Author: Jason Curtis

The SGLT2 inhibitors - where are we now? (2017)

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Type of publication:
Journal article

Author(s):
*Morris, David

Citation:
Journal of Diabetes Nursing; Jun 2017; vol. 21 (no. 5); p. 162-167

Abstract:
Sodium–glucose cotransporter 2 (SGLT2) inhibitors are once-daily oral agents effective in treating hyperglycaemia in people with type 2 diabetes, with additional benefits including weight loss and a low risk of hypoglycaemia. This review provides a basic guide to the SGLT2 inhibitors licensed in the UK, including their mechanism of action, benefits, adverse effects and limitations, and place in treatment. Advice on avoiding the rare but serious adverse effect of diabetic ketoacidosis is also provided.

Link to full-text: http://www.thejournalofdiabetesnursing.co.uk/media/content/_master/4984/files/pdf/jdn_21-5_162-7.pdf

Improving Oxygen Delivery on Wards (2017)

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Type of publication:
Post on the Academy of Fab NHS Stuff website

Author(s):
*Nawaid Ahmad

Full text:
Oxygen (O2) is a drug and should be prescribed if administered to a patient. The British Thoracic Society has published guidelines on emergency oxygen delivery and a recent audit showed that out of 100 patients on O2, 42 did not have a written order.

Cycle 1: 2 FY1s collected data on O2 prescription and delivery on the respiratory ward at the Princess Royal Hospital, a part of the Shrewsbury and Telford Hospital NHS trust. At our trust, O2 is prescribed on the patient’s drug chart and saturation targets are mentioned on the prescription. 61% patients on O2 had a written order and 58% had the target mentioned along with the prescription.

 

Cycle 2: After the data collection, we started doing face to face education about O2 prescription in the acute medical unit and the respiratory ward. We targeted the Drs, nurses and the health care assistants. This was done for a week. A prompt card was developed (Pic 1) which was attached next to the O2 delivery system on the wall to prompt nurses to get the O2 prescribed. A card mentioning O2 targets was attached to the board above the patients bed. Another data collection was done a month later which showed that O2 prescription rates had gone up to 79% and 77% had a target mentioned.

Cycle 3: This involved forming an O2 team comprising the 2FY1s, one staff nurse and one healthcare assistant from the ward. They are called ‘O2 Ninjas’ and wear a badge (Pic 2). Their main role now will be to continue the education of all staff, each at their own level. We plan to roll out an educational programme through the trust staff education department and teach using scenarios. The idea is to spread this process to other specialties within the trust. Work is on going.

Our Motto: “ An idea needs to become a movement, for change to happen”

Link to more details or full-text: http://fabnhsstuff.net/2017/05/27/improving-oxygen-delivery-wards/

Revision guide part 1 MRCOG (2016)

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Type of publication:
Book chapter

Author(s):
*Andrew Sizer, Mary Ann Lumsden

Citation:
In: Fiander, A. and Thilaganathan, B. (2016) MRCOG part one: your essential revision guide: the official companion to the Royal College of Obstetricians and Gynaecologists revision course. 2nd edn. London: Royal College of Obstetricians and Gynaecologists.

Link to library catalogue

Can hospital early warning score systems be used to predict mortality and readmissions in patients with chronic obstructive pulmonary disease exacerbations requiring hospitalisation? (2014)

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Type of publication:
Conference abstract

Author(s):
*Crawford E.-J.T., *A lvarez E., *Moudgil H., *Naicker T.R., *Srinivasan K.S.

Citation:
American Journal of Respiratory and Critical Care Medicine, 2014, vol./is. 189/

Abstract:
Rationale: Predicting mortality in chronic obstructive pulmonary disease (COPD) can be complex as disease progression does not often follow a smooth downward trajectory. Identifying patients with COPD approaching the end of the ir life is important as it allows clinicians to initiate appropriately time d discussions centred around advance care planning and palliative care. High rates of early readmission to hospital (within 30 days of discharge) for patients with COPD is also of some national concern and to date, effective strategies to reduce this readmission rate have been limited. The use of early warning score (EWS) systems are now widespread in UK hospitals and are used primarily to alert nursing and medical staff to the severity of, or changes in, a patient's condition. This study aimed to understand whether the EWS systems could be used to predict 30 or 90 day mortality, or readmission rates in patients admitted to hospital with a COPD exacerbation. Met hods Data was collected from 73 consecutive patients admitted to hospital over a three month period (May to August, 2013) with an acute exacerbation of COPD. Collected data included early warning scores on admission, discharge and the peak EWS score. Data regarding in-hospital death, death within 30 and 90 days of admission date and readmission within 30 days of discharge was also collected. Results One patient (1.4%) died during their hospital admission. Four patients (5%) had died within 30 days of admission and 11 pa tients (15%) had died within 90 days of admission. 17 patients were re-admitted within 30 days of discharge (23%). There was no significant difference between median admission, peak and discharge early warning scores in those patients who had died within either 30 or 90 days of admission or who were readmitted within 30 days compared to the median values for the rest of th e group (see table). Conclusions According to the findings of this study, measurement of early warning scores cannot be used in clinical practice to p redict readmission rates, 30 or 90 day mortality in patients admitted to hospital with an acute exacerbation of COPD. (Table Presented).