bluuebunny/crossref_metadata_2025 huggingface dataset:
Further legal protection needed for nurses who report poor practice?
Authors: Griffith Richard , Tengnah Cassam
Published: May 2014

There are persistent calls from Government, health regulators and even the Parliamentary health select committee for health professionals to report poor practice. The Government argues that district nurses who blow the whistle on substandard care will be protected by changes to the NHS Constitution for England. However, a recent decision of the Court of Appeal shows that whistleblowers who are subject to bullying and recriminations from colleagues are not protected by the law and cannot claim compensation. In this article Richard Griffith and Cassam Tengnah review the law protecting whistleblowers, and discusses ways in which district nurses who have concerns can safely report poor practice.
Breaking the silence: helping men with erectile dysfunction
Authors: Peate Ian
Published: May 2014

Erectile dysfunction is a condition that is often under-reported. This article provides the community nurse with a brief overview of erectile dysfunction in the context of sexual health and its importance to wellbeing. The article outlines issues concerning epidemiology, the possible causes of erectile dysfunction and the impact the condition can have on the man's quality of life. Often men with erectile dysfunction report being stigmatised, feeling shame and experiencing guilt. The role of the community nurse in assessing, making a diagnosis and helping the man with the condition is described. The article emphasises the fact that in order to offer care effectively and competently the community nurse must be up to date and knowledgeable concerning the condition.
Practice development: implementing a change of practice as a team
Authors: Covill Carl , Hope Angela
Published: May 2014

Practice development (PD), as a framework for multiprofessional working, has immense potential, specifically within change management and the clinical governance agenda. It has been acknowledged as a vehicle for ‘continuous improvement’. This article discusses PD through collaborative working using the example of a case study on change of practice in falls reduction within a localised community setting. The process is underpinned by a PD framework and facilitated by leaders of PD within a university setting. The article identifies that PD frameworks are conducive to developing leadership and management roles within a democratic process. The article discusses the potential for multiprofessional PD within the locality and further afield.
OptiLube Active. The role of lubricants in urinary catheterisation
Authors: Mangnall Joanne
Published: May 2014

Catheterisation is necessary for many patients but places them at risk of developing uncomfortable and potentially lethal infections. Catheter insertion can also be painful. It is essential that all staff who perform the procedure have a clear understanding of the measures they should implement to reduce discomfort, trauma and the risk of infection to the patient. The need for staff to be trained and competent and to use an aseptic technique when undertaking the procedure are core principles for practice. Guidance advises that lubricating gels are used in all patients undergoing urethral catheterisation to minimise the risk of urethral trauma and associated infection. Gels containing a local anaesthetic make the procedure less uncomfortable, but must be applied correctly to be effective. This article will consider the actions of these gels and the potential benefits and risks associated with each, focusing on use of OptiLube Active with case studies.
Transforming regional lymphoedema services: a managed clinical network
Authors: Rankin Jane
Published: May 2014

Lymphoedema is a complex, chronic condition caused by damage to the lymphatic vessels; it is associated with physical and psychological problems and is effectively managed by complex decongestive therapy (CDT). The 2004 Northern Ireland review of regional lymphoedema services produced an extensive list of problems and a focused set of objectives to creatively challenge practice and address deficits (Department of Health, Social Services and Public Safety, Northern Ireland ( DHSSPSNI), 2004 ). A managed clinical network was initiated to make the best use of scarce resources, aiming to prevent duplication, standardise care and improve services across the institutional boundaries of the five super trusts. Finances further challenged the network when only 39.68% of recommended funding was realised (£0.5 million). Leadership was recognised as essential for success for the regional project and included a part-time project lead and manager, and a lead for each trust. The network has created a model of care that is patient-focused through innovation, partnership and change led by clinicians.
Food and mood: evidence for diet-related changes in mental health
Authors: Dunne Annette
Published: May 2014

Studies have highlighted the ever-increasing role that food and nutrition play in our emotional status and the benefits of positive food choices in the management of mental health difficulties. Research is ongoing in this area, and the role of nutrition in mental health has yet to be fully understood and embraced. This article highlights how health professionals can encourage people to include a broad range of foods from a variety of sources to help ensure that macro- and micronutrient status is adequate. However, more research is required to develop our understanding of the role of nutrition in mental health.
Tools to identify nutritional risk for older people in the home
Authors: Söderhamn Ulrika
Published: May 2014

Community nurses are in an ideal position to identify older home-dwelling people at nutritional risk and thereby to prevent undernutrition. The aim of this paper is to present some nutritional screening instruments for older home-dwelling people and to discuss nutritional issues of importance for community nurses in order to assess nutritional risk and prevent undernutrition. The screening instruments Nutritional Form For the Elderly (NUFFE) and Mini Nutritional Assessment (MNA) are especially developed for screening older people. The Malnutrition Universal Screening Tool (MUST) is recommended for screening community-living people. Identifying nutritional at-risk persons by means of a screening instrument and being aware of risk factors and protective factors for undernutrition can guide nurses in their nutritional assessment and help them to find tailored interventions in order to prevent undernutrition.
Honey and Medihoney® Barrier Cream: their role in protecting and repairing skin
Authors: Greenwood Michelle , Handsaker Jo
Published: May 2014

This article will describe the use of Medihoney Barrier Cream (Derma Sciences) in use in clinical practice, through a series of case studies when used as a skin protectant where damage to the skin has occurred. It will discuss the antimicrobial benefits of the honey and the benefits of this being an added ingredient to a barrier cream, particularly where there is thought to be some candida/fungal infection present ( Irish et al, 2006 ). The Medihoney Barrier Cream moisturises to keep skin supple and soft and helping to support the skin's natural barrier function. Medihoney Barrier Cream also has a pH of 3.5–5, which helps to maintain the optimal pH to protect against pathogens ( Cooper et al, 2010 ). The Medihoney Barrier Cream is formulated with natural ingredients that have no lanolin, parabens, steroids or mineral oils.
Experiences of negative pressure wound therapy from the patient's perspective
Authors: Yarwood-Ross Lee
Published: May 2014

Enabling patients to be active in their care is constantly being promoted in the current healthcare arena, and there is strong evidence to suggest that outcomes can be improved through promoting this in the clinical setting. For clinicians to incorporate this in practice, we must firstly examine the patient's perspective of treatments offered to them. This article explores the few studies that have investigated the patient's experiences of negative pressure wound therapy, to provide clinicians with an awareness of the issues that are raised by patients when receiving NPWT. The findings demonstrate that NPWT impacts on patients physically and psychologically, in both positive and negative ways. Clinicians have the ability to deal with some of these issues but others will rely on technological advances.
Evaluation of a superabsorbent dressing in a primary care organization
Authors: Stephen-Haynes Jackie , Stephens Claire
Published: May 2014

This 40-patient evaluation of superabsorbent dressing DryMax Extra (Aspen Medical) was conducted within a large UK primary care organization adhering to an agreed evaluation protocol as approved by clinical governance. Exudate management and key performance requirements of absorbent dressings are considered with an analysis made of the clinical data relating to DryMax Extra. Clinical expectation of the product was rated and met in 38 of 40 cases, relating to ease of use, patient comfort, exudate management, maceration prevention, wear time and visual improvement of the wound bed. Additionally, evaluation findings resulted in a recommendation for formulary listing in 34 cases. Consequently, the authors recommend that there is a need for a large comparative study of the clinical and financial outcomes of superabsorbent dressings.
A personal journey towards Any Qualified Provider in the NHS
Authors: Hampton Sylvie
Published: May 2014

Any Qualified Provider (AQP) is a new and exciting way of organising health care that offers patient choice and cost-effective care. But there are many rumours and ‘Chinese whispers’ that are causing concern among healthcare workers throughout the UK. Although not all the rumours are false, there is a general misunderstanding of what AQP can provide and its potential to raise standards and lower costs throughout the NHS. This paper asks: can its promises be achieved? It also shows how AQP may work, through a personal experience of commissioning.
Managing work-related stress in the district nursing workplace
Authors: Burke Michelle
Published: May 2014

This article aims to highlight the issue of work-related stress within the district nursing workplace. It will acknowledge how the management of work-related stress has previously been discussed within nursing literature and will consider the emerging relationship between staff working conditions, staff wellbeing and quality of patient care. It will reintroduce the Health and Safety Executive's (HSE’s) Management Standards approach to tackling work-related stress, which provides management support to reduce environmental work stressors and encourage enabling work environments and a positive workplace culture.
Cognitive assessment: a guide for community nurses
Authors: Nazarko Linda
Published: May 2014

Ageing increases the risks of dementia and there are an estimated 667 000 people in England living with dementia. Less than half have a formal diagnosis. Community nurses are now being asked to screen older people for dementia under the Commissioning for Quality and Innovation framework. This article provides a brief explanation of common screening tools and explains the community nurse's role in identifying people who may have undiagnosed dementia.
Improving access to CPD for nurses: the uptake of online provision
Authors: Ousey Karen , Roberts Debbie
Published: May 2014

Qualified nurses want to access courses that develop their knowledge and skills base within specific areas that are relevant to the work that they do. Traditional methods of delivery for post registration education usually involve attendance at a university or continuing professional development department for lectures and seminars. It is well known that barriers exist which prevent staff from being released to attend such educational activities, or to fund nurses education and development directly. Furthermore, education of the nursing workforce presents a dilemma for many education providers due to the range of learning styles of the current pool of potential students together with the ever changing demographics of the workforce. This paper aims to explore the dilemma faced by education providers and makes suggestions regarding possible solutions to supporting the continuing professional development of the nursing work force. In particular, education providers are encouraged to consider developing non-traditional study packages which maximise uptake through mechanisms such as on-line provision.
Complications of stomas: their aetiology and management
Authors: Watson Angus JM , Nicol Laura , Donaldson Susan , Fraser Cathie , Silversides Andrew
Published: May 2014

The formation of a stoma is an essential part of many colorectal operations. Despite the frequency with which these surgeries are performed and the number of specialists involved in stoma care, complications are still common. This article investigates the most common complications, explains the reasons for their occurrence and suggests potential management options. Common stoma complications were identified by the colorectal/stoma clinical nurse specialist (CSCNS) and a literature search was performed using a variety of online databases, including Medline and CINAHL using the keywords stoma, complications, prolapse, ischaemia, retraction, hernia and stenosis. Articles used were selected on the basis of relevance to the topic. The commonest complications of stomas included skin irritation, prolapse, retraction, ischaemia, hernia and stenosis.
An overview of psoriasis and the role of emollient therapy
Authors: Onselen Julie Van
Published: May 2014

Psoriasis is a common skin condition affecting 1.5% of the UK population. Patients with psoriasis have to manage and cope with their psoriasis on a day to day basis; which includes understanding how to self manage and use topical therapy. General skin care, including the importance of emollients is often an overlooked therapy area in psoriasis. This article gives an overview of psoriasis and current recommended topical treatments by the new NICE Assessment and Management of psoriasis Guidelines (2012). A recent survey looking at emollients and psoriasis are discussed. The best emollient for the patients is the one with the formulation that individually suits them and they want to use as part of a daily skin care routine.
The community nurse and the use of social media
Authors: Peate Ian
Published: May 2014

The role and function of the community nurse has changed in a number of ways over the years; however, central to that role is the direct hands-on care that expert nurses provide to a variety of client groups. Social media can never replace that unique role yet it can help the community nurse provide safer and more effective care. The use of social media is growing and is having a significant influence on society. Social media can dictate tomorrow's news today, provide individuals with a public voice and help to form new social connections regardless of geography. Social media has become embedded within our daily lives. For community nurses social media networks offer alternative ways in which they can share knowledge and expertise and keep up to date. This article intends to stimulate thoughts about how social media could be used positively by the community nurse and his or her organisation to help meet the future demands on the NHS and community nursing services.
Preparing for a Nursing and Midwifery Council visit in the community setting
Authors: Carr Jacqui , Aston Liz , Pitt Margaret , Kelly Alison
Published: May 2014

Preparing for a Nursing and Midwifery Council placement monitoring visit can appear daunting if practitioners have not previously participated in the process. This paper identifies why visits are required and how practitioners and the local higher education provider representatives can work together to prepare. Based on the experience of the authors it is proposed that the visit is an opportunity to disseminate good practice linked to the education and mentorship of students. Suggestions linked to successful preparation are also shared to assist community nurse teams who encounter the process in the future. It is advocated that feedback from the visit can be used to further strengthen the practice learning experience for both mentors and students.
COPD in primary care settings in Ireland: stories from usual care
Authors: Hyde Nicola , Casey Dympna , Murphy Kathy , Cooney Adeline , Mee Lorraine , Kirwan Colette , Tully Agnes , Mooney Bróna
Published: May 2014

The aim of the PRINCE study was to determine the effectiveness of a structured education pulmonary rehabilitation programme for those living with COPD in primary care in Ireland. This qualitative element of the larger PRINCE trial aims to describe the constituents of ‘usual care’ for patients allocated to the control arm of the study.

A descriptive qualitative study was used to explore the constituents of usual care. A convenience sample of participants (n=20) allocated to the usual care group were interviewed.

Three main themes arose from the study: experiences of having and managing COPD, lifestyle advice, and factors that helped or hindered self-management.

Usual care left many people grappling in the dark trying to manage their COPD. It was found that usual care was not at its optimum for people with COPD in the control arm of the PRINCE study.
Effect of home-based nursing pulmonary rehabilitation on patients with chronic obstructive pulmonary disease: a randomised clinical trial
Authors: Mohammadi Fahrahnaz , Jowkar Zeynab , Reza Khankeh Hamid , Fallah Tafti Saeid
Published: May 2014

Fatigue is a common symptom of patients with chronic obstructive pulmonary disease (COPD), and results in a reduction of daily activity and quality of life in patients with the disease. The authors aimed to identify the effect of home-based nursing pulmonary rehabilitation on fatigue, activities of daily living (ADL) and quality of life (QOL) in patients with COPD. A block randomisation method was used to randomise participants into case and control groups. Fatigue, ADL and QOL were assessed before and after the intervention in both groups. Independent and paired t-tests, chi-squared tests and covariance analysis were used to analysing data. Findings showed the significant decrease in the mean scores of fatigue (p<0.001) and significant improvement in mean scores of ADL (p<0.001) and QOL (p<0.001) after home-based nursing pulmonary rehabilitation in the case group. Home-based nursing pulmonary rehabilitation can be an effective, inexpensive and accessible programme for decreasing fatigue and improving ADL and QOL for patients with COPD.
Smoking and its effects on the healing process of chronic wounds
Authors: McRobert-Tuck John
Published: May 2014

Smoking has a negative impact on skin health. Numerous studies have effectively linked smoking with delayed wound healing and healing complications. Research has identified cigarette smoking affects wound healing at a cellular level. Reducing fibroblast activity and keratinocyte migration. Such is the concern around the affects that smoking has on wound healing that some question whether smoking abstinence should be a pre requisite before some surgical procedures. This article will discuss current research and clinical studies that have investigated impaired wound healing as a result of cigarette smoking.
The Integrity® Full Replacement Alternating Mattress
Authors: Collins Fiona
Published: May 2014

The Integrity® Full Replacement Alternating Mattress, manufactured and distributed by Sumed, is an innovative alternative for those users who find conventional alternating pressure mattresses uncomfortable. The mattress is designed with smaller cells than conventional alternating mattresses and this has a number of benefits for the user, in that posture within the bed is not compromised as the cells alternatively inflate and deflate, maintaining mobility and function. Furthermore, users report that the small cell size results in their experiencing far more comfort on this mattress compared with other alternating mattresses previously tried, as they feel far less movement with the alternation. Importantly, the construction of the mattress affords significant safety to the user in the event of power failure, and this is particularly pertinent in the community setting where the user is monitored less frequently. This article discusses pressure injury prevention in the community and describes how the Integrity® mattress provides a solution.
Use of Urgotul SSD® to reduce bacteria and promote healing in chronic wounds
Authors: Downe Annette
Published: May 2014

This product focus seeks to give an overview of the management of wound bioburden in relation to the use of antimicrobial dressings, according to recent guidelines and best practice statements. Identification of critical colonisation/localised infection and the role of biofilms is a key aspect of effective wound management. Silver antimicrobial dressings are efficient in reducing bacteria in wounds, but must be used appropriately to prevent overuse. Silver sulphadiazine has traditionally been used for the treatment of burns or Pseudomonas infection in leg ulceration, often in a cream formation. This article will be looking specifically at the effective use of Urgotul SSD® in three critically colonised/non healing wounds.
Implications of patient shared decision-making on wound care
Authors: Brown Annemarie
Published: May 2014

This article discusses the Government's drive to promote health professional and patient partnership working within healthcare, with a focus on enhancing wellbeing and how this relates to tissue viability. The literature has demonstrated how wounds impact negatively on a patient's sense of wellbeing. Assessing the impact of a wound on patient wellbeing is an essential as part of an holistic assessment process, but is even more important when the wound is chronic or recalcitrant to treatment. Scenarios are presented that illustrate how working in partnership with patients with chronic wounds can result in a therapeutic and concordant relationship when the patient's priorities of care are established, even if they differ from those of the health professionals caring for them. The article also discusses objective and subjective methods of measuring wellbeing as a means of demonstrating alternative clinical outcomes of nursing interventions within a healthcare culture where the need to meet wound healing targets still remains the norm.
The role of community nursing in providing integrated care for older people with alcohol misuse
Authors: Rao Tony
Published: May 2014

Alcohol misuse in older people is a growing problem for health and social care providers, but remains largely hidden from public view and therefore largely overlooked by commissioners. Many older people with alcohol misuse have a ‘dual diagnosis’ (alcohol misuse accompanying other mental disorders) rather than alcohol misuse alone, which requires specialist nursing expertise. Over the past 10 years, assessment of and interventions for the detection of alcohol misuse in older people have been developed within one London borough. This article details the background, strategy and outcomes of this service, which provides integrated care in a multidisciplinary community mental health team covering an inner-city area with a high prevalence of alcohol misuse and dual diagnosis in older people.
Addressing older people's mental health needs in the community setting
Authors: Barker Sue , Heaslip Vanessa , Chelvanayagam Sonya
Published: May 2014

It is estimated that more than one third of older people may experience problems with their mental health. While, in some of these cases, people will be able to self-manage with little or no support, individuals who are socially isolated or physically unwell may experience significant mental distress. Community nurses are ideally placed to identify mental health problems in patients who are housebound, and to make appropriate referrals. Yet many nurses report apprehension regarding a perceived lack of knowledge and skills in which to undertake an initial assessment. This article outlines the most common mental illnesses experienced by older people living in the community and provides guidance for community nurses on conducting an initial assessment to ensure that patients' holistic needs are met.
Direct procurement of wound management products
Authors: Jenkins Trevor
Published: May 2014

This article describes a collaborative project between Bedfordshire Community Health Services and Primary Care Trusts/Clinical Commissioning Groups to improve provision of dressings to nurses for the patients they treat. Commissioners have facilitated a transformational approach and encouraged development of efficient systems of increased cost-effectiveness rather than a transactional approach based on opportunistic cost improvement plans. Reconfiguration to direct procurement from GP prescribing has reduced wastage, released nurse time from processes to spend on clinical contact time with patients, increased efficiency, and reduced prescription workload for GPs, all without adverse effects on expenditure. Establishing a wound care products formulary placed control under the nurses treating patients and facilitated decision-making based on cost-effectiveness in clinical use. Nurses now manage 60% of expenditure in the local community health economy, and this is increasing. Relationships with the dressings manufacturing industry have also changed in a positive, constructive direction.
The evolution of the healthcare assistant in primary care
Authors: Hand Tanis
Published: May 2014

The nursing team in an average GP surgery in the UK has grown and changed considerably in recent years. This article explores the development of the healthcare assistant role within the primary care team and considers how the role will continue to evolve in future.
New skills for HCAs: lifestyle modification
Authors: Thornett Andrew
Published: May 2014

Healthcare assistants (HCAs) can play a major role in helping patients to make lifestyle changes that will alter their risk of disease and its complications. Smoking, weight and exercise are key areas to improving length of life and reducing risk of death, especially for patients who suffer from coronary artery disease, vascular disease or diabetes mellitus. In addition, HCAs can provide valuable support to the nurse in helping patients reduce alcohol consumption and remain healthy on holiday and in their personal relationships.
Insulin administration in the community: a project
Authors: Owen Marnel
Published: May 2014

Diabetes UK (2005) estimated that 1.8 million people in the UK were diagnosed with diabetes in 2005, and calculated that this number would reach 3 million by 2010. Accordingly, the district nursing service within the North West Wales NHS Trust encounters an increasing number of housebound patients who require assistance with the administration of insulin. The recent expansion of the community nurse's role means they are becoming responsible for care traditionally undertaken by medical practitioners or within an in-patient setting; there is now a much greater emphasis on skill mix and flexible team approach to ensure both patients' and service delivery needs are met. The service had been developing the skills of its healthcare assistants for some time, supporting them to undertake recognized training courses such as NVQ level 2 and 3 in Care. It had also been developing their clinical skills in areas like venepuncture, near-patient testing and blood glucose monitoring, and so the benefit of extending those skills further to administering injections, commencing with insulin, was clear. This article describes the development and results of that project.
Diabetes: a guide to glucose meters
Authors: Lawal Muili
Published: May 2014

Standards 4 and 5 of the National Service Framework for diabetes put an emphasis on blood glucose control. Among other things, the two standards aim to improve the care of patients with diabetes by facilitating optimum glycaemic control. No doubt, blood glucose monitoring plays an important role in the control of blood sugar level. It helps to identify new cases, detect abnormal values, minimize long-term complications and promotes the quality of life for patients. This article illustrates the assessment, planning, implementation and evaluation of glucose estimation. The aim is to inform all members of the multi-professional diabetes team about effective glucose estimation, particularly those who have responsibility for day-to-day monitoring of blood glucose levels.
Nutrition part 5: dysphagia
Authors: Nazarko Linda
Published: May 2014

In 2007, 242 people died of malnutrition while being cared for in NHS hospitals. The number of people discharged malnourished exceeded the number admitted malnourished. Sometimes people become malnourished because they have difficulty swallowing (dysphagia). This article explains how to recognize and manage dysphagia.
Bed bug bites: identification, treatment and prevention
Authors: Nazarko Linda
Published: May 2014

The number of bedbug infestations has tripled in the last 10 years. Considering that bed bug bites are often misdiagnosed, it is important for healthcare assistants (HCAs) and assistant practitioners (APs) to be able to identify bed bug bites. Therefore, this article aims to enable HCAs and APs to understand why bed bug bites occur, how they are treated and how bed bugs can be eradicated from the patient's environment.
Understanding the Common Triggers and Effects of Stress
Authors: Swann Julie I
Published: May 2014

Stress is an important natural reaction that helps people to deal with potential problems, whether real or imaginary. Everyone experiences stress at some time during their lives, and we react to it in different ways. The article explains stress and how it affects our bodies, and discusses ways to reduce it.
Support for learning disabilities in forensic services
Authors: Chris Barber
Published: May 2014

The role of healthcare assistants (HCAs) and nurses who work in forensic services to support those with a learning disability who have broken the law is poorly recognized and understood. This short article sets out to highlight what forensic services are, the journey through forensic services and the role of the HCA in supporting these service users.
Exploring Issues of Maternity Care Assistant Role Boundaries
Authors: Willocks Katie
Published: May 2014

Workforce challenges in the NHS have lead to maternity care assistants (MCAs) playing an ever-increasing role in maternity services. However, with the development of the role of the MCA, it is important to recognize the potential for confusion regarding the tasks and responsibilities to be undertaken by the MCA. In some cases, uncertainty may lead to to role ambiguity and unclear boundaries between these two groups of staff. This article presents findings from a qualitative study into the perceptions of MCAs and midwives as to the role boundaries of the MCA. Findings illustrate that while many MCAs felt confident about the appropriate parameters of their practice, others recounted some instances when they had considered the boundary to be ambiguous. This article examines potential sources of this ambiguity, discusses some wider implications and offers some suggestions for more effective management of role boundaries to prevent ambiguity.
Making sense of hepatobiliary disease
Authors: Mulryan Chris
Published: May 2014

The incidence of liver disease is on the increase. While much is written about the role of alcohol in the development of liver diseases, there are many other causes. In this article, the normal anatomy and physiology of the liver will be detailed, along with its associated biliary structures. Details will then be provided to explain how the hepatobiliary system can malfunction and the types of problems that this produces for patients.
Sexually transmitted infections: 1/6—Epidemiology
Authors: Ian Peate , Emma Collins
Published: May 2014

The sexual health of the nation is as important as any other element of health care provision. The support worker should aim to incorporate sexual health in the total healthcare package, thus offering people holistic care. This article is the first in a six-part series and addresses some of the issues associated with sexual health care. In this article, the epidemiology (the study of sexually transmitted infections, the number of cases and the control of infection) is provided. It is important to understand the incidence of sexually transmitted infections (STIs), how they are transmitted and the control measures in place to provide care that is safe and effective. The support worker must also understand how to undertake a comprehensive sexual health history as part of a holistic assessment. Other articles in the series will include an overview of some of the diagnostic tests and investigations associated with STIs. The most common STIs — gonorrhoea, syphilis, chlamydia and herpes—will be discussed individually.
Supporting mental health issues alongside learning disabilities
Authors: Barber Chris
Published: May 2014

Those with a learning disability are as, if not more, likely to develop and experience mental health issues than those without a learning disability. This article will briefly explore the meaning of mental health, the occurrence of mental health issues in those with a learning disability and the various therapies and treatments that are available.
Time and resource management for support workers
Authors: Stonehouse David
Published: May 2014

The importance for support workers of managing both the resources within the workplace and importantly their own time will be considered in this article. Identifying resources as and planning how these can be managed successfully will be discussed. If resources are not managed correctly this can and will have a negative impact on the quality of patient care and service delivery and so is an important part of the support workers role.
Increasing the awareness of heart diseases and treatments
Authors: Swann Julie
Published: May 2014

Many health professionals, including healthcare assistants (HCAs) and assistant practitioners (APs) will come into contact with patients who are affected by heart disease or know somebody close to them who has suffered from a heart problem. The economic costs of heart disease to the UK are large, however many related conditions can be prevented, or their effects minimized, with the help of HCAs and APs. This article introduces the subject of heart conditions, discusses the cardiac system, symptoms of disease and treatments.
Heart failure: palliative care and changes in cognition
Authors: Nazarko Linda
Published: May 2014

Heart failure is the final stage of all diseases of the heart and is life-limiting. The incidence of heart failure increases with age, and many patients with chronic heart failure are older people. In addition, people with chronic heart failure are four times more likely to suffer cognitive impairment than other adults. This article examines how cognitive impairment affects a patient's ability to work with health professionals, such as healthcare assistants and assistant practitioners. In addition, simple strategies are outlined to enhance quality of life and continuity of care is discussed as an essential aspect of palliative treatment.
Valve disease: diagnosing normal and abnormal heart functioning
Authors: Keenan Jan
Published: May 2014

Heart valves are complex, sophisticated structures. In order for healthcare assistants and assistant practitioners to care for those with valve disease, they must be able to understand the basic physiology of this condition. Valve disease can be a challenge to recognize and manage, but accurate detection, referral and assessment are essential. This article gives an overview of the more common types of valvular heart disease, how they occur, their effects on the body and the symptoms they create. Timely treatment may be key to long-term prognosis, and this article will review the normal and altered physiology associated with valve disease and describe its natural course, diagnosis and treatment.
Reflective practice: the importance of treating patients with dignity
Authors: Grainger Angela
Published: May 2014

Every patient has the fundamental human right to receive high quality care that is safe, effective and respects their privacy and dignity. Therefore, all health professionals have a responsibility to ensure that they uphold patients’ privacy and dignity. This article explores how breaches of dignity and privacy can occur, and how such occurrences can be avoided. Guided reflective practice is used to facilitate further learning and understanding.
Effective management strategies for osteoarthritis
Authors: Walker Jennie
Published: May 2014

Osteoarthritis (OA) is a chronic disease that affects a significant number of people during working life and retirement. The principal symptoms of OA are pain and stiffness and the disease can also reduce movement and the function of the affected joint. In severe OA the ability to engage in work or social activity may be restricted and, as a result, the health-related quality of life of the patient may be affected. There are a variety of approaches that can be implemented to manage symptoms, including the use of orthoses, exercise programmes and, in severe cases, arthroplasty. It is important that emphasis is placed on patient empowerment and shared decision-making with regard to managing symptoms and preserving or improving function of affected joints.
Support workers and the challenges for men's health
Authors: Peate Ian
Published: May 2014

Men's health in the UK is poor. Men die younger than women, often as a result of preventable illnesses. Life expectancy in men is affected by socioeconomic and geographical circumstances. If the inequalities associated with men's health are to be addressed, it is important to understand the reasons why some men may fail to seek help and advice. Healthcare assistants (HCAs) and assistant practitioners (APs) have a role to play as members of the health and social care team to help men seek assistance and prevent unnecessary premature deaths. This article aims to help HCAs and APs understand men's health and become aware of male needs, as well as exploring the issues of cancer and mental health in men.
Stoma care: training in an era of health service cutbacks
Authors: Black Pat
Published: May 2014

Learning and development should be an essential element of a health professional's life. Cutbacks in the NHS are putting greater pressure on healthcare assistants (HCAs) who frequently feel unrecognized for their contribution and do not receive sufficent training. This article will examine a course in stoma care for HCAs that was piloted by Hillingdon and Royal Marsden Hospitals and has recently been launched nationally as an example of how the training needs of HCAs can be met effectively and at no cost to participants or employers.
Body talk: how we communicate before we open our mouths
Authors: Lynall Anna
Published: May 2014

This article explores how we can use our bodies to help us to improve communication with patients and team members. It outlines effective communication tools, including mirroring the body language of others, observing how eyes can indicate particular kinds of thinking and being aware of how we present ourselves.
Providing confident care: a guide for support workers
Authors: Peate Ian
Published: May 2014

Healthcare assistants (HCAs) and assistant practitioners (APs) make key contributions to the provision of high quality care. Through this work they can increase the confidence patients have in the care that is provided. There are, however, instances where patients and relatives feel that the care received has fallen below the expected standard. This article discusses the five ‘confidence creators’ that are central to a positive patient experience.
Maternity focus: documentation and record keeping
Authors: Gregory Irene , Connor Jane
Published: May 2014

Documentation and record keeping are crucial aspects of maternity care. Recording information accurately can be vital to the protection of the health of both mothers and babies. It also enables communication within a multi-disciplinary team to take place effectively. Ultimately, keeping accurate records of care provided, decisions made and coversations held can also protect maternity support workers in the future as they will be able to demonstrate their actions were within guidelines and their remit.
Review
Authors: Ian Peate
Published: May 2014

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The impact of motor neurone disease on daily activity
Authors: Swann Julie I
Published: May 2014

Motor neurone disease (MND) is a term used for a group of related diseases that cause selective and progressive functional loss of the upper and lower motor neurones, which are the motor nerve cells in the brain and spinal cord that control movement. This article, the third and final in the series, discusses the effect of MND on daily life and how support workers can help patients to cope with the practical problems that they encounter.
Common blood tests and the role of support workers
Authors: Peate Ian
Published: May 2014

Support workers are engaged in a wide variety of roles across many different health service settings. Many will be involved in assisting with blood tests, and it is important that they understand blood, the procedures involved and any tests that may result in order to provide safe and effective care. Support workers may also be required to explain the procedure to patients. This article provides insight into a number of common blood tests, describing how they are performed, the reasons why they are undertaken and the normal values associated with a full blood count.
Maternity focus: postnatal classes and effective care
Authors: Kinge Suzanne , Gregory Irene
Published: May 2014

Both antenatal and postnatal parenthood education classes are important for mothers, partners and families, enabling them to make informed choices and understand pregnancy, birth and the postnatal period. Postnatal classes are particularly important in allowing parents to develop enough confidence and the necessary skills to care for themselves and their new baby effectively. This article discusses how maternity care support workers can be involved in the provision of postnatal classes to help mothers prepare for the care of their babies once they have left the care environment.
Early identification of skin problems in older patients
Authors: Jean Watkins
Published: May 2014

Life expectancy is increasing and by 2034 it is estimated that 23% of the population will be over the age of 65 ( Office for National Statistics, 2011 ). A number of changes to the skin occur with increasing age, and many of these changes are accelerated by exposure to ultraviolet light. Many healthcare assistants will work with patients or clients in this age group. As a result, they are well placed to notice changes to the skin, such as dryness, the development of eczema, early signs of bedsores, other ulcerations, malignant skin change or rashes that suggest problems such as underlying disease or a reaction to medication. If such changes are noticed and reported early, discomforts can be reduced and adverse progression prevented.
Gestational diabetes mellitus— why awareness is paramount
Authors: Hayes Catherine
Published: May 2014

Incidence and prevalence of gestational diabetes mellitus (GDM) and impaired glucose tolerance (IGT) in pregnancy have increased significantly in the past 10 years. Evidence indicates that these increases can be categorically linked to parallel increases in the incidence of pre-pregnancy obesity and the diagnosis of Type 2 diabetes mellitus on a national and international level.

This article addresses the potential role of assistant practitioners (APs) and healthcare assistants (HCAs) to further develop their professional role in advocating healthy eating to women who might be pregnant or contemplating pregnancy in the near future. Raising the awareness of GDM and IGT in women who are not currently pregnant, the author suggests, might be one mechanism by which presenting cases could potentially be reduced.

The article discusses the likely long- and short-term prognostic outcomes for both the mother and the neonate during pregnancy, following a diagnosis of either GDM or IGT and the specific needs of this patient cohort both during pregnancy and following parturition, when the statistical likelihood of women progressing to Type 2 diabetes mellitus is significantly greater.

The article concludes with the recognition that APs and HCAs have a unique social opportunity to empower women of childbearing age to be proactive in the management of their reproductive health specifically and their general health and wellbeing overall, in relation to the potential development of GDM and IGT in pregnancy.
Difference in dementia care: a course for MHCSWs
Authors: Lambert Helen , Davies Karyn , Turner Alison
Published: May 2014

This article will describe the development, delivery and evaluation of the pilot of the course, An Introduction to Dementia Care for Mental Healthcare Support Workers, accredited at certificate level with Swansea University. It will allude to lessons learnt and consider next steps in future module delivery.
APs in ‘hospice at home’ and daycare in the northwest
Authors: Smith Joanne , Brown Trish
Published: May 2014

The third article in this series of four will look at the role of the assistant practitioner (AP) in the ‘hospice at home’ and daycare services that are situated in the hospice. There will be consideration of the innovative nature of the ‘hospice at home’ service and an examination of the vision for the AP within the setting. Also, an examination of the importance of daycare, which aims to give more breadth to the provision offered to individuals.

Advance care planning (ACP) will be looked at, as an area that should become of increased importance, as a forming knowledge, helping professionals and others to understand the wishes and choices of individuals.

The importance of caring for those at the end of life and the experiences of carers will also be explored, seen to be of such importance in terms of offering holistic care.

In addition, we have spoken with two APs about what skills escalation has helped them achieve.
Skin and sun awareness and skin cancer prevention
Authors: Andrews Hilary
Published: May 2014

It is vitally important for HCAs and APs to be knowledgeable about skin cancer and its prevention, as it is the most common cancer in the UK at present. This article describes the 3 main types of skin cancer and their prevalence, and explores who is at risk of developing skin cancer. The importance of skin and sun awareness is examined, along with the warning signs of skin cancer. The HCA/AP role in prevention is explored; this includes: skin assessment, encouraging skin awareness in others and giving appropriate advice to ‘at-risk’ individuals or groups. Current sun health promotion messages and useful sources of web-based information for both healthcare professionals and the public are also provided.
Shingles: clinical features, treatment and therapies
Authors: Nazarko Linda
Published: May 2014

Shingles, a viral infection caused by the herpes varicella-zoster virus, affects around 250 000 people in the UK every year. Older people are especially at risk of developing shingles. Around 100 000 of those who develop shingles (40%) have long-term problems with pain and burning post-herpetic neuralgia (PHN) as a result of this infection. This article aims to enable staff to recognize the clinical features of shingles, be aware of current treatments and future preventative therapy.
Overview of law and ethics— violence and aggression
Authors: Yeomans Paul
Published: May 2014

Does the law distinguish patients who behave aggressively in different settings (own home, surgery or health centre, specialist inpatient service)? What about threatening communications by phone, email or text? Heathcare assistants assistant practitioners need to ensure they are aware of violence or threats and have access to training on how to deal with such behaviour.