How benchmarking can improve patient nutrition

Benchmarking is a tool that originated in business to enable organisations to compare their services with industry-wide best practice. Early last year the Department of Health published The Essence of Care, a benchmarking toolkit adapted for use in health care. It focuses on eight elements of care that are crucial to patients' experiences. Nurses and other health care professionals at a London NHS trust have begun a trust-wide benchmarking project. The aim is to improve patients' experiences of health care by sharing and comparing information, and by identifying examples of good practice and areas for improvement. The project began with two of the eight elements of The Essence of Care, with the intention of covering the rest later. This article describes the benchmarking process for nutrition and some of the consequent improvements in care.     

Transformational leadership can improve workforce competencies

Staffing problems can arise because of poor delegation skills or a failure by leaders to respond appropriately to economic factors and patient demographics. Training dilemmas, meanwhile, can arise because of managers' confusion about what constitutes 'training' and what constitutes 'education', and where responsibility of provision lies, with the consequence that they neglect these activities. This article uses Kouzes and Posner's (2009) transformational leadership model to show how managers can respond. Leaders who challenge budgets, consider new ways of working and engage effectively with the workforce can improve productivity and care, while those who invest in appropriate learning will have a highly trained workforce. The author explains how integration of leadership roles and management functions can lead to innovative problem solving.     

Transvenous biventricular defibrillation can improve defibrillation threshold

A case report of a patient with a high defibrillation threshold at initial implantation that was improved by the insertion of a shocking coil in the left lateral cardiac vein is discussed.     

How dermatology units can improve psychological wellbeing

BACKGROUND: Skin conditions can result in many complex emotional and social problems. Psychological factors have long been associated with the onset, maintenance and exacerbation of many cutaneous disorders. CONCLUSION: This article is based on experience gained from contact with patients while on clinical placement at a specialist dermatology unit. It aims to assist nurses to understand the diverse ways in which stressors, coping strategies, acceptance, adaptation and compliance affect skin conditions. It will stimulate the reader to think about the psychological effect of skin conditions on everyday life and explore the advantages of specialised dermatology care in addressing the emotional problems of patients with such conditions.     

Insulin sensitizer--anti-diabetic drugs, metformin and pioglitazone that can improve insulin resistance

Nonalcoholic steatohepatitis (NASH), which is considered the hepatic manifestation of the metabolic syndrome is an increasingly cause of chronic liver disease in Japan. NASH is finally lead to liver cirrhosis and hepatocellular carcinoma as viral hepatitis, therefore, medical treatment should be considered, when NASH occurs. Treatment of patients with metabolic syndrome has been focused on the management of associated conditions such as obesity, hyperlipidemia, hypertension and hyperinsulinemia. Insulin resistance, that could accelerate liver inflammation and fibrosis by up-regulation of TNFa seems to be most important factor in many cases of NASH. The insulin-sensitizing drugs, which were biguanides (metformin) and thiazolidinediones (pioglitazone) have been shown to correct not only insulin resistance but also steatosis and inflammation in the liver. Metformin and pioglitazone might be useful drugs against NASH, however further investigations were needed.     

How grounded theory can improve nursing care quality

This article presents an overview of the grounded theory research method and demonstrates how nurses can employ specific grounded theories to improve patient care quality. Because grounded theory is derived from real-world experience, it is a particularly appropriate method for nursing research. An overview of the method and language of grounded theory provides a background for nurses as they read grounded theories and apply newly acquired understandings to predictable processes and patterns of behavior. This article presents 2 exemplar grounded theories with suggestions as to how nurses can apply these and other grounded theories to improve the provision of quality nursing care.     

How contraception nurses can improve teenage sexual health

The rising incidence of unwanted pregnancies and sexually transmitted infections among teenagers has made teenage sexual health a government priority. Contraceptive nurses can play a key role in advising young people about sexual health issues and contraception. This article discusses the factors affecting teenage sexual activity and how nurses can help young people take responsibility for their sexuality.     

How education can improve care for residents with dementia

Meeting the needs of people with dementia is topical in health and social care. However, the care of older people, including those with dementia, has received much negative media coverage over the past few years. Colten Care, a care home group in the south of England, asked staff from the School of Health and Social Care at Bournemouth University to develop and deliver an educational programme to 20 staff working at three of the group's care homes. The programme adopted a person-centred approach to residents and staff and focused on empowering staff to influence practice in the homes where they worked. This article explores the content of the programme and how aspects of it were incorporated in participants' care homes. The programme was positively evaluated and formed the basis for the development of Colten Care's inhouse two-and-a-half day education programme.     

Emergency care staff can improve survival rates from sepsis

Patients die from sepsis. Reports of mortality as high as 50% are associated with patients who have severe sepsis. Often the signs and symptoms are unmanaged within the emergency care environment. This paper discusses the Surviving Sepsis Campaign and outlines a number of management steps that practitioners caring for patients within emergency care can use to reduce mortality. The sepsis resuscitation bundle is discussed in depth as its goals can be achieved within the emergency department. A number of relevant web sites are provided that guide interested readers to other information on the Surviving Sepsis Campaign.     

How increased nurse prescribing can improve stoma care practice

Stoma care nurse specialists have a comprehensive knowledge of the range and use of stoma-related products, yet few are actually nurse prescribers. This article looks at why stoma care nurse specialists should consider becoming nurse prescribers and also examines ways to assist prescribing decisions.