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Influencing policy and practice in the field of surgical site infections and wound care

Summary of the impact

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.

Submitting Institution

University of Huddersfield

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Challenging traditional practice – cessation of routine night-time splinting following Dupuytren’s release can reduce patient discomfort, save money and maintain clinical outcomes

Summary of the impact

Many hand surgical units worldwide have routinely used night-time splints in all patients after Dupuytren's contracture fasciectomy and dermo-fasciectomy, despite the lack of robust evidence to support its use.

Jerosch-Herold's programme of research identified that routine night-time splinting for all patients after fasciectomy or dermo-fasciectomy surgical treatments for Dupuytren's contracture is not beneficial. This finding is changing clinical practice, and informing guidelines and policies in the UK, New Zealand and the USA. As a result, health care organisations are ceasing to prescribe routine night-time splinting. This reduces inconvenience and discomfort for patients, relieves pressure on services and generates financial savings, all whilst maintaining equally good clinical outcomes.

The reach of the research findings impact is high, as Dupuytren's contracture is a common disorder of people of Northern European ancestry which results in surgical interventions for thousands of people annually (13,000 pa in the UK alone).

Submitting Institution

University of East Anglia

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Changes to European Society of Cataract and Refractive Surgery guidelines reduces loss of sight for patients undergoing cataract surgery

Summary of the impact

Research at Strathclyde has brought about a change in eye surgery practice throughout Europe and worldwide. A four-year cross-Europe study in collaboration with the European Society of Cataract and Refractive Surgery (ESCRS) investigated antibiotic treatment to prevent endophthalmitis, a complication arising during cataract operations which typically results in loss of sight. The findings showed that when the treatment is given at the start of surgery it leads to a 5-fold reduction in the risk of endophthalmitis. The European Society of Cataract and Refractive Surgery has endorsed the discovery and widely promoted the uptake of the treatment through publications and guidelines, which over the last 6 years has led to the prevention of loss of sight in thousands of patients. In Europe alone it is estimated that each year there have been 7500 fewer cases of blindness following cataract surgery as a result of the ESCRS guidelines.

Submitting Institution

University of Strathclyde

Unit of Assessment

Mathematical Sciences

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Ophthalmology and Optometry, Public Health and Health Services

Improving the quality of care of people with and at risk of cardiovascular diseases

Summary of the impact

Research led by Professor Harry Hemingway at UCL on the quality and outcomes of care of people with, or at risk of, cardiovascular diseases has informed guidelines and clinical management in a number of areas. The work influenced NICE guidelines on Chest pain of recent onset (CG95) with regard to the use of exercise electrocardiography (ECG) in the diagnosis of stable angina and approaches to sex and ethnicity in diagnosis. Our research also underpinned recommendations on revascularisation in the NICE guidelines on Management of stable angina (CH126). Additionally, the research has led to recommendations about the need to assess psychosocial factors including depression in people with myocardial infarction.

Submitting Institution

University College London

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Cardiorespiratory Medicine and Haematology, Clinical Sciences, Public Health and Health Services

Informing national policy and practice in infection prevention and control to save lives

Summary of the impact

Healthcare-associated infections (HCAI) and antimicrobial resistance pose a constant threat to patients accessing healthcare in a range of settings. HCAI prolong recovery; delay discharge from hospital and, in extreme circumstances, cause serious disability or death. This case study describes the impact of the Epic (evidence-based practice in infection control) research programme that focuses on the translation of evidence into national infection prevention and control guidelines for the NHS. Through evaluation of initiatives to reduce the threat of HCAI and associated disability to patients, and by generating evidence to support the development of government policy, Epic has led to safer care for people during periods of health-related vulnerability, and saved lives.

Submitting Institution

University of West London

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Public Health and Health Services

Making in-vitro fertilisation (IVF) safer

Summary of the impact

Multiple births following in-vitro fertilisation (IVF) treatment leads to serious health risks in the mother and offspring. It is caused by replacing multiple embryos within the uterus. Concerns about reduced success rates have deterred patients and practitioners from transplanting a single embryo. A programme of research led from the University of Aberdeen established that a policy of replacing one embryo at a time minimises the risk of twins without compromising livebirth rates. This work has received international media coverage, influenced clinical guidance and resulted in an increased uptake of single embryo transfer in the United Kingdom and beyond.

The claimed impact, as defined by REF guidance, is therefore on public policy and services; practitioners and professional services and health and welfare.

Submitting Institution

University of Aberdeen

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Political

Research Subject Area(s)

Medical and Health Sciences: Paediatrics and Reproductive Medicine, Public Health and Health Services

Influencing national policy to improve service delivery and patient care in gastroenterology

Summary of the impact

Between 1996 and 2013 researchers at Swansea University evaluated service initiatives and changing professional roles associated with the management of patients with debilitating gastrointestinal disorders. This work showed the clinical and cost effectiveness of two main innovations: open access to hospital services for patients with inflammatory bowel disease; and increased responsibility for nurses, particularly as endoscopists. Our evidence has had a broad, significant impact on: national policy through incorporation in NHS strategies, professional service standards and commissioning guides; service delivery through the provision of increasing numbers of nurse endoscopists and the wide introduction of nurse-led open access to follow-up; and patient care, as documented in sequential national audits in 2006, 2008 and 2010.

Submitting Institution

Swansea University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Nursing, Public Health and Health Services

Enduring Impact on Global WHO Guidelines for Malaria Treatment

Summary of the impact

The World Health Organization (WHO) estimate 3.3 billion people are at risk of malaria, with 219 million cases and over half a million deaths annually. The Liverpool School of Tropical Medicine (LSTM) has applied new methods of research synthesis to malaria, and the results of this work have directly influenced important global decisions on malaria policies, including the adoption of new antimalarial drugs. In this case study, we report on the influence of the LSTM on malaria control over the last 15 years by preparing rigorous, up-to-date, timely systematic reviews on malaria. This work has also contributed to substantive improvements in the methodological rigor and transparency of the WHO malaria policy group in evidence-based policy formulation and guideline development.

Submitting Institutions

University of Warwick,Liverpool School of Tropical Medicine

Unit of Assessment

Public Health, Health Services and Primary Care

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Pharmacology and Pharmaceutical Sciences, Public Health and Health Services

Safe at the Point of Care: Reducing the Impact of Healthcare-Associated Infection

Summary of the impact

Healthcare Associated Infections (HAI) can be an unintended consequence of healthcare delivery. They are caused by a range of organisms but are often preventable. GCU-led research has reduced avoidable infections in healthcare in the UK and Europe by stimulating policy debate and investment in new healthcare practice and influencing policy decisions, evidence guidelines, and educational practices. Important changes have been made to national and international approaches to meticillin-resistant Staphylococcus aureus (MRSA) screening with cost savings of £7.5 million to the NHS. 28 European countries now use the HAI point prevalence survey validation method determined by our research.

Submitting Institution

Glasgow Caledonian University

Unit of Assessment

Allied Health Professions, Dentistry, Nursing and Pharmacy

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Public Health and Health Services

Preventing the gastroduodenal hazards of non-steroidal anti-inflammatory drugs and aspirin through widespread adoption of proton pump inhibitors

Summary of the impact

Non-steroidal anti-inflammatory drugs (NSAIDs) are valuable analgesics, but cause dyspepsia, ulcers and hospitalisation (UK: 3,500pa, USA: 100,000pa) for complications that can lead to death (UK: 400-1,000pa, USA: 16,500pa). Acid inhibition by proton pump inhibitors (PPIs), the only widely accepted preventative strategy, was proposed and systematically proved by studies from Nottingham. NICE now recommends PPIs for all patients using NSAIDs and PPIs are central to all major international guidelines. PPI co-prescription has increased worldwide (from 27.6% in 2008 to 44.1% in 2012, in the UK); and reduces the risk of hospitalisation for gastrointestinal bleeding by 54% and symptomatic ulcer by 63%, thereby preventing up to 540 deaths per annum in the UK.

Submitting Institution

University of Nottingham

Unit of Assessment

Clinical Medicine

Summary Impact Type

Health

Research Subject Area(s)

Medical and Health Sciences: Clinical Sciences, Pharmacology and Pharmaceutical Sciences

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