John Wells | South East Technological University (original) (raw)

Papers by John Wells

Journal of Substance Use, 2021

Background: Stakeholder’s views on the role of recovery capital, including issues and barriers, t... more Background: Stakeholder’s views on the role of recovery capital, including issues and barriers, that might address service provision for individuals with alcohol- and drug-related problems are impo...

International Journal of Childbirth, 2014

Ireland currently has the highest birthrate of the 27 European Union countries which has led to a... more Ireland currently has the highest birthrate of the 27 European Union countries which has led to an increase in demand for maternity services. In the Irish Republic, most maternity units have traditionally followed the medical-led model of care, which, as a result, has limited women’s choice for maternity care. Although various different midwifery-led schemes are available, concerns exist regarding the knowledge and accessibility of these schemes.The aim of this descriptive, exploratory survey was to explore and determine the views of “low-risk” pregnant women (n = 394) regarding their antenatal care and services. A purposive homogeneous sample comprised the first phase of a mixed methods study and data were analyzed using Predictive Analytics Software. The findings identified a lack of awareness and understanding of the concept of a low-risk pregnancy. Consequently, women identified an overall lack of information and an inability to access available options for their care.

Journal of Health and Rehabilitation Sciences

COST Actions are grants provided by the European Union to support the establishment of networks o... more COST Actions are grants provided by the European Union to support the establishment of networks of expertise to explore and address a scientific or social issue that impacts across Europe. This article introduces and describes one such action that started in October 2022 - CUPID - will address issues of policy and equity of access to cancer prevention initiatives by people with intellectual disabilities compared to the general population in Europe. With 82 individual members drawn from 30 countries CUPID will establish an interdisciplinary network of stakeholders representing carers, service providers, advocacy groups, educators, healthcare professionals, researchers and people with intellectual disabilities. The CUPID COST Action will be implemented over four years and will identify what needs to be addressed by the European Union and health and social services to improve cancer prevention among people with intellectual disabilities.

ABSTRACT The Impact that ‘Lean Healthcare’ and the Productive Ward: Releasing Time to Care Initia... more ABSTRACT The Impact that ‘Lean Healthcare’ and the Productive Ward: Releasing Time to Care Initiative has on Employees. A Review of the literature. Background The emphasis in health care is rapidly shifting from a model of low-cost provision to one that embraces low-cost, improvement and high-quality (Mazur, 2012). The Productive Ward: Releasing Time to Care (RTC) is an improvement initiative specifically led by nurses which has been relatively well accepted, adopted (Robert et al., 2011) and spread internationally (Clews, 2013). It was designed and developed using improvement principles of ‘Lean Manufacturing’ and formally introduced in Ireland in 2011. Lean and Lean-thinking have their origins in the Toyota Production System (Womack et al., 1990). It is a philosophy that loathes waste and strives to eliminate defects and continually attacks both in a never-ending pursuit of perfection (Liker, 2004). Lean thinking discourages the process of ‘workarounds’ and encourages resolution at the root of the problem (Womack and Jones, 1998). The term ‘Lean Healthcare’ is a relatively new term with a focus on efficiency and patient satisfaction (de Souza, 2009). Purpose: This paper reviews the Lean Healthcare Productive Ward: Releasing Time to Care (RTC) Literature and extracts the reported effects and impacts on employees who implement it. The study aims to identify and investigate the strength of the connection between the two models and discusses the implications for implementation. Design: This study reviewed the Lean Healthcare and Productive Ward: RTC literature using strict systematic inclusion criteria. A qualitative content analysis was used to identify key characteristics of reported employee experience, effect or impact. Themes and categories were ranked by the number of citations and presented. Findings: This study outlines the similar employee effects and impacts that exist between Lean-type initiatives and the Productive Ward: RTC programme. It discusses and explores the three top themes of: Empowerment, Leadership and Engagement. It also identifies one key difference between the two initiatives, the socio-cultural effect and impact that is well cited in the Lean-type improvement initiatives and poorly reported in the Productive Ward: RTC literature to date. The socio-cultural element is discussed and presented as one of the fundamental aspects of Lean and the original Toyota production system (Radnor et al., 2012; Joosten et al., 2009). Research limitations: Because of the research methods used, the variety of Lean-type methodologies examined, models of implementation reported in the literature and the contextual factors involved in each organisation, these results although valid lack generalisability and can only be applied to the health care sector. Originality/value: This study brings new insights into Lean-type improvement initiatives currently being imported into health care and provides a comprehensive list of reported employee impacts and effects of value to health care leaders involved with introducing or implementing improvement initiatives. References Clews, G. (2013) 'Productive ward goes global', Nursing times.net, (3 May 2011), pp. 1. de Souza, B. L. (2009) 'Trends and approaches in lean healthcare', Leadership in Health Services, 22(2), pp. 121-139. Joosten, T., Bongers, I. and Janssen, R. (2009) 'Application of lean thinking to health care: issues and observations', International Journal for quality in Health Care, 21(5), pp. 341-347. Liker, J. (2004) The toyota Way: 14 Management Principles from the worlds greatest manufacturer., New York: McGraw-Hill. Mazur, L. (2012) 'Facilitating Lean Learning and Behaviors in Hospitals During the Early Stages of Lean Implementation', vol. 24, no. 1 (Mar 2012), p. 11-22( Radnor, Z. J., Holweg, M. and Waring, J. (2012) 'Lean in healthcare: The unfilled promise?', Social Science & Medicine, 74(3), pp. 364-371. Robert, G., Morrow, E., Maben, J., Griffiths, P. and Callard, L. (2011) 'The adoption, local implementation and assimilation into routine nursing practice of a national quality improvement programme: the Productive Ward in England', Journal of Clinical Nursing, 20(7/8), pp. 1196-1207. Womack, J. P. and Jones, D. T. (1998) Lean thinking: banish waste and create wealth in your corporation, London: Touchstone. Womack, J. P., Jones, D. T., Roos, D. and Massachusetts Institute of, T. (1990) The machine that changed the world: based on the Massachusetts Institute of Technology 5-million dollar 5-year study on the future of the automobile, New York: Rawson Associates.

Journal of Clinical Nursing, 2014

Aims and objectives. To examine the literature related to a large-scale quality improvement initi... more Aims and objectives. To examine the literature related to a large-scale quality improvement initiative, the 'Productive Ward: Releasing Time to Care', providing a bibliometric profile that tracks the level of interest and scale of roll-out and adoption, discussing the implications for sustainability. Background. Productive Ward: Releasing Time to Care (aka Productive Ward) is probably one of the most ambitious quality improvement efforts engaged by the UK-NHS. Politically and financially supported, its main driver was the NHS Institute for Innovation and Improvement. The NHS institute closed in early 2013 leaving a void of resources, knowledge and expertise. UK roll-out of the initiative is well established and has arguably peaked. International interest in the initiative however continues to develop. Methods. A comprehensive literature review was undertaken to identify the literature related to the Productive Ward and its implementation (January 2006-June 2013). A bibliometric analysis examined/reviewed the trends and identified/measured interest, spread and uptake. Results. Overall distribution patterns identify a declining trend of interest, with reduced numbers of grey literature and evaluation publications. However, detailed examination of the data shows no reduction in peer-reviewed outputs. There is some evidence that international uptake of the initiative continues to generate publications and create interest. Conclusions. Sustaining this initiative in the UK will require re-energising, a new focus and financing. The transition period created by the closure of its creator may well contribute to further reduced levels of interest and publication outputs in the UK. However, international implementation, evaluation and associated publications could serve to attract professional/academic interest in this wellestablished, positively reported, quality improvement initiative. Relevance to clinical practice. This paper provides nurses and ward teams involved in quality improvement programmes with a detailed, current-state, examination and analysis of the Productive Ward literature, highlighting the bibliometric patterns of this large-scale, international, quality improvement programme. It serves to disseminate updated publication information to those in clinical practice who are involved in Productive Ward or a similar quality improvement initiative.

Journal of Research in Nursing, 2014

The year 2008 marked a profound crisis for Irish public services, with the economy moving from a ... more The year 2008 marked a profound crisis for Irish public services, with the economy moving from a state of ‘boom’ to ‘bust’. This economic context has significantly impacted on Irish nursing and midwifery. This paper outlines the profound changes that have taken place in the landscape of Irish nursing and midwifery, between 1997 and 2014 as a result. Firstly we outline the considerable changes that took place within the nursing and midwifery professions following the Government’s acceptance of the recommendations of the Commission on Nursing (Government of Ireland, 1998), including the introduction of a 4-year degree-level pre-registration training for all nurses, and the establishment of the Health Service Executive in 2005. We then describe the consequences of the austerity measures implemented by the Irish Government from 2009 to the present and their impact on the Irish nursing and midwifery professions. An employment moratorium, salary cuts, increased working hours and incentivi...

EDULEARN Proceedings

Mastering a healthy Work-Life-Flow (WLF) has become an ever-more challenging key competence to ma... more Mastering a healthy Work-Life-Flow (WLF) has become an ever-more challenging key competence to maintain an effective and sustainably enduring work performance while increasing social, physical and mental health. We propose in the frame of the Strategic Partnership project "Excellence based profiling to identify and apply tools and trainings for a better and sustainable Work-Life-Flow" (Project Number: 2020-1-ES01-KA203-083282 funded by Erasmus+) an innovative and transversal curriculum for higher education institution (HEI) students in Europe focusing on competencies for a healthy WLF. Within the scope of the European Green Deal and the accentuated transition need towards lifelong learning, young people entering the labour market will not only face an increase in complex and dynamic work contexts but also increasingly blurred boundaries between work and nonwork in highly flexible work arrangements, both temporally and spatially. This disruptive work systems change requires a change for personal agency. Specifically, a recent EU-OSHA report shows that the erosion and forced integration of work and nonwork domains results in longer working hours, presenteeism, more ruminative thinking after work hours, higher anxiety levels, more sleeping disorders, and generally higher stress levels. It is crucial to determine which personal competencies are needed to cope with this ongoing transformation and to achieve a healthy WLF. The WLF project embeds its competency-based approach within The European Framework for Personal, Social and Learning to Learn Key Competence and the Sustainable Development Goals, specifically Goals 3, 4 & 8.

Antecedentes: De acuerdo con el proceso de globalizacion de la enfermeria, se estan debatiendo ac... more Antecedentes: De acuerdo con el proceso de globalizacion de la enfermeria, se estan debatiendo actualmente cuestiones relacionadas con el aumento de la movilidad nacional e internacional de estudiantes y enfermeras cualificadas. Se recomienda identificar las diferencias internacionales y comparar similitudes para el entendimiento mutuo, el desarrollo y una mejor armonizacion de la formacion clinica de los estudiantes universitarios de enfermeria. Objetivos: El objetivo del estudio fue describir y comparar la naturaleza de los modelos de educacion de practicas clinicas de enfermeria adoptados en diferentes paises. Metodos: Se adopto un enfoque cualitativo implicando a un panel de enfermeras. Se empleo la Tecnica de Grupo Nominal para desarrollar el instrumento inicial de investigacion para la recopilacion de datos. Participaron once miembros de la red UDINE-C, representando a las instituciones que participaron en el proceso de educacion profesional en enfermeria e investigacion (univ...

Brain Sciences, 2021

Stress during the pandemic has had an impact on the mental health of healthcare professionals (HC... more Stress during the pandemic has had an impact on the mental health of healthcare professionals (HCPs). However, little is known about coping and “maladaptive” coping behaviours of this population. This study investigates “maladaptive” coping behaviours and their correlation with stress, anxiety and insomnia of Italian HCPs during the pandemic. It reports on a cross-sectional, descriptive and correlational study based on a survey of 1955 Italian HCPs. Overall participants reported increases in cigarette smoking, time spent online and video playing. Overall reported alcohol consumption decreased but increased in those reporting drinking more than once a week. Those reporting starting smoking during the pandemic were found to have higher SAS and PSS scores. Those reporting being online for 3 or more hours were found to have higher ISS scores. Doctors who reported playing video games were found to have higher PSS, ISS and SAS scores whilst nurses who reported playing video games were fou...

In the United Kingdom a combination of high profile incidents and reports personally critical of ... more In the United Kingdom a combination of high profile incidents and reports personally critical of mental health policy in general and individual practitioners' actions in particular (Sheppard 1995) highlight the pressures which operate on mental health professionals in the community (Mechanic 1995a). These pressures are exacerbated by policy contradictions and resource limitations. Consequently community mental health practitioners (e.g. psychiatrists, community psychiatric nurses and social workers) can be sensitive to political and managerial agendas which may have a negative impact on their implementation of individual care programs (Marks ef al. 1994). Using the concept of 'street level bureaucracy' (Lipsky 1980), this paper examines recent literature. It is argued that practitioners' reception and implementation of policy is influenced by the need to balance the tension between four elements: the political and policy imperatives, the agenda of local management, the professional and peer cultures in which practitioners operate and the balance of perceived personal advantage. It is further postulated that managers and policy makers may have a vested interest in not scrutinizing practitioners' implementation of policy too vigorously as a way of deflecting responsibility for its consequences. The 'Care Programme Approach and recent legislative changes regarding community supervision (Department of Health 1995a) highlight the important and sometimes negative consequences for the service user that may result.

Lo stress e una delle maggiori cause di problemi di salute e tale aspetto assume ulteriore rileva... more Lo stress e una delle maggiori cause di problemi di salute e tale aspetto assume ulteriore rilevanza se correlato all’ambiente lavorativo. Lo stress lavorativo e, secondo l’agenzia Europea della Salute e Sicurezza, la seconda causa di problemi di salute in Europa (European Commission, 2011; EASHW, 2014). I professionisti che operano nell’ambito sanitario e sociale, se confrontati con i valori medi della popolazione in generale, sono piu soggetti a stress in ambito lavorativo, spesso associato ad altri problemi di natura patologica, come droga, alcool e suicidio. Questi problemi portano spesso a cio che oggi viene comunemente chiamato “burnout” (European Commission, 2011; Department of Health, 2010; Wells, 2011). DELAROSE (Delivering E-Learning Accreditation to Reduce Occupational Stress in Employment) e un progetto del tipo TOI (Transfer Of Innovation) finanziato dall’Unione Europea, i cui partner comprendono istituzioni universitarie che si occupano di formazione sociale e sanitari...

Journal of Nursing Management, 2020

AIM To illustrate the value of Checkland's 'Soft Systems' approach to explore and ana... more AIM To illustrate the value of Checkland's 'Soft Systems' approach to explore and analyse the interaction of human and organisational factors that affect service delivery and patient experience in one specialist epilepsy service. BACKGROUND Checkland's approach is underutilised in relation to health service improvement. One epilepsy service in Ireland is used as an example to illustrate the value of his approach to improve service delivery, particularly when what needs to change is not clear. METHOD Checkland's 'Soft Systems' seven-stage approach was used collaboratively to explore patients' and clinicians' experience of service delivery and how to improve it. RESULTS The research identified the practice of empowerment affected the quality of the service experience. Checkland's concept of a Human Activity System was particularly pertinent in identifying this issue and providing a 'map' for change. CONCLUSION Wider inferences for the use of Checkland's approach by nurse managers are discussed, as is the value of using Checkland's approach to improve services. Implications for Nursing Management Checkland's 'Soft Systems' is an under-utilised approach in health care that could be used by managers to initiate and embed change within a health care service.

Journal of Patient Experience, 2020

Empowerment is integral to patient-centered practice, particularly as this relates to people with... more Empowerment is integral to patient-centered practice, particularly as this relates to people with chronic conditions, though operationally it is poorly understood in this context. Empowerment, therefore, as experienced by patients with a chronic condition needs exploration. This article reports the experience of empowerment by patients in one specialist epilepsy service in Ireland as an exemplar of broader issues affecting empowerment of patients with chronic conditions. A Frameworks Approach was used to analyze in-depth interviews with patients (n = 10) in one Irish epilepsy service. Analysis was further informed by nonparticipatory observation of service delivery. Results indicate that patients’ negative experiences of empowerment appear to be derived from traditional social norms relating to clinician patient power dimensions and social stigma internalized by clinicians at an unconscious level. With this in mind, educational approaches based upon critical social theory may provid...

Journal of Nursing Management, 2020

International Journal of Aquatic Research and Education, 2019

This is an exploratory study of the impacts of drowning death on local communities and families i... more This is an exploratory study of the impacts of drowning death on local communities and families in the Republic of Ireland as perceived by first responders. The impact of a death may be particularly stressful. The identified population of interest were members of the Garda and first responders from Community Rescue Boats Ireland. The principal data collection method was one-to-one narrative interviews followed by a focus group. Questioning involved asking interviewees to talk about specific events rather than providing general opinions. Community identity was a source of impact, an urban or rural setting was a significant factor, social media was clearly an issue, and once the immediate incident was dealt with families did not receive much formal support. Families require the support of counseling professionals. Participants identified the need for support for search and rescue personnel and improved inter-agency collaboration. There is a need for national guidelines.

Plastic Surgery, 2018

This study reports on an empirically underdocumented practice in contemporary aesthetic enhanceme... more This study reports on an empirically underdocumented practice in contemporary aesthetic enhancement culture, the self-injection of unregulated DIY Botox and dermal filler kits purchased online. Data were collected from 4 online discussion forums containing disclosures in relation to use of DIY kits and analyzed using ethnographic content analysis. Motivation to source DIY Botox and dermal fillers online was grounded in desire to avoid financial cost of professional services and a lack of confidence in practitioners. Future intentions to order online raw materials and “formulas” to prepare dermal fillers at home were expressed. Individuals taught themselves to inject through watching YouTube tutorials and downloading Botox injection maps from the Internet. Although individuals demonstrated awareness of the health risks involved with self-injection of unregulated products, this was not a deterrent. Future research is warranted to document the injecting practices and health outcomes of...

International Journal of Developmental Disabilities, 2019

Background: Understanding the nature of work-related stress and burnout among intellectual disabi... more Background: Understanding the nature of work-related stress and burnout among intellectual disability care staff is important to protect the well-being of these workers and encourage their retention in the sector. Though reviews of specific aspects of this literature have been conducted no article has sought to fully chart the range and nature of this research. Objective: This article addresses this gap by synthesizing the findings of such research with consideration to the future implications for protecting the well-being of care workers. Methods: A scoping review of the published literature was undertaken using a framework described in a previous article. Results: The findings of this review are presented thematically across six primary categories: challenging behavior; reciprocity; coping and stress; role issues; individual differences; and settings. A seventh theme, namely the positive aspects of intellectual disability care work was also identified through this process and is discussed. Conclusion: Occupational stress and strain is an internationally experienced issue in this sector. Challenging behavior and inequality in the relationships between staff and their clients, their colleagues, and their organization appear to exert a significant impact on the stress and well-being of workers in this sector. Excessive workplace demands, a low level of control, and a lack of support have been shown to be related to higher levels of stress and burnout among intellectual disability care workers.

European Journal of Education, 2018

The implementation within Europe of a credit system for vocational education and training known a... more The implementation within Europe of a credit system for vocational education and training known as ECVET is a European Commission priority. The potential for permeability between the ECVET and European Credit Transfer and accumulation System (ECTS) was foreseen in the Recommendation to establish ECVET in 2009, while the Bruges Communique of 2010 called for the promotion of flexible links between vocational and higher education and increased coherence between ECVET and ECTS. To this end a significant number of EU-funded projects were undertaken to explore compatibility between ECVET and ECTS. This article reviews the findings of these projects and reflects on their success in terms of achieving this policy goal. These bridging projects identified several points of compatibility between the two credit systems

International Journal of Aquatic Research and Education, 2018

Journal of Substance Use, 2021

Background: Stakeholder’s views on the role of recovery capital, including issues and barriers, t... more Background: Stakeholder’s views on the role of recovery capital, including issues and barriers, that might address service provision for individuals with alcohol- and drug-related problems are impo...

International Journal of Childbirth, 2014

Ireland currently has the highest birthrate of the 27 European Union countries which has led to a... more Ireland currently has the highest birthrate of the 27 European Union countries which has led to an increase in demand for maternity services. In the Irish Republic, most maternity units have traditionally followed the medical-led model of care, which, as a result, has limited women’s choice for maternity care. Although various different midwifery-led schemes are available, concerns exist regarding the knowledge and accessibility of these schemes.The aim of this descriptive, exploratory survey was to explore and determine the views of “low-risk” pregnant women (n = 394) regarding their antenatal care and services. A purposive homogeneous sample comprised the first phase of a mixed methods study and data were analyzed using Predictive Analytics Software. The findings identified a lack of awareness and understanding of the concept of a low-risk pregnancy. Consequently, women identified an overall lack of information and an inability to access available options for their care.

Journal of Health and Rehabilitation Sciences

COST Actions are grants provided by the European Union to support the establishment of networks o... more COST Actions are grants provided by the European Union to support the establishment of networks of expertise to explore and address a scientific or social issue that impacts across Europe. This article introduces and describes one such action that started in October 2022 - CUPID - will address issues of policy and equity of access to cancer prevention initiatives by people with intellectual disabilities compared to the general population in Europe. With 82 individual members drawn from 30 countries CUPID will establish an interdisciplinary network of stakeholders representing carers, service providers, advocacy groups, educators, healthcare professionals, researchers and people with intellectual disabilities. The CUPID COST Action will be implemented over four years and will identify what needs to be addressed by the European Union and health and social services to improve cancer prevention among people with intellectual disabilities.

ABSTRACT The Impact that ‘Lean Healthcare’ and the Productive Ward: Releasing Time to Care Initia... more ABSTRACT The Impact that ‘Lean Healthcare’ and the Productive Ward: Releasing Time to Care Initiative has on Employees. A Review of the literature. Background The emphasis in health care is rapidly shifting from a model of low-cost provision to one that embraces low-cost, improvement and high-quality (Mazur, 2012). The Productive Ward: Releasing Time to Care (RTC) is an improvement initiative specifically led by nurses which has been relatively well accepted, adopted (Robert et al., 2011) and spread internationally (Clews, 2013). It was designed and developed using improvement principles of ‘Lean Manufacturing’ and formally introduced in Ireland in 2011. Lean and Lean-thinking have their origins in the Toyota Production System (Womack et al., 1990). It is a philosophy that loathes waste and strives to eliminate defects and continually attacks both in a never-ending pursuit of perfection (Liker, 2004). Lean thinking discourages the process of ‘workarounds’ and encourages resolution at the root of the problem (Womack and Jones, 1998). The term ‘Lean Healthcare’ is a relatively new term with a focus on efficiency and patient satisfaction (de Souza, 2009). Purpose: This paper reviews the Lean Healthcare Productive Ward: Releasing Time to Care (RTC) Literature and extracts the reported effects and impacts on employees who implement it. The study aims to identify and investigate the strength of the connection between the two models and discusses the implications for implementation. Design: This study reviewed the Lean Healthcare and Productive Ward: RTC literature using strict systematic inclusion criteria. A qualitative content analysis was used to identify key characteristics of reported employee experience, effect or impact. Themes and categories were ranked by the number of citations and presented. Findings: This study outlines the similar employee effects and impacts that exist between Lean-type initiatives and the Productive Ward: RTC programme. It discusses and explores the three top themes of: Empowerment, Leadership and Engagement. It also identifies one key difference between the two initiatives, the socio-cultural effect and impact that is well cited in the Lean-type improvement initiatives and poorly reported in the Productive Ward: RTC literature to date. The socio-cultural element is discussed and presented as one of the fundamental aspects of Lean and the original Toyota production system (Radnor et al., 2012; Joosten et al., 2009). Research limitations: Because of the research methods used, the variety of Lean-type methodologies examined, models of implementation reported in the literature and the contextual factors involved in each organisation, these results although valid lack generalisability and can only be applied to the health care sector. Originality/value: This study brings new insights into Lean-type improvement initiatives currently being imported into health care and provides a comprehensive list of reported employee impacts and effects of value to health care leaders involved with introducing or implementing improvement initiatives. References Clews, G. (2013) 'Productive ward goes global', Nursing times.net, (3 May 2011), pp. 1. de Souza, B. L. (2009) 'Trends and approaches in lean healthcare', Leadership in Health Services, 22(2), pp. 121-139. Joosten, T., Bongers, I. and Janssen, R. (2009) 'Application of lean thinking to health care: issues and observations', International Journal for quality in Health Care, 21(5), pp. 341-347. Liker, J. (2004) The toyota Way: 14 Management Principles from the worlds greatest manufacturer., New York: McGraw-Hill. Mazur, L. (2012) 'Facilitating Lean Learning and Behaviors in Hospitals During the Early Stages of Lean Implementation', vol. 24, no. 1 (Mar 2012), p. 11-22( Radnor, Z. J., Holweg, M. and Waring, J. (2012) 'Lean in healthcare: The unfilled promise?', Social Science & Medicine, 74(3), pp. 364-371. Robert, G., Morrow, E., Maben, J., Griffiths, P. and Callard, L. (2011) 'The adoption, local implementation and assimilation into routine nursing practice of a national quality improvement programme: the Productive Ward in England', Journal of Clinical Nursing, 20(7/8), pp. 1196-1207. Womack, J. P. and Jones, D. T. (1998) Lean thinking: banish waste and create wealth in your corporation, London: Touchstone. Womack, J. P., Jones, D. T., Roos, D. and Massachusetts Institute of, T. (1990) The machine that changed the world: based on the Massachusetts Institute of Technology 5-million dollar 5-year study on the future of the automobile, New York: Rawson Associates.

Journal of Clinical Nursing, 2014

Aims and objectives. To examine the literature related to a large-scale quality improvement initi... more Aims and objectives. To examine the literature related to a large-scale quality improvement initiative, the 'Productive Ward: Releasing Time to Care', providing a bibliometric profile that tracks the level of interest and scale of roll-out and adoption, discussing the implications for sustainability. Background. Productive Ward: Releasing Time to Care (aka Productive Ward) is probably one of the most ambitious quality improvement efforts engaged by the UK-NHS. Politically and financially supported, its main driver was the NHS Institute for Innovation and Improvement. The NHS institute closed in early 2013 leaving a void of resources, knowledge and expertise. UK roll-out of the initiative is well established and has arguably peaked. International interest in the initiative however continues to develop. Methods. A comprehensive literature review was undertaken to identify the literature related to the Productive Ward and its implementation (January 2006-June 2013). A bibliometric analysis examined/reviewed the trends and identified/measured interest, spread and uptake. Results. Overall distribution patterns identify a declining trend of interest, with reduced numbers of grey literature and evaluation publications. However, detailed examination of the data shows no reduction in peer-reviewed outputs. There is some evidence that international uptake of the initiative continues to generate publications and create interest. Conclusions. Sustaining this initiative in the UK will require re-energising, a new focus and financing. The transition period created by the closure of its creator may well contribute to further reduced levels of interest and publication outputs in the UK. However, international implementation, evaluation and associated publications could serve to attract professional/academic interest in this wellestablished, positively reported, quality improvement initiative. Relevance to clinical practice. This paper provides nurses and ward teams involved in quality improvement programmes with a detailed, current-state, examination and analysis of the Productive Ward literature, highlighting the bibliometric patterns of this large-scale, international, quality improvement programme. It serves to disseminate updated publication information to those in clinical practice who are involved in Productive Ward or a similar quality improvement initiative.

Journal of Research in Nursing, 2014

The year 2008 marked a profound crisis for Irish public services, with the economy moving from a ... more The year 2008 marked a profound crisis for Irish public services, with the economy moving from a state of ‘boom’ to ‘bust’. This economic context has significantly impacted on Irish nursing and midwifery. This paper outlines the profound changes that have taken place in the landscape of Irish nursing and midwifery, between 1997 and 2014 as a result. Firstly we outline the considerable changes that took place within the nursing and midwifery professions following the Government’s acceptance of the recommendations of the Commission on Nursing (Government of Ireland, 1998), including the introduction of a 4-year degree-level pre-registration training for all nurses, and the establishment of the Health Service Executive in 2005. We then describe the consequences of the austerity measures implemented by the Irish Government from 2009 to the present and their impact on the Irish nursing and midwifery professions. An employment moratorium, salary cuts, increased working hours and incentivi...

EDULEARN Proceedings

Mastering a healthy Work-Life-Flow (WLF) has become an ever-more challenging key competence to ma... more Mastering a healthy Work-Life-Flow (WLF) has become an ever-more challenging key competence to maintain an effective and sustainably enduring work performance while increasing social, physical and mental health. We propose in the frame of the Strategic Partnership project "Excellence based profiling to identify and apply tools and trainings for a better and sustainable Work-Life-Flow" (Project Number: 2020-1-ES01-KA203-083282 funded by Erasmus+) an innovative and transversal curriculum for higher education institution (HEI) students in Europe focusing on competencies for a healthy WLF. Within the scope of the European Green Deal and the accentuated transition need towards lifelong learning, young people entering the labour market will not only face an increase in complex and dynamic work contexts but also increasingly blurred boundaries between work and nonwork in highly flexible work arrangements, both temporally and spatially. This disruptive work systems change requires a change for personal agency. Specifically, a recent EU-OSHA report shows that the erosion and forced integration of work and nonwork domains results in longer working hours, presenteeism, more ruminative thinking after work hours, higher anxiety levels, more sleeping disorders, and generally higher stress levels. It is crucial to determine which personal competencies are needed to cope with this ongoing transformation and to achieve a healthy WLF. The WLF project embeds its competency-based approach within The European Framework for Personal, Social and Learning to Learn Key Competence and the Sustainable Development Goals, specifically Goals 3, 4 & 8.

Antecedentes: De acuerdo con el proceso de globalizacion de la enfermeria, se estan debatiendo ac... more Antecedentes: De acuerdo con el proceso de globalizacion de la enfermeria, se estan debatiendo actualmente cuestiones relacionadas con el aumento de la movilidad nacional e internacional de estudiantes y enfermeras cualificadas. Se recomienda identificar las diferencias internacionales y comparar similitudes para el entendimiento mutuo, el desarrollo y una mejor armonizacion de la formacion clinica de los estudiantes universitarios de enfermeria. Objetivos: El objetivo del estudio fue describir y comparar la naturaleza de los modelos de educacion de practicas clinicas de enfermeria adoptados en diferentes paises. Metodos: Se adopto un enfoque cualitativo implicando a un panel de enfermeras. Se empleo la Tecnica de Grupo Nominal para desarrollar el instrumento inicial de investigacion para la recopilacion de datos. Participaron once miembros de la red UDINE-C, representando a las instituciones que participaron en el proceso de educacion profesional en enfermeria e investigacion (univ...

Brain Sciences, 2021

Stress during the pandemic has had an impact on the mental health of healthcare professionals (HC... more Stress during the pandemic has had an impact on the mental health of healthcare professionals (HCPs). However, little is known about coping and “maladaptive” coping behaviours of this population. This study investigates “maladaptive” coping behaviours and their correlation with stress, anxiety and insomnia of Italian HCPs during the pandemic. It reports on a cross-sectional, descriptive and correlational study based on a survey of 1955 Italian HCPs. Overall participants reported increases in cigarette smoking, time spent online and video playing. Overall reported alcohol consumption decreased but increased in those reporting drinking more than once a week. Those reporting starting smoking during the pandemic were found to have higher SAS and PSS scores. Those reporting being online for 3 or more hours were found to have higher ISS scores. Doctors who reported playing video games were found to have higher PSS, ISS and SAS scores whilst nurses who reported playing video games were fou...

In the United Kingdom a combination of high profile incidents and reports personally critical of ... more In the United Kingdom a combination of high profile incidents and reports personally critical of mental health policy in general and individual practitioners' actions in particular (Sheppard 1995) highlight the pressures which operate on mental health professionals in the community (Mechanic 1995a). These pressures are exacerbated by policy contradictions and resource limitations. Consequently community mental health practitioners (e.g. psychiatrists, community psychiatric nurses and social workers) can be sensitive to political and managerial agendas which may have a negative impact on their implementation of individual care programs (Marks ef al. 1994). Using the concept of 'street level bureaucracy' (Lipsky 1980), this paper examines recent literature. It is argued that practitioners' reception and implementation of policy is influenced by the need to balance the tension between four elements: the political and policy imperatives, the agenda of local management, the professional and peer cultures in which practitioners operate and the balance of perceived personal advantage. It is further postulated that managers and policy makers may have a vested interest in not scrutinizing practitioners' implementation of policy too vigorously as a way of deflecting responsibility for its consequences. The 'Care Programme Approach and recent legislative changes regarding community supervision (Department of Health 1995a) highlight the important and sometimes negative consequences for the service user that may result.

Lo stress e una delle maggiori cause di problemi di salute e tale aspetto assume ulteriore rileva... more Lo stress e una delle maggiori cause di problemi di salute e tale aspetto assume ulteriore rilevanza se correlato all’ambiente lavorativo. Lo stress lavorativo e, secondo l’agenzia Europea della Salute e Sicurezza, la seconda causa di problemi di salute in Europa (European Commission, 2011; EASHW, 2014). I professionisti che operano nell’ambito sanitario e sociale, se confrontati con i valori medi della popolazione in generale, sono piu soggetti a stress in ambito lavorativo, spesso associato ad altri problemi di natura patologica, come droga, alcool e suicidio. Questi problemi portano spesso a cio che oggi viene comunemente chiamato “burnout” (European Commission, 2011; Department of Health, 2010; Wells, 2011). DELAROSE (Delivering E-Learning Accreditation to Reduce Occupational Stress in Employment) e un progetto del tipo TOI (Transfer Of Innovation) finanziato dall’Unione Europea, i cui partner comprendono istituzioni universitarie che si occupano di formazione sociale e sanitari...

Journal of Nursing Management, 2020

AIM To illustrate the value of Checkland's 'Soft Systems' approach to explore and ana... more AIM To illustrate the value of Checkland's 'Soft Systems' approach to explore and analyse the interaction of human and organisational factors that affect service delivery and patient experience in one specialist epilepsy service. BACKGROUND Checkland's approach is underutilised in relation to health service improvement. One epilepsy service in Ireland is used as an example to illustrate the value of his approach to improve service delivery, particularly when what needs to change is not clear. METHOD Checkland's 'Soft Systems' seven-stage approach was used collaboratively to explore patients' and clinicians' experience of service delivery and how to improve it. RESULTS The research identified the practice of empowerment affected the quality of the service experience. Checkland's concept of a Human Activity System was particularly pertinent in identifying this issue and providing a 'map' for change. CONCLUSION Wider inferences for the use of Checkland's approach by nurse managers are discussed, as is the value of using Checkland's approach to improve services. Implications for Nursing Management Checkland's 'Soft Systems' is an under-utilised approach in health care that could be used by managers to initiate and embed change within a health care service.

Journal of Patient Experience, 2020

Empowerment is integral to patient-centered practice, particularly as this relates to people with... more Empowerment is integral to patient-centered practice, particularly as this relates to people with chronic conditions, though operationally it is poorly understood in this context. Empowerment, therefore, as experienced by patients with a chronic condition needs exploration. This article reports the experience of empowerment by patients in one specialist epilepsy service in Ireland as an exemplar of broader issues affecting empowerment of patients with chronic conditions. A Frameworks Approach was used to analyze in-depth interviews with patients (n = 10) in one Irish epilepsy service. Analysis was further informed by nonparticipatory observation of service delivery. Results indicate that patients’ negative experiences of empowerment appear to be derived from traditional social norms relating to clinician patient power dimensions and social stigma internalized by clinicians at an unconscious level. With this in mind, educational approaches based upon critical social theory may provid...

Journal of Nursing Management, 2020

International Journal of Aquatic Research and Education, 2019

This is an exploratory study of the impacts of drowning death on local communities and families i... more This is an exploratory study of the impacts of drowning death on local communities and families in the Republic of Ireland as perceived by first responders. The impact of a death may be particularly stressful. The identified population of interest were members of the Garda and first responders from Community Rescue Boats Ireland. The principal data collection method was one-to-one narrative interviews followed by a focus group. Questioning involved asking interviewees to talk about specific events rather than providing general opinions. Community identity was a source of impact, an urban or rural setting was a significant factor, social media was clearly an issue, and once the immediate incident was dealt with families did not receive much formal support. Families require the support of counseling professionals. Participants identified the need for support for search and rescue personnel and improved inter-agency collaboration. There is a need for national guidelines.

Plastic Surgery, 2018

This study reports on an empirically underdocumented practice in contemporary aesthetic enhanceme... more This study reports on an empirically underdocumented practice in contemporary aesthetic enhancement culture, the self-injection of unregulated DIY Botox and dermal filler kits purchased online. Data were collected from 4 online discussion forums containing disclosures in relation to use of DIY kits and analyzed using ethnographic content analysis. Motivation to source DIY Botox and dermal fillers online was grounded in desire to avoid financial cost of professional services and a lack of confidence in practitioners. Future intentions to order online raw materials and “formulas” to prepare dermal fillers at home were expressed. Individuals taught themselves to inject through watching YouTube tutorials and downloading Botox injection maps from the Internet. Although individuals demonstrated awareness of the health risks involved with self-injection of unregulated products, this was not a deterrent. Future research is warranted to document the injecting practices and health outcomes of...

International Journal of Developmental Disabilities, 2019

Background: Understanding the nature of work-related stress and burnout among intellectual disabi... more Background: Understanding the nature of work-related stress and burnout among intellectual disability care staff is important to protect the well-being of these workers and encourage their retention in the sector. Though reviews of specific aspects of this literature have been conducted no article has sought to fully chart the range and nature of this research. Objective: This article addresses this gap by synthesizing the findings of such research with consideration to the future implications for protecting the well-being of care workers. Methods: A scoping review of the published literature was undertaken using a framework described in a previous article. Results: The findings of this review are presented thematically across six primary categories: challenging behavior; reciprocity; coping and stress; role issues; individual differences; and settings. A seventh theme, namely the positive aspects of intellectual disability care work was also identified through this process and is discussed. Conclusion: Occupational stress and strain is an internationally experienced issue in this sector. Challenging behavior and inequality in the relationships between staff and their clients, their colleagues, and their organization appear to exert a significant impact on the stress and well-being of workers in this sector. Excessive workplace demands, a low level of control, and a lack of support have been shown to be related to higher levels of stress and burnout among intellectual disability care workers.

European Journal of Education, 2018

The implementation within Europe of a credit system for vocational education and training known a... more The implementation within Europe of a credit system for vocational education and training known as ECVET is a European Commission priority. The potential for permeability between the ECVET and European Credit Transfer and accumulation System (ECTS) was foreseen in the Recommendation to establish ECVET in 2009, while the Bruges Communique of 2010 called for the promotion of flexible links between vocational and higher education and increased coherence between ECVET and ECTS. To this end a significant number of EU-funded projects were undertaken to explore compatibility between ECVET and ECTS. This article reviews the findings of these projects and reflects on their success in terms of achieving this policy goal. These bridging projects identified several points of compatibility between the two credit systems

International Journal of Aquatic Research and Education, 2018