LAS improves out of hospital cardiac arrest survival rates

As part of a call to action from health secretary Jeremy Hunt to reduce the number of avoidable deaths in the UK, the Department of Health has published an outcomes strategy on cardiovascular disease (CVD), which will support the NHS and local authorities in delivering improved outcomes for those with or at risk of CVD.

The announcement comes following The Lancet’s recent report on the UK’s health performance, which highlighted that the UK was a long way behind many other countries.

CVD affects the lives of millions of people and is one of the largest causes of death and disability in the UK. However, fast responses to emergencies can save lives and, in some cases, reduce disability.

According to the strategy about 50 000 out of hospital cardiac arrests (OHCA) occur each year in England. Due to a variety of reasons, such as co-morbidity, resuscitation may be inappropriate, and so attempted resuscitation by ambulance services occurs in less than 50% of cases.

However, there is significant variability between ambulance services in rates of successful initial resuscitation (13-27%) and survival to hospital discharge (2-12%) following an OHCA. If survival rates were increased from the overall average (around 7%) to that of the best reported (12%), it is estimated that an additional 1 000 lives could be saved each year.

The strategy revealed that since 2004/2005 the London Ambulance Service (LAS) has improved overall OHCA survival to hospital discharge from a rate of 4% to 11% in 2011/2012. This is as a result of quicker response times; taking heart attack and cardiac arrest patients direct to heart attack centres; and improving bystander resuscitation.

Despite improvement in the LAS, variation in the quality of acute care in other parts of the country mean that much can still be done if patient mortality from CVD is to see considerable change.

The CVD outcomes strategy claims that the NHS Commissioning Board (CB) will work with the Resuscitation Council, the British Heart Foundation and others to promote automatic external defibrillator (AED) site mapping/registration and first responder programmes by ambulance services, and consider ways of increasing the numbers trained in cardiopulmonary resuscitation (CPR) and using automated AEDs.

Taken from Journal of Paramedic Practice, published 14 Mar 2013.

CNO introduces strategy for compassion in practice

A national strategy to build a culture of compassionate care across the NHS has been drawn up by Chief Nursing Officer (CNO), Jane Cummings.

Published on 4 December, the vision, entitled Compassion in Practice, aims to promote six fundamental values (6Cs) of nursing: care, compassion, competence, communication, courage and commitment.

CNO Jane Cummings said, ‘I want to make sure we give our patients the very best care with compassion and clinical skill, ensure pride in our professions and build respect.’

The new strategy identifies six areas of action to achieve the 6Cs: helping people to stay independent, maximizing wellbeing and improving health outcomes; working with people to provide a positive experience of care; delivering high quality care and measuring the impact of care; building and strengthening leadership; ensuring the NHS has the right staff, with the right skills, in the right place; and supporting positive staff experience.

Practice nurses

The new strategy commits the Department of Health and NHS Commissioning Board to developing the practice nursing contribution to the strategy by involving ‘practice nursing forums’.

Professor Beal, Director of Nursing: Quality Improvement and Care, said: ‘We will do this through the LAT [local area teams of the NHS Commissioning Board] nurses and nursing networks. We want to ensure practice nurses are fully involved with the development and implementation of the vision and strategy.’

The contribution of practice nurses is highlighted in the strategy as important to helping people to stay independent, maximize wellbeing and improve health outcomes. According to Professor Beal, practice nursing contributes in a number of valuable ways: ‘Practice nurses are the first point of contact for patients, know their patients, work closely with GPs and have expertise in long term conditions. They also carry out immunization and screening and they spend time giving patients high quality advice on their conditions, allowing them to sign post patients to other services as required.’

The strategy will be run over three years. Professor Beal says, ‘We are committed to having the detailed implementation plans in place by 31 March 2013.’

The strategy comes after an eight-week consultation involving over 9000 nurses, midwives, care staff and patients.

Taken from Practice Nursing, published 14 Dec 2012.