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‘Concerning rise’ in sexually transmitted infections

PHE has urged people to practice safer sex and take up the offer of STI screening.

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A rise of five per cent in the number of diagnosed sexually transmitted infections.

Cases of sexually transmitted infections (STI) have been increasing, according to a new Public Health England (PHE) report.

Chlamydia remains the most commonly diagnosed infection, but figures show a large increase in gonorrhoea and more moderate increases in chlamydia, syphilis and genital herpes.

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Compared to the previous year, there was a five per cent increase in diagnosed infections – from 424,724 in 2018 to 447,694.

The increase in infections has been attributed to a rise in the number of casual partners alongside a failure to use condoms correctly and consistently.

Concerning rise.

PHE has urged people to practice safer sex and take up the offer of STI screening, regardless of whether they show symptoms.

Dr Gwenda Hughes, Head of STI Surveillance at PHE, said: “The rise in sexually transmitted infections is concerning. STIs can pose serious consequences to health – both your own and that of current and future sexual partners.

“No matter what age you are, or what type of relationship you are in, it’s important to look after your sexual health. If you have sex with a new or casual partner, make sure you use condoms and get regularly tested.”

Those at risk of STIs can access services through sexual health clinics many of which offer online testing.

Preventable.

Patricia Marquis, the Royal College of Nursing’s Director for England, said: “We’ve seen more and more sexual health services provided online in recent years and while this report seems to show it means more people are able to seek help for a suspected STI, we need to make sure these services are robust, fit for purpose and safe.

“While the number of STI diagnoses has increased, many of these cases are preventable if the cuts to the public health grant for local authorities are reversed, and nursing staff in sexual and reproductive health are valued and given opportunities to develop their specialism.”

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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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