The immediate Life support course: implementation into an undergraduate nursing programme

This paper outlines how the immediate life support (ILS) course was incorporated into an undergraduate-nursing curriculum in a university in Northern Ireland. It also reports on how the students perceived the impact of this course on their clinical practice. The aim was to develop the student’s ability to recognise the acutely ill patient and to determine the relevance of this to clinical practice. Prior to this the ILS course was only available to qualified nurses and this paper reports on the first time students were provided with an ILS course in an undergraduate setting. The ILS course was delivered to 89 third year nursing students (Adult Branch) and comprised one full teaching day per week over two weeks. Recognised Advanced Life Support (ALS) instructors, in keeping with the United Kingdom Resuscitation Council guidelines, taught the students. Participants completed a 17 item questionnaire which comprised an open-ended section for student comment. Questionnaire data was analysed descriptively using SSPSS version 15.0. Open-ended responses from the questionnaire data was analysed by content and thematic analysis. Results Student feedback reported that the ILS course helped them understand what constituted the acutely ill patient and the role of the nurse in managing a deteriorating situation. Students also reported that they valued the experience as highlighting gaps in their knowledge Conclusion. The inclusion of the ILS course provides students with necessary skills to assess and manage the deteriorating patient. In addition the data from this study suggest the ILS course should be delivered in an inter-professional setting – i.e taught jointly with medical students. References: Department of Health & Quality Assurance Agency (2006). Department of Health Phase 2 benchmarking project – final report. Gloucester: Department of Health, London and Quality Assurance Agency for Higher Education

Temocillin in cystic fibrosis: A retrospective pilot study

Background: Temocillin is currently used in the treatment of acute pulmonary exacerbations caused by Burkholderia cepacia complex and multiresistant Pseudomonas aeruginosa in cystic fibrosis (CF) patients despite little published clinical data. This study assessed if intravenous (IV) antibiotic therapy including temocillin was equivalent to standard combination therapy for an acute exacerbation.

Clinical pharmacy-led disease and medicine management programme for patients with COPD

center dot The concept of self-management plans for patients with chronic obstructive pulmonary disease (COPD) is derived from their success in asthma management.

Invader-invader interactions in relation to environmental heterogeneity leads to zonation of two invasive amphipods, Dikerogammarus villosus (Sowinsky) and Gammarus tigrinus Sexton: amphipod pilot species project (AMPIS) report 6

As biological invasions continue, interactions occur not only between invaders and natives, but increasingly new invaders come into contact with previous invaders. Whilst this can lead to species replacements, co-existence may occur, but we lack knowledge of processes driving such patterns. Since environmental heterogeneity can determine species richness and co-existence, the present study examines habitat use and its mediation of the predatory interaction between invasive aquatic amphipods, the Ponto-Caspian Dikerogammarus villosus and the N. American Gammarus tigrinus. In the Dutch Lake IJsselmeer, we found broad segregation of D. villosus and G. tigrinus by habitat type, the former predominating in the boulder zone and the latter in the soft sediment. However, the two species co-exist in the boulder zone, both on the short and longer terms. We used an experimental simulation of habitat heterogeneity and show that both species utilize crevices, different sized holes in a plastic grid, non-randomly. These amphipods appear to optimise the use of holes with respect to their 'C-shape' body size. When placed together, D. villosus adults preyed on G. tigrinus adults and juveniles, while G. tigrinus adults preyed on D. villosus juveniles. Juveniles were also predators and both species were cannibalistic. However, the impact on G. tigrinus of the superior intraguild predator, D. villosus, was significantly reduced where experimental grids were present as compared to absent. This mitigation of intraguild predation between the two species in complex habitats may explain the co-existence of these two invasive species.

FLEXIBLE OMNIVORY IN DIKEROGAMMARUS VILLOSUS (SOWINSKY, 1894) (AMPHIPODA) - AMPHIPOD PILOT SPECIES PROJECT (AMPIS) REPORT 5

Feeding in Dikerogammarus villosus (Sowinsky, 1894) males was observed in the field and recorded on video in the laboratory. The following feeding modes were recognized: detritus feeding, grazing, particle feeding, coprophagy, predation on benthic and free swimming invertebrates, predation on fish eggs and larvae, as well as feeding on byssus threads of the zebra mussel, Dreissena polymorpha (Pallas, 1771). The feeding methods are described and illustrated with screenshots of video recordings. The very flexible feeding modes of D. villosus, which make diet switches possible, form a trait that must be an important factor in the invasion success of this Ponto-Caspian gammaridean species, and may thus explain for a great deal its high ecosystem impact.

Cluster randomised controlled trial of an infection control education and training intervention programme focusing on meticillin-resistant Staphylococcus aureus in nursing homes for older people

The aim of this cluster randomised controlled trial was to test the impact of an infection control education and training programme on meticillin-resistant Staphylococcus aureus (MRSA) prevalence in nursing homes. Nursing homes were randomised to intervention (infection control education and training programme; N¼16) or control (usual practice continued; N¼16). Staff in intervention homes were educated and trained (0, 3 and 6 months) in the principles and implementation of good infection control practice with infection control audits conducted in all sites (0, 3, 6 and 12 months) to assess compliance with good practice. Audit scores were fed back to nursing home managers in intervention homes, together with a written report indicating where practice could be improved. Nasal swabs were taken from all consenting residents and staff at 0, 3, 6 and 12 months. The primary outcome was MRSA prevalence in residents and staff, and the secondary outcome was a change in infection control audit scores. In all, 793 residents and 338 staff were recruited at baseline. MRSA prevalence did not change during the study in residents or staff. The relative risk of a resident being colonised with MRSA in an intervention home compared with a control home at 12 months was 0.99 (95% con?dence interval: 0.69, 1.42) after adjustment for clustering. Mean infection control audit scores were signi?cantly higher in the intervention homes (82%) compared with the control homes (64%) at 12 months (P<0.0001). Consideration should be given to other approaches which may help to reduce MRSA in this setting.

Developing a methodology for the National Frog Survey of Ireland: a pilot study in Co. Mayo.

A National Frog Survey of Ireland is planned for spring 2011. We conducted a pilot survey of 25 water bodies in ten 0.25 km2 survey squares in Co. Mayo during spring 2010. Drainage ditches were the most commonly available site for breeding and, generally, two 100 m stretches of ditch were surveyed in each square. The restricted period for peak spawning activity renders any methodology utilizing only one site visit inherently risky. Consequently, each site was visited three times from late March to early April. Occurrence of spawn declined significantly from 72 % to 44 % between the first and third visit whilst the overall occurrence of spawn at all sites was 76 %. As the breeding season advanced, spawn either hatched or was predated and, therefore, disappeared. In those water bodies where spawning was late, however, greater densities of spawn were deposited than in those sites where breeding was early. Consequently, spawn density and estimated frog density did not differ significantly between site visits. Future surveys should nevertheless include multiple site visits to avoid biased estimation of species occurrence and distribution. Ecological succession was identified as the main threat present at 44 % of sites.