Dr Heather Strachan | University of Stirling (original) (raw)

Papers by Dr Heather Strachan

Research and Theory for Nursing Practice, 2003

Cursing practice is an information-intensive process. Nurses spend about 25% of their time collec... more Cursing practice is an information-intensive process. Nurses spend about 25% of their time collecting and using information (The Audit Commission, 1995). Though they are already fairly well skilled in acquiring and using information, the changing nature of nursing and health care means the that informatics competencies required have changed and are more prominent than in the past. New information about health care is being generated at an explosive rate. Estimates show that 5 years after a nursing student graduates from school more than 50% of the knowledge acquired will be obsolete. (McCormick, 1984). Nurses need to continually update their knowledge, and this requires informatics competencies. The recent emphasis on evidence-based health care has contributed to this exponential growth in new knowledge. Evidence-based practice encompasses the conscientious, explicit, and judicious use of current best evidence based on systematic reviews of all available evidence-including patient-reported, clinician-observed, and research-derived evidence-in making and carrying out decisions about the care of individual patients. The best evidence, moderated by patient circumstances and preferences, is applied to improve the quality of clinical judgments (The National Center for Clinical Audit, 1997). By focusing on the nurse's role in evidence-based practice we can identify relevant informatics competencies required to formulate, access, interpret, utilize, and disseminate evidence. To formulate evidence, nurses must be competent in creating new knowledge. Research is an information-intensive activity involving identifying variables, collecting data to test hypotheses, developing survey tools to collect information to explore views, manipulating data with statistical techniques to reveal true answers, being able to analyze and interpret data in an objective way, and then presenting that data in a meaningful way to support the conclusions. Once that evidence is in the public domain, nurses need to be able to access it. They must have knowledge of the plethora of information sources from primary literature to government statistics in order to access the wide range of sources of evidence. Much of this evidence is accessible via literature databases. Nurses therefore need information retrieval skills to ensure that they know where and how to access relevant evidence. This requires an understanding of search terms and techniques to ensure appropriate specificity and sensitivity of the information retrieved. Nurses should develop skills in questioning and assessment techniques to obtain relevant information from patients in order to identify patients' problems and needs.

BMC Public Health, 2018

Background: The National Health Service (NHS) seems appropriately placed to be an exemplar employ... more Background: The National Health Service (NHS) seems appropriately placed to be an exemplar employer in providing effective and proactive workplace health and wellbeing services for its staff. However, NHS staff sickness absence costs an estimated £2.4 billion. Evidence suggests staff health and wellbeing services delivered in the NHS can improve health, productivity and sickness absence and yet the adoption of these services remains a challenge, with few examples nationally. This research aimed to explore the perceptions of NHS senior leaders and health and wellbeing practitioners regarding barriers and facilitators to implementing workplace health and wellbeing services for staff in the NHS. Methods: Semi-structured interviews were conducted with NHS staff, consisting of four senior leaders, four heads of department and three health and wellbeing practitioners in one region of the UK. Interviews were transcribed verbatim and analysed using thematic analysis. Results: Themes describe the experience of delivering workplace health and wellbeing services in the NHS, and barriers and facilitators to implementation from senior decision makers. Barriers to implementation of services include; a busy and pressurised environment, financial constraints and reluctance to invest in staff health and wellbeing. Barriers to staff engagement were also reported and include difficulty of access to health and wellbeing services and lack of time. Initiating services were facilitated by financial incentives, a supportive organisational structure and culture that takes a preventative, rather than reactive, approach to staff health and wellbeing. Facilitators to implementing health and wellbeing services include a coherent, strategic approach to implementation, effective communication and advertisement, being creative and innovative with resources and conducting a needs analysis and evaluation before, during and after implementation.

Drug and Alcohol Review

IntroductionMinimum unit pricing (MUP) may reduce harmful drinking in the general population, but... more IntroductionMinimum unit pricing (MUP) may reduce harmful drinking in the general population, but there is little evidence regarding its impact on marginalised groups. Our study is the first to explore the perceptions of MUP among stakeholders working with people experiencing homelessness following its introduction in Scotland in May 2018.MethodsQualitative semi‐structured interviews were conducted with 41 professional stakeholders from statutory and third sector organisations across Scotland. We explored their views on MUP and its impact on people experiencing homelessness, service provision and implications for policy. Data were analysed using thematic analysis.ResultsParticipants suggested that the introduction of MUP in Scotland had negligible if any discernible impact on people experiencing homelessness and services that support them. Most service providers felt insufficiently informed about MUP prior to its implementation. Participants reported that where consequences for thes...

Journal of Advanced Nursing

AimTo evaluate Advanced Nurse Practitioner (ANP) role implementation in primary care across Scotl... more AimTo evaluate Advanced Nurse Practitioner (ANP) role implementation in primary care across Scotland in contributing to primary care transformation, and establish what works, for whom, why and in what context.DesignA realist evaluation using multiple case studies.MethodsTwo phases, conducted March 2017 to May 2018: (1) multiple case studies of ANP implementation in 15 health boards across Scotland, deductive thematic analysis of interviews, documentary analysis; (2) in‐depth case studies of five health boards, framework analysis of interviews and focus groups.ResultsSixty‐eight informants were interviewed, and 72 documents were reviewed across both phases. ANP roles involved substitution for elements of the GP role for minor illness and injuries, across all ages. In rural areas ANPs undertook multiple nursing roles, were more autonomous and managed greater complexity. Mechanisms that facilitated implementation included: the national ANP definition; GP, primary care team and public e...

BMC Pregnancy and Childbirth, 2022

Background The study aimed to explore: • pregnant women’s and healthcare professionals’ perspecti... more Background The study aimed to explore: • pregnant women’s and healthcare professionals’ perspectives on provision of individual risk scores for future Pelvic Floor Dysfunction (PFD), • the feasibility of providing this during routine maternity care, • actions women might take as a result of knowing their PFD risk. Methods Qualitative study. Setting: UK NHS Health Board. Participants: Pregnant women (n = 14), obstetricians (n = 6), midwives (n = 8) and physiotherapists (n = 3). A purposive sample of pregnant women and obstetric healthcare professionals were introduced to the UR-CHOICE calculator, which estimates a woman’s PFD risk, and were shown examples of low, medium and high-risk women. Data were collected in 2019 by semi-structured interview and focus group and analysed using the Framework Approach. Results Women’s PFD knowledge was limited, meaning they were unlikely to raise PFD risk with healthcare professionals. Women believed it was important to know their individual PFD ri...

Abstract: This article is the first of three and describes the use of a two-round Delphi study to... more Abstract: This article is the first of three and describes the use of a two-round Delphi study to answer the questions: "What Information Systems should nurses be using in the next 5-1 0 years to support their work?" and "What issues need to be addressed to ensure successful usage?" The study identified the advantages and disadvantages of existing hospital Nursing Information Systems but few examples of benefits from information usage. In the first round 255 statements were collected and reduced to 68 issues for the second round. The second and third articles, in future issues of ITIN will describe the results of the research. 22 references.

Journal of Applied Research in Intellectual Disabilities

The World Health Organization estimates that 200 million people worldwide have an intellectual di... more The World Health Organization estimates that 200 million people worldwide have an intellectual disability. Of this number, approximately 250,000 families in the United States, 60,000 in the UK and 45,000 in Canada are affected by Down syndrome (World Health Organisation, 2018). As recently as the 1980s, life expectancy remained below 20 years for people with Down syndrome; this is now over 60 years in developed countries (Ng, Flygare Wallén, & Ahlström, 2017). This has resulted in awareness that dementia disproportionality affects people with Down syndrome at an earlier age, average fifty-five, and is associated with mortality in 70% of adults (Hithersay et al., 2019). People with intellectual disabilities other than Down syndrome are also more likely to develop dementia earlier, on average approximately 10 years prior to that experienced by the population without an intellectual disability (British Psychological Society, 2015). Such demographics demonstrate the global importance of identifying appropriate support for people ageing with intellectual disability.

Journal of Advanced Nursing

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial ... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

International Journal of Nursing Studies

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Journal of Nursing Regulation, 2012

The Quality Strategy for NHSScotland aims to deliver the highest quality health care services to ... more The Quality Strategy for NHSScotland aims to deliver the highest quality health care services to people in Scotland, and NHSScotland is well on its way to ensuring world-leading health care that has people at its center. The recognition that good relationships need to underpin how we deliver services is based on the values of respect, trust, and compassion among staff members, service users, and their families as well as within teams. These values and behaviors form the basis of innovative projects that are revitalizing the care and compassion at the heart of NHSScotland. With regulation existing to protect the public and ensure nurses, midwives, and other health professionals practice with the necessary competencies and conduct to deliver safe, effective, and person-centered care, the future of health care delivery is promising.

Lecture Notes in Medical Informatics, 1990

This paper will describe the development of a nursing information system strategy for the acute h... more This paper will describe the development of a nursing information system strategy for the acute hospital setting. It will additionally describe the implementation of the project and its evaluation. The evaluation of the project emphasises the importance of obtaining benefits at ward level by the ward manager.

Studies in health technology and informatics, 2009

The Scottish Government supports a culture of knowledge management and organisational learning fo... more The Scottish Government supports a culture of knowledge management and organisational learning for nurses, midwives and allied health professionals (NMAHP). To help facilitate this the National eHealth Programme has developed a portal, Using Information - Improving Healthcare, to enable sharing of international and national good practice in information use. The portal provides short stories of how information has been used to improve healthcare or services via text, sound bites or video, with links to resources and people connected with these examples. Evidence based user success criteria and governance arrangements ensure that the site remains a high quality resource.

Studies in health technology and informatics, 2009

The Managed Knowledge Network (MKN) for Nurses, Midwives and the Allied Health Professions (NMAHP... more The Managed Knowledge Network (MKN) for Nurses, Midwives and the Allied Health Professions (NMAHPs) in NHS Scotland was launched in November 2007. The online portal supports the NMAHP network to manage its knowledge and information sources that facilitate engagement with the national eHealth programme and realisation of benefits that eHealth offers to improve healthcare and service delivery. It is an integrated change management and knowledge management initiative. Web2 technologies support the social networking side of knowledge management and learning, allowing people to contact each other and collaborate. MKN resources are managed within the e-Library also giving access to over 5,000 online journals and over 500 bibliographic databases.

Research and theory for nursing practice, 2003

Research and theory for nursing practice, 2003

Concepts and Applications, 2011

The history of nursing informatics whilst arguably starting with Florence has exploded into a tal... more The history of nursing informatics whilst arguably starting with Florence has exploded into a tale of frenetic activity in the last 30 years. This tale is told in this chapter. The evolution of a nursing minimum data set and evolution of a shared language internationally is rightfully positioned as critical to the future of nursing. The argument is structured around the benefit of a sound informatics infrastructure that enables nurses to Care, Share and Compare. Direction of future development needed is discussed in light of the evolution of the nursing role as knowledge worker.

Research and Theory for Nursing Practice, 2004

Research and Theory for Nursing Practice, 2004

Research and Theory for Nursing Practice, 2003

Cursing practice is an information-intensive process. Nurses spend about 25% of their time collec... more Cursing practice is an information-intensive process. Nurses spend about 25% of their time collecting and using information (The Audit Commission, 1995). Though they are already fairly well skilled in acquiring and using information, the changing nature of nursing and health care means the that informatics competencies required have changed and are more prominent than in the past. New information about health care is being generated at an explosive rate. Estimates show that 5 years after a nursing student graduates from school more than 50% of the knowledge acquired will be obsolete. (McCormick, 1984). Nurses need to continually update their knowledge, and this requires informatics competencies. The recent emphasis on evidence-based health care has contributed to this exponential growth in new knowledge. Evidence-based practice encompasses the conscientious, explicit, and judicious use of current best evidence based on systematic reviews of all available evidence-including patient-reported, clinician-observed, and research-derived evidence-in making and carrying out decisions about the care of individual patients. The best evidence, moderated by patient circumstances and preferences, is applied to improve the quality of clinical judgments (The National Center for Clinical Audit, 1997). By focusing on the nurse's role in evidence-based practice we can identify relevant informatics competencies required to formulate, access, interpret, utilize, and disseminate evidence. To formulate evidence, nurses must be competent in creating new knowledge. Research is an information-intensive activity involving identifying variables, collecting data to test hypotheses, developing survey tools to collect information to explore views, manipulating data with statistical techniques to reveal true answers, being able to analyze and interpret data in an objective way, and then presenting that data in a meaningful way to support the conclusions. Once that evidence is in the public domain, nurses need to be able to access it. They must have knowledge of the plethora of information sources from primary literature to government statistics in order to access the wide range of sources of evidence. Much of this evidence is accessible via literature databases. Nurses therefore need information retrieval skills to ensure that they know where and how to access relevant evidence. This requires an understanding of search terms and techniques to ensure appropriate specificity and sensitivity of the information retrieved. Nurses should develop skills in questioning and assessment techniques to obtain relevant information from patients in order to identify patients' problems and needs.

BMC Public Health, 2018

Background: The National Health Service (NHS) seems appropriately placed to be an exemplar employ... more Background: The National Health Service (NHS) seems appropriately placed to be an exemplar employer in providing effective and proactive workplace health and wellbeing services for its staff. However, NHS staff sickness absence costs an estimated £2.4 billion. Evidence suggests staff health and wellbeing services delivered in the NHS can improve health, productivity and sickness absence and yet the adoption of these services remains a challenge, with few examples nationally. This research aimed to explore the perceptions of NHS senior leaders and health and wellbeing practitioners regarding barriers and facilitators to implementing workplace health and wellbeing services for staff in the NHS. Methods: Semi-structured interviews were conducted with NHS staff, consisting of four senior leaders, four heads of department and three health and wellbeing practitioners in one region of the UK. Interviews were transcribed verbatim and analysed using thematic analysis. Results: Themes describe the experience of delivering workplace health and wellbeing services in the NHS, and barriers and facilitators to implementation from senior decision makers. Barriers to implementation of services include; a busy and pressurised environment, financial constraints and reluctance to invest in staff health and wellbeing. Barriers to staff engagement were also reported and include difficulty of access to health and wellbeing services and lack of time. Initiating services were facilitated by financial incentives, a supportive organisational structure and culture that takes a preventative, rather than reactive, approach to staff health and wellbeing. Facilitators to implementing health and wellbeing services include a coherent, strategic approach to implementation, effective communication and advertisement, being creative and innovative with resources and conducting a needs analysis and evaluation before, during and after implementation.

Drug and Alcohol Review

IntroductionMinimum unit pricing (MUP) may reduce harmful drinking in the general population, but... more IntroductionMinimum unit pricing (MUP) may reduce harmful drinking in the general population, but there is little evidence regarding its impact on marginalised groups. Our study is the first to explore the perceptions of MUP among stakeholders working with people experiencing homelessness following its introduction in Scotland in May 2018.MethodsQualitative semi‐structured interviews were conducted with 41 professional stakeholders from statutory and third sector organisations across Scotland. We explored their views on MUP and its impact on people experiencing homelessness, service provision and implications for policy. Data were analysed using thematic analysis.ResultsParticipants suggested that the introduction of MUP in Scotland had negligible if any discernible impact on people experiencing homelessness and services that support them. Most service providers felt insufficiently informed about MUP prior to its implementation. Participants reported that where consequences for thes...

Journal of Advanced Nursing

AimTo evaluate Advanced Nurse Practitioner (ANP) role implementation in primary care across Scotl... more AimTo evaluate Advanced Nurse Practitioner (ANP) role implementation in primary care across Scotland in contributing to primary care transformation, and establish what works, for whom, why and in what context.DesignA realist evaluation using multiple case studies.MethodsTwo phases, conducted March 2017 to May 2018: (1) multiple case studies of ANP implementation in 15 health boards across Scotland, deductive thematic analysis of interviews, documentary analysis; (2) in‐depth case studies of five health boards, framework analysis of interviews and focus groups.ResultsSixty‐eight informants were interviewed, and 72 documents were reviewed across both phases. ANP roles involved substitution for elements of the GP role for minor illness and injuries, across all ages. In rural areas ANPs undertook multiple nursing roles, were more autonomous and managed greater complexity. Mechanisms that facilitated implementation included: the national ANP definition; GP, primary care team and public e...

BMC Pregnancy and Childbirth, 2022

Background The study aimed to explore: • pregnant women’s and healthcare professionals’ perspecti... more Background The study aimed to explore: • pregnant women’s and healthcare professionals’ perspectives on provision of individual risk scores for future Pelvic Floor Dysfunction (PFD), • the feasibility of providing this during routine maternity care, • actions women might take as a result of knowing their PFD risk. Methods Qualitative study. Setting: UK NHS Health Board. Participants: Pregnant women (n = 14), obstetricians (n = 6), midwives (n = 8) and physiotherapists (n = 3). A purposive sample of pregnant women and obstetric healthcare professionals were introduced to the UR-CHOICE calculator, which estimates a woman’s PFD risk, and were shown examples of low, medium and high-risk women. Data were collected in 2019 by semi-structured interview and focus group and analysed using the Framework Approach. Results Women’s PFD knowledge was limited, meaning they were unlikely to raise PFD risk with healthcare professionals. Women believed it was important to know their individual PFD ri...

Abstract: This article is the first of three and describes the use of a two-round Delphi study to... more Abstract: This article is the first of three and describes the use of a two-round Delphi study to answer the questions: "What Information Systems should nurses be using in the next 5-1 0 years to support their work?" and "What issues need to be addressed to ensure successful usage?" The study identified the advantages and disadvantages of existing hospital Nursing Information Systems but few examples of benefits from information usage. In the first round 255 statements were collected and reduced to 68 issues for the second round. The second and third articles, in future issues of ITIN will describe the results of the research. 22 references.

Journal of Applied Research in Intellectual Disabilities

The World Health Organization estimates that 200 million people worldwide have an intellectual di... more The World Health Organization estimates that 200 million people worldwide have an intellectual disability. Of this number, approximately 250,000 families in the United States, 60,000 in the UK and 45,000 in Canada are affected by Down syndrome (World Health Organisation, 2018). As recently as the 1980s, life expectancy remained below 20 years for people with Down syndrome; this is now over 60 years in developed countries (Ng, Flygare Wallén, & Ahlström, 2017). This has resulted in awareness that dementia disproportionality affects people with Down syndrome at an earlier age, average fifty-five, and is associated with mortality in 70% of adults (Hithersay et al., 2019). People with intellectual disabilities other than Down syndrome are also more likely to develop dementia earlier, on average approximately 10 years prior to that experienced by the population without an intellectual disability (British Psychological Society, 2015). Such demographics demonstrate the global importance of identifying appropriate support for people ageing with intellectual disability.

Journal of Advanced Nursing

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial ... more This is an open access article under the terms of the Creative Commons Attribution-NonCommercial License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes.

International Journal of Nursing Studies

This is a PDF file of an article that has undergone enhancements after acceptance, such as the ad... more This is a PDF file of an article that has undergone enhancements after acceptance, such as the addition of a cover page and metadata, and formatting for readability, but it is not yet the definitive version of record. This version will undergo additional copyediting, typesetting and review before it is published in its final form, but we are providing this version to give early visibility of the article. Please note that, during the production process, errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.

Journal of Nursing Regulation, 2012

The Quality Strategy for NHSScotland aims to deliver the highest quality health care services to ... more The Quality Strategy for NHSScotland aims to deliver the highest quality health care services to people in Scotland, and NHSScotland is well on its way to ensuring world-leading health care that has people at its center. The recognition that good relationships need to underpin how we deliver services is based on the values of respect, trust, and compassion among staff members, service users, and their families as well as within teams. These values and behaviors form the basis of innovative projects that are revitalizing the care and compassion at the heart of NHSScotland. With regulation existing to protect the public and ensure nurses, midwives, and other health professionals practice with the necessary competencies and conduct to deliver safe, effective, and person-centered care, the future of health care delivery is promising.

Lecture Notes in Medical Informatics, 1990

This paper will describe the development of a nursing information system strategy for the acute h... more This paper will describe the development of a nursing information system strategy for the acute hospital setting. It will additionally describe the implementation of the project and its evaluation. The evaluation of the project emphasises the importance of obtaining benefits at ward level by the ward manager.

Studies in health technology and informatics, 2009

The Scottish Government supports a culture of knowledge management and organisational learning fo... more The Scottish Government supports a culture of knowledge management and organisational learning for nurses, midwives and allied health professionals (NMAHP). To help facilitate this the National eHealth Programme has developed a portal, Using Information - Improving Healthcare, to enable sharing of international and national good practice in information use. The portal provides short stories of how information has been used to improve healthcare or services via text, sound bites or video, with links to resources and people connected with these examples. Evidence based user success criteria and governance arrangements ensure that the site remains a high quality resource.

Studies in health technology and informatics, 2009

The Managed Knowledge Network (MKN) for Nurses, Midwives and the Allied Health Professions (NMAHP... more The Managed Knowledge Network (MKN) for Nurses, Midwives and the Allied Health Professions (NMAHPs) in NHS Scotland was launched in November 2007. The online portal supports the NMAHP network to manage its knowledge and information sources that facilitate engagement with the national eHealth programme and realisation of benefits that eHealth offers to improve healthcare and service delivery. It is an integrated change management and knowledge management initiative. Web2 technologies support the social networking side of knowledge management and learning, allowing people to contact each other and collaborate. MKN resources are managed within the e-Library also giving access to over 5,000 online journals and over 500 bibliographic databases.

Research and theory for nursing practice, 2003

Research and theory for nursing practice, 2003

Concepts and Applications, 2011

The history of nursing informatics whilst arguably starting with Florence has exploded into a tal... more The history of nursing informatics whilst arguably starting with Florence has exploded into a tale of frenetic activity in the last 30 years. This tale is told in this chapter. The evolution of a nursing minimum data set and evolution of a shared language internationally is rightfully positioned as critical to the future of nursing. The argument is structured around the benefit of a sound informatics infrastructure that enables nurses to Care, Share and Compare. Direction of future development needed is discussed in light of the evolution of the nursing role as knowledge worker.

Research and Theory for Nursing Practice, 2004

Research and Theory for Nursing Practice, 2004