Digging For Dinosaurs: Change Idea

Presentation: Digging For Dinosaurs

Resource: Brown, C. E. (2012). Digging for Dinosaurs Contest: A Novel Strategy to Engage Nurses in Questioning Practice.

Change Management Strategy:  used a competition format to drive interest and engagement for ideas on removing ritualistic practices.

A strategy to engage nurses in practice change and the translation of evidence into practice.

Change ideas for nurses to reflect on clinical practice:

  • Why am I doing it this way????
  • Does it add value?
  • Improve quality of care?
  • Improve satisfaction?
  • Improve productivity?
  • Improve communication?
  • Improve motivation?

The aim was to aid nurses driving the change, engagement in research and evidence based practice.  Support is required from senior nurses to assist in the literature review process and any subsequent research projects. Setting up a project and completing ethics can be a time consuming process that the clinical nurse may require assistance.

This project is a great way to engage staff and encourage questioning of practice and aiding translation of evidence.


Brown, C. E. (2012). Digging for Dinosaurs Contest: A Novel Strategy to Engage Nurses in Questioning Practice.

Brown, G. H. (1993). The sacred cow contest. The Canadian Nurse89(1), 31-33.

Person-Centred Care Practice Development in Dementia

Person centred care has been promoted as best practice in dementia care, but the concept is still poorly defined. Four core themes, with the acronym (VIPS), have been described by Brooker (2006):

  • V –Valuing people with dementia and those who care for them
  • I – Treating people as individuals
  • P –Looking at the world from the perspective of the person with dementia
  • S – A positive social environment in which the person living with dementia can experience relative wellbeing.

The gold standard to aim for, but difficult to achieve? The important aspect for the hospital system to consider, is the interface where the chronic and acute care sections meet. Does the acute care sector meet the needs of chronic patients and provide opportunity for maintaining their independence and personal locus of control, or are admission/discharge targets the focus of ‘quality’ care? Individuals with dementia are likely to have higher risk for complications such as delirium, pressure sores, frailty, incontinence and risk of falls. Are extra specialist resources available to support such a high risk group within an acute care admission? Can acute care be delivered outside the hospital utilising an alternative healthcare model? Is it time to reconsider how health care is and will be delivered in the future? So many important questions for the acute care sector to consider in the drive for personalised healthcare.

The acute hospital setting is reliant on standardisation and checklists, but where do they fit in with person centred care? Do they provide a minimum standard or are too generalised and miss out marginal patient populations, such as elderly with dementia? So many questions, but hopefully the below resources will assist in answering person-centred care issues for delivering focused care for dementia populations.

Free Online Understanding Dementia Course

Understanding Dementia from The University of Tasmania


Brooker D. (2006) Person-centred dementia care: making services better. London: Jessica Kingsley Publishers.

Nilsson, A., Rasmussen, B. H. and Edvardsson, D. (2013), Falling behind: a substantive theory of care for older people with cognitive impairment in acute settings. Journal of Clinical Nursing, 22: 1682–1691.

McCormack, B., Dewing, J., & McCance, T. (2011). Developing person-centred care: addressing contextual challenges through practice development. OJIN: The Online Journal of Issues in Nursing Vol. 16, No. 2, Manuscript 3.

McCormack, B., Manley, K, & Garbett, R. (2008). Practice Development in Nursing. [sample here]

McCormack, B., Henderson, E., Wilson, V., & Wright, J. (2009). Making practice visible: the workplace culture critical analysis tool (WCCAT). Practice Development in Health Care, 8(1), 28-43.

McCormack, B., Manley, K., Kitson, A., Titchen, A., & Harvey, G. (1999). Towards practice development–a vision in reality or a reality without vision?. Journal of Nursing Management, 7(5), 255-264.

Harvey, G., Loftus‐Hills, A., Rycroft‐Malone, J., Titchen, A., Kitson, A., McCormack, B., & Seers, K. (2002). Getting evidence into practice: the role and function of facilitation. Journal of advanced nursing, 37(6), 577-588.

McCance, T., McCormack, B., Dewing, J., (May 31, 2011) “An Exploration of Person-Centredness in PracticeOJIN: The Online Journal of Issues in Nursing Vol. 16, No. 2, Manuscript 1.

Nursing Education Network. (2017).  Developing person-centred care: addressing contextual challenges through practice development.

Nursing Education Network. (2017). Practice Development in Nursing.


Fibonacci Numbers

Patterns, recurrance and mathematics. Not the usual source of inspiration for a post, but something intrigued me around the Fibonacci sequence and the links to nature, the body and the universe. One to mull over, although I have yet to work out in what context this may be used. Maybe just relate when watching the Da Vinci Code?

Fibonacci Sequence in Nature 

The Magic of Fibonacci Numbers

Fibonacci Numbers & The Human Body

Golden Number.net (2012). Fibonacci numbers and DNA

Park, A. E., Fernandez, J. J., Schmedders, K., & Cohen, M. S. (2003). The Fibonacci sequence: relationship to the human handJournal of Hand Surgery28(1), 157-160.

Persaud, D., & O’Leary, J. P. (2015). Fibonacci Series, Golden Proportions, and the Human Biology.

Wikipedia (2018) Fibonacci Numbers.

The Top Ten Websites in Critical Care Medicine Education Today (Journal Club)

Journal Club Article: Wolbrink, T. A., Rubin, L., Burns, J. P., & Markovitz, B. (2018). The Top Ten Websites in Critical Care Medicine Education TodayJournal of intensive care medicine, 0885066618759287.


Looks at the rapid growth of online educational resources in the critical care environment. From another review by Kleinpell et al (2011) which identified 135 websites, only 67 now are still available online. This demonstrates a rapidly changing environment and provides a rationale for this papers focus.


  • Literature review and web search.
  • Website assessment using the Critical Care Medical Education Website Quality Evaluation Tool (CCMEWQET).
  • Evaluation and ranking of identified websites.


  • 97 websites relevant critical care websites were identified and scored.
  • Common types of resources, included blog posts, podcasts, videos, online journal clubs, and interactive components such as quizzes.
  • Almost one quarter of websites (n 22) classified as Free Open Access to Medicine (FOAM) websites.
  • Top 10 websites analysed and described. “Most often included an editorial process, high-quality and appropriately attributed graphics and multimedia, scored much higher for comprehensiveness and ease of access, and included opportunities for interactive learning.”

The Top Ten 

In alphabetical order:

FOAM Highlight

“The majority of FOAM website domains were not educational, nonprofit, or governmental. The FOAM websites were updated more recently than the other critical care medicine educational websites” (pg. 5).


Kleinpell, R., Ely, E. W., Williams, G., Liolios, A., Ward, N., & Tisherman, S. A. (2011). Web-based resources for critical care educationCritical Care Medicine39(3), 541-553.

Olusanya, O., Day, J., Kirk-Bayley, J., & Szakmany, T. (2017). Free Open Access Med (ical edu) cation for critical care practitionersJournal of Intensive Care Medicine.

Wolbrink, T. A., Rubin, L., Burns, J. P., & Markovitz, B. (2018). The Top Ten Websites in Critical Care Medicine Education TodayJournal of Intensive Care Medicine. 0885066618759287.

Learning to Unlearn


To move into new domains of learning and knowledge there is a need for revolutionary thinking to be confident enough to rise to the challenge of moving into the unknown. Education from school to university and then into workplace, is normally planned and structured around a developmental trajectory as a persons skills, knowledge and experience increase. But what about the future and learning, if we don’t know the skills or knowledge that we will require, how do we unlearn any irrelevant information? This could be termed as a deimplementation process of learning. The process of unlearning becomes an important process in our learning skills repertoire.

From the organisation viewpoint comes the focus on becoming ‘learning organisations’, but maybe this could be supported with seeking new logic and a process of unlearning. “Unlearning is not about forgetting. It’s about the ability to choose an alternative mental model or paradigm” (Bonchek, 2016). The skill is recognising mental models that are no longer relevant or effective. This reflexivity of working with uncertainty could be benefited by utlising already well used practices such as self reflection, which could focus on considering any of our biases we hold and allowing change to occur as we move forward.

This post was inspired by the Twitter conversation below, thanks to @precordialthump.

Keywords: Unlearning; Reflexivity; Transformation; learning.


Bonchek, M. (2016).Why the Problem with Learning is Unlearning. Harvard Business Review.

Klein, E. J. (2008). Learning, unlearning, and relearning: Lessons from one school’s approach to creating and sustaining learning communitiesTeacher Education Quarterly35(1), 79-97.

McGregor, A. (2018). Unlearning: The key to the unlock 21st Century problems? International Teacher Magazine (ITM).

Gaming Addiction: Disorders Due to Addictive Behaviours

As education continues with an increasingly e-learning approach to delivery, its worthwhile to consider some of the precautionary aspects. Gamification and social media may enhance and offer different learning opportunities but the potential to create or exacerbate disorders due to addictive behaviours from gaming addiction, will need to be considered when delivering the e-learning approach and consideration of the well-being of students. Patterns of gaming behaviour when interfering with normal daily activities, and any changes in physical or psychological health will need to be monitored.

World Health Organisation: International Classification of Diseases (ICD)

Disorders due to addictive behaviours from gaming addiction:

“Gaming disorder is defined in the draft 11th Revision of the International Classification of Diseases (ICD-11) as a pattern of gaming behavior (“digital-gaming” or “video-gaming”) characterized by impaired control over gaming, increasing priority given to gaming over other activities to the extent that gaming takes precedence over other interests and daily activities, and continuation or escalation of gaming despite the occurrence of negative consequences” (WHO, 2018).


Symptoms to monitor:

  • impaired control over gaming (frequency, intensity, duration)
  • increased priority given to gaming
  • continuation or escalation of gaming despite negative consequences


Some questions around gaming:

  • Keen gamer or problem with addiction, at what point is too much and does age/maturity need to be factored into the guidelines?
  • How does a sensible mix of connectivity with social media, gaming, work and social time look?
  • The developing technology such as augmented reality (AR), simulation technology and virtual reality (VR). How will they be introduced and controlled?

A quick Google Scholar search using ‘gaming addiction’ shows there are plenty of research papers on this topical subject.


Petry, N. M., & O’brien, C. P. (2013). Internet gaming disorder and the DSM‐5Addiction108(7), 1186-1187.

Woodward, A. (2018). The World Health Organization Identifies Gaming Disorder as a Mental Health Condition. Futurism.com

World Health Organisation. (2018). Gaming Disorders.




Mix It Up Book Club: The Classics

Inspiration and thought can come from an array of sources. I have recently tried to make a focused effort on adjusting the balance of healthcare and normal reading material that I read, incorporating the classics onto my ‘to do’ reading list. This approach is part of that work/life balance ethos that can become skewed when all your focus is on studies or completing a work based project. Avoiding that path to burnout is key.

Book Club:

  • Orwell, G. (1945). Animal Farm. New American Library.
  • Orwell, G. (1950). 1984. New American Library.








Avoiding the clear political messages, the importance of finding individuality and choice is very real when one considers the way social media platforms may track and direct our focus. Will future generations have a multitude of choice when engaging in life and work in the online world, or will only a handful of multinational corporations exist?

Keywords: Big Brother; Thought Police; Totalitarian Dystopia; Orwellian.


Orwell, G. (1945). Animal Farm. New American Library.

Orwell, G. (1950). 1984. New American Library.

Penguin Books (2018). Your Classic Books Reading Challenge.

Wikipedia (2018) Nineteen Eighty-Four.