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Lung cancer screening to be offered in supermarket car parks

The roll out has the potential to save hundreds of lives across the country.

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NHS England is to make lung cancer screening more accessible by operating mobile CT scanners from supermarket car parks.

Mobile screening trucks, based in supermarket car parks, will offer patients aged 55 to 74 and at high risk of developing lung cancer an “MOT for their lungs” which includes a computerised tomography (CT) scan.

A recent study has show CT screening reduced lung cancer mortality by 26% in Men and between 39% and 61% in women.

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NHS England says the targeted screening will help improve survival rates by going first to the some of the areas with the highest death rates from lung cancer. The roll out has the potential to reach around 600,000 people over four years, detecting approximately 3,400 cancers and saving hundreds of lives across the country.

Early diagnosis is crucial.

The NHS Long Term Plan set out an ambition that 55,000 more people will survive their cancer – to achieve this the plan also included an ambition to increase the number of cancers diagnosed at stages one and two from half to three-quarters of cancer patients.

Cally Palmer, national cancer director at NHS England, said: “Catching more cancers early is a cornerstone of the NHS Long Term Plan to save a further 55,000 lives a year and targeted lung health checks is one of the first projects to roll out following publication.

“These new projects will save lives – early diagnosis for cancer is crucial as it is easier to treat, not only saving lives, but it will also mean thousands of patients will avoid life changing treatments.”

Paula Chadwick, chief executive of Roy Castle Lung Cancer Foundation, said: “We welcome today’s announcement confirming the roll out of 10 lung health check projects across England. Given our own first-hand knowledge of these programmes, coupled with the staggering results from the NELSON trial which saw a 26% reduction in mortality when high-risk patients had a CT scan, this is a big step forward in improving the early detection of lung cancer.

 

 

 

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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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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