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

Background: Clean intermittent self-catheterisation (CISC) with conventional eyelet catheters (CECs) is associated with urine flow-stops, which require the catheter to be repositioned so flow can resume. Flow-stops often occur because bladder mucosa is sucked into the eyelets.

Aims: This investigation aimed to compare the bladder-emptying performance of the micro-hole zone catheter (MHZC) with the CEC.

Methods: This was a multi-centre, randomised, open-label, controlled cross-over study with 82 women comparing the MHZC to the CEC. The endpoints relating to bladder-emptying performance included the residual volume at first flow-stop, the number of flow-stops and the proportion of successful treatment responses. The women's perception of the catheters was assessed as well as device discomfort.

Findings: Catheterisations with MHZC significantly reduced the risk of flow-stops, with relative risk results showing a 2.74 times lower risk of flow-stops with a health professional-led catheterisation and a 2.52 times lower risk during self-catheterisation. There was no statistical difference in residual urine volume at first flow-stop between the two catheters. Catheterisations with the MHZC were significantly more likely to achieve zero flow-stops and a residual urine volume of <10 ml at first flow-stop. The women had a significantly more positive perception of the MHZC than the CEC in areas including handling, confidence, sensation and satisfaction.

Conclusion: The MHZC enabled effective bladder emptying without catheters needing to be repositioned, supporting the women by simplifying the procedure and making them feel confident that their bladders were empty.

In the UK, student nurses, nursing associates and midwives are supervised by practice supervisors and practice assessors while completing the placement-based component of their training. Because of increased clinical commitments, staff shortages and rising student numbers, demands for the supervision and assessment of student nurses have increased in recent years and this was exacerbated by COVID-19. The Nursing and Midwifery Council's Standards for Student Supervision and Assessment separated the roles of practice supervisor and assessor, giving rise to opportunities to assess students in a different way. Some integrated care systems are exploring the new role of roaming assessor. Roaming assessors can fulfil the role of practice assessors while providing additional support for student nurses. This role could be expanded to other health professions. This article explores the use of practice learning facilitators as roaming assessors for student nurses in the UK and evaluates the potential benefits and limitations of this approach. Roaming assessors may provide a useful service to deliver practice assessments, increasing the reliability and availability of assessments.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, provides an update on recent patient safety reports.

Aims: This evaluation combines clinical and non-clinical collaborative breast referral triage to gain an understanding relating to the value of triage, by identifying 'suspected cancer' and 'cancer not suspected' populations, improve the patient pathway, and facilitate optimised resource availability.

Method: An iterative service improvement method was used, with distinct phases of the process outlined to facilitate testing of ideas. The evaluation ran for 13 weeks in 2022. Regular team member meetings were arranged to discuss and agree improvement aims and outcomes.

Findings: A triage flowchart was developed collaboratively, and subsequently adopted by the non-clinical booking team. Bespoke clinics were established, demonstrating no evidence of increased risk to patients, and meeting 28-day Faster Diagnosis Standard (FDS) requirements.

Conclusion: breast referral triage of 'suspected cancer' and 'cancer not suspected' patients, using a clinical and non-clinical collaborative approach facilitates improved service visibility, prioritisation, management, and measurement. This also supports delivery of the 2019 NHS Long Term Plan to enhance earlier and faster cancer diagnosis by optimising access to diagnostic resources where required.

Infection prevention and control (IPC) is essential in nursing practice to safeguard patient health and reduce healthcare-associated infections. This article explores IPC strategies, including hand hygiene, the use of personal protective equipment, environmental cleaning, safe injection practices, and antimicrobial stewardship. It discusses the implementation challenges and solutions, such as ensuring compliance through education, monitoring and strong leadership. IPC measures are crucial in preventing infections such as catheter-associated urinary tract infections, central line-associated bloodstream infections, surgical site infections, and ventilator-associated pneumonia. By integrating personalised IPC strategies into nursing practice, healthcare providers can significantly improve infection control outcomes and enhance overall patient safety and quality of care.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the soon to be published review of simulated practice learning and the messages for education provision and policy.