Advanced Professionals supporting our frail patients, but how?

Beverley Marriott is an Advanced Nurse Practitioner working in the Birmingham community healthcare foundation trust. She is also a King’s College Older Person Fellow. She tweets @bevbighair

Nationally there is increasing recognition of the needs of frail older people in health systems, and  the UK’s rapidly ageing population will only increase in the years to come.

Dr Ram Byravan (Consultant and Clinical Director Heart of England Elderly Care) states that the prevalence of multimorbidity is on the rise, with 44% of people over 75 now living with more than one long-term condition –  geriatricians and GPs are uniquely suited to lead the response to the challenges of caring for this group. Continue reading

MDTea Club and Podcast – Join the conversation

MDTea is by Dr Joanna Preston @GerisJo and Dr Iain Wilkinson @geriatricsdoc, consultant Geriatricians at St. George’s Hospital, London and Surrey and Sussex Healthcare Trust respectively.

MDTea offers free education on ageing for the whole MDT. We produce fortnightly podcasts on common topics encountered in clinical practice, critically looking at what evidence bases exist and which do not and applying practical solutions. The aim is to upskill a diverse workforce by discussing each topic from multi-disciplinary view points, not just one profession. We work and learn in teams in real life to solve problems so we aim to translate this to a shared format.

We have released 30 episodes over the last 18 months with funding for 20 more at the moment. Our 4th series started recently with an episode on Theories of Ageing. Others include mouth care, pain, delirium, falls prevention and management, interventions in early dementia, identity and nutrition, to name a few. Our most recent episode was on Sex and older adults – a largely neglected topic. Continue reading

Rapid assessment and frailty

Beverley Marriott is a Advanced nurse practitioner working in the Birmingham community healthcare foundation trust. She is also a King’s College Older Person Fellow

There continues to be a growing emphasis on older people and emergency hospital admissions, with Frailty often used as a ‘wrap’ around term for ‘older people’. Older people with multiple complex comorbidities are a growing number of emergency attendances, hospital stays and admissions.

Frailty defined as a loss of physical and psychological reserves, which means an increased vulnerability to minor stressor events. People living with frailty can often go unnoticed until they reach crisis point as many people with frailty are not necessarily known to their community services, acute care, voluntary sectors or GPs. Is A&E the only place for frail patients to go when they hit crisis?   Continue reading

Some things in life are free!

Cliff Kilgore is a Consultant Nurse for Intermediate Care and Older People within Dorset Healthcare NHS Trust and he is also a Visiting Fellow to Bournemouth University. He is Chair of the BGS Nurses and Allied Healthcare Professionals Council. He also is a member of the BGS Clinical Quality Steering Group. He tweets @kilgore_cliff

Many of our readers will know that the BGS has been at the forefront of promoting older people’s healthcare and wellbeing for many years. In fact, we celebrated 70 years of this in March. Leading the way for older people has enabled the BGS to have great influence on many aspects of policy and guidance including Fit for Frailty, The Silver Book, Comprehensive Geriatric Assessment (CGA), as well as ever increasing influence on training and development of all clinicians. The BGS has long recognised the importance of developing trainees and to support this has offered many benefits to its members including free membership for medical students and foundation doctors, study grants and sponsorship and support of research projects. Continue reading

Nursing documentation: Mind the gap?

Liz Charalambous is a qualified nurse on a female, acute medical HCOP (Health Care for Older People) ward at Queen’s Medical Centre, Nottingham University Hospital Trust. She is currently a PhD student at The University of Nottingham. She tweets at @lizcharalambou and is a regular guest blogger for the BGS. Her blogs are her own opinion and do not represent the opinion of her employer or any other organisation. Co-author and supervisor, Dr. Sarah Goldberg, is an associate professor at The University of Nottingham. She tweets as @se_goldberg

Introduction

docsNew research out this week highlights the importance of nursing documentation for older patients in an acute hospital setting. The research ‘Gaps, Mishaps and Overlaps: Nursing Documentation, how Does it Affect Care?’ published in The Journal of Research in Nursing found that paperwork is time consuming to complete, takes nurses away from caring for patients, and can be counterproductive to delivering good quality nursing care to older people in hospital.

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Patients don’t just have dementia

Beverley Marriott is Birmingham Community Healthcare Foundation Trust Nurse Practitioner – Community Matron based at Heart of England Good Hope Hospital. She is currently undertaking a Fellowship in Older People at Kings College London. Here she reminds us that we need to see the whole person when looking at someone with dementia.

medical-pillsMany of us work within dementia care on a daily basis. As a community matron on an AMU department supporting safe and timely discharges for patients with dementia, I understand the importance of getting it right and what happens when we get it wrong.

Dementia has reached a critical point – over recent years the government has seen improvements in diagnosis, raising public awareness and promoting dementia friendly settings. However to deliver this level of improvement requires, time, resources and focus.  Continue reading

Researchers find key to stroke survival

nurseThe number of trained nurses available to treat patients immediately after a stroke is the most reliable health services predictor of survival according to research from the University of Aberdeen and University of East Anglia published in Age & Ageing.

Having the optimal number of trained nurses available to look after patients in an acute stroke unit was consistently found to be the best predictor of survival from stroke – after personal health factors were accounted for, such as age, stroke severity and blood pressure.

The study found that just one additional trained nurse per ten beds could reduce the chance of death after thirty days by up to twenty-eight per cent, and after one year by up to twelve per cent. Continue reading

Game Theory: chess, Jenga, frailty and the future of the NHS

AIOiSvIVLiz Charalambous is a qualified nurse on a female, acute medical HCOP (Health Care for Older People) ward at Queen’s Medical Centre, Nottingham University Hospital Trust. She tweets at @lizcharalambou and is a regular guest blogger for the BGS.

During another busy shift last week, I worked with a student nurse who expressed an interest in the complications of older person care. I found the simplest analogy to be that of comparing frailty to the game of Jenga

Jenga is a game which involves removing one block at a time from a tower, until it is only a matter of time before the entire structure becomes so fragile that the whole thing comes tumbling down.

In older people, long term chronic illness is one such block; complications of unsupportive social situations, another. One urine infection, fall, or hospital admission can be the final block which causes their own personal tower to collapse, with devastating and life-changing consequences.

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Their death: their story

407953159_d8e8e41ef5_oKatie Wells is a Senior Staff Nurse who has worked with older people for 20 years, and couldn’t think of a more satisfying specialty. Here she explains her work to highlight the benefits of Advance Care Planning, and how the death of her Nan made her want to change the role of ward-based nurses to help patients plan for the future.

With so many older people in their last years of life being admitted into acute hospitals, contact with hospital staff gives us a golden opportunity to develop good relationships with both patients and families. These relationships can allow us to make the time to initiate structured conversations surrounding the care and support patients wish to receive at their End of Life.

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Calling all Rising Stars!

Do you have a colleague who does  excellent work in geriatric medicine, and deserves to be recognised for it? Do you feel that you do outstanding work and would like to be recognised for it?shutterstock_130344965

Well, the BGS is launching an award today  which can help that to happen!

Nominations for the BGS Rising Star Award 2014 open today. We would like to make two Rising Star Awards each year:

  1. One for research contributions that have translated into, or are in the process of being translated into, improvements to the care of older people.
  2. One for a clinical quality project which improves the care of older people with frailty in your locality.

Continue reading