Improving the systematic screening and documentation of mental capacity for patients with severe brain injury: The Mental Capacity Screening assessment tool (MCScreen).

For patients who may lack capacity, the Mental Capacity Act 2005 requires capacity to be assessed for each decision at the time that treatment is offered, but this is not practical for every element of basic care and intervention delivered to patients undergoing rehabilitation following acquired brain injury, especially if their needs are changing. In this quality improvement project, we introduced a system for screening Mental Capacity and documentation to identify patients with a) largely intact cognition for whom capacity may be reasonably be presumed, and b) those in prolonged disorders of consciousness who clearly lacked capacity for all decisions. This enabled the multidisciplinary team to concentrate on evaluation of capacity in the third group who had more nuanced ability and required detailed assessment or support for decision-making.

Development and implementation of a COVID-19 near real-time traffic light system in an acute hospital setting.

Common causes of death in COVID-19 due to SARS-CoV-2 include thromboembolic disease, cytokine storm and adult respiratory distress syndrome (ARDS). Our aim was to develop a system for early detection of disease pattern in the emergency department (ED) that would enhance opportunities for personalised accelerated care to prevent disease progression. A single Trust's COVID-19 response control command was established, and a reporting team with bioinformaticians was deployed to develop a real-time traffic light system to support clinical and operational teams.

How do we build a picture of a patient in prolonged disorder of consciousness?

Accurate diagnosis of prolonged disorders of consciousness can be challenging and requires the input of a specialist interdisciplinary team who are experienced in informal assessment as well as the administration of formal validated observational assessment tools. There is limited guidance on the selection of these assessment tools. This study examines the factors involved in a team's choice making and how choice of assessment helps build a picture of a patient.

Emotional labour: the challenges of working with children and cancer.

This article explains the concept of emotional labour and applies it to working with children with cancer. Emotional labour describes active management of the emotions, and the use of emotion as part of the work that is required in many jobs, particularly nursing. Although emotional labour is an important part of nursing work, it is often neglected or taken for granted.