NIHR DC Discover

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NIHR Signal Checklists are no substitute for experience in spotting patients who are deteriorating
Experience was found to count in recognising and acting on patient deterioration. National guidelines recommend the use of “track and trigger” systems to monitor seriously ill patients for the signs of deterioration. Following their identification, prompt referral to critical care teams is suggested, for example, but this does not always happen reliably. This realist review explored the organisational factors within UK hospitals that influence how and why these alert systems work in ...
NIHR Signal Humidified oxygen linked to increased chest infections
More respiratory infections in adults followed the use of humidified oxygen compared with non-humidified low-flow oxygen therapy. Bacterial contamination was common in the humidified oxygen bottles across various hospital departments including respiratory wards. UK guidelines currently recommend using non-humidified oxygen for adults requiring low-flow oxygen. However, in countries such as China, oxygen is routinely humidified regardless of flow rate to prevent respiratory dryness. This revie...
NIHR Signal People prefer shorter compression stockings to prevent blood clots
People having surgery prefer wearing knee length to thigh length compression stockings to prevent deep vein thrombosis (DVT). They are more likely to wear knee length stockings correctly and for the recommended time. DVT is a clot in the deep leg veins and surgery is a known risk factor. If the clot travels to the lung blood vessels, this can cause the potentially fatal complication of pulmonary embolism. This review of 16 studies included randomised trials and observational studies reporting ...
NIHR Signal Nurses lack confidence in escalating or identifying children at risk of abuse and neglect
On the face of it, nurses are well placed to safeguard children, but asking them about their experiences reveals barriers which hinder that role. The research points towards areas where support could help nurses fulfil their legal and ethical duties better. In a review of published qualitative research, including surveys, interviews and focus groups, nurses say they have insufficient confidence to report child abuse issues. They often feel a need to convince other professionals, viewed as above...
NIHR Signal Simple bedside check for nasogastric tube positioning is cost effective and prevents deaths
In adults who need a nasogastric tube for a short time, pH testing was the best initial approach followed by X-ray confirmation if pH testing wasn’t successful. pH testing was four times less expensive than X-ray confirmation and when used in sequence both were cost effective uses of NHS resources. Nasogastric tubes are used to deliver liquids directly to the stomach. Tubes can be misplaced, often into the lungs, with serious consequences, so their final position needs to be checked. This...
NIHR Signal How nurses support families of intensive care patients towards the end of life
Families of people dying in intensive care need to receive personalised communication and ongoing support, and be involved in the dying process. Researchers gathered evidence on how nurses care for patients and their families in intensive care when life-sustaining treatment is withdrawn. The included studies explored the care of the family before, during and after the process. Most of the studies in this small, mixed methods review were qualitative. Reviewers identified three main ways, or the...
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