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New digital portal will allow hospitals to quickly find care homes spaces for patients

Health bosses claims the portal will ‘save hours of time’ phoning around to check availability.

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NHS England claims the portal will help to reduce avoidable lengthy stays in hospital.

A new digital portal is being introduced by the NHS and councils which allows health and social care staff to see how many vacancies there are in local care homes.

In 2018, around a quarter of a million hospital bed days in England were taken up by people who were medically fit enough to be discharged, but who faced delays in an appropriate care home being found that could meet their recovery needs.

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NHS England says claims the portal will ‘save hours of time’ phoning around to check availability and helping people to get the right care or return home as quickly as possible.

The digital portal is accessible on any device, and takes care homes just 30 seconds to upload details of their available beds, helping health and social care staff to find the right services for individual patients, including those with dementia or a learning disability.

Over 6,250 care homes have already signed up to the system, piloted in the North, Devon and Berkshire last year, and now thousands more can sign up to use it.

‘Right care in the right place at the right time’.

The roll-out of the tool will contribute to ambitions set out in the NHS Long Term Plan to upgrade support to reduce avoidable long stays in hospital, including better sharing of information between care homes and hospital staff.

Ruth May, Chief Nursing Officer for England said: “One of the central ambitions of the NHS Long Term Plan is to better support people to age well, and that means joining up different services locally to better meet people’s needs.

“By using this technology to work together more closely, hospitals, local authorities and care homes can ensure that people get the right care in the right place at the right time, and aren’t left waiting in hospital unnecessarily.

“Working with our local government, hospitals and community services as well as patients and their families has been essential to developing this new approach and will be key to rolling it out everywhere.”

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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