bluuebunny/crossref_metadata_2025 huggingface dataset:
Presentation skills for nurses: how to prepare more effectively
Authors: Hadfield-Law Lisa
Published: May 2014

Many clinical nurses are changing the way they deliver care for the benefit of their patients. In order to share ideas, knowledge and opinions more widely, nurses need to either speak or write within the public arena. For all nurses, presentation skills are not just useful, they are essential, whether for sharing practice, influencing colleagues or seeking a new job. Such skills can be learnt, building on characteristics most nurses already possess. Effective presentations usually require learning to control nervousness and preparing properly. This article provides a framework for preparation and suggestions for ways to achieve calm and confidence.
Nursing scholarship within the British university system
Authors: Ramcharan Paul , Ashmore Russell , Nicklin Linda , Drew Jenny
Published: May 2014

This article is a review of how a school of nursing and midwifery might promote scholarship within the university system. It is argued that the emphasis on research in universities has undermined the importance of scholarship within education and practice. The difficulties of recognizing scholarly processes as opposed to products such as publications is outlined in relation to three areas of potential scholarship within nurse education, i.e. research, teaching and practice. Issues are raised about how scholarship might be promoted in these three areas in practical terms. It is argued that systems of recognition and reward should be equitably distributed between these wide areas of potential scholarship. This will mean universities accommodating different models of scholarship and nurses recognizing their responsibility to contribute to scholarly activity.
Intravenous care: the benefits of closed-system connectors
Authors: Cheeseman Debbie
Published: May 2014

Following a review of venous access care, a needleless closed-system connector was introduced to Plymouth Hospitals NHS Trust. A cannulation audit and a survey of central catheter care found a wide diversity of practice. The objective was to write a procedure for central line care that could be used by most clinical departments and that could be employed to improve the standard of cannula care. A trust-wide review found that staff appeared unconcerned about the care of cannulae and rarely documented their practice. In addition, general wards had a misguided idea of what central line care involved as a result of their infrequent exposure to them and the inconsistent information given to them by specialist wards. To help unify practice and simplify information a different approach was required. This led to a 12-month, nurse-led project to develop a tender specification for closed-system connectors and a 2-year contract being awarded to Kimal plc for its Clave™ connector.
Iodoflex and Iodosorb in the treatment of venous leg ulcers
Authors: Bianchi Janice
Published: May 2014

This article reviews the use of Iodoflex and Iodosorb in chronic venous leg ulcers. A description of prevalence and quality of life issues is given. Application and method of use of Iodoflex and Iodosorb in venous leg ulcers is then detailed along with relevant clinical evidence. A case study describes the use of Iodoflex in a difficult-to-heal venous leg ulcer.
Supporting family carers in the UK: overview of issues and challenges
Authors: Nolan Mike
Published: May 2014

Support for family carers is currently a policy priority in both health and social care. However, despite the launch of the Carers' National Strategy there is a need for further innovation if services are to be optimally effective. This article identifies a number of issues and challenges for the future if family carers are to receive the type and level of support they need. It highlights the need to think more clearly about the intended outcomes of services supporting carers and about the range and type of interventions that should be provided if such outcomes are to be achieved.
The problems of student supernumerary status
Authors: Castledine George
Published: May 2014

The allocation of nursing students to wards and clinical areas often leads to much debate, confusion and controversy over their supernumerary status. A common complaint from clinical staff is that students are not as willing or as keen as they once were to get involved in aspects of nursing care. Not all students follow this line, but there is growing concern that this may be a factor in the fall in standards of general nursing care.
Challenges faced by TVNs in the UK and abroad
Authors: Gray David
Published: May 2014

Welcome to this issue of the British Journal of Nursing Tissue Viability Supplement. As you would expect of a supplement aimed at nurse specialists in tissue viability, it carries many articles relating directly to the challenges faced by our readers. We are grateful to those of you who take the time to comment on this publication; if you wish to make any points please e-mail me directly on dgray92900@aol.com
National Patient Safety Agency and the reporting of errors
Authors: Dimond Bridgit
Published: May 2014

May, the ward sister of an acute medical ward, was devastated when a young girl suffering from leukaemia died because an injection was given by a junior doctor as an epidural rather than into a vein. May subsequently heard that the same error had occurred several times before in the NHS, with fatal results. In her interview with the investigation team which was set up following the incident she deplored the fact that so many patients should die before the lessons were learnt.
Web Watch
Authors: Redmayne Jon
Published: May 2014

This edition of Web Watch looks at sites relating to critical care nursing. While we have been careful to list only sites that have been recommended by specialists in the field, we re-emphasize our usual warning about evaluating any material you get from the internet in the same way that you would with materials you find anywhere else.
Hearing disability: a source of distress for older people and carers
Authors: Tolson Debbie , Swan Iain , Knussen Christina
Published: May 2014

Many older people develop hearing disability; however, only a small proportion who would benefit from a hearing aid own one. Communication is a shared experience which can be substantially limited by hearing difficulty, so this lack of hearing aid provision is likely to affect both individuals and those around them. This study, a randomized, controlled trial, was designed to examine the influence of hearing aid provision on dependent older people and caring family members who lived together within multigeneration households. A total of 63 intervention families and 70 control group families participated in the trial. We found that hearing disability and handicap are related to reduced wellbeing and depression in older people, and in turn these are related to increased levels of carer distress. Of the 63 older people in the intervention group fitted with hearing aids, all but one was experiencing benefit at 6 months, although no changes in depression were detected. Hearing aids significantly reduced the carer's perception of related difficulties and was a welcomed intervention.
Professional networking using computer-mediated communication
Authors: Washer Peter
Published: May 2014

Traditionally, professionals have networked with others in their field through attending conferences, professional organizations, direct mailing, and via the workplace. Recently, there have been new possibilities to network with other professionals using the internet. This article looks at the possibilities that the internet offers for professional networking, particularly e-mailing lists, newsgroups and membership databases, and compares them against more traditional methods of professional networking. The different types of computer-mediated communication are discussed and their relative merits and disadvantages are examined. The benefits and potential pitfalls of internet professional networking, as it relates to the nursing profession, are examined. Practical advice is offered on how the internet can be used as a means to foster professional networks of academic, clinical or research interests.
Removal of urinary catheters: midnight vs 0600 hours
Authors: Kelleher Michaela MB
Published: May 2014

In the fields of both nursing and medicine there is a dearth of published literature on the optimum time to remove indwelling urinary catheters (IDCs) following urological surgery. Tradition seems to be in favour of removing IDCs at 0600 hours despite a lack of evidence to support this practice. This study was undertaken to determine whether midnight removal of IDCs resulted in patients’ resuming normal voiding patterns. A prospective clinical trial was conducted to determine the impact midnight removal of urinary catheters would have on the patients’ voiding pattern, and subsequent discharge from hospital. One hundred and sixty patients were entered into the study. The patients were allocated at random to have their urinary catheter removed either at midnight or at 0600 hours. Patients who had their catheters removed at midnight passed a greater volume of urine with both their first (268 ml compared with 177 ml; P< 0.0001) and second voids (322 ml compared with 195 ml; P< 0.0001) than their counterparts in the 0600 group. This permitted earlier discharge from hospital. The results reported in this study support the findings of earlier research that midnight removal of IDC leads to an earlier resumption of normal voiding patterns, permits earlier discharge from hospital and appears to reduce patients’ anxiety. The recommendation from this study is that there should be a change in hospital policy so that the majority of IDCs are removed at midnight.
Nurses' perceptions of their role and skills in a medium secure unit
Authors: Baxter Vincent
Published: May 2014

This descriptive study investigated the perceptions — in relation to their own role and skills — of 25 qualified nurses who work in a medium secure unit. Data were collected by means of semistructured interviews and analysed by thematic content analysis. The findings suggest that nurses in this environment had a broad role, and possessed a range of skills and personal qualities. Similarities with colleagues in generic psychiatric settings were identified, but further specialist skills and knowledge were perceived to be required within the medium secure environment. Preregistration training was seen not to prepare nurses for the secure environment; after registration, there was a perceived lack of structure. Various factors were believed to affect the nursing role, which was also perceived as being complementary to that of other disciplines. Nurses were viewed as making a unique contribution to the multidisciplinary team. The provision of a therapeutic and secure environment was perceived to present a challenge.
Nurses’ education and skills in bandaging the lower limb
Authors: Penn Elaine
Published: May 2014

Given that community nurses are the primary professional carers or patients presenting with leg ulcers, this article considers and argues for nurses to be educated once more in the precise skills of bandaging the lower limb. Although in the early part of the 20th century bandaging techniques were precisely taught as part of basic nurse education, modern nursing texts and curriculum fail to give the subject the attention it deserves to ensure patients receive high-quality care.
Nutritional care: implications and recommendations for nursing
Authors: Grieve Robert John , Finnie Alison
Published: May 2014

Nutrition is a basic human requirement with both physiological and psychosocial dimensions that affect wellbeing. In times of illness ensuring adequate nutrition is particularly important because of the central part it plays in healing and recovery. This article explores the premise that current nutritional care in nursing practice is often inadequate with the result that patients' nutritional requirements are not met. It investigates the causative factors of poor nutritional care in nursing practice, the implications of such practice for both the patient and the professional, and proposes a number of recommendations for future change.
The ACCESS model: a transcultural nursing practice framework
Authors: Narayanasamy Aru
Published: May 2014

Britain is regarded as a multiethnic and multicultural society with about 3 million people (6% of the population) belonging to black and other minority ethnic groups (Le Var, 1998). These figures are based on the 1991 census; however, new figures are imminent following the results of the 2001 population census. It is clear that within this society, healthcare providers need to not only respond to the cultural and ethnic diversity but also deliver a culturally appropriate and sensitive service based on fairness and justice.
Development of nurse specialists/advanced practitioners in Ireland
Authors: Wickham Sheelagh
Published: May 2014

An Bord Altranais (Irish Nursing Board) published ‘Report of the Commission on Nursing: A Blueprint for the Future’ in 1998. This report was the result of collaborative work among those involved in nursing in Ireland. It recommended the establishment of clinical career pathways, which would allow a nurse with extensive experience and advanced expertise, as well as an appropriate course, to be recognized as a clinical nurse specialist. Further advancement along this pathway could possibly enable the nurse to progress to an advanced practitioner grade. The report acknowledged that there are ‘various and differing interpretations’ of the title ‘practitioner’. This article explores the growth and development of the roles of the clinical nurse specialist and advanced nurse practitioner in Ireland over the past number of years. The literature reflects elements of confusion that exist in some areas about the role of a clinical nurse specialist and an advanced nurse practitioner. The ‘Review of the Scope of Nursing and Midwifery Practice’ (An Bord Altranais, 2000) recognized a lack of clear differentiation between the role of the clinical nurse specialist and the advanced nurse practitioner. Overall, some clear roles are identified for the nurse who advances or wishes to advance along clinical career pathways in nursing. However, there still appears to be a certain degree of confusion about the use of titles such as ‘nurse specialist’ and/or ‘nurse practitioner’. The guidelines about the level of practice and education/training required for the nurse moving along the pathways of clinical nurse specialism and/or advanced nursing practice is somewhat obscure and is interpreted in different ways in the literature.
Role of a paediatric nurse in primary care 2: research findings
Authors: Drew Jenny , Nathan Dilip , Hall David
Published: May 2014

This article is the second of a two-part article that presents the findings of a study focusing on the role and function of two qualified children's nurses, each working within a different primary healthcare team (PHCT). The first part described the variation in settings for community paediatric nurses, the paucity of literature discussing the role of a paediatric nurse working as a member of a PHCT, the application of a research methodology that incorporated practitioner values and experience, the application of naturalistic inquiry and the use of a formative evaluation strategy which enabled the researcher to be involved in directing and supporting the research nurses with the data collection (Vol 11(22): 1452–60). This second part focuses on the findings and discussions where it was demonstrated that qualified children's nurses working in community setting contributes to raising the overall support and quality of care for a whole range of conditions currently perceived as low profile. There was evidence that these nurses catered for unmet need and were, at times, functioning as nurse practitioners and on occasions as advanced practitioners. These findings may contribute as a catalyst for change in informing the development of children's nursing services as part of the Children's National Service Framework.
Reflecting on the nursing contribution to vascular access
Authors: Jackson Andrew
Published: May 2014

Intravenous (IV) therapy and care has become indispensable in today's modern healthcare environment. However, in a striking reversal of fortune, it has been suggested that the provision of IV services is often taken for granted and underpinned by routine and habit (Lundgren and Ek, 1996; Creamer, 2000). In an attempt to promote reflection within the profession, this article asks key questions about ownership and responsibility, level of ability, appropriateness of device selection, documentation and evaluation of IV care.
Research cautions against an all-graduate nursing profession
Authors: Scott Helen
Published: May 2014

Research comparing the careers, competencies and continuing professional development of nurses qualifying from degree and diploma courses has concluded that nursing should not at present increase the number of nursing degree programmes available and that caution should be exercised in relation to moving nursing towards becoming an all-graduate profession (Robinson et al, 2003).
A history of insulin: from discovery to modern alternatives
Authors: M King Kathryn
Published: May 2014

Following on from the first article in this series (Vol 12(18): 1091–5), which described the history of diabetes, this article, the second of three literature reviews, explores the early production and development of insulin, from its initial production in a university laboratory to becoming a major pharmaceutical product. Also discussed are the various forms of insulin developed over the last 80 years and their means of delivery to the patient. The future is considered and the development of insulin analogues (substances that mimic the effect of human insulin) is described. The article also looks at the introduction of DAFNE (dose adjustment for normal eating) — an intensive programme of education aimed at teaching individuals the necessary skills to adjust their own insulin injection dosage to reflect their individual eating patterns.
Benefits/problems of enhancing students' intercultural competence
Authors: Koskinen Liisa , Tossavainen Kerttu
Published: May 2014

Nursing has responded to the challenges of multicultural society by integrating student exchange programmes into nursing education since the 1990s. For students, these programmes provide opportunities to study in another EU member state and to develop intercultural competence as part of the training. The aim of this study was to describe the process of gaining intercultural competence among British undergraduate nursing students during their study abroad in Finland. Fifteen British students participated in this study. Data were obtained from interviews, observations, background questionnaires and research diary notes. The data were analysed with Spradley's developmental research sequence (DRS) method. Campinha-Bacote's model of cultural competence was used as a framework of rendering the results. Students' intercultural desire, i.e. their effort to become interculturally competent, turned out to be the foundation of the entire process. Study abroad is an intensive experience, and therefore the preparation, the selection of exchange students, the design of the programme and intercultural tutoring warrant careful attention.
Fungating wounds: informing practice through knowledge/theory
Authors: Laverty Diane
Published: May 2014

The assessment and management of fungating wounds is a challenging situation which necessitates nurses using many skills. Literature is limited, especially relating to the psychological issues that arise for the patient and his/her family. As nurses, we must begin to address this by considering how our philosophy, knowledge and theory impact on and inform our practice. This article will critique and explore the different influences that affect our way of being and thinking in the world and how we can guide practice by using our fundamental skills of caring.
Nursing management of stress urinary incontinence in women
Authors: Haslam Jeanette
Published: May 2014

Although urinary incontinence is not a subject spoken about in general conversation, it is a cause of concern for many people. Stress urinary incontinence is common, being reported by 16.8% of women (Hunskaar et al, 2002). In the past, women with stress urinary incontinence were often dismissed as having an inevitable problem resulting from childbirth and the hormonal changes associated with ageing. They were often made to feel that they just had to put up with the problem — this is no longer the case. Conservative therapy is advocated as the primary intervention for those suffering with stress urinary incontinence and nurses are ideally placed to be a source of information and help. Furthermore, nurses can develop their skills in order to encompass therapies to become more specialist and effective. In 2000, the Department of Health (DoH) issued guidance on establishing integrated continence services (DoH, 2000). This becomes mandatory for older people from April 2004 (DoH, 2001a).
The challenge and management of phantom limb pain after amputation
Authors: Siddle Lynn
Published: May 2014

Phantom limb pain (PLP) is thought to occur in most amputees. This common clinical phenomenon often provides a challenge to those involved in the treatment and management of pain, since the causes of PLP are often misunderstood. This article will look at some of the theories of PLP which will highlight why normal analgesic drugs are often not effective. The article will then consider pain management strategies used in PLP in the ward setting. These pain management strategies include the use of drugs not traditionally known as analgesics, but which are usually used in the treatment of epilepsy and depression.
The patient's perspective of the nurses' caring role
Authors: Fullbrook Suzanne
Published: May 2014

In an article published in The Sunday Times, Julia Magnet wrote: ‘What was profoundly wrong in my hospital was that nursing in its most basic sense — care — was almost entirely absent’ (Manget, 2003).
The coroner's jurisdiction 2: the current law in the UK
Authors: Dimond Bridgit
Published: May 2014

Ivy Smith was admitted to the accident and emergency (A&E) department following an overdose. The A&E staff attempted to ‘pump’ her out, but she died despite their efforts. The coroner was informed. Ivy's mother said that she did not feel that she could give evidence at an inquest and wondered if she could be excused. What is the law?
Preventing hip fractures in care homes 1: views of residents and staff
Authors: Doherty Donna , Glover Jean , Davies Sue , Johnson Tracy
Published: May 2014

Hip protectors have been shown to be effective in reducing the incidence of hip fracture among older people living in care homes (Parker et al, 2004). However, there are problems with compliance. This article reports findings from a survey of 138 staff from 23 care homes about experiences and perceptions of using hip protectors. The survey was complemented by qualitative case studies involving staff, residents and relatives in seven homes. Findings suggest a number of factors likely to be linked to compliance with wearing hip protectors including comfort, acceptability to the resident and appearance. Few practical difficulties in using hip protectors were identified. Staff and residents' perceptions and experiences of using hip protectors vary and are likely to influence compliance.
The importance of the nurse-patient relationship
Authors: Castledine George
Published: May 2014

The quality of the nurse–patient relationship is under threat from the more technical skills the nurse is having to carry out. The relationship has always been regarded as the ‘essential’ aspect of nursing, but is now being ignored in the race to get patients through the system. With the introduction of mobile operating rooms and ‘quick fix’ surgeries, there is a danger that patients will be treated more inhumanely than ever before.
Accountability and medicinal products 3: employment
Authors: Dimond Bridgit
Published: May 2014

Mohammed had been trained in a previous post as an independent nurse prescriber. He wished to continue to use those skills in his new post as a clinical nurse specialist. He was notified by the trust that it was not its policy to introduce independent nurse prescribing. Can he lawfully refuse to obey these instructions?.
Hydrocapillary dressing to manage exudate in venous leg ulcers
Authors: Karlsmark Tonny , Hahn Tina W , Thomsen Jan K , Gottrup Finn
Published: May 2014

This study evaluated the safety and clinical performance of Alione hydrocapillary adhesive dressing, Coloplast A/S, a newly developed moist wound healing dressing designed for exudate management of heavily to lightly exuding ulcers. Twelve patients with heavily to moderately exuding chronic venous leg ulcers were assessed during a 4-week observation period. Assessments included healing progress, pain, odour, peri-ulcer skin condition, ease of use, patient comfort and suitability of the dressing for managing exudate. The median ulcer area was reduced by 71% (P<0.05) and the wound bed tissue improved markedly. No leakages of exudate were reported and the overall impression of the dressing was good. The amount of exudate produced correlated well with the level of exudate assessed subjectively (P<0.05). Pain and odour were reduced effectively. No dressing-related adverse events were observed. This study has demonstrated that Alione is safe and easy to use, and exhibits convincing clinical performance and exudate-handling properties in the treatment of chronic venous leg ulcers.
Beyond Zero Tolerance: a varied approach to workplace violence
Authors: Patterson Brodie , Leadbetter David , Miller Gail
Published: May 2014

Violence in the health- and social-care workplace remains unexplored, with a knowledge base which is often ambiguous or incomplete. However, the issue has attracted increasing attention over the last two decades as indicated by an expanding range of policy initiatives and growing research literature. Additionally, a proliferation of training programmes for healthcare staff has appeared. This paper will explore the reasons for an observed tendency for interventions to focus on training as the primary response, which suggests a misperception of the problem of violence as principally a function of interpersonal conflict. It argues that a radical cultural shift is needed, which recognises the organizational and societal roots of violence, and that adopts and applies the principles of a public health approach.
Supplementary prescribing for nurses
Authors: Hall Jason
Published: May 2014

The three classifications of nurses that can prescribe are community nurses, extended nurse prescribers and supplementary prescribers. Supplementary prescribers can prescribe almost any medicine provided it has been specified in the clinical management plan. Supplementary prescribing is likely to benefit those patients with uncomplicated chronic conditions and is open to all registered nurses who have completed the appropriate training. Both nurses and their managers should be aware of potential pressures on clinical decision-making and appropriate support and encouragement should be provided.
Patient safety must be an absolute priority for the NHS
Authors: Tingle John
Published: May 2014

The safety of patients in the NHS is a key issue for all those who work in the health service. To make the NHS safer and to advance the quality of health care the Government has carried out a number of initiatives which include the creation of the National Patient Safety Agency (NPSA), the Healthcare Commission and the concept of clinical governance, to name but a few. These are all essential drivers of quality and safety in the NHS.
Dual diagnosis: co-existence of drug, alcohol and mental health problems
Authors: Manley David
Published: May 2014

The Department of Health (DoH) published a set of good practice implementation guidelines on dual diagnosis in May 2002. This guidance suggests that in order to improve the prognosis for clients who have mental health problems and who drink or take drugs problematically, mental health and substance misuse services should adopt an integrated service model. There is a considerable amount of American-based research supporting this approach, but little evidence from the UK researchers demonstrating its application in the UK. This article offers an example of a service that has been developed in the city of Nottingham and argues that this client group will be served most effectively if mental health services support specialist dual-diagnosis resources. Integrated care pathways for this client group can be developed and led by specialist clinicians acting as consultants to mental health services (DoH, 2002a). This consultancy role within mental health services enhances the links needed between substance misuse and mental health services. As a result, specialist dual-diagnosis teams are best placed to increase positive prognoses for clients by ensuring evidence-based substance misuse skills are utilized and adapted by mental health teams to ensure fully integrated care coordination.
Genetics knowledge for nurses: necessity or luxury?
Authors: Pfeil Michael , Chi-Meih Luo
Published: May 2014

Senior nurses within frontline NHS Trusts in East Anglia were consulted about their perceptions of the genetics-related knowledge and education required by nurses working in their Trusts. They disagreed with policy decision makers, i.e. the Government and genetics specialists, on the currently necessary knowledge levels. They also did not recognize genetics as an important issue in current everyday nursing activities. The difference in perception also related to the speed with which its presence and importance will increase. Nurses already working under considerable pressure while not perceiving the importance of genetics in everyday practice cannot be expected to willingly absorb new genetics-related knowledge. The National Genetics Education and Development Centre in Birmingham will have to reach out to practitioners and managers throughout the UK and establish a shared platform from which to develop this issue in the future.
Nelson's Touch: Knowledge + Action = Power
Authors: Aylott Marion
Published: May 2014

We have brought back matron!' insisted Dr John Read (former Minister for Health) in a television interview as if ‘Matron’ was some kind of magical cure for all NHS ills. Did he really think this? Is matron really now at-large patrolling the wards?
Giving information on compression to patients with venous leg ulcers
Authors: Goode Mary Louise
Published: May 2014

Venous leg ulceration is a common condition that is more likely to affect the elderly (Alexander House Group, 1992; Coupe and Walukiewicz, 2000) and often has a psychological, as well as physical, impact on the individual (Charles, 1995). Many of those affected are cared for within the community (Maylor, 2002) and may become isolated because of the difficulties caused by their condition (Charles, 1995). Compression bandaging therapy has been shown as an effective treatment for venous leg ulcers (Loftus and Wheatley, 2000) but the bandages must be worn continually during treatment and therefore need to be socially and psychologically acceptable if the patient is to be happy with the treatment regimen (Pudner, 1998). Nurses need to be competent in the care of leg ulcers so that pain and discomfort are minimized and patients need to be willing to accept the treatment given.
Causes and prevention of carotid artery rupture
Authors: Frawley Theresa , Begley Cecily M
Published: May 2014

Rupture of the carotid arteries, which provide blood supply to the head and neck, results in massive haemorrhage leading to death within a matter of minutes in 33% of cases. Those who survive are frequently left handicapped. Patients with head and neck cancer who are over 50years of age with excessive weight loss and reduced haemoglobin, have a greater risk of carotid artery damage leading to rupture, as have those with existing nutritional deficiencies, cardiovascular or renal disease, or endocrine disorders. Prevention includes improving the nutritional status, preventing infection and constipation, promoting healing and using safe suctioning. The signs of impending rupture are few and include: retro-sternal or high epigastric pain, pulsation of the wound, ballooning of the artery and, occasionally, a small ‘herald’ bleed. Nurses need to be aware of ‘at risk’ patients, and the warning signs. All ear, nose and throat wards should document an evidence-based protocol for the management of carotid artery rupture.
Rapid recovery following cardiac surgery: a nursing perspective
Authors: Naughton Corina , Cheek Lisa , O'Hara Kim
Published: May 2014

Fast-track or rapid-recovery pathways following cardiac surgery are becoming common practice in many cardiac units in order to maximize use of scarce critical care resources. Within the UK, rapid recovery generally describes same-day discharge from the initial intensive care facility to a lower-dependency unit. There are no nationally agreed protocols to help guide this practice. In a London teaching hospital a nurse-led audit was undertaken to identify which patients were selected for rapid recovery and to evaluate safety (length of hospital stay and incidences of postoperative complications) compared to a conventional recovery pathway. The study also sought to gain insight into the patients' views on rapid recovery. Data were collected on 104 patients, all patients (n=56) who followed a rapid-recovery pathway were included. A comparison group (n=48) was selected from patients who followed a conventional recovery but who were eligible for rapid recovery. The primary outcome, median length of hospital stay was 6 days for both groups, but the rapid-recovery group experienced significantly less postoperative complications. Rapid recovery as currently practised on this unit is safe for carefully selected cardiac surgical patients but barriers to rapid recovery need to be explored.
Effects of music-based therapy on distress following knee arthroplasty
Authors: Giaquinto Salvatore , Minasi Susanna , Sostero Elena , Amanda Suor , Cacciato Angelo
Published: May 2014

Anxiety and depression are frequent after total knee arthroplasty (TKA). Musical intervention can benefit many, including severe patients (agitated older people with dementia and terminal-ill patients) and surgical cases. This pilot study was aimed at verifying whether music therapy is beneficial after TKA. Reducing anxiety and depression is has a positive effect for the wellbeing of patients and is likely to have positive effects on outcome. In their pilot study, the authors found that a positive and specific effect of singing on depression was seen and that music therapy may be recommended after TKA instead of a pharmacological intervention.
Fraud and the role of the NHS nurse
Authors: Castledine George
Published: May 2014

Fraud is defined as criminal deception, which is deceitfulness or the use of false representations to gain unjust advantage. There are so many tricks or shams which fall into the category of fraud that it has become a major problem not only in society but also within the NHS.
Managing pain after shingles: a nursing perspective
Authors: Hawksley Heather
Published: May 2014

Post-herpetic neuralgia (PHN) is the neuropathic pain syndrome that may develop following an attack of shingles. While for many the symptoms subside, there can be long-term pain problems for up to 40% of those affected with PHN, and for 3% of these, symptoms can be severe (Dworkin and Portenoy, 1996). Knowledge and understanding of the symptoms and various treatments and approaches available is important to enable nurses and patients to work together in partnership to achieve the best outcomes. Realizing that more than one approach may be needed can allow for treatments which are complementary and for optimization of both biomedical and self-care approaches.
Ayurvedic medicine: an introduction for nurses
Authors: Narayanasamy Aru , Narayanasamy Mani
Published: May 2014

Ayurvedic medicine is an ancient Indian form of healing. It is gaining popularity as part of the growing interest in New Age spirituality and in complementary and alternative medicine (CAM). In this article the principles and practices of Ayurvedic medicine are outlined. In doing so, the safety of ayurvedic medicine is explored in the context of evidence-based practice and the implications of Ayurvedic medicine for nursing are discussed. It is concluded that an awareness of Ayurvedic medicine may help nurses to be cognisant of its benefits and potential complications if it is used with conventional medicine. Although the therapeutic value of ayurvedic treatment is yet to be fully established through randomized control trials, its potential in terms of health promotion, nutrition and spirituality are acknowledged in the emerging literature.
Nursing management of the patient with Alzheimer's disease
Authors: Nair Muralitharan
Published: May 2014

Alzheimer's disease (AD) is a progresive, degenerative, debilitating illness that affects all races and both sexes. In 2002 the numbers of women over the age of 90 years with AD were higher compared with men of the same age group (Office for National Statistics (ONS), 2004). Although there are no data identifying the number of women suffering from AD compared with men, it could be concluded from these data (ONS, 2004) that more women than men suffer from AD. The number of individuals suffering from AD is increasing as peopleare living longer. Analysis of postmortem brain tissue in patients with AD has identified senile plaques in the hippocampal region, neurofibrillary tangles in the brain cells and also a decline in levels of acetylcholine in the brain. There is no known cure for the illness and therefore patients will ultimately require constant care in the community or in special units in residential homes. The National Service Framework for Long-Term Conditions (Department of Health, 2005) gives clear guidelines for healthcare providers in caring for these patients.
Congenital cardiac malformations in relation to central venous access
Authors: Thompson Christine
Published: May 2014

During the third and seventh weeks of gestation, teratogenic exposure may lead to fetal abnormality such as congenital heart defects or intrauterine death. Congenital heart defects are present from birth, but may appear at any time, or only revealed postmortem. Often defects are present by degree. Some defects are life-threatening, while other, less severe conditions, may have minimal physiological impact. Left superior vena cava exists in early embryonic development, but the vessel degenerates as the cardiovascular system matures. When not associated with other malformations, an incidence of persistent left-sided superior vena cava (PLSVC) has no clinical signs or symptoms. However, it may not be as innocuous as it appears due to its association with the cyanotic defect, tetralogy of Fallot (TOF). Using a case history as an illustration it can be shown that all cases of defect or chromosomal suspicion should be documented as there may be implications for future interventions.
Pain management of older people in care homes: a pilot study
Authors: Schofield Patricia
Published: May 2014

This article presents the findings of a pilot study conducted within six care homes within a district of the UK. This is stage one of a programme of funded research designed to explore issues surrounding pain and older people living in care homes. The aim of the study was to determine the residents' perceptions of pain and identify their preferred pain management strategies. Staff working in the care homes were interviewed to identify their level of pain knowledge, and the problems perceived by them, as preventing their role in the management of pain within this group. A number of important issues were identified as barriers to reporting pain among the residents, along with important concerns for staff about communication and education. A serendipitous finding demonstrated some age-related differences in perceptions of pain. Recommendations are made for further research in this area.
Addressing the needs of an ethnic minority diabetic population
Authors: Davies Karen
Published: May 2014

Even if ethnic minority populations in our health community are small in numbers, it is important to identify factors that may affect the quality of the healthcare encounter, such as linguistic needs and health beliefs. Despite increased prevalence and morbidity of diabetes in certain ethnic minority groups, inequalities in health may exist and can be multifactorial in nature. This article looks at the importance of cultural sensitivity, so health professionals can articulate difference, show respect and understand health-related beliefs and values. Individual assessment means that health information can be given that values diversity and is specific to an individual. This article uses social and psychological theory to offer explanations as to how prejudice occurs, and looks at the start of a journey for a diabetes team that cares for a small ethnic minority population.
Caring for the diabetic patient with a foot ulcer
Authors: Hampton Sylvie
Published: May 2014

Neuropathy is the most common complication of diabetes. Those patients with diabetic foot ulceration on the plantar, medial and lateral surfaces of the foot will almost all have clinically significant peripheral neuropathy. The diabetic ulcer is a significant healthcare problem and inadequate or improper therapy may lead to amputation. Therefore, an understanding of foot pathology associated with diabetes is essential for anyone who will be caring for diabetic patients. Equally important is an understanding of how to prevent these life-threatening wounds and at least a basic knowledge of wound healing in hard-to-heal foot ulceration. This article provides a basic understanding of the pathology and describes preventative techniques.
Emergency defence nursing, skills and development
Authors: Harper Phil
Published: May 2014

Welcome to this edition of the Defence Nursing focus in the British Journal of Nursing. The aim of the focus is to share with the wider nursing profession different aspects of the roles undertaken by defence nurses. This current edition focuses on some specific nursing roles and responsibilities when deployed overseas, particularly relating to emergency nursing
Group clinical supervision for mental health nursing students
Authors: Clibbens Nicola , Ashmore Russell , Carver Neil
Published: May 2014

Clinical supervision is recognized as important for developing safe professional practice in nursing. Although attention has been given to the development of training and education in clinical supervision for registered nurses, less discussion exists regarding these issues for pre-registration nursing students. This article outlines an initiative developed at the University of Sheffield to introduce pre-registration mental health nursing students to the theory and practice of group clinical supervision. In particular, this article raises awareness and promotes discussion of the practical issues involved in such an initiative.
Factors contributing to incidents in medicine administration. Part 2
Authors: Mary Fry Margaret , Dacey Caroline
Published: May 2014

The lack of empirical research on nurses’ views of the factors contributing to medication errors, and particularly of studies conducted in the UK, formed the starting point for this study. Part 2 of this two-part article aims to inform the wider nursing population about the views of nurses working in the medicine directorate of a large London teaching hospital, and to explore the reporting of medication incidents and the effect of this on the practice of the nurses involved. Quantitative results of a self-administered questionnaire indicated that this group of nurses felt that the most important factors contributing to medication incidents were interruptions by patients and relatives/visitors and telephone calls during the process of administration. Suggested ways of reducing errors were ‘protected’ medicine rounds, unique or distinct packaging of medications and regular revision sessions on mathematical calculations. These nurses’ views confirmed that factors identified in the literature as contributing to medication incidents were problematic for them too. Simple changes to practice could help to reduce the number of such incidents.
Compassionate metrics: an oxymoron in practice
Authors: Bailey Asa
Published: May 2014

As we approach the 60th anniversary of the NHS on July 5, the Government have been feverishly brainstorming back at Department of Health HQ to produce a slew of fresh initiatives to ensure the stability of the service into the 21st century. One such initiative that has just been unveiled, and has caught the attention of the media yet again, is to rate nurses on how compassionate and ‘smiley’ they are. If only the same could be done with politicians.
From Council to the coffee room
Authors: Karstadt Lyn
Published: May 2014

Nursing and midwifery education has evolved over the past few decades, making many in the profession — as well as education 2014 slightly confused as to what is going on. In this first of a brand new column, Lyn Karstadt looks to shed light on the issues affecting nursing educators, from her perspective as an Executive Member of the Council of Deans.
The psychological impact of aggression on nursing staff
Authors: Bonner Gwen , McLaughlin Sue
Published: May 2014

Aggression and violence towards nursing staff in UK health care is a growing problem. While the National Institute for Health and Clinical Excellence’s (NICE, 2005a) guidelines ‘The Short-Term Management of Disturbed/Violent Behaviour in In-Patient Psychiatric Setting and Emergency Department’ offer a way forward in managing aggression for healthcare staff, the psychological impact of aggression remains an area of concern. Post-incident review has been identified as an approach to considering untoward incidents of aggression, yet post-incident support and interventions for staff experiencing the psychological effects of aggression remain inconsistent and curtailed in many areas. This article discusses the care of a nurse who experienced post-traumatic stress disorder as a result of aggression in the workplace. The process of assessment and treatment is presented with underpinning theories of trauma used to illuminate the discussion. Practical use of current recommended treatments of cognitive behavioural therapy and eye movement desensitization and reprocessing is offered as a method of addressing a growing problem in UK health care.
Rectal irrigation in the management of functional bowel disorders: a review
Authors: MaryTod Angela , Strainger Elaine , Levery\ Carol , Dean Jill , Brown Jayne
Published: May 2014

Faecal incontinence and constipation are examples of functional bowel disorders that can lead to distressing psychological and physical symptoms which seriously impact upon quality of life. Rectal irrigation has been introduced as a treatment option for such patients. This article critically reviews and evaluates the current evidence on the effectiveness of rectal irrigation as a management option for functional bowel disorders. The review was conducted using BIOSIS, AHMED, CINAHL, MEDLINE, and Web of Knowledge. From 1051 articles identified through the literacy search, only nine were specifically concerned with the evaluation of rectal irrigation as a treatment option for functional bowel disorders. The results of the literature review do indicate that rectal irrigation could be a successful treatment option for some people, however, variations between studies and methodological limitations mean evidence of the effectiveness of rectal irrigation is lacking.