bluuebunny/crossref_metadata_2025 huggingface dataset:
Evaluation of two coated catheters in intermittent self-catheterization
Authors: Pascoe Gill , Clovis Sharon
Published: May 2014

Intermittent self-catheterization (ISC) has addressed the problems of mechanical or functional urological voiding since the 1970s. Patient quality of life is enhanced by the increased independence and security offered by ISC (Lapides et al, 1972). A randomized, comparative crossover study was undertaken in two centres to evaluate the performance of SpeediCath (Coloplast) and Lofric (Astra Tech) catheters. A total of 27 subjects were recruited, all of whom had been performing ISC more than twice a day for longer than 3 months with a coated catheter. Each catheter was used for 1 week to assess catheter performance and acceptability. There were no significant differences recorded for the performance of each catheter. However, SpeediCath demonstrated favourable statistical significance in relation to ease of use, speed of use, and the concept of water as an integral part of the packaging of the catheter.
Is smoking a cause of erectile dysfunction? A literature review
Authors: Dorey Grace
Published: May 2014

Erectile dysfunction is common, and its prevalence increases with age owing to age-related diseases of vascular, hormonal, neurogenic and psychogenic factors. A literature review was undertaken to explore the impact of smoking on erectile dysfunction. The literature review of 18 studies revealed the detrimental effect of smoking on erectile function. Smokers were 1.5 times more likely to suffer erectile dysfunction than non-smokers. Men may be unaware of the effect of tobacco on erectile function. This literature review presents strong reasons for stopping smoking, and highlights the need for education within a comprehensive smoking cessation programme. All men should be offered smoking cessation treatment which includes nicotine replacement therapy and continued support. Randomized controlled trials are needed to explore the effect of smoking and smoking cessation on erectile dysfunction.
3M Cavilon Durable Barrier Cream in skin problem management
Authors: Williams Clare
Published: May 2014

Maintaining healthy intact skin is an important issue for many healthcare professions. Elderly patients are at particular risk from damage by moisture and mechanical forces such as pressure, friction and shear because of age-related skin changes. This product focus looks at the skin and describes the changes that occur in the older person. It also describes the second product in the 3M Health Care skin care range, Cavilon Durable Barrier Cream. This product follows on from and complements the success of Cavilon No Sting Barrier Film.
Clinical efficacy of C-View transparent film wound dressing
Authors: Morris Louise
Published: May 2014

This article discusses the use of transparent film dressings in wound management. It focuses on one particular product, C-View (Maersk Medical), determining its efficacy through multiple case study review. C-View was found to be easy to use and cost-effective, both as a primary and secondary wound dressing.
Using a new foam dressing in the care of fungating wounds
Authors: Naylor Wayne
Published: May 2014

Fungating wounds may present with a number of unpleasant symptoms such as malodour, high levels of exudate and pain. The cosmetic appearance of the wound, along with these associated symptoms, can be a significant cause of distress to patients. As a result of the fact that fungating wounds rarely heal, their management is based on symptom control, promoting comfort and maintaining or improving the patient’s quality of life. The treatment of these wounds is generally palliative in nature and often involves the use of dressings or other topical products to control symptoms. This case study details the use of a new hydropolymer foam dressing (Tielle Plus) in the management of a large fungating breast wound. The dressing was clinically and cost-effective, nursing staff found it easy to use, and the patient found it very comfortable and less noticeable under her clothing.
The use of a hydrofibre dressing in fulminating necrotizing fasciitis
Authors: Foster Lorraine , Smith Elaine , Moore Peter , Turton Phillip
Published: May 2014

This article describes a case of necrotizing fasciitis in a 52-year-old man with previously undiagnosed diabetes. Treatment involved massive debridement and subsequent dressing of the open surgical wound. A modern hydrofibre dressing (Aquacel) was inserted intraoperatively and subsequently continued postoperatively. Wound healing occurred over 3 months and the patient was discharged with no disability. The dressing managed the exudate level and kept the wound moist. It also was well tolerated by the patient, was comfortable and easy for the nurses to remove and apply.
The role of a clinical doctorate in the advancement of practice
Authors: Fairbairn Gavin
Published: May 2014

A professor of obstetrics and gynaecology once chose at random (at least he said it was at random) three publications from my curriculum vitae and asked, in all seriousness: ‘Which of these is the real you?’. I was being interviewed at the time. The three publications were a diverse bunch. All were books — the first was about ethical issues in the sexuality of people with learning difficulties, the second concerned the language and ethics of suicide, and the third was a textbook about reading, writing and reasoning as a student.
Evaluating Snoezelen for relaxation within chronic pain management
Authors: Schofield Pat
Published: May 2014

This experimental study investigated the use of Snoezelen — a sensory environment purported to produce relaxation — against traditional relaxation within the pain clinic setting. The variables measured included pain, anxiety, depression, coping, self-efficacy and disability. Assessments were carried out at three time intervals on a range of symptoms designed to reflect the multidimensional nature of the chronic pain experience, including pain intensity and quality, anxiety, depression, coping, confidence and quality of life. The experimental group experienced significant reductions in pain (sensory score P = 0.002, pain rating index P = 0.002), and an improvement in self-efficacy (P = 0.02) and sickness impact for the following scales: physical (P = 0.009), psychosocial (P = 0.009), recreation (P = 0.001), sleep (P = 0.001) and sickness impact total (P = 0.001). The control group experienced significant improvements in sickness impact scales of psychosocial (P = 0.05), sleep (P = 0.01) and sickness impact total (P = 0.004). The findings suggest that Snoezelen environments are as effective as, if not slightly better than, teaching relaxation within the traditional pain clinic environment for this group of patients.
Can alcohol hand rubs increase compliance with hand hygiene?
Authors: Bissett Linda
Published: May 2014

A review of the literature indicates that alcohol hand rubs reduce microbial load, are less irritant to the skin of healthcare workers, and are more easily accessible than conventional methods of hand hygiene. The review also indicates that using alcohol hand rub increases compliance to hand hygiene guideline rates by 25%. This study examines whether making alcohol hand rubs readily available to healthcare workers will increase and maintain compliance with hand hygiene protocols and guidelines, thereby reducing nosocomial infection, or whether the methods of staff education on the use and benefits of products and other interventions need to be examined.
Culture of care in care homes in need of further research
Authors: Davies Sue , Nolan Mike
Published: May 2014

The Care Standards Bill introduced a range of minimum standards which care homes proprietors and managers must achieve from April 2002 (Department of Health (DoH), 2000). These include standards in relation to health and personal care, the physical environment of care, staff training, and management. This initiative has been broadly welcomed by professional and service user groups.
Management of people with diabetes during Ramadan
Authors: Pinar Rukiye
Published: May 2014

In the UK, Islam is the second largest religion after Christianity and there are about 2.5 million Muslims living in the UK. Fasting is obligatory for all healthy adult Muslims during the holy month of Ramadan. During Ramadan, no food, drink, or medication is allowed between dawn and sunset. As a result of different research results there is no agreement on whether it is safe for Muslim diabetics to fast. Through dialogue between health professionals and patients, it is usually possible to facilitate at least some safe fasting for those who wish to observe this annual ritual. In this article some key pointers will be given for health professionals to consider with the aim of improving the quality of care of Muslim patients with diabetes during Ramadan.
Role of a paediatric nurse in primary care 1: research issues
Authors: Drew Jenny , Nathan Dilip , Hall David
Published: May 2014

This study which looked at the potential for the role of a paediatric nurse in primary care, was a tripartite partnership arrangement with Community Health Sheffield NHS Trust, The University of Sheffield and The Children's Hospital Sheffield. The study focused on the role and function of two qualified children's nurses each working within a different primary healthcare team (PHCT). It was important to allow the role to evolve without undue pressure, so that members of the PHCT could work with the nurses to establish what would be the most useful and relevant tasks to be carried out by them. The methodological problems posed in this type of study where little was known about how a children's nurse would work in a PHCT resulted in exploring the concept of a formative evaluation process. The major data source and contribution to the evaluation were the nurses' reflective accounts of their role and function as members of the PHCT. Case studies written in the form of reflective diaries provided a self-critical approach to the record of tasks undertaken and explained why the service was taken up. Five constructions emerged: duplication and perceived threats to established nursing roles within the PHCT; improved care of children in PHCT settings; the nature of support for children and families; working as a nurse practitioner; and meeting unmet need. A clear need was demonstrated for a qualified children's nurse working in a community setting to raise the overall support and quality of care for a whole range of conditions which are currently low profile. There was evidence that these nurses met unmet need and were, at times, functioning as nurse practitioners and at times as advanced practitioners. This article, the first of two parts, focuses on the methods used and the associated problems. The second part will present the findings and discussions of the research.
Anticipating the patient's needs: a key nursing skill
Authors: Castledine George
Published: May 2014

Over the past few years I have come increasingly to appreciate the importance of the nurse anticipating patients’ requirements or needs. The word ‘anticipate’ is rarely used in the nursing literature. However, anticipation is an essential part of skilled nursing care. For example, Pearce (1953) states that a patient ‘likes to feel that the nurse will not miss any feature of his case, which should be observed, and that the nurse knows how to interpret his needs and how to relieve them’.
Health facilitators in learning disability are important roles
Authors: Jukes Mark , Bollard Martin
Published: May 2014

The strategy for people with learning disabilities states that people with learning disabilities need to have health facilitators by 2003, and individual action plans by 2005 (Department of Health (DoH), 2001). Health facilitators will help GPs and the primary care team identify patients with a learning disability and facilitate, advocate and ensure that this client group gains full access to the health care they need. The strategy states that learning disability nurses, particularly those within community learning disability teams, are the most appropriate professionals for the role.
Collecting pressure ulcer prevention and management outcomes: 2
Authors: Clark Michael , Benbow Maureen , Butcher Martyn , Gebhardt Krzys , Teasley Gail , Zoller Jim
Published: May 2014

The first part of this article (Vol 11(4): 230–8) outlined the argument that a combination of efficacy and effectiveness is required to assess fully the impact of interventions such as pressure-redistributing (PR) beds and mattresses. In addition, it described the methodology of this multinational, multicentre, prospective, non-randomized cohort study designed to record the occurrence and characteristics of patients vulnerable to, or with, established pressure ulcers. This article reports further details of the characteristics of the 2507 UK adult hospital patients recruited to the study. Over 40% (42%; n = 1046) of all subjects were considered to be at an elevated risk of developing ulcers (Waterlow score of 15 or greater) (Waterlow, 1985). Many were inactive with 332 (13%) confined to bed alone with a further 262 (10%) confined to bed and their chair. Most (74%; n = 1868) were nursed upon PR beds and mattresses, while fewer subjects were provided with a PR seat cushion (n = 547; 27%). Two hundred and fifty-seven subjects (10%) experienced at least one change of bed mattress during their stay in hospital, with two subjects being nursed on five different mattresses during their hospital stay.
Multidisciplinary care of skin problems in stoma patients
Authors: Smith Amanda J , Lyon Calum C , Hart Carol A
Published: May 2014

Skin integrity is essential for the normal usage of a stoma appliance. There is little published on the prevalence, prevention or management of stoma skin problems. Allergic contact dermatitis is often cited as the cause, usually without evidence from formal investigations. The authors approached, by postal questionnaire, 525 patients who had had a stoma formation in the last 10 years. A total of 325 responded. All those who described a skin problem were invited to attend a multidisciplinary clinic for further investigations and appropriate treatment of their peristomal skin. This may be severe and debilitating as well as socially restricting. However, with a multidisciplinary approach a number of conditions can be recognized and easily treated, thus improving the quality of life for stoma patients.
The treatment and diagnosis of non-epileptic attack disorder
Authors: Ross Elizabeth
Published: May 2014

Epilepsy is the most common serious neurological condition in the UK with a lifetime prevalence of 2–5% of the population. Epilepsy is also common in the learning disability population. As many as 36% of patients diagnosed with epilepsy may have ‘pseudoepileptic’ episodes instead of, or as well as, true epileptic attacks. This article explains how the diagnosis of non-epileptic attack disorder is made and identifies some of the difficulties inherent in diagnosing and treating this disorder. The costs of failing to recognize the condition are illustrated in a case study which also demonstrates the effectiveness of the interventions of a specialist epilepsy nurse in terms of health and economic gains and is an example of the benefits of effective multidisciplinary teamwork.
The district nursing workforce: so where do we go from here?
Authors: Hesketh Jo
Published: May 2014

It was in a mood of weary resignation that the Queen's Nursing Institute and the English National Board greeted the findings of its year-long study of district nurses' views of their future role (Low and Hesketh, 2002). Anecdotal evidence gathered in the wake of the Audit Commission's (1999) First Assessment report indicated that the district nursing workforce was increasingly worried at a professional future which involved the seemingly incompatible elements of increased workload, added responsibility and a paucity of resources. It is an equation as old as healthcare itself, but what is new and of great concern is the workforce's negative perception of itself and its belief that the dynamics which are driving today's community nursing agenda pose a serious threat to the future of the service and, by extension, the welfare of patients.
Transfoam Visco™: evaluation of a viscoelastic foam mattress
Authors: Beldon Pauline , Helier St
Published: May 2014

The cost of pressure damage in terms of physical and psychological suffering for a patient is immeasurable. Pressure ulcers are frequently painful, malodorous, may become infected and difficult to heal, and may even cause the death of a patient. The financial cost of treating pressure ulcers are also considerable; Collier (1995) estimated the cost of one pressure ulcer treatment to be £40 000, including cost of specialist pressure-relieving equipment, wound management products and nursing time. In addition, legal costs may range from between £100 000 and £250 000 per patient in compensation and legal fees incurred by a hospital (Department of Health (DoH), 1993).
Management of a patient with postoperative necrotizing fasciitis
Authors: Holloway Samantha , Ryder Jonathan
Published: May 2014

This case study highlights the care of a diabetic woman who had previously undergone elective surgery for a hernia repair, and who later presented with necrotizing fasciitis. The need for a flexible approach to dressing choice is emphasized, in terms of patient comfort and ease of management in the community.
Teaching nurses psychological support of patients with wounds
Authors: Hollinworth Helen , Hawkins Jen
Published: May 2014

Concerns about lack of professional empathy with psychological aspects of wound care provided the springboard for this study. Forty-three qualified nurses who regularly care for patients with wounds recorded in research diaries how they supported patients holistically before and after attending a counselling skills workshop. Thirty-nine nurses then attended focus groups to share their experiences. Participants represented varied practice settings, with 581 patient situations recorded in the diaries. Data analysis identified four themes: reflection sharpens the focus on practice; complex situations; emotional labour; and knowing the patient. While patients' feelings were identified in the first diary period, and reflection sharpened the focus on practice, patients' psychological needs were not attended to fully. Following the workshop there was a major shift in the understanding and provision of psychological support for patients with wounds by some of the nurses. Others were unable or unwilling to embrace counselling skills into care. This highlights the need to address nurses' attitudes and beliefs that might interfere with psychological support for patients with wounds.
Autonomy, privacy and informed consent 1: concepts and definitions
Authors: Scott PA , Vlimki M , Leino-Kilpi H , Dassen T , Gasull M , Lemonidou C , Arndt M
Published: May 2014

This article is the first in a four-part series that explores the concepts of patient autonomy, privacy and informed consent in the context of the provision of nursing care. In this first article an overview of the concepts is provided, and some of the difficulties with definitions of these concepts are considered. The dearth of empirical exploration of the operationalization of the concepts of patient autonomy, privacy and informed consent within nursing practice is highlighted. The second, third and fourth articles report a series of empirical studies carried out with patients and staff in postnatal care, in continuing care of elderly people and in acute surgical care within Scottish NHS settings. These studies are part of a concerted effort to address the lack of empirical investigation of the ethical dimension of nursing care provision and clinical nursing practice.
Health-related quality of life tools for venous-ulcerated patients
Authors: Anand SC , Dean C , Nettleton R , Praburaj DV
Published: May 2014

Healthcare manufacturing companies have developed many new and novel materials for wound care. They claim that the dressing materials will improve the healing progress of the wound or have a therapeutic value and have sought to assess their efficacy and effectiveness in clinical trials. These claims should be clearly supported by the perspectives of those who actually use the devices. Compression therapy, which is regarded as an effective treatment for venous leg ulcers, is far from ideal owing to a number of limitations that it possesses, such as patient discomfort, difficulty experienced in applying correct compression on the limbs, choosing a correct dressing for the wound or finding differences between the performance of various devices. It is necessary to investigate the patient's views and perspectives while randomized controlled clinical trials are conducted. In this review the concept of quality of life (QoL) and the tools used to measure QoL and studies that were conducted with patients suffering from chronic venous leg ulcers and undergoing therapy are considered, along with contributory factors to the healing process. In addition, a questionnaire modified from the original format is recommended as the suitable tool for assessing the QoL of patients suffering from venous leg ulcers while participating in clinical trials.
Women are neglected when it comes to cardiac rehabilitation
Authors: Higginson Ray
Published: May 2014

Heart disease is a leading cause of premature death in the UK (Peterson and Rayner, 2002). Every year 150000 people suffer a myocardial infarction (MI) (British Heart Foundation, 1999). Heart disease is the number one killer of women in the industrialized world, with MI being the primary cause of death for women who are more than 40 years of age. Meta-analysis of studies suggests that women's risk of dying during the first 2 weeks after a MI is double that of men (Schenck-Gustafsson, 1996).
Nurses must be immune to product promotions
Authors: Castledine George
Published: May 2014

Until now, the professional misconduct series in BJN has not carried a case relating to nurses promoting certain commercial products (clauses 7.2 and 7.3). However, considering how many nurses will be involved in prescribing and purchasing healthcare products and drugs the tide may be about to turn.
Journal reviewers and reviews: should the system be revised?
Authors: Birchenall Peter D , Parrish Alan A
Published: May 2014

A system of peer review of articles presented for publication is one of a number of measures taken by editors to ensure the quality of the journal. It is a system that employs subject specialists to judge whether an article meets the aims and scope of the journal. Peer review is also designed to pick out errors of fact, remark on writing style and judge the author's competence in respect of subject matter. Authors are generally happy to receive positive and constructive feedback on their work, accepting it is a valuable tool to be used as a means of bringing an article to a publishable standard.
The information sources used by community nurse prescribers
Authors: Hall Jason , Cantrill Judith , Noyce Peter
Published: May 2014

A purposive sample of 22 community nurse prescribers and five prescribing leads were interviewed to determine how nurses both access and assess the reliability of pharmacological information. Prescribers used both printed material and other professionals to obtain pharmacological information. The most commonly mentioned sources of printed material were journals and the British National Formulary. Other people that nurses obtained information from included pharmaceutical company representatives, community pharmacists, nurse specialists, colleagues, and GPs. Nurses described the attributes that they associated with reliable information (previous vetting, up-to-date and used by other healthcare professionals) and unreliable information (produced by those with a vested interest). Much of the pharmacological information supporting prescribers is aimed at doctors and may not be accessible for nurse prescribers. Organizations seeking to influence prescribing in order to improve quality, control costs and implement evidence-based practice should consider the method of communication in addition to the message.
Pathways for continence care: an audit to assess how they are used
Authors: Bayliss Valerie , Salter Liz , Locke Rachel
Published: May 2014

This is a follow-up article to three articles that were published between 2000 and 2001 in the British Journal of Nursing about the development of template pathways for continence care (Bayliss et al, 2000a,b, 2001). It reports on what has happened since the development of these templates. One hundred and forty-four healthcare professionals working in the field of continence care were asked to complete a questionnaire about whether the pathways are being used and what changes have been made to them. The audit found nearly half of the respondents are currently using the pathways and find them an effective method of assessing incontinence and providing equitable quality of care for patients. Many respondents have made changes to the pathways, making them easier to use and adapting them to local practice and the availability of local resources. This was what was anticipated, although the authors noted that variance tracking, which should be the driver for change, had not significantly influenced local pathways. Of those healthcare professionals not using pathways, all said they were still interested in using them, which is particularly encouraging as pathways are promoted in ‘Guidelines for Continence Care’ (Department of Health, 2000). To provide support to these individuals and encourage the efforts of those already using the pathways, a support group is to be established following a further conference on pathways for continence care later this year. It will be the role of this group to facilitate information sharing on pathway development. As a first step in the dissemination of information, a pack is being produced comprising consolidated versions of the changes to the pathways used in practice all over the country.
Nurses' inappropriate use of gloves in caring for patients
Authors: Hampton Sylvie
Published: May 2014

Asepsis still remains an important part of infection control and sterile gloves are still required in acute wound care and surgical procedures. Some tissue viability practitioners have for many years used unsterile gloves for chronic wound care and this provides a cost-effective method of protection for both the patient and the nurse. However, there are still those nurses who are bound in nursing rituals and find it difficult to discard a practice that has been shown to be costly and unnecessary. At the same time, there is a worrying practice of wearing gloves for all procedures without changing between each patient contact and this can be a dangerous method of introducing cross-infection and increasing the potential for latex allergies. Therefore, the use of gloves must be carefully thought through and the rationale for their use should be based on researched evidence. This article reviews the available evidence.
Surgical wound benchmark tool and best practice guidelines
Authors: Birchall Lynne , Taylor Sheena
Published: May 2014

Surgical wounds that heal by primary intention are expected to heal without complication (Watret and White, 2001). Patients are frequently subjected to a variety of treatment regimens, often based on individual practitioners' preferences. This article discusses how one acute hospital trust developed a multidisciplinary approach to devise best practice guidelines. This was achieved through consensus and expertise of a working party, and a clinical practice benchmark tool for patients with surgical wounds to standardize and ensure the implementation of evidence-based practice. Clinical practice benchmarking is ‘a process through which best practice is identified and continuous improvement pursued through comparison and sharing’ (Department of Health (DoH), 1999). The work has led to the development of a standardized assessment and documentation tool, which the working party hopes will be used trust-wide. In addition, ward staff are encouraged to undertake the benchmark process as a method of identifying areas where the use of this tool would ensure that standards of care could be improved.
Life in the COPD straitjacket: improving lives of sufferers
Authors: Booker Rachael
Published: May 2014

Chronic obstructive pulmonary disease (COPD) is a crippling, under-recognized and underestimated condition. It kills 30000 people prematurely every year in the UK (British Thoracic Society (BTS), 2001). COPD disables before it kills. It progressively saps energy and self-confidence, induces fear and anxiety and produces misery and dependence.
The male menopause: possible causes, symptoms and treatment
Authors: Peate Ian
Published: May 2014

This article discusses the controversial concept of the male menopause, by explaining what the literature reveals about this condition. It does not wish to put forward a case for treating men with the male menopause with hormone replacement therapy, merely to provide information to nurses who may nurse men with the symptoms associated with the disorder. Definitions of key terms, i.e. male menopause, are considered and the endocrinological changes that occur with ageing are outlined. Assessment of the extent of the problem is confounded by the concept of definition. Some middle-aged men often describe similar symptoms that women describe associated with the menopause; therefore, it may be reasonable to suggest that an andropause with an endocrine basis does exist. The investigations undertaken to make a diagnosis are described and treatments available are discussed. A shared approach to the care for men with menopausal symptoms is advocated. The role the nurse plays is described and recommendations for practice suggested. Finally, a conclusion is offered and a call is made for further empirical investigations to be made available, to ensure that men are provided with safe effective care based on the best available evidence.
Perceptions of nurses with regard to doctor-patient communication
Authors: Ángeles-Llerenas Anglica , Álvarez del Ro Asuncin , Salazar-Martinez Eduardo , Kraus-Weissman Arnoldo , Zamora-Muñoz Salvador , Hernández-Avila Mauricio , Lazcano-Ponce Eduardo
Published: May 2014

The objective of this study was to evaluate nurses' perceptions of communication between doctors and patients with cancer, AIDS and rheumatoid arthritis. A cross-sectional study was conducted with 741 nurses in 12 hospitals. Nurses received a self questionnaire that included questions on personal values and attitudes. The answers were used in constructing affective variables (religious beliefs, attitude towards death, paternalism). The prevalence of explicit communication in ‘nurse perception of doctor–patient communication’ in the case of cancer was 4.5%, with AIDS 30%, and with rheumatoid arthritis 41.8%. When the value of communication was evaluated, it became evident that the likelihood of a nurse perceiving explicit communication in reference to a diagnosis of cancer was 6.5 times greater when communication was considered to be of greater value (CI 95% 2.6–6.6). For nurses who accept the possibility of death, the likelihood of perceiving explicit communication in the case of AIDS was 7.4 times greater than for nurses who deny this possibility (CI 95% 3.7–14.7), and when nurses displayed a deeply religious attitude, the likelihood of perceiving explicit communication was 80% greater than for nurses without this attitude (CI 95% 1.0–3.3). When nurses displayed deeply religious attitudes, there was a 70% greater likelihood of perceiving explicit communication in cases of rheumatoid arthritis, compared with nurses not demonstrating this attitude (CI 95% 1.1–2.9). Nurses participate actively in the process of attending to patients with cancer and other disabling illnesses. Thus, there is a need for health professionals who provide compassionate attention, and this will improve the various interrelationships between nurses and patients.
Pain related to Optiva 2, Biovalve, and Venflon 2 intravenous catheters
Authors: Lücker Peter , Stahlheber-Dilg Bodo A
Published: May 2014

Pain related to the insertion of intravenous catheters is a major issue for many patients. This study investigated differences in pain on insertion for three different catheters — Optiva 2, Biovalve and Venflon 2 — as assessed by 100 volunteers. Clinicians also assessed a variety of parameters related to their overall ease of use. This study demonstrates that Optiva 2 can offer significant benefits for both patient and clinician. Pain on insertion was significantly lower with Optiva 2 than with Venflon 2, but comparable with Biovalve. Ease of insertion and flashback were significantly better for Optiva 2 than for Venflon 2, but similar to Biovalve. For the parameters ‘ease of catheter advancement’ and ‘overall ease of use’, the operators rated Optiva 2 significantly better than Biovalve and Venflon 2.
Consumerism 1: the different perspectives within health care
Authors: Fox Jane
Published: May 2014

This is the first of two articles which collectively consider the evolving concept of ‘consumerism’ within the NHS and the degree to which this can be seen as having informed preregistration nursing and midwifery education within England. The impact upon preregistration education is the focus of the second article within which findings from a four-stage study will be explored. This first article considers the nature of consumerism in relation to the health service. It seeks to explore the place of consumerism within the NHS reforms heralded in 2000, while acknowledging that as a concept it remains problematic. The potential distinction between the individualistic and more collectively based notion of consumerism is highlighted. Finally, the article suggests that in order to adopt fully the consumer ethos in the NHS -— more latterly redefined as a user- or partnership-based service — appropriate resources and education are required.
Consumerism 2: preregistration nursing and midwifery curricula
Authors: Fox Jane
Published: May 2014

This article, the second of two parts, presents findings from a four-stage study exploring the extent to which consumerism and its related aspects have been incorporated into the preregistration nursing and midwifery curriculum. The study was undertaken in recognition that NHS policy (as considered in the first article: Vol 12(5): 321–6) increasingly gave emphasis to the development of a health service that was more consumer and user focused. The study involved use of a Delphi panel, postal questionnaire, review of curriculum documentation, and timetables, together with a small focused group discussion. Findings indicate some aspects relevant to consumerism in health care, e.g. communication and ethical principles were included in the curriculum. Other aspects, such as advocacy, quality assurance, and lay health beliefs, were viewed logically from the perspective of the professional role. In essence, no curriculum transparently addressed consumerism in a central and focused way, although midwifery — and to some extent mental health, learning disabilities, and child branches — gave more overt attention to consumerism than adult branches.
Research shows administration of medicines needs attention
Authors: Dimond Bridgit
Published: May 2014

According to The Times, ‘Nurses get half of intravenous drug injections wrong’ (Wright, 2003). The report highlighted research into intravenous (IV) drug injections in Britain (Taxis and Barber, 2003). The researchers studied 113 nurses and one doctor at two hospitals: a teaching and non-teaching hospital. The basic findings were that of 1042 doses prescribed to 106 patients, there was an error in 49% of the cases.
Thrombolysis for acute ischaemic stroke: core nursing requirements
Authors: Innes Karen
Published: May 2014

This article describes a nursing protocol for patients treated with thrombolysis for acute ischaemic stroke developed during the Stroke Association phase of the Third International Stroke Trial (IST-3), a randomized controlled trial of recombinant tissue plasminogen activator for acute ischaemic stroke. The IST-3 nurse collaborative group met three times over 3 years. The meetings consisted of educational updates on stroke thrombolysis, training on trial procedures, presentations by participating nurses and discussions of good practice, local initiatives and sharing common problems. Lack of knowledge, fear of bleeding complications and lack of appropriate NHS beds were common barriers. Core nursing requirements suggested by this research included: fast-tracking of patients; access to trained stroke physicians; acute physiological monitoring and nursing intervention; effective communication and support of patients and carers; knowledge of complications and actions to be taken; transfer to an appropriately skilled stroke unit environment and successful discharge planning to home or rehabilitation.
A comparative user evaluation of three needle-protective devices
Authors: Adams Debra , Elliot TSJ
Published: May 2014

Needlestick injuries (NSI) can result in healthcare workers being exposed to bloodborne viruses. Between 1997 and 2002, three healthcare workers in the UK have seroconverted to hepatitis C and one to human immunodeficiency virus (Public Health Laboratory Service (PHLS), 2003). Experience both in the UK and the USA suggests that even robust educational strategies may be insufficient to reduce the number of occupationally acquired NSI (Jagger et al, 1988). Needle-protective devices have now become more widely available and several studies have demonstrated an associated reduced risk of NSI. It is, however, essential that the devices are appropriately evaluated before introduction to ensure that they meet user requirements, do not interfere with function and reduce NSI risk. This article describes an evaluation programme carried out at the University Hospital Birmingham, UK. The programme focused on three key areas: safety, usability and compatibility. Results demonstrated that nurses rapidly adapt their practices to use the new safety devices and the study highlighted key education requirements that would be required before implementation. In addition, without this evaluation, it would not have been identified that attachment of the safety needles to the syringes requires a push-and-twist method or the use of LuerLokTM syringes to prevent detachment on activation of the safety procedure.
Palliative wound management: the use of a glycerine hydrogel
Authors: Burns June , Stephens Melanie
Published: May 2014

This article describes the use of a topical glycerine hydrogel and the role it can play in the management of malignant fungating wounds. The value of the product is reviewed in two case studies. The authors accept that no significant statistical evidence can be offered from the case studies, but highlight the benefit of the product to the patients' quality of life.
Improving pressure ulcer care through designer education
Authors: Jones Menna Lloyd , Young Trudie , Liptrot Peter
Published: May 2014

In 2001, a tissue viability audit was undertaken within a medical directorate of an acute district general hospital. The audit highlighted deficiencies in the knowledge base of the staff and in the care given to prevent and manage pressure ulceration. As a result, the tissue viability nurse, head of nursing (medical directorate) and lecturer in tissue viability identified educational and service needs and developed a specifically designed education programme that integrated diploma- and degree-level study. Pre- and post-course questionnaires were designed to assess students' theoretical knowledge; this was combined with an assessment that focused on the implementation of the pressure ulcer prevention and management guidelines. The success of the programme was demonstrated by an increase in nurses' knowledge of pressure ulcer prevention and management. This positive outcome could not have been achieved without the willingness of the trust manager, tissue viability nurse and nurse educator to work together and support the development of this new initiative.
Mentors need more support to fail incompetent students
Authors: Duffy Kathleen
Published: May 2014

The dilemma of whether or not to fail a student in clinical practice is not always straightforward and evidence suggests that student nurses sometimes pass clinical assessments when in fact their performance is unsatisfactory (Watson and Harris, 1999). So why does this happen? Research I undertook with mentors and lecturers, in a recently publicized Nursing and Midwifery Council funded study, has highlighted some of the issues surrounding this area (Duffy, 2003).
Current practice of antibiotic prophylaxis for catheter procedures
Authors: Fraczyk Linda , Godfrey Helen
Published: May 2014

The practice of giving prophylactic antibiotics to patients at the time of urinary catheter insertion, change or removal is variable since guidelines for their use have yet to be established. The use of prophylactic antibiotics to prevent urinary catheter-related infections and the possibility of bacteraemia and septicaemia, despite a lack of evidence for their efficacy, is a matter of concern in light of the reported overuse of, and increased resistance to, antibiotics. This article describes an audit conducted in one trust to establish the current practice of antibiotic prophylaxis for urinary catheter procedures. The audit confirmed that in 60% of the recorded catheter procedures, patients were given antibiotics, usually gentamicin. Variations in gentamicin prophylaxis were revealed, including differences in the timing of administration relative to the catheter procedure. This audit revealed that intramuscular gentamicin was given simultaneously with the procedure or after the procedure in a number of cases, suggesting that on these occasions ‘prophylaxis’ was suboptimal.
Understanding different religions when caring for diabetes patients
Authors: Green Veronica
Published: May 2014

A significant and accelerating worldwide increase in the incidence of diabetes, coupled with growing population mobility, will lead to an urgent need for all nurses to develop a greater understanding of the role of different cultural and religious beliefs in diabetes control and care. In this article, the author presents a brief overview of the five major religions practised in the UK and the associated beliefs, customs and lifestyle factors that may affect the person with diabetes and his/her compliance with current advice and education with the aim of promoting culturally competent health care.
Nursing management issues in hip and knee replacement surgery
Authors: Lucas Brian
Published: May 2014

Total hip replacement (THR) and total knee replacement (TKR) are carried out for the relief of pain in hip or knee joints usually caused by osteoarthritis. Such replacements last for 10-15 years and therefore many nurses will care for patients with a THR/TKR even if that is not the primary reason for the patient seeking care. The different types of THR/TKR and how patients can be prepared for surgery are discussed. The major long-term complications of loosening or dislocation of the components of the THR/TKR and of infection are explored and the presenting symptoms are highlighted. The article is intended to be useful not only for orthopaedic nurses but also for nurses generally.
Autism: developing a strategy for nursing to prevent discrimination
Authors: Aylott Jill
Published: May 2014

The final phase of the Disability Discrimination Act (DDA) comes into force in October 2004. The DDA Code of Practice is a document to guide organizations in the implementation of and compliance with the Act. The DDA Code of Practice (2002) makes reference to specific impairments, such as hearing and visual impairments, and there are numerous examples of how ‘reasonable adjustments’ can be made to enable access to those so disabled. There is recognition that some impairments are hidden, e.g. learning disabilities and diabetes. However, no mention is made of those with autism. The impairments of autism including Asperger syndrome are also ‘hidden impairments’ as defined by the DDA and this will mean that it will not be immediately obvious as to how the Act will help nurses to amend their practice to enable people with autism full inclusion and access to health care. This article will explore practical implications and outline how nurses can develop their practice to be compliant with the Act and to ensure good ‘health care’ practice for people diagnosed within the autism spectrum.
Exploring the evidence surrounding the debate on MMR and autism
Authors: Purssell Edward
Published: May 2014

Autism is a poorly understood condition that would appear to be on the increase. There is currently much concern about a possible link between the measles, mumps and rubella (MMR) vaccination and autism which has resulted in a substantial reduction in the uptake of MMR, putting children at risk of three significant childhood diseases. This article looks at the evidence for a link between MMR and autism, finding that while a plausible hypothesis has been constructed, there is no substantive evidence for such a link and that the quality of this evidence is, in many cases, poor. This is due, in part, to the difficulties inherent in pre- and postlicensure vaccination research. These difficulties and the importance of vaccination and parental understanding of risk are discussed.
The nursing role in recognizing and assessing neuropathic pain
Authors: Johnson Lucy
Published: May 2014

Neuropathic pain is suffered by approximately 1% of the UK population and poses a vast socioeconomic problem through unemployment and expenditure on medical and social services. It also presents a major therapeutic challenge to healthcare professionals, since it can be difficult to recognize and to treat. With the advent of new and effective medications, the prognosis for patients can be significantly improved by early recognition and aggressive therapy. This article aims to equip nurses with the assessment skills to identify neuropathic pain and a basis from which to expedite pain relief through appropriate intervention and referral within the multidisciplinary team.
Thrombolysis for acute ischaemic stroke and the role of the nurse
Authors: Fitzpatrick Maria , Birns Jonathan
Published: May 2014

This article describes thrombolysis for acute ischaemic stroke as an emerging treatment modality. National clinical guidelines emphasized the need to identify acute stroke as a clinical priority and to develop protocols for the early assessment and treatment of stroke patients. Fast-track services developed in other clinical scenarios have proven successful and this article outlines the potential benefits a fast-track service for acute stroke. The role of the clinical nurse specialist in stroke is central to this service; this role includes development and implementation of fast-track protocols in accident and emergency, rapid assessment for eligibility of thrombolysis and coordinating post-thrombolysis monitoring and acute stroke care.
The issues for nurses involved in implementing evidence in practice
Authors: Gagan Mark
Published: May 2014

Evidence-based practice (EBP) is currently high on political and professional agendas. However, there is a suggestion that despite apparent enthusiasm for EBP, it is not becoming a reality. A variety of reasons for evidence not being implemented in practice exist, including the way in which evidence is communicated, how staff are involved in changes in practice, the availability of resources, patient expectations and the priority afforded to EBP by individuals and organizations. These issues must be addressed if EBP is to succeed.