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San Francisco, CA, United States

Warner J.P.,Nightingale
British Journal of Psychiatry | Year: 2015

Old age psychiatry services globally are under threat. The discipline enjoyed its heyday in the two decades bridging the millennium. More recently there has been a move to integrate old age services with those of working age adults, to create ageless' services. Evidence is beginning to accumulate that this is a bad idea. Copyright © 2015 The Royal College of Psychiatrists, unless otherwise stated.


Ridgers H.,Nightingale
Nursing standard (Royal College of Nursing (Great Britain) : 1987) | Year: 2013

The availability of antiretroviral therapy has changed the course of human immunodeficiency virus (HIV) disease progression, and as a result the face of HIV in the UK is ageing. Men who have sex with men remain disproportionately affected. Those who have lived into older age with HIV, as well as those older men that are newly diagnosed with the virus, are at risk of a range of non acquired immune deficiency syndrome-related co-morbidities, resulting in the need for care not only in HIV specialist settings but also in other areas of healthcare provision. This article examines some of the issues that nurses caring for people ageing with HIV in non-HIV healthcare settings may encounter. Particular attention is paid to issues that affect older HIV-positive men who have sex with men.


A method of compensating for sample misalignment in an optical measurement apparatus (


A method for locating the centre of a beam profile, comprises the steps of: providing a beam profile; selecting one or more strips through the beam profile; identifying distinct regions of intensity along the one or more strips and labelling them consistently; calculating a combined average intensity for each labelled region, using data from the one or more strips; plotting the average intensity against the labelled regions and comparing the results with a plot of the actual intensity obtained by taking a cross-section through the centre of at least one of the one or more strips; and optimising the location of the centre of at least one of the one or more strips so as to obtain the best fit between the average intensity plot and the actual intensity plot to thereby identify the centre of the beam profile.


Ball J.E.,Nightingale | Murrells T.,Nightingale | Rafferty A.M.,Kings College London | Morrow E.,Nightingale | Griffiths P.,University of Southampton
BMJ Quality and Safety | Year: 2014

Background There is strong evidence to show that lower nurse staffing levels in hospitals are associated with worse patient outcomes. One hypothesised mechanism is the omission of necessary nursing care caused by time pressure-'missed care'. Aim To examine the nature and prevalence of care left undone by nurses in English National Health Service hospitals and to assess whether the number of missed care episodes is associated with nurse staffing levels and nurse ratings of the quality of nursing care and patient safety environment. Methods Cross-sectional survey of 2917 registered nurses working in 401 general medical/ surgical wards in 46 general acute National Health Service hospitals in England. Results Most nurses (86%) reported that one or more care activity had been left undone due to lack of time on their last shift. Most frequently left undone were: comforting or talking with patients (66%), educating patients (52%) and developing/ updating nursing care plans (47%). The number of patients per registered nurse was significantly associated with the incidence of 'missed care' (p<0.001). A mean of 7.8 activities per shift were left undone on wards that are rated as 'failing' on patient safety, compared with 2.4 where patient safety was rated as 'excellent' (p <0. 001). Conclusions Nurses working in English hospitals report that care is frequently left undone. Care not being delivered may be the reason low nurse staffing levels adversely affects quality and safety. Hospitals could use a nurse-rated assessment of 'missed care' as an early warning measure to identify wards with inadequate nurse staffing.

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