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Book reviews Clinical Research Manual: Practical Tools and Templates for Managing Clinical Research Jennifer Cavalieri and Mark Rupp Sigma Theta Tau 336pp | US$44.95 ISBN: 9781937554637

CLINICAL NURSES, alongside other healthcare professionals, are being drawn into clinical research in their day-to-day working in different ways, so an understanding of how clinical trials are managed and what role nurses can play in them is important. Those involved in the direct management of clinical trials face ever increasing regulatory requirements to ensure the safety of patients and research subjects. Therefore, anything that can help with these will be welcomed by those in the field. This practical manual written by an experienced research nurse and doctor provides some useful ‘tools and templates for managing clinical research’ so it does what is expected. However, it is presented from an American perspective so all of the regulatory references are relevant only to the American system. Anyone contemplating using this manual should realise that there will be considerable adaptation required for the regulatory environments in the UK and the rest of Europe. That said, there are some aspects that transcend regulatory environments and these will be useful to clinical staff who are new to the management of clinical research trials. The final chapter, covering professional development, has some useful suggestions on how those involved in clinical trials can maintain their professional development, particularly for those new to the field and looking to establish new practices. James Miller is director of the Open University in Scotland NURSING MANAGEMENT

A Witness Account of the Rise and Fall of the NHS Donald Longmore ShieldCrest 409pp | £29 ISBN: 9781907629228

AS QUALITY and standards in the National Health Service appear to be under ever increasing scrutiny and criticism, this personal account and reflection on a 50-year career by eminent physician Donald Longmore, fellow of the Royal College of Surgeons Edinburgh and Royal College of Radiologists, offers far more than a factual autobiography. The book provides an analysis of a health service that would appear to be floundering in the current economic and political environment. In relating his rationale to clinical practice, he provides numerous examples of services that could have been improved if there were more involvement and consideration of those involved in delivering care. He identifies the initial qualities that made the NHS the envy of the world, and how its demise is being championed by uninformed political interference, resources wasted on bureaucracy, quangos and poor management. Nursing practices do not escape criticism. The book is readable and engaging, and the analysis of the health and social care legislation is sufficiently challenging to enable a debate on its effect on service delivery and patient outcomes. However, it must be said that this is a personal view and the thoughts expressed are open to interpretation and may not be accepted uniformly. Helen Inwood is deputy chief nurse at University Hospital of North Staffordshire NHS Trust

Early warning flaws USING AN EARLY warning score (EWS) system should improve the detection of acutely deteriorating patients. Under such a system, a score is allocated to each of six physiological measurements including respiratory rate and oxygen saturations, which are aggregated to produce an overall score. An aggregated score of seven or higher prompts nursing staff to refer a patient for emergency assessment. But what do you do when the patient triggers a ‘red score’ of three, representing extreme variation from the norm, in one physiological parameter but has a total score of less than seven? In December 2012, my 75-year-old fit mum had a hip revision operation, which went well. However, the next day she became a medical emergency, scoring three due to low blood pressure, nausea and vomiting, plus a reaction to morphine. The nursing team responded quickly but, during the night, having remained ‘a score three’, she vomited again, aspirated the vomit and was rushed to the intensive treatment unit. My father and I were told she would very likely die but, thanks to outstanding care, my mum is now well and you would never know this ordeal had occurred. Why did this happen? The nurses on the ward had been compassionate and had identified the scores correctly, but there was no capacity to increase the frequency of observation. There were only two staff on night duty. It was a small ward but most patients were older people who had undergone major surgery and each required two nurses simultaneously. The EWS is a good system, but should be complemented with adequate staffing levels. The staffing on my mum’s ward met the one-to-eight ratio, but it did not take into account that many patients required two nurses at a time nor the unhelpful ward layout. Once again, we hear the rhetoric, but will there be any action? Donna Swinden is a senior therapist at Tees, Esk and Wear Valleys NHS Foundation Trust and a member of the Nursing Management editorial advisory board September 2014 | Volume 21 | Number 5 13

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Clinical Research Manual: Practical Tools and Templates for Managing Clinical Research Cavalieri Jennifer and Rupp Mark Clinical Research Manual: Practical Tools and Templates for Managing Clinical Research 336pp US$44.95 Sigma Theta Tau 9781937554637 1937554635 [Formula: see text].

CLINICAL NURSES, alongside other healthcare professionals, are being drawn into clinical research in their day-to-day working in different ways, so an...
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