Steps to better understanding resistant behaviours and the culture of bedside dementia care in hospitals
High levels of resistance to care by people with dementia can be exacerbated by responses by staff on the wards. This study sought to understand the interactions and culture underlying care by closely observing and documenting what was actually happening on ten wards in five UK hospitals, and through interviews with carers and families.
This in-depth study confirmed that people living with dementia are often resistant to care in acute hospital settings. Behaviour included wandering in wards, pu...
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 ...
New insights into how ethnicity and culture affect maternal mental health
Ethnicity and culture can affect how and when women seek help for mental health problems before or after having a baby. Many women avoid seeking help because they feel services are not sensitive to their beliefs. Services should ensure all women, regardless of background, can access the support they need during and after pregnancy.
This mixed methods systematic review of UK evidence found that many women are not aware of the help available to them, and those that are aware often view it negativ...
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...
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...
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...
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 ...
Updated evidence on progesterone to prevent preterm birth in at-risk pregnancies
Progesterone administered via the vagina may reduce the risk of preterm birth in women who are at risk of giving birth early when compared to a placebo, treatment as usual or no intervention. Other treatments, such as oral or injected progesterone, cervical stitch, and pessary, appear not to show the same level of effectiveness.
A recent trial suggested that vaginal progesterone provided little or no benefit in preventing preterm birth. Those results have been pooled with 39 other trials in thi...
Honey may help painful mouth inflammation caused by cancer treatments
Compared to usual care, honey was more likely to reduce moderate or severe pain for patients after radiotherapy and/or chemotherapy treatment.
This systematic review looked at trials from around the world comparing different types of honey with other treatments such as chamomile, golden syrup or placebo. The main outcome was the onset of moderately severe oral mucositis as measured by a range of standardised assessment scales.
The findings suggest that honey might be useful, although whether t...
NHS managers need support to use tools to ensure safe nurse staffing levels
Workforce planning technologies can help NHS managers plan for safe nurse staffing levels, but only with proper support and tools that are designed with good understanding of local needs. Tools also need to give easy access to standardised information such as staff availability and costs. NHS Trusts need to be open to information sharing and system integration.
Adequate nurse staffing is linked with improved patient outcomes and quality of care, making this an NHS priority. Technologies are ava...