Niche In-Brief Summer 2019 - Flipbook - Page 1
HEALTH & SOCIAL CARE CONSULTING
In-Brief
The assurance issue - Summer 2019
Welcome to In-Brief
Welcome to our summer 2019 edition of Niche In-Brief; our collection of insights and articles from our
practitioners and partners. In this edition we are focussed on various aspects of assurance, particularly
understanding how, as healthcare professionals, we know when an action plan has been properly
implemented. In addition to this we discuss the concept of internal investigations versus external
investigations and we bust some of the myths associated with the ‘true’ costs of making different choices.
Our lead article covers the ‘new confusion’ described in NEWS2 scorecards and how delirium particularly is
an underestimated clinical condition which can carry catastrophic outcomes if not recognised early enough
in the patient journey. We hope you enjoy this edition and we will see you again in autumn 2019.
In this edition:
Dangerous delirium.
Page 1-3
Investigations – what cost?
Page 4-5
Flexing up for retirement.
Page 5
NHS sacred cows.
Page 6
The sure in reassurance.
Page 7
Mobilising safe spaces.
Page 8
Mortality review.
Page 9-10
Sorry. Not sorry.
Page 11
Dangerous delirium
Tackling the new confusion – Emma Foreman
NICE describes delirium as a common
clinical syndrome characterised by
disturbed consciousness, cognitive
function or perception, which has an
acute onset and fluctuating course. It is
also referred to as 'acute confusion'. It
can develop very quickly (from a few
hours to a couple of days) and is a
serious condition that is associated
with poor outcomes. However, delirium
can be prevented and treated if dealt
with urgently.
People with delirium tend to have an
inability to concentrate, are
disorientated, anxious and may
experience hallucinations (of objects,
visual patterns, people, or lights).
Their presentation can change from one hour to the next, and from one
extreme to another; with hyperactive symptoms at one end to hypoactive
symptoms at the other. Some people show signs of both (mixed or fluctuating
delirium).
People with hyperactive delirium can be restless, agitated, aggressive, and
may have abnormal or paranoid beliefs believing that other people are trying to
hurt or even kill them.
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