Newsletter - Issue 19, January 2013

The National Clinical Effectiveness Committee (NCEC) is the body which provides a framework for national endorsement of clinical guidelines and audit to optimise patient care. It is part of the Patient Safety First Initiative.

The NCEC is seeking submissions of clinical guidelines from any interested group for consideration to become part of the national suite of clinical guidelines by 5pm on 5 March 2013.

Clinical guidelines are systematically developed statements, based on a thorough evaluation of the evidence, to assist practitioner and patient decisions about appropriate health care for specific clinical circumstances, across the entire clinical spectrum.

In order to ensure that the national suite of clinical guidelines address health care priorities and are based on the highest level of evidence the NCEC will prioritise, appraise and make recommendations to the Minister for Health to endorse clinical guidelines. It is recognised that the NCEC, and the health system as a whole, is likely to be able to effectively implement and monitor only a small number of new national clinical guidelines each year. Not all clinical guidelines need to be submitted for national endorsement and guideline development groups should continue to develop clinical guidelines in response to the needs of their own organisations. However, once a national clinical guideline is endorsed it will supersede any other guidelines on that topic.

The deadline for submission of clinical guidelines for consideration by NCEC is 5pm, March 5th, 2013.

In order for clinical guidelines to be endorsed at national level they must meet certain criteria as outlined in the 8 step process in the Framework for Endorsement of National Clinical Guidelines (2012). All guideline submissions must include the Checklist for Submission to NCEC.

The following may also be helpful to clinical guideline development groups:

NCEC Framework for Endorsement of National Clinical Guidelines, Version 2 (2012)

NCEC Clinical Guideline Development Manual (2012)

NCEC Clinical Guideline Screening and Prioritisation Criteria Version 3 (2012)

HIQA National Quality Assurance Criteria for Clinical Guidelines (2011)

Complete the Agree II Tutorial - www.agreetrust.org

All NCEC documentation on how to submit are available at http://www.patientsafetyfirst.ie

All HIQA documentation is available at www.hiqa.ie

Notice of Intent to Develop a Clinical Guideline: Guideline development groups are encouraged to notify their intent to develop a clinical guideline or that they have a guideline currently in development which they intend to submit to the NCEC.

The main purpose of this is to share information with all stakeholders who have an interest in a clinical area, in order to allow them communicate with each other and to prevent the possible duplication of effort where a number of stakeholders are undertaking work in the same area.

This notification neither commits the guideline development group to submit their guideline to NCEC, nor does it indicate that the guideline will be endorsed by NCEC. The list of guideline development groups who notify their intent to develop clinical guidelines which they intend to submit to the NCEC will be published on the NCEC website.

For further information or queries regarding submission of clinical guidelines please contact:

Antoinette Treacy

Department of Health

Hawkins House

Dublin 2

Email: ncec@health.gov.ie

Telephone: 01 6354115

www.patientsafetyfirst.ie

Think ahead: How it can help healthcare professionals and their patients

Think Ahead is a public awareness initiative to guide members of the public in discussing and recording their end of life preferences, in the event of an emergency, serious illness or death, when they may be unable to speak for themselves.

Think Ahead is a public awareness initiative to guide members of the public in discussing and recording their preferences around end of life.

Think Ahead was developed by the Forum on End of Life in Ireland – an initiative of the Irish Hospice Foundation (IHF) – following a year-long public consultation process between 2009 and 2010 to explore what issues mattered most to Irish people around death, dying and bereavement. The Think Ahead project involves people thinking about and recording their preferences in the event of an emergency, serious illness or death, when they may be unable to speak for themselves.

Importantly, Think Ahead will engage all members of the public - young and old, those who are healthy and those living with illness. Ideally, this is something that we would do while healthy and then go on with living our lives, revisiting our preferences over the years to make sure that they continue to express our current wishes. In addition to enabling people to express their care preferences, the Think Ahead form will also allow people to record the location of key legal and financial documents and approve the donation of their organs and a hospital post-mortem in the event of their death. The Think Ahead form and useful related guidance and resources are available on the Think Ahead website.

Health care professions play a key role in this area. Nurses, in particular, are often involved in having advance care planning conversations with patients and their families. Think Ahead has been designed as a tool that can help with these discussions.

A pilot has been carried out which included four GP practices in Dublin and consisted of 100 patients up to 70 years of age. This has received very positive responses from the GPs and patients. Patients did not report being distressed at discussing these issues and indeed the vast majority of them welcomed being the opportunity to have this conversation.

I think often, as health care professionals, we can assume a reluctance on the part of the public to discuss these issues that may in fact reflect our own discomfort; experience with ‘Think Ahead’ strongly suggests otherwise. GPs, similarly, reported that being involved in the process of assisting their patient in filling in the Think Ahead form enhanced their relationship with the patient. GPs also saw the Think Ahead form as a means to avoid becoming involved in very difficult situations where a patient may have lost capacity and their loved ones have conflicting opinions as to what they would have wanted. In this way, the Think Ahead form gives relatives and partners peace of mind, knowing that they have done the right thing and have followed their loved one’s wishes.

For the next stage of developing Think Ahead, the focus will be on working with other health professionals across care settings. Two regional pilots were rolled out in Limerick and Louth from September to November 2012. The Limerick pilot was organised in conjunction with the Compassionate Communities project of Milford Care Centre, which is working with the community to engage people in conversation and action around death, dying, loss and care. People in Limerick and Louth were asked to think, talk and tell: to think about their wishes for end of life, talk to their families as well as other trusted professionals in their communities, including their doctors and nurses, and then to fill out their Think Ahead form and tell someone they trust where it is kept. Feedback from the pilots is currently being analysed. People have been specifically asked to fill out a survey which will allow the National Council of the Forum on End of Life in Ireland to learn about any features of the initiative and the Think Ahead form in particular that should be revised in advance of a national campaign.

Briefing sessions were held with health care professionals in Louth and Limerick, acknowledging the important role that they can play in facilitating these conversations. We are currently in the process of developing a guidance document for health care professionals in using Think Ahead as a care planning tool with their patients.

Finally, I would really encourage nurses to engage with this very timely initiative which empowers people to decide the care they would like for their future. I know I have filled in my own Think Ahead form and you might think of doing the same!

For more information on Think Ahead see www.thinkahead.ie or contact Sarah Murphy at 01 6793188.

Author: Ms. Una Marren, Deputy Director of Nursing at the Mater Misericordiae Hospital, Dublin. Una Marren is also a member of the National Council of the Forum on End of Life

IMB - Information for patients on safety monitoring of medicines

The Irish Medicines Board has posted information on its website explaining the updated legislation for monitoring the safety of medicines (Pharmacovigilance) which came into effect in Ireland and across the EU in July 2012 and the impact of this legislation for patients and consumers.

A key aspect of the new legislation is the important role of patients and consumers in contributing to the strengthened system of pharmacovigilance. This document explains the changes to the reporting of side effects (also known as adverse reactions) and the steps a patient or consumer can take to report them.

To view the full article on the website please click the following link: http://www.imb.ie/7453.htm. If this link does not work, please copy the URL into your browser.

Events, Courses and Research that may be of interest to you

NMBI is happy to host the advertisement/promotion of an event/course/research that may be of interest to nurses and midwives and meets the Board's standards as a regulator. Please see our policy and disclaimer for the promotion and advertisement of external courses/research and events on our website for further information.

NMBI also provides a directory that has information on hundreds of continuing education and professional development programmes that have NMBI Category 1 approval. This Directory is available to access on our website and is managed by the Education Department of the Board.

University College Dublin are running a course entitled Professional Certificate: Dual Energy X-ray Absorptiometry (DEXA).

For further information on the course please contact Ms. Anne Hegarty - anne.hegarty@ucd.ie or call 01 716 6545. www.ucd.ie/medicine/

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