Ethical issues experienced by healthcare workers in nursing homes: Literature review

BACKGROUND: Ethical issues are increasingly being reported by care-providers; however, little is known about the nature of these issues within the nursing home. Ethical issues are unavoidable in healthcare and can result in opportunities for improving work and care conditions; however, they are also associated with detrimental outcomes including staff burnout and moral distress.

OBJECTIVES: The purpose of this review was to identify prior research which focuses on ethical issues in the nursing home and to explore staffs' experiences of ethical issues.

METHODS: Using a systematic approach based on Aveyard (2014), a literature review was conducted which focused on ethical and moral issues, nurses and nursing assistants, and the nursing home.

FINDINGS: The most salient themes identified in the review included clashing ethical principles, issues related to communication, lack of resources and quality of care provision. The review also identified solutions for overcoming the ethical issues that were identified and revealed the definitional challenges that permeate this area of work.

CONCLUSIONS: The review highlighted a need for improved ethics education for care-providers.

Reviewing the Literature on the Breakdown of Foster Care Placements for Young People: Complexity and the Social Work Task

Young people in long-term foster care are at risk of experiencing poor social, emotional, behavioural and educational outcomes. Moreover, these placements have a significantly greater chance of breaking down compared to those involving children. This article critically evaluates the factors associated with this particular outcome. It was carried out through a literature review conducted by a social work practitioner in one Health and Social Care Trust in Northern Ireland. The findings evidenced that, apart from overriding safety concerns, placement breakdown was not a one-off event but rather a complex process involving the interplay between a range of dynamic risk and protective factors over time, operating in the wider context of the young person’s history and life experiences. The significance of these findings for social work practitioners is finally considered by identifying key theories to inform understanding and intervention.

Development of a pharmacy practice intervention: lessons from the literature

The development of health interventions is receiving increasing attention within the scientific literature. In the past, interventions were often based on the ISLAGIATT principle: that is, ‘It seemed like a good idea at the time’. However, such interventions were frequently ineffective because they were either delivered in part or not at all, demonstrating a lack of fidelity, or because little attention had been paid to their development, content, and mode of delivery. This commentary seeks to highlight the latest methodological advances in the field of intervention development, drawing on health psychology literature, together with guidance from key organisations and research consortia which are setting standards for development and reporting. Those working within pharmacy practice research can learn from the more systematic approach being advocated, and apply these methods to help generate evidence to support new services and professional roles.

Accessory minerals and potentially toxic elements in Tanzanian vermiculites with respect to agricultural applications

The study assessed accessory minerals and metals in Tanzanian vermiculites with respect to their potential suitability for agricultural applications. Mineral and chemical analyses were involved. Pot experiments were also conducted to assess plant uptake of metals from soil with vermiculites. Fibrous sepiolite and amphiboles were minerals of health concern found in some samples. The sepiolite fibers had aspect ratios similar to those of asbestos minerals, which cause respiratory disorders and lung cancer when inhaled and thus pose a potential health risk to animals and humans. The amphibole fibers were thicker than 10 μm and are unlikely to be inhaled. Chromium (Cr) and nickel (Ni) concentrations in some samples were greater than the limits permitted in agricultural soils, but the elements are not highly plant available and do not inhibit the uptake of essential macronutrients. Heating vermiculites at 400-600° C enhanced extractability of Cr and Ni and should preferably be avoided. © Taylor & Francis Group, LLC.

Mineralogical and chemical characterization of some vermiculites from the mozambique belt of tanzania for agricultural use

Vermiculite minerals are locally available in the Mozambique Belt of Tanzania but are not currently commercially exploited. In part this may be due to lack of any precise characterization. This study was carried out as a first step to assess the suitability of these vermiculites for crop production by characterization of their mineralogical and chemical compositions. X-ray diffraction and scanning electron microscopy combined with an energydispersive X-ray system were used to establish the mineralogy. Electron microprobe analysis and inductively coupled plasma-mass spectrometry were used to study the chemical compositions and to identify any possible issues related to chemical composition that might affect their use if applied as soil conditioners. The samples were characterized as vermiculites and hydrobiotites with a wide variety of accessory minerals. Accessory minerals that might be of some concern are galena, fibrous amphiboles and sepiolite. The total levels of Ni in all vermiculites, and Cr in some, were also found to be high relative to common European standards and this might limit their potential as soil conditioners. It is clear that a field assessment of the bioavailability of various elements would be necessary before decisions relating to potential agricultural use could be made. © 2009 The Mineralogical Society.

Measuring non-use value of environmental goods using the contingent valuation method:problems of information and cognition and the application of cognitive questionnaire design methods

Much interest now focuses on the use of the contingent valuation method (CVM) to assess non-use value of environmental goods. The paper reviews recent literature and highlights particular problems of information provision and respondent knowledge, comprehension and cognition. These must be dealt with by economists in designing CVM surveys for eliciting non-use values. Cognitive questionnaire design methods are presented which invoke concepts from psychology and tools from cognitive survey design (focus groups and verbal reports) to reduce a complex environmnetal good into a meaningful commodity that can be valued by respondents in a contingent market. This process is illustrated with examples from the authors' own research valuing alternative afforestation programmes. -Authors

Medication Reconciliation at Discharge from Hospital: A Systematic Review of the Quantitative Literature

Medicines reconciliation is a way to identify and act on discrepancies in patients’ medical histories and it is found to play a key role in patient safety. This review focuses on discrepancies and medical errors that occurred at point of discharge from hospital. Studies were identified through the following electronic databases: PubMed, Sciences Direct, EMBASE, Google Scholar, Cochrane Reviews and CINAHL. Each of the six databases was screened from inception to end of January 2014. To determine eligibility of the studies; the title, abstract and full manuscript were screened to find 15 articles that meet the inclusion criteria. The median number of discrepancies across the articles was found to be 60%. In average patient had between 1.2–5.3 discrepancies when leaving the hospital. More studies also found a relation between the numbers of drugs a patient was on and the number of discrepancies. The variation in the number of discrepancies found in the 15 studies could be due to the fact that some studies excluded patient taking more than 5 drugs at admission. Medication reconciliation would be a way to avoid the high number of discrepancies that was found in this literature review and thereby increase patient safety.