British journal of nursing (Mark Allen Publishing)
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This article examines current research, literature and government policy that influences how health funding is allocated for treatment and care of the chronically sick. Chronic disease represents a huge burden of ill health in the UK and a substantial cost to the NHS. With both an increase in the ageing population and advancing technological developments giving doctors the theoretical ability to sustain the most fragile life, the issue of providing unlimited access of care to the chronically sick within financial limitations is clearly untenable. ⋯ The issue of how to ration resources to the chronically sick remains unresolved. Social gerontologists predict that living to 120 years of age may become the norm before the end of this century. Exploitation of the genome map and society's unwillingness to accept the inevitability of disability resulting from chronic illness will further increase pressure on healthcare financing and, as a result, demands will be forever increasing despite the most rigorous attempts at rationing.
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There is a wealth of literature that addresses the needs of informal caregivers and the needs of health professionals caring for someone with a life-threatening illness. However, there is a paucity of research that deals with nurses who are caring for their own relative who has a life-threatening illness. This qualitative study explores the information needs, support systems available, and the impact that this experience has upon the nurse's quality of life. ⋯ This study has established that nurses providing care for their own relatives have specific needs with regard to their dual role as a health professional and family carer. In understanding these specific needs, it may be possible to provide a more effective and equal level of support for these individuals. Implications for practice and future research are discussed.
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Critical care 'outreach' and early warning scoring tools have become fundamental in identifying patients at risk of clinical deterioration and promoting their optimization within the ward environment. Outreach has been implemented in various ways, ranging from the 'flying squad' (staff attending to a patient at risk of deterioration on the ward) approach to an educational model. ⋯ The authors' approach focused on linking critical care outreach to the clinical governance agenda through incident reporting. This enabled the authors to demonstrate the effectiveness of the critical care outreach service by producing both quantitative and qualitative data in respect of patients who had deteriorated following cardiothoracic surgery, and required intervention from the outreach service.