British journal of nursing (Mark Allen Publishing)
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As practitioners, we need to have an awareness and recognition of how policy affects our professional practice. The NHS has undergone major policy changes in recent years, many of them affecting older people. These include national policies and guidance intended to prevent and reduce falls in the older adult. ⋯ Nurses have an active role to play in assessing older people who have fallen. They are also pivotal in implementing falls-prevention programmes and in influencing policy that will change practice. If falls prevention policies are to be effective, it is imperative that effective training systems are in place and healthcare professionals are trained and equipped to deliver the quality of care needed to help reduce falls in the older adult.
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John Tingle highlights key findings from two important reports by the Care Quality Commission (CQC) which maintain important implications for patient safety and provide a 'real time view' of patient care in the NHS.
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Caring for infants at end of life is challenging and distressing for parents and healthcare professionals, especially in relation to making decisions regarding withholding or withdrawal of treatment. The concept of medical futility must be considered under these circumstances. Parents and healthcare professionals should be involved together in making these difficult decisions. ⋯ While nurses do not have a legitimate role in decision making at the end of life, it is often nurses who, through their advocacy role, inform doctors about parents' wishes and it is often nurses who support parents during this difficult time. Furthermore, nurses caring for dying children should be familiar to the family, experienced in end-of-life care and comfortable talking to parents about death and dying and treatment choices. Children's nurses therefore require advanced communication skills and an essential understanding of the ethical and legal knowledge relating to medical futility in end-of-life children's nursing.