Roads to recovery: Organisation and quality of stroke services

Stroke is a devastating disease affecting many people as well as being an area of substantial health and care spend. It represents around 5% of total NHS costs and is the fourth largest cause of death in the UK. Recent years have seen huge improvements in the clinical management of people with stroke with early assessment, use of thrombolysis and better organisation of services into acute stroke units. Over the last twenty years, stroke mortality rates have halved.

Yet providing the right care over many years to those living with stroke and their families remains a challenge. Roads to Recovery brings together recent NIHR evidence relevant to those planning and delivering stroke services, those delivering treatments to people with stroke and to those living with stroke.

Enhanced Recovery After Surgery (ERAS) and Nutritional Aspects

Book chapter 21 from Adenocarcinoma of the Esophagogastric Junction: from Barrett's Esophagus to Cancer  978 3 319 28776 8 (e-ISSN) / 978 3 319 28774 4.  Springer International 2017

UHCW Research: C Grocock

Following programmes to improve recovery after surgery linked to shorter hospital stays

Reduced compliance with enhanced recovery protocols was associated with more days in hospital after keyhole bowel surgery, an increased likelihood of readmission and complications. Enhanced recovery, also known as fast track access, is considered standard practice but there is considerable variation in what this means and how this is implemented locally.

From the NIHR Dissemination Centre

Most Eating Disorder Patients Eventually Recover

Around two out of three women with anorexia nervosa or bulimia nervosa will eventually recover in their lifetime, according to a new study at Massachusetts General Hospital (MGH).

Read more HERE.

Study looks at nursing assistants' effect on patient outcomes

This latest research into 243 hospitals across Europe found those with more professional nurses, compared to nursing assistants, had lower death rates after surgery and were rated more highly by nurses and patients.

However, analysis of the data is complicated by differences from country to country and interpreting it is more complex than media headlines suggest. It is unclear whether training for nursing assistants was equivalent in all countries studied. In England, the Department of Health plans to introduce "nursing associates", who would have 18 months' training and work alongside professional nurses and existing, less well-trained health care assistants.

Additionally, the study does not prove that more qualified nurses are the reason for the differences in death rates and quality of care. The research is based on one "snapshot" of what was happening in hospitals at one point in time (2009 to 2010). Other factors, such as local doctor staffing levels, may also have an effect on outcomes.

New standards of monitoring which mandate capnography during anaesthesia, recovery and sedation, with the aim of improving patient safety

The Association of Anaesthetists of Great Britain and Ireland (AAGBI) has 

published new Standards in patient monitoring (Recommendations for standards of monitoring during anaesthesia and recovering 2016), and calls for all hospitals to work towards using capnography for all anaesthetist-led sedation to improve patient safety. Capnography (the monitoring of carbon dioxide in the breath) is used to monitor patients’ breathing, and is the only way to make sure patients are breathing adequately while they are asleep or sedated.