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NMC calls for regular staff training on learning disability and autism

Training should be specifically tailored to those working in care homes, schools and prisons in addition to hospitals and GP surgeries

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The regulator acknowledged a “fatal gap” in the knowledge of healthcare professionals.

The Nursing and Midwifery Council (NMC) has welcomed the Department of Health and Social Care’s consultation focussing on the training of health and care professionals to better support people living with learning disability and autism.

The consultation proposes all health and social care staff should receive mandatory learning disabilities and autism training.

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In response to the consultation, the NMC has acknowledged a “fatal gap” in the knowledge of healthcare professionals and called for regular, ongoing learning disability and autism training for staff rather than one-off training sessions. Emphasising that training should be specifically tailored to those working in care homes, schools and prisons in addition to hospitals and GP surgeries.

The regulator also promised to have a “stronger focus” on learning disabilities and autism in undergraduate nursing programs.

‘Shameful reality’.

Andrea Sutcliffe, Chief Executive and Registrar at the NMC, said: “People with a learning disability and autistic people, their families and carers, have the same right as anyone else to receive safe and effective health and care.

“Instead; the shameful reality is people with a learning disability die, on average, 14 to 18 years sooner than the general population. There are too many heart-breaking stories where the individual needs of people in the most vulnerable of circumstances have not been recognised, listened to, acted on or properly supported.

“Much needs to be done to improve this situation. From our work at the NMC, we know the vital difference that health and care professionals make to the lives of people with learning disabilities and autistic people when they are equipped with the right skills and training.

“Through our own programme to reform nursing and midwifery education, we are already working to ensure that professionals across all health and care settings have the knowledge and understanding to support people with learning disabilities and autistic people to live longer, healthier and happier lives.

Simple changes can help.

Jane Harris, Director of External Affairs at the National Autistic Society, previously said the training “has the potential to improve the health and wellbeing of hundreds of thousands of autistic people”

“This is a direct result of Paula McGowan’s tireless campaigning, in memory of her son Oliver, including her petition which gained over 50,000 signatures. We are proud to support Paula’s campaign and will continue to work with her to make sure the Government honours its commitment.

“Many autistic people continue to have much worse physical and mental health than the general public – and may even be at greater risk of dying early. Making sure that all healthcare staff understand autism, and the often simple changes that can help autistic people, is an important step to tackling this unacceptable health inequality – and creating a society that works for autistic people.”

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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