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Content Article
Family Integrated Care (FICare) is an approach to neonatal care which aims to involve parents as equal partners in the care of their babies while in the Neonatal Intensive Care Unit (NICU). FICare aims to minimise separation, support parent-child bonding and promote parental decision-making. In this blog, Katie Cullum, Lead Nurse for Innovation and Quality Improvement at East of England Neonatal Operational Delivery Network, talks about the proven benefits of Family Integrated Care and why all NICUs should be implementing the model to improve outcomes. -
Content ArticleThis report outlines the results of a survey of 10,000 nursing staff in the UK carried out by the Royal College of Nursing (RCN). The survey highlighted stark differences in career progression and treatment in the workplace between White nurses and those from a mixed ethnic background, and Black and Asian nurses. In the 35-44 age group, 66% of White and 64% of respondents from mixed ethnic backgrounds said they’d been promoted. This dropped to just 38% of Asian and 35% of Black respondents. Black respondents working in both hospital (39%) and community (32%) settings are more likely to report having experienced physical abuse than respondents of other ethnic backgrounds. In response to these findings, the RCN is calling on the UK Government to reform human rights law to help tackle workplace racism, including introducing a legal requirement to eliminate disparities in recruitment, retention and career progression. They also want employers to have greater responsibility to protect minority ethnic groups from racism in all its forms.
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Content ArticleKrista Haugen is National Director of Patient Safety for US-based emergency and patient relocation services provider Global Medical Response. In this interview, she describes how her 25-year career as an emergency medicine nurse has influenced her approach to safety and patient care. She discusses her personal experience of being involved in an accident as an air-ambulance flight nurse, and how this caused her to look at safety and risk management from a systems perspective, focussing on building a just culture where safety is optimised through organisational reflection and learning.
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Content ArticleThis report from the Royal College of Nursing (RCN) reveals the full extent of the UK nursing workforce crisis. In March 2022, nursing and midwifery staff from across the UK were invited to tell the RCN about their experiences of the last time they were at work. The survey report provides valuable insight into the realities of staffing levels across the UK, and the impact on our members and the people they are caring for.
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Content ArticleReturning to work as a nurse with Long Covid is thwart with difficulties in part due to its relapsing-remitting nature. Many nurses with Long Covid experience post-exertional malaise and symptom exacerbation if they push themselves and this may trigger a major relapse. This means that a return to work needs to be planned carefully. Dr Alison Twycross, Editor in Chief of Evidence-Based Nursing, speaks to two freelance consultants from Long Covid Work: Dr Clare Rayner, a consultant occupational physician, and Kirsty Stanley, Director, Occupational Therapist & Writer at Occupation4Life Ltd, about best practice in this context. They provide guidance for both employers and employees. Alison, Clare and Kirsty are also members of the Long Covid Support Employment Group.
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Content ArticleMedical error is a serious issue in hospitals in Jordan. This study from Suliman et al. explored Jordanian nurses' perceptions of the culture of safety in their hospitals. The Hospital Survey of Patient Safety Culture translated into Arabic was administered to a convenience sample of 391 nurses from 7 hospitals in Jordan. The positive responses to the 12 dimensions of safety culture ranged from 20.0% to 74.6%. These are lower than the benchmarks of the Agency for Healthcare Research and Quality. Jordanian nurses perceive their hospitals as places that need more effort to improve the safety culture.
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Content ArticleAn expert committee will extend the vision for the nursing profession into 2030 and chart a path for the nursing profession to help create a culture of health, reduce health disparities, and improve the health and well-being of the US population in the 21st century. The committee will consider newly emerging evidence related to the COVID-19 global pandemic and include recommendations regarding the role of nurses in responding to the crisis created by a pandemic.
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Content Article"Shaming and punishing healthcare workers when an incident occurs sets a dangerous precedent for the industry. This will lead to a culture where healthcare workers avoid reporting near misses or errors for fear of repercussions, allowing process inefficiencies and systemic problems to occur." In this letter, Michael Ramsay, CEO of the Patient Safety Movement Foundation, highlights the negative ways in which criminalising healthcare workers who make mistakes will affect patient safety. He refers to the case of RaDonda Vaught, a nurse who was convicted of criminally negligent manslaughter in March 2022 for a medication error made while working at Vanderbilt University Medical Center in Nashville.
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Content ArticleAnalysis suggests potential instability and workforce gaps in the US healthcare sector. A call to action for all stakeholders could help. COVID-19 has altered many US nurses’ career plans. Over the past two years, McKinsey has found that nurses consistently, and increasingly, report planning to leave the workforce at higher rates compared with the past decade. Even as COVID-19 cases fluctuate, US healthcare providers are still experiencing the workforce and operational challenges exacerbated by the pandemic. Patient demand is expected to rise, given the growing and aging population of the United States. Without addressing this potentially wider divide between patient demand and the clinical workforce, with a specific focus on nurses, the US health sector could face substantial repercussions. If no actions are taken, there will likely be more patients in the United States who will need care than nurses available to deliver it. This report from McKinsey& Company provides context for how COVID-19 changed the nursing workforce, the long-term implications for nurses and healthcare stakeholders, and actions to consider to increase the odds of closing the gap. In the last section, it highlights how healthcare providers, federal and state governments, the private sector, the nursing workforce, and broader society could encourage those who are training to be nurses.
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Content ArticleThe link between nurse staffing levels and patient outcomes has been proven time and again – so why do we have a persistent shortage of nurses? Is it all due to lack of funding? And do, or should, nurses have a role in calling this out and finding solutions? These questions are explored in the latest episode of the Nursing Standard podcast, which hears from Jane Ball, professor of nursing workforce and policy at the University of Southampton, who has spent 30 years researching nurse staffing issues. She speaks about the positive impact on patient care of having the right number of nurses who are well-trained and have a good working environment.
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Content ArticleThere are an estimated 3.8 million people with a wound being managed by the NHS, which is equivalent to 7% of the UK population. The impact of wounds on patients is significant and can lead to deteriorating mental health as well as further physical health issues. In addition, the cost to the NHS of providing wound care services is around £8.3 billion annually. This report by Mölnlycke and the Patients Association provides an outline of the state of wound care services in England by mid-2021. It features patient stories and data analysis on the following topics: Wound care in the health service The impact of Covid-19 Supported self-care Getting wound care right first time What next for wound care?
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Content ArticleIn its 2019 manifesto the government pledged to increase the full-time equivalent number of nurses working in the NHS by 50,000 by March 2024. But although data suggests that the NHS will hit that target, Ruth May, England's Chief Nursing Officer, has stated publicly that there are still substantial shortages in spite of this increase. This analysis by the King's Fund highlights that the supply of nurses to the NHS is not keeping up with demand, with vacancy levels remaining static in spite of an increase to the raw number of nurses. It also highlights wide regional variation in nurse shortages.
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Content ArticleThese tools and resources from the National Institute for Health and Care Excellence (NICE) accompany the NICE guidance on Hypothermia: prevention and management in adults having surgery. Resources available for download include: Audit and service improvement baseline assessment tool Implementation support advice document Education information Shared learning information Practical steps to improving the quality of care and services using NICE guidance
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Content ArticleHypothermia is a common problem in the operating theatre, and it contributes to many poor outcomes including rising costs, increased complications and higher morbidity rates. This literature review in the Journal of PeriAnesthesia Nursing aimed to determine the best method and time to prewarm a patient in order to prevent hypothermia during or after surgery. The authors suggest that forced-air warming is most effective in preventing perioperative hypothermia. Eighty-one percent of the experimental studies reviewed found that there was a significantly higher temperature throughout surgery and in the post-operative care unit for patients who received forced-air prewarming.
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Content ArticleMidwives, public health nurses and practice nurses are in an ideal position to address mental health and emotional well-being with women in the perinatal period. However, research involving midwives, public health nurses and practice nurses in Ireland indicates that there is considerable variation in perinatal mental health assessment and care. All three groups identify the following issues as barriers to addressing perinatal mental health issues: Lack of knowledge on the range of perinatal mental health problems Lack of skill in opening a discussion and developing a plan of care with women Organisational issues, such as lack of policies, guidelines and care pathways This document produced by the Irish Health Service Executive, aims to provide an evidence-based guidance document for midwives, public health nurses and practice nurses in the area of perinatal mental health care.
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Content ArticleIssues with medication management and errors in medication administration are major threats to patient safety. This article for the US Agency for Healthcare Research and Quality (AHRQ) Patient Safety Network takes a look at the AHRQ's current areas of focus for medication safety. The authors look at evidence-based solutions to improve medication safety in three areas: High-risk medication use and polypharmacy in older adults Reducing opioid overprescribing, increasing naloxone access and use and other interventions for opioid medication safety Nursing-sensitive medication safety The article also explores future research directions in medication safety and highlights that these will advance patient safety overall.
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Content ArticlePatient safety culture is a vital component in ensuring high-quality and safe patient care. This cross-sectional study aimed to assess doctors’ and nurses’ perceptions of patient safety culture in five public general hospitals in Hanoi, Vietnam. The study found that the mean scores among nurses were significantly higher than that among physicians for several categories: supervisor/manager expectations staffing management support for patient safety teamwork across units handoffs and transitions Nurses reported significantly higher patient grades than physicians (75% vs 67.1%) and around two-thirds of physicians and nurses reported no event in the past 12 months (62.8 and 71.7% respectively). The authors recommend that hospitals develop and implement intervention programs to improve patient safety, including around teamwork and communication, encouraging staff to notify incidents and avoiding punitive responses.
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Content ArticleThis report from the Royal College of Nursing sets out the range of different factors that influence the total demand for staff and highlights the variety of methods for planning or reviewing staffing. However, recognising the complexities and difficulties of ensuring that staffing levels are safe is not an excuse for inaction. Health care systems are without doubt complex; which provides more reason, not less, to have a rational system in place to ensure that staffing levels and mix are evidence based and patient safety is maintained.
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Content ArticleThe importance of nurse staffing to the delivery of high-quality patient care was a principal finding in the landmark report of the Institute of Medicine’s (IOM) Committee on the Adequacy of Nurse Staffing in Hospitals and Nursing Homes: “Nursing is a critical factor in determining the quality of care in hospitals and the nature of patient outcomes”. Nurse staffing is a crucial health policy issue on which there is a great deal of consensus on an abstract level (that nurses are an important component of the health care delivery system and that nurse staffing has impacts on safety), much less agreement on exactly what research data have and have not established, and active disagreement about the appropriate policy directions to protect public safety. Researchers have generally found that lower staffing levels are associated with heightened risks of poor patient outcomes. Staffing levels, particularly those related to nurse workload, also appear related to occupational health issues (like back injuries and needlestick injuries) and psychological states and experiences (like burnout) that may represent precursors for nurse turnover from specific jobs as well as the profession. This chapter from the Patient Safety and Quality: An Evidence-based Handbook for Nurses summarises and discusses the state of the science examining the impact of nurse staffing in hospitals and other health care organisations on patient care quality, as well as safety-focused outcomes. To address some of the inconsistencies and limitations in existing studies, design issues and limitations of current methods and measures will be presented. The chapter concludes with a discussion of implications for future research, the management of patient care and public policy.
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Content ArticleThis paper from Claire Su-Yeon Park aims to propose Park's sweet spot theory-driven implementation strategy, which makes optimal safe staffing policy really work in nursing practice.
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Content ArticleWhen hospital patients do not have their teeth brushed it can lead to them developing pneumonia—poor dental hygiene in hospital is believed to be a leading cause of hundreds of thousands of cases of pneumonia a year. In this blog for Medscape, reporter Brett Kelman looks at the link between dental hygiene and hospital-acquired pneumonia, which kills up to 30% of patients who are infected with it. He highlights a lack of understanding of the impact of failing to brush inpatients' teeth, in spite of a growing body of research evidence that links lack of adequate toothbrushing to pneumonia infection.
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Content Article
Laurence Goldberg, an independent pharmaceutical consultant, discusses the effectiveness and also the potential for harm of unit-dose medicines distribution. -
Content ArticlePatient safety culture is the foundation of patient safety and refers to a healthcare organisation’s shared values, norms and beliefs that influence staff’s behaviour and actions. This study in BMJ Open Quality aimed to assess nurses’ reporting on the predictors and outcomes of patient safety culture and the differences between patient safety grades and the number of events reported. It aimed to fill a gap in research by looking at patient safety culture in terms of both predictors and outcomes. The author developed a cross-sectional comparative research design and recruited 300 registered nurses to take part in a survey on patient safety culture. The author found that nurses generally perceived patient safety culture as 'moderate', and identified areas that should be prioritised to improve patient safety culture. They concluded that assessing patient safety culture is the first step in improving hospitals’ overall performance and quality of services, and that improving patient safety practices is essential to improving culture and clinical outcomes.
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Content ArticleIn this episode of 'Better Never Stops', Virginia Mason Institute Senior Partner Melissa Lin interviews Dana Nelson-Peterson, Vice President of Nursing Operations at Virginia Mason Franciscan Health, who shares what happens when you trust a management system and improvement process to solve your toughest challenges. Dana shares her story of leading a critical part of Virginia Mason’s Covid response.
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Content ArticleNHS chiefs and regulators have written to hospital bosses admitting winter could be so bad NHS staff may have to "depart from established procedures" to care for patients. Letter says regulators will take the challenging situations into context...
