Staff Publication

Understanding The Needs of People with Dementia and Family Carers (2015)

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Type of publication:
Journal article

Author(s):
Bray, J., Evans, S., Thompson, R., Bruce, M., Carter, C., Brooker, D., Milosevic, S., *Coleman, H., *McSherry, W.

Citation:
Nursing Older People 27 (7) p.18-23

Abstract:
This is the first in a short series that presents case study examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. When a person with dementia is in hospital, poor understanding of individual needs and preferences can contribute to a lack of person-centred care. Similarly, the needs of family carers can often be overlooked and staff do not always appreciate these needs at such a stressful time. This article illustrates how three NHS trusts have addressed these issues. To help staff get to know patients with dementia, Salford Royal NHS Foundation Trust has implemented a patient passport. Similarly, The Shrewsbury and Telford Hospital NHS Trust has implemented a carer passport that overcomes the restrictions imposed by hospital visiting hours. Royal Devon and Exeter NHS Foundation Trust also focused on carers, holding a workshop to elicit feedback on what was important to them. This was a useful means of engaging with carers and helped staff to realise that even simple changes can have a significant effect.

The role of ultrasound scanning (USS) in right iliac fossa (RIF) pain: Is USS imaging delaying emergency appendicectomies? (2015)

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Type of publication:
Conference abstract

Author(s):
*Sukha A., *Luke D.

Citation:
International Journal of Surgery, November 2015, vol./is. 23/(S114)

Abstract:
Aim: This project investigates USS results from patients who had undergone appendicectomies to assess the sensitivity and specificity in detecting a histology positive acute appendicitis. We also investigated whether the decision to USS delayed an emergency procedure. Methods: Retrospective data collection between January-June 2014. Data was collected from Theatre log books, Pathology/PACS systems. Results: Between January-June 2014, 226 appendectomies were performed on the emergency-operating list. 15% (n = 34) ha d undergone pre-operative USS (74% Female, Mean age = 27 years). 76% (n = 26) of those who had a scan went onto have a diagnostic laparoscopy and appendicectomy, 24% (n = 8) had an open appendicectomy.53% (n = 18) were found to have a histology proven positive appendicitis. USS as an investigation to detect acute appendicitis demonstrated a sensitivity of 22.2% an d specificity of 68.8%, PPV of 44.4% and a NPV of 44.0%. A mean delay of 0.97 days was observed from admission to operation due to USS. Conclusion: US S result often does not change the definitive management in patients with ongoing RIF pain. Diagnostic laparoscopy can be therapeutic even in the absence of appendicitis. With USS delaying time to theatre and increasing hospital stay we conclude the USS has a limited role in investigating RIF pain in a patient presenting with the classic acute appendicitis.

Smoking cessation and best medical therapy (BMT) how well are vascular surgeons doing? (2015)

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Type of publication:
Conference abstract

Author(s):
Slade R., *Sukha A., *Sykes T.

Citation:
International Journal of Surgery, November 2015, vol./is. 23/(S131)

Abstract:
Aim: BMT is a key component in the management of patients with vascular disease. The aim of this study is to determine how well BMT is documented in the correspondence to primary care with particular reference to the preoperative clinic letter and discharge summary following a surgical intervention. Methods: Patients between Jan-Jun 2014 were identified from a prospectively maintained vascular-database and the corresponding clinic letters and discharge summaries were retrieved. Results: 107 patients underwent vascular surgery between Jan-Jun 2014. The operations identified were: AAA repair n=21,Carotid endarterectomy n=23,Femoral endarterectomy n= 12,Vascular bypass n=43 and Revision surgery n=8. Overall, antiplatelet therapy was documented in 79%(n=85) of pre: operative clinic letters and 96%(n=103) of discharge summaries. Similarly, lipid-lowering therapy was recorded in 79%(n=85) and 92%(n=98). Smoking status was recorded in 32 %(n=34) of pre-operative clinic letters; 21%(n=23) were smokers and all identified smokers were offered advice to stop smoking. Conclusion: Documentation of smoking status and advice is poorly recorded in the pre and post -operative correspondence to primary care and unrecorded in the discharge summary. Similarly, pre-operative anti platelet and lipid lowering therapy documentation is suboptimal. 'Best Medical Therapy,' has been implemented into a standardised clinic template and a 'smoking status/advice' section in the electronically generated discharge summary has been implemented.