The Knowledge @lert Service

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Knowledge @lert for Wednesday 14th October

October 14, 2015 CCG Daily News

Community matrons’ experience as independent prescribers. – British Journal of Community Nursing.

Factors influencing evidence-based practice for community nurses. – British Journal of Community Nursing.

Context for successful quality improvement. N Fulop, G Robert, The Health Foundation, October 2015.

Measuring the performance of local health systems: a review for the Department of Health. C Ham, V Raleigh, C Foot, R Robertson, H Alderwick. The King’s Fund, October 2015.

HSJ launches NHS workforce investigation – Health Service Journal.

How To Set Up A Staff Support Network – NHS Employers.

Registered Nurses And Health Care Support Workers: A Summary Of RCN Policy Positions – Royal College of Nursing.

Measuring the performance of local health systems – The Kings Fund.

Improving productivity in elective care – Monitor.

Adult social care – The Local Government Association.

Venous thromboembolism in cancer patients – All-Party Parliamentary Thrombosis Group.


Community matrons’ experience as independent prescribers. British Journal of Community Nursing
Community matrons prescribe medications and treatments for arguably the most complex patients in the community setting, yet little is known about their experiences of prescribing. Drug events and inappropriate prescribing are known to account for around 16% of hospital admissions. With a remit of reducing unplanned admissions to hospital, it is important to understand community matrons’ experiences as prescribers and to examine the role of prescribing in fulfilling this agenda with consideration given to the adequacy of the prescribing support available. In this study, a qualitative research design was used and a purposive sample of seven community matrons from the south of England took part in the study. Semi-structured interviews were carried out and analysed using Braun and Clarke’s six phases of thematic analysis. The findings show that community matrons consider prescribing-related knowledge to be essential in fulfilling their role and that the ability to prescribe speeds patient access to medicines. In some instances it may be instrumental in preventing hospital admission. Community matrons prescribe a limited range of medicines regularly, while referring to GPs for other prescribing that they consider outside their competency. Community matron prescribers mostly access their support from GPs and this is considered adequate in supporting them in their prescribing role.


Factors influencing evidence-based practice for community nurses. – British Journal of Community Nursing.
Factors influencing the development of evidence-based nursing practice (EBNP) were examined in Prince Edward Island, Canada. An adapted electronic questionnaire was distributed to practicing registered nurses and nurse practitioners (n=68). An analysis of variance revealed a significant difference between nurses’ clinical practice setting and the EBNP scale. Significant differences were also found between age and education level when compared with the EBNP subscales where novice nurses were less likely to rely on experience and intuition, and expert nurses with a higher level of education reported being more skilful at synthesising and applying information from research findings into their nursing practice.


Context for successful quality improvement. N Fulop, G Robert, The Health Foundation, October 2015
Research and evaluation of quality improvement in health care repeatedly shows that results fall short of expectations; promising interventions shown to be initially successful do not transfer to new settings, or are not sustained. Again and again contextual factors, changing over time or varying between settings, seem to frustrate efforts to improve quality. Building on a series of thought pieces – published by the Health Foundation in Perspectives on context – this best evidence review combines the ideas of receptive and non-receptive contexts for change, with a psychological perspective and the proposition that social context is the key facilitator of quality improvement.


Measuring the performance of local health systems: a review for the Department of Health C Ham, V Raleigh, C Foot, R Robertson, H Alderwick. The King’s Fund, October 2015
This report summarises the results of a rapid review of how to assess the performance of local health systems through the lens of clinical commissioning groups (CCGs). The review was commissioned by the Department of Health who asked The King’s Fund to advise on the ‘first principles’ of a local health system scorecard for the NHS in England.


HSJ launches NHS workforce investigation – Health Service Journal
HSJ has launched an investigation into the causes and consequences of the NHS’s growing reliance on temporary clinical and medical staff. Following recommendations on workforce made by Lord Carter’s efficiency review, HSJ’s investigation will go further, drawing on experience from around the system in order to generate proposals that will directly address the problem of a temporary workforce.

  • Contact the Library & Knowledge Service to request this article in full or Phn. 01704 704202

How To Set Up A Staff Support Network – NHS Employers
This guidance is designed to help in setting up a staff support network group in your organisation. It provides ideas based on established good practice, and can be adapted to suit your organisation’s needs for non-commercial purposes. It can be adapted for any type of staff support network, and it has been developed as an example for black and minority ethnic staff networks.


Registered Nurses And Health Care Support Workers: A Summary Of RCN Policy Positions – Royal College of Nursing
This briefing provides an overview of RCN positions on the education of the registered and non-registered nursing workforce. It argues that the registered nursing workforce should remain an all graduate profession and that the RCN does not support the return of the second level registered nurse.


Measuring the performance of local health systems – The Kings Fund
The Kings Fund has published Measuring the performance of local health systems: a review for the Department of Health.  This report summarises the results of a rapid review of how to assess the performance of local health systems through the lens of clinical commissioning groups.  The review was commissioned by the Department of Health who asked The King’s Fund to advise on the ‘first principles’ of a local health system scorecard for the NHS in England.


Improving productivity in elective care – Monitor
Monitor has published Helping NHS providers improve productivity in elective care. This guidance concentrates on potential improvements in the operational management of elective patient pathways within the direct control of NHS providers and identifies a mechanism whereby clinicians and managers can work together to maximise provision of care.  It scrutinises a group of ophthalmic and orthopaedic elective care providers at home and abroad selected for their strong performance on quality and cost metrics.


Adult social care – The Local Government Association
The Local Government Association has published Adult social care, health and wellbeing: a shared commitment. The document is a joint submission to the Government’s Spending Review by the Local Government Association and the Association of Directors of Adult Social Services, outlining the social care funding crisis.  It highlights how local government leaders and directors of adult social care warn that the ability of councils to provide dignified care for people in old age or for those with a disability is at risk unless urgent steps are taken to plug the burgeoning gap in social care funding.   


Venous thromboembolism in cancer patients – All-Party Parliamentary Thrombosis Group
The All-Party Parliamentary Thrombosis Group has published Venous thromboembolism (VTE) in cancer patients: cancer chemotherapy and clots.  Published on World Thrombosis Day, this report seeks to further establish the known link between the treatment of cancer patients and the increased risk of venous thromboembolism (VTE). It aims to identify both individual hospitals where death rates for patients with cancer and VTE are particularly high, and to paint an overall national picture. Furthermore, it is hoped that it will reveal a breakdown of which cancers (and their treatments) are associated with particularly high rates of VTE. Finally, it will identify if hospitals provide advice (both verbal and written) to cancer patients about the risks of VTE; and if appropriate pathways are followed to treat affected patients.

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