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NIHR Signal Treating asymptomatic MRSA on discharge from hospital reduces risk of later infection
Use of medicated creams, mouthwash and body wash for six months after discharge from hospital led to a 30% lower risk of MRSA infection, compared with basic hygiene education. This study was carried out in the USA using 2,121 adults who had tested positive for MRSA in hospital, but who had no symptoms. Meticillin-resistant Staphylococcus aureus (MRSA) bacteria have developed resistance to widely-used antibiotics. MRSA is easily transferable within healthcare settings, and people may become colo...
NIHR Signal Better care of deteriorating patients has reduced US mortality after surgery
Improved management of deteriorating patients with surgical complications has reduced the number of deaths in US hospitals rather than it being due to fewer complications. Over the past 10 years, complication rates have remained fairly similar. It is the reduction in 'failure to rescue'that has made the main difference in mortality. It is unclear if this is because of earlier detection of patients who are deteriorating due to complications, or improved response and treatment. This large...
NIHR Signal Getting hospital patients up and moving shortens stay and improves fitness
Interventions to encourage patients admitted to hospital for medical problems to get out of bed and walk around increases their mobility, without increasing their risk of falls. Older inpatients frequently spend much of their time in bed, which risks a loss of physical condition and muscle tone. This can make it harder for them to manage independently at home, and may contribute to delayed discharge. A review summarised thirteen trials from the UK, Europe and Australia, involving 2,703 adults ...
NIHR Signal Are track and trigger systems linked to rates of in-hospital cardiac arrest?
Use of the National Early Warning Score (NEWS) to monitor adults in hospital is associated with reduced risk of having a cardiac arrest while in hospital. Using an electronic rather than paper-based system is also linked to reduced risk. Many patients who die from a cardiac arrest while in hospital show signs of deterioration beforehand that aren’t identified or acted upon. Several interventions aimed at reducing these avoidable deaths have been introduced in the NHS. These includeNEWS, a...
NIHR Signal Communication problems are top of patients’ concerns about hospital care
Patients have different concerns from clinicians when asked about problems with their care, and may identify preventable safety issues. When trained volunteers surveyed 2,471 patients from three NHS Trusts in England, 23% of patients identified concerns about their care. The biggest category of concerns related to communication, with staffing issues and ward environment the next most common and safety issues. Although the majority of safety issues were categorised as negligible or minor, they w...
NIHR Signal Having more registered nurses on general wards is linked to lower mortality
Higher registered nurse staffing levels are associated with lower mortality, and the fact that fewer vital sign observations are missed is the most likely explanation for this. Increasing registered nursing staff by an hour for each patient per day could reduce the risk of death by 3%. If the ratio of healthcare assistants to nurses gets too high, the data also suggest that rates of missed vital sign observations and mortality increase in line with the extra registered nurse time spent supervis...
NIHR Signal Antimicrobial stewardship programmes reduce antibiotic use in long-term care homes
Antimicrobial stewardship programmes have been found to reduce antibiotic use in long-term care residences by 14% when pooling evidence across a range of study types and interventions. Antimicrobial resistance is a public health threat, and overuse of antimicrobials is one of the main causes. Antimicrobial stewardship programmes are a government strategy to support the appropriate prescribing of antimicrobials within the NHS. There has been little evidence for their use or effectiveness in lon...
NIHR Signal Training programme to improve communication between staff and patients with dementia in hospital shows promise
Communication with people with dementia can be challenging for healthcare professionals. A new two-day training programme shows potential to help professionals become more confident in managing difficult situations on the ward. After analysis of 41 videoed exchanges between 26 healthcare professionals and 26 people with dementia in acute hospitals, researchers identified particular challenges. These included requests for action, such as asking them to take a drink or get out of bed, and at the ...
NIHR Signal A new tool helps predict recovery from ankle sprain
The SPRAINED model may improve prediction of people who are at risk of delayed recovery from ankle sprain. This model was developed in the UK using clinical information from 584 adults with ankle injuries. The model was validated using observational data from 682 people with ankle sprains across 10 different UK emergency departments. Delayed recovery from ankle injury was more likely to be detected when using the SPRAINED model than by clinicians using judgment alone. Re-assessing pain levels ...
NIHR Signal New strategies for maintaining blood supplies from donations may be cost-effective
Opening blood donation centres on weekday evenings and at weekends is a cost-effective way of increasing the blood supply used by hospitals in the UK. Allowing donors to give blood more often could increase supplies in the short term, but it isn’t clear if it would be cost-effective in the long-term. This NIHR-funded modelling study used data from a recent large randomised trial in the UK that investigated the safety of donating blood more frequently than current guidance allows. This was...
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