Week 2,5

Posted on August 24, 2015 by jb779

The start of the week was quite exciting with a research project at the ophthalmology unit, which my colleague is supervising. The study investigates the outcomes of different treatment methods for the patients. We went in together and organised the patients’ treatment prior to their visit. The treatment plan is adaptive and changes on the basis of their diagnosis and their progress within the trial. It had been an interesting morning and I got to see an eye treatment “live” gaining more clinical research practice and experience in dealing with patients.

 

I got to speak to a clinical psychologist assistant who gave me some advice for future career and degree options. I also went to a meeting with the principle project investigator who just came back from annual leave and discussed the medical research context of the project with me.

 

I have spent a lot of time researching background literature and have started to systematically conduct a literature review.

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Week Seven

Posted on August 24, 2015 by jsm36

This week I edited the tables in the literature review into themes; I found four themes for both the barriers and facilitators of implementing evidence based practice. I also created a diagram which demonstrates the relationship between practice and evidence; showing that neither is more important than the other. Instead, I have tried to emphasise throughout the literature review that it is important for academics and clinicians to work closely together to ensure that the research conducted is applicable to practice.

We had our focus group at Folkestone this week, although this was our smallest focus group to date a lot of useful information came out of the group. I will warn anybody who goes to Westcliffe House at Folkestone; there is not a lot of parking! In the evening I popped to WHSmith’s and was very surprised to find that they sell the Nursing Standard which is a nursing journal. In this was a new article that I had to add to the literature review; as I said before, there’s so much research out there, and new research coming through all the time!

After transcribing the focus group, I decided to add a new paragraph to the review surrounding Clinical Nurse Specialists and how they support/facilitate evidence-based practice. I finalised the citations and references. I also wrote key summary sentences and author information required by the journals. Finally I re-wrote the abstract; this is the part of the paper that I am least confident writing, but Jo thinks I’ve got it this time!

This week was also time to say goodbye to a member of the team Emily, who undertook a Kent Health placement last year after doing a psychology degree too. Emily is off to do a degree in medicine now, so we all wish her the best of luck!

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Week Seven

Posted on August 21, 2015 by eb82

Much like the past couple of weeks, this week mainly consisted of me continuing with the ever lengthening lab report as well as still trying to get my head around the numerous statistical tests which had to be carried out on the data.

During the week, I undertook my last HPLC run, with the dwindling sample set, by now I was confidently carrying out the analysis in record time, leaving me with ample opportunity to work on my lab report and start seriously thinking about my upcoming presentation.

On one day, one of the staff members quizzed me on some of the tests carried out in one of the labs, and helped fill any gaps in my knowledge regarding the various specialised tests for things such as sepsis, subarachnoid haemorrhaging and one of the most common tests in the lab involving blood glucose, in order to help diagnose and monitor diabetes.

Another portion of my week was spend continuing with planning (and worrying about) the upcoming presentation I would have to give in my final week in the department. Hours were spent painstakingly planning exactly what to say and when (although I’ll probably forget everything on the day). With the reassurance from several staff members assuring me it isn’t as scary as it seems, I started to put more trust into the fact that hopefully I will be able to talk about the project I’ve just spent the last 7 weeks working on, without messing up too much.

With much of my second to last week spent writing up various aspects of the project and bugging staff with even more questions about everything, I felt like I’ve managed to somehow learn (and remember) most of what I’ve been taught and am looking forward to completing my portion of the project next week.

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Week One – Induction – getting to know the research and development department

Posted on August 17, 2015 by jb779

Welcome and great that you have found your way to my very first blog! From now on, I will update you weekly for the next 8 weeks on the progress of my placement. My first 1,5 weeks have been pretty imposing and I have learnt a lot:

On my very first day, I only met a part of the team as most of the Research and Development Department were on annual leave. Nonetheless, the team made me feel really welcome. They introduced themselves and explained the general role of the department and I soon realised that the research conducted here is on a much larger scale than anything I have encountered at university.

One of my colleagues showed me my way around the maze that is the hospital and helped me sort out my ID badge and my parking permit. They also introduced me to dozens of people on our way through the hospital. In the afternoon, we went to meet Mr Haythem Ali who is a surgeon at Maidstone and the PI for the research projects I will be working on. Mr Ali invited me into the operation theatre and I observed three operations, which were really impressive. This gave me a really good understanding of the importance of the research project- to ensure a fast recovery after abdominal surgery. There could not have been a better start to a clinical placement.

In the following days, I learnt the essentials of the research project, including the role of the research physiotherapist, an introduction course to the library and research system I also learnt about good clinical practice which provides ethical and practical guidelines for research in a clinical area. I read the protocols of what research had been completed and written so far and some background reading into the subject matter itself. I have now started with a literature review and some potential outcome measures that could be included in the study.

One of my colleagues is conducting research exploring the relation between hip dysplasia and genetic variables. I joined her for an afternoon and we spoke to the parents of the babies to inform them about the study. If parents consented to their child taking part, we took a saliva sample of the babies. It is a really interesting and a large-scale study and it gave me a good insight into study procedures in a clinical setting.

Mr Ali took me the multidisciplinary meeting (MDM) where the specialists of the hospital get together to discuss the medical cases (think Dr. House). It has been an interesting experience to see how the medical “background” works. On the same day, Mr Ali and I discussed the objective for the projects and he explained the general procedure for medical research processes. In the afternoon, I was invited to observe the work in the outpatient’s clinic. It was a unique experience being able to join the meeting and the clinic.

Finally, over the weekend I managed it to get to the library at the University of Kent, and armed with a few books and background literature, I am ready for the next week.

All in all, it has been an overwhelming 1,5 weeks it gave me a good overview of a hospital, some theoretical and practical medical background about abdominal surgery and plenty of new medical terminology.  I am really grateful for the chance to join the R & D team for another 6,5 weeks.

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Week Six

Posted on August 17, 2015 by jsm36

I have spent the majority of this week finalising the literature review; I’ve gone through and updated different references to make them as recent as possible. I have also come across some more journals which needed adding into my review; there does seem to be an endless amount of research that I want to include! I have also added two tables; one summarising barriers and one facilitators. It does help to make it clearer to read and I must admit when I went back through to make the summaries it did surprise me how many barriers and facilitators there are! Next week I will be editing my tables to split them into themes; hopefully this should make it clearer still. In addition to the tables I am adding a diagram to explain the relationship between practice and evidence.

On Wednesday we had the focus group at Trinity (my base). After a concerning start the number of participants did pick up and we were able to conduct the group. After the group Jo and I had a longer meeting than normal. We went through even more ideas for future research; the project really is snowballing! Jo also showed me how to use Open Athens effectively; it’s a database of different ways to access journals and, although I find it a bit more tricky to work my way around than the University journals, I am picking it up quickly and am accessing even more journals (meaning there’s even more to add!).

Wednesday afternoon consisted of the research interest group where I had to give my presentation. Although I was really nervous before hand, I actually felt quite confident when I started talking. I only presented to about 20 people, but it’s a good starting point for the conferences we hope to speak at. I was asked a lot of questions and could answer all of them! The rest of the research interest group went really well; we had a speaker from Kent Health and a brief discussion about the upcoming research conference. Jo and I will be applying to present at the Research Conference; it’s the 24th September in Maidstone and is open to all NHS staff.

On a side note, I have now realised that the study is no longer simply a 9-5 job for me and is a genuine interest. In fact I have now found a couple of nursing ‘magazine-style’ journals, Nursing Standard and Nursing Times, which can be purchased at WHSmith and Sainsbury’s that I am finding very interesting.

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Week Six

Posted on August 14, 2015 by eb82

Week six mainly constituted of continuing with the lab report alongside attempting a tonne of statistics.

I spent a good portion of the week shifting through the results we’d gained so far and scouring the internet for reports and papers expressing similar finds regarding the sudden loss of analyte in a number of the samples. However apart from the odd sentence in the majority of ‘relevant’ papers found, on the whole nothing really proved that useful as a means of explanation.

Due to the data we’d uncovered throughout the course of the project, in order to expand on this and draw further conclusions regarding pH stability, a new project plan went underway which, when undertaken, will hopefully give more substantial results.

Part way through the week, the second to last run was undertaken, with the results (for most of the samples) showing patterns which thankfully made sense when added to the long list of data obtained so far.

On Friday I had the opportunity to attend a staff meeting, this provided me with an opportunity to better understand how the NHS is run and hear the queries/questions fellow staff members had, and although I didn’t fully understand everything that was discussed, I found the meeting as a whole very interesting.

Looking back over the past six weeks, I’m very glad to have been given the opportunity to work in the labs here and feel that the knowledge I’ve gained from this placement will be vital in my studies and future job opportunities both within lab settings and elsewhere.

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Week Five

Posted on August 10, 2015 by jsm36

This week there was no operation stack so the office was back to normal; everyone was back in, so a lot more people to talk to!

I started this week off with the literature review and have now completed this. I also completed the worst part of research… writing up the references! I’m going to be spending some time next week adjusting the review to fit the requirements of the different journals for submission. Each journal has different requirements which need to be met, for example the nursing times requires a key points sections, some journals require Harvard referencing, whilst others require their own form of referencing. Once I’ve reformatted the review we will be sending it in for submission! We will be trying the British Journal of Nursing first, but having a journal published can be quite a lengthy process so I’m not sure when we will hear the outcome of this.

We conducted the focus group at Tonbridge Cottage Hospital and had our best turn out yet; nine mentors, all of whom stayed for our study. The group went really well and we have got some similar feedback from the participants of this group to other groups. Some participants also identified new barriers which have not been suggested previously. As the focus group was so large we recorded for a longer period of time, meaning I had much more to transcribe this week; I spent Thursday and half of Friday completing.

Friday afternoon I went to the library at University to research Interpretive Phenomenological Analysis; the method we will be using to analyse the transcripts. I’ve already done quite a lot of research around this, but it is a difficult topic to get your head around, so Jo has recommended a good book for me to read.

I have some really exciting news! We are looking at extending our study to include a comparison with acute nursing services, as well as a cross-cultural study. The paperwork has now been submitted for the acute research and we are just waiting for approval to come through. Jo has also identified a research department in Slovenia who would like to take part in our study, so I will be writing the paperwork for this.

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Week Five

Posted on August 7, 2015 by eb82

With only a few weeks left of my part of the project, this week mainly constituted of continuing with the mammoth lab report I’d started. This involved bringing together everything we’d done so far and starting to (try) and draw some conclusions from the data.

I spend the majority of my time glued to a computer, bringing together the endless stream of results and creating some colourful looking graphs along with pages and pages of tables and information regarding the study. In order to test my knowledge and demonstrate what I’d learnt from my time here, I ‘agreed’ to do a small presentation in my last week to show some of the staff members what the project has brought to light so far.

Part way through the week I undertook another of the batch runs, completing the preparation in record time due to all the practice I’d had from the previous runs, and when quizzed on the SOP by a member of staff, I pretty much knew the entire procedure off by heart! Once this run was done I worked out that there were only two more runs left to do during my placement, which made me realise how fast the time had gone, and even though I’m looking forward to having a break from pipetting, I think I’m going to miss working in the lab.

My fifth week passed in a blur, and in between carrying out the experiments, writing the lab report (along with attempting a whole lot of statistics), and starting my presentation, I feel like the project and the placement as a whole has provided invaluable experience and knowledge which couldn’t have been gained any other way. The staff have been extremely helpful (and patient) with helping me get to grips with everything, and have also been great fun to work with!

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Week Four

Posted on August 3, 2015 by jsm36

I was only office based for two days this week. Operation Stack has been really bad! I did manage to get in one day, to find out that they were shutting my route home, so the ladies in the office made everyone from the Maidstone area head for home! The rest of the week I worked from home so that I wasn’t spending time sitting in traffic.

This week I wrote the introduction and method sections for the study Jo and I are conducting. I’ve had to try and learn about interpretive phenomenological analysis; I’ve got quite a few questions for when I next meet with Jo! There wasn’t a focus group this week as Jo was away on holiday, so I didn’t have any transcribing to do. Instead I spent the time thinking of ways that the project could be expanded in the future, which Jo and I will go through when I see her next.

I mainly focused on my presentation that’s coming up soon. I will be attending the research interest group at Trinity, Ashford and explain the study we are conducting, the issues we’ve come across and how we’ve overcome them. I’ve now finished my PowerPoint (spent quite a lot of time finding pictures!) and have written a script to learn too. Must admit I am quite nervous to present this, but it’ll be good practice for any conferences we are able to present at. When I was looking for bits to add to my presentation, I came across a really good youtube clip that I think explains evidence based practice in a very simple way. I’ve put the link at the end of the blog, I’d definitely recommend watching it.

This week seems to have flown by, I can’t believe that I’m half way through my placement already!

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Week Four

Posted on July 31, 2015 by eb82

Week 4 began much the same as last week, I spent the first couple of days sorting through the piles of data we’d accumulated so far, and then spent a good deal of time trying to work out what on earth was going on with the results that were just refusing to make sense. After some deliberation, it was found that these anomalous results were in fact following some sort of trend… just not the one we were expecting (in a few of the samples the presence of 5-HIAA had all but disappeared upon acidification).

From picking out a couple of these mystery samples, I began working on some separate tests to decipher why they were doing what they were doing. These tests involved altering the pH and studying the affect this change had on the concentration of analyte. Before the testing could begin, I had the unfortunate task of altering the pH of each urine aliquot using HCL to give a range of acidities to test the degradation against. After painstakingly pipetting the acid into the samples drop-by-drop and creating a rainbow of pH indicator sticks, I’d finally perfected a suitable range ready to analyse.

When the results from the HPLC came through, it became clear that the oddities weren’t a result of me doing something wrong the entire time (thankfully), but were in fact an important discovery regarding the stability of 5-HIAA (the whole point of the project). Due to the immense importance of these findings regarding the collection of patient’s urine, I got to work frantically searching the Internet in hopes of an answer as to why the 5-HIAA was disappearing. A few (pretty old) papers contained some round about information which proved some-what useful in the reasoning behind the disappearance, and when pieced together with some more recent research we decided that we still had a lot more work to do regarding this find.

When I wasn’t working on the project, my time was taken up with continuing my lab report and ‘harassing’ staff members with millions questions about various aspects of the project.

My fourth week (like all the others) has passed in a blur, and I’m finding it hard to believe that I’ve already been here for a month! I feel as if I’m really getting to grips with the everyday goings-on in the department, and amid actually remembering everyone’s names, (finally) not getting lost and being trusted to independently run the equipment for the project without the fear of breaking it; I feel like the placement has provided me with invaluable experience which I am looking forward to applying to my studies during my final year at Kent.

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