Clinical extra

Click the links below for the eight most recent Research and Development articles from Nursing Times. Articles are free to registered users for one month after publication, and available to subscribers thereafter. Older articles can be found in the Clinical Archive.

Research

Developing an information prescription service

Abstract
Hand, A. et al (2008) Developing an information prescription service. Nursing Times; 104: 39, 34–37.
Background: Availability and accessibility of high-quality information is inconsistent nationally and improving information is central to Department of Health policy. This article outlines an information prescription (IP) pilot.
Aim and Method: Using a quality-improvement cycle, feedback was gathered from stakeholders to develop an IP service for people with Parkinson's disease and their relatives/carers.
Results and Discussion: Generally, service users were satisfied with the information and felt it enabled them to better understand, manage and be in control of their condition. Despite initial concerns, health staff identified benefits to themselves and patients. Barriers to implementing IPs were discussed.
Conclusion: IPs are essential to patient-centred care and can lead to additional benefits for patients, relatives/carers and clinical services.

Evaluating protected time in mental health acute care

Abstract
Edwards, K. et al (2008) Evaluating protected time in mental health acute care. This is an extended version of the article published in Nursing Times; 104: 36, 28-29.
BACKGROUND: Despite increasing changes within mental health services, time spent with patients is still an issue of concern. A protected time initiative was introduced in a mental health acute care unit with an agreed protocol to enable nursing staff to spend more time with patients.
AIM: To investigate the implementation of protected time in the unit.
METHOD: Patients and nurses in four wards were invited to complete questionnaires.
RESULTS: Sixteen nurses and 17 patients responded. The results suggest a variety of reasons why nurses do not spend sufficient one-to-one time with patients. Patient responses were inconsistent and at times contradictory and the findings suggest nurse supervision needs to be more readily available.
CONCLUSION: A clearer understanding of protected time and a consistent approach are required, as well as venues that allow patients to discuss sensitive issues without being disrupted.

Exploring the health concerns of people taking methadone

ABSTRACT
James, P. et al (2008) Exploring the health concerns of people taking methadone. This is an extended version of the article published in Nursing Times; 104: 35, 26–27.
Background: Health promotion is an important aspect of nurses' work in addiction services. It encompasses a huge range of relevant topics. Previous research has demonstrated that clients with addiction problems have poor health compared with the general population. Those on methadone maintenance perceive their health negatively but continue to engage in behaviours likely to have negative health outcomes.
Aim: This article reports on a study to uncover the health concerns of clients attending a methadone maintenance programme in an addiction service in Ireland.
Method: The Health Concerns Questionnaire 3 was completed by 261 clients attending methadone maintenance clinics.
Results: The most endorsed items tended to be psychosocial health concerns, particularly mood-related items. Additional comments highlighted various health issues including hepatitis C, diet, and sexual and mental health.
Conclusion: Clients on methadone maintenance demonstrate a high level of health-related concerns. In particular, they were most concerned about mood and hepatitis C; these topics therefore merit attention from staff in addiction services. This research confirms that clients on methadone maintenance require regular screening and follow-up in relation to mood disorders and hepatitis C.

Development

Setting up a buddy scheme for pulmonary rehabilitation

Abstract
Hancock, P., Cox, K. (2008) Setting up a buddy scheme for pulmonary rehabilitation. Nursing Times; 104: 39, 31–33.
North East Lincolnshire Care Trust Plus's HOPE specialist service has developed one of the most successful pulmonary rehabilitation (PR) programmes nationally. One element of this service is the use of buddies (expert patients with COPD), who assist with the design and delivery of the programme, alongside the specialist multidisciplinary team. This service has some of the best patient outcomes seen nationally; it won two awards in December 2007. This article outlines how the service was established and its outcomes.

Evaluating palliative care skills for community matrons

Abstract
Bowler, M. (2008) Evaluating palliative care skills for community matrons. Nursing Times; 104: 38, 28–30.
The role of the community matron was developed to improve standards of care for people with complex long-term conditions. Initial emphasis was to support patients to help take control of their condition and reduce unnecessary use of urgent care services and hospital admissions.
The community matron caseload requires skill to balance the risks involved in keeping people in their own homes. Recent audits show that end-of-life planning and palliative care are crucial aspects of their work so matrons need training and support to ensure positive outcomes for patients at the end of life.

Using nitrous oxide and oxygen to control pain in primary care

Abstract
Gregory, J. (2008) Using nitrous oxide and oxygen to control
pain in primary care. Nursing Times; 104: 37, 24–26.
Improving pain control is an area where nurses have the clinical expertise to make a significant difference to the quality of patient care. The inhaled analgesic 50% nitrous oxide and 50% oxygen is ideal for use when undertaking short, potentially painful procedures as it is a safe and effective method of pain relief. Many patients in the community require procedures that can be extremely painful. This article describes how this analgesic has been successfully introduced throughout a PCT, through collaborative working between acute pain nurses based in the hospital setting and community nurses.

Developing a risk-assessment tool to improve patient safety

Abstract
Sud, H., Gorman, J. (2008) Developing a risk-assessment tool to improve patient safety. This is an extended version of the article published in Nursing Times; 104: 36, 26-27.
The Health Protection Agency has suggested that one in ten hospital patients experiences an incident that puts their safety at risk, around half of which could be prevented, and the RCN has identified the need to reduce nurses' paperwork considerably. This article reports a successful project that set out to tackle these two issues by developing a risk-based nursing assessment system that is simple to use, reduces unnecessary paperwork and reduces the risk of harm to patients.
It outlines how the initiative was introduced, as well as obstacles encountered during the process. The risk-assessment tool received positive feedback from nursing staff as it reduces paperwork while providing a risk-based assessment of care needs.