NEWS
Assessment guidance would help staff pinpoint under-fives at risk By Alistair Kleebauer @alistairkleebauer Nurses should use a traffic light system of signs and symptoms to assess whether a high temperature in children aged five or under indicates serious illness, according to a quality standard published by the National Institute for Health and Care Excellence. Advice released by NICE last week says identifying the cause of fever in young children can be problematic because there may be no obvious cause, making it difficult to distinguish between common viruses and life-threatening bacterial infection.
Signs and symptoms should be grouped into green, amber and red categories. Red symptoms, for example, include grunting and neck stiffness. Amber symptoms include reduced urine output.
Listen to parents
Nurses should measure and record temperature, heart rate and respiratory rate if a fever is suspected, says the document. A urine test should be carried out within 24 hours if a child has a temperature of 38ºC or higher, it adds, because the child may have a urinary tract infection.
Hospital trials patient monitoring system A chest patch that checks patients’ vital signs and transmits readings wirelessly to pagers has been introduced at a private hospital in Brighton. Spire Healthcare’s Montefiore Hospital has been trialling the SensiumVitals system on its patients, recording their heart rate, respiration and temperature every two minutes. The information provided by the monitoring system, which is sent to pagers and computers at nurse stations,
gives early warning of deterioration. Nurses receive alerts if measurements exceed pre-set levels and fall into a range determined by the National Early Warning Score. Matron Lynette Awdry (pictured with patient Bill Edwards) said: ‘The system does not replace nurses or routine monitoring, but provides additional monitoring. Nothing can replace the “eyes-on” assessment of a patient and direct communication.’
The quality standard, developed by a committee including Penny McDougall, a paediatric matron at the Variety Children’s Hospital, King’s College Hospital NHS Foundation Trust in London, advises nurses on how to assess the child’s level of risk. Ms McDougall said: ‘We have learned from various incidents across the country where parents have been concerned about their child, they have raised it and it has not been taken as seriously as perhaps it should have been. One of the learning outcomes of reports from organisations such as the National Patient Safety Agency is we should listen to parents and talk to them.’ She added that if parents report that a child has had a high temperature it should form part of the healthcare professional’s assessment, even if the temperature has returned to a normal range. Carol Webley-Brown, a practice nurse at Downham Family Medical Practice in Bromley, Kent, said the advice was helpful. ‘We do a lot of what is recommended in primary care already, this helps newer nurses and helps us to give the right information to parents.’ She added: ‘Clinical judgement can be different with every doctor and nurse. The traffic light system gives a defined reaction and it improves patient safety.’ She said the checks outlined by the system go further than those practice nurses would currently carry out, adding: ‘It will help me communicate to the GP that I am concerned.’ The quality standard can be found at www.nice.org.uk/Guidance/QS64 and it prioritises recommendations from the NICE guidance with advice on action dependent on the child’s level of risk at www.nice.org.uk/guidance/CG160
10 july 30 :: vol 28 48 :: 2014 STANDARD Downloaded fromnoRCNi.com by ${individualUser.displayName} on Nov 13, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
Assessment guidance would help staff pinpoint under-fives at risk By Alistair Kleebauer @alistairkleebauer Nurses should use a traffic light system of signs and symptoms to assess whether a high temperature in children aged five or under indicates serious illness, according to a quality standard published by the National Institute for Health and Care Excellence. Advice released by NICE last week says identifying the cause of fever in young children can be problematic because there may be no obvious cause, making it difficult to distinguish between common viruses and life-threatening bacterial infection.
Signs and symptoms should be grouped into green, amber and red categories. Red symptoms, for example, include grunting and neck stiffness. Amber symptoms include reduced urine output.
Listen to parents
Nurses should measure and record temperature, heart rate and respiratory rate if a fever is suspected, says the document. A urine test should be carried out within 24 hours if a child has a temperature of 38ºC or higher, it adds, because the child may have a urinary tract infection.
Hospital trials patient monitoring system A chest patch that checks patients’ vital signs and transmits readings wirelessly to pagers has been introduced at a private hospital in Brighton. Spire Healthcare’s Montefiore Hospital has been trialling the SensiumVitals system on its patients, recording their heart rate, respiration and temperature every two minutes. The information provided by the monitoring system, which is sent to pagers and computers at nurse stations,
gives early warning of deterioration. Nurses receive alerts if measurements exceed pre-set levels and fall into a range determined by the National Early Warning Score. Matron Lynette Awdry (pictured with patient Bill Edwards) said: ‘The system does not replace nurses or routine monitoring, but provides additional monitoring. Nothing can replace the “eyes-on” assessment of a patient and direct communication.’
The quality standard, developed by a committee including Penny McDougall, a paediatric matron at the Variety Children’s Hospital, King’s College Hospital NHS Foundation Trust in London, advises nurses on how to assess the child’s level of risk. Ms McDougall said: ‘We have learned from various incidents across the country where parents have been concerned about their child, they have raised it and it has not been taken as seriously as perhaps it should have been. One of the learning outcomes of reports from organisations such as the National Patient Safety Agency is we should listen to parents and talk to them.’ She added that if parents report that a child has had a high temperature it should form part of the healthcare professional’s assessment, even if the temperature has returned to a normal range. Carol Webley-Brown, a practice nurse at Downham Family Medical Practice in Bromley, Kent, said the advice was helpful. ‘We do a lot of what is recommended in primary care already, this helps newer nurses and helps us to give the right information to parents.’ She added: ‘Clinical judgement can be different with every doctor and nurse. The traffic light system gives a defined reaction and it improves patient safety.’ She said the checks outlined by the system go further than those practice nurses would currently carry out, adding: ‘It will help me communicate to the GP that I am concerned.’ The quality standard can be found at www.nice.org.uk/Guidance/QS64 and it prioritises recommendations from the NICE guidance with advice on action dependent on the child’s level of risk at www.nice.org.uk/guidance/CG160
10 july 30 :: vol 28 48 :: 2014 STANDARD Downloaded fromnoRCNi.com by ${individualUser.displayName} on Nov 13, 2015. For personal use only. NoNURSING other uses without permission. Copyright © 2015 RCNi Ltd. All rights reserved.
