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Nurses vital in coronary care plans

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Doctors must be more receptive to nurse involvement in drawing up multidisciplinary care plans, say nurses following a report published this month.

The profession has a key role to play in improving care for patients following coronary artery bypass grafting, which
is not currently being realised, according to the National Confidential Enquiry into Patient Outcome and Death (NCEPOD).

It examined care experienced by patients in 39 NHS and 19 independent sector hospitals. NCEPOD’s report says that, although mortality rates remain low at around 2%, patients are still losing out on quality care due to a lack of coordination between different teams.

The authors reviewed 821 sets of case notes. Only four of the 58 units had a protocol for multidisciplinary case planning and only 21 had pre-operative multidisciplinary team meetings, they found.

Ian Martin, lead clinical coordinator at NCEPOD, said: ‘The nursing profession needs to be involved in planning protocols and appropriately configured care plans.

‘The nursing profession is good at leading in this area – they could help devise care plans that are integrated with pre-assessment through the whole process of care.’

But nurses said doctors were often unwilling to sign up to the idea of integrated care plans. Alison Pottle, cardiology nurse consultant at Royal Brompton and Harefield NHS Trust in London, said: ‘Sometimes medical staff are not so keen.

If you don’t have agreement across the disciplines they will not work as well.’

RCN acute care adviser Mike Hayward said: ‘Some of our medical colleagues need enlightenment in terms of the potential of multidisciplinary work, particularly from advanced nursing roles.’

Cutbacks in specialist nursing roles has prevented integrated care plans being implemented properly, he added.

‘We need more specialist nurses but the funding is not there,’ he said.

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