We know that nurses miss or delay taking patients’ vital signs (such as pulse, temperature and blood pressure) at night. Until now, no one knew why.
The NHS expects hospitals to use ‘Early Warning Scores’ to measure how ill someone is. These are based on the observation of ‘vital signs’ – measurements of things like pulse, temperature, blood pressure and breathing speed. The higher the score, the more often someone’s vital signs should be checked. This is so staff can spot the early danger signs of someone becoming very unwell, in time to help them.
Your local hospital will probably have an ‘early warning protocol’ that says how often people should be checked according to their early warning score. At higher levels observations will need to be done in the middle of the night. Despite this, we know that nurses are much less likely to do the observations that are expected to be done at night.
Nearly two thirds (65%) of people admitted to hospital in the UK are aged over 65 years old. Many of them are frail and at high risk of poor healthcare outcomes – like staying longer in hospital, reduced physical abilities, becoming dependant, going to a care home, and even death.
National recommendations suggest that these high-risk older individuals should be routinely identified when they are admitted to hospital to allow healthcare teams to provide appropriate individual care that meets patient’s needs (1). It is unclear whether and how those people are identified in hospital. Therefore our study looked at the current practice in one hospital with regard to identification of patients at high-risk of poor healthcare outcomes. To do that, we reviewed a random sample of patient’s clinical notes and interviewed staff members who worked at five acute medicine for older people wards (2).
The event in Southampton attracted organisations* from across the Wessex region and beyond and a wide range of people including the public, paramedics, nursing staff, clinicians, managers and researchers.
Many stakeholders were represented bringing together 44 delegates, all there to examine and reflect on whether the ReSPECT approach to decision making for emergency care should be adopted.
As PPI Champion for the Fundamentals of Care theme within NIHR CLAHRC Wessex, I’ve a great experience and opportunity to be an equal member of a team developing the research priorities for this area of work. Crucially, these weren’t priorities that we developed together in a closed room, but rather they were co-produced at several stages.
Lindsay Welch is the Integrated COPD Team Lead; Solent NHS Trust and UHS NHS Foundation Trust
COPD or Chronic Obstructive Pulmonary Disease is a preventable disease and is one of the world’s biggest killers – it causes a narrowing of the breathing tubes and air sacs in our chest and lungs, reducing the amount of oxygen we can get into our bodies. There are several causes, air pollution and exposure to dust, but the main culprit is smoking. It is estimated that over three million people with COPD in the UK but only a quarter of those are diagnosed
Ryan Buchanan is a specialist registrar doctor in liver disease and a PhD student supported by CLAHRC Wessex.
In my previous blog I described how a novel, award winning case-finding initiative was identifying some of the estimated 200 missing cases of Hepatitis C on the Isle of Wight and linking them directly to specialist care. The second part of this project, which I describe here, is an attempt to establish a more accurate estimation of the true number of missing cases in order to guide future service design and inform best practice elsewhere.
Could this statement be the one that encapsulates the perception that mental health services are frequently unable to help people with mental health issues?
A research participant in a study I’m conducting into support networks of people with long term mental health problems outlined what she saw as some of the problems with her encounters with health professionals in the mental health system.
Previously I have written about using a detailed computer model to ask ‘what-if’ an emergency department could be run differently. Hidden away in complex models like these are important rules of thumb that tell us how to efficiently manage patient flow.
Our muscles play an important role in our health and grip strength is a good way of measuring how well our muscles are doing. Our grip strength builds through young adulthood to reach its peak in our 30s after which it gradually tails away. It is a reliable and valid way of evaluating someone’s hand strength, which in turns provides an objective measure of the skeletal muscle strength and function in their whole body.
This site promotes independent research by the National Institute for Health Research Collaboration for Leadership in Applied Health Research and Care (CLAHRC) Funding Scheme. The views expressed in this blog are those of the author(s) and not necessarily those of the NHS, the National Institute for Health Research or the Department of Health