A rapid evidence assessment of sickle cell disease educational interventions.

AIMS AND OBJECTIVES: To assess the impact of educational interventions on the knowledge and attitude of healthcare professionals (HCPs) regarding sickle cell disease (SCD) pain management in the UK. BACKGROUND: Variations and inadequate pain management due toHCPs' lack of knowledge and negative attitude is still an ongoing global concern for SCD patients despite availability of effective treatment and evidence-based guidelines. Several international studies have implemented interventions aimed at improving knowledge, attitude, and pain management. No review on the effectiveness of these interventions was found. Also, no previous intervention done in the UK was found from the thorough search of research databases. However, there are estimated 240,000 genetic carriers with about 12,500-15,000 estimated people living with SCD in the UK. DESIGN: Rapid Evidence Assessment of existing evidence. METHODS: A rapid evidence assessment was conducted between March 2021-January 2022 following the PRISMA 2020 guidelines. Included papers must have an educational intervention about SCD or related symptom management where the learners were HCPs. Excluded papers were those not published in English or before 2010. The following databases were searched: CINAHL, MEDLINE, PubMed America and Europe, Scopus, PsycINFO and Web of Science. Data quality was assessed using the Mixed Methods Assessment Tool (MMAT) and analysed using a narrative approach. RESULTS: Ten studies were included in the final review. Overall, they reported improved outcomes in six main themes: knowledge, attitude, perception, adoption, satisfaction and efficiency. Five studies reported statistically significant improvement in at least one outcome, four studies reported positive improvement, and two studies reported no significant improvement in knowledge and attitude. These heterogeneous studies were implemented once, and all designs were prone to bias; this makes it difficult to state how effective interventions are for SCD. CONCLUSION: Current evidence of positive improvement in HCPs' knowledge and attitude is insufficient for generalisation and recommendation for adoption. However, we believe that implementing validated educational interventions remains essential for effective acute SCD pain management and patient-centred care. Further research is needed to find a suitable educational intervention that can be replicated. RELEVANCE TO CLINICAL PRACTICE: Quality SCD education, timely crisis management and reduced patient stigma are crucial in reducing the risk of rapid clinical decompensation to avoid developing life-threatening complications. Understanding SCD can also support the building of therapeutic relationships between the patient and practitioner. TRIAL REGISTRATION: This review was not registered.

The utility and impact of information communication technology (ICT) for pre-registration nurse education: A narrative synthesis systematic review.

OBJECTIVES: To evaluate and summarise the utility and impact of information communication technology (ICT) in enhancing student performance and the learning environment in pre-registration nursing. DESIGN: A systematic review of empirical research across a range of themes in ICT health-related education. DATA SOURCES: Science Direct, Cinahl, AMED, MEDLINE, PubMed, ASSIA, OVID and OVID SP (2008-2014). Further date parameters were imposed by theme. REVIEW METHODS: Evidence was reviewed by narrative synthesis, adopting Caldwell's appraisal framework and CASP for qualitative methods. Selection and inclusion was grounded in the PICOS structure, with language requirements (English), and further parameters were guided by theme appropriateness. RESULTS: Fifty studies were selected for review across six domains: reusable learning objects, media, audience response systems, e-portfolios, computer-based assessment and faculty adoption of e-learning. Educational ICT was found to be non-inferior to traditional teaching, while offering benefits to teaching and learning efficiency. Where support is in place, ICT improves the learning environment for staff and students, but human and environmental barriers need to be addressed. CONCLUSION: This review illuminates more advantages for ICT in nurse training than previously. The key advantage of flexibility is supported, though with little evidence for effect on depth of learning.

Greater Manchester: reducing infant mortality and promoting child health.

Targeting services in order to reduce health inequalities is a key national priority.This paper describes a project funded by the Greater Manchester Public Health Network looking at service provision to reduce infant mortality and promote child health across Greater Manchester. The aim of this was to improve standards of care by setting a standard service provision for targeting services toward the most deprived groups. It involved the production of child health indicators, a literature review, standard setting, dissemination of findings, collation of data and production of a service pathway for breastfeeding, smoking cessation, nutrition and postnatal depression.

Inequalities in child health up to five years: a supradistrict audit.

Reducing inequalities is a key national priority. This paper describes a unique retrospective multidisciplinary audit that was carried out across the Greater Manchester area. The aim of the audit was to identify the extent to which local health and local authority services were implementing evidence-based interventions to reduce health inequalities in children aged below five, using both qualitative and quantitative approaches. Health visitor and midwifery records were audited against service provision around seven standards--reducing postnatal depression, promoting breastfeeding, social and emotional support for parents, improving the health of looked-after children, improving nutrition in children and women of childbearing age, provision of day care and pre-school education, and reducing smoking in pregnancy and the postnatal period. The results suggest that recommendations for reducing inequalities were not implemented across all geographic areas, services or populations consistently, particularly in relation to smoking cessation, the management of postnatal depression and the promotion of breastfeeding initiation and continuation. It is recommended that, with the widening gap in health outcomes between both ends of the socioeconomic spectrum, local services should be targeted for those most in need.