All Journals from Andrew Thompson
Abstract
Objectives: Patients with suspected Neutropenic sepsis require rapid antibiotic administration, but despite extensive education, only 67% of patients received antibiotics within 60 minutes.
Methods: A Neutropenic Sepsis Alert Card was created, as a Patient Specific Directive - this allows nurses to administer antibiotics to specific patients without prior medical review.
Results: Since the intervention, 301 patients presented with suspected neutropenic sepsis. 277 patients (92%) received their first dose of intravenous antibiotics within 1 hour of arrival into hospital, compared to 95 out of 143 patients (67%) presenting between January and June of 2014 (p=0.036).
Conclusion: The Neutropenic Sepsis Alert Card can significantly improve door to antibiotic needle time for chemotherapy patients with suspected neutropenic sepsis. This intervention is inexpensive and easily replicable in other health care organisations.
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Abstract
Aims: To develop and evaluate nurse-led discharge criteria for a clinical decision unit in a large NHS Foundation Trust
Method: Criteria for nurse led discharge were developed for patients presenting to hospital via the emergency department with chest pain, headache and deliberate self poisoning. Data on length of stay on CDU and readmission were collected for these patient groups during a 2 month period, during which the nurse-led criteria were introduced. Following introduction of the criteria a survey was conducted to evaluate staff opinions of the new system.
Results: A trend towards reduced length of stay was noted during the month after introduction of nurse-led discharge (18.26hrs vs 20 hours p=0.582). Our staff survey indicated that the process was popular and has been continued since the study period.
Conclusion: Nurse-led discharge using defined criteria is feasible and popular with staff in an acute medical setting.
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A fifty-eight year old man was referred to the Acute Medical Unit by his general practitioner with a generalised erythematous rash. The rash had appeared 3 weeks earlier, initially affecting his back, but had not responded to topical emollient treatment, nor the subsequent addition of an antibiotic.
Erythroderma (or ‘red man syndrome’) is a diffuse inf lammation of the skin, affecting at least 90% of the skin surface. It can be the clinical manifestation of a variety of dermatological, systemic, malignant and haematological diseases. It can be also the result of a hypersensitivity reaction to drugs.