The Department of Health have produced a leaflet for the public to explain proteinuria.
The leaflet aimed at patients explains the meaning of proteinuria, cases, signs and tests to determine proteinuria. It also covers how to manage diabetes and blood pressure with proteinuria. This is part of a pack of information on proteinuria testing. Information sheets for GPs and labs have been published on the Department of Health website.
Thursday, 10 September 2009
Monday, 7 September 2009
Going Green
The NHS faces a major challenge – no, not just the £20 billion that needs to be saved because of the fiscal crisis but the need to reduce the carbon footprint of healthcare.
The health sector is responding by signing up to the bold new climate change campaign 10:10. Ten NHS organisations plus the BMJ Group have committed to cutting their carbon emissions by 10% in 2010 from a 2009 base year. The target is challenging but by no means impossible for many organisations. The NHS ten include one Strategic Health Authority, several large acute teaching hospitals, two PCTs, a mental health trust, and a GP Surgery.
Green Nephrology is leading the way, Dr Andrew Connor took up his new post as "Green Nephrology Fellow" at the Campaign for Greener Healthcare on 1 September. Andrew is a specialist trainee in kidney medicine and is generously funded by NHS Kidney Care. Over the next year, he will be exploring the environmental impacts of kidney care and working with NHS staff and patients to improve practice in kidney units. Andrew has an ambitious programme of work and is supported by both the British Renal Society and the Renal Association who co-Hosted a Green Nephrology Summit earlier in the year. Given the water, electricity, dialysis consumables and amount of drugs used in Kidney care, let alone the travelling back and forth to renal units, it’s likely that kidney services can make a big contribution.
The Royal Cornwall Hospital Renal Unit has already begun a comprehensive green project and I was delighted to learn that Simeon Edwards and the team have been shortlisted for a Health Service Journal award this year . Their action plan includes energy saving in lighting and heating, greener pharmaceuticals and consumables , water reduction, managing transport to reduce carbon emissions at the same time as improving patient transport quality in addition to reducing, better management and increased recycling of waste . Everyone in the unit, patients included are playing their part. I am sure that we will all want to wish Simeon and colleagues good luck for the award. There is lots we can learn from the Cornwall team - perhaps the most import thing being - a thousand mile journey begins with the first step.
Less of the same is not the answer; we need to transform clinical services to sustain healthcare. The waste water reclamation initiative at Kent and Canterbury and the Chronic Kidney Disease electronic advisory service at Bradford are examples of different ways of doing things; both save money and save carbon. For a capital investment of £14,000 Kent and Canterbury Hospital have made an annual saving of £8000 and shown a 38% reduction in mains water usage. Well done Steve Milne.
Looking to the future, every kidney unit is going to be asking green questions, Green Nephrology and Andrew Connor’s work will help the kidney community and provide answers for some of these questions. The actions are for all of us.
The health sector is responding by signing up to the bold new climate change campaign 10:10. Ten NHS organisations plus the BMJ Group have committed to cutting their carbon emissions by 10% in 2010 from a 2009 base year. The target is challenging but by no means impossible for many organisations. The NHS ten include one Strategic Health Authority, several large acute teaching hospitals, two PCTs, a mental health trust, and a GP Surgery.
Green Nephrology is leading the way, Dr Andrew Connor took up his new post as "Green Nephrology Fellow" at the Campaign for Greener Healthcare on 1 September. Andrew is a specialist trainee in kidney medicine and is generously funded by NHS Kidney Care. Over the next year, he will be exploring the environmental impacts of kidney care and working with NHS staff and patients to improve practice in kidney units. Andrew has an ambitious programme of work and is supported by both the British Renal Society and the Renal Association who co-Hosted a Green Nephrology Summit earlier in the year. Given the water, electricity, dialysis consumables and amount of drugs used in Kidney care, let alone the travelling back and forth to renal units, it’s likely that kidney services can make a big contribution.
The Royal Cornwall Hospital Renal Unit has already begun a comprehensive green project and I was delighted to learn that Simeon Edwards and the team have been shortlisted for a Health Service Journal award this year . Their action plan includes energy saving in lighting and heating, greener pharmaceuticals and consumables , water reduction, managing transport to reduce carbon emissions at the same time as improving patient transport quality in addition to reducing, better management and increased recycling of waste . Everyone in the unit, patients included are playing their part. I am sure that we will all want to wish Simeon and colleagues good luck for the award. There is lots we can learn from the Cornwall team - perhaps the most import thing being - a thousand mile journey begins with the first step.
Less of the same is not the answer; we need to transform clinical services to sustain healthcare. The waste water reclamation initiative at Kent and Canterbury and the Chronic Kidney Disease electronic advisory service at Bradford are examples of different ways of doing things; both save money and save carbon. For a capital investment of £14,000 Kent and Canterbury Hospital have made an annual saving of £8000 and shown a 38% reduction in mains water usage. Well done Steve Milne.
Looking to the future, every kidney unit is going to be asking green questions, Green Nephrology and Andrew Connor’s work will help the kidney community and provide answers for some of these questions. The actions are for all of us.
Monday, 17 August 2009
Bedtime reading: National Diabetes Audit 2007/08
This Audit makes interesting reading. All complications of diabetes apart from eye disease are more common with increasing social deprivation with a two fold increase between the least and most deprived. Even more striking are the large differences in the rates of complications between regions with up to two fold difference for kidney failure. This variance suggests that significant improvements could be made and I think that also follows from a knowledge of the pathophysiology. It depends whether you are a glass half full or a glass half empty person on how you respond to the albuminuria testing data. This has improved from only 20% of registered patients having an ACR in 2003/04 to 62% in 2007/08. That's still nearly 40% of the people who are known to have diabetes who are not getting satisfactory kidney care, let along those who have not yet been identified with diabetes. There are clear opportunities to work locally, regionally and nationally with primary care and diabetes colleague to improve the kidney care of those with diabetes.
Thursday, 13 August 2009
Q & A: Wristbands improve patient safety
Q: Dear Donal, I was wondering if it would be possible for you to comment on the NPSA 'standardising wristbands' safer practice notice that will come into force on 18th July this year, in the context of outpatient haemodialysis?
We are experiencing some problems with various interpretations of the safer practice notice when applied to outpatient haemodialysis patients.
I have been asked to ensure that every patient has a new identification wristband attached, each time they attend for outpatient dialysis.
The nurses are being put into a panic by being told that it is 'illegal' to give any drug such as epo/iron during dialysis (and even saline washback at the end of dialysis) unless there is a wristband in place.
Looking at the actual NPSA document, it appears that it applies to "hospital inpatients in general acute and community settings". This infers that outpatient haemodialysis, as a chronic disese treatment., is not within the remit.
I am sure that this is not the only dialysis unit to be asking themselves this question, and so I wondered if you could clarify. David Gledhill, Unit Manager - Haemodialysis, North Cumbria University Hospital NHS Trust
A: Dear David, as you say, the wristband Safer Practice Notice specifies that the recommendations are to implemented by " all NHS organisations in England and Wales that use patient wristbands". It also says that the SPN "applies to hospital inpatients in general acute and community settings." As such, it is not necessary for outpatients attending for haemodialysis at renal units to wear wristbands. However, the purpose of the Notice was to make patient identification as safe as possible and that must be a concern in respect of patients attending for regular haemodialysis. The Safer Practice Notice relating to correct blood transfusion, recommends in 3b photo identification cards for patients who undergo regular blood transfusions. While few dialysis patients get regular blood transfusions, many of course get intravenous iron and quite frequently people on dialysis are receiving intravenous antibiotics. It may be appropriate to consider whether patients undergoing regular haemodialysis would be safer with a similar approach.
We are experiencing some problems with various interpretations of the safer practice notice when applied to outpatient haemodialysis patients.
I have been asked to ensure that every patient has a new identification wristband attached, each time they attend for outpatient dialysis.
The nurses are being put into a panic by being told that it is 'illegal' to give any drug such as epo/iron during dialysis (and even saline washback at the end of dialysis) unless there is a wristband in place.
Looking at the actual NPSA document, it appears that it applies to "hospital inpatients in general acute and community settings". This infers that outpatient haemodialysis, as a chronic disese treatment., is not within the remit.
I am sure that this is not the only dialysis unit to be asking themselves this question, and so I wondered if you could clarify. David Gledhill, Unit Manager - Haemodialysis, North Cumbria University Hospital NHS Trust
A: Dear David, as you say, the wristband Safer Practice Notice specifies that the recommendations are to implemented by " all NHS organisations in England and Wales that use patient wristbands". It also says that the SPN "applies to hospital inpatients in general acute and community settings." As such, it is not necessary for outpatients attending for haemodialysis at renal units to wear wristbands. However, the purpose of the Notice was to make patient identification as safe as possible and that must be a concern in respect of patients attending for regular haemodialysis. The Safer Practice Notice relating to correct blood transfusion, recommends in 3b photo identification cards for patients who undergo regular blood transfusions. While few dialysis patients get regular blood transfusions, many of course get intravenous iron and quite frequently people on dialysis are receiving intravenous antibiotics. It may be appropriate to consider whether patients undergoing regular haemodialysis would be safer with a similar approach.
Subscribe to:
Posts (Atom)