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Healthcare staff should help the police to tackle knife crime, says Hancock

Staff should offer support “to get away from knife crime”.

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The NHS should help people to ‘turn their lives around’ rather than simply ‘patching them up’.

NHS staff should be helping people to ‘turn their lives around’ rather than simply ‘patching them up’ and sending them on their way, the Health Secretary has said.

Hancock said that he wanted to mirror an approach taken in Baltimore, where police alongside health and social care professionals work together to help tackle knife crime.

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In an interview with Sky News presenter Sophie Ridge, Matt Hancock said; “[Knife crime] isn’t just an issue for the police – although obviously, they are very important. I want the NHS to play its full part in making sure we rise to this challenge that everybody feels is so important to tackle,”

“When these people, when these children arrive in hospital, that is a moment when you can intervene and try to tackle the problem. They were just little kids a few years ago and the idea that this can only be tackled by the strong arm of the law is wrong.”

“When they arrive in hospital that’s a moment that you can really make a strong intervention – get people involved and try to turn peoples lives around,” he said.

However, when Ms Ridge points NHS staff are already under immense pressure to deliver existing services, he replies; “Often the moment you arrive in hospital is obviously a critical moment for anybody and that’s when people are open to changing their behaviour. If you just treat the physical person then your only treating part of the problem. What we don’t want to do is patch people up and send them back out to exactly the same environment that led them in the first place.”

Before adding; “at that moment we want to intervene and give them the full support to turn around, get out of the gangs and to make the changes needed to get away from knife crime”. 

His statement comes only days after Theresa May denied a rise in knife crime was related to a drop in police numbers.

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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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