Article: Parallel planning and the paediatric critical care patient

A growing number of children with life-limiting conditions (LLCs) are being cared for in paediatric critical care (PCC) settings where they are at high risk of developing complications and many die after prolonged admissions.   Relatively few of these patient and their parents/carers have had documented discussions about their wishes in the event of serious deterioration before admission to PCC.  This article examines the complexities of decision-making in children with LLCs  who are admitted to PCC settings.

Sidgwick, P. et al. 2019.  Parallel planning and the paediatric critical care patient.  Archives of Diseases in Childhood, 104, p 994-997.

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Article: Pressure ulcer education 4: selection and use of support surfaces

The use of support surfaces is one of the most common interventions for preventing pressure ulcers.  These support surfaces can include mattresses, chairs, cushion, foot/heel protection and offloading  (removing  pressure from the affected area) devices.  This article the fourth in an eight-part series on pressure ulcer prevention and management, discusses surface selection and use.

Fletcher J (2020) Pressure ulcer education 4: selection and use of support surfaces. Nursing Times; 116: 1, p 41-43.

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Article: Pressure ulcer education 3: skin assessment and care

This article highlights what practitioners need to know about risk factors associated with impaired skin integrity, how to check for non-blanchable erythema, and evidence-based interventions to promoted skin integrity and prevent pressure ulcers.

Fletcher, J. 2019. Pressure ulcer education 3: skin assessment and care. Nursing Times, 115(12) p26-29.

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Article: Pressure ulcer education 2: assessing patients' risk of pressure ulcers

Risk assessment is the first step in pressure ulcer prevention to identify patients most at risk, plan and implement interventions, and ensure resources are used appropriately. This article outlines the key factors in assessing risk for effective pressure ulcer prevention.

Young, C. Fletcher, J. 2019 Pressure ulcer education 2: assessing patients' risk of pressure ulcers. Nursing Times, 115(11) p20-22.

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Article: How to perform chest auscultation and interpret the findings

Chest auscultation is frequently used in the clinical examination of patients.  This article explains the clinical procedure for chest auscultation and provides a guide to interpreting findings.

Proctor J, Rickards E (2020) How to perform chest auscultation and interpret the findings.
Nursing Times; 116: 1, 23-26.

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Article: Improving the uptake of medical device training to promote patient safety.

Safe and effective patient care is dependent on the appropriate use of medical devices, so it is necessary to ensure that all nursing staff are competent in their use.  This article describes how one urology ward in a large acute NHD trust has supported medical device training for its staff.

Shields R, Latter K (2019) Improving the uptake of medical device training to promote patient safety.
Nursing Standard, 35 (1) p 31 - 34.

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Article: Improving nursing students' experience of clinical placements

This article describes the challenges involved in clinical placements, and discusses the importance of person-centred care and techniques such as reasoning and reflection that can improve nursing students' learning in practice. It uses two case studies to illustrate how clinical supervisors and mentors can design  clinical placements that enable nursing students to develop their skills, knowledge and self confidence.

Price B (2019) Improving nursing students' experience of clinical placements.  Nursing Standard, 34 (9) p 43 - 47.

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Article: Does your workplace know what matters to its nurses?

Like many healthcare organisations the Royal Berkshire NHS Foundation Trust created an organisational vision based on consultation with staff, patients, carers and the community.  The following year in 2018 it published it's values and behaviours framework.  The article provides details as to how this was put into practice, investing in "champions on the ground" and turned the framework into a booklet providing real details as to what these values look like on a day to day basis.

Pearce, L. 2019.  Does your workplace know what matters to its nurses?  Nursing Standard, 34 (11) p 14 - 18.

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Article: 12 hour shifts: why nurses so often see them as the key to their work-life balance

An overview of the benefits and disadvantages to 12 hour shifts, including recent research which suggests an adverse effect, particularly for staff aged 50 and over.

Jones-Berry, S. 2020.  12 hour shifts: why nurses so often see them as the key to their work-life balance.  Nursing Standard, 35 (1) p 8-11.

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Article: Developing the personal qualities required for effective nurse leadership.

Leadership within the healthcare system should be visible at all levels, rather than being dependent solely on the characteristics of those who exert control from the top of the organisation.  All nurses can act as leaders, and providing effective leadership requires them to develop specific personal qualities and behaviours.  This article explores four 'leadership intelligences' - spiritual, emotional, business or practice, and political and discusses how understanding these can assist nurses to enhance their leadership skills.

Lucas B. (2019) Developing the personal qualities required for effective nurse leadership. Nursing Standard. 34 (12) p 45-48

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Article: Using digital tools to improve staff rostering and patient flow.

In 2016, the Countess of Chester Hospital Foundation Trust decided to develop an automated coordination centre that would help it improve its management of staff allocation and patient flow.  Operational since October 2017, this digital coordination centre works in real time using both an acuity-based rostering tool and a bed management tool.  Its implementation required an overhaul of work practices and culture, which was achieved by engaging with staff.   It resulted in nursing staff having more time for patient care and nurse managers more time for clinical leadership.

Bett (2019) Using digital tools to improve staff rostering and patient flow. Nursing Times; 115 (7) p 56-57.

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Article: Infection control: equipment for facial and respiratory protection

Respiratory and facial protection are used by health professionals when there is a risk of blood or body fluids splashing into the face and eyes or exposure via inhalation.  This article discusses when and how to use the right protective equipment.

Wigglesworth, N. 2019. Infection control 5: equipment for facial and respiratory protection. Nursing Times, 115(10) p30-32.

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Article: Infection control: use of disposable gloves and aprons

Disposable gloves and aprons are used to protect health professionals and patients from the risks of infection. However, it is important to use them appropriately or they may increase patients' risk of healthcare-associated infections. This article discusses when and how to use them.

Wigglesworth,N. 2019. Infection control 3: use of disposable gloves and aprons. Nursing Times, 115(7) p34-36

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Online presentation: Just because we can... should we?

From Together for Short Lives a chance to watch the online discussion (webinar) in November 2018 by Amanda Whateley, Director of Rainbow's Hospice for Care on ethics entitled "Just because we can ...... should we".  It discusses basic ethical principles, what ethics are raised by those involved in decision making for children with life-limiting illnesses and considerations for hospices when working with families where there may be/have been conflict.

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Article: In the child's best interests: should life be sustained when further treatment is futile?

There have been several recent cases where medical staff have considered that there was no possibility of recovery for a child, yet their clinical judgements were challenged by the parents. The private anguish of these families became public, social media heightened emotions and this was followed by political and religious intrusion.  The aim of this article is to explore the concept of medical futility and the withdrawal of care for children in intensive care units. 

Marland E, Davies B (2019) In the child's best interests: should life be sustained when further treatment is futile? Nursing children and Young People, 31 (6) p 23 - 27.

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Article: Improving safety with nasogastric tubes: a whole-system approach

Misplacement of nasogastric tubes can have disastrous consequences for patients and is listed as a "never event" by NHS England.  When Lancashire Teaching Hospitals NHS Foundation Trust had two of these never events, the nutrition nursing team carried out a system-wide evaluation to identify problems and develop plans to address them.  An e-learning package, robust standardisation in staff's approach to patient care, re-setting "red lines" to support and empower staff, and the introduction of monitoring and reporting systems have contributed to improving patient safety.

Earley, T. 2019.  Improving safety with nasogastric tubes; a whole-system approach. Nursing Times; 115: 12, p 50-51

Article: Bridging the evidence gap in the care of indwelling urethral catheters.

In catheter care, as in other areas of healthcare, nurses need to base treatment decisions on the best available evidence, but what do they do if the evidence is lacking or inconclusive?  This article draws on evidence from Cochrane reviews that examine questions relating to catheter care, reflects on what practitioners can do when evidence is ambiguous or unclear, and explores how they can bridge the evidence gap.

Cowan H (2020) Bridging the evidence gap in the care of indwelling urethral catheters. Nursing Times; 116: 1, p56-58.

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Family Guide: Caring for your child at end of life

The aim of this guide is to provide families with practical support at this most difficult of times.  It answers some of the questions families might have, with some reflections from families on their own experience of losing a child.  It sets out what should be expected from children's palliative care services with useful links to further sources of information and support.

Together for Short Lives, 2019.  Caring for your child at end of life: a guide for parents and carers.
Available to download

Guide: Caring for a child at end of life: a guide for professionals on the care before death, at the time of death and after death

Caring for a child at end of life aims to provide a practical toolkit for all practitioners providing end of life care to babies, children and young people. It sets out key standards and goals for good practice alongside links to useful sources of information, legislation and regulations.  Updated from 2018.

Together for Short Lives, 2019.  Caring for a child at end of life: a guide for professionals on the care of children and young people before death, at the time of death and after death.
Available to download

Article: Long-term nurse-parent relationships in paediatric palliative care

Close, long-lasting relationships frequently exist in children's palliative care and can enhance emotional support and influence how parents manage their role in the face of uncertainty.  This literature review on the long term relationships between parents and nurses in children's palliative care identified 4 main themes: bonds, attachment and trust; sharing the journey; going the extra mile and boundaries and integrity.  All themes revealed an element of tension between closeness and professionalism.  Gaining a greater understanding of how closeness and professionalism are successfully managed by children's palliative care nurses is thought to be useful for pre and post registration nurse education.

Brimble, M. 2019. Long-term nurse-parent relationships in paediatric palliative care: a narrative literature review.  International Journal of Palliative Nursing, 25 (11) p 542-550.

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