Charting new territory: medication administration records and transcribing in district nursing services.

Community nurses are often requested to administer medicines. A medicines administration record (MAR) is usually used to demonstrate all medicines administered, withheld or declined. In Wales, district nursing teams have highlighted concerns about accessing MARs and have been seeking solutions, which includes transcription of medication, where an exact copy of previously prescribed medicines are made to enable their administration. To understand the types of medicines administered in district nursing teams and nurses' views on transcribing, an anonymised electronic survey was developed and shared with such teams across Wales. A total of 286 responses were received from Health Boards in Wales. The survey found 60% of nurses experienced difficulties in accessing MARs, particularly during the out of hours period. Overall, 77% of nurses supported transcribing as a possible solution. Further work is required to develop clear policies and training to support safe transcribing within district nursing services. This can be supported by providing access to the person's medical records.

Person-Centred Care Including Deprescribing for Older People.

There is concern internationally that many older people are using an inappropriate number of medicines, and that complex combinations of medicines may cause more harm than good. This article discusses how person-centred medicines optimisation for older people can be conducted in clinical practice, including the process of deprescribing. The evidence supports that if clinicians actively include people in decision making, it leads to better outcomes. We share techniques, frameworks, and tools that can be used to deprescribe safely whilst placing the person's views, values, and beliefs about their medicines at the heart of any deprescribing discussions. This includes the person-centred approach to deprescribing (seven steps), which incorporates the identification of the person's priorities and the clinician's priorities in relation to treatment with medication and promotes shared decision making, agreed goals, good communication, and follow up. The authors believe that delivering deprescribing consultations in this manner is effective, as the person is integral to the deprescribing decision-making process, and we illustrate how this approach can be applied in real-life case studies.

Zeolite Y supported nickel phosphide catalysts for the hydrodenitrogenation of quinoline as a proxy for crude bio-oils from hydrothermal liquefaction of microalgae.

This work demonstrates the potential of zeolite Y supported nickel phosphide materials as highly active catalysts for the upgrading of bio-oil as an improved alternative to noble metal and transition metal sulphide systems. Our systematic work studied the effect of using different counterions (NH4+, H+, K+ and Na+) and Si/Al ratios (2.56 and 15) of the zeolite Y. It demonstrates that whilst the zeolite counterion itself has little impact on the catalytic activity of the bare Y-zeolite, it has a strong influence on the activity of the resulting nickel phosphide catalysts. This effect is related to the nature of the nickel phases formed during the synthesis process Zeolites containing K+ and Na+ favour the formation of a mixed Ni12P5/Ni2P phase, H+ Y produces both Ni2P and metallic Ni, whereas NH4+ Y produces pure Ni2P, which can be attributed to the strength of the phosphorus-aluminium interaction and the metal reduction temperature. Using quinoline as a model for the nitrogen-containing compounds in bio-oils, it is shown that the hydrodenitrogenation activity increases in the order Ni2P > Ni0 > Ni12P5. While significant research has been dedicated to the development of bio-oils produced by thermal liquefaction of biomass, surprisingly little work has been conducted on the subsequent catalytic upgrading of these oils to reduce their heteroatom content and enable processing in conventional petrochemical refineries. This work provides important insights for the design and deployment of novel active transition metal catalysts to enable the incorporation of bio-oils into refineries.

How summary care records can improve patient safety.

Summary care records (SCRs), which have been created for more than 53 million people in England, contain clinical information from patients' GP electronic records and can be accessed by authorised healthcare workers in other settings. The information is available for viewing at any time day or night, anywhere in England, as long as strict information governance processes that protect patients' confidentiality are followed. As this article explains, enabling SCR viewing in an organisation is straightforward and requires no major capital funding. Early findings indicate that access to information in SCRs increases patient safety, improves the quality and effectiveness of care, and can save healthcare staff and their organisations time and money.

Merlin Pryce (1902-1976) and penicillin: an abiding mystery.

In the scientific and medical pantheon few have received more adulation and honour than Sir Alexander Fleming. Even so it is abundantly clear that his triumphant discovery of penicillin owed much to the work of others, especially Florey and Chain, who accomplished the difficult task of taking penicillin from the test tube to patient. This essay does not attempt a detailed re-examination of that discovery. Rather the present study suggests that even the initial observation on that critical day in September 1928 and its subsequent ramifications were even more complex and perplexing than the accepted version. It is likely that Professor Daniel Merlin Pryce, a somewhat unconventional but gifted son of the Welsh mining valleys played an important, quite possibly a crucial, role in the original observation. However one which, except for a very few occasions, he himself sought to downplay, even virtually to deny.