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Child health record ‘red book’ and maternity records to go digital

The Department of Health and Social Care has announced modernisation of neonatal and maturity services.

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Newborn baby

The Government has announced major changes to maternity services including the digitisation of child and maternity health records.

The Department of Health and Social Care has announced modernisation of neonatal and maturity services in a bid to improve safety, quality and continuity of care.

While official figures show that the number of stillbirths have declined steadily since 2010, England still lags behind many European countries on baby deaths.

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The plans, which are backed a funding increase of £20.5 billion, include digitising the paper child health record and maternity record, improved accommodation for critically ill new-borns, wider availability of physiotherapy for women who experience incontinence after childbirth and offering accredited evidence-based infant feeding programmes.

Matt Hancock, the Secretary of State for Health and Social Care, has also promised an increase in staffing numbers – with more expert neonatal nurses and specialists, and new roles – which could include the introduction of associate midwives.

‘We need to keep pace with the times’.

Matt Hancock said: “Having a baby is one of the best moments of our lives, so I want our NHS to be the best place in the world to give birth. Today we will take steps to ensure every expectant mother is supported – from pregnancy, to birth, to those critical first months of parenthood – with a comprehensive package of personalised, high-quality support.

“Every parent will remember the red book that comes from the NHS with each baby. In this digital age we need to keep pace with the times. So, from birth, each child will now be able to start life using the best of modern technology – in a way that’s easier for parents and fit for the future.

“Great care also means safe care, but sadly too many women are still suffering the unimaginable tragedy of losing a child.

Adding; “We are committed to saving 4,000 lives by 2025 by halving stillbirths, maternal and infant deaths and serious brain injuries in new-borns.

“These new measures to improve maternity care, funded by taxpayers as part of the NHS long-term plan, will mean hundreds of thousands of new families get the very best care.

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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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Nurse with patient in bed

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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Clinical Updates

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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