Best practice for chronic oedema in community settings: what can we learn?

2020 ◽  
Vol 25 (12) ◽  
pp. 610-614
Author(s):  
Garry Cooper-Stanton
Keyword(s):  
Service Provision ◽  
Best Practice ◽  
Evidence Base ◽  
Community Services ◽  
Guidance Document ◽  
Community Settings ◽  
Tissue Viability ◽  
Delivery Of Care ◽  
Specialist Nurses ◽  
The Uk

There are various opportunities and challenges in the delivery of care to those diagnosed with chronic oedema/lymphoedema. Service provision is not consistent within the UK, and non-specialist nurses and other health professionals may be called on to fill the gaps in this area. The latest best practice guidance on chronic oedema is directed at community services that care for people within their own homes in primary care. This guide was developed in order to increase awareness, knowledge and access to an evidence base. Those involved in its creation cross specialist fields (lymphoedema and tissue viability), resulting in the document covering a number of areas, including an explanation of chronic oedema, its assessment and management and the association between chronic oedema and wet legs. The document complements existing frameworks on the condition and its management and also increases the available tools within chronic oedema management in the community. The present article provides an overview of the guidance document and discusses its salient features.

scholarly journals ASPiH standards for simulation-based education: process of consultation, design and implementation

2017 ◽  
Vol 4 (3) ◽  
pp. 117-125 ◽  
Author(s):  
Makani Purva ◽  
Jane Nicklin
Keyword(s):  
Best Practice ◽  
Evidence Base ◽  
Development Project ◽  
Full Potential ◽  
Guidance Document ◽  
Consultation Process ◽  
For Profit ◽  
Simulation Based ◽  
Literature Evidence ◽  
The Uk

There is widespread enthusiasm and emerging evidence of the efficacy of simulation-based education (SBE) but the full potential of SBE has not been explored. The Association for Simulated Practice in Healthcare (ASPiH) is a not-for-profit membership association with members from healthcare, education and patient safety background. ASPiH’s National Simulation Development Project in 2012 identified the lack of standardisation in the approach to SBE with failure to adopt best practice in design and delivery of SBE programmes. ASPiH created a standards project team in 2015 to address this need. The article describes the iterative process modelled on implementation science framework, spread over six stages and 2 years that resulted in the creation of the standards. The consultation process supported by Health Education England resulted in a unique document that was driven by front line providers while also having strong foundations in evidence base. The final ASPiH document consisting of 21 standards for SBE has been extensively mapped to regulatory and professional bodies in the UK and abroad ensuring that the document is relevant to a wide healthcare audience. Underpinning the standards is a detailed guidance document that summarises the key literature evidence to support the standard statements. It is envisaged the standards will be widely used by the simulation community for quality assurance and improving the standard of SBE delivered.

scholarly journals Community services and transforming care: reflections and considerations

2019 ◽  
Vol 24 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Magali Barnoux
Keyword(s):  
Learning Disabilities ◽  
Design Methodology ◽  
Best Practice ◽  
Evidence Base ◽  
Community Services ◽  
Community Learning ◽  
Content Type ◽  
Best Practice Guidelines ◽  
Assessment And Treatment ◽  
The Uk

Purpose The purpose of this paper is to consider the existing evidence base regarding community services for people with learning disabilities in the context of transforming care (TC). Design/methodology/approach Reflections and commentary on the provision of community services for people with learning disabilities following Washington et al.’s article on admissions and discharges from assessment and treatment units in England. Findings The existing evidence base pertaining to community learning disability teams in the UK is dated, sparse and methodologically weak. A greater focus on researching community services for people with learning disabilities is needed in order to inform best practice guidelines. Originality/value The success of the TC agenda is contingent on the provision of high quality community services. However, the focus has been on discharging individuals from hospital, rather than the support available to them once they leave.

scholarly journals Assessment and Management of Dysphagia in Acute Stroke: An Initial Service Review of International Practice

Geriatrics ◽  
2020 ◽  
Vol 5 (1) ◽  
pp. 4
Author(s):  
Carol A. Fairfield ◽  
David G. Smithard
Keyword(s):  
Acute Phase ◽  
Best Practice ◽  
Evidence Base ◽  
Post Stroke ◽  
Effortful Swallow ◽  
The Us ◽  
Screening Assessment ◽  
The Uk ◽  
Management Of Dysphagia ◽  
The Impact

The international approach to the assessment and management of dysphagia in the acute phase post stroke is little studied. A questionnaire was sent to clinicians in stroke services that explored the current practice in dysphagia screening, assessment, and management within the acute phase post stroke. The findings from four (the UK, the US, Canada, and Australia) of the 22 countries returning data are analysed. Consistent approaches to dysphagia screening and the modification of food and liquid were identified across all four countries. The timing of videofluoroscopy (VFS) assessment was significantly different, with the US utilising this assessment earlier post stroke. Compensatory and Postural techniques were employed significantly more by Canada and the US than the UK and Australia. Only food and fluid modification, tongue exercises, effortful swallow and chin down/tuck were employed by more than fifty percent of all respondents. The techniques used for assessment and management tended to be similar within, but not between, countries. Relationships were found between the use of instrumental assessment and the compensatory management techniques that were employed. The variation in practice that was found, may reflect the lack of an available robust evidence base to develop care pathways and identify the best practice. Further investigation and identification of the impact on dysphagia outcome is needed.

scholarly journals Clinical management of lipomas in dogs under primary care in the UK

2020 ◽  
Vol 187 (10) ◽  
pp. e83-e83
Author(s):  
Camilla Leonie Pegram ◽  
Lynda Rutherford ◽  
Caroline Corah ◽  
David B Church ◽  
David C Brodbelt ◽  
...  
Keyword(s):  
Clinical Management ◽  
Best Practice ◽  
Evidence Base ◽  
Fine Needle Aspirate ◽  
Cross Sectional ◽  
Benchmark Data ◽  
Wound Breakdown ◽  
The Uk ◽  
Sectional Analysis ◽  
Surgical Drain

Lipomas are relatively common and biologically benign masses of mesenchymal origin consisting of adipocytes. This study reports benchmark data on the clinical management and outcomes of lipomas in dogs under UK primary veterinary care. The study used a cross-sectional analysis of cohort clinical data from dogs that were under veterinary care at practices participating within VetCompass from January 1, 2013 to December 31, 2013. Descriptive and analytic statistics characterised the clinical management and outcomes following presumptive lipoma diagnosis. The study included 2765 lipoma cases from 384 284 dogs under UK veterinary care during 2013. Diagnostics included fine needle aspirate in 1119 (40.5 per cent) cases, biopsy in 215 (7.8 per cent) cases and diagnostic imaging in 11 (0.4 per cent) cases. Overall, 525 (19.0 per cent) cases were managed surgically. Of the surgical cases, 307 (58.5 per cent) solely had mass removal whilst 218 (41.5 per cent) included another procedure during the same surgical episode. A surgical drain was placed during surgery in 90 (17.1 per cent) cases. Wound breakdown was reported in 14 (2.7 per cent) surgical procedures. Wound infection followed surgery in 11 (2.1 per cent) dogs. The findings provide veterinarians with an evidence base that benchmarks how lipoma cases are currently managed in the UK, but these results do not necessarily reflect optimal management or best practice.

scholarly journals Mental health rehabilitation services in the UK in 2007

2009 ◽  
Vol 33 (6) ◽  
pp. 215-218 ◽  
Author(s):  
Debbie Mountain ◽  
Helen Killaspy ◽  
Frank Holloway
Keyword(s):  
Service Provision ◽  
Rapid Change ◽  
Community Services ◽  
Rehabilitation Services ◽  
Clinical Implications ◽  
Complex Needs ◽  
The Past ◽  
Health Rehabilitation ◽  
Mental Health Rehabilitation ◽  
The Uk

Aims and MethodA survey of UK consultants in rehabilitation psychiatry was carried out to investigate current service provision and changes over the past 3 years.ResultsMost services had undergone multiple changes, with an overall reduction in over half and an overall expansion in a minority. the proportion with low secure provision had doubled. Around a third reported reinvestment of rehabilitation resources into other specialist in-patient and community services.Clinical ImplicationsRehabilitation services are undergoing rapid change with diversion of resources into services that may lack rehabilitation expertise. This risks an increase in independent sector referrals for in-patient rehabilitation for those with complex needs. Expansion of community services should be balanced against the need for local in-patient rehabilitation services.

Best practice skin antisepsis for insertion of peripheral catheters

2021 ◽  
Vol 30 (1) ◽  
pp. 8-14
Author(s):  
Simon Clare ◽  
Stephen Rowley
Keyword(s):  
Best Practice ◽  
Evidence Base ◽  
Clinical Indication ◽  
Major Surgery ◽  
Medical Procedures ◽  
Skin Disinfection ◽  
Skin Antisepsis ◽  
The Uk ◽  
New Research ◽  
Time Frames

This article discusses the importance of effective skin antisepsis prior to the insertion of peripheral intravenous catheters (PIVCs) and how best clinical practice is promoted by application of an appropriate method of skin disinfection integrated effectively with a proprietary aseptic non touch technique, or other standard aseptic technique. Historically under-reported, incidence of infection and risk to patients from PIVCs is now increasingly being recognised, with new research and evidence raising concern and helping to drive new clinical guidance and improvement. The risks posed by PIVCs are particularly significant given increasing PIVC dwell times, due to cannula removal now being determined by new guidance for clinical indication, rather than predefined time frames. Clinical ‘best practice’ is considered in context of the evidence base, importantly including availability and access to appropriate skin antisepsis products. In the UK, and other countries, ChloraPrep is the only skin antisepsis applicator licensed as a drug to disinfect skin and help prevent infections before invasive medical procedures, such as injections, blood sampling, insertion of PIVCs and minor or major surgery.

scholarly journals The rise of new university presses and academic-led presses in the UK

2017 ◽  
Author(s):  
Graham Stone
Keyword(s):  
Best Practice ◽  
Knowledge Exchange ◽  
Evidence Base ◽  
Academic Publishing ◽  
Disruptive Effect ◽  
Legal Advice ◽  
Best Practice Guidelines ◽  
University Presses ◽  
Dissemination Of Research ◽  
The Uk

Watch the VIDEO here.The recent report, Changing publishing ecologies: A landscape study of new university presses and academic-led publishing, shows a discernible increase in new UK publishing initiatives entering the sector over the last few years. The new university press strand of the research consisted of a survey, which collected 43 responses, the academic-led press strand was informed by interviews with 14 scholar-led presses. Taking different approaches for these two types of press, the report captures the take-up, reasoning and characteristics of these initiatives, as well as their future plans. It complements previous research, such as OAPEN-UK, the UK National Monographs strategy, the Jisc/OAPEN Investigating OA monograph services project and the new Knowledge Exchange Landscape Study on Open Access Monographs which will be published in September 2017. These new publishing initiatives have a potentially disruptive effect on the scholarly communication environment, providing new avenues for the dissemination of research outputs and acting as pathfinders for the evolution of academic publishing and the scholarly record. The findings of the research carried out as part of this report provide an evidence base for future support for both new university presses and academic-led publishing initiatives to help create and maintain a diverse publishing ecology. The report concludes with a series of recommendations to help support and foster new developments in this space, share best practice, collaboration and the tools and services to facilitate further innovation. For example, the report recommends to support community building for both NUPs and ALPs, the establishment of guidelines for setting up a press, the provision of legal advice and guidelines for preservation and dissemination, and the development of future projects to support these new initiatives. In particular, the community professed a need for the development of a toolkit that would aid both existing NUPs and academic-led presses, as well as those universities and academics that are thinking about setting up their own publishing initiatives. This paper will precis the report, before exploring the progress made in establishing an infrastructure for UK university and academic-led presses. Finally, the author would like to encourage other European countries to build upon this research by adapting the questions asked in the research. This would allow for a more complete view of European NUPs and ALPs and the demand for shared approach, such as a wider set of best practice guidelines, workshops and a European Library Publishing Coalition for library presses.

scholarly journals The impact of the COVID-19 pandemic on cardiology services

Open Heart ◽  
2020 ◽  
Vol 7 (2) ◽  
pp. e001359 ◽  
Author(s):  
Omar Fersia ◽  
Sue Bryant ◽  
Rachael Nicholson ◽  
Karen McMeeken ◽  
Carolyn Brown ◽  
...  
Keyword(s):  
Performance Indicators ◽  
Service Provision ◽  
Recovery Phase ◽  
Community Services ◽  
Outpatient Clinics ◽  
Clinical Activity ◽  
Single Centre ◽  
Number Of Patients ◽  
The Uk ◽  
The Impact

ObjectiveThe COVID-19 pandemic resulted in prioritisation of National Health Service (NHS) resources to cope with the surge in infected patients. However, there have been no studies in the UK looking at the effect of the COVID-19 work pattern on the provision of cardiology services. We aimed to assess the impact of the pandemic on cardiology services and clinical activity.MethodsWe analysed key performance indicators in cardiology services in a single centre in the UK in the periods prior to and during lockdown to assess reduction or changes in service provision.ResultsThere has been a greater than 50% drop in the number of patients presenting to cardiology and those diagnosed with myocardial infarction. All areas of cardiology service provision sustained significant reductions, which included outpatient clinics, investigations, procedures and cardiology community services such as heart failure and cardiac rehabilitation.ConclusionsAs ischaemic heart disease continues to be the leading cause of death nationally and globally, cardiology services need to prepare for a significant increase in workload in the recovery phase and develop new pathways to urgently help those adversely affected by the changes in service provision.

Mental health nursing: is Rome burning?

2020 ◽  
Vol 9 (2) ◽  
pp. 1-11
Author(s):  
Edward White ◽  
Charles Brooker
Keyword(s):  
Mental Health ◽  
Service Provision ◽  
Evidence Base ◽  
Research Activity ◽  
Mental Health Nursing ◽  
Mental Health Nurses ◽  
Health Service Provision ◽  
Health Nursing ◽  
The Uk ◽  
Mental Health Service Provision

Background/Aims The recent period of financial austerity, between 2010 and 2020, adversely impacted mental health service provision and raised fundamental questions for mental health nurses. This article aims to identify and discuss present areas of professional concern to mental health nurses in the UK. Methods The authors invited submissions from 12 experienced mental health nurses regarding the contemporary circumstances and likely future direction of mental health nursing. Each manuscript was reviewed, and recurrent themes emerged around which an editorial discussion was framed. Findings Many issues around service provision have persisted and/or deteriorated over time. The impacts on mental health nursing continue to be largely related to the type of educational preparation required, the size of the workforce and the research activity deemed necessary to strengthen the evidence base of clinical practice. Conclusions Mental health nursing faces several challenging issues to address if it is to survive and then to establish the unique professional identity it seeks.

Regulatory Guidance for Risk-Informed In-Service Inspection of Nuclear Power Plants in Bulgaria

2007 ◽  
Author(s):  
Adam Toft ◽  
David Lidbury ◽  
Rossitza Miteva ◽  
Dimitar Vasilev
Keyword(s):  
Nuclear Power ◽  
Power Plants ◽  
Best Practice ◽  
Operating Conditions ◽  
Guidance Document ◽  
Draft Guidance ◽  
Nuclear Facilities ◽  
Regulatory Guidance ◽  
The Uk ◽  
Service Inspection

Risk-Informed In-Service Inspection (RI-ISI) aims to integrate service experience, plant and operating conditions, other deterministic information, and risk insights in developing augmented in-service inspection (ISI) programmes for Nuclear Power Plant (NPP). RI-ISI is a developing methodology which is increasingly being adopted world-wide, and is seen as having the potential to make ISI programmes more effective and efficient in terms of both nuclear safety and the economical operation of nuclear plant. The Nuclear Regulatory Agency (NRA) bears responsibility for regulating nuclear facilities in Bulgaria. In anticipation of a forthcoming application by Kozloduy NPP to adopt an RI-ISI programme for selected systems in WWER-1000 plant, the NRA required a suitable regulatory guidance document to help assess such an application. The UK Department of Trade and Industry-funded Project NSP/04-B23 “Assistance with the Regulatory Aspects of Risk-informed In-Service Inspection (RI-ISI)” has enabled the development of a guidance document, the initial draft of which was produced by Serco Assurance in close consultation with the NRA and other Bulgarian stakeholders. This paper presents a description of how current international best practice has been tailored to Bulgarian NPP, and provides a summary of the draft guidance document produced as the principal output of Project NSP/04-B23.

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