Nursing needs its leaders to respond to FrancisPutting it into practice
All posts from: September 2011
What additional training do nurses need to carry out defibrillation?
- Article: Defibrillation 1: using an AED outside hospital. Nursing Times; 107: 38, early online publication.
- Author: Phil Jevon is resuscitation officer and clinical skills lead, Manor Hospital, Walsall.
Key points
- Most out-of-hospital cardiac arrests are caused by ventricular fibrillation or pulseless ventricular tachycardia. Electrical defibrillation is the only effective therapy for these.
- Prompt defibrillation can achieve survival rates as high as 75%. The chances of success decline by around 10% with each minute of delay.
- Automated external defibrillators (AEDs) are sophisticated, computerised devices that deliver defibrillatory shocks to a person in cardiopulmonary arrest.
- Before starting defibrillation, the patient’s chest should be exposed to allow correct placement of AED pads, and the chest should be dried if it is clammy or wet.
- All healthcare staff should be trained, equipped, and encouraged to perform defibrillation. AEDs should be easily accessible and not locked away.
Let’s discuss
- What additional training do nurses need to carry our defibrillation?
You might like to consider:
- Does your current CPR training cover defibrillation and is this annual update adequate to ensure you are competent to carry it out?
- How can you identify ventricular fibrillation (VF) or pulseless ventricular tachycardia
(VT)? - Outline the procedure and safety precautions for defibrilliation.
Follow the debate on Twitter #NTjournalclub
Are temporary ward staff cost effective?
- Article: Hurst K (2011) Are temporary ward staff cost effective? Nursing Times; 107: 37, early online publication.
- Author: Keith Hurst is an independent researcher and analyst from Nottinghamshire.
Key points
- More than half of UK nurses do temporary work.
- Wards with permanent staff only have less sickness absence and are better staffed.
- Wards with permanent and temporary staff have a greater workload than those with only permanent staff.
- Permanent staff-only wards have higher ward quality scores than those that also have temporary staff.
- Ward managers should monitor temporary staffing and its effects.
Let’s discuss
- Why do you think ward using agency and bank staff have lower quality scores than wards with permanent staff only?
To think about:
- How do you introduce temporary staff to your ward? How do you know this is effective?
- What strategies could you use to ensure temporary staff understand their role and
responsibilities in your ward team? - If you work as a bank or agency nurse what advice would you give ward staff about
introducing you to the ward and team?
Follow the debate on Twitter #NTjournalclub
Should registered nurses have their aseptic technique competency regularly reviewed?
- Article: ANTT: a standard approach to aseptic technique
- Author: Stephen Rowley is clinical director; Simon Clare is practice development lead, both at The Association of Safe Aseptic Practice.
Key points
- The Health and Social Care Act (2008) requires healthcare providers to have a standardised aspetic technique in which education and audit can be demonstrated
- Aseptic technique represents the last line of defence for patients from microorganisms during invasive clinical procedures
- Aseptic Non Touch Technique is the de facto standard aseptic technique in the UK
- Safe aseptic technique relies on effective staff training, safe environments and equipment that is fit for purpose
- Basic infection prevention precautions, such as effective hand hygiene and glove usage also help to ensure asepsis
Let’s discuss
- What does the term “aseptic technique” mean?
- Why is non-touch technique important?
- How can you achieve a standardised approach to aseptic technique in your trust?
- Should registered nurses have their competency to carry out this procedure reviewed regularly?
Follow the debate on Twitter #NTjournalclub
How could you assess the impact of venous leg ulceration on a patient's quality of life?
- Article: Developments in venous leg ulcer management. Nursing Times; 107: 35, early online publication.
- Author: Irene Anderson is senior lecturer, tissue viability, University of Hertfordshire; Susan Knight is Queen’s nurse and tissue viability specialist nurse, Milton Keynes Community Health.
Key points
- Leg ulcers are complex wounds and should be managed by skilled practitioners
- Factors such as age, obesity and co-morbidity can affect the effectiveness of treatment
- A better understanding of the benefits of different compression materials is needed
- Surgery may be appropriate for some patients
- Quality of life is an important issue and patients’ needs should be taken into account
Let’s discuss
- What is the role of obesity in the development of venous leg ulcers?
- How could you assess the impact of venous leg ulceration on a patient’s quality of life?
- What training and education do you think you need to manage venous leg ulcers effectively? When should you refer patients to a specialist service?
- Outline why is compression therapy used to treat venous leg ulcers?
Follow the debate on Twitter #NTjournalclub
