British journal of nursing (Mark Allen Publishing)
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Stroke patients with dysphagia often depend on nutrition, hydration and medication via nasogastric (NG) feeding tubes. Securing tubes using tape is associated with repeated tube loss. In this study, the authors determined cause and effect by auditing tube placement methods, delays incurred, duration and costs. ⋯ In the 17 tracked patients, it was estimated that 55% of the £5979 direct costs could be saved by nasal bridle use. In conclusion, most tubes studied were lost to inadvertent tube removal, leading to clinically significant delays to nutrition, hydration and drug treatments; this may impair recovery. Reducing tube loss is likely to reduce patient distress, treatment cost and enhance recovery.
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John Tingle, Reader in Health Law at Nottingham Trent University, and Jen Minford, Junior Doctor Coordinator, Nottingham University Hospitals NHS Trust, look at the role of patient safety culture change agents in the NHS.
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Randomized Controlled Trial
Oral decontamination techniques and ventilator-associated pneumonia.
Ventilator-associated pneumonia (VAP) is one of the major nosocomial infections in the intensive care unit (ICU), contributing to increased mortality and morbidity. Studies have shown that oral decontamination through the use of mechanical and pharmacological agents significantly reduces the incidence of VAP, but oral care practices in ICUs are not consistent. ⋯ The greatest risk factor for developing VAP was the number of ventilator days (length of time on a ventilator). There was a statistical association between gender and presence of antibiotics with VAP.
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John Tingle, Reader in Health Law at Nottingham Trent University, discusses a recent publication of the NHS Litigation Authority, now renamed NHS Resolution, which points to realignment of activity and focus in core areas.