NHS Improvement have published this guide to support maternity safety champions at every levels (fron line, trust board and regional). It outlines the role descriptions and responsibilities for maternity safety champions, suggests activities to promote best practice, and also signposts existing safety initiatives and improvements that can offer support. The full guide is available from NHS Improvement here .
Group B Streptococcal Disease, Early-onset (Green-top Guideline No 36) | The Royal College of Obstetricians and Gynaecologists.
Group B Streptococcal Disease (GBS) is recognised as the most frequent cause of severe early-onset infection in newborn infants. GBS is present in the bowel flora of 20–40% of adults (colonisation) and those who are colonised are called ‘carriers’. This includes pregnant women. There is variation in practice across the UK regarding the best strategies to prevent EOGBS disease.
In 2015, the incidence of EOGBS in the UK and Ireland was 0.57/1000 births (517 cases), a significant increase from the previous surveillance undertaken in 2000 where an incidence of 0.48/1000 was recorded.
The purpose of this guideline is to provide guidance for obstetricians, midwives and neonatologists on the prevention of early-onset (less than 7 days of age) neonatal group B streptococcal (EOGBS) disease and the information to be provided to women, their partners and families.
New report, published the Royal College of Paediatrics and Child Health (RCPCH) and the British Association for Community Child Health (BACCH), highlights an alarming 25% shortfall in the number of community paediatricians.
The report raises concerns over the system failing to cope with growing demand and the unprecedented pressures faced by specialist community children’s doctors, who have a wide remit from child protection to managing children with disabilities and diagnosing those with conditions such as autism and ADHD.
The report makes a number of recommendations to turn the situation around. This includes an increase of 25% in the number of community paediatricians, equivalent to 320 more doctors, to meet recommended levels and reduce waiting times. It also provides extensive guidance and clear specifications for commissioners, clinicians and health care organisations, all with the aim of providing a high quality of care.
This guideline was updated in August 2017. It covers the assessment and early management of fever with no obvious cause in children aged under 5. It aims to improve clinical assessment and help healthcare professionals diagnose serious illness among young children who present with fever in primary and secondary care.
Controlling seizures in children approaching death can be difficult, and there is a limited evidence base to guide best practice | BMJ Supportive & Palliative Care
Objectives: We compared current practice against the guidance for seizure management produced by the Association of Paediatric Palliative Medicine (APPM).
Methods: Retrospective case note review of episodes of challenging seizure management in children receiving end-of-life care over a 10-year period (2006–2015) in the south-west region of England.
Results: We reviewed 19 admissions, in 18 individuals. Six (33%) had a malignancy, nine (50%) had a progressive neurodegenerative condition and three (17%) had a static neurological condition with associated epilepsy. Thirteen (72%) died in their local hospice, four (22%) at home, and one (6%) in hospital. Seventeen of 19 episodes involved the use of subcutaneous or intravenous midazolam infusion, for a mean of 11 days (range 3–27). There was a wide range of starting doses of midazolam, and 9/17 (53%) received final doses in excess of current dose recommendations. Six individuals received subcutaneous phenobarbital infusions, with four of these (67%) receiving final doses in excess of current dose recommendations. Plans for adjustments of infusion rates, maximal doses or alternative approaches should treatment fail were inconsistent or absent. In 16/18 (88%) cases seizures were successfully controlled prior to the day of the child’s death. Staff found the experience of managing seizures at end of life challenging and stressful.
Conclusions: Pharmacological approaches to seizure management in end-of-life care are variable, often exceeding APPM dose recommendations. Despite this, safe and effective seizure control was possible in all settings.
Guidance to raise awareness among nurses and their managers of the complex issues surrounding safeguarding in the context of relationships between nurses and children and young people | RCN
For the vast majority of nurses, harming those in their care, or even the possibility that another professional/colleague could, is the farthest thing from their minds. However, the RCN recognises that there are child abusers who target young people when they are at their most vulnerable. Abusers of children sometimes actively seek access to children by joining professions such as nursing, medicine, social work and teaching.
While in most identified cases, sexual abuse against children is carried out by men, it is important to recognise that women do it too. It is also important to keep things in perspective – the vast majority of nurses provide high standards in all aspects of caring for children and young people and protecting them from harm.
This infographic is the latest addition to a series commissioned by the UK Chief Medical Officers. It aims to provide clarity and consistency, and to equip health professionals to deliver evidence based recommendations on physical activity in pregnancy.
The aim is to ensure pregnant women are aware of the benefits of being active throughout their pregnancy and are clear about the physical activity recommendations. The infographic provides details regarding frequency, intensity and time, together with specific examples of suitable activities and key safety messages.