Miss any of the clinical and practice news affecting the profession during January 2018? Catch up with our summary of the main study headlines and clinical breakthroughs.
Fewer obs at night to avoid disturbing patients ‘may pose risk’
Nurses are deviating from early warning scoring systems and taking fewer vital signs at night so they do not disrupt patients’ sleep, which could be posing a risk to patient safety, according to a study.
“Efforts were made to support the longest possible period of uninterrupted sleep”
Researchers from Southampton, Portsmouth and Bournemouth universities highlighted that completing observations was key to reducing avoidable deterioration and that early warning scores were often used to decide how frequently this should be done.
But their study, based on interviews with 17 nursing staff at a district general hospital in England, found staff varied this routine at night to allow patients to sleep for longer.
While the frequency of night-time observations was mostly determined by clinical judgement, some nurses suggested they would also take fewer vital signs for non-clinical reasons, such as if patients had dementia and were more likely to disturb others when woken.
All of the participating nursing staff said supporting patients to sleep was a core part of their job. However, they also said taking vital signs was key to their role, meaning they faced a dilemma.
“Vital signs observations were not necessarily taken as frequently as the protocol required. Instead efforts were made to support the longest possible period of uninterrupted sleep,” said the researchers in the Journal of Clinical Nursing.
They acknowledged that the evidence for the frequency of observations set by early warning scores was still developing, but warned that believing that scores could be deviated from may threaten patient safety.
Nurses told to use paracetamol for acute sore throat, not antibiotics
swine flu home visit GP
Nurses should tell patients that most sore throats do not need antibiotics and to manage their symptoms with pain relief, such as paracetamol or ibuprofen, according to the National Institute for Health and Care Excellence and Public Health England. However, they noted that people with a sore throat caused by streptococcal bacteria were more likely to benefit from antibiotics and highlighted two scoring tools, FeverPAIN and Centor, as useful ways for prescribers to identify these patients.
Hospital trust rolling out symbol to improve end-of-life care
Hospital trust introduces new symbol to indicate end-of-life care
East Kent Hospitals University Foundation Trust has worked with a local hospice to introduce a new symbol to improve end of life care. The “compassion symbol” is displayed on wards when a person is expected to die within the next few hours or days, or if they have just died, to encourage an atmosphere of quiet and respect. It is also used on bags that contain a deceased person’s clothing.
Incorrect use of oxygen cylinders risking patient death
Trusts are being urged to ensure clinicians know how to operate oxygen cylinders correctly. In recent years cylinder design has changed, meaning staff may believe oxygen is flowing when it is not, or they are unable to turn the flow on in an emergency. Between January 2015 and October 2017, more than 400 safety incidents were reported following incorrect operation of oxygen cylinders.
Patient reminders ‘effective’ at boosting vaccination uptake
Nurse working phone
Reminding patients when their vaccinations are due or overdue increases the number of people being immunised, according to a Cochrane review led by nurse researchers. They highlighted that recent developments in digital technology meant reminders could be delivered in a range of ways, as well as via telephone, and could be routinely incorporated into primary care.
Night shift nurses at higher risk of developing common cancers
Night shift nurses at higher risk of developing common cancers
Female nurses who regularly work nights are significantly more likely to develop breast cancer and other common forms of the disease than those on day shifts, according to Chinese researchers. In particular, they found a “remarkable” increase in breast cancer risk with nurses on nights being 58% more likely to get breast cancer than colleagues on day shifts.
Use of video feedback by health visitors ‘helps vulnerable families’
Student video promotes understanding between nurses and patients
Use of video feedback by health visitors as part of their work with new parents strengthens the relationship between the infant child and the mother, according to Danish public health researchers. They said their findings underlined that when a health visitor reviewed the clips with the mother and talked about what was working well, it helped to promote the early establishment of relations.
New handheld device ‘to improve fundamental wound care’
moleculight ix 2
A new handheld wound assessment device developed in Canada is being launched across Europe to help nurses and other clinicians provide more effective care, according to those behind it. The MolecuLight i:X device uses fluorescent light to produce an image showing the location of bacteria in a wound when the technology is held over it.
Side effects significantly reducing adherence to diabetes drugs
Campaign recognises ‘key role’ of nurses in preventing infection
Many people with type 2 diabetes are not taking their medication due to unpleasant side effects including flatulence and diarrhoea, suggests a large-scale study. In particular, researchers from Surrey University found those on metformin were least likely to take the required dosage.
Risk of adverse drug reactions found to be ‘higher for COPD patients’
Patients with chronic obstructive pulmonary disease are at greater risk of adverse medication reactions, according to a Glasgow University study. It found COPD patients were more likely to be prescribed multiple medications linked to potential adverse effects like falls, bleeding, kidney damage, constipation, urinary retention, and drowsiness.
Tool launched to reduce ‘variability’ in dementia training quality
Dementia older person patient feed
Tailoring and face-to-face delivery are among the keys to providing effective training on dementia, according to researchers behind a new audit tool to assess courses. The tool’s development, led by Leeds Beckett University, was sparked by recognition of the wide range of training available that varied in quality. It has been launched by Health Education England to help standardise and improve the quality of training for nurses and other staff.
Lack of drinks leaving dementia patients ‘vulnerable’
Hydrated residents have better appetites because they are more alert
Patients with dementia are being given few opportunities to drink water on wards and in accident and emergency departments in London, leaving them “extremely vulnerable”, a review has found. Senior nurses, who peer reviewed six of the capital’s acute trusts, found it was not uncommon to see patients without fresh water or cups in reach.
Frail older adults ‘more likely to experience delirium after surgery’
Older adults who are also frail are twice as likely to experience delirium following elective surgery than others of an older age, a new review by Canadian researchers suggests. They found that a history of delirium, frailty and cognitive impairment were the risk factors for delirium.