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RCN pledges to promote lifelong learning for nursing home staff

An agreement outlines the role learning representatives play in promoting learning and development.

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The new agreement will support the creation of learning representative roles in social care.

The Royal College of Nursing will be working in partnership with one of the UK’s largest care home providers to promote and support lifelong learning for nursing staff.

The learning agreement, which was signed by both parties today, provides a framework for the RCN and Caring Homes Group to work together to provide ongoing training and development for RCN members and other staff working through Caring Homes Group, both employed and agency staff.

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The national agreement, which is the second of its kind for the RCN, also outlines the crucial role RCN learning representatives play in promoting learning and development. It will support the creation of new learning representative roles in Caring Homes’ services across the UK. So far, 14 RCN learning representatives have been recruited.

Development of our people.

Tracey Humphreys, Clinical Training Manager, Caring Homes Group, and RCN Learning Representative said: “I’ve been a rep for over a year and the training’s very good and has really benefited my own development. A learning agreement helps signpost people to the right training and helps colleagues with any further training and development.

“I’d seen the benefits of being in a learning agreement with the RCN so, in my role as Clinical Training Manager, it was something I really wanted Caring Homes to consider and I saw lots of potential in an agreement.

“It’s a further example of Caring Homes Group’s commitment to the learning and development of our people, and it shows our residents that we care.“

Support for members in social care.

RCN National Officer Irene Murray said: “Sometimes it has been hard for our members in the social care sector to take full advantage of the services the RCN offers because we didn’t have enough representatives in place – services such as career development or well-being support.

“This agreement gives us the chance to really support our members in the social care sector and make sure we have a base of representatives in place. This agreement means our learning reps know what to expect and formalises that relationship so they can work in partnership with their employer, sitting on relevant groups or committees.

“The RCN has a huge amount to offer as a professional body and our learning reps have access to a wealth of resources to help support training and development in their workplace, which in turn has a positive impact on patient care.”

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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Nurse with patient in bed

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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