Projects - Developments in Acute Care Nursing

This section of the website provides details of current projects undertaken by the Developments in Acute Care Research Group. Areas of research include Pain management, Termination of pregnancy, Organ transplantation, Cardiac care, Palliative care, Systematic reviews and Disaster relief healthcare.

Pain management

The assessment and management of pain is an essential aspect of nursing practice in acute care and, consequently, forms an integral component of acute care research. Research in this area is led by Dr Anne Marie Coll. Previous research has explored areas such as, the effects of day surgery on patients, postoperative pain and the assessment and management of it by nurses. Current research includes the development of an assessment tool for postoperative pain in Ghana.


Termination of pregnancy

Dr Allyson Lipp has been funded by the Research Capacity Building Collaboration, Wales to undertake a two year study on termination of pregnancy services in Wales.

With examples of patchy service provision nationally and internationally, nurses face moral distress daily as they support women through the traumatic experience of termination, risking protest if they become involved and discrimination if they refuse. Recent advances have resulted in more terminations performed through the sole use of pharmacological agents, commonly administered by nurses. Consequently, nurses are becoming more directly involved in terminations accentuating the complex issues involved in this procedure. It is unclear how this greater involvement will affect the nurses/midwives.

  • The first phase of this research aims to establish an all-Wales baseline of termination services. Watch out for the report which will be posted on this website when finalised.
  • The second phase will identify and measure nurses/midwives specific affective attributes via a qualitative study. A summary of the results of this part of the study will be posted here when completed.

One of the outcomes of the research is the opportunity for Allyson to coordinate the development of bilingual leaflets for women undergoing termination of pregnancy on behalf of the All-Wales Termination of Pregnancy Network.


Systematic reviews

As part of her ongoing interest in evidence-based practice Dr Allyson Lipp has undertaken three systematic reviews under the auspices of the Cochrane Collaboration:

Surgical face masks

  • Lipp, A. and P. Edwards (2002). Disposable surgical face masks to prevent surgical wound infection in clean surgery. Systematic Review Cochrane Library (updated 2012). Oxford, Update Software
  • Lipp A (2012) Examining the effectiveness of surgical face masks. Featured on BBC, Radio 4 In Inside Health.
  • Lipp, A. and P. Edwards (2012) “Journal Club: Disposable surgical face masks for preventing surgical wound infection in clean surgery.” Cochrane Database of Systematic Reviews.
  • Lipp A (2012) Cochrane reviews – in their own words (Surgical face masks). Journal of Evidence Based Medicine, 5:43.
  • Lipp A (2012) Disposable surgical face masks for preventing surgical wound infection in clean surgery. Listen to the podcast

Preoperative skin antiseptics

  • Dumville JC, M. E., Edwards P, Lipp A, Holmes A. (2013). Preoperative skin antiseptics for preventing surgical wound infections after clean surgery. Cochrane Database of Systematic Reviews. Issue 3.

Urinary tract

  • Lipp A, Shaw C, Glavind K: Mechanical devices for urinary incontinence in women. Systematic Review, Cochrane Library. 6th July edition Wiley and Co; 2011. Cited by 9 in Google Scholar.
  • Lusardi, G. and A. Lipp (2013). “Antibiotic prophylaxis for short-term catheter bladder drainage in adults.” International Journal of Evidence Based Healthcare: 1-3.

Percutaneous gastrostomy

  • Lipp A, Lusardi G: Systemic Antimicrobials for Percutaneous Endoscopic Gastrostomy (systematic review). Volume Issue 4. Edited by The Cochrane Database of Systematic Reviews: Cochrane Library; 2006 (updated 2013). Cited by 65 in Google Scholar.
  • Lipp A, Lusardi G (2009): A systematic review of prophylactic antimicrobials in PEG placement. Journal of Clinical Nursing 18(7):938-948. Cited by 22 in Google Scholar.

Miscarriage

Diabetic foot ulcer

  • Lewis J, Lipp A: Pressure-relieving interventions for treating diabetic foot ulcers. Issue 1. Cochrane Library 2013.
  • Lusardi, G., A. Lipp, et al. (2013) “Antibiotic prophylaxis for short-term catheter bladder drainage in adults.” Cochrane Database of Systematic Reviews DOI: DOI: 10.1002/14651858.


Organ transplantation

Organ transplantation, particularly kidney transplantation, is a prominent focus of research in acute care and is led by rcbcwales Fellow Dr Paul Gill. Previous research has focused on donor and recipient experiences of live kidney transplantation, before and in the first year after transplantation. A two year qualitative study, funded by rcbcwales, is currently being undertaken, to explore participant’s experiences of kidney transplant failure.


Cardiac Care

Cardiac care research is led by Dr. Ray Higginson. A recently completed study focused on cardiac rehabilitation attendance (CR) in women. A follow up study is currently planned, exploring ongoing adherence to CR regimens, as well as investigating perceptions of cardiovascular risk (CVR), not only in women but also in members of the general public. CVR perception seems to be that women suffer from breast cancer, men get heart attacks. Other research interests in this area include evolution and heart disease; for example, are there any possible evolutionary advantages of high cholesterol, hypertension and heart disease?


Palliative care

Maria Parry and her colleague Matthew Thornton are currently involved in a multidisciplinary qualitative research project exploring the decision making process patients undergo during a consultation with a consultant clinical oncologist in relation to treatment options for an incurable advanced non small cell lung cancer.


Critical care

An evaluation performed by Cheryl Phillips found that the Welsh Critical Care Improvement Programme (WCCIP) enabled debate and collaborative action towards improvement in Critical Care.

The purpose of this report was to evaluate the collaborative methodology utilised for the Welsh Critical Care Improvement Programme (WCCIP) and to assess its feasibility for use in future programme developments. The programme was launched in May 2006 with the first year ending in March 2007 and was delivered by the National Leadership and Innovation Agency for Healthcare (NLIAH) and sponsored by the Welsh Assembly Government.

The WCCIP was initiated as a result of work from the United States on care bundles which has shown that by combining evidence based practices rather than conducting them singularly risks to patients can be significantly reduced. The evaluation comprised interviews and focus groups. It found that the WCCIP met its ambitious aims, achieving significant change in clinical practice simultaneously across all Trusts in Wales in a pre-determined timescale. The evaluation demonstrates that this sort of collaborative model, when appropriately led and resourced, is one which should prove adaptable to other similar clinical change tasks.

Cheryl Phillips has also been awarded an RCBC Wales Fellowship grant to do her PhD part time and is currently working on a Longitudinal Grounded Theory Study: Patient diaries in critical care: an exploration of patient perceptions.

Semi-structured interviews with patients have been completed at 2, 6 and 12 months after discharge from hospital, home. Diaries were implemented as part of care delivery in the Critical Care Unit at the Royal Gwent Hospital, Aneurin Bevan Health Board (ABHB) 4 years ago: the first known use of patient diaries in Wales. The diary is written on behalf of the sedated and ventilated patient in critical care by nurses, other healthcare professionals and relatives. It forms a chronological insight into the patients critical Illness. It is thought that the diary can potentially form a bridge between a patient’s sense of incomprehension of their critical illness journey and the reality of what has happened. However, the evidence base regarding critical care patient diaries is lacking. In partnership between ABHB and the University of South Wales we are currently researching patient perceptions of their diaries to enable the patient voice to impact on this innovative addition to service delivery.


Disaster relief healthcare

This is a developing area of interest. Professor Kevin Davies is building on his considerable expertise as Lieutenant Colonel in the Army Medical Services to conduct his PhD on Creating a model for the future provision of training and education for healthcare workers involved in the delivery services in known areas of disaster. For his PhD, Stephen Guillot is looking to develop a warning system for tornadoes that responds to the needs of communities within the Metro Nashville area in the USA.