Month: March 2014
Grand Round: 19 March 2014
On Wednesday, 19th March 2014, the Grand Round will feature a presentation by Rachel Ruddy, entitled ‘Dementia‘.
The lecture takes place at 1:00pm
in the lecture theatre, 1st Floor, Macclesfield District General Hospital. It will be preceded by a hot buffet from 12:15pm, this meeting is sponsored by Astra Zeneca. Due to only having one sponsor the food will be limited.Next week , the Grand Round topic on Wednesday, 26th March 2014 will be a presentation by Dr I Losa entitled ‘Recent advances in immunisation’.
Concern over missing hospital patient
Extract from the Macclesfield Express 17 Mar 2014 11:19
The 52-year-old has not been seen since leaving the hospital, where he was receiving treatment, at around 10am Sunday. Police are urgently searching for a man who has gone missing from Macclesfield Hospital.
He is described as a white man, around 5ft 8in tall with short hair and stubble. He was last seen wearing a black coat, brown trousers and brown shoes.
Anyone with information should call Macclesfield Police on 101.
BMJ Best Practice: Hep B update
- Featured updated topic: HepatitisB
For the latest updates and best practice for hepatitis B, see the update summary below.
Best Practice writes “Most people with hepatitis B infection are asymptomatic, although some present with complications such as cirrhosis, hepatocellular carcinoma, or liver failure. Serological markers are essential in making the diagnosis and evaluating disease activity, including for differentiation of acute and chronic infection, and for identifying chronic asymptomatic carriers. Therapy for acute infection is almost always supportive care alone. However, some patients with acute infection may develop liver failure, and these patients may require referral to liver transplant centre. Therapy for chronic infection includes nucleoside/nucleotide analogues, interferon-alfa, and pegylated interferon-alfa”. Click for more.
Eyes on Evidence topics for March
This month from NICE, Eyes on Evidence topics as follows:
Blood oxygen levels in preterm infants
One randomised controlled trial reports that preterm infants with low blood oxygen levels have higher mortality at discharge than infants with high levels. However, a second randomised controlled trial finds no difference in mortality on the basis of blood oxygen level.
Premature mortality in people with epilepsy
A Swedish total population study finds that people with epilepsy are at increased risk of premature death, with the risk even higher among those with psychiatric disorders.
Oral contraceptive pills in preventing ovarian cancer
A meta-analysis reports a lower incidence of ovarian cancer in women who have ever used oral contraceptive pills than in women who have never used oral contraceptives.
Tamsulosin for benign prostatic hyperplasia and risk of severe hypotension
An observational study suggests that tamsulosin for benign prostatic hyperplasia is associated with an increased risk of severe hypotension during the first 8 weeks after both starting and restarting treatment.
Socioeconomic disadvantage and onset of disabling chronic conditions in childhood
A longitudinal study of census data from England and Wales shows a link between socioeconomic disadvantage in early childhood and later development of disabling chronic conditions.
Evidence Updates
NICE has recently published Evidence Updates on:
- Patient experience in adult NHS services
- The epilepsies
Terminally ill people not receiving the right care
Difficult conversations with dying people and their families
This survey of over 1,000 GPs reveals that terminally ill people are not getting access to the right care when they need it. The report highlights issues surrounding round-the-clock care with families reporting having to chase after prescriptions, nurses waiting hours for vital drugs to arrive, and locums unable to prescribe.
Nursing Technology Fund Success for East Cheshire NHS Trust
Extract from NHS England article
In October 2012 the Prime Minister announced the establishment of a Nursing Technology Fund to support nurses, midwives and health visitors to make better use of digital technology in all care settings, in order to deliver safer, more effective and more efficient care. The funding was to be allocated to providers in two rounds. The first round, for £30m, was for funding to be spent in FY13/14.
East Cheshire’s application was one of 226 received from a total of 139 Trusts. Following evaluation by a panel of senior nurses, 75 Trusts have been awarded funding totalling almost £30m for 86 projects. A list of successful applications is available to download.
EAST CHESHIRE NHS TRUST
- Accelerating Integrated Care and improving Nursing Agility and Care Quality with mobile working – £734,97
- Bedside e-Observation System – £725,030
NHS Networks: The Staff Friends and Family Test
NHS England’s vision for Staff FFT is that all staff should have the opportunity to feedback their views on their organisation at least once per year. It is hoped that Staff FFT will help to promote a big cultural shift in the NHS, where staff have further opportunity and confidence to speak up, and where the views of staff are increasingly heard and are acted upon.
The Staff FFT was developed by NHS England and a working group made up of representatives from provider trusts, staff side representatives and NHS Employers. Draft guidance was circulated across the NHS in December 2013 and views were sought from academic experts working in the field of staff engagement.
For the first year, NHS England has adopted a flexible approach to how organisations may implement the Staff FFT. This decision has been taken as a result of feedback received and because it is important that Staff FFT is an improvement tool which works at a local level.
Research has shown a relationship between staff engagement and individual and organisational outcome measures, such as staff absenteeism and turnover, patient satisfaction and mortality; and safety measures, including infection rates. The more engaged staff members are, the better the outcomes for patients and the organisation generally. It is therefore important that we strengthen the staff voice, as well as the patient voice.
The key principles of Staff FFT, the full guidance for implementation, and a list of frequently asked questions are provided below.
Further information/supporting publications
BMJ Learning available through Google+
If you are one of the millions of people with a Google+ account, you may be interested to know that BMJ Learning also uses it as a platform to share its expertise and learning modules via posts, articles and You Tube videos. Simply adding BMJ Learning to ‘your circles’ – your chosen subscriptions, enables you to stay up-to-date most easily.
Urology topics from BMJ Learning
Click on any of the links below to complete these online modules from BMJ Learning
- Idiopathic constipation and nocturnal enuresis in childhood: a guide to management – in association with NICE
- Lower urinary tract symptoms in men: a guide to management – in association with NICE
- Erectile dysfunction: diagnosis and treatment
- Managing patients at risk of prostate cancer: in association with the NHS prostate cancer management programme
- Urinary tract infection in children: diagnosis, treatment, and long term management – in association with NICE
BMJ Learning: Stroke – differential diagnosis
Take a look at this module available online from BMJ
Scenario:
You review a 53 year old woman because earlier in the day she had an episode where she experienced zigzag lines at the periphery of her vision. Her husband witnessed the event and reports that, at the time, she was “talking nonsense”. This lasted several minutes, and then she noticed pins and needles in her left arm. What is the most likely diagnosis? And what would you do? Not sure? — then complete the module below.
