia

Image of health professional in scrubs holding a small organ transport box

Why England’s 2020 opt-out organ donation law is so important for emergency services

Early engagement with specialist organ donation colleagues is vital

Development of a behavioural assessment tool for use in forensic mental health services

Development of a behavioural assessment tool for use in forensic mental health services

This article presents the Forensic Functional Assessment Measure (FFAM): a tool to assess the triggers and functions of behaviours that challenge in a medium-secure mental health setting. The measure was designed by a group of practitioners in the field who were implementing positive behaviour support (PBS). The aim was to replace other widely used tools that were designed for use with a learning disability population. The FFAM is a semi-structured interview tool and informant-based assessment. Preliminary testing of the tool was carried out by four staff members with seven service users. Findings indicate that the FFAM successfully identified triggers and functions of behaviours that challenge and that it could be used to develop PBS plans. This was a pilot study focusing on a small sample; additional research is required to determine the reliability and validity of the FFAM.

Evaluation

An evaluation of recovery in a forensic mental health service

This service evaluation aims to gain service users’ and staff members’ perspectives on one forensic mental health service’s approach to recovery; to provide feedback about awareness of recovery, what has worked well and what needs improving; and to ensure the service’s recovery action plan is shaped by and is responsive to the needs of those it affects. Surveys for staff and service users were developed and disseminated to all. The responses revealed positive outcomes in relation to the awareness of recovery and the use of the Mental Health Recovery Star tool at the service. Areas where there was a need for improvement were highlighted and have informed recommendations.

Simulation

High fidelity simulation to improve multidisciplinary team working with pre-registrants

Simulation has been introduced in recent years into international nursing curricula. Many educational establishments have developed simulation centres that resemble the ward settings nursing students will be exposed to so that they can use the same equipment as they will in clinical practice. This is referred to as high fidelity simulation training (HFST). This article reflects on an example of a multidisciplinary HFST scenario in the context of the assessment and accountability and learning domains of the Nursing and Midwifery Council standards. The article also discusses the assessment, feedback and evaluation process.

Auscultation

How to auscultate for heart sounds in adults

Rationale and key points This article aims to improve nurses’ knowledge and understanding of the procedure for auscultating heart sounds in adults, as part of a cardiovascular examination. It focuses on auscultating normal heart sounds; it is beyond the scope of this article to discuss the pathophysiology of abnormal findings. » A stethoscope is used to auscultate for heart sounds. The diaphragm of the stethoscope is used to identify high-pitched sounds, while the bell is used to identify low-pitched sounds. » There are two normal heart sounds that should be elicited in auscultation: S1 (lub) and S2 (dub). » The practitioner should listen over each of the four main heart valve areas: the aortic, pulmonary, tricuspid and mitral valve areas. They should also listen for any additional sounds such as clicks, and heart murmurs. Reflective activity ‘How to’ articles can help update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: » How you think you could use this article to improve your practice in undertaking cardiac examinations. » How you could use this resource to educate your colleagues about auscultating for heart sounds.

Developing trainees

Developing trainee advanced nurse practitioners in clinical environments

Teaching and mentorship are fundamental parts of registered nurses’ roles, and learning should be managed and promoted in clinical practice to ensure excellence. This article reflects on, and critically analyses, the developing relationship between the author, who is an advanced nurse practitioner (ANP) and practice educator, and an experienced nurse undertaking an ANP level 7 programme of study. The article describes the supervision and mentorship of the student ANP in an emergency department, in the context of the ‘facilitation of learning’ and ‘evaluation of learning’ domains of the Nursing and Midwifery Council (NMC) Standards to Support Learning and Assessment in Practice ( NMC 2008 ).

The use of Lorazepam in status epilepticus

Status epilepticus has been defined as a ‘life threatening emergency’, with the potential for causing permanent neurological damage and lasting at least 30 minutes (Mitchell and Crawford 1990; Starreveld and Starreveld 2000) affecting between 65,000 to 150,000 people in the United States each year (Treiman et al 1998). Leppik et al (1983) shows that status epilepticus requires prompt treatment so that death and neurological deficit can be minimised, describing the urgent need for pharmacological intervention to suppress seizure activity. This paper will focus on the pharmacological and nursing management of a patient in status epilepticus following a generalised tonic clonic seizure. This has been defined by Kingsley et al (1997) as ‘affecting the entire brain at once’, characterised by the tonic contractions of all muscles, leading to rhythmic muscular jerking.