Putting it into practice

Key points

• Patients’ perspectives on care are vital to improving the quality of NHS services
• Patients occasionally give feedback on the way student nurses have cared for them, but usually in an ad hoc way
• Developing a structured tool allows patients, carers and relatives to become part of the student nurse assessment process
• Patients can evaluate communication, comfort, and treating individuals with respect
• It is not appropriate to request feedback from some patients, for example those who are sedated or too ill

Let’s discuss

• How can structured patient feedback help in student assessment?
• How could patient feedback affect the relationship between the student and patient?
• What aspects of a student nurse’s care should patients assess?
• Could patient feedback be used to assess registered nurses performance?

• Poor physical and mental health is often related to modern lifestyles with a lack of exercise, poor diet, stress and isolation
• Outdoor activities can help people relax, reduce stress and instil a sense of wellbeing
• Exercising in a green space is more beneficial than forms that concentrate on exertion without considering the surroundings
• Promoting outdoor activity could save money through fewer medical interventions, prescription drugs and hospital admissions

• Do you agree outdoor activities should be a treatment option for some patients

Think about a patient you are caring for with a long-term condition:

• How would you explain the benefits of outdoor activities to them?
• What sort of activity would you encourage them to participate in?
• How could you evaluate whether the activity has had a positive impact on their health?

• The principles of the Mental Capacity Act 2005 should be followed by all staff caring for people who may lack capacity to make healthcare decisions
• Many people with learning disabilities can make healthcare decisions with support, such as the use of simple language and pictures, to communicate
• A mental capacity assessment must be carried out to determine whether individuals have the capacity to make adecision, and before any decisions can be made on their behalf
• The nurse or doctor is usually responsible for best-interests decisions, with input from patients’ families and carers
• Health professionals should try to limit restrictions on patients’ families and carers
• Health professinals shoult try to limit restrictions on patients’ rights nad freedoms y avoiding any form of restraint, unless it is in the patients’ best interests

• Do general nurses understand the needs of people with learning disabilities when they are admitted to hospital with health problems?
• In your experience, are people with learning disabilities are involved in decisions about medical treatment?
• How would you assess whether a patient with learning disabilities has the capacity to make a decision about their medical treatment?
• How would you explain a best interest decision to relatives and carers?

1. What problems do you have with traditional off duty? Think about incorporating requests, holidays, bank and agency staff.
2. How could e-rostering improve management of staff time in your clinical area?
3. How can e-rostering promote fairer off duty planning and improve staff morale?
4. How would you explain the benefits of e-rostering to your team?

• Evaluating the strengths and weaknesses of NHS workforce planning methods
• How do those charged with delivering safe care ensure safe staffing?
• How to manage the staff duty roster

• Since 2005-06, there has been a 465% increase in outpatient attendances at specialist nurse clinics – a rise of more 100,000 outpatients a year
• Patients appear to value the services provided by specialist nurses; they are consistently rated better than those of other health professionals
• The role and function of specialist nurses, services they provide and their effects should be described and measured accurately
• Specialist nurses need to ensure that they have evidence their services are cost-effective and improve patient safety and services
• The unique knowledge, skills and experiences of specialist nurses means they could play a vital role in commissioning

• What value do specialist nurses add to care of patients in your ward, department or team?
• What evidence could you use to demonstrate their value to managers or service commissioners?
• Do specialist nurses have appropriate business skills to justify the services they provide?
• Do you think specialist nurses are at greater risk of cuts in times of financial austerity than general nurses?