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Update on Current Vascular Research

Update on Current Vascular Research. Christi Deaton Professor of Nursing University Hospital of South Manchester NHS FT School of Nursing, Midwifery & Social Work The University of Manchester. Vascular Research. Broad area of research Heart disease Diabetes Stroke Kidney disease

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Update on Current Vascular Research

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  1. Update on Current Vascular Research Christi Deaton Professor of Nursing University Hospital of South Manchester NHS FT School of Nursing, Midwifery & Social Work The University of Manchester

  2. Vascular Research • Broad area of research • Heart disease • Diabetes • Stroke • Kidney disease • Focus on: • CLAHRC (implementation) • Examples of nurse-led cardiovascular research

  3. Greater Manchester CLAHRC • Collaborations for Leadership in Applied Health Research and Care • Innovative programme from NIHR • The NIHR CLAHRC for Greater Manchester is a collaboration of Greater Manchester NHS Trusts and the University of Manchester • Conduct high quality health services research • Ensure knowledge gained from the research is translated into improved health care in the NHS “Knowledge Transformation”

  4. Greater Manchester Why CLAHRCs? • Aim to provide high quality research and apply it! • Addressing Cooksey’s second translational gap • Major problem in the health service re “know how” • Evaluative component

  5. CLAHRC in UK • Nine approved CLAHRCs in England • Manchester, Birmingham, Leeds/York, Leicester, Exeter/Peninsula, London-Imperial, Sheffield, Nottingham, Cambridge. • Each receives £10 million over 5 years from the NIHR alongside £10 million in ‘matched funds’ • Began in October 2008

  6. NIHR CLAHRC • Director Bonnie Sibbald • Deputy Director Ruth Boaden • Vascular disease focus • Major health problem in GM • Expertise in the University • Stroke, Kidney, Heart, Diabetes • Aims to improve the quality of care and the health of citizens suffering from these conditions

  7. Greater Manchester The WISE Approach WISE: Whole-system Informing Self-management Engagement

  8. People with Long Term ConditionsResearch Theme 1. Anne Rogers, Carolyn Chew-Graham • Develop new information resources to support patient self-management in diabetes, kidney and heart disease. • Adapt these resources to the needs of people living in poverty. • Assess cost and effectiveness through randomised controlled trials.

  9. Health Care PractitionersResearch Theme 2. Linda Gask, Christine Bundy & Chris Dickens • Develop better approach to the management of depression in patientswith diabetes and heart disease. • Adapt this approach to meet the needs of people from ethnic minority groups. • Assess cost and effectiveness through randomised controlled trials.

  10. Health Care ServicesResearch Theme 3. Kinta Beaver • Develop patient-led access to specialist care for people with diabetes and kidney disease. • Adapt these to the needs of people from ethnic minority groups. • Assess cost and effectiveness through randomised controlled trials.

  11. Health Information SystemsResearch Theme 4. Iain Buchan • Use existing NHS information systems to- • Map clinical care pathways • Measure inequalities • Develop simulation models to assess impacts of planned interventions on cost and quality of care.

  12. CLAHRC Implementation • Stroke – Pippa Tyrrell (Salford) • Diabetes – Martin Gibson (Salford) • Chronic Kidney Disease – Donal O’Donoghue/Janet Hegarty (Salford) • Heart Disease – Christi Deaton (UHSM/UoM)

  13. Academic Partners

  14. Model for Improvement and Promoting Action on Research • Implementation in Health Services” (PARiHS) framework * Implementation Strategy Evidence-based framework* for change • Agree the goals of change • Determine how attainment of these goals will be measured • Identify what changes should be made to attain the goals • Implement change using Plan-Do-Study-Act cycles • Sustain and spread the change

  15. Implement Research Theme output

  16. Stroke Implementation of national stroke strategy • Work with emergency services to ensure people with acute symptoms are triaged without delay to specialist stroke centres • Develop patient-centred management plans to support people through the sequelae of stroke / TIA, and prevent future vascular injury and death.

  17. Greater Manchester Diabetes Improve access and quality of care • Nurse-led call centre management with regular proactive telephone advice • Nurse-led specialist ambulatory care clinic for people with hypertension and hyperlipidemia.

  18. Chronic Kidney Disease Improve general practice management • Local adaptation of national clinical guidelines, including referral protocols to specialist care • Training for nurses and GPs in chronic kidney disease management • Educational outreach by hospital specialists

  19. Heart Disease Improve access and quality of care • Decrease stroke risk in AF through early diagnosis (pulse checks) and anti-coagulation management • Improve MDT management of chronic heart failure (CHF) • Optimal doses ACEI/ARB and BB • Discharge planning and follow-up

  20. Implementation Sites

  21. Patient and Public Engagement • Research themes • Patient consultation and participation • Implementation themes • Patient consultation through new/existing patient engagement networks • Governance • Patient representation on Steering Group • Wider engagement • Public dissemination of findings • Public debate/scrutiny:- use of NHS information resources for research

  22. Step Change Implementation • Large-scale sustained knowledge transfer between University and NHS. • Increased capacity in the NHS to plan and implement evidence-based changes to service delivery • Inputting into commissioning

  23. Other Vascular Research….

  24. Examples of Nurse-Led Research in Cardiovascular • Predictors of Impaired health related QoL in patients receiving thrombolysis or primary PCI • Linda McGowan, Chris Dickens, Heather Iles-Smith, Cat Rogers, F. Fath-Ordoubadi • 6 Month Interim Findings • Winner of best poster abstract at 9th Annual Spring Meeting on Cardiovascular Nursing, Dublin, April 2009 (presented by Cat Rogers) • Council on Cardiovascular Nursing and Allied Professions (CCNAP) of the European Society of Cardiology

  25. Doctoral Student Research • An investigation of the role of anxiety and depression on representation rates post Primary PCI for STEMI • Heather Iles-Smith • The impact of anxiety on health status and quality of life of patients with heart failure • Katherine Easton

  26. Doctoral Student Research • The relationship between self-care and health related QoL in adult patients with dilated cardiomyopathy • Maria Kaprana • An investigation into the factors that facilitate early help-seeking behaviour for CHD related conditions among Chinese Elders in NW England • Zhenmi Liu

  27. Conclusions • Number of ongoing and developing projects • Opportunities for research development and involvement connected to the CLAHRC programme and other studies

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