End of Life Journal – Spring Issue 2013

End of Life Journal is the free, online, peer-reviewed, quarterly journal that publishes articles on all aspects of nursing practice relating to end-of-life care.   It is primarily aimed at generalist nurses working in hospital, community and care home settings. However, many articles will also be of interest to the specialist palliative care nursing audience as well as members of the wider multidisciplinary team.   The journal focuses on care for patients with both malignant and non-malignant disease and their family and friends.

Articles include:endoflife_logo

CLINICAL REVIEW

CLINICAL SKILLS

CLINICAL PRACTICE DEVELOPMENT

ETHICAL/LEGAL DISCUSSIONS

NURSING CASE REVIEW

NATIONAL END OF LIFE CARE PROGRAMME UPDATE

This month in Eyes on Evidence

Data from the National Joint Registry for England and Wales indicates high failure rates for metal-on-metal hip replacements.
A Cochrane review shows cognitive stimulation therapies have beneficial effects on memory and thinking in people with dementia, as well as positive effects for wellbeing.
Developing more integrated support for people with mental and physical health problems could improve outcomes, by recognising the role of emotional and mental health problems in reducing people’s ability and motivation to manage their physical health.

Do renin-angiotensin system drugs reduce mortality in hypertension?

This systematic review provides good quality clinical evidence that  angiotensin-converting enzyme inhibitors reduce the risk of death in patients with hypertension. The benefits of angiotensin receptor blockers in reducing mortality are uncertain.
Angiotensin receptor blockers (ARBs) are no better than placebo or angiotensin-converting enzyme  inhibitors in reducing the risk of death, disability, or hospital admission for any reason. However, more patients stopped treatment early with ARBs than with placebo due to side effects.
An example from the Quality, Innovation, Productivity and Prevention collection on how the University Hospitals of Leicester NHS Trust has reduced delays, complications and costs around central venous access for patients.
Potential disinvestment opportunities highlighted this month are:
  • Biofeedback training for the management of faecal incontinence in children.
  • Non-pharmacological interventions for breathlessness.

Evidence Updates

This month NICE has published online via NHS Evidence an Evidence Update on constipation in children and young people.
How to get access, via NHS Athens on Apple and Android devices, to authoritative and practical information on the selection and clinical use of medicines from the British National Formulary.

Warfarin v Aspirin – new research published

“Aspirin could be as effective as more expensive drugs for heart failure patients with a normal heart rhythm, according to researchers.

Their study on more than 2,000 patients, published in the New England Journal of Medicine, said aspirin was as effective as the commonly prescribed drug warfarin.   It said each drug had risks, but they had similar benefits overall.” (BBC News)

Read the full findings at http://www.nejm.org/doi/pdf/10.1056/NEJMe1202504

“The benefit of warfarin in reducing the rate of ischemic stroke was offset by an increase in the rate of major bleeding (1.78 events per 100 patient-years with warfarin vs. 0.87 events per 100 patient-years with aspirin, P<0.001; number needed to harm, 110), although there was no excess of intracerebral bleeding events (0.12 events per 100 patient-years with warfarin and 0.05 events per 100 patient-years with aspirin, P = 0.35).”

Aqua news update

AQUA news and events

The trust is a member of the Advancing Quality Alliance (AQuA,) a membership health improvement organisation in theNorth West. Its mission is to mission is to stimulate innovation, spread best practice and support local improvement in health and in the quality and productivity of health services.

To help it achieve its mission AQuA provides a range of free webinars, workshop and training materials to stimulate innovation and improvements in clinical practices.

N.B Access to resources is free but staff members must sign up to the free AQuA membership portal. Each of the links below will prompt you to sign up before progressing to the resources or register for the free training sessions.

Latest roundup

Demand Management WebEx: Urgent and Emergency Care – Friday, 27 April 2012.
Urgent and Emergency Care – the national policy context and A&E quality standards, the first year.Guest Speaker: Dr Matthew Cooke, Department of Health National Clinical Director for Urgent and Emergency Care.

Improving quality outcomes
AQuA is pleased to announce an update to its COPD Improving Outcomes Packs (IOPs). Improving the quality of services for patients who have been diagnosed with, or are at risk of developing COPD should be high on every commissioner’s agenda. Follow the link above to access contemporary resource.

AQuA Improvement Methodologies (AIM)

Cohort 8 (April – June 2012)

Cohort 9 (May – July 2012)
The AQuA Improvement Methodology programme is geared at front line staff/operational leaders in member organisations wanting to gain an introduction to the fundamentals and concepts of quality improvement. Suitable for staff with a basic knowledge of quality improvement tools or for experienced staff wanting to refresh their knowledge and skills.

Long Term Conditions Update
A Monthly update, which covers the AQuA LTC programme.

Mental Health Update
Issue 2 – A Monthly update, which covers the AQuA MH programme.

Long Term Conditions Diagnostic tool
The AQuA LTC diagnostic tool, based onThe King’s Fund’s Ten Priorities for Commisisoners, aims to provide a cross sectional view of outcomes across the ten priorities benchmarked against regional and national data.

Advancing Quality Heart Failure/CABG collaboratives
Advancing Quality is hosting two collaboratives on Monday 23rd April 2012 – one focusing on heart failure and one focusing on Coronary Artery Bypass Graph (CABG).Both events will include a number of presentations and networking opportunities where we hope to share best practice across theNorth West in heart failure and CABG care.

Advancing Quality Stroke collaborative
We are inviting you and your AQ stroke team to this Advancing Quality stroke collaborative on Tuesday 29th May 2012.
The meeting will include a number of presentations and networking opportunities where we hope to share best practice across theNorth West in stroke care.