The identification of the armed forces community (AFC) within health services is essential if they are to receive person-centred, evidence-based care. While health services may routinely ask individuals whether they have served in the armed forces, recognition of the wider AFC, including family members, remains inconsistent. Accurate recognition supports access to specialist services, continuity of care, proactive intervention and improved health outcomes. Veterans experience higher rates of mental health difficulties, comorbidities and health inequalities than the general population, and many may be reluctant to seek support or disclose their AFC status. A whole-community approach that recognises the impact of military service on both families and veterans is needed. Clinical coding, data collection and collaborative working between healthcare and third-sector organisations all have a role in developing culturally informed pathways of care. Improved identification of the AFC could strengthen evidence-based practice, support early intervention and help reduce inequalities experienced by the AFC.
Background: Inappropriate urinary device use and catheter-associated urinary tract infection (CAUTI) contribute to preventable patient harm, antimicrobial resistance, incontinence-associated dermatitis (IAD) and prolonged hospitalisation. Aim: To describe the development, implementation and evaluation of a digitally enabled urinary device knowledge-to-practice framework designed to strengthen clinical governance, improve CAUTI surveillance and support harm prevention. Methods: A practice-based implementation programme was led by the Continence Lead Nurse at University Hospitals of Leicester NHS Trust. Following an evidence review, the Continence Lead Nurse independently undertook a prospective clinical audit of CAUTI symptoms and microbiology findings. The audit informed the decision to embed CAUTI symptom prompts within electronic catheter care plans and develop CAUTIon+, a digital surveillance dashboard. Evidence-based urinary device pathways and digital care plans were integrated into trust-wide clinical policy. A female external catheter (FEC) pathway was evaluated through a 6-week feasibility study and a separate 6-month value-based procurement evaluation. Results: Implementation established daily prospective CAUTI surveillance through CAUTIon+, supporting earlier identification of suspected infection and structured clinical review. In the initial FEC evaluation, all nine patients reported positive experiences, while 19 of 21 staff respondents highly recommended the device. The subsequent procurement evaluation recorded a 93% reduction in IAD cases (43 to 3), with an estimated 132 bed days avoided and £67 896.30 in reported net savings. Conclusion: Integrating digital urinary device care plans, trust-wide clinical policy and CAUTIon+ surveillance translated evidence into routine practice and strengthened urinary device stewardship. The framework supports earlier clinical intervention and antimicrobial stewardship, with the potential to contribute to prevention of urinary-source sepsis. It aligns with the NHS 10-year health plan's shift towards digital, preventive health care and offers a model for wider NHS evaluation
John Tingle , Associate Professor, Birmingham Law School, University of Birmingham, discusses some recent NHS patient safety publications considering the role of AI in the NHS and the implications of its roll-out
Background: Preventing hospital-acquired pressure ulcers (HAPUs) remains a high priority safety concern on local and national agendas. Rigorous action plans and improvement strategies are central to reducing the incidence of PUs, which are largely preventable. Using data to drive improvement and deep-dive thematic analysis enables staff to learn from the real causes of these safety incidents. This article explores the local strategies and methodology put in place to achieve sustained HAPU improvement in an acute teaching hospital NHS trust. Aim: To evaluate the effectiveness of locally implemented strategies in reducing HAPUs and identify key factors to learn from the incidents. Methods: PU data were measured via a statistical process control chart, with deep-dive thematic analyses used to identify contributory factors, by adopting the ‘swarm’ huddle model. Strategies implemented included targeted staff ‘prevention rounds’, improving documentation and photography, promoting timely escalation to the tissue viability team, multidisciplinary collaboration, joint validation of category 3 and above PUs, and leadership oversight. The work was conducted as a quality improvement case review using routinely collected clinical trust data. Formal ethical approval was not required as this work constituted a service evaluation and quality improvement strategy using routinely collected data in line with trust governance processes. Findings: Staff awareness and accountability increased through shared learning and leadership engagement. A sustained reduction in HAPU incidents was observed. Thematic analysis highlighted recurring contributing factors, such as repositioning gaps, handover limitations, communication issues, delayed assessments, and documentation inconsistencies and gaps, enabling focused action plans to be implemented. Conclusion: Sustained reduction in HAPUs requires a trust-wide system approach that combines data-driven insight, multidisciplinary collaboration, leadership engagement and continuous education in HAPU prevention. Embedding prevention and learning from incident thematic analysis are essential to sustain improvements.
Background: Venous leg ulcers (VLUs) are chronic, recurrent wounds associated with significant physical, psychological and healthcare burden. Despite effective healing rates with compression therapy, recurrence rates remain high, often exceeding 60% within 1 to 2 years. Patient education has been identified as a key strategy to improve adherence to preventive measures and support long-term self-management. Aim: To evaluate the impact of a structured education programme on leg ulcer recurrence prevention and self-management following ulcer healing. Methods: This interim analysis reports findings from the first year of a 4-year longitudinal evaluation conducted within a community-based leg ulcer service in Ireland. Eighty-five patients with recently healed VLUs participated in a 1-hour nurse-led education session covering venous insufficiency, compression hosiery, skin care, exercise and recurrence prevention. Educational materials, practical demonstrations and hosiery application aids were provided. Data were collected using pre- and post-intervention questionnaires, follow-up telephone reviews and recurrence monitoring over 12 months. Results: Baseline recurrence data demonstrated a recurrence rate of 78% prior to programme implementation. Following the intervention no ulcer recurrences were recorded at 6 months and recurrence at 12 months was 5%. Improvements were observed in self-management behaviours, including reduced difficulty with compression hosiery application (67% to 35%), skin care (39% to 28%) and exercise participation (47% to 27%). All participants reported improved understanding of ulcer prevention and satisfaction with the programme. Conclusion: Structured patient education delivered by specialist nurses was associated with substantial reductions in VLU recurrence and improved self-management. This approach may represent an effective and practical strategy for long-term recurrence prevention within community leg ulcer services.
