British journal of nursing (Mark Allen Publishing)
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Accidents at work cost the NHS some billion pounds every year. Over half of these accidents are due to avoidable slips and falls-the most common cause of claim for compensation faced by the NHS. Under the Management of Health and Safety at Work Regulations 1999, the NHS as an employer and nurses as employees have a legal obligation to manage health and safety and to ensure that others are not put at risk by work-related activities. The first of a series, this article on health and safety law sets out the duties imposed on NHS organisations and their employees.
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This study was designed to audit nurse assessment and documentation for neuropathic pain in postoperative patients. The audit focused on recorded signs of neuropathic pain in the immediate postoperative period. Nurses were educated on how to screen patients for neuropathic signs using the validated and reliable 7-item DN4. ⋯ Of the 450 patient charts reviewed, 423 included a record of nurse screening of neuropathic pain signs. Screening by nurses found 24% (n=102) of the patients reported between one and four signs of neuropathic pain within the first 3 days following their surgery. This study demonstrated that the incorporation of the 7-item DN4 neuropathic pain assessment tool within the generic pain chart enabled nurses to regularly screen postoperative patients for signs of neuropathic pain in the immediate postoperative period.
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Enhanced recovery after surgery (ERAS) is a multimodal pathway whose strong evidence base is changing the methods used to care for patients before, during and after surgery. As a result, patients are being safely discharged at a much earlier stage than has previously been thought possible. Literature concentrates on the surgical and economical benefits of ERAS. ⋯ This study used semi-structured interviews to investigate issues of significance to ERAS patients. The issues were grouped into themes: information provision, inpatient experiences, home recovery experiences (i.e. home convalescence) and psychological and emotional experiences. Although participants reported many good aspects of their ERAS experience, the findings highlighted the need for improvement particularly with regard to post-discharge support from both community services and hospital follow-up.
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Ultrasound is an imaging technique that uses ultra-high frequency sound waves. The interaction of the sound waves with body tissue enables an image to be produced. Following guidance from the National Institute for Health and Care Excellence (NICE) (2002), the use of two-dimensional ultrasound imaging for central venous catheter (CVC) insertion has increased. ⋯ Increased first-time puncture rates and decreased complications are among the benefits of ultrasound use for CVC placement described in the literature. However, NICE (2002) guidance recommended that education and training be sought by those using this technology. The aim of this article, therefore, is to provide useful information regarding ultrasound-guided venous access and to describe some techniques to improve image quality.