Miss any of the clinical and practice news affecting the profession during July 2017? Catch up with our summary of the main study headlines and clinical breakthroughs.
Hospitals failing on nurse ratios for non-invasive ventilation
Less than a third of hospitals are meeting recommended nurse to patient ratios for treating those on non-invasive ventilation (NIV), according to an in-depth investigation.
A ratio of one nurse to two NIV patients is recommended by the British Thoracic Society, but the new review found compliance with this was the exception rather than the rule.
As well as concerns about “inadequate” levels of nursing, it also warned about “inappropriate” locations in which NIV was delivered and poor recording on ventilator settings and changes to them.
Ensuring appropriate NIV treatment was available in hospitals was of “major importance”, said the National Confidential Enquiry into Patient Outcome and Death. “Sadly, our study found that this was not always the case.”
The NCEPOD study was based on feedback from 162 hospitals, 430 questionnaires from clinicians and 350 sets of case notes. Less than half of the 79 hospitals that responded said they had a defined ratio of nurses to NIV patients, and just 53 used a ratio in line with the BTS recommendations or better. In 17, the ratio was one nurse to three or more patients.
Hospitals failing on nurse ratios for non-invasive ventilation
The reviewers also found NIV treatment was often delayed due to poor recognition of which patients would benefit from it. For example, they found cases where NIV was commenced but palliative care would have been a more appropriate option.
A key part of the problems with organisation surrounded the “wide variation” in where hospitals provided NIV. It was delivered in intensive care or specialist respiratory high dependency units in some, but in others it was given on the medical wards, raising concerns with the reviewers.
On a similar theme, the review found staff from a variety of professional groups and at different grades made changes to ventilator settings and took arterial blood gas samples.
NCEPOD chair Professor Lesley Regan said: “For clinicians, we would like to emphasise the importance of case selection, regular patient assessment, specialist involvement and a clear understanding of the clinical factors that influence treatment outcome.”
Charity funds more genetics nurse posts
New heart charity fund pays for more genetics nurse posts
Specialist nurses are to play a key role in delivering a new nationwide genetic testing service for hypertrophic cardiomyopathy. The Northern Ireland Inherited Cardiac Conditions service, based at Belfast Health and Social Care Trust, is the first of six specialist centres to receive funding from the Miles Frost Fund. It will see 14 posts created, including seven specialist cardiac genetic nurse roles. The service was launched in July by the British Heart Foundation and the family of Sir David Frost, whose son Miles died from the inherited condition. (Pictured: Belfast cardiomyopathy specialist nurse Liz McKeever with patient Maire Gorman)
Cardiovascular risk from infections
A&E overcrowding risk to prompt sepsis treatment
Pneumonia or sepsis in adults that results in hospital admission is associated with a six-fold increased risk of cardiovascular disease in the first year, according to Swedish researchers. They found cardiovascular risk was more than doubled during the second and third year following the infection and persisted for at least five years. “Preventative therapies such as statins could be investigated,” said the study authors.
Smoking cessation training for nurses
Nurses will have access to training on helping patients quit smoking as part of a new national anti-tobacco drive, which also calls on them to promote cessation at every opportunity. All health professionals should be “engaging with smokers to promote quitting” and there will be a “drive forward” on smoke-free policies in all hospitals, mental health facilities and prisons, said the government’s new tobacco control plan.
NICE set to back new drug for severe asthma
A new drug for patients with severe asthma has taken a significant step towards being made available on the NHS. The National Institute for Health and Care Excellence has published draft guidance recommending reslizumab (Cinqaero) for adult patients with severe eosinophilic asthma. NICE said it had heard the drug could reduce exacerbations and oral corticosteroid use.
Insulin device aids diabetes control
Insulin device makes ‘huge difference’ to diabetes control
A device designed to help patients with diabetes safely manage their insulin can have a “dramatic” impact, with reductions in missed injections and double doses, according to nurse researchers at Cardiff University. The NeedleBay device allows patients to prepare needles a week in advance and provides a visual reminder of when to take injections, meaning they feel more in control, found a study led by Professor Molly Courtenay (Pictured, right, with patient Carole Terrett and Andrew Tasker, chief executive of Diabetes Care Technology, which developed the device).
Advanced nursing roles should be explored
What works to change culture in care depends most on local leadership and staff competence
Advanced practice nursing roles should be properly evaluated as a potential approach for improving outcomes for older people with cancer, University of Southampton researchers have suggested. Specialist and advanced nursing roles were among the most “promising interventions” for delivering high-quality targeted care to older people with cancer, they said in the journal BMJ Open.
Exercise programme aids sleep after chemo
A six-week exercise programme can help cancer patients get the sleep they needed to recover from chemotherapy and prepare for surgery, according to a UK study. Researchers found quality of sleep, amount of sleep and amount of time spent lying down were better among bowel cancer patients who had done a “prehabilitation” programme consisting of 40 minutes of interval training on an exercise bike, alternating from moderate to severe intensities.
Impulse side-eff ects from Parkinson’s drug
Compulsive gambling, excessive sexual urges and obsessive shopping are among side effects from a Parkinson’s disease drug that specialist nurses should watch out for, said the National Institute for Health and Care Excellence. Its updated guideline on diagnosing and treating Parkinson’s in adults includes new advice on monitoring and managing “impulse control disorders”. It highlighted that such side effects could sometimes result from dopamine therapy.