Ms Wendy Padley

Job: Research Assistant

School/department: School of Nursing and Midwifery

Address: Edith Murphy Building De Montfort University The Gateway Leicester LE1 9BH

T: +44 (0)116 2013917

E: wpadley@dmu.ac.uk

W: www.dmu.ac.uk/hls

 

Personal profile

Wendy's particular interests lie in the following fields:
  • Qualitative research
  • Literature reviewing.

Publications and outputs 

  • Development of a tool to support managers in planning and evaluating staff training
    Development of a tool to support managers in planning and evaluating staff training Padley, Wendy; Long, Jaqui; Welyczko, Nikki; Dowsett, Deborah; Salter, Nick; Ford, Karen; Greenway, Carol; Brown, Jayne Aim To explore decision-making and evaluation strategies used by healthcare managers in relation to staff training and education, and to develop a tool to support managers with these tasks. Method Using snowball sampling, 30 healthcare managers in a variety of healthcare settings were recruited and interviewed using semi-structured interviews. Data were transcribed and analysed using thematic analysis. Findings Four overarching themes were identified in relation to decision-making regarding staff training: the nature and characteristics of courses relevant to practice; the effect of practice requirements for education and training; staff motivation and interest; and the process of staff selection for training. Managers did not use formal, structured processes to make decisions about staff selection for training, nor to evaluate the outcomes of the training. Instead, they largely relied on their personal experience, knowledge and professional judgements. Based on these findings, the study team developed the Assessment, Planning and Evaluation of Training (APET) tool to support the planning and evaluation of training, and they invited feedback from healthcare managers. Positive feedback suggests that this tool could support managers’ decision-making in relation to planning and evaluating staff training. Conclusion Healthcare managers’ decision-making in relation to the planning and evaluation of staff training relied on judgements based on their personal experience and knowledge. The APET tool developed by the study team has the potential to ensure vital resources such as time and money are used optimally, which would improve outcomes for staff, patients and healthcare organisations.
  • Towards LGBTQ-affirmative cancer care and support: Barriers and opportunities
    Towards LGBTQ-affirmative cancer care and support: Barriers and opportunities Williamson, I. R.; Fish, Julie; Wildbur, D.; Bell, Katie; Padley, Wendy; Brown, Jayne Background: Survey data suggest that LGBT people report lower levels of satisfaction with healthcare for cancer than heterosexuals. This presentation summarises findings from recent qualitative research to understand the experiences of British LGBT people with cancer and their long-term partners. Methods: Participants were recruited through 5 oncology units at British hospitals, 2 cancer support charities and through media campaigns. In-depth interviews typically lasting between 45 and 75 minutes were carried out with 31 cancer patients who identified as lesbian (N=13), gay (N=14), bisexual (N= 3) and queer (N=1) and 9 long-term partners of cancer patients who identified as lesbian (N= 5), gay (N= 2) and trans* (N=2). Data were analysed through thematic analysis. Findings: Three themes are presented: Understanding the Motives, Meanings and ‘Mechanics’ of Disclosure explores how decisions around whether to ‘come out’ as LGBTQ are influenced by several factors including anticipated stigma, perceived moral or political ‘obligation’ and the manner of healthcare professionals. Creating and Communicating LGBTQ-Affirmative Spaces outlines anxieties faced by LGBTQ patients in interactions with staff and patients in clinical spaces such as waiting-rooms and hospital wards and the desire for more explicit evidencing of an anti-discriminatory culture. Finally Seeking LGBTQ-tailored Information and Support shows how current cancer support typically fails to meet psychosocial and psychosexual needs of LGBTQ patients. Discussion: The findings can be used to influence policy and practice by statutory and voluntary agencies to ensure that effective oncology treatment is accompanied by an holistic understanding of the needs and concerns of LGBTQ patients
  • Promoting good outcomes in Lesbian, Gay and Bisexual cancer care: a qualitative study of patients’experiences in clinical oncology
    Promoting good outcomes in Lesbian, Gay and Bisexual cancer care: a qualitative study of patients’experiences in clinical oncology Fish, Julie; Williamson, I.; Brown, Jayne; Padley, Wendy; Bell, Kathleen; Long, J. EXECUTIVE SUMMARY Cancer inequalities, including differences in cancer outcomes and patient satisfaction, affect a range of groups including lesbian, gay and bisexual (LGB) people. In its strategy to reduce these inequalities, the Department of Health commissioned the Cancer Patient Experience Survey (CPES) providing baseline data in which LGB patients were more likely to say their experiences were less positive than those of heterosexual patients. These differences included accessible information, psychosocial support and the human rights concerns of dignity and respect. The CPES, which was carried out in four successive years (2010-2014), suggesting that these are intractable problems, found that LGB patients were more likely to disagree with statements such as they ‘never felt treated as a set of cancer symptoms rather than as a whole person’ or the ‘doctor never talked about me as if I wasn’t there’. The CPES did not collect qualitative data and consequently the reasons for these differences were not known. This De Montfort University study, funded by Macmillan, illuminates some of the reasons for these survey findings as we were able to gather people’s accounts of their treatment and care. This report identifies key moments in the cancer journey where care provided for LGB cancer patients can contribute to their recovery and well-being. Alongside this evidence of unmet need, NHS England (2017) has recently issued guidance to support the introduction of mechanisms for recording sexual orientation across all health services in England for patients over 16. It recommends that sexual orientation monitoring occurs at every face to face contact with the patient. The collection of this monitoring data has implications; not only for cancer professionals, but also that patients themselves understand why this information is being requested. The report draws on LGB cancer patients’ motivations and methods for disclosing their sexual orientation and the perceived benefits of doing so for their quality of life. The findings will contribute to understanding the health benefits of coming out and how disclosure might be facilitated in hospital settings. This study provides compelling data about some of the factors underpinning inequalities in the experiences and, potentially, cancer outcomes for LGB patients. Managing the worry about whether it is safe to disclose their sexual orientation to professionals and the uncertainty about how this will be received presents an additional burden for LGB people with cancer. Participants in this study were sometimes hesitant to disclose because the opportunity did not arise or they were uncertain about its relevance. The report identifies some moments that matter in the care relationship where professionals could seek to facilitate disclosure thus contributing to Achieving World Class Cancer Outcomes (Department of Health, 2015) for LGB patients. In addition, the findings point to the importance of creating an inclusive care environment; participants noted that even in the Cancer Centres of Excellence, there were few visible signs of inclusion for LGB cancer patients. Steps to promote inclusion may entail a diversity policy statement, imagery on walls or the display of a LGB staff network on a hospital notice-board. participants also shared experiences where they were accepted in an everyday manner by hospital staff. They often talked about a whole hospital approach where they were acknowledged by staff from porters, health care assistants, nurses and consultants. These cancer narratives also highlight the need for LGB cancer support groups and tailored resources. The lack of LGB support groups in the UK mean that some participants were coping with their cancer with few forms of social and emotional support and they found few sources of information which addressed their needs. There was a clear demand for a greater range of LGB support resources that were relevant to the challenges and concerns of specific cancer types and reports of rather patchy provision in this regard, with differences influenced primarily by geographic location and cancer type. Finally, our findings suggest that participants had heterogeneous expectations of cancer care requiring complex .skills from professionals. Yet there is little or no curricula content in university programmes of Medicine or Nursing. This might suggest a lack of recognition of distinctive cancer care needs and may explain why participants reported different patient experiences even within the same hospital. The inclusion of research with LGB patients alongside heterosexual populations and relevant case studies to underpin Learning and Development and Continuous Professional Development to inform understanding of patient experience, psychosocial concerns and cancer risk is urgently needed.
  • Development of a tool to support managers’ decision-making and evaluation of staff education and training
    Development of a tool to support managers’ decision-making and evaluation of staff education and training Padley, Wendy; Long, J.; Welyczko, N. Managers have a key role in ensuring staff are trained effectively so they can carry out their work to a high standard (Alvarez et al 2004, Duffield et al 2011). However, within the last five years, a number of high profile reports in England have identified significant failings in healthcare delivery and made recommendations to improve workforce education and training to enhance safety, quality and patient outcomes (Keogh 2013, Francis 2013, Cavendish 2013, Imison et al 2016). Indeed the UK Health Select committee in January 2018 stated that ‘Health Education England must reverse cuts to nurses’(House of Commons 2018) continuing professional development budgets. Funding allocated to trusts should be specifically ring-fenced for continuing professional development (CPD) for nurses, and specific funding should be made available to support CPD for nurses working in the community.’ They indicated they had heard ‘a clear message (…) that access to continuing professional development plays an important role in retention’ (House of Commons 2018). Operating in a climate where both time and financial resources are limited, it is important that managers make informed decisions about staff education and training which demonstrate value for money as well as improved service quality. However, factors such as competing organisational priorities and managers’ own time constraints may impact on their ability to make such decisions and to evaluate the outcomes of training attended. Decision making takes place in a variety of ways which include, but are not limited to, appraisals. This can result in choices which do not best serve staff, the patient or the organisation. In this context, a tool to aid managers’ decision-making regarding staff training may be valuable.
  • An exploration of the experience of using the TENA Pants product compared to usual continence products as perceived by carers of people with dementia in care homes
    An exploration of the experience of using the TENA Pants product compared to usual continence products as perceived by carers of people with dementia in care homes Knifton, Chris; Bell, Katie; Padley, Wendy; Brown, Jayne Abstract: Incontinence is a common symptom experienced by many older people with dementia, with an increased prevalence noted in care home settings when compared to community dwellings. Incontinence may often be a reason for care home admission. Absorbent continence pads are a common form of intervention with this client group. However, disposable continence pants are becoming more common and TENA Pants are one such example. Research Aim: To understand what are the key product satisfaction indicators for absorbent continence pads; and in light of this review the experience of using the TENA Pants product compared to currently used continence products with people with dementia in care homes. Methods: A review of the literature was undertaken to identify factors reported to affect user experience of absorbent continence pads. These results led to the development of a pre and post carer intervention questionnaire that focused on user satisfaction, which together with a semi-structured interview, reviewed a 4 week user trial of the TENA pull-up pants. Findings: Overall, high satisfaction levels with the product were recorded suggesting this to be a suitable continence product for people with dementia residing in care homes. However, the qualitative data showed that satisfaction with the pads was greatest when used with people in the early and mid-stages of disease progression. Three key factors were found to account for the highest percentage of satisfaction and as such are likely to become key predictor variables for good quality and satisfaction when developing absorbent continence pads for this client group, as well as key points for product development and marketing. These were: • Absorbent pads are comfortable to wear when they are dry • Absorbent pads need to be designed so they can be easily fitted and removed • Absorbent pads need to control odour well • Considerations for further research in this area are also discussed.
  • Do surgical care bundles reducethe risk of surgical site infectionsin patients undergoing colorectalsurgery? A systematic review andcohort meta-analysis of 8,515 patients
    Do surgical care bundles reducethe risk of surgical site infectionsin patients undergoing colorectalsurgery? A systematic review andcohort meta-analysis of 8,515 patients Tanner, Judith; Padley, Wendy; Assadian, O.; Leaper, David; Kiernan, Martin BACKGROUND: Care bundles are a strategy that can be used to reduce the risk of surgical site infection (SSI), but individual studies of care bundles report conflicting outcomes. This study assesses the effectiveness of care bundles to reduce SSI among patients undergoing colorectal surgery. METHODS: We performed a systematic review and meta-analysis of randomized controlled trials, quasi-experimental studies, and cohort studies of care bundles to reduce SSI. The search strategy included database and clinical trials register searches from 2012 until June 2014, searching reference lists of retrieved studies and contacting study authors to obtain missing data. The Downs and Black checklist was used to assess the quality of all studies. Raw data were used to calculate pooled relative risk (RR) estimates using Cochrane Review Manager. The I(2) statistic and funnel plots were performed to identify publication bias. Sensitivity analysis was carried out to examine the influence of individual data sets on pooled RRs. RESULTS: Sixteen studies were included in the analysis, with 13 providing sufficient data for a meta-analysis. Most study bundles included core interventions such as antibiotic administration, appropriate hair removal, glycemic control, and normothermia. The SSI rate in the bundle group was 7.0% (328/4,649) compared with 15.1% (585/3,866) in a standard care group. The pooled effect of 13 studies with a total sample of 8,515 patients shows that surgical care bundles have a clinically important impact on reducing the risk of SSI compared to standard care with a CI of 0.55 (0.39-0.77; P = .0005). CONCLUSION: The systematic review and meta-analysis documents that use of an evidence-based, surgical care bundle in patients undergoing colorectal surgery significantly reduced the risk of SSI. open access article
  • ‘This wound has spoiled everything’: Emotional capital and the experience of surgical site infections
    ‘This wound has spoiled everything’: Emotional capital and the experience of surgical site infections Tanner, Judith; Padley, Wendy; Brown, Brian J. In this article we explore the experience of suffering from a surgical site infection, a common complication of surgery affecting around 5 per cent of surgical patients, via an interview study of 17 patients in the Midlands in the UK. Despite their prevalence, the experience of surgical site infections has received little attention so far. In spite of the impairment resulting from these iatrogenic problems, participants expressed considerable stoicism and we interpret this via the notion of emotional capital. This idea derives from the work of Pierre Bourdieu, Helga Nowotny and Diane Reay and helps us conceptualise the emotional resources accumulated and expended in managing illness and in gaining the most from healthcare services. Participants were frequently at pains not to blame healthcare personnel or hospitals, often discounting the infection’s severity, and attributing it to chance, to ‘germs’ or to their own failure to buy and apply wound care products. The participants’ stoicism was thus partly afforded by their refusal to blame healthcare institutions or personnel. Where anger was described, this was either defused or expressed on behalf of another person. Emotional capital is associated with deflecting the possibility of complaint and sustaining a deferential and grateful position in relation to the healthcare system. ‘This is the peer reviewed version of the following article: Brown, B., Tanner, J. and Padley, W. (2014) ‘This wound has spoiled everything’: Emotional capital and the experience of surgical site infections. Sociology of Health and illness, 36, (8), pp. 1171–1187. which has been published in final form at http://dx.doi.org/10.1111/1467-9566.12160. This article may be used for non-commercial purposes in accordance With Wiley Terms and Conditions for self-archiving'.
  • English hospitals under report SSIs
    English hospitals under report SSIs Tanner, Judith; Padley, Wendy; Kiernan, Martin; Leaper, David; Baggott, Rob; Norrie, Peter We thank Lamagini and colleagues for their interest in our paper. These authors from the HPA claim that we are misinformed and lacking in understanding. Yet, our criticisms are the same as those expressed by the Public Accounts Committee and the DH Advisory Committee on HCAIs. Even the European Centers for Disease Control says the English SSI surveillance system ‘lags’ behind the rest of Europe. The SSI surveillance data published by the HPA does not include post discharge surveillance (save for readmission data in the mandatory scheme) which account up to 80% of SSIs. This results in the ‘true’ scale of SSIs being hugely under reported. As length of stay after surgery continues to fall this becomes ever more important. An SSI surveillance system which does not include post discharge surveillance is akin to describing the size of iceberg by measuring only the part seen above the water.
  • A benchmark too far: findings from a national survey of surgical site infection surveillance
    A benchmark too far: findings from a national survey of surgical site infection surveillance Tanner, Judith; Padley, Wendy; Kiernan, Martin; Leaper, David; Norrie, Peter; Baggott, Rob Background The national surgical site infection (SSI) surveillance service in England collates and publishes SSI rates that are used for benchmarking and to identify the prevalence of SSIs. However, research studies using high-quality SSI surveillance report rates that are much higher than those published by the national surveillance service. This variance questions the validity of data collected through the national service. Aim To audit SSI definitions and data collection methods used by hospital trusts in England. Method All 156 hospital trusts in England were sent questionnaires that focused on aspects of SSI definitions and data collection methods. Findings Completed questionnaires were received from 106 hospital trusts. There were considerable differences in data collection methods and data quality that caused wide variation in reported SSI rates. For example, the SSI rate for knee replacement surgery was 4.1% for trusts that used high-quality postdischarge surveillance (PDS) and 1.5% for trusts that used low-quality PDS. Contrary to national protocols and definitions, 10% of trusts did not provide data on superficial infections, 15% of trusts did not use the recommended SSI definition, and 8% of trusts used inpatient data alone. Thirty trusts did not submit a complete set of their data to the national surveillance service. Unsubmitted data included non-mandatory data, PDS data and continuous data. Conclusion The national surveillance service underestimates the prevalence of SSIs and is not appropriate for benchmarking. Hospitals that conduct high-quality SSI surveillance will be penalized within the current surveillance service.
  • Patient Narratives of Surgical Site Infection: Implications for Practice
    Patient Narratives of Surgical Site Infection: Implications for Practice Tanner, Judith; Padley, Wendy; Davey, S.; Murphy, K.; Brown, Brian J. Background: Exploring patients’ experiences has been used widely within healthcare to improve clinical service delivery. To date there has been minimal patient input of this kind into aspects of surgical site infection (SSI), such as surveillance or prevention interventions. Aim: To obtain information from patients’ experiences of SSIs to improve clinical practice. Methods: Narrative interviews with 17 patients with SSIs (four deep, 12 organ space and one superficial) from three hospitals in England were conducted followed by thematic content analysis. Results: Patients lacked overall awareness, concern and understanding of SSIs. Seven patients did not know that they had SSIs and, judging from patients’ accounts, staff may have contributed to the lack of awareness by not informing patients of SSIs or downplaying their existence. The use of primary care resources was considerable and six of the patients were absent from work for two to four months. Conclusions: SSIs have a low profile among patients which, if it were raised, could increase compliance with preventive interventions. This study confirms the appropriateness of using patient self-assessment post-discharge surveillance questionnaires to identify SSI symptoms, and highlights the need to identify total costings including to primary care, patients and the economy.

Click here to view a full listing of Wendy Padley's publications and outputs.

Key research outputs

Williamson, I.R., Fish,J., Wildbur, D., Bell, K., Padley, W. & Brown, J. (2018) Towards LGBTQ-affirmative cancer care and support: Barriers and opportunities [Oral Presentation]. 32nd Conference of European Health Psychological Society, Galway, Ireland, August 2018.

Fish, J., Williamson, I., Brown, J., Padley, W., Bell, K. and Long, J. (2018) Promoting good outcomes in Lesbian, Gay and Bisexual cancer care: a qualitative study of patients’ experiences in clinical oncology. Leicester: De Montfort University.

Tanner, J., Padley W., Kiernan M., Leaper D., Norrie, P., Baggott R. (2013) A benchmark too far: findings from a national survey of surgical site infection surveillance.

Tanner J., Padley W., Davey S., Murphy K., Brown B. (2012) Patients' experiences of surgical site infection.

Tanner J., Padley W., Davey S., Brown B., Murphy K. (2012) Patient narratives of surgical site infection patient narratives of surgical site infection.

Tanner J., Padley W., Davey S., Brown B., Murphy K. (2012) Utter despair: patients’ experiences of surgical site infection.

 

Research interests/expertise

Qualitative methods,  thematic analysis, interviewing in sensitive subjects, mental health; psychotherapy.

Areas of teaching

Literature searching, reviewing.

Qualifications

MA Psychotherapy, MBACP

MSc Library and Information Studies

Membership of professional associations and societies

Chartered Member, Chartered Institute of Library and Information Professionals

Member, British Association of Counselling and Psychotherapy

Externally funded research grants information

  • The patient experience of surgical site infection: Infection Prevention Society, qualitative interview based project, March 2011 - March 2012, research assistant (literature search, interviewing, writing up/dissemination).
  • Prototype skin preparation solution clinical trial: Molnlycke Health Care, clinical trial, July 2011 - November 2011, research assistant (lab work, carrying out trial work).

Internally funded research project information

Infection Control in the Ambulance Service: RIF award, background information audit, June 2011 - January 2012, research assistant (carrying out information audit and scoping exercise).

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