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Charity calls for routine Group B Strep testing in all pregnant women

After routine testing was introduced in the United States, the number of group B Strep infections dropped by over 80 per cent.

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A charity is calling for the NHS to fall in line with other developed countries and offer routine Group B Strep testing to pregnant women.

The Group B Strep Support Charity has called for the NHS to fund routine testing for Group B Streptococcus (GBS or group B Strep) in order to prevent group B Strep infections in approximately 350 babies every year.

Group B Strep is a normal bacterium which is carried around 25% of women in the vagina – usually without symptoms or side-effects.

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Most pregnant women who carry group B strep bacteria have healthy babies. But there’s a small risk that GBS can pass to the baby during childbirth causing serious complications and in extremely rare cases it can cause miscarriage, premature labour, or stillbirth.

Unlike other developed countries, Group B Strep is not routinely tested for, but may be found during tests carried out for another reason, such as a urine test or vaginal swab.

Reduces the risk by 90%.

Jane Plumb, CEO and founder of Group B Strep Support charity says: “Each week in the UK, one baby dies and another is left with a long-term disability as a result of group B Strep infection. Rarely harmful to adults, it’s the UK’s most common cause of severe infection in newborn babies, causing sepsis, pneumonia, and meningitis.

“The bacteria may be passed unknowingly from a mother to her baby around birth. The UK doesn’t currently routinely test pregnant women for group B Strep, unlike many other developed countries, including the United States, Canada, Germany, France and Spain.

“Most group B Strep infections in newborn babies could be prevented by identifying carriers during pregnancy and offering them intravenous antibiotics during labour. This reduces the risk of a baby developing a group B Strep infection by up to 90 per cent.

“After routine testing was introduced in the United States, the rate dropped by over 80 per cent. If the rate was reduced in the UK in the same way, we could prevent group B Strep infection in approximately 350 babies every year, saving 15 babies’ lives and protecting another 15 from life-changing disability. The UK rate is currently more than double that of the US.

“The test would cost the NHS just £11 and costs from £35 privately. Pregnant women can take this simple, safe test between 35 and 37 weeks.“

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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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