Elaine Maxwell

Improving communication and palliative care at times of clinical uncertainty in...

This is the fifth in a series of six articles that aims to encourage nurse leaders to explore how to use research findings to improve practice and services where they work. The series focuses on research that has been funded by the National Institute for Health Research (NIHR) and included in NIHR Dissemination Centre publications. The authors seek to relate the content directly to the Nursing and Midwifery Council’s code of professional standards of practice and behaviour, specifically the themes of practising safely and promoting professionalism and trust

Child

The risks of admitting children and young people to mental health inpatient units

Last of six articles on how to use research findings to improve practice and services

Comforting

Managing transitions to palliative care for older people in acute hospitals

This is the fourth in a series of six articles that aim to encourage nurse leaders to explore how to use research findings to improve practice and services where they work. The series focuses on research that has been funded by the National Institute for Health Research (NIHR) and included in NIHR Dissemination Centre publications. The authors seek to relate the content directly to the Nursing and Midwifery Council’s code of professional standards of practice and behaviour, specifically the themes of practising safely and promoting professionalism and trust. Introduction by Elaine Maxwell, clinical adviser at the National Institute for Health Research Dissemination Centre The NIHR Dissemination Centre helps clinical staff, commissioners and patients to make informed decisions about best practice and treatment in health and social care. In 2015, we looked at the evidence on best practice in caring for people who are dying in our themed review Better Endings . Every year in England and Wales over 500,000 people die (Office for National Statistics (ONS) 2017). For many of it is a process that may take days, weeks or even years, involving a progressive decline in functioning and frequent interactions with health professionals (Hughes-Hallett et al 2011). Improvements in health care have contributed to increased life expectancy and a shift in the age at which most people die. However, as the number of older people in the population is increasing the number of annual deaths is expected to rise by almost 10% by 2030 to 574,000 (ONS 2016). While much work has been done on end of life care for people with premature deaths, such as from cancer, we still have much to do in ensuring good deaths for older people. Most still die in hospital and the National Survey of Bereaved People in England (ONS 2015) found family members of people cared for in hospitals are consistently less likely to express satisfaction with the quality of end of life care their loved one received. Our review included the findings of one study, Transitions to palliative care for older people in acute hospitals: a mixed-methods study (Gott et al 2013), that concentrated on older people approaching the end of their lives and the attitudes and actions of staff in acute hospitals. This article looks at how the research was conducted and how healthcare providers might respond.

Stroke

Interprofessional teamwork in stroke care

This is the third in a series of six articles that aim to encourage nurse leaders to explore how to use research findings to improve practice and services where they work. The series focuses on research that has been funded by the National Institute for Health Research (NIHR) and included in NIHR Dissemination Centre publications. The authors seek to relate the content directly to the Nursing and Midwifery Council’s code of professional standards of practice and behaviour, specifically the themes of practising safely and promoting professionalism and trust. Picture: iStock Introduction by Elaine Maxwell, clinical adviser at the National Institute for Health Research Dissemination Centre: The NIHR Dissemination Centre aims to assist practitioners, managers and policy maker by summarising, contextualising and analysing research findings and presenting them as dependable, accessible, actionable information for those who need it. In recent years, stroke care has been transformed, in part by changes to how care services are organised. We brought together some of the research that has helped with this transformation in our themed review, Roads to Recovery . One of the studies we included, Interprofessional Teamwork across Stroke Care Pathways: Outcomes and Patient and Carer Experience (Harris et al 2013), looks at how different professions work together and affect outcomes for people with stroke. In this article, the lead researchers discuss their studies of how teamwork, or the lack of it, affects people who have had stroke and their families. A chief nurse then reflects on the implications for providers of stroke care and the importance of whole-team visibility to achieve the best outcomes.

Providing care for people with dementia alongside other long-term conditions

Part two in our research series: supporting carers responsible for people with dementia

How training could improve the way HCAs relate to older people

A research review shows the importance of good relationships for clinical outcomes

Encouraging professionalism in research-informed practice environments

How the National Institute for Health Research is putting evidence at the heart of decision-making

Turning risk tools into life savers

According to the Royal College of Physicians, the updated National Early Warning Score tool could save 1,800 lives a year. Clinical adviser at the National Institute for Health Research Dissemination Centre Elaine Maxwell explores the possibilities.