Act now to reduce impact of staffing crisisBehind the Rituals
Should falls be a “never event”? Or are some falls inevitable?
All hospital patients aged over 65 should be considered to be at high risk of falling and have an appropriate care plan drawn up, according to guidance from the National Institute for Health and Care Excellence.
This also applies to all patients aged 50 and above who have dementia, stroke, vision or hearing problems and other underlying conditions.
NICE said nurses and doctors should identify the individual risks of these patients to help reduce serious injury and death. For example, whether they had fallen previously, what drugs they are taking, and whether they had poor eyesight or problems with balance or walking.
Clinicians should then create a tailored plan to reduce the risk of falls – for example, by adjusting medication, offering alternative footwear and helping patients go to the lavatory.
The NICE guidelines also advise clinicians to encourage patients to use their bedside calling system and to explain to friends and relatives when and how bedrails might be adjusted.
What do you think?
- What measures have you introduced in your clinical area to reduce falls?
- Are some falls inevitable?
- Can falls prevention measures have a negative impact on rehabilitation?
- Do falls risk assessments change how care is delivered?
Does current nurse education reflect government aims to provide more care in the community?
They have warned of “widespread and significant” concerns over the number of district nurses currently being educated, stating that there simply are not enough coming through to replace those who are retiring.
‘Worryingly’ low numbers of district nurses being trained
What do you think?
- Are there currently enough district nurses to provide safe and effective care?
- Why are we lacking district nurses?
- Should more district nurse placements be included in pre-registration nurse training?
- Does current nurse education reflect government aims to provide more care in the community?
Do patients receive less care at the weekends?
New research has shown that patients who have elective surgery later in the week and at the weekend have a greater risk of dying. Previous studies have found there to be a significantly higher risk of death if patients are admitted as an emergency over the weekend compared with a weekday.
What do you think?
- Are there fewer nurses on duty at weekends?
- Do you have less experienced staff in charge of wards at the weekend?
- Is patient deterioration is more likely to be missed?
- Is there a lack of specialist care after 5pm on Fridays?
- Should specialist care be available seven days a week?
What training do you need to manage an intravenous infusion?
Article: NICE launches draft guidance on IV fluids for clinicians
Hospital patients who have problems with fluid balance are having their lives potentially put at risk by overstretched or under trained NHS staff, the National Institute for Health and Care Excellence has warned.
They have issued draft recommendations for management of intravenous infusions which are due to be published later this year.
What do you think?
- Do you have time to monitor and assess patients receiving intravenous fluids?
- Are patient ever put at risk because of poor management of intravenous infusions?
- Have you received any training to manage intravenous infusions?
- Do you feel fluid balance is adequately monitored in your clinical area?
Should nurses be on hand to help police in dealing with mental health offenders?
Article: Nurses to aid police with mental health offenders
Theresa May has unveiled plans for nurses to accompany police officers when they are dealing with those perceived to have a mental illness, particularly when it is likely the individual is going to be detained under the mental health act.
What do you think?
- Will this recommendation improve safety for mental health patients detained in police custody?
- Should the police be offered better training in dealing with mental health problems?
- Would it be more appropriate for those with the power to apply the MHA to accompany the police?
- Does this open up possibilities for senior nurses to have the power to section?
Does opening windows reduce infection rates?
We reported this week that the chance of infection in wards varies dramatically depending on whether nursing staff leave the windows open. A study by the University of Leeds and Bradford Teaching Foundation Trust looked at airflow in a disused “Nightingale” ward using tracer gases to simulate the spread of airborne infections.
They found ventilation in the ward was generally when windows were left open, keeping the danger of airborne infection low. But risks increased fourfold when the windows were closed.
Lead investigator Cath Noakes, from Leeds University, said: “These wards are still in operation and, although they have often been subdivided into smaller areas with six-eight beds, their ventilation and structure is still fundamentally the same.
“People are being told to seal up their buildings to save energy. If you do that without alternative ventilation systems, you could be increasing the airborne infection risk significantly,” she said.
The story produced an interesting response on Twitter:
@eileenshepherdgreat story …just goes to show that some of the old ways are still good Even open my windows at home after bed making !
— AgencyNurse(@AgencyNurse) May 13, 2013
@eileenshepherdFlorence was right all those years ago. High and low level ventilation (windows) evident in many Nightingale designs.
— Gary Thirkell (@pollygary) May 13, 2013
What do you think?
Should nurses undertake study in their own time?
Nursing is described as a profession, but terms such as “vocation” and “calling” are also used to describe the principles that attract people into nursing.
What do you think? Should nurses undertake study in their own time?
Is it safe to care for patients in 'hospital hotels'?
The proposals to ease so-called bed-blocking on NHS wards are based on a system used in Scandinavia, where services are run by private hotel chains.
NHS England, the new body responsible for recommending how local doctors’ groups should provide for their patients, has been asked to review the scheme.
An estimated 30,000 patients each year remain in hospital despite being well enough to be discharged.
What do you think? Will the scheme compromise patient safety?
Should patients be involved in nurses’ appraisals?
The new-style appraisal, which will also include feedback from patients, is being introduced in England by March 2014 as part of the Compassion in Practice national nursing strategy.
It follows a recommendation in the Mid Staffordshire Foundation Trust Public Inquiry report that common standards be developed for appraisals, including 360-degree anonymous feedback by colleagues and input from patients.
What do you think? Is this a good idea?
Should nurses accept education funding/grants from the drugs industry?
The money was paid to both NHS and private staff for consultancies, sponsorships and other interactions with drug businesses, according to the Association of the British Pharmaceutical Industry (ABPI).
According to a spokesperson, the money was paid for attending medical education events, training and development, and fees for services such as speaking engagements to share good clinical practice and participation in advisory boards.
What do you think? Should nurses accept education funding/grants from the drugs industry?
