British journal of nursing (Mark Allen Publishing)最新文献

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, discusses some recent reports that show significant and continuing patient safety challenges for the NHS in 2026.

Intravenous fluid resuscitation (IFR) is one of the most common interventions administered to patients with complex presentations of acute health deterioration. However, a growing body of evidence details variations in practice surrounding IFR due to differences in clinical guidelines, with the effectiveness of IFR reliant upon the selection of the appropriate rate, type and volume of fluid to be administered. According to governing bodies such as the Nursing and Midwifery Council, it is vital that both the prescriber and administrator of IFR have sound understanding of the physiological implications of the intervention and the evidence base for its efficacy. Critical reflection on nursing practice is fundamental in order to influence and improve future practice and patient outcomes. This article aims to extrapolate clinical learning from a case study from a physiological, evidence-based and role perspective on the administration of IFR.

The Objective Structured Clinical Examination (OSCE), developed by Harden and Gleeson in the 1970s, was designed to standardise the assessment of medical student performance. The OSCE is the most common assessment method used to assess capability in advanced practice programmes. However, earlier research has indicated that there is limited evidence supporting the effectiveness of OSCEs within advanced practice programmes. In 2023, a multiprofessional collaboration of educators with expertise in advanced practice conducted a national survey to determine the perceived reliability and validity of OSCEs. This article reports findings from this survey and offers critical insights into the challenges and opportunities of using OSCEs for evaluating the capability of advanced practitioners. The article highlights the importance of selecting the most appropriate instruments to determine capability to ensure that assessments are relevant to the role of an advanced practitioner.

Intravenous (IV) therapy is a cornerstone of modern medical care, enabling rapid and controlled delivery of fluids, medications and nutrition. However, consideration must be given to the use of in-line filters to maintain patient safety. This product focus outlines the benefits of using Pall Medical in-line filters, which have emerged as a vital measure to mitigate the risks of inadvertently administering particulate matter, microorganisms, endotoxins, and air bubbles during infusion therapy. The use of Pall Medical in-line filters can enhance patient safety and clinical outcomes, particularly in high-risk settings such as neonatal care, oncology, and intensive care units. The use of these filters is outlined in two clinical case studies here. First, the use of Pall Medical TNA1E and NLF2E 1.2 µm (lipid) filters, which has been shown to adhere to current practice guidelines. The case study discusses the use of 1.2 µm in-line filters for the administration of parenteral nutrition in paediatric care to reduce complications and ensure safe infusion practice. The second case study details the integration of the Pall Medical 0.2 µm Supor AEF low protein binding IV in-line filter for the administration of monoclonal antibodies in an outpatient infusion centre setting. This filter was chosen to standardise clinical practice as it was suitable for all the monoclonal antibody infusions. The need to standardise this practice and maintain safety is discussed.

Pneumonia is a common and potentially life-threatening acute respiratory infection that continues to cause high levels of illness and hospitalisation in the UK. It affects the lung parenchyma and patients may present with fever, cough, chest pain, sputum production and difficulty in breathing. While it can affect people of any age, it is particularly risky at extreme ages. Timely recognition, evidence-based care and holistic support are essential to optimise outcomes for patients and families. Nurses have a central role in the care of patients with pneumonia, including in recognition of severity, referral to hospital, oxygen support, nutrition and hydration, monitoring, ensuring adherence to antibiotic regimens and in discharge planning and follow-up. They are also involved in prevention and advising patients and families. Recent updates to national guidance present opportunities and responsibilities for nurses in assessment, monitoring, patient education and ensuring safety in treatment.

Richard Griffith, Senior Lecturer in Health Law at Swansea University, uses examples from recent case law to illustrate when the compulsory treatment of physical disorders under the Mental Health Act 1983 would be lawful.