No abstract

A hand-held computer helps to improve the accuracy and efficiency of EWS in acute hospital care and is acceptable to nurses.

Marking practices are variable and marking is not always used. Introducing standard guidance on marking may reduce the overall risk of wrong site surgery, especially as clinicians work at different hospital sites. However, the more specific needs of people and specialties must also be considered.

BackgroundGiven the increasing use of telephone consultation it is important to determine the factors which influence the length of a telephone consultation.MethodAnalysis of 128717 telephone consultations during January to December 2011 to a National Health Service (NHS) out-of-hours primary care service provider in Shropshire and Telford and Powys, England, involving 102 General Practitioners (GPs) and 36 Nurse Practitioners (NPs). Telephone consultation conclude with one of three outcomes – advice only, the patient is invited to a face-to-face consultation with a GP or NP at a nearby health centre (known as a base visit) or the patient is visited at home by a GP or NP (known as home visit). Call length was analysed by these outcomes.ResultsThe overall mean call length was 7.78 minutes (standard deviation (SD) 4.77). Calls for advice only were longest (mean 8.11 minutes, SD 5.17), followed by calls which concluded with a base visit (mean 7.36 minutes, SD 4.08) or a home visit (mean 7.16 minutes, SD 4.53). Two primary factors influenced call length. Calls by GPs were shorter (mean 7.15 minutes, SD 4.41) than those by NPs (mean 8.74 minutes, SD 5.31) and calls designated as a mental health call were longer (mean 11.16 minutes, SD 4.75) than all other calls (mean 7.73 minutes, SD 7.7).ConclusionsTelephone consultation length in the out-of-hours setting is influenced primarily by whether the clinician is a GP or a NP and whether the call is designated as a mental health call or not. These findings suggest that appropriate attempts to reduce the length of the telephone consultations should focus on these two areas, although the longer consultation length associated with NPs is offset to some extent by their lower employment costs compared to GPs. Nonetheless the extent to which the length of a telephone consultation impacts on subsequent use of the health service and correlates with quality and safety remains unclear.

Aims and objectives To compare and contrast job descriptions for nursing roles in out‐of‐hours services to obtain a general understanding of what is required for a nurse working in this job. Background Out‐of‐hours services provide nursing services to patients either through telephone or face‐to‐face contact in care centres. Many of these services are newly created giving job opportunities to nurses working in this area. It is vital that nurses know what their role entails but also that patients and other professionals know how out‐of‐hours nurses function in terms of competence and clinical role. Design Content analysis of out‐of‐hours job descriptions. Method Content analysis of a convenience sample of 16 job descriptions of out‐of‐hours nurses from five out‐of‐hours care providers across England was undertaken. The findings were narratively synthesised, supported by tabulation. Results Key role descriptors were examined in terms of job titles, managerial skills, clinical skills, professional qualifications and previous experience. Content analysis of each out‐of‐hours job description revealed a lack of consensus in clinical competence and skills required related to job title although there were many similarities in skills across all the roles. Conclusion This study highlights key differences and some similarities between roles and job titles in out‐of‐hours nursing but requires a larger study to inform workforce planning. Relevance to clinical practice Out‐of‐hours nursing is a developing area of practice which requires clarity to ensure patient safety and quality care.