Three quarters of nurses don’t have time to talk to patients

Three out of four nurses lack the time to talk to patients, a major survey of NHS trusts has revealed.Three quarters of nurses don't have time to talk to patientsThe results of a survey involving almost 3,000 nurses by researchers at King’s College London will prompt further alarm over the standards of care in the NHS.

A quarter admit they are too busy to administer drugs on time and more than 40 per cent said at least one patient under their care had suffered a serious fall in the last month.

The findings were based on unannounced inspections at 100 hospitals to check elderly patients were given enough to eat and drink and were treated with dignity.

In some instances, watchdog’s inspectors saw patients rattling bedrails or banging on water jugs in an effort to attract the attention of nurses.

The report also claimed that some hospitals were “putting paperwork over people” with patients being left for more than ten hours without a drink.

The latest study involving 2,943 nurses looked at 31 NHS trusts across England. Researchers found there was an absence of humanity as without regularly talking to their patients nurses had no way of knowing their needs.

The survey revealed that 76 per cent of nurses did not have enough time to talk to or comfort patients and 40 per cent of staff were too busy to carry out necessary checks such as taking their temperature.

Thirty-nine per cent admitted they did not have enough time to record details about patient care such as whether they had been given anything to eat or drink.

Twenty-six per cent said they were too busy to administer drugs on time and 24 per cent had not been able to check skin for signs of pressure sores.

A further 44 per cent admitted that in the past month at least one patient under their care had suffered a serious fall.

And 26 per cent said that at least one patient in the same period had been given the wrong dose of drugs or developed bed sores.

Professor Peter Griffiths, of the national nursing research unit at King’s College London, told the Daily Mail: “Talking and comforting patients is very important as nurses need to know how they are and how they feel.

“It’s about having humanity, having a relationship with people. It’s important to understand what patients need. Sometimes staff feel that paperwork has to come first.”

The Royal College of Nursing admitted it was “not surprised” that so many nurses lacked the time to talk to patients.

Janet Davies, its executive director of nursing and service delivery, said: “We know many nurses are wilting under the strain of longer working hours, taking on the burden on unfilled vacancies and reduced staffing levels.”


Daily calorie counting limits changed by nanny state

An advisory committee has concluded that the recommended daily calorie limits to maintain a healthy weight, laid down 20 years ago, have been slightly on the low side.Daily calorie counting limits changed by nanny stateIn 1991 the Committee on the Medical Aspects of Food Policy (COMA) set out that the average man should be eating 2,550 calories daily, and the average woman 1,940.

After lengthy consultation, those have now been raised slightly – by a frugal 55 calories for men, but a comparatively generous 139 calories for women.

Which means 2,605 calories a day for men and 2,079 calories a day for women.

Prof Alan Jackman, chair of the Scientific Advisory Committee on Nutrition (SACN), explained that the old figures were based on “limited available evidence”.

They have been updated to take into account advances in science and better understanding of the physical activity people took.

Sadly, that is where the good news ends.

Speaking at a briefing to launch the Government’s new “ambition” to see obesity levels falling by 2020, Prof Jackman; Andrew Lansley, the Health Secretary; and Prof Dame Sally Davies, the Chief Medical Officer for England, emphasised that this was “not a licence to eat more”.

Prof Jackman said “the majority of adults” already ate much more than the new guideline amounts.

“We estimate that on average the population is eating 10 per cent more than they require,” he said.

Thus, as little over a third of the adult population is now not overweight or obese, only that minority is really entitled to an extra guilt-free indulgence.

Mr Lansley decided to unveil the Government’s new anti-obesity ambition the same day, leading to accusations of mixed messages.

The Health Secretary said Britain had to become a nation of calorie counters.

“People should have a pretty good sense of how many calories they are consuming,” he said.

Department of Health policy officers have calculated that England needs to consume five billion fewer calories daily, to ensure average weights fall to healthy levels.

That equates to enough cheeseburgers to cover 20 football pitches, or enough cafe lattes to fill four Olympic swimming pools, said a spokesman.

But Prof Terence Stephenson, president of the Royal College of Paediatrics and Child Health, said it amounted to “peanuts”.

He added: “Sixteen dry roasted peanuts per person, per day to be precise.”

Like others, he attacked the Health Secretary’s reluctance to use stronger measures to tackle obesity, which already costs the NHS one pound in every 20 it spends.

The Prime Minister last week said a ‘fat tax’ on some foods was “something we should look at”, but yesterday Mr Lansley would only say that while taxes might have “a part to play”, they were not a “first resort”.

But Jamie Oliver, the chef and healthy eatign campaigner, dismissed the whole strategy as a “farce” and a “cop-out”, saying it was “worthless, regurgitated, patronising rubbish”.

He said: “Simply telling people what they already know – that they need to eat less and move more – is a complete cop out.  The country’s bill of health is shocking, and it’s not going to get any better over the next 30 years if a clearly defined plan isn’t put into place soon.”

“We simply can’t afford the financial or health costs of doing nothing. This Government might be able to navigate us slowly out of a recession, but it has no clue about how to make sustainable change in the short or long term, or how to inspire, enforce or empower public health.”

Dr David Haslam, a GP and chair of the National Obesity Forum, said issuing the new calorie guidelines alongside the updated anti-obesity drive was “really unhelpful”.

“It gives out entirely the wrong message,” he said. “People are going to think that they can eat that little bit more. If anything, that will add to the obesity problem.”

Women who meet husbands while on pill have happier and longer marriages

Women who are using the contraceptive pill when they first meet their future husband are less attracted to them but are more likely to have a lasting and happy marriage, according to a new study.Women who meet husbands while on pill have happier and longer marriagesMarriages last on average two years longer if the female partner is on the pill when the pair share their first encounter.

While they are less likely to be attracted to or sexually satisfied by their husbands, women who take the pill are happier with other aspects of their marriage such as financial support and faithfulness, making the couple less likely to split up.

Taking a contraceptive pill makes a woman’s hormones more balanced over a month, remaining at levels which occur during the non-fertile stages of the natural monthly cycle.

Not using the pill means hormone levels are allowed to change, causing a change in emotions which make physical attraction a higher priority.

Researchers questioned 2,500 women from a number of countries including Britain about various aspects of their relationship with the biological father of their first born child.

The study, published in the Proceedings of the Royal Society B journal, suggests that using the pill could have an influence on a woman’s choice of husband.

Dr Craig Roberts, of Stirling University, who led the study, said: Our results show some positive and negative consequences of using the pill when a woman meets her partner. Such women may, on average, be less satisfied with the sexual aspects of their relationship, but more so with non-sexual aspects.

“Overall, women who met their partner on the pill had longer relationships – by two years on average – and were less likely to separate. So there is both good news and bad news for women who meet while on the pill. One effect seems to compensate for the other.”


Chocolate cuts stroke risk

Women who eat a bar of chocolate a week could reduce their chances of having a stroke by 20 per cent, according to a new research.Chocolate cuts stroke riskA study of more than 33,000 Swedish women found that those who ate the most chocolate had the lowest chance of stroke.

People who ate 66g per week – about a bar and a half – were 20 per cent less likely to suffer a stroke, while those who consumed 8g a week or less were at the highest risk.

The findings, published in the Journal of the American College of Cardiology, add further weight to previous studies which highlight the health benefits of eating chocolate and cocoa.

Earlier this year Cambridge University experts found that regular doses of chocolate can reduce the risk of heart disease by a third, while a separate study suggested it can be as good for the health as exercise.

Scientists from the Karolinska Institute in Stockholm questioned 33,372 women about their eating habits in 1997 and over the next decade about 1,600 suffered strokes.
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Susanna Larsson, one of three researchers, said: “We followed 33,000 women over the course of 10 years, and we found that those who ate most chocolate had a much lower risk – 20 per cent lower – of suffering a stroke.”

Chocolate was expected to help protect against stroke because it lowers blood pressure, thereby reducing a key risk factor, she added.

The women who took part were not asked whether the chocolate they ate was dark or light, a distinction which would have helped establish a firmer connection between cocoa – the protective agent in chocolate – and stroke risk.

The researchers will now carry out a similar study in men, and expect to find similar results.


Paramedic patients resuscitation advice- DNR if patients want to die

Paramedics are to be told if a patient does not wish to be resuscitated or wants to die at home, under plans backed by ministers.Paramedic patients resuscitation advice- DNR if patients want to dieAdults in Britain can legally refuse medical treatment, even if it leads to their death but doctors cannot undertake treatment to a patient if it clashes with any clinical judgment.

Patients should, however, be given an opportunity for a second opinion wherever possible.

While the General Medical Council (GMC), the doctor’s watchdog, said last year there was no absolute obligation to prolong life, the medical profession does have a final say about whether resuscitation is in the patient’s best interest.

This has led to accusations from some critics who believe doctors are “playing God” and ignoring vulnerable patients’ right to life.

It has also prompted fears that as hospitals face deeper budget cuts, not resuscitating patients will become a cost-cutting option. It is thought that four in five people who die in hospital are the subject of “do not resuscitate”(DNR) orders.

Cardiopulmonary resuscitation (CPR) attempts to restore breathing or blood flow to those whose heart has stopped beating or who have stopped breathing.

It can include using electric shocks to try to correct the rhythm of the heart, repeatedly pushing down firmly on the patient’s chest and inflating the lungs with a mask or tube inserted into the windpipe.

While television medical dramas suggest it is often successful less than a fifth of those who have had such treatment actually go home, according to the British Medical Association (BMA). Inevitably, the young and fit are more likely to survive than the frail and elderly.

In 2007 the BMA, together with the Resuscitation Council (UK) and the Royal College of Nursing, issued joint guidelines on the issue in a 25 page document titled “decision relating to cardiopulmonary resuscitation”.

Legal experts say the “do not resuscitate” advice is essential where a “patient or their family disagree with doctors about whether a particular treatment is futile, a burden rather than a benefit, or inappropriate”.

Roger Goss, the co-director of Patient Concern, has raised concerns previously that “do not attempt resuscitation” orders are being misused.

“We are concerned that patients are having “do not resuscitate” written on their notes without they or their relatives knowing,’ he said earlier this month.

‘Bearing in mind NHS budget cuts over the next few years, it is not far-fetched to foresee that “do not resuscitate” orders will proliferate to the point where everyone over a certain age — perhaps 65 or 70 — gets one stuck on them.”

In England, Andrew Lansley, the Health Secretary, has stopped short of a national policy.


Weight loss plan lacks evidence

‘Nudging’ people to lose weight by thinking about their lifestyle shows little evidence of success, an analysis of published data suggests.Weight loss plan lacks evidenceIt showed the step by step “nanny state” behavioural approach used in hospitals and clinics led to an average weight loss of 2kg or less.

The report, by The Cochrane Library, looked at studies involving nearly 4,000 people around the world.

The method, known as the transtheoretical model (TTM) stages of change, is used to encourage people to move towards more healthy forms of behaviour.

The five step process encourages people to see the need to change and then give it a go.

It has been shown to be successful in helping people quit smoking, and has also been used in alcohol and drug addiction.

The analysis looked at five trials – in the UK, US, Netherlands, Canada, and Australia – involving 1,834 overweight or obese patients, and 2,076 people of normal weight.

The authors, led by Professor Azeem Majeed and Dr Nik Tuah of Imperial College London, found no convincing evidence of any sustained or significant weight loss.

Professor Majeed: “Changing people’s dietary patterns is very difficult – that’s why we’ve got such a problem with obesity.”

Dr Tuah added: “This review does not necessarily challenge the notion that diet and exercise are effective weight loss strategies, but instead raises questions about how to approach lifestyle changes for individuals who want to adopt them.”

The report concluded: ” The use of TTM SOC resulted in minimal weight loss (about 2 kg or less) and there was no conclusive evidence for sustainable weight loss amongst participants.”

The report’s abstract is at: Transtheoretical model for dietary and physical exercise modification in weight loss management for overweight and obese adults

Numbers of heroin and crack cocaine users in treatment falls

The number of heroin and crack cocaine users needing treatment in England has fallen by 10,000 in two years. Numbers of heroin and crack cocaine users in treatment fallsThe National Treatment Agency for Substance Abuse said the number of adults that began treatment for the class A drugs fell from 62,963 in 2008/09 to 52,933 in 2010/11.

The steepest decline was in the under 30 age group.

The number of people accessing treatment for all drugs also fell for the second year running.

The latest figures also show an increase in the number of drug users “recovering” from addiction – people who no longer need treatment.

Some 27,969 users were classed as recovering in 2010/11, a rise of 18% on the previous year and 150% higher than 11,208 in 2005/06.

The figures showed that, of the 255,556 people who entered a drugs treatment programme since April 2005 for the first time, 28% (71,887) had successfully completed the course and did not need further treatment.

Paul Hayes, the NTA’s chief executive, said the figures showed that “recovery is now becoming a reality for more individuals each year.  More drug users are recovering from addiction, fewer need treatment, and more are getting over their addiction quickly.”

Mr Hayes went on to say he thought the figures showed England had “probably passed the high watermark of the impact of epidemic of the late ’80s and early ’90s and that younger groups of people were reluctant to begin patterns of behaviour… that they’ve seen cause damage to their older siblings, people in their community, sometimes, sadly their mums and dads.”

“They realise the consequences of heroin and crack use and they’re turning their backs on that,” he said.

He said officials were also seeing “significant declines in purity” which “suggests that attempts to restrict supply are having an impact”.

“It’s extremely likely, from where we sit, that the different aspects of the government’s drugs strategy are coming together to have a positive effect,” he added.

But he warned that addiction remained a “serious problem” for many communities, particularly the poorest ones.

“We need to remain vigilant, particularly in a tough economic climate. There’s absolutely no inevitability that rising unemployment among young people will see a rise to ’80s levels of heroin use, but we need to watch that situation very carefully,” he said.

The research can be found at:

Obesity and chronic disease cost UK PLC £20 billion a year

Obesity and chronic health conditions such as high blood pressure and diabetes cost Britain £20 billion a year in terms of lost productivity, analysis by the polling firm Gallup has found.Obesity and chronic disease cost UK PLC £20 billion a yearOverweight and obese workers with no chronic problems take twice as many days off as comparable workers of a healthy weight, found the survey of almost 9,000 people.

Those who were overweight or obese and had three or more chronic health problems took 12 times as many sick days as healthy weight individuals with no health problems, or 18 compared to 1.5.

The survey was conducted by Gallup and Healthways, a firm that runs fitness centres.

It also found obesity alone counts for six lost work days per worker each year – or over £1,200 in lost productivity.

Ben Leedle, president and chief executive of Healthways, said it showed that the level of chronic disease in the UK workforce was at “alarming levels”.

He said: “Employers who recognize the importance of improving well-being at the workplace are most likely to gain a competitive advantage.”


Alcohol limits advice confusing

The advice on alcohol limits is too confusing according to Debbie Bannigan the head of the charity SwanswellAlcohol limits advice confusingShe says that ‘units’ mean nothing to many people – and the guidance should be clearer and easier to remember.

In this week’s Scrubbing Up, she says that to have a daily “safe” amount is misleading and that some people – including pregnant women and drivers – should be told “no alcohol is best”.

Most people think they have a rough idea of “how much is too much?”, but ask them for specifics and they’re not sure. Who can blame them, when the measure that is used to define safe limits – ‘units’ – is so hard to understand?

While 82% of adults claim to know what a unit of alcohol is, 77% don’t know how many units are in a typical large glass of wine.

Ironically, ‘units’ become even harder to compute when we’ve had a drink, because the part of our brain that works that sort of thing out switches off.

And the concept of a daily safe amount may even encourage the idea that we should drink alcohol every day.

To add to the confusion, we’re bombarded with new “scientific” findings about alcohol.

In the last couple of months alone, we’ve been told that alcohol damages the DNA of unborn children beyond repair, but that it’s OK for pregnant women to have a couple of glasses of wine a week, which is pretty conflicting advice.

Reported health benefits from alcohol are rarely balanced with information about the risks, or the observation that the benefits can be achieved in other ways that don’t carry any significant risks at all.

It’s little surprise that people are confused about the impact alcohol can have on their lives.

But walk into any supermarket and you’ll be encouraged to buy alcohol.

My local supermarket’s “seasonal aisle” – one of the first things you see when you enter the store – has become a wine festival.

And the end of each aisle – the “impulse buy” space – is also stacked with cans of lager and cider, so selecting and purchasing alcohol is just part of the weekly shop rather than something that we have to think about doing.

The people who come to us for help are just like you and me, but they’ve found that their choice to drink alcohol has been riskier than they expected.

What can be done about it? Official guidelines could be clearer. Other public health messages are short and snappy, like ‘clunk-click every trip’ or ‘catch it bin it kill it’. We shouldn’t be afraid of setting clear guidelines and sticking to them”

They are designed to be simple and memorable, so we learn and apply them without trying.

Units don’t work this way, but a simple phrase like ‘one or two, once or twice’ gives us a simple yardstick that drinking one or two alcoholic drinks, once or twice a week, is a good limit.

Sometimes a clear, easy to understand and safe message is that no alcohol is best – for example, for children, in pregnancy or when driving.

Scientific evidence shows that even one drink can impair judgement when driving and that alcohol affects children disproportionately, especially before they are born.

A zero limit for drivers, pregnant women and children avoids confusion and helps us all to take responsibility.  We shouldn’t be afraid of setting clear guidelines and sticking to them.

With co-operation between drinks manufacturers, supermarkets and the government we can judge the risk of alcohol use for ourselves.

Not only can we reach the point where hospital admissions are going down instead of up, we can create a society that is free from problem alcohol use altogether.

Researchers seek diabetic patients for diabetes dating agency

A massive recruitment drive is under way to match up thousands of diabetic patients with diabetes research projects aimed at finding a cure for the disease.Researchers seek diabetic patients for diabetes dating agencyThe scheme is being likened to a kind of “dating agency” that puts researchers and patients in contact.

Researchers say about 30% of cancer patients may be taking part in clinical trials, but for diabetes that figure is less than 1%.

About 2.8 million people in the UK are known to have diabetes.

But the charity Diabetes UK believes another 800,000 people may not know they already have the disease.

Part of the reason researchers have found it hard to find diabetes patients is that most only see their GP.

But three regions in England have been chosen to pilot a scheme which aims to offer 25,000 patients, with any form of diabetes, the chance to take part in clinical trials or other forms of research.

A recruitment drive is taking place in north east London, the south west and the north west of England.

Prof Martin Gibson, from the Diabetes Research Network at Salford Royal NHS Foundation Trust, says clinical trials are essential in order to find better treatments for diabetes – or even a cure.

“Pretty much everyone I talk to with diabetes is interested in research but they don’t get the opportunity.  It’s not like cancer where people are increasingly offered the chance to take part in research projects.”

“Part of the problem is that people with diabetes are very often out in the community, which is not where the researchers are.  So what we’re trying to create is a dating agency so we can bring the two groups together, because both are very interested in trying to find a cure for diabetes.”

Diabetes UK estimates that about 10% of the total NHS budget across the UK is spent on illnesses related to the disease.

The charity calculates this works out at about £173m a week – or £1m an hour.

Dr Iain Frame, director of research at Diabetes UK, said: “This is a huge opportunity for people with diabetes to play their part in crucial research that is piecing together the gaps in our knowledge and in our understanding of the condition.

“This exciting campaign will help future generations of people diagnosed with this serious, life-long condition and help us take a step further to a future without diabetes.”

If you would like to be involved in the diabetes research project please click here now.