Putting it into practice
Dalphinis J (2013) Physical and social causes of hypothermia. Nursing Times; 109: 49/50, 12-15.
Hypothermia has a number of physical and social causes, particularly among older people. It is vital that nurses are aware of these risk factors. This article explores the causes of hypothermia, preventive measures, clinical signs and immediate treatment in the community.
5 key points
- Hypothermia is defined as a core temperature of 35oC or less
- It is difficult to estimate the role of hypothermia in excess winter mortality figures
- Hypothermia has multiple causes including environmental issues, physical ill health and drug therapies
- Thorough health and social assessment is needed to identify those at risk
- Patients diagnosed with hypothermia need immediate emergency care
What do you think?
- Think about your patients. How many have risk factors for hypothermia?
- What should you consider when you assess at risk patients?
- What preventative measures would you recommend?
- What emergency measures should you take if you suspect a patient has hypothermia?
More information about temperature measurement is available in our archive:
- Measuring body temperature
- What is the evidence base for the assessment and evaluation of body temperature?
Our assessment skills section provides useful information on all aspects of patient assessment:
Hawley CJ et al (2013) The effect of single-sex wards in mental health; Nursing Times; 109: 48, 20-22.
The need for single-sex accommodation in mental health trusts has been widely expressed in documents from the NHS Executive and in national and local policies. This case study describes the effects of changing two mixed-sex wards into single-sex wards.
Two mixed-sex inpatient wards were reorganised into two single-sex wards. Qualitative data on staff views was gained from semi-structured interviews and collected.
Staff and patients appear to have made the transition from mixed to single-sex wards with relatively few problems. Staff described differences emerging between the male and female wards, with the male ward becoming calmer, while the female ward became more disruptive.
Overall, the implementation was successful. We suggest that in general single-sex wards are just as effective as mixed-sex wards and, in some respects, may be better.
What do you think?
- What are the advantages and disadvantages of single-sex accommodation?
- Why do you think the female ward became more disruptive while the male ward became calmer?
- Should all mental health wards be single-sex?
Hamer S, Cipriano P (2013) Involving nurses in developing new technology. Nursing Times; 109: 47, 18-19.
“Throughout history, nurses have been accepting of change and adapted to new ways of working. Despite this, nursing has a reputation of being obstructive to change, particularly around technology.
“Healthcare technology implementation is not always successful and we argue that this is because nurses and other frontline workers are not involved enough in the change process. Nurse leaders need to be actively involved in the debate over appropriate technology and resources.”
- Do nurses have a reputation for being “obstructive to change”?
- What technology and resources would help you improve patient care?
- Is emphasis on developing healthcare technology taking away from compassionate care?
Peterken C (2013) Hospital nurses’ role in smoking cessation. Nursing Times; 109: 46, 16-19.
“This article discusses how a stop smoking adviser role enhanced the smoking cessation service already offered at Lewisham University Hospital.”
- What role should hospital nurses play in smoking cessation?
- Do hospital nurses have time to advice on health promotion?
- Why does motivation often drop off once patients are discharged?
We’re going to be discussing smoking cessation in a #NTtwitchat Special on Tuesday 19 November. The Association of Respiratory Nurse Specialists and The British Lung Foundation will be joining us to answer your questions.
You can email questions over in advance to nursingtimesGA@gmail.com.
Winkley K (2013) Depression and diabetes: what should nurses do? Nursing Times; 109: 45, 20-22.
“Depression is recognised as a major health problem for people with diabetes and is associated with morbidity, mortality and a poor quality of life. This article outlines how depression is diagnosed, its consequences and how to screen for and treat it. It also gives some practical tips that nurses can use to support patients with diabetes who have depression.”
What do you think?
- Do patients with long-term conditions receive enough emotional support?
- Are diabetes specialist nurses well placed to screen for depression?
“Catheter-associated urinary tract infections (CAUTI) are a major cause of morbidity in hospitals worldwide. Urethral catheters coated with antimicrobial substances such as silver alloy and nitrofurazone were introduced as a strategy to reduce CAUTI. A previous Cochrane review reported that antimicrobial-coated or impregnated catheters may reduce the number of asymptomaticbacteriuria present, but it was uncertain whether they reduced CAUTI.
“The Catheter Trial compared these catheters with standard catheters for short-term use in NHS hospitals, in terms of CAUTI reduction. The results showed that silver alloy-coated catheters did not reduce symptomatic CAUTI compared with standard catheters, while nitrofurazone-impregnated catheters had borderline clinical benefit in reducing symptomatic CAUTI. The findings do not support the routine use of antimicrobial-coated or impregnated catheters for patients who need short-term catheters in hospital. Health professionals should instead focus on simple preventative strategies and reducing the need for catheterisation.”
- Do antimicrobial-coated catheters provide misplaced reassurance?
- Why are catheter related infections still so common?
Brownhill KM (2013) Training care homes to reduce avoidable harm. Nursing Times; 109: 43, 20-22.
This article discusses a project of introducing training to unregistered health professionals working in a care home.
“This article demonstrates the effectiveness of using workshop-based education and service-improvement models in care homes. The models were designed around both threshold and predictive modelling and were intended to raise awareness of the symptoms that may result from a fall, pressure ulcers or urinary tract infections.
“The project exceeded our targets. Preventive assessments, care planning and timely referrals resulted in a reduction in avoidable hospital admissions and district nurse and GP visits.”
- What do you think of this project?
- Should care home staff all have the same, compulsory training?
- Should care homes decide on their own level of training?
- What problems could this sort of project incur?
Bayliss-Pratt L et al (2013) Confidence in leadership among the newly qualified. Nursing Times; 109: 42, 15-16.
“The Francis report highlighted the importance of strong leadership from health professionals but it is unclear how prepared those who are newly qualified feel to take on a leadership role. We aimed to assess the confidence of newly qualified health professionals working in the West Midlands in the different competencies of the NHS Leadership Framework. Most respondents felt confident in their abilities to demonstrate personal qualities and work with others, but less so at managing or improving services or setting direction.”
- Do these findings surprise you?
- How can existing nurses help newly qualifieds feel more confident in their leadership ability?
- Is it important for new nurses to feel able to lead?
Jackson H (2013) Motivational interviewing and HIV drug adherence. Nursing Times; 109: 41, 21-23.
“Despite advances in HIV treatment, adherence rates remain low, with only around 50-70% of those who should be taking antiretroviral therapy fully concordant with the treatment regimen.
“This article explores why this might be. It analyses the literature on motivational interviewing, and its effectiveness in improving patient adherence to antiretroviral therapy in the treatment of HIV.”
- Why is HIV drug adherence low?
- What role can health professionals play in encouraging adherence?
Author: Lyn McIntyre is deputy director: patient experience, at NHS England Midlands and East.
“A strategic health authority cluster-wide programme was established in 2011 with the aim of minimising occurrences of avoidable grade 2, 3 and 4 pressure ulcers. This aim was achieved using an engagement programme, a SSKIN care bundle for frontline staff, a pressure ulcer collaborative and a communications campaign. This article focuses on the communications campaign developed to support the SHA ambition, discussing the social marketing approach used and describing some of the resources developed to raise awareness among staff. Implications for practice are highlighted.”
- Have you tried anything similar in your place of work?
- Do health professionals always know how to prevent pressure ulcers
- Are pressure ulcers always avoidable?