sharryn gardner - Academia.edu (original) (raw)

Papers by sharryn gardner

Paediatric Clinical Leaders: Service Planning, Provision and Best Practice

Methods Over a 3-year period, three events were organised by Paediatric trainees: the initial eve... more Methods Over a 3-year period, three events were organised by Paediatric trainees: the initial event was face-to-face, and the following two years were virtual events due to the COVID-19 pandemic. The day long programme involved sessions covering a range of topics including: an introduction to Paediatric training in Yorkshire; a 'Job Idol' competition which allowed us to showcase the many sub-specialties in Paediatrics; what the application and interview involves; and finally, a session on other opportunities in Paediatric training, such as leadership projects and working abroad. Feedback was collected from each event. Results Over the course of our three events, 100 people attended, with the majority being Foundation Doctors. The majority of attendees gave feedback that they had found the day useful, had gained something out of it, and were feeling certain or quite certain about applying for Paediatrics. People stated that the day had been 'inspiring' and 'motivational' and was a 'good showcase of future paediatric colleagues'. Application numbers to Paediatrics for 2022, although not formally released at the time of writing, were up from previous years. Conclusion In order to ensure the safe and efficient care of children in the future, we need to invest in encouraging recruitment to Paediatrics. There is clearly a demand amongst potential applicants to find out more about the speciality, and an existing workforce who are passionate to share their experiences of working in order to encourage others to apply. Regular events such as those we have carried out in Yorkshire and Humber provide a platform to do just this.

Staff engagement is much more than just a bonus in any organisation. CQC data shows that it is ve... more Staff engagement is much more than just a bonus in any organisation. CQC data shows that it is very clearly linked to positive results in both patient and staff outcomes (fewer complaints, improved safety, reduced sickness, fewer accidents, and more as per Michael West). Staff engagement may seem nebulous but is in fact measured routinely annually in the National Staff Survey. The problem is that often Trust Boards with poor Staff Survey results may struggle to increase staff engagement as staff see management initiatives as 'management fads ' or 'tick-box exercises ' purely for targets, not their own benefit. Compassionate Conversations are a ground-level initiative focused primarily on supporting and motivating individual staff as the primary focus. This allows the benefits to patients and in Human Resources to be an unspoken anticipated benefit. They are led by a Psychologist and Consultant in a coaching supportive atmosphere in an open or selected group. The ...

BMC Emergency Medicine, 2022

Background Point-of-care testing (POCT) is diagnostic testing performed at or near to the site of... more Background Point-of-care testing (POCT) is diagnostic testing performed at or near to the site of the patient. Understanding the current capacity, and scope, of POCT in this setting is essential in order to respond to new research evidence which may lead to wide implementation. Methods A cross-sectional online survey study of POCT use was conducted between 6th January and 2nd February 2020 on behalf of two United Kingdom (UK) and Ireland-based paediatric research networks (Paediatric Emergency Research UK and Ireland, and General and Adolescent Paediatric Research UK and Ireland). Results In total 91/109 (83.5%) sites responded, with some respondents providing details for multiple units on their site based on network membership (139 units in total). The most commonly performed POCT were blood sugar (137/139; 98.6%), urinalysis (134/139; 96.4%) and blood gas analysis (132/139; 95%). The use of POCT for Influenza/Respiratory Syncytial Virus (RSV) (45/139; 32.4%, 41/139; 29.5%), C-Reac...

JAMA, 2021

The optimal dose and duration of oral amoxicillin for children with community-acquired pneumonia ... more The optimal dose and duration of oral amoxicillin for children with community-acquired pneumonia (CAP) are unclear. OBJECTIVE To determine whether lower-dose amoxicillin is noninferior to higher dose and whether 3-day treatment is noninferior to 7 days. DESIGN, SETTING, AND PARTICIPANTS Multicenter, randomized, 2 × 2 factorial noninferiority trial enrolling 824 children, aged 6 months and older, with clinically diagnosed CAP, treated with amoxicillin on discharge from emergency departments and inpatient wards of 28 hospitals in the UK and 1 in Ireland between February 2017 and April 2019, with last trial visit on May 21, 2019. INTERVENTIONS Children were randomized 1:1 to receive oral amoxicillin at a lower dose (35-50 mg/kg/d; n = 410) or higher dose (70-90 mg/kg/d; n = 404), for a shorter duration (3 days; n = 413) or a longer duration (7 days; n = 401). MAIN OUTCOMES AND MEASURES The primary outcome was clinically indicated antibiotic re-treatment for respiratory infection within 28 days after randomization. The noninferiority margin was 8%. Secondary outcomes included severity/duration of 9 parent-reported CAP symptoms, 3 antibiotic-related adverse events, and phenotypic resistance in colonizing Streptococcus pneumoniae isolates. RESULTS Of 824 participants randomized into 1 of the 4 groups, 814 received at least 1 dose of trial medication (median [IQR] age, 2.5 years [1.6-2.7]; 421 [52%] males and 393 [48%] females), and the primary outcome was available for 789 (97%). For lower vs higher dose, the primary outcome occurred in 12.6% with lower dose vs 12.4% with higher dose (difference, 0.2% [1-sided 95% CI-ϱ to 4.0%]), and in 12.5% with 3-day treatment vs 12.5% with 7-day treatment (difference, 0.1% [1-sided 95% CI-ϱ to 3.9]). Both groups demonstrated noninferiority with no significant interaction between dose and duration (P = .63). Of the 14 prespecified secondary end points, the only significant differences were 3-day vs 7-day treatment for cough duration (median 12 days vs 10 days; hazard ratio [HR], 1.2 [95% CI, 1.0 to 1.4]; P = .04) and sleep disturbed by cough (median, 4 days vs 4 days; HR, 1.2 [95% CI, 1.0 to 1.4]; P = .03). Among the subgroup of children with severe CAP, the primary end point occurred in 17.3% of lower-dose recipients vs 13.5% of higher-dose recipients (difference, 3.8% [1-sided 95% CI,-ϱ to10%]; P value for interaction = .18) and in 16.0% with 3-day treatment vs 14.8% with 7-day treatment (difference, 1.2% [1-sided 95% CI,-ϱ to 7.4%]; P value for interaction = .73). CONCLUSIONS AND RELEVANCE Among children with CAP discharged from an emergency department or hospital ward (within 48 hours), lower-dose outpatient oral amoxicillin was noninferior to higher dose, and 3-day duration was noninferior to 7 days, with regard to need for antibiotic re-treatment. However, disease severity, treatment setting, prior antibiotics received, and acceptability of the noninferiority margin require consideration when interpreting the findings.

Don't Forget The Bubbles, 2013

BMJ Quality Improvement Reports, 2014

Staff engagement is much more than just a bonus in any organisation. CQC data shows that it is ve... more Staff engagement is much more than just a bonus in any organisation. CQC data shows that it is very clearly linked to positive results in both patient and staff outcomes (fewer complaints, improved safety, reduced sickness, fewer accidents, and more as per Michael West). Staff engagement may seem nebulous but is in fact measured routinely annually in the National Staff Survey. The problem is that often Trust Boards with poor Staff Survey results may struggle to increase staff engagement as staff see management initiatives as 'management fads' or 'tick-box exercises' purely for targets, not their own benefit. Compassionate Conversations are a ground-level initiative focused primarily on supporting and motivating individual staff as the primary focus. This allows the benefits to patients and in Human Resources to be an unspoken anticipated benefit. They are led by a Psychologist and Consultant in a coaching supportive atmosphere in an open or selected group. The Conversations have been rated 9/10 or higher by 64% of participants, while 75% of all participants voluntarily provided feedback. Feedback initially was that Conversations were too clinically-focused and further Conversations were more wide-ranging in topic and included departmental roadshows.

Experimental and Therapeutic Medicine, 2016

The '2nd Workshop on Paediatric Virology', which took place on Saturday the 8th of October 2016 i... more The '2nd Workshop on Paediatric Virology', which took place on Saturday the 8th of October 2016 in Athens, Greece, provided an overview on recent views and advances on Paediatric Virology. Emphasis was given to HIV-1 management in Greece, a country under continuous financial crisis, hepatitis B vaccination in Africa, treatment options for hepatitis C virus in childhood, Zika virus in pregnancy and infancy, the burden of influenza on childhood, hand-foot-mouth disease and myocarditis associated with Coxsackie viruses. Other general topics covered included a critical evaluation of Paediatric Accident and Emergency viral infections, multimodality imaging of viral infections in children, surgical approaches of otolaryngologists to complex viral infections, new advances in the diagnosis and treatment of viral conjunctivitis and novel molecular diagnostic methods for HPV in childhood. A brief historical overview of the anti-vaccination movement was also provided, as well as presentations on the educational challenge of Paediatric Virology as a new subspecialty of Paediatrics.

BMJ (Clinical research ed.), 2014

2013 was a terrible year for the NHS as a whole, and for nurses in particular.1 There is a dichot... more 2013 was a terrible year for the NHS as a whole, and for nurses in particular.1 There is a dichotomy between most staff who remain compassionate in very challenging circumstances and those few who have lapses in compassion. Edmund Burke said that good men need only do nothing to allow evil to triumph (he was speaking of lapses rather than actual evil). Many may have known something, but …

The Lancet Infectious Diseases, 2021

Paediatric Emergency Research in the UK and Ireland (PERUKI) Group (2021). Validating clinical pr... more Paediatric Emergency Research in the UK and Ireland (PERUKI) Group (2021). Validating clinical practice guidelines for the management of children with non-blanching rashes in the UK (PiC) a prospective, multicentre cohort study. The Lancet Infectious Diseases, 21(4), 569-577.

Paediatric Clinical Leaders: Service Planning, Provision and Best Practice

Methods Over a 3-year period, three events were organised by Paediatric trainees: the initial eve... more Methods Over a 3-year period, three events were organised by Paediatric trainees: the initial event was face-to-face, and the following two years were virtual events due to the COVID-19 pandemic. The day long programme involved sessions covering a range of topics including: an introduction to Paediatric training in Yorkshire; a 'Job Idol' competition which allowed us to showcase the many sub-specialties in Paediatrics; what the application and interview involves; and finally, a session on other opportunities in Paediatric training, such as leadership projects and working abroad. Feedback was collected from each event. Results Over the course of our three events, 100 people attended, with the majority being Foundation Doctors. The majority of attendees gave feedback that they had found the day useful, had gained something out of it, and were feeling certain or quite certain about applying for Paediatrics. People stated that the day had been 'inspiring' and 'motivational' and was a 'good showcase of future paediatric colleagues'. Application numbers to Paediatrics for 2022, although not formally released at the time of writing, were up from previous years. Conclusion In order to ensure the safe and efficient care of children in the future, we need to invest in encouraging recruitment to Paediatrics. There is clearly a demand amongst potential applicants to find out more about the speciality, and an existing workforce who are passionate to share their experiences of working in order to encourage others to apply. Regular events such as those we have carried out in Yorkshire and Humber provide a platform to do just this.

Staff engagement is much more than just a bonus in any organisation. CQC data shows that it is ve... more Staff engagement is much more than just a bonus in any organisation. CQC data shows that it is very clearly linked to positive results in both patient and staff outcomes (fewer complaints, improved safety, reduced sickness, fewer accidents, and more as per Michael West). Staff engagement may seem nebulous but is in fact measured routinely annually in the National Staff Survey. The problem is that often Trust Boards with poor Staff Survey results may struggle to increase staff engagement as staff see management initiatives as 'management fads ' or 'tick-box exercises ' purely for targets, not their own benefit. Compassionate Conversations are a ground-level initiative focused primarily on supporting and motivating individual staff as the primary focus. This allows the benefits to patients and in Human Resources to be an unspoken anticipated benefit. They are led by a Psychologist and Consultant in a coaching supportive atmosphere in an open or selected group. The ...

BMC Emergency Medicine, 2022

Background Point-of-care testing (POCT) is diagnostic testing performed at or near to the site of... more Background Point-of-care testing (POCT) is diagnostic testing performed at or near to the site of the patient. Understanding the current capacity, and scope, of POCT in this setting is essential in order to respond to new research evidence which may lead to wide implementation. Methods A cross-sectional online survey study of POCT use was conducted between 6th January and 2nd February 2020 on behalf of two United Kingdom (UK) and Ireland-based paediatric research networks (Paediatric Emergency Research UK and Ireland, and General and Adolescent Paediatric Research UK and Ireland). Results In total 91/109 (83.5%) sites responded, with some respondents providing details for multiple units on their site based on network membership (139 units in total). The most commonly performed POCT were blood sugar (137/139; 98.6%), urinalysis (134/139; 96.4%) and blood gas analysis (132/139; 95%). The use of POCT for Influenza/Respiratory Syncytial Virus (RSV) (45/139; 32.4%, 41/139; 29.5%), C-Reac...

JAMA, 2021

The optimal dose and duration of oral amoxicillin for children with community-acquired pneumonia ... more The optimal dose and duration of oral amoxicillin for children with community-acquired pneumonia (CAP) are unclear. OBJECTIVE To determine whether lower-dose amoxicillin is noninferior to higher dose and whether 3-day treatment is noninferior to 7 days. DESIGN, SETTING, AND PARTICIPANTS Multicenter, randomized, 2 × 2 factorial noninferiority trial enrolling 824 children, aged 6 months and older, with clinically diagnosed CAP, treated with amoxicillin on discharge from emergency departments and inpatient wards of 28 hospitals in the UK and 1 in Ireland between February 2017 and April 2019, with last trial visit on May 21, 2019. INTERVENTIONS Children were randomized 1:1 to receive oral amoxicillin at a lower dose (35-50 mg/kg/d; n = 410) or higher dose (70-90 mg/kg/d; n = 404), for a shorter duration (3 days; n = 413) or a longer duration (7 days; n = 401). MAIN OUTCOMES AND MEASURES The primary outcome was clinically indicated antibiotic re-treatment for respiratory infection within 28 days after randomization. The noninferiority margin was 8%. Secondary outcomes included severity/duration of 9 parent-reported CAP symptoms, 3 antibiotic-related adverse events, and phenotypic resistance in colonizing Streptococcus pneumoniae isolates. RESULTS Of 824 participants randomized into 1 of the 4 groups, 814 received at least 1 dose of trial medication (median [IQR] age, 2.5 years [1.6-2.7]; 421 [52%] males and 393 [48%] females), and the primary outcome was available for 789 (97%). For lower vs higher dose, the primary outcome occurred in 12.6% with lower dose vs 12.4% with higher dose (difference, 0.2% [1-sided 95% CI-ϱ to 4.0%]), and in 12.5% with 3-day treatment vs 12.5% with 7-day treatment (difference, 0.1% [1-sided 95% CI-ϱ to 3.9]). Both groups demonstrated noninferiority with no significant interaction between dose and duration (P = .63). Of the 14 prespecified secondary end points, the only significant differences were 3-day vs 7-day treatment for cough duration (median 12 days vs 10 days; hazard ratio [HR], 1.2 [95% CI, 1.0 to 1.4]; P = .04) and sleep disturbed by cough (median, 4 days vs 4 days; HR, 1.2 [95% CI, 1.0 to 1.4]; P = .03). Among the subgroup of children with severe CAP, the primary end point occurred in 17.3% of lower-dose recipients vs 13.5% of higher-dose recipients (difference, 3.8% [1-sided 95% CI,-ϱ to10%]; P value for interaction = .18) and in 16.0% with 3-day treatment vs 14.8% with 7-day treatment (difference, 1.2% [1-sided 95% CI,-ϱ to 7.4%]; P value for interaction = .73). CONCLUSIONS AND RELEVANCE Among children with CAP discharged from an emergency department or hospital ward (within 48 hours), lower-dose outpatient oral amoxicillin was noninferior to higher dose, and 3-day duration was noninferior to 7 days, with regard to need for antibiotic re-treatment. However, disease severity, treatment setting, prior antibiotics received, and acceptability of the noninferiority margin require consideration when interpreting the findings.

Don't Forget The Bubbles, 2013

BMJ Quality Improvement Reports, 2014

Staff engagement is much more than just a bonus in any organisation. CQC data shows that it is ve... more Staff engagement is much more than just a bonus in any organisation. CQC data shows that it is very clearly linked to positive results in both patient and staff outcomes (fewer complaints, improved safety, reduced sickness, fewer accidents, and more as per Michael West). Staff engagement may seem nebulous but is in fact measured routinely annually in the National Staff Survey. The problem is that often Trust Boards with poor Staff Survey results may struggle to increase staff engagement as staff see management initiatives as 'management fads' or 'tick-box exercises' purely for targets, not their own benefit. Compassionate Conversations are a ground-level initiative focused primarily on supporting and motivating individual staff as the primary focus. This allows the benefits to patients and in Human Resources to be an unspoken anticipated benefit. They are led by a Psychologist and Consultant in a coaching supportive atmosphere in an open or selected group. The Conversations have been rated 9/10 or higher by 64% of participants, while 75% of all participants voluntarily provided feedback. Feedback initially was that Conversations were too clinically-focused and further Conversations were more wide-ranging in topic and included departmental roadshows.

Experimental and Therapeutic Medicine, 2016

The '2nd Workshop on Paediatric Virology', which took place on Saturday the 8th of October 2016 i... more The '2nd Workshop on Paediatric Virology', which took place on Saturday the 8th of October 2016 in Athens, Greece, provided an overview on recent views and advances on Paediatric Virology. Emphasis was given to HIV-1 management in Greece, a country under continuous financial crisis, hepatitis B vaccination in Africa, treatment options for hepatitis C virus in childhood, Zika virus in pregnancy and infancy, the burden of influenza on childhood, hand-foot-mouth disease and myocarditis associated with Coxsackie viruses. Other general topics covered included a critical evaluation of Paediatric Accident and Emergency viral infections, multimodality imaging of viral infections in children, surgical approaches of otolaryngologists to complex viral infections, new advances in the diagnosis and treatment of viral conjunctivitis and novel molecular diagnostic methods for HPV in childhood. A brief historical overview of the anti-vaccination movement was also provided, as well as presentations on the educational challenge of Paediatric Virology as a new subspecialty of Paediatrics.

BMJ (Clinical research ed.), 2014

2013 was a terrible year for the NHS as a whole, and for nurses in particular.1 There is a dichot... more 2013 was a terrible year for the NHS as a whole, and for nurses in particular.1 There is a dichotomy between most staff who remain compassionate in very challenging circumstances and those few who have lapses in compassion. Edmund Burke said that good men need only do nothing to allow evil to triumph (he was speaking of lapses rather than actual evil). Many may have known something, but …

The Lancet Infectious Diseases, 2021

Paediatric Emergency Research in the UK and Ireland (PERUKI) Group (2021). Validating clinical pr... more Paediatric Emergency Research in the UK and Ireland (PERUKI) Group (2021). Validating clinical practice guidelines for the management of children with non-blanching rashes in the UK (PiC) a prospective, multicentre cohort study. The Lancet Infectious Diseases, 21(4), 569-577.