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Clinical news summary: Top nurse research and practice stories from April 2019

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Miss any of the clinical and practice news affecting the profession during April 2019? Catch up with our summary of the main study headlines and clinical breakthroughs.

 

Nurse-led A&E pilot ‘improving cardiac care and cutting admissions’

Derriford hospital

Derriford hospital

Plymouth’s Derriford Hospital

Early evidence suggests a nurse-led scheme to assess and support people with heart conditions while in accident and emergency is helping slash A&E admissions.

“Early intervention from a specialist nurse is really beneficial to patients”

Becky Horne

The project at Derriford Hospital – run by University Hospitals Plymouth Trust – has seen heart failure nurses review patients soon after they come into the emergency department.

As a result, many people have been able to return home safely without being admitted.

The three-month pilot, devised by the hospital’s heart failure nursing team, set out to examine the impact of earlier input from specialist nurses for those with a primary or secondary diagnosis of heart failure, atrial fibrillation or irregular heartbeat, and other cardiac conditions.

“Early intervention from a specialist nurse is really beneficial to patients, as in many cases they can be sent home with a package of care and can avoid having to stay in hospital. In terms of patient experience, this is the best possible outcome,” said lead heart failure specialist nurse, Becky Horne.

“We are able to directly admit patients to the most appropriate specialist ward”

Becky Horne

During the first two weeks of the pilot, which got under way in March, heart failure nurses assessed more than 30 patients in the emergency department.

They were able to provide the majority – 91% – with advice or care packages allowing them to return home. The admission rate during this time plummeted from 70% to just 9%.

“In the reducing number of instances where admission is necessary, we are able to directly admit patients to the most appropriate specialist ward,” said Ms Horne. “This is better for patients as it speeds up their onward journey, bypassing a transitional stay in an assessment unit.”

 

Re-using tourniquets poses patient safety risk, warn researchers

Tourniquet

Military tourniquet practice could save lives and limbs in civilians

The majority of tourniquets used in peripheral venepuncture may contain microbes which could put patient safety and care quality at risk, warn researchers from Portugal. They found that most of the neatly 1,500 tourniquets that were inspected in their study contained microbes.

 

Curtains revealed as source of drug-resistant bacteria transmission

Privacy curtain

Hospital curtains

The contamination of privacy curtains with multidrug-resistant organisms is a common problem and could be a source of disease transmission to patients, warn US researchers. They noted that patient privacy curtains were surfaces that were subjected to frequent touching but were only cleaned infrequently.

 

Study advocates using hand rub with three steps for 15 seconds

Glasgow Caledonian University

Six-step hand-washing technique ‘most effective’

Applying hand rub with three steps for 15 seconds is as effective at reducing bacteria as the six steps for 30 seconds recommended by the World Health Organization, according to Swiss researchers. They found the shortened 15-second application time and a simpler three-step technique for use of alcohol-based hand rub was as effective at reducing bacteria and could improve hygiene compliance.

 

Call for caution over prescribing antibiotics for UTIs in A&E

Generic drugs

Source: Evgeny Rannev

Most accident and emergency patients with a suspected urinary tract infection and who are treated with antibiotics actually lack evidence of this infection, warn researchers from University College London. They found that only one third of patients that enter the A&E department with suspected UTI actually have evidence of one, yet almost all are treated with antibiotics.

 

Metformin ‘reduces’ risk of heart disease in non-diabetic patients

g0fctj heart failure index

g0fctj heart failure index

The commonly used diabetes drug metformin could reverse the harmful thickening of heart muscle that leads to cardiovascular disease, according to researchers. A study by the University of Dundee suggests metformin has the potential to be repurposed as a heart disease treatment in non-diabetic patients.

 

Drug ‘reduces’ risk of kidney failure for type 2 diabetes patients

Kidney Xray anatomy

Kidney Xray anatomy

A landmark clinical trial has provided “renewed optimism” for patients with type 2 diabetes and kidney disease, after researchers found a drug reduced the risk of renal failure by almost a third. In the study, researchers found that the drug canagliflozin minimised the risk of end-stage kidney disease in people with type 2 diabetes by 30%.

 

NICE decision aid encourages choice of ‘greener’ asthma inhalers

Short-acting beta-agonists

Woman using her asthma inhaler

Nurses should consider encouraging asthma patients to choose an inhaler that is both best for them and also the environment, according to the National Institute for Health and Care Excellence. A patient decision aid, released last month by NICE, provides information to help people with asthma and their healthcare professionals discuss their options for inhaler devices.

 

CBT can provide ‘better’ relief for irritable bowel symptoms

IBD

Crohn’s and colitis

Cognitive behavioural therapy tailored specifically for irritable bowel syndrome is more effective in relieving the symptoms than usual care, according to researchers at the University of Southampton and King’s College London. Their study suggested tailored CBT delivered over the phone or through an interactive website was more effective in relieving the symptoms of IBS than standard care.

 

Care home study will see if seated exercising improves health

mental health depressed elderly woman wheelchair

mental health depressed elderly woman wheelchair

Volunteer residents at a care home are taking part in a new study aimed at assessing whether exercising while seated can improve the health and wellbeing of frail older adults. The study, called Keeping Active in Residential Elderly, is being conducted by the University of Birmingham.

 

Obesity often leaves people feeling ‘dehumanised’, finds study

weighing scales

weighing scales

People who are obese are not only stigmatised but are being left feeling “blatantly dehumanised”, according to researchers. A study, conducted at the University of Liverpool, examined whether people believed individuals with obesity were less evolved and human than those without obesity.

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