British journal of nursing (Mark Allen Publishing)
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The coalition Government, in its White Paper Equity and Excellence: Liberating the NHS and in the subsequent paper Liberating the NHS: the new Legislative Framework has advanced its proposals for NHS restructuring. These proposals are intended to provide much enhanced roles for GPs in relation to the commissioning of NHS services in the future. This article explores these proposals and considers whether they can be seen as a return to the 1990s and the approach of the NHS Community Care Act 1990. It also explores the nature of these greater responsibilities and some of the problems that this may give rise to in the future.
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Patients can experience unexpected deterioration in their physiological condition that can lead to critical illness, cardiac arrest, admission to the intensive care unit and death. While ward staff can identify deterioration through monitoring physiological signs, these signs can be missed, interpreted incorrectly or mismanaged. Rapid response systems using early warning scores can fail if staff do not follow protocols or do not notice or manage deterioration adequately. ⋯ C4C has the potential to prevent clinical deterioration and is valued by patients and relatives. Concerns of ward staff could be managed through project management. As it is relatively new, this field offers further opportunities for research.
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This article reports on the introduction of simulation (using a high fidelity patient simulator) into an undergraduate nursing curriculum in Northern Ireland to develop confidence and proficiency without compromising patient safety. It also reports on how the students perceived the impact of this experience on their clinical practice. The simulation was developed for third-year adult branch nursing students (n=90). ⋯ The students participated in three case scenarios using a high-fidelity patient simulator (HPS). Students' responses showed that the simulation helped them to gain a perspective on the role of a qualified nurse and also enhanced their understanding of the relationship between theory and practice. Students also reported that they valued the experience as a means of highlighting gaps in their knowledge, but it also had given them confidence for future clinical practice.
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John Tingle discusses a recent report by the National Confidential Enquiry into Patient Outcome and Death (NCEPOD) into the care received by elderly patients undergoing surgery.