Evidence
Alert

Delaying pushing in labour has no benefit for women with an epidural and/or spinal for pain relief

For women having their first baby with an epidural and/or spinal anaesthetic for pain-relief, the timing of pushing after full dilatation of the cervix does not affect the numbers that achieve normal vaginal delivery. The best management for the second stage of labour is still debated. In the UK epidurals are by far the most ...

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NHS managers need support to use tools to ensure safe nurse staffing levels

Workforce planning technologies can help NHS managers plan for safe nurse staffing levels, but only with proper support and tools that are designed with good understanding of local needs. Tools also need to give easy access to standardised information such as staff availability and costs. NHS Trusts need to be open to information sharing and ...

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Decontamination of the mouth or digestive tract was not linked to reductions in drug-resistant bloodstream infections in the intensive care unit

Decontamination strategies to remove potentially harmful bacteria from the mouth, throat and gut of critically ill patients don’t reduce the risk of intensive care unit-acquired bloodstream infections or deaths from bacteria that were resistant to antibiotics. The study was carried out in 13 intensive care units across Europe, including the UK, with moderate to high ...

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Reconfiguring neonatal services balances survival chances against increased travel for families

Centralising services so that all babies are delivered in high-volume neonatal units could more than halve the number of units from 161 to 72, meaning that more parents would need to travel above 30 minutes. However, ensuring that all very preterm and low birthweight babies are cared for in high-volume neonatal intensive care units would reduce ...

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Training for clinical competence and resilience reduced job strain among intensive care nurses in France

A five-day educational course showed potential to reduce work-based stress and burnout among nurses working in intensive care units in France. The study conducted in multiple adult intensive care units aimed to identify the effects of an intensive, continuing medical education program on occupational stress. The course focussed on nursing theory, role-play and debriefing sessions. ...

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A reflective group activity supports healthcare staff in England

Regular participation in structured organisation-wide forums, known as Schwartz Center Rounds®, helps support healthcare staff. The forums are linked with increased empathy and compassion for colleagues and patients, and they facilitate practice change. Levels of poor psychological well-being decrease in forum attendees compared with non-attendees. Originating in the US, these forums provide the opportunity for ...

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Standing desks with a support package reduce time sitting at work

An office-based intervention involving a height-adjustable workstation and instruction package reduced the amount of time spent sitting. Workers sat for around 60 to 90 minutes less per day at six and 12 months compared with the control group. Sitting for long periods is a risk factor for ill health even in people meeting recommended levels ...

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Early cooling provides no benefit following traumatic brain injury

Deliberate cooling (prophylactic hypothermia) in the early management of traumatic brain injury does not improve neurological outcomes at six months. Inducing hypothermia may also increase the risk of pneumonia. Hypothermia (33-35oC) is sometimes induced to try and limit brain damage in people with severe head injuries. However, evidence for its safety and effectiveness has been ...

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Warfarin and newer anticoagulants equally effective for long-term treatment of blood clots

Warfarin and newer anticoagulants work equally well to prevent blood clots in extended treatment after venous thromboembolism. One clot is prevented for every 15 people receiving either anticoagulant. Aspirin is ineffective. Following venous thromboembolism – a blood clot in the deep leg veins (deep vein thrombosis) or lungs (pulmonary embolism) – anticoagulant treatment is given ...

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Several antibiotics appear effective against early-stage Lyme disease

Most cases of Lyme disease, which is an infection carried by ticks, can be easily managed if treated early using antibiotics, with choice of antibiotic agent having little bearing on success. This network meta-analysis suggests that when symptoms of the disease are confined to a localised skin infection, treatment failures are relatively infrequent, only 2% ...

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