Bereavement
We undertook an analysis of the current thinking on how best to provide care to those who have suffered bereavement. The key message was that grief is a normal but complex process, and there is a clear need to raise awareness of the impact of bereavement. Education and training for practitioners emerged as an important priority that is fundamental to fostering greater understanding of the process of bereavement and its consequences.
Ear care
A best practice statement was published on ear care. As well as helping healthcare professionals to deliver a high standard of care, it aimed to stimulate research. It is hoped that a future review of this statement could draw on a larger body of evidence as the report acknowledged that the evidence base for much of the practice of ear care is still evolving, in particular for ear care in children.
expert opinion -“As a nurse practitioner in the ear, nose and throat team within NHS Ayrshire & Arran, I
was invited to participate in developing the ear care best practice statement. It was encouraging to see so many experts from around the country on the working group. There is a lack of available research evidence on ear care, and the first-hand knowledge and experience of those on the group allowed us to develop a local guideline that provides a strong foundation for researched-based practice in the management and delivery of ear care.”
Fiona McCabe, ENT Nurse Practitioner, Crosshouse Hospital
Good nutritional care
Providing good nutritional care to NHS patients is a question of assessing and responding to individual patients’ needs as part of their overall treatment. In 2003 we published national standards on nutritional care in hospitals and, following a round of review visits to all parts of Scotland, we published a report in August 2006 detailing the performance of NHS boards against three of these standards.
Our report found that NHSScotland has taken a big step forward towards ensuring that every patient gets the right nutritional care, at the right time, delivered by properly trained staff. Assessment of patients’ nutritional care needs is widespread and NHS boards have begun to achieve the target of completing this process within one day of admission. We also found that a fundamental change in approach is under way in NHSScotland, with food, fluid and nutrition increasingly accepted as an important part of a patient’s clinical care. All NHS boards now have nutritional care groups to oversee implementation of the national standards and they are all making progress with developing a nutritional care policy.
Homeopathy
We carried out a detailed study to identify if there was any merit in assessing the clinical and economic effectiveness of homeopathy. Our early research demonstrated that there is a lack of existing evidence, clearly highlighting the need for more research in this growing area. We decided not to undertake a more detailed assessment until further evidence becomes available.
Surgical profiles
As part of a programme of work to improve the delivery and outcomes of surgical care NHS QIS, in conjunction with the Information Services Division of NHS National Services Scotland, provided each NHS board with a report called a surgical profile. The profile presents a suite of clinical indicators setting local findings in the context of the Scotland-wide picture. Each NHS board was asked to respond formally to the profile, explaining how the data had been considered and how this exercise had contributed to improvement in surgical services. NHS boards were given their profile in November 2006 and were asked to respond by March 2007. Their responses were considered by a clinically-led national review panel and included in our summary report.
This project aims to facilitate more effective and consistent use of existing data. It is an important first step in putting into practice the strategy for clinical indicators in Scotland which NHS QIS published in October 2006.
Urinary tract infection
Healthcare professionals regularly have to make decisions about the prescription of antibiotics for urinary tract infection. How a diagnosis of urinary tract infection is made, and subsequently managed, differs greatly across the UK. We produced a SIGN guideline to help remove these variations. Using the best evidence available, we outlined simple decision rules that healthcare professionals can follow to ensure the best diagnosis and management for their patients.
Further reading
Access SIGN’s guideline on urinary tract infection
Ear care best practice statement
Local reports on nutritional care