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Health Secretary ‘looking very seriously’ at compulsory vaccines for children

“False and misleading information on vaccinations,” is being blamed for a downturn in uptake.

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MMR Vaccine
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Unvaccinated children are “putting other children at risk”.

The Health Secretary is “looking very seriously” at making vaccinations compulsory for children going to school in England.

Matt Hancock, the Secretary of State for Health and Social Care, admitted to a Fringe event at the Conservative Party Conference he had taken legal advice this week on how to implement a mandatory vaccination program.

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Unvaccinated children were “putting other children at risk”, he told attendees.

The news comes only days after official figures revealed an overall downturn in the uptake of the recommended vaccinations such as the Measles, Mumps and Rubella (MMR).

The British Medical Association (BMA) blamed the fall in vaccine uptake on “false and misleading information on vaccinations” particularly on social media.

Putting children at risk.

Speaking at the event organised by the Huffington Post, Mr Hancock said: “I’m very worried about falling rates of vaccinations – especially measles.

“For measles, the falling vaccination rates are a serious problem and it is unbelievable that Britain has lost its measles-free status.”

He added: “The worst thing is if you don’t vaccinate your child and you can, then the person you are putting at risk is not only just your own child, but it’s also the child that can’t be vaccinated for medical reasons.

“Maybe they have cancer and their immune system is too weak.

“I don’t want the debate to put people off because there is absolute clarity on what the science says and what the right thing is to do.”

Commenting further at the conference in Manchester on Sunday he added; “I have received advice from inside government this week on how we would go about it and I am looking into it very seriously.”

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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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