Behind the Rituals
All posts from: July 2011
Would hospital patients benefit if those who were able were allowed to administer their own medicines? What do you think?
Self-administration of medicines schemes allow patients to continue to take their own medicines while in hospital. This maintains their independence and routines and allows health professionals to monitor how they take their medicine and offer advice and support.
However, in acute hospital wards, factors such as short length of stay and dependency of patients means opportunities for assessing patients to self-medicate are limited. As a result, patients who could benefit are overlooked.
In some trusts, models of care are being tried that assume all patients can self-administer their medicines rather than automatically assuming they cannot. It will be interesting to see the results of these “opt out” schemes.
Martin Shepherd, head of medicines management, Chesterfield Royal Hospital NHS Foundation Trust
Should healthcare professionals always be ‘bare below the elbows’? Are long sleeves an infection risk?
“Although there is a limited evidence base around the ‘Bare below the elbows’ directive I feel it is a common sense approach for both patients and staff. For example although making the link between transmission of potentially pathogenic organisms from jewellery, long sleeves etc may be difficult, jewellery can be a potential health and safety risk to both patients and staff. Stoned rings or watches can tear personal protective clothing such as gloves and can also scratch a patient during a care procedure. Long sleeves can also become contaminated with bodily fluids. In addition both make effective hand decontamination difficult where there is an evidence base about associated risks.”
Julie Hughes is a nurse consultant in infection control at 5 Boroughs Partnership NHS Foundation Trust - a specialist provider of mental health and learning disabilities services. She is also a Lecturer at the University of Chester.
What do you think?
It’s the most common sampling method in the UK, but does it have clinical value? Does moistening the swab increase bacteria survival in the wound? Is routine swabbing helpful?
Patients have long been told not to eat or drink for hours before surgery because of the risk of pulmonary aspiration, but is this really necessary?
Some studies have suggested that light meals and liquids are not harmful before surgery, and that fasting can sometimes cause adverse effects, but many guidelines continue to insist on complete fasting.
What do you think?