Promoting the 6Cs of Nursing in Patient Assessment

Recognising the deteriorating patient is an essential nursing skill, and structured frameworks should be in place to assist effective patient assessment. The aim of this article is to encourage nurses to consider how to promote the 6Cs of nursing within such assessment. The article provides an overview of the Patient Assessment and Clinical reasoning Tool designed to facilitate the development of clinical reasoning skills and effective communication with other healthcare professionals, therebyenhancing patientcentred care.

Survivorship and Clinical Outcome of the Minimally Invasive Uniglide Medial Fixed Bearing, All-polyethylene Tibia, Unicompartmental Knee Arthroplasty at a Mean Follow-up of 7.3 Years

Background: Medial UKA performed in England and Wales represents 7 to 11% of all knee arthroplasty procedures, and is most commonly performed using mobile-bearing designs. Fixed bearing eliminates the risk of bearing dislocation, however some studies have shown higher revision rates for all-polyethylene tibial components compared to those that utilize metal-backed implants. The aim of the study is to analyse survivorship and maximum 8-year clinical outcome of medial fixed bearing, Uniglide unicompartmental knee arthroplasty performed using an all-polyethylene tibial component with a minimal invasive approach. Methods: Between 2002 and 2009, 270 medial fixed UKAs were performed in our unit. Patients were reviewed pre-operatively, 5 and 8 years post-operatively. Clinical and radiographic reviews were carried out. Patients’ outcome scores (Oxford, WOMAC and American Knee Score) were documented in our database and analysed. Results: Survival and clinical outcome data of 236 knees with a mean 7.3 years follow-up are reported. Every patient with less than 4.93 years follow-up underwent a revision. The patients’ average age at the time of surgery was 69.5 years. The American Knee Society Pain and Function scores, the Oxford Knee Score and the WOMAC score all improved significantly. The 5 years survival rate was 94.1% with implant revision surgery as an end point. The estimated 10 years survival rate is 91.3%. 14 patients were revised before the 5 year follow-up. Conclusion: Fixed bearing Uniglide UKA with an all-polyethylene tibial component is a valuable tool in the management of a medial compartment osteoarthritis, affording good short term survivorship.

Designing and Developing Digital and Blended Learning Solutions

The continuous advancement in computing, together with the decline in its cost, has resulted in technology becoming ubiquitous (Arbaugh, 2008, Gros, 2007). Technology is growing and is part of our lives in almost every respect, including the way we learn. Technology helps to collapse time and space in learning. For example, technology allows learners to engage with their instructors synchronously, in real time and also asynchronously, by enabling sessions to be recorded. Space and distance is no longer an issue provided there is adequate bandwidth, which determines the most appropriate format such text, audio or video. Technology has revolutionised the way learners learn; courses are designed; and ‘lessons’ are delivered, and continues to do so. The learning process can be made vastly more efficient as learners have knowledge at their fingertips, and unfamiliar concepts can be easily searched and an explanation found in seconds. Technology has also enabled learning to be more flexible, as learners can learn anywhere; at any time; and using different formats, e.g. text or audio. From the perspective of the instructors and L&D providers, technology offers these same advantages, plus easy scalability. Administratively, preparatory work can be undertaken more quickly even whilst student numbers grow. Learners from far and new locations can be easily accommodated. In addition, many technologies can be easily scaled to accommodate new functionality and/ or other new technologies. ‘Designing and Developing Digital and Blended Learning Solutions’ (5DBS), has been developed to recognise the growing importance of technology in L&D. This unit contains four learning outcomes and two assessment criteria, which is the same for all other units, besides Learning Outcome 3 which has three assessment criteria. The four learning outcomes in this unit are: • Learning Outcome 1: Understand current digital technologies and their contribution to learning and development solutions; • Learning Outcome 2: Be able to design blended learning solutions that make appropriate use of new technologies alongside more traditional approaches; • Learning Outcome 3: Know about the processes involved in designing and developing digital learning content efficiently and what makes for engaging and effective digital learning content; • Learning Outcome 4: Understand the issues involved in the successful implementation of digital and blended learning solutions. Each learning outcome is an individual chapter and each assessment unit is allocated its own sections within the respective chapters. This first chapter addresses the first learning outcome, which has two assessment criteria: summarise the range of currently available learning technologies; critically assess a learning requirement to determine the contribution that could be made through the use of learning technologies. The introduction to chapter one is in Section 1.0. Chapter 2 discusses the design of blended learning solutions in consideration of how digital learning technologies may support face-to-face and online delivery. Three learning theory sets: behaviourism; cognitivism; constructivism, are introduced, and the implication of each set of theory on instructional design for blended learning discussed. Chapter 3 centres on how relevant digital learning content may be created. This chapter includes a review of the key roles, tools and processes that are involved in developing digital learning content. Finally, Chapter 4 concerns delivery and implementation of digital and blended learning solutions. This chapter surveys the key formats and models used to inform the configuration of virtual learning environment software platforms. In addition, various software technologies which may be important in creating a VLE ecosystem that helps to enhance the learning experience, are outlined. We introduce the notion of personal learning environment (PLE), which has emerged from the democratisation of learning. We also review the roles, tools, standards and processes that L&D practitioners need to consider within a delivery and implementation of digital and blended learning solution.