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NHS Ayrshire and Arran Sustainability and Well-being Committee - Assessing and Improving Trainee Well-being
- Sam Fraser, Megan Barrett, Sophie Clark, Racheal Pulley
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, p. S90
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Aims
To promote the Royal College's core principles of sustainable psychiatry, Junior Doctors at Ayrshire Central Hospital formed the Sustainability and Well-being Committee. The principle aim through 2022, following the COVID-19 pandemic, was to maximise junior well-being - knowing a sustainable workforce is one that feels supported and fulfilled by work and working conditions.
MethodsThrough meetings with junior doctors, qualitative information on factors impacting well-being in the work place was gathered, and three targets for improvement were identified.
The following domains and interventions were implemented:
1. Improve working environment: The doctor's office was sized for 2 staff maximum - despite staffing levels consistently in excess of 20 junior doctors. Additionally, there was no natural light. We obtained a new significantly larger office space, with natural light.
2. Comfort break area – Doctors identified that having an area with comfort seating to take breaks and socialise away from patients and visitors would be beneficial. We obtained a seating area and a coffee machine, maintained by the junior doctors.
3. Access technology – Absence of desktops and IT issues with older laptops was impairing productivity and morale. We obtained 4 new desktop computers, and personal laptops for core trainees.
A digital questionnaire was used to collect quantitative data retrospectively, from doctors currently working in the department, or who had done so in the last 6 months.
Likert scales were used to assess pre and post-intervention levels of well-being, and ranking intervention impact on this. Doctors also identified future areas of intervention going forward into 2023.
ResultsA total of 16 responses were obtained, and 100% of these agreed that feeling supported and good working conditions was important to maintaining wellness and productivity. Pre-intervention average wellness was rated 5.2 (with 1 being extremely poor, and 10 being extremely good), this increased to 8.1 post-intervention. Improved working environment had the most significant impact on well-being.
Respondents identified environmental sustainability as target for improvement in 2023, potentially through improved recycling, reducing meat consumption and car sharing. Further well-being interventions e.g., walks, promotion of Balint group and social events were also suggested.
ConclusionInterventions from the trainee-led Sustainability and Well-being Committee through 2022 improved working environment and subjective well-being. This demonstrates that junior staff can successfully initiate and lead projects to promote and improve sustainability in psychiatry. Results indicate that junior staff are willing to actively participate in interventions to improve well-being, and environmental sustainability in 2023.
Medical Emergencies in a Mental-Health Setting (MEAMS)
- Sam Fraser, Megan Barrett, Alex McLean, Yvonne Moulds, Brian Lennon, Derek Pettigrew, Ashley Ryan, Alison Toner, Linda Bell
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S22-S23
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Aims
Medical Emergencies in A Mental Health Setting (MEAMS) was a proposed high-fidelity simulation training course specifically designed for the mental health multidisciplinary team (MDT). A team of resus officers, mental health nurses and psychiatric doctors worked to create scenarios reflecting the emergencies encountered in mental health. It aimed to gives staff simulated experience in approaching and managing a verity of complex emergencies, including physical health, as well as communication scenarios. Specifically the aims were: (1) Determine if course was perceived to benefit staff, (2) Determine if course subjectively increased staff knowledge and confidence in mental health emergencies, (3) Review for continued areas of improvement
MethodsThe full day sessions were carried out in the Electroconvulsive therapy (ECT) suite, with it being modified into an immersive environment similar to wards or clinics. The faculty of medical resus officers, mental health nurses and psychiatric consultants ran the courses, with participants joining from across the MDT including nursing staff, junior doctors, consultants, students and nursing assistants.
The morning program, run by resus officers, provided education in life support, initial assessment of the unwell patient and intraosseous access. The afternoon contained various scenarios, including for example managing neuroleptic malignant syndrome. Scenarios were observed via video link by faculty, with constructive feedback and debriefs provided.
Quantitative data of knowledge and confidence was obtained pre and post sessions using Likert scales. Qualitative information regarding future proposed scenarios, areas of improvement and areas of notable value was gathered.
Results36 staff attended the program, run over 4 days. Average knowledge and confidence (scored out of 10) improved from 4.9 pre-session to 8.1 post-session. All 36 staff felt the session was beneficial. Particular positive feedback on scenario realism, MDT working, safe/ supportive teaching and the resus faculty teaching was highlighted.
Areas for improvement highlighted included running sessions more often, widening accessibility to more staff and teaching on resus medications and fluids. A variety of further scenarios were suggested, for example management of withdrawal seizure.
ConclusionMEAMS was felt to achieve its aims, and demonstrated clear subjective increase in staff knowledge and confidence regarding common emergencies seen in mental health settings. Further sessions and wider accessibility to the mental health MDT is anticipated to continually benefit staff. Taking on qualitative feedback, the faculty aims to continually adapt the program to provide the best possible training and education, adapting and creating new relevant scenarios.
Psychiatric Inpatient Admissions–- Improving Handover Standards
- Megan Barrett, Sam Fraser
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- Journal:
- BJPsych Open / Volume 9 / Issue S1 / July 2023
- Published online by Cambridge University Press:
- 07 July 2023, pp. S79-S80
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Aims
Within NHS Ayrshire and Arran for psychiatric inpatient admissions, the admitting clinician is to directly handover clinical details and relevant aspects of mental state, risk and management plan to the inpatient duty doctor. Over 2022, there was concerns this process was not being followed, resulting in prescription errors, difficulty in assessing risk at admission and difficulty in prioritising workload. The aim of the project was to first assess pre-intervention rates of handover for inpatient admissions. Then with these data, look for interventions. The final aim was to re-asses post-intervention, analysing if interventions improved rates of handover.
MethodsPre-intervention quantitative data were gathered over a three week period in April 2022, with Junior Doctors noting for admissions to Woodland View Psychiatric Hospital whether handover had been received, or if the Duty Doctor had been alerted at all to the admission prior to patient's arrival on the ward.
Qualitative data were also gathered, specifically asking what factors admitting clinicians found impacted ability to handover.
Data were presented at the monthly division of psychiatry meeting, and subsequently interventions were discussed in a meeting with Hospital bed managers, Hospital co-coordinators and the clinical director for inpatient care. The outcome resulted in change to the local hospital admission protocol, with bed managers prompting the importance of handover, and transferring admitting clinician's phone calls to the duty doctor at the time admissions are accepted by bed managers.
Post-Intervention, the same criteria assessed in April 2022 was reassessed in January 2023.
ResultsPre-intervention, of 25 admissions, a handover was provided for 32% of patients. Duty doctor was alerted to 52% of admissions prior to the patient's arrival on the ward. Post-intervention, this increased to 71% and 82% respectively for 17 patients admitted in January 2023.
Qualitative themes thought to impact ability of handover were admitting clinicians feeling there was already a number of calls made when admitting, and one with duty doctor could be neglected. Secondly the clinicians thought another member of the team would alert duty doctor of admissions.
ConclusionThe project met its aims, showing pre-intervention rates of handover as low, and post-intervention rates rising after the admission process was changed, taking on the feedback from admitting clinicians. Given rates remain still significantly below 100%, there is still further work to be done. Results are due to be shared again with bed managers and at division to discuss further interventions.
Epidemiology of protozoan and helminthic parasites in wild passerine birds of Britain and Ireland
- Fatemeh (Rose) Parsa, Sam Bayley, Fraser Bell, Stephen Dodd, Ray Morris, Jean Roberts, Denise Wawman, Simon R. Clegg, Jenny C. Dunn
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- Journal:
- Parasitology / Volume 150 / Issue 3 / March 2023
- Published online by Cambridge University Press:
- 04 January 2023, pp. 297-310
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Avian endoparasites play important roles in conservation, biodiversity and host evolution. Currently, little is known about the epidemiology of intestinal helminths and protozoans infecting wild birds of Britain and Ireland. This study aimed to determine the rates of parasite prevalence, abundance and infection intensity in wild passerines. Fecal samples (n = 755) from 18 bird families were collected from 13 sites across England, Wales and Ireland from March 2020 to June 2021. A conventional sodium nitrate flotation method allowed morphological identification and abundance estimation of eggs/oocysts. Associations with host family and age were examined alongside spatiotemporal and ecological factors using Bayesian phylogenetically controlled models. Parasites were detected in 20.0% of samples, with corvids and finches having the highest prevalences and intensities, respectively. Syngamus (33%) and Isospora (32%) were the most prevalent genera observed. Parasite prevalence and abundance differed amongst avian families and seasons, while infection intensity varied between families and regions. Prevalence was affected by diet diversity, while abundance differed by host age and habitat diversity. Infection intensity was higher in birds using a wider range of habitats, and doubled in areas with feeders present. The elucidation of these patterns will increase the understanding of parasite fauna in British and Irish birds.
DRAT: Data risk assessment tool for university–industry collaborations
- Joanna Sikorska, Sam Bradley, Melinda Hodkiewicz, Ryan Fraser
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- Journal:
- Data-Centric Engineering / Volume 1 / 2020
- Published online by Cambridge University Press:
- 11 December 2020, e17
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For research in the fields of engineering asset management (EAM) and system health, relevant data resides in the information systems of the asset owners, typically industrial corporations or government bodies. For academics to access EAM data sets for research purposes can be a difficult and time-consuming task. To facilitate a more consistent approach toward releasing asset-related data, we have developed a data risk assessment tool (DRAT). This tool evaluates and suggests controls to manage, risks associated with the release of EAM datasets to academic entities for research purposes. Factors considered in developing the tool include issues such as where accountability for approval sits in organizations, what affects an individual manager’s willingness to approve release, and how trust between universities and industry can be established and damaged. This paper describes the design of the DRAT tool and demonstrates its use on case studies provided by EAM owners for past research projects. The DRAT tool is currently being used to manage the data release process in a government-industry-university research partnership.
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