An interprofessional approach to improving paediatric medication safety.

BACKGROUND: Safe drug prescribing and administration are essential elements within undergraduate healthcare curricula, but medication errors, especially in paediatric practice, continue to compromise patient safety. In this area of clinical care, collective responsibility, team working and communication between health professionals have been identified as key elements in safe clinical practice. To date, there is limited research evidence as to how best to deliver teaching and learning of these competencies to practitioners of the future.

METHODS: An interprofessional workshop to facilitate learning of knowledge, core competencies, communication and team working skills in paediatric drug prescribing and administration at undergraduate level was developed and evaluated. The practical, ward-based workshop was delivered to 4th year medical and 3rd year nursing students and evaluated using a pre and post workshop questionnaire with open-ended response questions.

RESULTS: Following the workshop, students reported an increase in their knowledge and awareness of paediatric medication safety and the causes of medication errors (p < 0.001), with the greatest increase noted among medical students. Highly significant changes in students' attitudes to shared learning were observed, indicating that safe medication practice is learnt more effectively with students from other healthcare disciplines. Qualitative data revealed that students' participation in the workshop improved communication and teamworking skills, and led to greater awareness of the role of other healthcare professionals.

CONCLUSION: This study has helped bridge the knowledge-skills gap, demonstrating how an interprofessional approach to drug prescribing and administration has the potential to improve quality and safety within healthcare.

Sharing Classes between Separate Schools: a mechanism for improving inter-group relations in Northern Ireland?

One manifestation of division and the history of conflict in Northern Ireland is the parallel education system that exists for Protestants and Catholics. Although recent decades have seen some advances in the promotion of integrated education, around 95% of children continue to attend schools separated on ethno-religious lines. In 2007 a programme for sharing education was established. Underpinned by intergroup contact theory, and reflecting educational priorities shared by all school sectors, the programme seeks to offer children from different denominational schools an opportunity to engage with each other on a sustained basis. In this article the authors adopt a quantitative approach to examining the impact of participation in the Sharing Education Programme on a range of outcomes (out-group attitudes, positive action tendencies and out-group trust) via, first, intergroup contact (cross-group friendships) and, second, intergroup anxiety. Their findings confirm the value of contact as a mechanism for promoting more harmonious relationships, and affirm the Sharing Education Programme as an initiative that can help promote social cohesion in a society that remains deeply divided.

Improving the ultra-low-power performance of IEEE 802.15.6 by adaptive synchronisation

In ultra-low data rate wireless sensor networks (WSNs) waking up just to listen to a beacon every superframe can be a major waste of energy. This study introduces MedMAC, a medium access protocol for ultra-low data rate WSNs that achieves significant energy efficiency through a novel synchronisation mechanism. The new draft IEEE 802.15.6 standard for body area networks includes a sub-class of applications such as medical implantable devices and long-term micro miniature sensors with ultra-low power requirements. It will be desirable for these devices to have 10 years or more of operation between battery changes, or to have average current requirements matched to energy harvesting technology. Simulation results are presented to show that the MedMAC allows nodes to maintain synchronisation to the network while sleeping through many beacons with a significant increase in energy efficiency during periods of particularly low data transfer. Results from a comparative analysis of MedMAC and IEEE 802.15.6 MAC show that MedMAC has superior efficiency with energy savings of between 25 and 87 for the presented scenarios. © 2011 The Institution of Engineering and Technology.

Treatment Foster Care for improving outcomes in children and young people (Review)

Background: Treatment foster care (TFC) is a foster family-based intervention that aims to provide young people (and, where appropriate, their families) with a tailored programme designed to effect positive changes in their lives. TFC was designed specifically to cater for the needs of children whose difficulties or circumstances place them at risk of multiple placements and/or more restrictive placements such as hospital or secure residential or youth justice settings.

Objectives: To assess the impact of TFC on psychosocial and behavioural outcomes, delinquency, placement stability, and discharge status for children and adolescents who require out-of-home placement.

Search methods: We searched the Cochrane Controlled Trials Register (CENTRAL) 2006 (Issue 4), MEDLINE (1966 to January 2007), CINAHL (1982 to December 2006), PsycINFO (1872 to January 2007), ASSIA (1987 to January 2007), LILACS (1982 to January 2007), ERIC (1966 to January 2007), Sociological Abstracts (1963 to January 2007), and the National Research Register 2006 (Issue 4).

Selection criteria: Included studies were randomised controlled trials investigating the effectiveness of TFC with children and young people up to the age of 18 who, for reasons of severe medical, social, psychological and behavioural problems, were placed in out of home care in restrictive settings (e.g. secure residential care, psychiatric hospital) or at risk of placement in such settings.

Data collection and analysis: Titles and abstracts identified in the search were independently assessed for eligibility by the two authors (GM and WT) who also extracted and entered into REVMAN. Date were synthesised on the few occasions where this was possible. Results are presented in tabular, graphical (forest plots) and textual form.

Main results: Five studies including 390 participants were included in this review. Data suggest that treatment foster care may be a useful intervention for children and young people with complex emotional, psychological and behavioural need, who are at risk of placements in nonfamily settings that restrict their liberty and opportunities for social inclusion.

Authors’ conclusions: Although the inclusion criteria for this systematic review set a study design threshold higher than that of previous reviews, the results mirror those of earlier reviews but also highlights the tendency of the perceived effectiveness of popular interventions to outstrip their evidence base. Whilst the results of individual studies generally indicate that TFC is a promising intervention for children and youth experiencing mental health problems, behavioural problems or problems of delinquency, the evidence base is less robust than that usually reported.The Cochrane Database of Systematic Reviews is a peer reviewed, international journal, published electronically each month. The 2010 Inpact Factor for the Cochrane Database of Systematic Reviews was 6.185.The CDSR is now ranked in the top 10 of the 151 in the Medicine, General & Internal category.