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Clinical news summary: Top nurse research and practice stories from May 2017

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Miss any of the clinical and practice news affecting the profession during May 2017? Catch up with our summary of the main study headlines and clinical breakthroughs.


Call to boost midwife training in vital foetal monitoring


Midwifery staff must receive better training in how to interpret measures of baby heart rates and contractions to reduce the risk of stillbirth or injury, experts have warned.

“There shouldn’t be a brick wall around obstetrics and a brick wall around midwifery”

Eddie Morris

The issue relates to the ability of NHS staff to properly understand cardiotocograph, or CTG, readings of a baby’s heart rate and mother’s contractions.

There are hundreds of NHS negligence claims each year showing a failure to properly monitor and respond to warning signs in foetal heart rates. Significant concerns have been raised by coroners about training standards and ministers launched an investigation in April into five baby deaths at Shrewsbury and Telford Hospitals Trust.

The Nursing and Midwifery Council said student midwives must be able to demonstrate they were competent to monitor mothers and babies during labour. But an NMC spokeswoman noted that “concerns have been raised around the type and consistency of specific training in CTG tracing interpretation”. “We have recently commenced a wholesale review of our pre-registration midwifery standards and will be developing new standards of competence,” she said.

Mandy Forrester, head of quality and standards at the Royal College of Midwives, warned that an NHS shortage of 3,500 midwives was putting staff under significant pressure. “If you are not able to provide one-to-one care there is more scope for error,” she said.

Eddie Morris, vice president for clinical quality at the Royal College of Obstetricians and Gynaecologists, said trusts needed to focus on multi-disciplinary training to reduce errors. “If we can get a team to function better, then a lot of what we see in terms of CTG misinterpretations would be significantly reduced,” he said. “There shouldn’t be a brick wall around obstetrics and a brick wall around midwifery.”


Kent critical care nurses using social media to spread best practice on sepsis

East Kent Hospitals University NHS Foundation Trust

Nurses using social media to spread best practice on sepsis

Grace McMahan and Debbie Higgs

Nurses at East Kent Hospitals University NHS Foundation Trust are successfully using social media to share best practice and ideas. The nurse-led critical care outreach team’s innovative use of social media has included uploading video clips featuring advice from nurses and other clinicians on various topics and, in particular, sepsis. “We use Facebook and Twitter, both of which enable us to share ideas and help get across best practice,” said critical care consultant nurse Debbie Higgs (pictured right, with senior sister Grace McMahan).


Sepsis care in A&E improving but faster treatment needed

Discharge after being in critical care is the start of a long recovery process for patients

Discharge after being in critical care is the start of a long recovery process for patients

Sepsis care is improving but treatment needs to be faster, according to an audit by the Royal College of Emergency Medicine of 13,129 adults presenting to 196 accident and emergency departments. It identified a steady improvement in use of the “Sepsis Six” care bundle. However, the report also found standards were not yet being met by all A&Es. For example, 44% of patients did not receive antibiotics within an hour of arrival. RCEM president Dr Taj Hassan “strongly” recommended that all A&E nursing and medical staff read the audit report.


New test finds one in three hypertensives in UK failing to take prescribed medication

blood pressure monitoring hypertension hypotension patient assessment

One in three patients high blood pressure are failing to take medication as prescribed by their healthcare professionals, according to a new study by UK researchers who used an innovative new test. The study used a novel urine test, which was designed by University Hospitals of Leicester Trust and Leicester University, to help to diagnose adherence to blood pressure medications. The study, involving 1,400 hypertensive patients, saw the test used to find that non-adherence to prescribed medications was around 30-40%.


Cartilage supplement ‘as good as NSAIDs’ for knee pain

knee replacements

knee replacements

High grade chondroitin sulfate is as good as non-steroidal anti-inflammatory drugs for treating painful knee arthritis, according to researchers who suggest it could be a safer long-term treatment. Their findings are based on a clinical trial involving more than 600 patients with symptomatic knee osteoarthritis from five European countries.


‘Invaluable’ guideline update launched on gout management


‘Invaluable’ guideline launched on gout management

Spiked rods of monosodium urate crystals

Urate-lowering drugs should be offered to all gout patients early in the course of their disease, according to updated clinical guidance from the British Society for Rheumatology. It warned that gout was becoming more common but continued to be poorly managed in both primary and secondary care. It said the most “important change” from the previous version of its guidance was recommending that “curative” treatment with urate-lowering drugs should be offered to all patients early, rather than waiting for them to develop troublesome, disabling symptoms.


MI patients without heart failure gain no beta-blocker benefit, finds UK study


The established practice that all heart attack patients should routinely receive beta-blockers has been challenged by UK researchers. Myocardial infarction patients without heart failure given beta-blockers did not live any longer than those who did not receive the drugs. The study authors, from the University of Leeds, noted that beta-blockers could have unwanted side-effects.


Increase in ‘premature and preventable’ deaths found in Australian care homes

chair elderly stick falls

At least 15% of deaths among nursing home residents are premature, usually injury-related, and potentially preventable, according to Australian researchers. They said their national study was the first in the world to look at potentially preventable deaths in nursing homes using information from medico-legal investigations. Of the deaths reported over 13 years, 3,289 were from preventable causes and almost all were unintentional – with 81.5% of these linked to falls and 7.9% to choking.


Baby boxes and education cut bed-sharing in early infancy

North Middlesex University Hospital NHS Trust

London hospital adopts Finnish-style baby boxes

Baby Alen, three days old, tries a baby box at North Middlesex Hospital

The introduction of baby boxes and sleep education reduces risky bed-sharing between parents and babies in the first week of infancy, according to a US study. It found face-to-face education about safe infant sleep, combined with a free cardboard baby box, reduced the rates of bed-sharing during babies’ first eight days of life. In Finland, giving new mothers the boxes for their babies to sleep in has been credited with reducing infant deaths. Imperial College Healthcare Trust began trialing baby boxes last year. A number of other trusts have since adopted the idea.



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