Following on from the 2010 Francis Report, which set out a variety of recommended changed to NHS practices in the light of perceived failures in patient care at Mid-Staffordshire NHS Foundation Trust, an Inquiry has been published on February 6.
The Inquiry is intended, in its own words, to ”examine the commissioning, supervisory and regulatory organisations in relation to their monitoring role at Mid Staffordshire NHS Foundation Trust between January 2005 and March 2009. It will consider why the serious problems at the Trust were not identified and acted on sooner, and will identify important lessons to be learnt for the future of patient care”.
You can download the various sections of the report here.
As reported by BBC News, the Inquiry lays particular emphasis on:
- The merger of the regulation of care into one body – two are currently involved
- Senior managers to be given a code of conduct and the ability to disqualify them if they are not fit to hold such positions
- Hiding information about poor care to become a criminal offence as would failing to adhere to basic standards that lead to death or serious harm
- A statutory obligation on doctors and nurses for a duty of candour so they are open with patients about mistakes
- An increased focus on compassion in the recruitment, training and education of nurses, including an aptitude test for new recruits and regular checks of competence as is being rolled out for doctors
NHS Chief Executive David Nicholson has commented on the Inquiry, in a video which you can see here.
On January 9 this year, the National Institute for Health and Clinical Excellence (NICE) has released new guidelines supporting the use of a new device for healing bone fractures.
In their own words, the guidance ”advises that the EXOGEN ultrasound bone healing system benefits patients and the NHS when used for treating long bone fractures with non-union (bone fractures that have failed to heal after 9 months). However, the case for adopting EXOGEN routinely for long bone fractures with delayed healing, that is, fractures which do not show radiological evidence of healing after 3 months, wasn’t supported because of uncertainties in the evidence.
“EXOGEN delivers low-intensity pulsed ultrasound waves that aim to promote bone healing through stimulating the production of growth factors and proteins which increase the removal of old bone, and increase the production of new bone. Long bone fractures are suitable for treatment if the fracture is stable and well-aligned. Ultrasound waves are delivered straight to the fracture site via a small transducer which is secured by a strap. For patients wearing a cast, a hole is cut to allow the transducer to make contact with the skin at the fracture site. The device is programmed to deliver ultrasound in 20-minute sessions which the patient administers themselves each day at home.”
The Lancet has recently published an RCT concerning whiplash, entitled “Emergency department treatments and physiotherapy for acute whiplash: a pragmatic, two-step, randomised controlled trial.”
The article aimed to “estimate whether training of staff in emergency departments to provide active management consultations was more effective than usual consultations (Step 1) and to estimate whether a physiotherapy package was more effective than one additional physiotherapy advice session in patients with persisting symptoms (Step 2).”
You can read the article’s abstract here.
You should be able to access the article by signing in to your NOC Athens account, but accessing articles published by Science Direct can be a little complicated, so don’t hesitate to contact us if you’re unable to open the full-text.
Some of you will be familiar with this paper from early 2012, entitled “The diagnostic performance of MRI in osteoarthritis: a systematic review and meta-analysis”.
The paper’s abstract states that its objective is “to determine the diagnostic utility of MRI in OA through a meta-analysis of published studies”, and concludes that “MRI can detect OA with an overall high specificity and moderate sensitivity when compared with various reference standards …at this time [the] standard clinical algorithm for OA diagnosis, aided by radiographs appears to be the most effective method for diagnosing OA.”
You can see the article referenced here from PubMed.
Given our recent subscription to Clinical Key, you can also see the full-text online or download a pdf. You can visit Clinical Key here, and access the material by signing on through your Athens account.
From NICE (National Institute for Health and Clinical Excellence):
“NICE has [this week] published guidance on the role of new and established treatments for the management of Crohn´s disease in adults and children.
“Crohn’s disease is a chronic inflammatory condition that mainly affects the gastrointestinal tract (gut). It can develop at any age but most commonly starts between the ages of 15 and 30, with around a third of patients diagnosed before the age of 21. The disease affects slightly more women than men. Its cause is unknown, but it is around twice as common in smokers. There are currently around 115,000 people living with Crohn’s disease in the UK and between 3000 and 6000 new cases are diagnosed each year. An estimated 5% of patients have severe disease, but the proportion of people with moderate Crohn’s disease is unclear. The condition can lead to delay of growth and puberty in children, as well as affecting fertility and sexual relationships in adults.”
A recent paper published by The Lancet has warned against resurfacing – a hip replacement technique commonly employed instead of full hip replacement.
From BBC Health News: “The UK’s Medicines and Healthcare products Regulatory Agency (MHRA) has already advised annual checks for people with large head metal-on-metal full hip replacements due to safety concerns. It is thought tiny pieces of metal can break off and leak into the blood.
“The current study did not look at the safety of the metal resurfacing implants, although the researchers say there could be the same theoretical safety risk as with metal-on-metal hips.
“Instead it looked at failure rates with metal-on-metal resurfacing – where the socket and ball of the hip bone has a metal surface applied to it rather than being totally replaced.”
“The resurfacing implants failed more quickly than total hip replacements. The five-year failure rate was about 5% on average compared with less than 2% for total hip replacement. The failure rate in women was so high – up to five times greater – that the researchers believe resurfacing implants should never be used in women.
“Similar, they should not be recommended to men – the only exception is men with particularly large hip bones who appear to fare as well with resurfacing as with a total hip replacement.”
You can read the full story from the BBC website by clicking here, and analysis from the New York Times about the paper here. Further commentary is available from the University of Bristol here and from Onmedica here.
Staff involved in obstetrics at the Horton Hospital in Banbury may be especially interested in an article published in May 2012 by the prestigious Cochrane Library, which gathers together high quality research and systematic reviews.
The paper is entitled “Antenatal breastfeeding education for increasing breastfeeding duration”, and deals with “the impact of antenatal BF (breastfeeding) education on the duration of BF”. You can access it by clicking here, providing you have signed in to your NOC and Horton Athens account.
If you have any problems accessing the article or your Athens account, or if there is anything you feel the library can do to help you unearth information about the topic, please don’t hesitate to contact us.
A UK study of over 4000 people has found a genetic link to age-related lumbar disc degeneration.
Published in Ann Rheum Dis-2012-Williams-annrheumdis-2012-201551 the researchers at King’s College London found that the (PARK2) gene and its variants seemed to influence the speed at which degenerating lumbar discs deteriorated.
The nature and extent of what surgeons should tell their patients before and about their operations has long been a matter of debate. An article in the most recent issue of the journal Spine seeks to address this question.
In the words of the article’s abstract, the article is a “systematic review of the available medical literature from 1980 to 2010 was conducted and combined with expert opinion from a recent survey of experts regarding cervical spine fractures”, published with the intention of “[providing] an evidence-based set of guidelines for cervical spine injuries in order to reduce variability in the information given to patients and their families”.
The journal Spine, including the most recent issues, is freely available online to all NOC and Horton staff, being provided nationally by the NHS. The easiest way to access material available is via your Athens account. You can find out more about Athens and how to set up an account here. For more information, or if you would like any help or further information, please contact library staff. If you already have a fully functioning Athens account, please sign in and search for the journal Spine here, and follow the link, to gain access to both the article detailed above and the journal’s archive.