Search

The recent landmark report into the care failings at Stafford Hospital has called for sweeping changes to end the NHS's neglect of patient safety (Francis 2013). The report calls for a 'fundamental change' in culture so that patients are always put first, and it makes 290 recommendations covering a broad range of issues relating to patient care and safety in the NHS. This article explores issues surrounding patient safety, including the terminology associated with harm and error. The types of patient safety incidents that occur in different care environments are discussed. It offers insight into why patient safety incidents occur and describes some of the underlying factors. It also discusses preventive strategies and the role of patients and family members in enhancing safety. INSETS: Example of an adverse event and the effect on the patient;Case study of Elaine Bromiley. [ABSTRACT FROM AUTHOR]

Face coverings are going to be with us for quite some time and will present an additional communication hurdle for most of us. [ABSTRACT FROM AUTHOR]

I am a nurse working in a respiratory ward, and a PhD student. I have a long-standing interest in ethics and was keen to discuss how to prepare for the ethical challenges of the COVID-19 pandemic. In April, I posed some questions to Ann Gallagher, professor of ethics and care at the University of Surrey. [ABSTRACT FROM AUTHOR]

While nursing handovers are predominantly used in ward settings, this essential form of communication is also used by community mental health teams to promote continuity of care. A community mental health nursing handover form was developed to overcome poor communication of patient information. It is expected that the form will increase efficiency and reduce handover time by focusing on pertinent and current patient information. Implementation of a community mental health nursing handover form requires the willingness of staff to be proactive and embrace change. The involvement of nurse leaders is essential to implement successful change, overcome barriers and motivate staff. [ABSTRACT FROM AUTHOR]

Dementia is a progressive terminal condition affecting all aspects of a person's functioning. People with dementia require sensitive communication approaches and skilled interventions. In addition, medications may be used to promote wellbeing, but concerns have been raised about covert medication and use of antipsychotics for managing behavioural problems. In the middle and later stages of dementia, nurses and pharmacists can work in partnership to promote effective person-centred care, ensuring medication is used safely as part of a holistic approach. [ABSTRACT FROM AUTHOR]

Service improvement is an important aspect of healthcare practice. Practitioners need to identify improvements in processes to free up time and resources for patient care. The obligation to do this falls to all staff, from students to chief executives. The project described in this article was led by a nursing student at the University of Bedfordshire, Luton, as part of the final-year assessment requirement of the pre-registration nursing degree programme. The project involved the development of a language identification tool to address communication barriers in the emergency department. [ABSTRACT FROM AUTHOR]

Aim: To investigate healthcare professionals' perceptions of caring for people from ethnic minorities with poor or no English language skills when accessing health care. Method: Semi-structured interviews were carried out with 34 healthcare professionals to identify their perception of barriers encountered by those with poor or no English language skills. Findings: Five main themes were identified in relation to barriers in accessing health care: language; low literacy; lack of understanding; attitudes, gender attitudes and health beliefs; and retention of information. Conclusion: It is essential that all individuals are able to interact effectively with healthcare services. New and innovative approaches are necessary to meet the needs of people from ethnic minorities accessing health care. [ABSTRACT FROM AUTHOR]

This article discusses the role of service improvement methodology in changing the quality of care delivered. It outlines the six-stage framework for quality improvement recommended by the NHS Institute for Innovation and Improvement. The reader is encouraged to complete a series of activities to plan and deliver a service improvement project. Potential challenges to the successful delivery of a service improvement project are also considered. The article concludes with an example of the use of the six-stage framework to improve the quality of urinary catheter care in one acute NHS trust. [ABSTRACT FROM AUTHOR]

This article aims to inspire nurses to recognise how human factors affect individual and team performance. Use of a case study and learning derived from a subsequent independent inquiry exposes the dynamics that can affect teamwork and inhibit effective communication with devastating consequences. The contribution of situational awareness and the importance of nurses speaking up when they have concerns are demonstrated as vital components in the delivery of safe patient care. [ABSTRACT FROM AUTHOR]

History taking is a key component of patient assessment, enabling the delivery of high-quality care. Understanding the complexity and processes involved in history taking allows nurses to gain a better understanding of patients' problems. Care priorities can be identified and the most appropriate interventions commenced to optimise patient outcomes. [ABSTRACT FROM AUTHOR]

Communication disorders following stroke are common, but have varied presentations. This article explains the range of communication disorders that can occur after stroke. The effect of communication impairment is not always related to its severity and should be considered in terms of its effects on patient relationships and wellbeing, and healthcare delivery. Speech and language therapists have a key role in assessing, planning and delivering interventions for patients with communication impairment following stroke. However, it is vital that all members of the multidisciplinary team have sufficient awareness to recognise potential communication difficulties. It is hoped that with increased knowledge and awareness of communication impairment, healthcare staff can make full use of their skills as effective communicators to overcome any potential barriers to communication. [ABSTRACT FROM AUTHOR]

This article presents a communication framework, devised by the authors, that could be used by healthcare professionals who come into contact with people who have dementia. The framework is based on four key concepts: validation, emotion, reassure and activity (VERA). It describes a stage-by-stage process of communication that guides nurses towards providing compassionate and caring responses. The framework was developed in response to students who said they find it useful to have structured guidance on how to interact with people who have dementia. The VERA framework offers a means of interpreting communication and responding appropriately. [ABSTRACT FROM AUTHOR]

Nurses want to help patients; it is one of their main roles and a key source of job satisfaction. However, finding the time despite low staffing levels and a heavy workload is a constant challenge. This article provides an overview of solution-focused communication -- an approach valued by an increasing number of nurses because of its brevity and effectiveness in empowering patients to find the solutions that will help them to deal with their health challenges. [ABSTRACT FROM AUTHOR]

Staying in hospital, particularly when undergoing surgical treatment, may be emotionally distressing. Patients may have to deal with separation from family and friends, disruption to routine as well as the possibility of an uncertain future. Anxiety may be related to anticipation of painful or life-changing investigations, or the effects of surgery on the individual's future family and social life. Therefore it is important that patients are given appropriate information to reassure them and enable informed decision making. This article outlines the importance of using targeted information to meet the needs of individual patients to reduce pre-operative anxiety. [ABSTRACT FROM AUTHOR]

One of the key aspects of successful collaborative working is the relevant and effective exchange of information between professionals. Boundaries exist not only between health and social care in a community setting, but also in acute care between and within departments and professions. Patients continuously cross these boundaries during transfers and transitions, when nurses interact with other professionals and are in a prime position to demonstrate exemplary interprofessional relationships and seamless patient care to other staff and to students. Mentors act as role models for students of all professions and are expected to promote opportunities that will maximise student learning and enhance patient care. This article provides mentors with some suggestions for maximising these opportunities. Mentors are encouraged to reflect on practice-based learning opportunities for students, particularly situations that are challenging and involve critical judgement. The article focuses on learning opportunities in the peri-operative department, however the same challenges are experienced in other clinical areas and the principles of good interprofessional care can be applied to any team that aspires to work collaboratively. [ABSTRACT FROM AUTHOR]

Patient choice and control should be central to the delivery of high-quality, end of life care. Advance care planning (ACP) is a process through which a patient's choices and preferences for care can be discussed and documented. It also enables patients to express what they would want to happen to them in the event that they lose capacity to make decisions. This article focuses on the use of the patient-held Preferred Priorities for Care (PPC) document, an example of an ACP tool. This article aims to provide a greater understanding of the PPC document as an end of life care tool and increase practitioners' knowledge, confidence and competence in undertaking ACP conversations with patients and their carers. Four case studies are provided to link theory to practice. [ABSTRACT FROM AUTHOR]

This article explores the skills needed for effective communication with people who have dementia. It describes the factors that influence the communication process and the effect this may have on the nurse-patient therapeutic relationship. Cognitive impairment in people with dementia may limit their ability to communicate effectively. This may, in turn, affect the nurse's ability to identify patients' needs. Communication is central to providing good dementia care. The article examines some of the challenges nurses may face when caring for this patient group and suggests some strategies to overcome any barriers, enhance quality of care and improve patient outcomes. [ABSTRACT FROM AUTHOR]

Sexuality is a fundamental aspect of being human. Guidance states that to support and improve the lives of adults with life-limiting illness, health professionals must address care in the social, psychological, spiritual and physical domains, yet no mention is made of the sexual domain. Palliative care aims to be holistic yet evidence suggests that sexuality is often overlooked when assessing care needs. This literature review will identify the issues that prevent sexual needs assessment in palliative care. [ABSTRACT FROM AUTHOR]

This article, the final in a five-part series, explains the term web log or blog and explores key considerations regarding their use to disseminate best practice in nursing. The article identifies key points for commencing a blog and provides links to other sources of planning guidance. The ways in which blogs can be used to convey best practice are discussed. [ABSTRACT FROM AUTHOR]

This article, the first in a five-part series, discusses the skills required to present information and study findings at conferences. The article explores the ways in which best practice might be most successfully disseminated, through either verbal or poster presentations. In subsequent issues of Nursing Standard the author examines the dissemination of best practice through publication, taught sessions, workshops and electronic forms of communication. [ABSTRACT FROM AUTHOR]

The nurse-to-nurse handover is not taught formally during training, yet it is one of the most important rituals of the nursing shift. This article focuses on the structure and function of change-of-shift reports and lists the events that occur within them, describing the locations of the handover process and the mode of communication involved. The problems that can occur during handover are discussed and solutions are proposed. [ABSTRACT FROM AUTHOR]

The article provides an overview of the process of how nurses should introduce themselves to their patient to help foster nurse-patient relationships. The important clinical skills and approaches, cultural considerations and potential barriers to communications that must be taken into account when introducing one's self are highlighted. It outlines the non-verbal and verbal communication considerations and active listening skills necessary for effective communication and relationship building.

The article offers tips on how nurses should care for a patient after death and support his/her family and loved ones in the community setting. Among the recommended procedures are recording the time of death and the time of verification of death in the patient documentation and on the verification of death form, informing the family of patient about his/her death, and informing the doctor of the patient's death.

The article discusses the importance of effective communication skills and demonstrating passions when informing relatives and loved ones of a patient's death. Topics include the need for nurses to use suitable language and choose an appropriate environment to clearly convey information without interruptions, and the imperative for nurses to have the necessary knowledge and skills to ensure that the task is performed with compassion and sensitivity.

Aim To explore patients' and nurses' views on their experience of nursing care in mixed-sex bays. Method Using a descriptive exploratory method, tape-recorded semi-structured interviews were conducted with a purposive sample of patients and nurses drawn from wards where mixed-sex bays were located. The resulting transcripts were analysed to identify shared themes. Findings The key themes identified were: communication from nursing staff, first reactions, relationships in the bay, reactions of others, awareness of organisational issues and nursing in a mixed-sex ward. Conclusion While some individuals felt that the attitudes and behaviours displayed by their fellow patients were of greater significance than their gender, there was a general view that mixed-sex bays were less than ideal. Nurses also struggled to maintain patient dignity in mixed-sex bays. [ABSTRACT FROM AUTHOR]

Part of nurses' unique and challenging role in healthcare settings is engaging in difficult conversation with patients. Effective communication is essential to establish a successful nurse-patient relationship, put the patient at ease and promote better interactions. A reflective approach to care can help nurses to learn from experience and use this knowledge to communicate bad news to patients in a sensitive and timely manner. [ABSTRACT FROM AUTHOR]

In early November I met Jane Cummings at her London office to discuss the new strategy for nursing and midwifery. The chief nursing officer for England would, I suspect, object if I called it 'her' strategy; several times she points out it is not a top-down initiative. The strategy owes its existence -- not just its content -- to the nurses and midwives who have contributed ideas to it, a process that began back in May. [ABSTRACT FROM AUTHOR]

The article offers information on the safe and effective administration of rectal suppositories. The equipment that nurses should prepare before insertion include the patient's prescription, non-latex gloves and a protective bed cover. The rectal suppository administration procedure is given, which includes confirming the patient's identity, assessing his or her needs and checking the prescribed medication.

Mobile phones are being used to improve nurse-patient communication and monitor health outcomes in chronic disease. Innovative applications of mobile technology are expected to increase over time in community management of cancer, heart disease, asthma and diabetes. This article focuses on mobile phone technology and its contribution to health care. [ABSTRACT FROM AUTHOR]

AIMS: The primary aim of this study was to investigate whether a questionnaire developed for patients with rheumatoid arthritis (RA) could also be used with patients who have fibromyalgia. A secondary aim was to assess the impact of fibromyalgia on sexuality. METHOD: In the first of two phases the face and content validity of a sexuality questionnaire already being used in patients with RA were assessed in a qualitative, audio-taped, interview study of five patients with fibromyalgia. The second phase consisted of a self-report questionnaire distributed to 60 patients with fibromyalgia. FINDINGS: The interview data confirmed that the content of the RA sexuality questionnaire was relevant to patients with fibromyalgia. A total of 43 (72%) questionnaires were returned and, of these, 41 (95%) were usable. Patients reported that fibromyalgia had altered their sexual relationship. They cited pain, stiffness, fatigue, reduced sexual drive and the impact of drug therapy as the main reasons. CONCLUSION: The symptoms associated with fibromyalgia had a negative effect on sexual enjoyment. The questionnaire appears to be useful in addressing sexuality in patients with fibromyalgia. [ABSTRACT FROM AUTHOR]

When I tell people I work in a prison, they often assume I face daily threats and intimidation. [ABSTRACT FROM AUTHOR]

Aim To measure competence, self-reported competence and self-efficacy; explore any differences between cohorts and student entry criteria; and explore the relationship between competence, self-reported competence, support and self-efficacy. Method All students undertook a three-station objective structured clinical examination (OSCE) and had previously completed a questionnaire, which included measures of self-reported competence, support and self-efficacy. The performance of two single year cohorts enabled measurement of competence development and progression. Results Students were competent in the core generalist skills of communication and hand decontamination but demonstrated low levels of numeracy. Conclusion Doubts are raised about the explanatory value or practical use of social cognitive theory in pre-registration curricula and questions are raised about the value of self-reported competence. This has implications for nursing and midwifery curricula, which emphasise the importance of self-assessment. [ABSTRACT FROM AUTHOR]

This article outlines the process of taking a history from a patient, including preparing the environment, communication skills and the importance of order. The rationale for taking a comprehensive history is also explained. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has put the NHS under unprecedented pressure. As nurses and other healthcare staff strive to deliver safe and effective care, they will likely experience a range of emotions, including fear and anxiety. [ABSTRACT FROM AUTHOR]

A job interview is a nerve-wracking experience; no matter how many you attend, you always get that heart-in-mouth feeling. I wouldn't call myself an interview specialist, but I have had enough interviews over the years to be able to offer some practical advice. So, you've got the good news that you've been invited for interview, meaning you're one step closer to your first job as a nurse. But what do you do next? From pre-interview preparation to questions to ask afterwards, here are my top tips for getting the most out of your interview. [ABSTRACT FROM AUTHOR]

Patients with learning disabilities have higher healthcare risks than the general population. Health professionals need to develop skills that enable them to communicate effectively with this patient group. Identifying barriers to communication is the first step to reducing or removing them. Suggested strategies to improve healthcare access for patients with learning disabilities include: developing individualised health action plans, simplifying communication styles and providing accessible facilities and tailored resources. [ABSTRACT FROM AUTHOR]

This article examines intimacy from a sociological perspective. It reveals that ‘over-involved’ or ‘intimate’ nurse-patient relationships do not tend to be welcomed by nurses. The work of certain theorists is explored to provide a sociological explanation of intimate nurse-patient relationships and to highlight the complexities of nurses developing intimate relationships with patients in the workplace. [ABSTRACT FROM AUTHOR]

This article explores the communication needs of deaf patients who use British Sign Language as their first or preferred language. It would appear that these needs are not being met, particularly in acute hospital settings. Practical advice is provided for nurses to improve the quality of care that deaf patients receive. [ABSTRACT FROM AUTHOR]

Patient safety incidents have physical and emotional consequences for those involved, including patients, carers, relatives and healthcare staff. This article, the fifth of seven in this series, focuses on Step Five of the Seven Steps to Patient Safety (National Patient Safety Agency (NPSA) 2004): involve and communicate with patients and the public. The article discusses how to communicate with patients and their carers who have been involved in a patient safety incident that led to moderate harm, severe harm or death. [ABSTRACT FROM AUTHOR]

After graduating from Coventry University in September 2015, I worked in critical care before deciding to pursue a career in perioperative practice. [ABSTRACT FROM AUTHOR]

This article focuses on the definitions of communication and an examination of their relationship to palliative care nursing. The underpinning theory is analysed as a means of understanding the communication process. The communication process in nursing is considered in the context of nurse/patient/family communication. While the focus of the article is on palliative care, the principles of communication as outlined also have relevance and applicability to nurses working in a variety of other clinical settings. [ABSTRACT FROM AUTHOR]

Aim To identify the most appropriate method of breaking news of a patient's death to unrelated stem cell donors, and to establish best practice guidelines based on the findings. Method In this retrospective study, 100 unrelated stem cell donors from the Welsh Bone Marrow Donor Registry were interviewed regarding their experiences of receiving news of a patient's death. Results were analysed by counting responses to the interview schedule, and identifying common themes from the open comments. Results Of the 100 participants, 78 had been informed of the patient's death by letter and 22 by telephone with the option of a follow-up letter. Overall, 61 per cent {n=61) of donors interviewed preferred to be contacted by telephone, 25 per cent (n=25) by letter and 13 per cent (n=13) by face-to-face contact at a visit. Conclusion There is no easy way to break bad news, and each individual responds to grief in a unique way. By building up a trusting relationship with the donor, the healthcare professional can assess the individual to ascertain which method of receiving news of a patient's death would be most appropriate. [ABSTRACT FROM AUTHOR]

Aim To explore the reasons given by a disability, assessment and rehabilitation team (DART) for perceived difficulties in discussing sexual problems with male patients with multiple sclerosis (MS), and to compare them with the views of a sample of patients. Method Data were gathered from a multidisciplinary team who were responsible for assessment and rehabilitation of patients with MS, using a focus group and semi-structured interviews with 11 male patients. Data were analysed thematically, with reference to An non's (1976) model of communication. Findings Patients felt a need to discuss problems with sexual dysfunction, and would welcome the introduction of the topic in a straightforward way. Health professionals were worried about intrusiveness and lack of information and training. Team members and the patients indicated that nurses are the best people to deal with these issues. Conclusion Rehabilitation teams need training to deal with patients' sexual problems, and the nurse is likely to be identified as the specialist in this area. [ABSTRACT FROM AUTHOR]

This article emphasises the need for the development of a therapeutic relationship between nurse and patient in day surgery settings. While the short patient stay associated with day surgery may appear to mitigate against this, the use of interpersonal skills can directly support its augmentation. Enhancing skills such as listening, empowerment and caring has the potential to increase patient satisfaction with services in this area. [ABSTRACT FROM AUTHOR]

This article explores the challenges nurses face when caring for patients with wounds in a palliative care context. Combining the principles of effective wound management with the key elements of holistic, person-centred care will ensure that realistic and patient-focused aims of management are identified. Nurses with effective communication skills can play an important role in supporting patients and their families at a difficult time. [ABSTRACT FROM AUTHOR]

Iremember my first day in charge of a ward as if it were yesterday. I had qualified four months earlier and was on a 28-bed surgical ward. When I arrived for my shift, I was told the ward sister was off sick and I would be in charge and I would be fine. [ABSTRACT FROM AUTHOR]

The article offers insights on saying no others. Topics discussed include the vicious cycle of saying yes to avoid disappointing others which leads people to expect agreement whenever and whatever is being asked on one's self, the non-need to shoulder all responsibilities in one's work area, and questions to ask when one feels compelled to say yes. Also noted are tips for saying what one really wants.

The article offers tips for making effective handover of patients. Topics covered include involving the whole team in handovers, prioritising patient risks and safety, describing specific conditions and symptoms, maintaining confidentiality and social distance, and trying out ward-specific approaches. Also noted are holding concise but focused handovers and being ready to learn from practice.

How can you bring theories of leadership alive, particularly for those who don't see themselves as leaders? [ABSTRACT FROM AUTHOR]

The author reflects on the lessons she learned as a healthcare support worker with regards to communication between staff and casual healthcare workers. The author said poor communication in a team can lead to agency staff feeling isolated. She said nursing students have the 6Cs approach to patient care drilled into them. She urges nurses and care staff to reflect on how they treat agency workers.