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Autism awareness training to be made mandatory for healthcare staff

Training is to be introduced for the entire health and care workforce, including ancillary staff, by the end of 2019.

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Autism awareness training is to be included within mandatory training for healthcare staff.

Minister for Care, Caroline Dinenage MP, has announced plans to include autism training within the mandatory training framework for NHS and healthcare staff.

The announcement comes following a parliamentary debate organised in response to a petition started following the tragic death of Oliver McGowan in November 2016. Oliver’s mother believes his death could have been prevented if doctors and nurses had understood the adjustments needed for his autism and learning disabilities.

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The Government’s final plans for the training will be published by the summer with the aim of training being introduced for the entire health and care workforce, including ancillary staff, by the end of 2019. The requirement will be added to tier one of the Core Skills Education and Training Framework.

People with learning disabilities are still dying prematurely.

In September, the Learning Disabilities Mortality Review (LeDeR) annual report identified an unacceptable situation in which people with learning disabilities die at a rate far greater than the general population, from conditions that could be prevented or treated by a better quality of care.

A parliamentary spokesperson said; “We want all staff to receive the support, training and professional development they need to support people with learning disabilities and autism, in line with employers’ existing responsibilities.”

“To ensure that health and care staff also have appropriate knowledge and awareness of autism, the Department of Health and Social Care has commissioned the development of a Core Skills and Competency Framework for Autism.”

“The recent annual report of the Learning Disability Mortality Review (LeDeR) Programme highlighted that people with a learning disability are still dying prematurely due to avoidable factors. We recognise that more is needed to address this profound inequality.”

Simple changes can help.

Jane Harris, Director of External Affairs at the National Autistic Society said the training “has the potential to improve the health and wellbeing of hundreds of thousands of autistic people”

“This is a direct result of Paula McGowan’s tireless campaigning, in memory of her son Oliver, including her petition which gained over 50,000 signatures. We are proud to support Paula’s campaign and will continue to work with her to make sure the Government honours its commitment.

“Many autistic people continue to have much worse physical and mental health than the general public – and may even be at greater risk of dying early. Making sure that all healthcare staff understand autism, and the often simple changes that can help autistic people, is an important step to tackling this unacceptable health inequality – and creating a society that works for autistic people.”

Clinical Care

Hourly rounding ‘may not be the best way for nurses to deliver care’, finds study

Hourly rounding places an emphasis on ‘tick box’ care.

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Hourly rounding made a minor contribution, if at all, to the way nurses engage with patients.

A new report by researchers at King’s College London has found that the widespread practice of hourly or intentional rounding, may not be the best way for nurses to deliver care to patients.

The report also found that rounding makes a minor contribution, if at all, to the way nurses engage with patients.

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Hourly or intentional rounding involves standardised regular checks with individual patients at set intervals and was introduced in hospitals in England in 2013, with 97% of NHS acute Trusts in England implementing it in some way.

The majority of NHS trusts adopted the ‘4Ps’ (Position, Pain, Personal needs, Placement of items) model of rounding.

The research was commissioned and funded by the National Institute for Health Research (NIHR) and was led by Professor Ruth Harris in the Florence Nightingale Faculty of Nursing, Midwifery & Palliative Care.

Hourly rounding places an emphasis on ‘tick box’ care.

The NIHR report – Intentional rounding in hospital wards to improve regular interaction and engagement between nurses and patients: a realist evaluation – is the first study of its kind in the world.

The study found that rounding placed an emphasis on transactional ‘tick box’ care delivery, rather than individualised care. However, patients were found to value their interactions with nursing staff, which the study argues could be delivered during other care activities and rather than through intentional rounding.

The report also found that rounding was implemented without consultation, careful planning and piloting in the interests of political expediency following the Francis Inquiry Report into care failures in the NHS.

Ruth Harris, Professor of Health Care for Older Adults at King’s College London, said; “Checking patients regularly to make sure that they are OK is really important but intentional rounding tends to prompt nurses to focus on completion of the rounding documentation rather than on the relational aspects of care delivery.

“Few frontline nursing staff or senior nursing staff felt intentional rounding improved either the quality or the frequency of their interactions with patients and their family.”

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Nurses’ ‘worry’ better than most early warning scores, finds study

Nurses were asked to grade patients between ‘no concern’ and ‘extreme concern’. 

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Observations

A sense of worry can provide important information for the detection of acute physiological deterioration.

Nurses’ worry has a “higher accuracy” than most published early warning scores (EWS) at predicting if a patient is becoming more unwell, according to a recent study.

The study looked at 31,159 patient-shifts for 3185 patients during 3551 hospitalisations across two surgical and two medical wards. Researchers compared if the nurses were worried about a patients potential for deterioration using ‘the Worry Factor’ with early warning score indicators.

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Nurses were asked to grade each patient between “no concern” and “extreme concern”.

The Worry Score

Out of 492 potential deterioration events identified, researchers found that when nurses had an increasing worry factor the patient was more likely to require emergency medical treatment – 7 cardiac arrest calls, 86 medical emergency calls and 76 transfers to the intensive care unit.

The study also revealed that accuracy rates were significantly higher in nurses with over a year of experience.

The researchers concluded that “nurses’ pattern recognition and sense of worry can provide important information for the detection of acute physiological deterioration” and was often more reliable than traditional early warning systems.

They also noted that the worry score could be used alone or easily incorporated into existing EWS to potentially improve their performance.

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