June suts current awareness by Musgrove Park Hospital Library

Library Services Musgrove Park and Somerset Partnership

Current Awareness Sign Up To Safety This monthly Current Awareness Bulletin is produced by the Library Team, Musgrove Park Academy to provide staff with a range of resources to support Sign Up To Safety. It includes recently published guidelines and research articles, news and policy items.

This guide provides a selection of relevant resources and is not intended to be a comprehensive list. All websites have been evaluated and details are correct at the time of publications. Details correct at time of going to print. Please note that resources are continuously updated. For further help or guidance, please contact a member of library staff.

This guide has been compiled by: Carol-Ann Regan Musgrove Park Hospital Library Service Carol-ann.regan@tst.nhs.uk @musgrovesompar

ď&#x20AC;şď&#x20AC; http://librarymph.wordpress.com/ Issue 7 June 2016

Contents Click on a section title to navigate contents Page Recent journal articles

Books

Cochrane Systematic Reviews

UpToDate and Dynamed Plus

Reports, publications and resources

Literature search service

Training and Athens

Library contact details: Library Musgrove Park Academy Musgrove Park Hospital Taunton Somerset TA1 5DA Tel: 01823 34 (2433) Fax: 01823 34 (2434) Email: library@tst.nhs.uk Blog: http://librarymph.wordpress.com @musgrovesompar

RECENT JOURNAL ARTICLES BACK TO TOP Some articles are available in the library or on-line via an OpenAthens password by following the fulltext link. If you would like an article which is not available as full-text then please contact library staff. Please note that abstracts are not always available for articles.

FALLS Title: Exercise for reducing fear of falling in older people living in the community: Cochrane systematic review and meta-analysis. Citation: Age & Ageing, 2016, vol./is. 45/3(345-352) Author(s): KUMAR, ARUN, DELBAERE, KIM, ZIJLSTRA, G. A. R., CARPENTER, HANNAH, ILIFFE, STEVE, MASUD, TAHIR, SKELTON, DAWN, MORRIS, RICHARD, KENDRICK, DENISE Full Text: Available from Ovid online collection in Age & Ageing Available from Ovid fulltext collection in Age and Ageing Title: Recurrent falls in Parkinson's disease after one year of follow-up: A nested case-control study. Citation: Archives of gerontology and geriatrics, Jul 2016, vol. 65, p. 17-24 Author(s): Gazibara, Tatjana, Tepavcevic, Darija Kisic, Svetel, Marina, Tomic, Aleksandra, Stankovic, Iva, Kostic, Vladimir S, Pekmezovic, Tatjana Abstract: The aims of this study were to compare clinical and fall characteristics of single and recurrent falls among persons with PD and to evaluate factors associated with recurrent falls. A total of 120 consecutive persons with PD, who denied having fallen in the past 6 months, were recruited. Occurrence of falling was registered during one year. Each person was given a "fall diary" with the aim at writing characteristics of the fall and contacted by telephone each month. Over one year of follow-up 42 persons with PD (35.0%) reported falling. Of 42 persons, 19 (45.2%) went on to become single and 23 (54.8%) went on to become recurrent fallers. Indoor falls were more common among single fallers, whilst outdoor falls were more common among recurrent fallers (p=0.017). Slipping and freezing of gait was more common among single fallers (p=0.035 and p=0.024, respectively). Lower extremity weakness was more frequent among recurrent fallers (p=0.023). The most common injury both among single and recurrent fallers was the soft-tissue contusion. The only factor associated with recurrent falling among persons with PD, who did not fall in past 6 months before the start of followup, was worse motor performance as measured by the UPDRS III score (odds ratio [OR]=1.06, 95% confidence interval [CI] 1.01-1.11, p=0.022). These results could be used in selection of persons with PD to enroll in fall prevention programs. Copyright ÂŠ 2016 Elsevier Ireland Ltd. All rights reserved.

Title: Prehospital emergency services screening and referral to reduce falls in community-dwelling older adults: a systematic review. Citation: Emergency medicine journal : EMJ, May 2016, vol. 33, no. 5, p. 345-350 Author(s): Zozula, Alexander, Carpenter, Christopher R, Lipsey, Kim, Stark, Susan

Abstract: Falls represent an increasing source of geriatric morbidity and mortality. Prehospital emergency services may be uniquely suited to screen and refer subsets of high-risk older adults to fall prevention programmes. This systematic review assesses the effectiveness of such screening and referral programmes. We searched PubMed, Embase, CINAHL, Web of Science, Scopus, the Cochrane Library and OTseeker for English-language peer-reviewed randomised trials, nonrandomised trials and cohort studies evaluating prehospital fall risk screening and referral programmes for community-dwelling adults â&#x2030;Ľ60 years of age. Risk of bias was assessed using the Cochrane Collaboration's tool. Primary outcomes included the risk and rate of falling. Secondary outcomes included successful follow-up to address fall risks and adverse events. From 6187 unique records, 6 studies were included. Screening varied from using semistructured risk assessments to recording chief complaints. All studies were at high risk of bias. One unblinded trial of a multifactorial fall prevention programme demonstrated a 14.3% (95% CI 6.1% to 22.5%) absolute reduction in annual fall risk and a relative fall incidence of 0.45 (95% CI 0.35 to 0.58). The probability of successful follow-up varied from 9.8% to 81.0%. No studies demonstrated any attributable adverse events. No high-quality evidence demonstrates that prehospital services reduce falls in community-dwelling older adults. Screening by prehospital personnel using semistructured risk assessments appears feasible, but it is unclear whether this is superior to referral based on fall-related chief complaints. PROSPERO 2012:CRD42012002782. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/productsservices/rights-and-licensing/ Full Text: Available from Highwire Press in Emergency Medicine Journal Title: Systematic review of risk prediction models for falls after stroke. Citation: Journal of epidemiology and community health, May 2016, vol. 70, no. 5, p. 513-519 Author(s): Walsh, Mary E, Horgan, N Frances, Walsh, Cathal D, Galvin, Rose Abstract: Falls are a significant cause of morbidity after stroke. The aim of this review was to identify, critically appraise and summarise risk prediction models for the occurrence of falling after stroke. A systematic literature search was conducted in December 2014 and repeated in June 2015. Studies that used multivariable analysis to build risk prediction models for falls early after stroke were included. 2 reviewers independently assessed methodological quality. Data relating to model calibration, discrimination (C-statistic) and clinical utility (sensitivity and specificity) were extracted. A narrative review of models was conducted. PROSPERO reference: CRD42014015612. The 12 included articles presented 18 risk prediction models. 7 studies predicted falls among inpatients only and 5 recorded falls in the community. Methodological quality was variable. A C-statistic was reported for 7 models and values ranged from 0.62 to 0.87. Models for use in the inpatient setting most frequently included measures of hemi-inattention, while those predicting community events included falls (or near-falls) history and balance measures most commonly. Only 2 studies reported any form of validation, and none presented a validated model with acceptable performance. A number of falls-risk prediction models have been developed for use in the acute and subacute stages of stroke. Future research should focus on validating and improving existing models, with reference to the Transparent Reporting of a multivariable prediction model for Individual Prognosis Or Diagnosis (TRIPOD) guidelines to ensure quality reporting and expedite clinical implementation. Published by the BMJ Publishing Group Limited. For permission to use (where not already granted under a licence) please go to http://www.bmj.com/company/products-services/rights-and-licensing/ Full Text: Available from Highwire Press in Journal of Epidemiology and Community Health Title: Barriers to and promoters of screening for falls in elderly community-dwelling patients by general practitioners: a large cross-sectional survey in two areas of France. Citation: Archives of gerontology and geriatrics, Jul 2016, vol. 65, p. 85-91

Author(s): Gaboreau, Yoann, Imbert, Patrick, Jacquet, Jean-Pierre, Royer De Vericourt, Guillaume, Couturier, Pascal, Gavazzi, Gaëtan Abstract: The objective was to determine the factors affecting French GPs' implementation of annual screening for falls among patients of 75 years old and over. We conduct a cross-sectional study in two areas in the South-east of France (Savoie and Isère). An anonymized survey was sent by e-mail and/or post in May 2008 to all GPs with a large practice. Reminder letters were sent to GPs who hadn't answered between June and July 2008. Potentials barriers were measured by dichotomous scale. On GPs characteristics (socio-demographic, knowledge, attitude and practice), a multiple logistic regression was performed to identify others factors affecting falls screening. 493 questionnaires were analyzed (26.8%). 65.3% of respondents considered annual screening for falls to be useful, though only 28.8% of them implemented it each year and 9.3% every two to five years. Barriers to achieving annual screening included patient selecting (56.3%), forgetting to screen (26.6%), unsuitable working conditions (18.5%), lack of time (13.3%), of knowledge (13.3%), or of financial compensation (11.1%). Perception of the usefulness of annual screening for falls (OR=5.38 (2.07-14.08); p=0.001), satisfaction with medical care for falls (OR=1.34 (1.09-1.65); p=0.006) and increased consultation time (OR=2.65 (1.37-5.13); p=0.004), were found to have a significant impact on the implementation of annual screening for falls. Asking your patient each year if s/he has had any falls, inquiring about gait and balance disturbance is not time consuming. Finally, to improve a healthrelated quality of life, GPs should consider fall assessment as a fundamental feature of medical care. Copyright © 2016 Elsevier Ireland Ltd. All rights reserved.

Title: Association of Hearing Impairment With Incident Frailty and Falls in Older Adults. Citation: Journal of aging and health, Jun 2016, vol. 28, no. 4, p. 644-660 Author(s): Kamil, Rebecca J, Betz, Joshua, Powers, Becky Brott, Pratt, Sheila, Kritchevsky, Stephen, Ayonayon, Hilsa N, Harris, Tammy B, Helzner, Elizabeth, Deal, Jennifer A, Martin, Kathryn, Peterson, Matthew, Satterfield, Suzanne, Simonsick, Eleanor M, Lin, Frank R, Health ABC study Abstract: We aimed to determine whether hearing impairment (HI) in older adults is associated with the development of frailty and falls. Longitudinal analysis of observational data from the Health, Aging and Body Composition study of 2,000 participants aged 70 to 79 was conducted. Hearing was defined by the pure-tone-average of hearing thresholds at 0.5, 1, 2, and 4 kHz in the better hearing ear. Frailty was defined as a gait speed of <0.60 m/s and/or inability to rise from a chair without using arms. Falls were assessed annually by self-report. Older adults with moderate-or-greater HI had a 63% increased risk of developing frailty (adjusted hazard ratio [HR] = 1.63, 95% confidence interval [CI] = [1.26, 2.12]) compared with normal-hearing individuals. Moderate-or-greater HI was significantly associated with a greater annual percent increase in odds of falling over time (9.7%, 95% CI = [7.0, 12.4] compared with normal hearing, 4.4%, 95% CI = [2.6, 6.2]). HI is independently associated with the risk of frailty in older adults and with greater odds of falling over time. © The Author(s) 2015.

Title: Falls screening and assessment tools used in acute mental health settings: a review of policies in England and Wales. Citation: Physiotherapy, Jun 2016, vol. 102, no. 2, p. 178-183 Author(s): Narayanan, V, Dickinson, A, Victor, C, Griffiths, C, Humphrey, D Abstract: There is an urgent need to improve the care of older people at risk of falls or who experience falls in mental health settings. The aims of this study were to evaluate the individual falls risk assessment tools adopted by National Health Service (NHS) mental health trusts in England and healthcare boards in Wales, to evaluate the comprehensiveness of these tools and to review their predictive validity. All NHS mental health trusts in England (n=56) and healthcare boards in Wales (n=6) were invited to supply their falls policies and other relevant documentation (e.g. local falls audits). In order to check the comprehensiveness of tools listed in policy documents, the risk variables of the tools adopted by the mental health trusts' policies were compared with the 2004 National

Institute for Health and Care Excellence (NICE) falls prevention guidelines. A comprehensive analytical literature review was undertaken to evaluate the predictive validity of the tools used in these settings. Falls policies were obtained from 46 mental health trusts. Thirty-five policies met the study inclusion criteria and were included in the analysis. The main falls assessment tools used were the St. Thomas' Risk Assessment Tool in Falling Elderly Inpatients (STRATIFY), Falls Risk Assessment Scale for the Elderly, Morse Falls Scale (MFS) and Falls Risk Assessment Tool (FRAT). On detailed examination, a number of different versions of the FRAT were evident; validated tools had inconsistent predictive validity and none of them had been validated in mental health settings. Falls risk assessment is the most commonly used component of risk prevention strategies, but most policies included unvalidated tools and even well validated tool such as the STRATIFY and the MFS that are reported to have inconsistent predictive accuracy. This raises questions about operational usefulness, as none of these tools have been tested in acute mental health settings. The falls risk assessment tools from only four mental health trusts met all the recommendations of the NICE falls guidelines on multifactorial assessment for prevention of falls. The recent NICE (2013) guidance states that tools predicting risk using numeric scales should no longer be used; however, multifactorial risk assessment and interventions tailored to patient needs is recommended. Trusts will need to update their policies in response to this guidance. Copyright ÂŠ 2015 The Authors. Published by Elsevier Ltd.. All rights reserved.

PRESSURE ULCERS Title: A comparison of the performance of the Braden Q and the Glamorgan paediatric pressure ulcer risk assessment scales in general and intensive care paediatric and neonatal units Citation: Journal of Tissue Viability, May 2016, vol. 25, no. 2, p. 119-126 Author(s): Willock, Jane, Habiballah, Laila, Long, Deborah, Palmer, Kelli, Anthony, Denis Abstract: Aims: To compare the predictive ability of two risk assessment scales used in children. Background: There are several risk assessment scales (RASs) employed in paediatric settings but most have been modified from adult scales such as the Braden Q whereas the Glamorgan was an example of a scale designed for children. Methods: Using incidence data from 513 paediatric hospital admissions, receiver operating characteristic (ROC) was employed to compare the two scales. The area under the curve (AUC) was the outcome of interest. Results: The two scales were similar in this population in terms of area under the curve. Neonatal and paediatric intensive care were similar in terms of AUC for both scales but in general paediatric wards the Braden Q may be superior in predicting risk. Conclusion: Either scale could be used if the predictive ability was the outcome of interest. The scales appear to work well with neonatal, paediatric intensive care and general children's wards. However the Glamorgan scale is probably preferred by childrens' nurses as it is easy to use and designed for use in children. There is some suggestion that while the two scales are similar in intensive care, for general paediatrics the Braden Q may be the better scale. References

Title: Inpatient Pressure Ulcer Prevalence in an Acute Care Hospital Using Evidence-Based Practice Citation: Worldviews on Evidence-Based Nursing, Apr 2016, vol. 13, no. 2, p. 112-117, Author(s): Beal, M. Elizabeth, Smith, Kimberly Abstract: Background. A national goal was set in 2004 for decreasing hospital-acquired pressure ulcers (HAPUs). A mean to achieve that goal was initiated in 2005 with long-term care facilities. Acute care facilities, with encouragement from the Centers for Medicare and Medicaid Services, took action. Aims. Pressure ulcer prevention efforts at MaineGeneral Medical Center (MGMC), a 192-bed acute care hospital in Augusta, Maine, sought to reduce HAPU prevalence from a mean of 7.8% in 2005. Methods. A retrospective study over a 10-year period, from 2005 through 2014, tracked HAPUs and evidence-based practice (EBP) initiatives to decrease the annual mean prevalence rate. Results. The

annual mean HAPU prevalence rate of 7.8% in 2005 decreased to 1.4% in 2011, then maintaining this level through 2014 at MGMC. Evidence-based practices for pressure ulcer prevention were implemented using data collection tools from the National Database of Nursing Quality Indicators; guidelines from the National Pressure Ulcer Advisory Panel; and procedural guidance tools from the 5 Million Lives Campaign and the Agency for Healthcare Research and Quality. Conclusions. Accurate data collection methods and evidence-based guidelines are vital to improving care; yet planning with annual review, fostering an EBP culture, by-in of stakeholders, and education, are the means to longterm consistent implementation of pressure ulcer prevention measures. Linking Evidence to Action. Keys to decreasing and maintaining the rate were based on effective scientific evidence for prevention of pressure ulcers: assessment tools, education, planning guidance, documentation, and evidence-based practice guidelines. References

Title: Inter-Rater Agreement of Pressure Ulcer Risk and Prevention Measures in the National Database of Nursing Quality Indicators速 (NDNQI). Citation: Research in Nursing & Health, 2016, vol./is. 39/3(164-174) Author(s): Waugh, Shirley Moore, Bergquist-Beringer, Sandra

Title: Cost-effectiveness Analysis of Nutritional Support for the Prevention of Pressure Ulcers in HighRisk Hospitalized Patients. Citation: Advances in skin & wound care, Jun 2016, vol. 29, no. 6, p. 261-267 Author(s): Tuffaha, Haitham W, Roberts, Shelley, Chaboyer, Wendy, Gordon, Louisa G, Scuffham, Paul A Abstract: To evaluate the cost-effectiveness of nutritional support compared with standard care in preventing pressure ulcers (PrUs) in high-risk hospitalized patients. An economic model using data from a systematic literature review. A meta-analysis of randomized controlled trials on the efficacy of nutritional support in reducing the incidence of PrUs was conducted. Modeled cohort of hospitalized patients at high risk of developing PrUs and malnutrition simulated during their hospital stay and up to 1 year. Standard care included PrU prevention strategies, such as redistribution surfaces, repositioning, and skin protection strategies, along with standard hospital diet. In addition to the standard care, the intervention group received nutritional support comprising patient education, nutrition goal setting, and the consumption of high-protein supplements. The analysis was from a healthcare payer perspective. Key outcomes of the model included the average costs and qualityadjusted life years. Model results were tested in univariate sensitivity analyses, and decision uncertainty was characterized using a probabilistic sensitivity analysis. Compared with standard care, nutritional support was cost saving at AU $425 per patient and marginally more effective with an average 0.005 quality-adjusted life years gained. The probability of nutritional support being costeffective was 87%. Nutritional support to prevent PrUs in high-risk hospitalized patients is costeffective with substantial cost savings predicted. Hospitals should implement the recommendations from the current PrU practice guidelines and offer nutritional support to high-risk patients.

Title: Prophylactic Sacral Dressing for Pressure Ulcer Prevention in High-Risk Patients. Citation: American journal of critical care : an official publication, American Association of CriticalCare Nurses, May 2016, vol. 25, no. 3, p. 228-234 Author(s): Byrne, Jaime, Nichols, Patricia, Sroczynski, Marzena, Stelmaski, Laurie, Stetzer, Molly, Line, Cynthia, Carlin, Kristen Abstract: Patients in intensive care units are likely to have limited mobility owing to hemodynamic instability and activity orders for bed rest. Bed rest is indicated because of the severity of the disease process, which often involves intubation, sedation, paralysis, surgical procedures, poor nutrition, low

flow states, and poor circulation. These patients are predisposed to the development and/or the progression of pressure ulcers not only because of their underlying diseases, but also because of limited mobility and deconditioned states of health. To assess whether treating high-risk patients with a prophylactic sacral dressing decreases the incidence of unit-acquired sacral pressure ulcers. An evidence-based tool for identifying patients at high risk for pressure ulcers was used in 3 intensive care units at an urban tertiary care hospital and academic medical center. Those patients deemed at high risk had a prophylactic sacral dressing applied. Incidence rates were collected and compared for the 7 months preceding use of the dressings and for 7 months during the trial period when the dressing was used. After the sacral dressing began being used, the number of unit-acquired sacral pressure ulcers decreased by 3.4 to 7.6 per 1000 patient days depending on the unit. A prophylactic sacral dressing may help prevent unit-acquired sacral pressure ulcers. Implementation of an involved care team with heightened awareness and increased education along with a prophylactic sacral dressing in patients deemed high risk for skin breakdown are all essential for success. ÂŠ2016 American Association of Critical-Care Nurses. Full Text: Available from EBSCOhost in American Journal of Critical Care

SEPSIS Title: Gaps and improvement in the management of sepsis Citation: Nursing Times, 2016, 112(17) pp15-17 Authors: C Plowright Abstract: This article discusses the findings of the 2015 National Confidential Enquiry into Patient Outcome and Death in relation to sepsis.

Title: Sepsis Update: A New Core Measure of Quality Citation; The Journal of Continuing Education in Nursing 2016 47 (5) p204-206. Authors: Fiona Winterbottom, Misty Jenkins, Marlene Alonzo

Title: Neutropenic sepsis: prevention, identification and treatment Citation: Nursing Standard, Apr 2016, vol. 30, no. 35, p. 51-60 Author(s): Warnock, Clare Abstract: Chemotherapy-induced neutropenia may result in significant physical, social and emotional consequences for patients receiving anticancer therapy. Chemotherapy-induced neutropenia also leads to delays in treatment and reductions in dose intensity. In some cases neutropenia may be prevented by the use of granulocyte-colony stimulating factor, but it remains one of the most common side effects of chemotherapy. Patients who are neutropenic have a reduced ability to fight infection and are at increased risk of developing neutropenic sepsis. Nurses need to be able to recognise the signs and symptoms of neutropenic sepsis to ensure early diagnosis and treatment. There are evidence-based pathways for the treatment of patients with neutropenic sepsis and nurses have the potential to develop services and initiatives to support best practice for this group of patients. [Continuing Professional Development, NS841] References Full Text:

Available from NURSING STANDARD in Library MPH Title: Prevalence and Characteristics of Chronic Intensive Care-Related Pain: The Role of Severe Sepsis and Septic Shock. Citation: Critical Care Medicine, 2016, vol./is. 44/6(1129-1137) Author(s): Baumbach, Philipp, Götz, Theresa, Günther, Albrecht, Weiss, Thomas, Meissner, Winfried Abstract: Objective: There is only limited knowledge about chronic pain conditions resulting from critical care. Experimental and clinical data suggest a close relationship between inflammation and pain perception. Since sepsis is the most severe form of systemic inflammation, the primary objective was to evaluate chronic pain states and functional impairment of septic and nonseptic patients 6 months after discharge from ICU. Second, we aimed to obtain the total prevalence and characteristics of chronic ICU-related pain.Design: Case-control study.Setting: Observational study in long-term survivors of mixed surgical and medical ICUs.Patients: Septic and nonseptic survivors of critical care (n = 207) and healthy controls (n = 46).Interventions: None.Measurements and Main Results: We collected comprehensive information on patients' past and present pain 6 months after ICU discharge by means of the German pain questionnaire. Pain intensity levels and pain interference ratings were compared between septic and nonseptic patients and healthy controls. We found no differences in prevalence, severity, and interference of pain between septic and nonseptic patients. However, both patient groups differed significantly from controls. In secondary analysis, a third of all patients reported chronic clinically relevant pain associated with the ICU stay 6 months after ICU discharge. Half of these patients experienced chronic pain conditions before ICU admission and reported additional sources of pain. Most important, 16% of all patients had no preexisting pain condition and now experience chronic ICU-related pain. The majority of patients with chronic ICU-related pain reported a high degree of disabling pain, limiting daily activities.Conclusions: A high percentage of former ICU patients develop chronic pain conditions associated with critical care. These patients differ significantly from control data in terms of pain intensity and show high levels of interference with pain. The presence of sepsis per se seems to play a marginal role for the development of chronic ICUrelated pain. Full Text: Available from Ovid online collection in Critical Care Medicine Available from Ovid fulltext collection in Critical Care Medicine Title: Treating Sepsis: Nearest Neighbors and Predicting Beginnings. Citation: Critical Care Medicine, 2016, vol./is. 44/6(1261-1262) Author(s): Seely, Andrew J. E. Language: English Full Text: Available from Ovid online collection in Critical Care Medicine Available from Ovid fulltext collection in Critical Care Medicine Title: Pediatric sepsis. Citation: Current Opinion in Pediatrics, 2016, vol./is. 28/3(380-387) Author(s): Mathias, Brittany, Mira, Juan C., Larson, Shawn D. Abstract: Purpose Of Review: Sepsis is the leading cause of pediatric death worldwide. In the United States alone, there are 72 000 children hospitalized for sepsis annually with a reported mortality rate of 25% and an economic cost estimated to be $4.8 billion. However, it is only recently that the definition and management of pediatric sepsis has been recognized as being distinct from adult sepsis.Recent Findings: The definition of pediatric sepsis is currently in a state of evolution, and there

is a large disconnect between the clinical and research definitions of sepsis which impacts the application of research findings into clinical practice. Despite this, it is the speed of diagnosis and the timely implementation of current treatment guidelines that has been shown to improve outcomes. However, adherence to treatment guidelines is currently low and it is only through the implementation of protocols that improved care and outcomes have been demonstrated.Summary: The current management of pediatric sepsis is largely based on adaptations from adult sepsis treatment; however, distinct physiology demands more prospective pediatric trials to tailor management to the pediatric population. Adherence to current and emerging practice guidelines will require that protocolized care pathways become a commonplace.

Full Text: Available from Ovid online collection in Current Opinion in Pediatrics Available from Ovid fulltext collection in Current Opinion in Pediatrics Title: Evolving Management of the Cancer Patient With Sepsis. Citation: Oncology Times, 2016, vol./is. 38/9(1-3) Author(s): Goldman, Jason D.

Title: Sepsis and Acute Respiratory Distress Syndrome: Recent Update. Citation: Tuberculosis and respiratory diseases, Apr 2016, vol. 79, no. 2, p. 53-57 Author(s): Kim, Won-Young, Hong, Sang-Bum Abstract: Severe sepsis or septic shock is characterized by an excessive inflammatory response to infectious pathogens. Acute respiratory distress syndrome (ARDS) is a devastating complication of severe sepsis, from which patients have high mortality. Advances in treatment modalities including lung protective ventilation, prone positioning, use of neuromuscular blockade, and extracorporeal membrane oxygenation, have improved the outcome over recent decades, nevertheless, the mortality rate still remains high. Timely treatment of underlying sepsis and early identification of patients at risk of ARDS can help to decrease its development. In addition, further studies are needed regarding pathogenesis and novel therapies in order to show promising future treatments of sepsis-induced ARDS.

Full Text: Available from National Library of Medicine in Tuberculosis and Respiratory Diseases Title: A rational approach to fluid therapy in sepsis. Citation: British journal of anaesthesia, Mar 2016, vol. 116, no. 3, p. 339-349 Author(s): Marik, P, Bellomo, R Abstract: Aggressive fluid resuscitation to achieve a central venous pressure (CVP) greater than 8 mm Hg has been promoted as the standard of care, in the management of patients with severe sepsis and septic shock. However recent clinical trials have demonstrated that this approach does not improve the outcome of patients with severe sepsis and septic shock. Pathophysiologically, sepsis is characterized by vasoplegia with loss of arterial tone, venodilation with sequestration of blood in the unstressed blood compartment and changes in ventricular function with reduced compliance and reduced preload responsiveness. These data suggest that sepsis is primarily not a volume-depleted state and recent evidence demonstrates that most septic patients are poorly responsive to fluids. Furthermore, almost all of the administered fluid is sequestered in the tissues, resulting in severe oedema in vital organs and, thereby, increasing the risk of organ dysfunction. These data suggest that a physiologic, haemodynamically guided conservative approach to fluid therapy in patients with sepsis

would be prudent and would likely reduce the morbidity and improve the outcome of this disease. © The Author 2015. Published by Oxford University Press on behalf of the British Journal of Anaesthesia. All rights reserved. For Permissions, please email: journals.permissions@oup.com.

DETERIORATING PATIENT Title: Consumer participation in early detection of the deteriorating patient and call activation to rapid response systems: a literature review. Citation: Journal of Clinical Nursing, 2016, vol./is. 25/1/2(38-52) Author(s): Vorwerk, Jane, King, Lindy

Title: The experiences of nurses implementing the Modified Early Warning Score and a 24-hour oncall Mobile Intensive Care Nurse: An exploratory study. Citation: Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses, Jun 2016, vol. 34, p. 25-33 Author(s): Stafseth, Siv K, Grønbeck, Sturle, Lien, Tine, Randen, Irene, Lerdal, Anners Abstract: To explore experiences of nurses implementing and using the Modified Early Warning Score (MEWS) and a Mobile Intensive Care Nurse (MICN) providing 24-hour on-call nursing support. To secure patient safety in hospital wards, nurses may increase the quality of care using a tool to detect the failure of vital functions. Possibilities for support can be provided through on-call supervision from a qualified team or nurse. This exploratory qualitative investigation used focus group interviews with nurses from two wards of a university hospital in Norway. A purposive sample of seven registered nurses was interviewed in focus groups. A semi-structured guide and an inductive thematic analysis were used to identify interview themes. Three themes emerged: (1) experiences with the early recognition of deterioration using the MEWS, (2) supportive collaboration and knowledge transfer between nurses and (3) a "new" precise language using the score for communicating with physicians. The use of scores and support were perceived as improving care for deteriorating patients and for supporting the collaboration of nurses with other professionals. In our study, nurses described increased confidence in the recognition of deteriorating patients and in the management of such situations. The non-critical attitude, supportive communication and interactive learning according to the MICN were essential elements for success. Copyright © 2015 Elsevier Ltd. All rights reserved.

Title: Vital signs monitoring and nurse-patient interaction: A qualitative observational study of hospital practice. Citation: International journal of nursing studies, Apr 2016, vol. 56, p. 9-16 Author(s): Cardona-Morrell, M, Prgomet, M, Lake, R, Nicholson, M, Harrison, R, Long, J, Westbrook, J, Braithwaite, J, Hillman, K Abstract: High profile safety failures have demonstrated that recognising early warning signs of clinical and physiological deterioration can prevent or reduce harm resulting from serious adverse events. Early warning scoring systems are now routinely used in many places to detect and escalate deteriorating patients. Timely and accurate vital signs monitoring are critical for ensuring patient safety through providing data for early warning scoring systems, but little is known about current monitoring practices. To establish a profile of nurses' vital signs monitoring practices, related dialogue, and adherence to health service protocol in New South Wales, Australia. Direct observations of nurses' working practices were conducted in two wards. The observations focused on

times of the day when vital signs were generally measured. Patient interactions were recorded if occurring any time during the observation periods. Participants (n=42) included nursing staff on one chronic disease medical and one acute surgical ward in a large urban teaching hospital in New South Wales. We observed 441 patient interactions. Measurement of vital signs occurred in 52% of interactions. The minimum five vital signs measures required by New South Wales Health policy were taken in only 6-21% of instances of vital signs monitoring. Vital signs were documented immediately on 93% of vitals-taking occasions and documented according to the policy in the patient's chart on 89% of these occasions. Nurse-patient interactions were initiated for the purpose of taking vital signs in 49% of interactions, with nurse-patient discourse observed during 88% of all interactions. Nursepatient dialogue led to additional care being provided to patients in 12% of interactions. The selection of appropriate vital signs measured and responses to these appears to rely on nurses' clinical judgement or time availability rather than on policy-mandated frequency. The prevalence of incomplete sets of vital signs may limit identification of deteriorating patients. The findings from this study present an important baseline profile against which to evaluate the impact of introducing continuous monitoring approaches on current hospital practice. Copyright ÂŠ 2015 Elsevier Ltd. All rights reserved.

RESTRICTIVE PRACTICE Title: Using restraint: legal and professional considerations Citation: British Journal of Neuroscience Nursing, Apr 2016, vol. 12, no. 2, p. 94-95 Author(s): Griffith, Richard Abstract: In this article Richard Griffith considers the legal and professional requirements that must inform a nurse's decision to use restraint. References ________________________________________________________________________________ Title: Is an unhealthy work environment in nursing home care for people with dementia associated with the prescription of psychotropic drugs and physical restraints? Citation: International Psychogeriatrics, 2016, vol./is. 28/6(983-994) Author(s): Willemse, Bernadette M., de Jonge, Jan, Smit, Dieneke, Dasselaar, Wouter, Depla, Marja F. I. A., Pot, Anne Margriet Abstract: Background: Research showed that long-term care facilities differ widely in the use of psychotropic drugs and physical restraints. The aim of this study is to investigate whether characteristics of an unhealthy work environment in facilities for people with dementia are associated with more prescription of psychotropic drugs and physical restraints.Methods: Data were derived from the first wave (2008-2009) of a national monitoring study in the Netherlands. This paper used data on prescription of psychotropic drugs and physical restraints from 111 long-term care facilities, residing 4,796 residents. Survey data of a sample of 996 staff and 1,138 residents were considered. The number of residents with prescribed benzodiazepines and anti-psychotic drugs, and physical restraints were registered. Work environment was assessed using the Leiden Quality of Work Questionnaire (LQWQ).Results: Logistic regression analyses showed that more supervisor support was associated with less prescription of benzodiazepines. Coworker support was found to be related to less prescription of deep chairs. Job demands and decision authority were not found to be predictors of psychotropic drugs and physical restraints.Conclusions: Staff's job characteristics were scarcely related to the prescription of psychotropic drugs and physical restraints. This finding indicates that in facilities with an unhealthy work environment for nursing staff, one is not more likely to prescribe drugs or restraints. Further longitudinal research is needed with special attention for multidisciplinary decision making - especially role of physician, staff's knowledge, philosophy of care and institutional policy to gain further insight into factors influencing the use of psychotropic drugs and

restraints. ________________________________________________________________________________ Title: Use of physical restraint: ethical, legal and political issues. Citation: Learning Disability Practice, 2016, vol./is. 19/4(23-27), 14658712 Author(s): Hughes, Layla, Lane, Paula Language: English Publication type: Academic Journal Source: CINAHL Full text: Available RCN Publishing at Learning Disability Practice ________________________________________________________________________________ Title: A non-pharmacologic approach to decrease restraint use. Citation: Intensive & critical care nursing : the official journal of the British Association of Critical Care Nurses, Jun 2016, vol. 34, p. 12-19 Author(s): Johnson, Kari, Curry, Valerie, Steubing, Alison, Diana, Shelly, McCray, Andrea, McFarren, Amanda, Domb, Alisa Abstract: To evaluate an education intervention to decrease restraint use in patients in a Trauma Intensive Care Unit (TICU) and to evaluate nurses' perceptions regarding restraints. To measure restraint use pre/post-intervention and to measure nurses' perceptions of restraint use. Pre/post-intervention design to collate incidences of delirium and restraints pre/post-intervention. Data reporting nurses' views and preferences were collected pre-intervention. Patients were assessed by nursing on admission and every shift with the Confusion Assessment Method for TICU. Restraint use was measured in a 24-hour period. Nurses' perception of restraints was measured using Perceptions of Restraint Use Questionnaire (PRUQ). A statistically significant difference was demonstrated in restraint use before and after the educational intervention. Mean and standard deviation for restraints per 1000 patient days pre-intervention was 314.1 (35.4), post-intervention 237.8 (56.4) (p=0.008). Mean PRUQ overall, 3.57 (range 1-5) indicated that nurses had positive attitudes towards restraints in certain circumstances. The primary reasons for using restraints were: "protecting patients from falling out of bed", 37 (72.5%), and "protecting patients from falling out of chair", 34 (66.7%). This study demonstrates that a low risk educational intervention aimed at use of an alternative device use can reduce restraint use. ________________________________________________________________________________ Title: Australian nurses' perceptions of the use of manual restraint in the Emergency Department: a qualitative perspective. Citation: Journal of clinical nursing, May 2016, vol. 25, no. 9-10, p. 1273-1281 Author(s): Chapman, Rose, Ogle, Kaye Robyn, Martin, Catherine, Rahman, Asheq, McKenna, Brian, Barnfield, Jakqui Abstract: To explore emergency nurses perceptions of the use of manual restraint. Manual restraint of patients has historically been an accepted practice, though little is known about the use of manual restraint in general hospitals. A qualitative, descriptive, exploratory, study was undertaken. Fifteen semi-structured interviews with emergency nurses were completed. Data were analysed using qualitative thematic analysis procedures. The following themes were identified: 'part of the job', 'reasons for manual restraint', 'restraint techniques', 'consequences' and 'lack of documentation'. Manual restraint occurred frequently each shift and most were not documented. This may be due to nurse's perceptions that manually restraining a patient did not comprise formal restraint and was the only option. Nurses used manual restraint to manage patients who were violent and aggressive or to perform procedures. However, they reported a lack of education and training in manual restraint. Nurses identified several consequences for the patient, staff and the organisation as a result of these events including psychological and physical injuries. Empirical research of prevalence and issues surrounding manual restraint events is required to inform

health care organisations and government to develop, implement and evaluate appropriate policies and strategies to ensure safety of patients and staff. The employment of peer support workers and professionals with expertise in mental health and dementia may aid in the reduction of manual restraint events and improve care of all patients within the Emergency Department. Research on manual restraint in health settings is also needed. Nurses need to be aware that manual restraint is not just an accepted part of their work, but is a strategy of last resort that should be documented. Organisations must implement standardised educational programmes for nurses together with policies and processes to monitor and evaluate manual restraint events.

________________________________________________________________________________

PATIENT SAFETY Supporting infection control and patient safety Rosanna Shackleton, Lorraine Pollard, SinĂŠad Smith British Journal of Healthcare Management 2016 22 (5) p258â&#x20AC;&#x201C;260 ________________________________________________________________________________ Title: Sleep deprivation and starvation in hospitalised patients: how medical care can harm patients Citation: BMJ Quality and Safety, May 2016, vol. 25, no. 5, p. 311-314, 2044 Author(s): Xu, Tim, Wick, Elizabeth C, Makary, Martin A Abstract: The field of patient safety has focused on acute adverse events. However, hospitalised patients face regular stressors, such as sleep deprivation and malnutrition, which frequently predispose them to other complications, yet are unlikely to be detected as preventable adverse events in chartbased studies. References

Full text: Available Highwire Press at BMJ Quality and Safety ________________________________________________________________________________ Title: Developing a primary care patient measure of safety (PC PMOS): a modified Delphi process and face validity testing Citation: BMJ Quality and Safety, Apr 2016, vol. 25, no. 4, p. 273-280 Author(s): Hernan, Andrea L, Giles, Sally J, O'Hara, Jane K, Fuller, Jeffrey, Johnson, Julie K, Dunbar, James A Abstract: Background Patients are a valuable source of information about ways to prevent harm in primary care and are in a unique position to provide feedback about the factors that contribute to safety incidents. Unlike in the hospital setting, there are currently no tools that allow the systematic capture of this information from patients. The aim of this study was to develop a quantitative primary care patient measure of safety (PC PMOS). Methods A two-stage approach was undertaken to develop questionnaire domains and items. Stage 1 involved a modified Delphi process. An expert panel reached consensus on domains and items based on three sources of information (validated hospital PMOS, previous research conducted by our study team and literature on threats to patient safety). Stage 2 involved testing the face validity of the questionnaire developed during stage 1 with patients and primary care staff using the 'think aloud' method. Following this process, the questionnaire was revised accordingly. Results The PC PMOS was received positively by both patients and staff during face validity testing. Barriers to completion included the length, relevance and clarity of questions. The final PC PMOS consisted of 50 items across 15 domains. The contributory factors to safety incidents centred on communication, access to care, patient-related factors, organisation and care planning, task performance and information flow. Discussion This is the

first tool specifically designed for primary care settings, which allows patients to provide feedback about factors contributing to potential safety incidents. The PC PMOS provides a way for primary care organisations to learn about safety from the patient perspective and make service improvements with the aim of reducing harm in this setting. Future research will explore the reliability and construct validity of the PC PMOS. References Full text: Available Highwire Press at BMJ Quality and Safety ________________________________________________________________________________ Title: Trust, temporality and systems: how do patients understand patient safety in primary care? A qualitative study Citation: Health Expectations, Apr 2016, vol. 19, no. 2, p. 253-263 Author(s): Rhodes, Penny, Campbell, Stephen, Sanders, Caroline Abstract: Introduction: Patient safety research has tended to focus on hospital settings, although most clinical encounters occur in primary care, and to emphasize practitioner errors, rather than patients' own understandings of safety. Objective: To explore patients' understandings of safety in primary care. Methods: Qualitative interviews were conducted with patients recruited from general practices in northwest England. Participants were asked basic socio-demographic information; thereafter, topics were largely introduced by interviewees themselves. Transcripts were coded and analysed using NVivo10 (qualitative data software), following a process of constant comparison. Results: Thirty-eight people (14 men, 24 women) from 19 general practices in rural, small town and city locations were interviewed. Many of their concerns (about access, length of consultation, relationship continuity) have been discussed in terms of quality, but, in the interviews, were raised as matters of safety. Three broad themes were identified: (i) trust and psycho-social aspects of professional-patient relationships; (ii) choice, continuity, access, and the temporal underpinnings of safety; and (iii) organizational and systems-level tensions constraining safety. Discussion: Conceptualizations of safety included common reliance on a bureaucratic framework of accreditation, accountability, procedural rules and regulation, but were also individual and context-dependent. For patients, safety is not just a property of systems, but personal and contingent and is realized in the interaction between doctor and patient. However, it is the systems approach that has dominated safety thinking, and patients' individualistic and relational conceptualizations are poorly accommodated within current service organization. References ________________________________________________________________________________ Title: Relationship between patient safety climate and standard precaution adherence: a systematic review of the literature Citation: Journal of Hospital Infection, Apr 2016, vol. 92, no. 4, p. 349-362 Author(s): Hessels, A.J., Larson, E.L. Abstract: Standard precaution (SP) adherence is universally suboptimal, despite being a core component of healthcare-associated infection (HCAI) prevention and healthcare worker (HCW) safety. Emerging evidence suggests that patient safety climate (PSC) factors may improve HCW behaviours. Our aim was to examine the relationship between PSC and SP adherence by HCWs in acute care hospitals. A systematic review was conducted as guided by the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Three electronic databases were comprehensively searched for literature published or available in English between 2000 and 2014. Seven of 888 articles identified were eligible for final inclusion in the review. Two reviewers independently assessed study quality using a validated quality tool. The seven articles were assigned quality scores ranging from 7 to 10 of 10 possible points. Five measured all aspects of SP and two solely measured needlestick and sharps handling. Three included a secondary outcome of HCW exposure; none included HCAIs. All reported a statistically significant relationship between better PSC and greater SP adherence and used data from self-report surveys including validated PSC measures or measures of management support and leadership. Although limited in number, studies were of high quality and confirmed that PSC and SP adherence were correlated, suggesting that efforts to improve PSC may enhance adherence to a core component of HCAI prevention and HCW safety. More clearly evident is

the need for additional high-quality research. References ________________________________________________________________________________ Title: Moving from a blame culture to a learning culture in the NHS . Citation: British Journal of Nursing, 2016, vol./is. 25/7(410-411) Author(s): Glasper, Alan Abstract: The article offers the author's insights on the speech made by Great Britain Secretary of State for Health Jeremy Hunt on the priority on patient safety in the National Health Service (NHS). Topics include the establishment of the Healthcare Safety Investigation Branch (HSIB) which provides legal protection for whistleblowers related to clinical mistakes, the review made by medical examiners on death causes, and Care Quality Commission (CQC)'s focus on safety during hospital inspections. Full text: Available EBSCOhost at British Journal of Nursing Full text: Available EBSCOhost at British Journal of Nursing ________________________________________________________________________________ Title: An integrative review of patient safety in studies on the care and safety of patients with communication disabilities in hospital Citation: Patient Education & Counseling, 2016, vol./is. 99/4 Author(s): Hemsley, Bronwyn, Georgiou, Andrew, Hill, Sophie, Rollo, Megan, Steel, Joanne, Balandin, Susan Abstract: Objective: To review the research literature on the experiences of patients with communication disabilities in hospital according to the Generic Model of patient safety.Methods: In 2014 and 2015, we searched four scientific databases for studies with an aim or result relevant to safety of hospital patients with communication disabilities. The review included 27 studies.Results: A range of adverse event types were outlined in qualitative research. Little detail was provided about contributing or protective factors for safety incidents in hospital for these patients or the impact of the incidents on the patient or organisations involved.Conclusion: Further research addressing the safety of patients with communication disabilities is needed. Sufficient detail is required to identify the nature, timing, and detection of incidents; factors that contribute to or prevent adverse events; and detail the impact of the adverse events.Practice Implications: In order to provide safe and effective care to people with communication disabilities in hospital, a priority for health and disability services must be the design and evaluation of ecologically appropriate and evidence-based interventions to improve patient care, communication, and reduce the risk of costly and harmful patient safety incidents.

________________________________________________________________________________

HUMAN FACTORS Title: Implicit Coordination Strategies for Effective Team Communication. Citation: Human factors, Jun 2016, vol. 58, no. 4, p. 595-610 Author(s): Butchibabu, Abhizna, Sparano-Huiban, Christopher, Sonenberg, Liz, Shah, Julie Abstract: We investigated implicit communication strategies for anticipatory information sharing during team performance of tasks with varying degrees of complexity. We compared the strategies used by teams with the highest level of performance to those used by the lowest-performing teams to evaluate the frequency and methods of communications used as a function of task structure.

High-performing teams share information by anticipating the needs of their teammates rather than explicitly requesting the exchange of information. As the complexity of a task increases to involve more interdependence among teammates, the impact of coordination on team performance also increases. This observation motivated us to conduct a study of anticipatory information sharing as a function of task complexity. We conducted an experiment in which 13 teams of four people performed collaborative search-anddeliver tasks with varying degrees of complexity in a simulation environment. We elaborated upon prior characterizations of communication as implicit versus explicit by dividing implicit communication into two subtypes: (a) deliberative/goal information and (b) reactive status updates. We then characterized relationships between task structure, implicit communication, and team performance. We found that the five teams with the fastest task completion times and lowest idle times exhibited higher rates of deliberative communication versus reactive communication during high-complexity tasks compared with the five teams with the slowest completion times and longest idle times (p = .039). Teams in which members proactively communicated information about their next goal to teammates exhibited improved team performance. The findings from our work can inform the design of communication strategies for team training to improve performance of complex tasks. ________________________________________________________________________________ Title: Discovering Innovation at the Intersection of Undergraduate Medical Education, Human Factors, and Collaboration: The Development of a Nasogastric Tube Safety Pack. Citation: Academic medicine : journal of the Association of American Medical Colleges, Apr 2016, vol. 91, no. 4, p. 512-516 Author(s): Taylor, Natalie, Bamford, Thomas, Haindl, Cornelia, Cracknell, Alison Abstract: Significant deficiencies exist in the knowledge and skills of medical students and residents around health care quality and safety. The theory and practice of quality and safety should be embedded into undergraduate medical practice so that health care professionals are capable of developing interventions and innovations to effectively anticipate and mitigate errors. Since 2011, Leeds Medical School in the United Kingdom has used case study examples of nasogastric (NG) tube patient safety incidents within the undergraduate patient safety curriculum. In 2012, a medical undergraduate student approached a clinician with an innovative idea after undertaking an NG tubes root cause analysis case study. Simultaneously, a separate local project demonstrated low compliance (11.6%) with the United Kingdom's National Patient Safety Agency NG tubes guideline for use of the correct method to check tube position. These separate endeavors led to interdisciplinary collaboration between a medical student, health care professionals, researchers, and industry to develop the Initial Placement Nasogastric Tube Safety Pack. Human factors engineering was used to inform pack design to allow guideline recommendations to be accessible and easy to follow. A timeline of product development, mapped against key human factors and medical device design principles used throughout the process, is presented. The safety pack has since been launched in five UK National Health Service (NHS) hospitals, and the pack has been introduced into health care professional staff training for NG tubes. A mixed-methods evaluation is currently under way in five NHS organizations.

________________________________________________________________________________

BOOKS BACK TO TOP If you are unable to find a book, or require a book that is not on this list, please ask library staff who will be able to locate the book for you using interlibrary loan. We now have a subscription to EBL Electronic Books and would be interested to know if there are any titles you feel would be of benefit to be added to our collection. The catalogue can be browsed here; you will need your OpenAthens password to access it. You can request books either on the site itself or by emailing us on library@tst.nhs.uk

Dekker,S. Patient safety People often think, understandably, that safety lies mainly in the hands through which care ultimately flows to the patient--those who are closest to the patient, whose decisions can mean the difference between life and death, between health and morbidity. The human factors approach refuses to lay the responsibility for safety and risk solely at the feet of people at the sharp end. That is where we should intervene to make things safer, to tighten practice, to focus attention, to remind people to be careful, to impose rules and guidelines. The book defines an approach that looks relentlessly for sources of safety and risk everywhere in the system--the designs of devices; the teamwork and coordination between different practitioners; their communication across hierarchical and gender boundaries; the cognitive processes of individuals; the organization that surrounds, constrains, and empowers them; the economic and human resources offered; the technology available; the political landscape; and even the culture of the place

E copy can be viewed: https://ebookcentral.proquest.com/lib/tstnhs/detail.action?docID=726851

COCHRANE SYSTEMATIC REVIEWS BACK TO TOP

Antibiotics and antiseptics for pressure ulcers Gill Norman , Jo C Dumville , Zena EH Moore, Judith Tanner , Janice Christie and Saori Goto Online Publication Date: April 2016

Oral aspirin for treating venous leg ulcers Paulo Eduardo de Oliveira Carvalho, Natiara G Magolbo, Rebeca F De Aquino and Carolina D Weller Online Publication Date: February 2016

New review

UPTODATE and DYAMED PLUS BACK TO TOP

UpToDate Access is available to MPH staff only but topics from UpTodate can be supplied to Sompar staff on request. OpenAthens password required. 

Falls in older persons: Risk factors and patient evaluation



Falls: Prevention in nursing care facilities and the hospital setting



Prevention of pressure ulcers



Evaluation and management of severe sepsis and septic shock in adults



Assessment and emergency management of the acutely agitated or violent adult



Prevention of adverse drug events in hospitals

Please contact library staff for details on how to access this resource; you will need an Athens password if accessing from home.

Dynamed Plus Access is available to Sompar staff only but topics from UpTodate can be supplied to MPH staff on request. Open Athens password required

Falls in the elderly Pressure ulcer Sepsis in adults Sepsis treatment in adults Please contact library staff for details on how to access this resource; you will need an Athens password if accessing from home.

REPORTS, PUBLICATIONS AND RESOURCES

Staff Stories â&#x20AC;&#x201C; understanding the reality of working in healthcare In the first half of 2016, NHS England funded Patient Voices workshops for staff to create their own digital stories about working in healthcare. The intention is that the stories will be used to help other people understand the reality of working in healthcare so we may all learn from experiences, both good and bad; sharing stories in this way helps contribute to healthcare that is safer, more dignified, more humane and more compassionate for everyone.

http://www.patientvoices.org.uk/dnaoc.htm

Safety Scores: a new tool developed at Bartâ&#x20AC;&#x2122;s NHS Trust Safety Scores is a tool created to help distribute patient workload more evenly amongst the team Read more at: http://www.fabnhsstuff.net/2016/05/18/safety-scores/

Adult Sepsis Safety Net

This leaflet has been produced in collaboration with The UK Sepsis Trust. http://patient.info/health/adult-sepsis-safety-net 20

Free Sepsis App 31,000 people die every year as a result of sepsis according to NHS figures. This free app created by NHS Education for Scotland/ the Scottish Patient Safety Programme aims to help clinicians cut the number of deaths from the condition. The app can act as a valuable resource to refer back to guidelines, while nurses and health professionals can also use the screening tool to confirm sepsis diagnosis. Available free from the App Store. For more details click here

MPH Colleague App For Musgrove staff the SUTS current awareness is now available on the Colleague App. If you have not downloaded this App here are the instructions: To download, follow the short instructions below: For Apple / Android devices: 1. Copy or type the link below into your device browser: https://apps.appmachine.com/3591BD/download 2. Give permissions for the download when asked 3. Allow push notifications, to get regular updates/rewards info 4. Click on the app and start exploring. Please note: if you have upgraded your software to iOS 9 you will need to follow these steps once the app has been downloaded: o Click on ‘Settings’ o Click on ‘General’ o Click on ‘Profile’ o Tap on the colleague app o Tap on @Trust (Chapelcroft Limited).

In addition to the above the following QR Code is now appearing in the staff bulletin inviting staff to ‘download the free colleague app to your mobile device’

LITERATURE SEARCH SERVICE BACK TO TOP Looking for the latest evidence-based research but havenâ&#x20AC;&#x2122;t got time to trawl the databases? Do you need a literature search carried out? Do you need to find evidence to support an improvement? Do you want to know how something has been done elsewhere and whether it worked?

Library staff provide a literature search service for busy clinicians who are pressed for time.

To request a search please complete and return the attached form ,providing as much information as possible. Alternatively if you would like an assisted search training session, where we will sit down with you and go through the steps of a literature search, then please contact the library.

TRAINING AND ATHENS BACK TO TOP Most electronic resources are available via an Athens password. You can register for this via the Library intranet page, or from home at www.swice.nhs.uk and following the link for Athens selfregistration. Please note that registering from home will take longer as it will need to be verified that you are NHS staff/student on placement. The library offers training on how to access and use Athens resources, as well as an introductory course on critical appraisal. You can book a course through the Learning and Development intranet page, or by contacting the library directly.