Notes

Additively-manufactured PEEK/HA porous scaffolds using highly-controllable physical components and excellent biocompatibility.
John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, introduces the recently published NHS National Patient Safety Syllabus and some recent patient safety reports.
The current practice of fluid intake and output monitoring for hospitalised patients in one local acute care tertiary hospital was unclear and inconsistent. Inaccurate fluid balance monitoring and poor documentation can result in poor clinical outcomes.

To provide an overview of the current practice of ordering, monitoring and documentation of patient fluid intake and output during hospitalisation.

Electronic charts of 2199 adults were reviewed for appropriateness and accuracy of monitoring and documentation of the fluid balance records. Data retrieved for each patient included (1) Was daily fluid balance monitoring clinically indicated? (2) Was daily fluid balance monitoring prescribed by the doctors or initiated by the nurses? (3) Was the daily fluid balance documentation accurate for the entire admission?

Of the reviewed patients, 68% were on fluid balance monitoring, of whom 31% were prescribed by medical teams and 69% were nurse-initiated. Among patients who were receiving fluid balance monitorinatients' intake and output charts. Future quality improvement and research work is needed to improve patient safety and outcomes.Emeritus Professor Alan Glasper, from the University of Southampton, and Debbie Fallon, Chair of the Children's and Young People's Nursing Academics of the United Kingdom group, explore concerns raised by academic nurses regarding the Nursing and Midwifery Council standards for pre-registration nursing education.
Newly qualified nurses are known to experience a range of feelings and fears in the first transitional 12 months post-qualifying, with absence and turnover among potential outcomes.

To evaluate the personal professional mentor role and scheme, a new pastoral support initiative, from the perspective of participating newly qualified nurses.

Newly qualified paediatric nurses (
=10), who had been assigned a personal professional mentor (an experienced nurse who worked elsewhere in their employing NHS Trust), completed a semi-structured interview. The data were analysed using thematic analysis.

The personal professional mentor counteracted some aspects of transition isolation for the newly qualified nurses. They were an independent, accessible, experienced confidant and a welcome new supportive role.

Pairing experienced nurses with newly qualified nurses provided a new type of workplace support during transition. Inexpensive to set up and run, it is an easy addition to any portfolio of support strategies.
Pairing experienced nurses with newly qualified nurses provided a new type of workplace support during transition. Inexpensive to set up and run, it is an easy addition to any portfolio of support strategies.Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the prohibition of torture under Article 3 of the European Convention on Human Rights (1950) and why it is relevant to nursing.This article considers the potential development of advanced clinical practitioners (ACPs) and consultant practitioners, beyond the 'expert' status as defined by Pat Benner in 1984. The suggested Derby Model 7 Levels of Practice Advancement, adapted from Benner's From Novice to Expert, recognises Health Education England's four pillars of advanced practice and how they can be implemented and enhanced within these senior roles, and what that means in a 21st century healthcare system.
Although the mental health burden in healthcare workers caused by COVID-19 has gained increasing attention both within the profession and through public opinion, there has been a lack of data describing their experience; specifically, the mental wellbeing of healthcare workers in the intensive care unit (ICU), including those redeployed.

The authors aimed to compare the mental health status of ICU healthcare workers (physicians, nurses and allied health professionals) affected by various factors during the COVID-19 pandemic; and highlight to policymakers areas of staff vulnerabilities in order to improve wellbeing strategies within healthcare systems.

An online survey using three validated scales was conducted in France, the UK, Italy, Mainland China, Taiwan, Egypt and Belgium.

The proportion of respondents who screened positive on the three scales across the countries was 16-49% for depression, 60-86% for insomnia and 17-35% for post-traumatic stress disorder. The authors also identified an increase in the scores with longer time spent in personal protective equipment, female gender, advancing age and redeployed status.

The high prevalence of mental disorders among ICU staff during the COVID-19 crisis should inform local and national wellbeing policies.
The high prevalence of mental disorders among ICU staff during the COVID-19 crisis should inform local and national wellbeing policies.The COVID-19 pandemic compelled states to limit free movement, in order to protect at-risk and more vulnerable groups, particularly older adults. Due to old age or debilitating chronic diseases, this group is also more vulnerable to loneliness (perceived discrepancy between actual and desired social relationships) and social isolation (feeling that one does not belong to society). This forced isolation has negative consequences for the health of older people, particularly their mental health. This is an especially challenging time for gerontological nursing, but it is also an opportunity for professionals to combat age stereotypes reinforced with COVID-19, to urge the measurement of loneliness and social isolation, and to rethink how to further adjust interventions in times of crisis, such as considering technology-mediated interventions in these uncertain times.Pulse oximetry is widely used to assess oxygen saturation (SpO2) in order to guide patient care and monitor the response to treatment. However, inappropriate oximeter probe placement has been shown to affect the measured oximetry values in healthy and normoxic outpatients. This study evaluated how treatment decisions might be impacted by SpO2 values obtained using a finger probe placed on the pinna of the ear in a cohort of 46 patients receiving non-invasive ventilation compared with values obtained from a probe on the finger and the results of arterial blood gas (ABG) (SaO2) analysis. Bland-Altman analysis was performed to evaluate agreement between the methods. Finger probe saturation was not statistically different from SaO2, with a mean difference of -0.66% (P>0.05). Saturation from the ear was significantly different (-4.29%; P less then 0.001). Subgroup analysis in hypoxic patients (SaO2 less then 90%) showed a significant difference between ABG SaO2, and finger and ear SpO2. The study provides evidence that placement of a finger probe on the ear is unsafe clinical practice, potentially leading to patient mismanagement.
Losing a loved one in the intensive care unit (ICU) can be a traumatic experience. The literature highlights that relatives of those who have died in ICU can experience symptoms of stress, anxiety, depression, post-traumatic stress disorder (PTSD) and prolonged grief.

To evaluate the service delivery of the bereavement care that is provided on a 20-bed general ICU.

A literature review informing and supporting the service evaluation and development of the questionnaire. Thematic analysis was undertaken using the six-phase framework.

Five main themes were found timing; care, dignity and respect; support; information; and memory making. Bereavement care is described as after-death care. N6022 order However, the participants stipulated that bereavement care should be discussed prior to the death. Participants described using a range of interventions, such as memorial services, condolence letters, follow-up meetings and diaries.

Bereavement care was regarded as an important aspect of the care delivered in ICU. It was evident that participants strived to deliver an holistic approach, yet some found this difficult to achieve.
Bereavement care was regarded as an important aspect of the care delivered in ICU. It was evident that participants strived to deliver an holistic approach, yet some found this difficult to achieve.Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on how the pandemic has changed work practices and suggests that refocusing priorities can not only improve staff wellbeing but also productivity and competition.The prognostic value of high-sensitivity C-reactive protein (hsCRP) in complex coronary artery disease has not been fully established. We aimed to determine the association between hsCRP and long-term outcomes in elderly patients with 3-vessel disease (TVD). From April 2004 to February 2011, 3069 patients aged ≥65 years with TVD were consecutively enrolled and received medical treatment alone, percutaneous coronary intervention, or coronary artery bypass grafting. The patients were divided into 2 groups according to their hsCRP levels less then 3.00 mg/L (62.1%) and ≥3.00 mg/L (37.9%). The mean age was 71 ± 4 years. The high hsCRP group had more risk factors and more frequently received conservative treatment than the low hsCRP group. During a median follow-up period of 6.2 years, elevated hsCRP was significantly associated with increased all-cause death (19.5% vs 29.6%, P less then .001), cardiac death (9.4% vs 15.2%, P = .001), and major adverse cardiovascular and cerebrovascular events (34.1% vs 42.5%, P = .001). Multivariable Cox regression analyses revealed that hsCRP was an independent predictor for all of these events. Combining hsCRP with Synergy between PCI with TAXUS and Cardiac Surgery score II further improved the predictive power of the score. The relationship between hsCRP and mortality was relatively consistent across subgroups. Overall, hsCRP could prove useful for risk prediction in elderly patients.At the time of the accident at Fukushima Daiichi nuclear power plant in 2011, I was living in Iwaki City with my two children and my husband. With our home damaged by the tsunami and the deteriorating status following the situation at the nuclear power plant, we spent 2 years as evacuees before returning to Iwaki City. Subsequently, I decided to work as a radiation counsellor in the Suetsugi district of Iwaki City. I would like to describe my experience of taking measurements and helping to communicate with the residents while respecting the lives of local people.The familiar talker advantage is the finding that a listener's ability to perceive and understand a talker is facilitated when the listener is familiar with the talker. However, it is unclear when the benefits of familiarity emerge and whether they strengthen over time. To better understand the time course of the familiar talker advantage, we assessed the effects of long-term, implicit voice learning on 89 young adults' sentence recognition accuracy in the presence of four-talker babble. A university professor served as the target talker in the experiment. Half the participants were students of the professor and familiar with her voice. The professor was a stranger to the remaining participants. We manipulated the listeners' degree of familiarity with the professor over the course of a semester. We used mixed effects modeling to test for the effects of the two independent variables talker and hours of exposure. Analyses revealed a familiar talker advantage in the listeners after 16 weeks (∼32 h) of exposure to the target voice.
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