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Standard checklist for emergency patients to be introduced

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Nurses will have to follow a standard list of clinical checks for all NHS hospital emergency patients, under plans being developed by the Department of Health.

The DH is working with the Royal College of Nursing and other professional groups to produce the checklist, which will require clinicians to record whether checks such as venous thromboembolism risk assessment, vital signs and pain management had been carried out for every patient.

The plan is part of the NHS quality, innovation, productivity and prevention (QIPP) programme, which is intended to prepare the NHS for spending cuts while protecting and improving care. It is expected to be launched over the next couple of months.

The checklist is intended to improve safety by ensuring checks are carried out and also to help trusts prove they are doing them in order to qualify for bonus payments on quality. For example, from April, trusts will receive extra funding if they can prove they are risk assessing all patients for VTE.

RCN acute and emergency care advisor Alan Dobson, who has been involved in developing the checks, said it would also prevent the same checks being repeated unnecessarily at various stages of the emergency pathway, thus improving productivity.

He said: “There is some evidence that if we do this right we will get better outcomes and less duplication. We have being saying that these checks should happen for years and in some places it does happen every time. It shouldn’t be hit and miss, it should be standardised.”

Mr Dobson added that the plan reflected a shift to a clinical, quality motivated approach in acute emergency care, which would be supported by nurses.

Nursing Times understands the checklist may also be used to improve end of life care by requiring clinicians to answer what is known as “the surprise question” for each admitted patient. This refers to whether the clinician would be surprised if the patient died within a year of admission and, if not, plan for palliative and end of life care.

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