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Patients have ‘confidence and trust’ in practice nurses, GPs and pharmacists

The majority of patients also reported a positive experience with out of hours services

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Patients said they felt staff treated them with “care and concern” and listened to their needs.

A recent NHS survey identified that 90% of patients have ‘confidence and trust’ in NHS staff such as practice nurses, GPs and pharmacists.

In addition, it also revealed that 70% of patients reported a positive experience with out of hours services.

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Describing their experiences regarding services given by GP practices, the NHS GP Patient Survey 2019 gathered responses from almost 800,000 patients nationwide: including access to GPs.

The survey also reveals that over half of patients manage to get same day appointments and see their prefered GP or health practitioner.

Dr Becks Fisher, GP and Senior Policy Fellow at the Health Foundation, stated that these figures “show most people remain satisfied with general practice,” and that this is “a testament to the hard work of general practice teams.”

A pressing need for more staff.

However, Dr Fisher goes on to warn that a shortfall of healthcare professionals working in primary care is causing more people “waiting too long for appointments, or problems contacting their practice”.

Almost 1 in 4 patients found accessing information or services on their GP practice website difficult. Furthermore, 1 in 5 patients waited more than 15 minutes to be seen after their appointment time at their GP practice.

In February the NHS announced an ‘army of social prescribers’ would be implemented to reduce the demand on primary care providers.

While the intention is to relieve GP workloads to minimise the effect of their absence, Dr Fisher added; “there remains a pressing need for more GPs. The NHS can’t deliver a comprehensive workforce plan until the government decides how much funding to make available to recruit and train new staff.

“The current paralysis in Westminster is continuing to delay the long-awaited spending review, and the impact of those delays is being felt by both patients and general practice.’

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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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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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