Evaluation of service user-led workshops in children's palliative care education.

Children's nurses report feeling unprepared when caring for children with life-limiting conditions and their families, while the value of including service users in the provision of nursing education is increasingly recognised. This small-scale service evaluation examined the effect on learning of service user-led workshops as part of a module for final-year children's nursing students and post-registration children's nurses. The workshops focused on the experience of children's palliative care and child bereavement from the parents' perspective.

Advanced care planning 5 years on: An observational study of multi-centred service development for children with life-limiting conditions.

Aim: The purpose of this study was to compare how planning has developed over the 5 years across a range of children's health care services in a single U.K. city.

Seizure management in children requiring palliative care: a review of current practice.

Objectives: Controlling seizures in children approaching death can be difficult, and there is a limited evidence base to guide best practice. We compared current practice against the guidance for seizure management produced by the Association of Paediatric Palliative Medicine (APPM).

Methods: Retrospective case note review of episodes of challenging seizure management in children receiving end-of-life care over a 10-year period (2006-2015) in the south-west region of England.

Families' priorities in life-limiting illness: improving quality with online empowerment.

Objective: Improving quality of life (QOL) is the central focus of palliative care support for children with life-limiting illness (LLI), but achieving this can be challenging.

Intervention: MyQuality is an online tool that enables families to choose and monitor parameters they identify as having an impact on their QOL, which aims to improve patient-professional communications and also to enhance patient empowerment within healthcare dialogues.

Design: A longitudinal, multisite mixed-method evaluation of MyQuality.

Advance care planning: challenges and approaches for pediatricians.

Background: There is increasing recognition of the value of advance care planning for children with life-limiting conditions. It is important that we acknowledge and reflect on the challenges that this work presents in order to optimize practice.

Objective: Our aim was to review advance care planning for children with life-threatening or life-limiting conditions (LTLLCs) in our local area.

Using data and quality monitoring to enhance maternity outcomes: a qualitative study of risk managers' perspectives.

Introduction: Risk management is a core part of healthcare practice, especially within maternity services, where litigation and societal costs are high. There has been little investigation into the experiences and opinions of those staff directly involved in risk management: lead obstetricians and specialist risk midwives, who are ideally placed to identify how current implementation of risk management strategies can be improved.

Methods: A qualitative study of consultant-led maternity units in an English region.

Development of maternity dashboards across a UK health region; current practice, continuing problems.

Objective: To assess the development of local clinical dashboards in line with UK national guidance and to identify ongoing issues being faced by maternity units, across an entire health region, in developing quality assurance systems.

Study Design: A mixed-methods study involving all consultant-led maternity units in the South West of England Strategic Health Authority region (SWSHA). An electronic survey, followed by semi-structured interviews with the lead obstetrician and risk management midwife (or equivalent) of each maternity unit, to investigate methods employed to monitor outcomes locally, particularly the development of tools including maternity dashboards.

Developing practice and staff: enabling improvement in care delivery through participatory action research.

We describe the process and outcomes of a programme to enable improvement in care coordination in a children's hospital. Staff identified care coordination issues they wanted to improve and were facilitated to achieve change using a participatory action research (PAR) approach. The seven participating wards were each offered the same opportunity and yet the degree to which they were able to engage in the process, and the level to which they achieved outcomes, varied considerably.

Waiting for surgery after orthopaedic trauma.

Nursing staff on a paediatric surgical ward were concerned about delays experienced by children waiting to go to theatre following orthopaedic trauma, and their families. A facilitated action research approach was used which involved describing the issue, gathering information from a range of sources and introducing changes to the process of care. A flowchart was developed to clarify the stages and the staff involved in admitting a child with orthopaedic trauma for surgery.

Time off the ward: an action research approach to reducing nursing time spent accompanying children to X-ray.

Unlabelled: Nursing staff on a busy medical ward were concerned about the amount of time spent off the ward accompanying children to X-ray and for other radiological investigations. They chose this as the focus for an action research project.

Aim: To improve the process of accompanying a child to X-ray and reduce the amount of time spent off the ward by nursing staff.

Who does what? How staff in England and Denmark perceive roles in the coordination of children's inpatient care: a comparison of questionnaire survey data.

Aims And Objectives: To explore and compare staff perceptions of their own and others roles in the coordination of care for children in hospital in Denmark and England.

Background: The provision of well-coordinated care is a declared aim of health care providers; however, there is no universally held model for achieving this. Staff have developed ways of coordinating care in response to local conditions creating diversity and inconsistency in practice.

Rules and resources: a structuration approach to understanding the coordination of children's inpatient health care.

Aim: This paper presents findings from a multi-method study exploring the process of care coordination in children's inpatient health care.

Background: Existing work on care coordination is typified by "black-box" type studies that measure inputs to and outcomes of care coordination roles and practices, without addressing the process of coordination.

Method: Using questionnaires, interviews and observation to collect data in multiple sites in the United Kingdom and Denmark between 1999 and 2005, the study gathered the perceptions of staff and compared these with observed practice.