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NIHR Signal Impact of a national quality improvement programme for hospital wards is unclear
The Productive Ward quality improvement programme has shown some procedural changes on hospital wards in England in the 10 years since it was introduced. But evidence to show any sustained changes to the experiences of staff or patients is hard to find. This NIHR-funded study used quantitative and qualitative methods to evaluate the programme in six acute hospitals in England. It found some evidence of a lasting impact, such as wards continuing to display metrics and using equipment storage sys...
NIHR Signal Computerised speech and language therapy can help people with aphasia find words following a stroke
People with aphasia caused by a stroke showimprovements in retrieving words when they useself-managed computerised speech and language therapy in addition to usual care from a speech and language therapist. No improvements are seen in patients’ conversational abilities or their quality of life. Aphasia is a complex language and communication disorder. It can affect people’s abilities to read, listen, speak, and write or type. Symptoms vary: some people may mix up a few words, while ...
NIHR Signal Online patient feedback is mostly positive — but is not being used effectively
People are increasingly reading online feedback from other patients to gauge service qualitybut fewer people go online to write feedback themselves. Health organisations and professionals are not currently effective at using this feedback to improve services. These findings come from an NIHR-funded study which used five research streams to provide an overview of online patient feedback in the NHS. Healthcare professionals rarely encourage online patient feedback and may be sceptical about it. ...
NIHR Signal Working in groups with ongoing support is valued by people with severe obesity trying to lose weight
People with severe obesity, a BMI of 35kg/m² or more, value the support and motivation they get from weight management programmes that include group-based interventions. However, commissioners and service managers should consider how to maintain adequate support and motivation once programmes end. Although previous studies have assessed the impact of non-surgical weight management programmes for obese adults, this is the first qualitative review to focus on the opinions of providers and ad...
NIHR Signal Voucher rewards do not reduce frequency of cannabis use or relapse in people with early psychosis
Contingency management - the use of positive reinforcement in the form of supermarket vouchers to shape behaviour - makes no difference in the frequency of cannabis use or relapse rates in those with early psychosis. Although psychotic symptoms initially decrease, these changes are not sustained over the longer term and are no better than with an optimised educational intervention. This NIHR-funded multicentre randomised controlled trial included 551 young adults who were being treated in an &l...
NIHR Signal Holistic services in advanced lung disease can help people cope better with breathlessness
Services providing holistic health care can improve the psychological well-being of people who are living with breathlessness associated with chronic or advanced lung disease, such as lung cancer or chronic obstructive pulmonary disease. Breathlessness is a distressing symptom in which feelings of fear and helplessness, social isolation, high levels of anxiety and significant carer burden are common experiences. Drugs can have limited effectiveness in advanced disease and do not address the und...
NIHR Signal Longer duration of urinary catheter placement associated with an increase in urinary infection
The risk of urinary infection appears low with very short-term use but increases with the time that a patient has a catheter. Women and patients with paraplegia or cerebrovascular disease are at increased risk. This US-based retrospective analysis of electronic health records identified 148,361 indwelling catheterisations, of which 61,047 were for three or more days, in five hospitals - two university hospitals, two community and one children’s hospital - where the median duration of cath...
NIHR Signal Patients, in theory, might prefer GP-led care to self-management for high blood pressure
Patients offered the pros and cons of different monitoring options appear reluctant to self-manage high blood pressure, and prefer frequent monitoring by a GP, pharmacist or via telehealth (where readings are sent to health professionals and medicines managed remotely). The small online survey, completed by 167 patients, was used to explore how patients might feel about moving away from GP-led care to other care models not currently routinely offered in the UK. Perhaps surprisingly, patients, i...
NIHR Signal Partial knee replacement ‘could be first choice’ for suitable patients with osteoarthritis
Partial knee replacement surgery improves pain and function similarly tototal knee replacement in people with osteoarthritis that affects only a single compartment of the knee. Partial knee replacement surgery is also cheaper. In this NIHR-funded trial of 528 people with osteoarthritis affecting only one compartment of the knee, those who had partial knee replacement saw at least as much improvement as those who had a total joint replacement. Their care also cost about £900 less over five...
NIHR Signal Better strategies are needed to reduce preventable patient harm in healthcare
About 6% of patients in healthcare settings internationally experience harm that could have been prevented. Around one in eight of these cases result in severe harm, causing permanent disability or death. Drug errors, therapeutic management incidents and incidents involving invasive clinical procedures are the most common causes of preventable patient harm. Higher rates of harm were seen in intensive care and surgical departments than in general hospital settings. This NIHR-funded review poole...
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