Log in
"We've currently made a 40 per cent reduction on last year's infection figures ... the commode is definitely part of that", said an Infection Prevention and Control Clinical Nurse Specialist for Scarborough and North East Yorkshire NHS Trust. The commode referred is the result of a joint effort between Brunel University, Kirton Healthcare and PearsonLloyd, in responding to the Design Council's `Design Bugs Out' competition. Designed for thorough cleaning, easy maintenance, and patient dignity, the commode has been widely exhibited in the UK and Europe, and was shortlisted for the BRIT Best Design of the Year (2009) award. Now over 2,000 have been sold to more than 60 hospitals in the UK.
Through the introduction of innovative design approaches, processes tools and methods into the research of complex healthcare issues, a range of individuals — including members of professional groups, e.g., in nutrition management and physical rehabilitation, clinical trials managers, healthcare professionals and patients (involved, e.g., in random controlled trials), are now able to consider and use tools and approaches that they did not use previously. These, policy-makers, leads in research councils, charities, and members of lay user representative groups have seen, through demonstrations, national and international presentations and professional publications, advantages of these innovative tools and approaches that enable more patient-centred treatment and enhanced patient-professional relationships.
Design research at the Royal College of Art (RCA) has pioneered projects and studies developing a design-led, systems-based approach to improve patient safety in hospital and mobile healthcare. It has led a multidisciplinary culture in which designers, clinicians, psychologists and business specialists collaborate in development projects. This new approach to Design for Patient Safety has had a profound impact on understanding public service provision, on practice and policy, and has realised commercial benefit.
Misconnection errors involve the administration of drugs via the wrong route. For example, the injection of a toxic drug into the spine which should only be injected into a vein. Following a death in 2001 and 13 others in the UK over the previous 15 years, work began to find an engineered solution to misconnection errors. R.Lawton, at the University of Leeds (UoL), evaluated the usability and acceptability and explored the implementation of these different engineered solutions. This research was the basis for the UK National Patient Safety Agency policy and was used by companies to inform the design of these new devices. Ultimately, this research has led to the production of safer devices that are now being purchased by NHS Trusts to reduce patient risk.
Methicillin-resistant Staphylococcus aureus (MRSA) are strains of bacteria which are resistant to a range of commonly used antibiotics and as a result are difficult to treat and cause significant morbidity and mortality amongst hospitalised patients and individuals with compromised immunity. Research conducted by Professor Peter Hawkey at the University of Birmingham has demonstrated that by rapidly screening patients for MRSA on hospital admission and then using an effective decolonisation treatment, the rate of MRSA acquisition can be significantly reduced. The Department of Health (DoH), who commissioned the research, used the results of the work to formulate guidance, which was published in 2008, for universal MRSA screening in England. This has contributed to the sustained reduction in MRSA infection in England, which is indicated by the fall in MRSA bacteraemia rates from 7,274 in 2002 to 1,185 in 2011 (-83.7%).
Research at Kingston University led by Hilary Dalke has established the beneficial effects of colour design for application in long-term health care environments for people with neural disabilities. This work has led to the development of spatial design principles for improving the experience of service users, patients and staff.
Through her consultancy work with architectural firms, individual NHS hospitals, mental health units, independent charities and healthcare furniture and equipment suppliers such as Hill-Rom, Dalke has influenced their understanding of the issues involved, leading to improved design in hospitals, care homes and day centres, with consequent benefits for patients, staff and visitors in four institutions.
Glaucoma affects around 2% of people over 40 years of age and almost 10% of those over 75. There are more than one million glaucoma-related outpatient visits to hospital eye services annually. Once lost through glaucoma, sight cannot be restored. Therefore early detection (mainly by optometrists) and appropriate management of the condition are crucial to maintaining a sighted lifetime. Uncertainty and variation exist in clinical practice and service delivery. Research undertaken by academic staff at City University London has led to:
In addition, City research on the scope of therapeutic practice by optometrists and the development of clinical management guidelines (CMGs) strongly influenced the decision to extend independent prescribing to optometrists. CMGs developed at City were incorporated into the Map of Medicine and other national ophthalmology primary care pathways. Research on a repeat-measurement-enhanced glaucoma scheme generated a National Institute for Health and Care Excellence (NICE) Quality, Innovation, Productivity and Prevention (QIPP) Case Study and informed Joint College Commissioning Guidance on Glaucoma and Local Optical Committee Support Unit (LOCSU) schemes. City's Standardised Patient research, where actors play the role of patients to collect evidence on actual clinical practice, is unique in optometric research and has been referred to by experts and relied upon in the defence of optometrists' actions in several clinico-legal cases before the General Optical Council.
Research by the University of Huddersfield has helped shape policy and practice in the field of surgical site infection (SSI) and wound management. It has contributed to best practice guidance and helped to raise practitioner, industry and public awareness of the importance of effective clinical interventions in infection prevention, tissue viability and wound care. These efforts, recognised by numerous awards, have been supported by significant industry engagement and the successful development and use of on-line tools to share best practice, promote evidence-based care and highlight the value of an inter-disciplinary approach to the problem of SSI.
Management science research that has evolved over two decades at Southampton Management School has provided the Sri Lankan government with the means to revolutionise its dental care system, and to devise new strategies for the more effective recruitment of health care professionals. A computer simulation model, based on Southampton's research, underpinned a government decision to limit dental student intake, create 400 new posts in under-resourced rural areas and grant access to dental care to an additional 1.5 million people. This in turn led to better use of taxpayers' money and improved career prospects for Sri Lankan dentists.
Two significant impacts have resulted from King's College London (KCL) research on preventing infections of the so-called antibiotic-resistant MRSA `superbug' associated with hospital treatment. KCL's research exemplifies NIHR's stated "end-to-end" strategy for translating discoveries made in individual infections to population benefit through treatment and prevention.
First, KCL research contributed to Department of Health guidelines. Following the publication of those guidelines, NHS Trusts set out stronger procedures for screening patients for MRSA and for routine `decolonisation' — involving the use of antibacterial shampoo, bodywash and nasal cream by patients. This made a major contribution to the dramatic 75% fall in MRSA cases reported by Public Health England between 2008/09 and 20012/13.
Second, KCL research showed that some MRSA strains are more easily transmitted and more virulent than others. Specifically, we identified a molecule produced by one such strain of bacteria that enabled it to adhere to and colonise a host. We patented this molecule as a rational vaccine component to prevent MRSA infection, and the Novartis pharmaceutical company took up this patent in 2009.