Why might nurses miss people’s ‘danger signs’ at night? – Dr Jo Hope

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.

What are we missing here? (Are at risk older people spotted early enough in hospital?) – Dr Kinda Ibrahim, Research Fellow at Academic Geriatric Medicine

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).

Using Health Systems Analytics to help the NHS improve the quality and equity of services -Dr Marion Penn, Dr Rudabeh Meskarian and Dr Thomas Monks

In Hampshire, Solent NHS Trust and Commissioners are making use of advanced Health Systems Analytics to visualise their demand, and support their decisions about the how many sexual health clinics should be funded to meet future patient need.

Hepatitis C – How many cases are out there?

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.

Dementia care at meal times in acute hospitals – Naomi Gallant

Almost a year on from my last post here and I’ve done a lot of work on my developing my research proposal – reading, learning, literature reviewing – but sadly not a lot has changed for people with dementia in acute hospitals. My desire to improve the quality of care, especially at meal times has certainly grown.

Maths without equations: Dr Tom Monks insights into patient flow from queuing theory

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.

Research shows nurses are short on time not compassion – Jane Ball

Research shows nurses are short on time, not compassion

Jane Ball, University of Southampton

For the past 50 years, May 12 – Florence Nightingale’s birthday – has been celebrated around the world as “International Nurses Day”. But who exactly is celebrating nursing in 2015, when nurses appear to be under constant criticism and their morale is at an all-time low?

What are the fresh ideas to reduce A&E overcrowding? Dr Tom Monks CLAHRC Wessex Methodological Hub

Spring.  The headlines about A&E overcrowding are beginning to disappear just as a fresh wave of news reports burst forth with the NHS priorities for the next government.  We now have the luxury of a brief respite to reflect on how we can improve the lot of our hospital A&E’s before the seasonal cycle repeats itself.  I have spent my winter looking at A&E data examining the question – could the answer to A&E attendance lie in providing GP appointments for urgent – but non-emergency – care at the weekend?

Involving patients and the public in research: Reflecting back and looking ahead

By Claire Ballinger and Mark Stafford-Watson – Chairs, Wessex Inclusion in Service Design and Delivery (WISeRD) group

It’s the end of our first year in CLAHRC Wessex, we have been thinking about our progress in involving patients and the public in our work (or PPI as it’s called), and reviewing where our focus should be for the coming year.  We have settled on five strategic aims:

• Develop our capacity for patient and public involvement (PPI) in research and implementation programmes
• Promote our CLAHRC Wessex activities to the wider public (public engagement)
• Evolve and measure ways to include patients and the public to identify research priorities
• Develop a group of patient and public researchers
• Measure the impact of patient and public involvement within CLAHRC Wessex

Are you 1 of the MISSING 200? – Tackling the Hepatitis C virus by Bicycle

I’m Ryan Buchanan, a specialist registrar doctor in liver disease and a PhD student carrying out research for NIHR CLAHRC Wessex. My project is centred on Hepatitis C in the Isle of Wight community.

Hepatitis C is a virus, which unlike other viruses such as ‘flu’ or the common cold directly affects your liver. It is usually passed from person to person via blood and develops into a long lasting infection. The virus actually causes very few symptoms allowing it to hide within the body making people unaware they carry it.