Can information technology help ward sisters become ward managers?

AIM: This paper describes an evaluation methodology that focuses on management decisions at the ward level in a hospital. BACKGROUND: Successive governments in the 1990s have provided considerable funds to introduce decision support systems for ward management, but few have been evaluated rigorously. This paper reviews the approaches to systems' evaluation that have been developed. METHODS: Measuring instruments were designed to define and measure management decisions and those organizational factors which affect decision making. The resulting difficulty index was validated in a before-and-after study of ward decision making. FINDINGS: Changes in decision making, after the implementation of a decision support system, were found to relate to the identified organizational factors. CONCLUSION: The evaluation methodology described in this paper showed that the potential benefits of a computerized management system would not be realized unless managers, doctors and nurses carried out an organizational review before implementation and then took joint ownership of the system.     

Are patient information materials too difficult to read?

This article describes a study that found much of the written patient information materials used during home visits may be too difficult for patients and caregivers to read and comprehend. A discussion of literacy and suggestions for selecting, developing, and analyzing health education and information materials that are easy-to-read and culturally appropriate are provided.     

Direct oral anticoagulants: New drugs with practical problems. How can nurses help prevent patient harm?

The safe use of anticoagulants requires a delicate balance between the risk of bleeding and the risk of thrombosis, particularly in drug‐sensitive patients, such as older people. Recently‐marketed “direct oral anticoagulants” are now being increasingly prescribed and administered in the hospital setting. Direct oral anticoagulants have pharmacological properties that are often unpredictable, and inter‐patient variability in drug response is high. Therefore, people often require meticulous review and planning to ensure they receive optimal dosing and monitoring. The multidisciplinary medication management of those receiving these drugs needs to be effectively coordinated to reduce the risk of patient harm. All clinical staff, including nurses, doctors, and pharmacists, should be competent in the pharmacology of these drugs, and know which people require individualized care plans. In this study, we introduced important concepts via the use of case studies developed from commonly‐seen scenarios at our quaternary hospital. In particular, the important role of nurses in ensuring patient safety in the periprocedural setting is highlighted.     

Can direct patient referral help the NHS modernisation agenda?

Patient referral systems have a direct impact on the patient experience: reducing unnecessary delays and stages relieves a great deal of anxiety. The NHS benefits from more efficient systems, which ease workload and reduce costs. This paper describes a nurse-to-nurse referral project set up by NHS Direct in one area, working with representatives from the local health economy.     

Lipid-lowering: can ezetimibe help close the treatment gap?

Most patients who should be on lipid-lowering therapy are not receiving it, and most patients who are receiving it are not reaching their appropriate low-density lipoprotein (LDL) goals. This is in part because physicians and patients fear side effects of statins and other lipid-lowering agents. Ezetimibe (Zetia), a new lipid-lowering drug, may help physicians close this "treatment gap" in more patients, especially in combination with a statin.