Behind the Rituals
All posts from: February 2012
How do you define a safe staffing level? What do you think?
Most nurses believe that staffing levels have regularly dipped below safe levels over the last year and want mandatory ratios for the number of staff per patient introduced, according to a Nursing Times survey.
Asked whether staffing had regularly fallen below safe levels on their ward over the past 12 months, 72% of respondents said that it had.
The issue is explored in: Nurses warn of dangerous dips in safe staffing levels. Nursing Times. 15 February 2012.
Do red trays improve food intake? What do you think?
Many hospitals are introducing a red tray system at mealtimes to identify patients who need help or their dietary intake monitored. It was recently introduced at Norfolk Community Health and Care NHS Trust where patients with a specific dietary requirement have their meals served on an orange tray, while water jugs with red lids are provided to patients that require their fluids to be monitored.
However in this week’s practice comment Neil Wilson, senior lecturer at Manchester Metropolitan University asks whether red tray systems are putting a sticking plaster over the greater problems of poor nursing direction and leadership.
Wilson said: “The introduction of a vast amount of initiatives - such as “nutritionally screening” all patients on admission, even if the initial nursing assessment identifies they are at minimal risk of being nutritionally deficient - have increased the documentation workload for nurses. Alongside this, “red tray systems” and “red water jugs” for those at risk of dehydration/malnutrition have only proved to put a sticking plaster over the problem of poor nursing direction, leadership and the lack of management support for nursing quality care”.
Are there any circumstances where covert administration of drugs is acceptable? What do you think?
The NMC Standards for Medicines Management state: “As a general principle, by disguising medication in food or drink, the patient is being led to believe they are not receiving medication, when in fact they are. The NMC would not consider this to be good practice. The registrant would need to be sure what they are doing is in the best interest of the patient, and that they are accountable for this decision”.
The issue is explored in the NMC “Advice on Covert administration of medicines: Disguising medicine in food and drink”
Does telehealth threaten the nurse/patient relationship? What do you think?
The Queen’s Nursing Institute has launched a new drive to encourage district nurses to make the best use of new communications technology such as telehealth systems. A report published by the institute said some district nursing teams had already made significant changes to their practice as a result of new technology but others lagged behind.
The report said: “The first, and possibly the biggest issue is the attitudes of professionals to the adoption of new technologies, and their readiness to embrace such changes to practice.”
It cited a Royal College of Nursing survey from 2010 in which 20% of 1,300 respondents thought an electronic patient record could be a “threat” to the nurse-patient relationship.
But the report said communications technology was becoming part of “mainstream” community nursing provision and was “no longer just a series of interesting pilot projects”.
QNI director Rosemary Cook said: “Technology is transforming the way that care is delivered, as well as the relationship between the patient and the professional.
“It doesn’t replace the nurse, or the need for a high level of both clinical skills and interpersonal skills in community nurses. Technology only works for patients when it is combined with expert, relationship-based care.”