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Clinical news summary: Top nurse research and practice stories from October 2018

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Miss any of the clinical and practice news affecting the profession during October 2018? Catch up with our summary of the main study headlines and clinical breakthroughs.

 

Nurse-led care trumps management by GPs for treating gout

Gout

‘Invaluable’ guideline launched on gout management

Source: Bobjgalindo

Spiked rods of monosodium urate crystals photographed under polarized light from a synovial fluid sample

Nurse-led care with a more patient-centred approach appears to be more effective than GP-led care for successfully treating gout, according to researchers.

The study, by the University of Nottingham and the University of Sheffield, found nurse-led care significantly reduced flare-up frequency, improved quality of life and was more cost effective.

It indicated that keeping patients fully informed and involving them in care decisions was more successful in managing gout. The findings, published in The Lancet, also highlighted the importance of individualised patient education and engagement to treat the condition.

The researchers carried out a two-year trial to directly compare nurse-led care to usual GP-led care. More than 500 gout patients were randomly split between the two methods from more than 50 general practices.

“The nurses delivered recommended best practice that includes full patient information and engagement”

Michael Doherty

The nurses delivered an individualised package of care, which included a holistic assessment, a discussion of perceptions about the illness, full information about gout, for example its causes, consequences and treatment options, and patient involvement.

The study found that nurse-led care was associated with a much higher take up of urate-lowering therapies, with patients subsequently being more likely to stick to their treatment. At two years, 96% of the nurse-led group were on ULT, compared to 56% in the usual care group. In addition, 95% had urate levels below the required target level, compared to just 30% in the GP-led group.

Study author Professor Michael Doherty said: “The nurses delivered recommended best practice that includes full patient information and engagement and a treat-to-target strategy for urate-lowering treatment. Once fully informed almost all patients want urate-lowering treatment and continue to take it regularly. This results in gradual elimination of the urate crystals that cause gout.”

 

‘Eyeballing’ patients best predicts those most at risk of death in A&E

Intubation

One in three older patients may die following emergency intubation

A simple clinical assessment by an experienced nurse is “superior” to systematic triage in the emergency department, according to Danish researchers. They said “simply eyeballing” a patient may be more effective than a formal structured assessment to prioritise those most in need of urgent care.

 

NICE reveals raft of new primary care indicators for diabetes

Diabetes

Patients ‘at risk’ over failure to recognise diabetes subtype

The National Institute of Health and Care Excellence has proposed a raft of new primary care performance indicators aimed at improving diabetes care. Nine indicators could be added to next year’s Quality and Outcomes Framework – the payment scheme for general practice – of which eight are focused on diabetes. The other concerns atrial fibrillation.

 

Guide launched to ‘empower’ nurses treating complex TB patients

M. tuberculosis (stained red) in sputum

Tuberculosis

Source: CDC Public Health

Photomicrograph of a sputum sample containing Mycobacterium tuberculosis

A guide has been launched to help nurses better support patients struggling with life-limiting side effects such as hearing loss and fatigue from treatment for drug-resistant tuberculosis. It has been created by the International Council of Nurses and Curry International Tuberculosis Center.

 

New online tool launched to help nurses ‘prescribe exercise’

Sport, exercise, fitness, lifestyle and technology

Man with smartphone and earphones exercising on treadmill in gym

A database has been developed to arm nurses and other healthcare professionals with the knowledge and skills needed to confidently prescribe physical activity to patients. The Moving Medicine resource includes latest evidence for staff to access and feedback to patients on how exercise can be beneficial in the management and prevention of a variety of common conditions.

 

Trust introduces new highly accurate test for pre-eclampsia

Oxford University Hospitals NHS Trust

Nurse pleads guilty to sexually assaulting unconscious patients

John Radcliffe Hospital in Oxford

A blood test that predicts pre-eclampsia risk with a high level of accuracy has been given the green light to be used as standard clinical practice in one of the UK’s biggest acute hospital trusts. The test, which shows with almost 100% accuracy whether a pregnant woman will not develop pre-eclampsia within the following seven days, is being introduced by Oxford University Hospitals Foundation Trust.

 

Researchers advise against decongestants for colds in children

Paediatrics

Children

Decongestants should not be given to young children because there is no evidence they help clear up a blocked or runny nose and their safety is unclear, according to experts writing in the British Medical Journal.

 

New tool can identify heart failure patients at high risk of sepsis

Sepsis

Sepsis

A tool has been developed by Leeds University researchers to help identify heart failure patients at high risk of sepsis, which they say could catch cases early and save thousands of lives every year.

 

Nurses asked to adopt ‘non-prescription’ pads to cut antibiotics

Public Health England

Campaign recognises ‘key role’ of nurses in preventing infection

Nurses across England are being urged to get involved in the latest phase of a national campaign to tackle antibiotic resistance, including handing out “non-prescriptions” to patients. Public Health England’s Keep Antibiotics Working campaign, first launched last year, is back this autumn.

 

Study to investigate best timing of monitoring by nurses

record keeping nurse monitoring patient on bed

How often nurses should check blood pressure, temperature, respiration rate and other indicators is being examined by University of Portsmouth researchers. Their study, which has just started, aims to identify the ideal frequency of observations for safety while avoiding unnecessary extra work.

 

Domestic refrigerators ‘may pose risk to insulin quality’

Insulin/diabetes

Patients ‘at risk’ over failure to recognise diabetes subtype

Insulin syringes

Many people with diabetes may be unwittingly storing their insulin incorrectly inside their kitchen fridge, a study has found. German researchers suggested storing insulin in an ordinary kitchen fridge may harm quality because of changes in temperature.

 

Midwifery matron develops key pregnancy information app

MOMA

My Own Maternity App

The My Own Maternity App

(pic attached) A senior midwife at East Kent Hospitals University Foundation Trust has developed a smartphone app to enable families to access key pregnancy information at the touch of a button. The My Own Maternity App (MOMA) was spearheaded by midwifery matron Jo Olagboyega.

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