RCEM Learning January 2025
15 snips
Jan 8, 2025 
Becky Maxwell, an expert in emergency medicine, and Chris Connolly, an emergency medicine physician, dive deep into the updated NICE guidelines on acute kidney injury (AKI). They emphasize the importance of timely imaging and collaboration across specialties for improved patient outcomes. The duo also navigates the challenges of diagnosing kidney issues, including creative alternatives for obtaining ultrasounds. Additionally, they tackle the complexities of assessing febrile infants and the evolving clinical decision aids that support physicians in pediatric emergency care.
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Turnover Correlates With Mortality
- Higher staff turnover correlates with worse patient outcomes in NHS trusts but doesn't prove causation.
- A one SD rise in nurse turnover linked to 35 extra deaths per 100,000 admissions monthly.
Adjust And Investigate Locally
- Use risk adjustment when comparing hospital outcomes to account for age, comorbidity, and month of admission.
- Interpret large database associations cautiously and seek local qualitative investigation to find causes.
Short-Medium Term Impact Window
- Staff turnover effects on mortality persisted for up to nine months after peaks but not at 12 months.
- The impact was stronger for emergency admissions than elective care.