Enhanced supervision: new ways to promote safety and well-being in patients requiring one-to-one or cohort nursing.

The number of older people with multiple co-morbidities and cognitive impairment being admitted to hospital is increasing, and behavioural disturbances, such as confusion, agitation and delirium, are becoming commonplace. The need for nursing teams to manage the patients with such disturbances has led to the proliferation of one-to-one nursing or close observation, anecdotally known as 'specialing'. This article describes the implementation and outcomes of a new framework for providing enhanced supervision of patients in clinical wards run by the Cardiff and Vale University Health Board, one of the largest acute providers of care in Wales.

Epilepsy: a review of reports, guidelines, recommendations and models for the provision of care for patients with epilepsy.

Epilepsy is common and has a variety of causes and associated pathologies. Increased understanding of the pathophysiology underlying the epilepsies and advances in classification, diagnostic imaging and drug treatments have led to a reduction in stigma and growing demand for services to be improved for patients. A number of important reports and guidelines have emerged in the UK in recent years, which are summarised here. Diagnosis, classification, management and models of care are discussed as well as the management of drug intractable seizures, status epilepticus, and approaches to special patient groups: women in the fertile years, the elderly and those with learning difficulties.