Recognition, assessment, and management of coeliac disease: summary of updated NICE guidance

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Coeliac disease is a common autoimmune condition, in which the ingestion of gluten (present in wheat, barley, and rye) activates an abnormal immune response, leading to chronic inflammation of the small intestine and malabsorption of nutrients. It affects about 1% of the UK population.

NICE recommendations are based on systematic reviews of the best available evidence and explicit consideration of cost effectiveness.

NICE recommends tighter blood sugar control in diabetes to reduce risk of complications

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The National Institute for Health and Care Excellence (NICE) has recommended tighter blood sugar control for patients with diabetes, to minimise the risk of long term vascular complications, according to the BMJ.

An updated NICE guideline on diagnosing and managing type 1 diabetes in adults is now available.

 

Listening to music helps reduce pain and anxiety after surgery, review shows

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Listening to music before, during, or after surgery notably decreases patients’ pain and anxiety and reduces their use of analgesic drugs, a review published in the Lancet has shown

Use of music has a long history of improving patients’ experience of being in hospital, and studies have shown positive effects on postoperative recovery. But no comprehensive review has previously studied its use in different types of surgery and at different stages of procedures

Statins for people at low risk

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Statins are the UK’s most commonly prescribed drugs and are among the most widely prescribed drugs globally. Though their use in people at high risk of stroke and heart disease is uncontroversial, recent recommendations to treat much larger numbers of people at low risk have caused a storm of controversy. Most hotly debated are the nature and frequency of side effects of statins and whether arguably small gains in life expectancy are worth the risk.

Healthwatch calls for change to discharge process

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Healthwatch England has called for national change to the process of discharging people from health and care settings, following a special inquiry which has underscored the human and financial cost of poor and unsafe discharges from health services.

With more than one million emergency readmissions within 30 days of discharge in 2012/13 alone, costing an estimated £2.4 billion, the organisation said on Tuesday that the time has come for “concerted action and coordinated national leadership to ensure the discharge process meets people’s needs.”

NHS drive for action to tackle trans inequalities

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Health leaders urged to work together to tackle issues faced by transgender and non-binary people across NHS services. NHS England is spearheading a collective drive to improve the experience of transgender and non-binary people when accessing health and care services.

Being underweight in middle age is associated with raised dementia risk, large study finds

People who are underweight in middle age are at increased risk of developing dementia, while increasing weight and obesity offer protection against the condition, a large cohort study has found.

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A number of previous studies have looked at the association between weight and dementia, and most have found that the risk of dementia increased among adults who are overweight or obese, although some studies have found the opposite. Most of these studies have been small, which led the present researchers to conduct a much larger analysis of the link.

Financial incentives help people change health behaviours, review shows

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Personal financial incentives help people to change health behaviours, but these effects are lost within three months of the payments stopping, says a study of the overall effect of payments across various health related behaviours.

Researchers analysed 34 studies including 10 585 adults that assessed the effect of financial incentives on a range of health behaviours, including smoking cessation and healthier eating, measured for at least six months from baseline.

UK death rates in children’s heart surgery have almost halved over past decade

More children survived for at least 30 days after heart surgery at the end of the past decade than at the start, an analysis has found. The death rate fell from 4.3% to 2.6% of cases.

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The findings have prompted the researchers to call for a shift away from scrutinising short term survival to looking at the longer term effects of heart surgery in children, such as measures of ill health and the effect on functional capacity.

HRT increases risk of blood clots and stroke, finds new analysis

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Hormone replacement therapy (HRT) offers women no protection against having or dying from a myocardial infarction while increasing the risk of blood clots and stroke, a new analysis published by the Cochrane Collaboration has shown.

But, complicating the message, a subgroup analysis of women who were given HRT below the age of 60 or within 10 years of the menopause did show a reduction in the risk of myocardial infarction and death from any cause while also showing an increased risk of blood clots and possibly stroke

Doctors are urged to encourage patients to be more active to reduce chronic ill health

thebmj_logoDoctors in the United Kingdom have been urged to encourage patients to take small amounts of regular exercise and told that they have a leading role to play in reversing the growing contribution of sedentary lifestyles to chronic ill health.

More than 40% of adults do not reach the minimum recommended level of 30 minutes of moderately intense exercise five times a week, figures reviewed in the Academy of Medical Royal Colleges’ report showed.

NHS Networks News

Thanks to NHS Networks weekly news for the following items:

Patient safety alert on the risk of cutting in-line suction catheters

NHS England has issued a patient safety alert on the risk of inadvertently cutting in-line (closed) suction catheters.  Read more »

Phone app emergency alert for medically trained

A smartphone app has been developed that aims to help doctors improve patient survival rates during medical emergencies.  Read more »

CKD guidance updated to help improve diagnosis

NICE has updated its clinical guideline on chronic kidney disease (CKD) to include new recommendations on the diagnosis and classification of the condition, and on its relationship with acute kidney injury. Read more »

 

 

Nursing leadership and service quality articles

The following articles have recently been published. We do not subscribe to all of them but they can be ordered via our inter-library loan scheme for a small charge.  Subscribed publishers are accessible through an Athens login.

Leadershipsupport for ward managers in acute mental health inpatient settings: Gwen Bonner and Sue McLaughlin report on a study into the tensions inherent in the …

G Bonner, S McLaughlin – Nursing Management, 2014

They have fewer opportunities to provide the role modelling and senior clinical leadership required to support a recovery-focused environment. The inquiry led by Robert Francis (2013) into poor care at the Mid Staffordshire NHS Foundation Trust has provided serious

The Nurse’s Survival Guide–A Simple ABC
B Ryan – Nursing Management, 2014

director of nursing at NHS City and Hackney, London, Mary Clarke asked how we could address the lack of BME leadership in the
West M, Dawson J (2011) NHS Staff Management and Health Service Quality.

Health service plays it safe: A plan to increase transparency and improve patient safety has been welcomed by nurses–but front line staff need confidence to change …
N Triggle – Nursing Management, 2014

was launched in 2008 with the goal of making the trust the ‘safest in the NHS‘. Connecting senior leadership with front line staff was prioritised, which has led to weekly ‘safety walk which detail the six interventions they need and whether they have had them (PHSO 2013).

Patient Safety and Managing Risk in Nursing
K Grocott – Nursing Management, 2014

director of nursing at NHS City and Hackney, London, Mary Clarke asked how we could address the lack of BME leadership in the
West M, Dawson J (2011) NHS Staff Management and Health Service Quality.

An analysis of National Health Service Trust websites on the occupational backgrounds of ‘Non-Executive Directors’ on England’s Acute Trusts
C Pritchard, AJE Harding – JRSM Open, 2014

With a predominance of Chairs and NED without health or social care leadership experience, are current Boards equipped to avoid inadvertently ‘doing the system’s business’ (Francis, 2013) rather than developing a more patient-centred, clinically led and integrated NHS?

Developing advanced nursing skills for frail older people: An ageing population with complex needs means there is scope for a post that will sit between medicine and …
S Goldberg, J Cooper, C Russell – Nursing Older People, 2014

are unable to fill posts (Royal College of Nursing (RCN) 2013), which compounds involved in leadership, teaching, research and service development (National Leadership and Innovation … Training Nottingham University Hospitals NHS Trust is piloting the innovative new role of

[HTML] The friends and family test: a qualitative study of concerns that influence the willingness of English National Health Service staff to recommend their organisation
M Dixon-Woods, JT Minion, L McKee, J Willars… – Journal of the Royal Society …, 2014

… In 2013, the most recent year for which data are available, the proportion of staff 12,33 All of these efforts will require high-quality leadership, engagement with staff and excellent We therefore
have some confidence that our findings reflect shared concerns of many NHS staff.

Watching closely? Lindsay Etherington asks whether nurses can do more to improve the detection of acutely deteriorating patients
L Etherington – Nursing Management, 2014

The government’s response to the inquiry by Robert Francis that examined care at Mid Staffordshire NHS Foundation Trust reiterates the need for effective leadership in assuring good quality patient care (Department of Health 2013).

Hyperacute stroke care and NHS England’s business plan
T Monks, M Pitt, K Stein, MA James – BMJ: British Medical Journal, 2014

1 National Institute for Health Research Collaboration in Leadership and Applied Health Research and NHS England aims to develop the case for major reconfigurations in two further Improvements have continued, with 2013 audit data for London reporting a thrombolysis rate

 

Event: Improving Patient Flow within Urgent and Emergency Care Workshop

Improving Patient Flow within Urgent and Emergency Care Workshop event taking place at the Manchester Conference Centre on the 15 November 2013.

The workshop will look at the linkages between emergency care, frail older people, and the concerns about safety, patient experience, and mortality that have emerged from the Francis and Keogh Reports.

To register please go to https://www.aquanw.nhs.uk/ and sign in.

July update from AQuA

https://www.aquanw.nhs.uk/content_items/7540

In this edition you will find:

 

• AQuA launches Improving Outcomes Pack for Diabetes

• AQuA Improvement Methodologies Plus (AIM+)

• AQuA’s Lean Network

• Spotlight on organisational improvement

• Safety Seminar with Robert Francis QC

• Patient Safety Champions

• Academy events round-up

• Community SAFE – programme update

• A New Role for Finance in Quality Improvement – Cohort 4

• Update on Academic Health Science Networks

• Showing the value – EPaCCS Economic Evaluation Report now available

• Advancing Quality under conference spotlight

• iNetwork’s services free to AQuA’s members

• Shared Decision Making’s Ask 3 Questions campaign shortlisted for efficiency award

• AQuA at this year’s NHS Confederation annual conference and exhibition

• Annual report highlights mortality rates for people with severe mental illness

• Sharing the Shared Decision Making process

• Chance to join Advancing Quality’s new COPD Pilot

• Twitter round up

The Challenges of Making Care Safer: Leadership and System Transformation

Published in Healthcare Quarterly, 2012, GR Baker
  New programs, such as Releasing Time to Care: The Productive Ward, in Saskatchewan and Ontario offer systematic ways to examine and improve nursing care and patient unit environments, with the potential to improve efficiency, increase patient safety and quality, boost
 
Other articles included in this Canadian publication include:
  • The culture of patient safety
  • Teamwork and communication
  • Human factors in patient safety
  • Daignostic safety
  • Safety in the community and many more

Applications welcome: Patient Safety Leaders’ Programme

Extract from the Institute of Improvement and Innovation

Apply now for the Patient Safety Leaders’ programme

The NHS Institute’s Patient Safety Leaders’ (PSL) programme provides practical guidance on safety improvement tools and techniques. Accredited by the University of Derby, it helps PSLs identify, implement and measure improvement projects and successfully achieve the aims of the Safety Express QIPP workstream. The next wave of the programme starts in February 2012.


Click here to find out more and register your interest

Perioperative management of patients with cardiac implantable electronic devices

British Journal of Anaesthesia:  Volume 107, Issue suppl 1 p116-126

Many anaesthesia practitioners caring for patients with a cardiac implantable electronic device (CIED) lack the knowledge, experience, and requisite programming devices to independently manage these patients perioperatively. A recently updated ASA task force Practice Advisory presents expert opinion regarding the perioperative management of patients with CIEDs, and the Heart Rhythm Society (HRS) recently published a consensus statement on this subject in collaboration with the ASA, American Heart Association (AHA), and Society of Thoracic Surgeons (STS).

The abstract is free and the full text article may be requested as an inter library loan.

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Kings Fund: RCN and Sharps safety

Royal College of Nursing (RCN)
Sharps safety: RCN guidance to support implementation of the EU Directive 2010/32/EU on the prevention of sharps injuries in the health care sectorThis guidance covers the law on sharps injuries, including the European Directive 2010/32/EU and its underlying principles as well as its requirements on health care providers. It includes information on preparing an organisation, introducing risk assessments, selecting and evaluating safety-engineered devices and what employers should be doing to comply with the directive. It also includes a checklist to help safety representatives assess organisational and ward/departmental level compliance with the directive.