bluuebunny/crossref_metadata_2025 huggingface dataset:
The benefits of a ward simulation exercise as a learning experience
Authors: Stirling Kevin , Smith Gill , Hogg George
Published: May 2014

This article describes the findings from a pilot study undertaken to identify the potential benefits of a ward simulation exercise in developing the capabilities of newly qualified nurses. Eight newly qualified nurses were recruited to participate in this pilot study which was based in the Clinical Skills Centre, Ninewells Hospital, Dundee. This pilot study was performed in conjunction with NHS Tayside Practice Education Facilitators and the University of Dundee. Data collection methods involved reflective learning logs which were reviewed independently by an expert group of teachers and practitioners. A focus group session was also undertaken to understand the lived experience of the newly qualified nurse during the ward simulation exercise. Core themes (listed in order of importance) related to the professional development of newly qualified nurses that were identified through this pilot study were: an increase in confidence, development of stress management skills, improved management of the acutely unwell patient, the transfer of skills learnt in simulation to the clinical setting, development of communication skills and reflection skills.

Participants in this pilot study demonstrated increased levels of confidence in their communication skills, their ability to prioritize care and to engage in collaborative teamworking.
Telephone triage assessment for musculoskeletal disorders: part 1
Authors: Chetty Laran
Published: May 2014

Changes in the delivery of occupational health and wellbeing services can affect the employer, employees and service users. Despite the impact of such changes, many organisations implement them without understanding their true effects. Support of staff and service users is needed if change is to be implemented and services reconfigured to improve overall efficiency. A diagnostic analysis has been recommended as a precursor to assess what impact a change would have. This paper explores the process of a diagnostic analysis before nursing telephone triage assessment for musculoskeletal disorders was implemented in an occupational health and wellbeing service. Mixed methods were used to gather the relevant information.
READS: the Rapid Electronic Assessment Documentation System
Authors: Hickey Ann , Gleeson Margaret , Kellett John
Published: May 2014

Patient documentation is time consuming and can detract from care. The authors report a novel computer programme that manipulates routinely collected information to quantify nursing workload, along with the reason for admission, functional status, estimates of in-hospital mortality and life expectancy. The programme stores information in a database, and produces a print-out in a situation/background/assessment/recommendation (SBAR) format. The average time taken to enter 629 patient encounters was 6.6 minutes. Pain was the most common presentation for low workload patients, while high workload patients often presented with altered mental status and reduced mobility. There was only a modest correlation between the risk of death and nursing workload. The programme measures nursing workload without further paperwork, and improves routine documentation with a legible brief report that is automatically generated. This report can be shared and provides data that is immediately available for day-to-day care, audit, quality control and service planning.
Exploring patients' rights: what does the NHS Constitution tell us?
Authors: McHale Jean V
Published: May 2014

On 8 March 2012, the NHS published the latest version of its Constitution. In this article, the author explores the background of the debate regarding patients' rights and entitlements in the NHS. The author also discusses the provisions of the NHS Constitution, noting that it is largely a statement of existing principles, rather than a bold statement of rights. The paper suggests that, in some instances, its discussion of rights may suggest that patients have broader rights than may in fact be the case. The Constitution is currently under review, and the author recommends that the way forward for a society where the provision of care is likely to be more complex would be the introduction of a Patients' Rights Act.
Pressure ulcer prevention: the role of the multidisciplinary team
Authors: Samuriwo Ray
Published: May 2014

Pressure ulcer prevention has long been a priority for health professionals; however, poor pressure-ulcer-related practices like poor documentation continue to be identified. Research has shown that the attitude and behaviour of some nurses towards pressure ulcer prevention are not conducive to the best possible patient outcomes. This article reviews the findings of a Straussian grounded theory study, which sought to ascertain the value that is placed on pressure ulcer prevention by nurses, but also revealed the role that other health professionals in the multidisciplinary team play in the maintenance of skin integrity. The findings of this study which are presented in this paper highlight a number of important issues. Firstly, nurses are expected to know how to prevent and manage pressure ulcers, but in reality they are very reliant on the advice and support of other health professionals to maintain their patients' skin integrity. In addition, the level of support that nurses get from other health professionals in the multidisciplinary varies tremendously. Therefore, nurses in clinical practice need to be proactive in seeking input from other health professionals, as there are many members of the multidisciplinary team who are able to give them the advice and support that they need in prevention and management.
Prevention, recognition and treatment of dry skin conditions
Authors: Andriessen Anneke
Published: May 2014

Dry skin is common and impacts on wound healing, the severity of other skin disorders, such as inflammatory dermatoses, and on the patient's quality of life. Dry skin may delay wound healing, especially in patients with venous leg ulcers and those with pressure ulcers. The aim of this review was to help clinicians recognise where dry skin may impact on patient management in general and on the patient's quality of life. The review addresses causes of dry skin and the impact dry skin can have on patients. The presentation of dry skin is discussed and a classification tool for dry skin is proposed. Prevention measures and options for treatment using complete emollient therapy are presented and discussed.
Making a difference to patients' lives
Authors: Easby Deborah
Published: May 2014

Deborah Easby looks back on three demanding but rewarding years as a nursing student and encourages those who are about to embark on their own journeys to embrace the challenges ahead.
Nurses must be more confident in assessing Gillick competence
Authors: Griffith Richard
Published: May 2014

The recent measles outbreak in south west Wales saw mass immunisation of children who had not received both doses of the measles, mumps and rubella (MMR) vaccine. The most difficult target group to immunise proved to be children in the 14–17 year age group, due in primarily to the reliance on parental consent for the immunisation instead of the child's consent under the rule in Gillick. For future mass immunisation programmes with this age group to be successful, nurses must be more confident in assessing Gillick competence and allow the child to consent to the vaccination. In this article the author considers the requirements for Gillick competence and highlights the factors nurses must consider when determining whether a child is competent to give consent to treatment.
Disinfectants in health care: finding an alternative to chlorine dioxide
Authors: Keward Josephine
Published: May 2014

Cleanliness of the clinical environment has a direct impact on healthcare-associated infection (HCAI) incidence and there is increasing evidence of its importance with regard to infection prevention and control. While traditional high-level disinfectants have excellent antimicrobial properties, these are typically offset against issues such as corrosiveness, toxicity, cost and user acceptance. Recent years have seen several user-friendly sporicidal disinfectants emerge onto the market. Antimicrobial profile and user acceptance determine the clinical success of any disinfectant. Therefore, product adoption is often a two-stage process with a tabletop evaluation of the appropriate technical data, including efficacy claims, followed by an in-use product evaluation. The first part of this article demonstrates the importance of the clinical environment with respect to HCAI and examines some of the issues around disinfectants used in health care and considerations when selecting a new disinfectant for use. The second part reports the experiences of the Infection Prevention and Control team at Alder Hey Children's Hospital in their assessment and subsequent adoption of a new user-friendly sporicidal disinfectant into clinical practice.
Clinical competency assessment in intravenous therapy and vascular access: part 1
Authors: Hulse Anna Louise
Published: May 2014

Nurse training and education programmes have changed in recent years, moving from a ‘learning on the job’ process of training and learning to a much more structured and academic approach.

As professionals in health, we must continually update and refresh our knowledge and skills ( Mann et al, 2009 ), a view supported by Fry et al (2003) who highlight that nurses are now encouraged to continue with lifelong learning. The Nursing and Midwifery Council (NMC) Code of Conduct 40 states: ‘You must keep your knowledge and skills up to date throughout your working life’. Code 41 states: ‘You must take part in appropriate learning and practice activities that maintain and develop your competence’ ( NMC, 2010 ).

Within the hospital setting, most patients will receive some form of intravenous therapy (IV) treatment ( Peterson, 2002 : cited by RCN, 2010 ). Infusion therapy has therefore become an integral part of professional practice for most nurses, who must learn the initial skills in IV therapy and vascular access and achieve clinical competence.

Education and clinical training by specialist teams in organisations must be delivered to ensure safe skills are learnt ( RCN, 2010 ). This education and training must incorporate both theoretical and practical elements, with appropriate means of assessment. The delivery methods should be diverse, recognising that individuals have different approaches to learning. Clinical competency assessment frameworks are widely used within nurse education. But are they the most appropriate method of assessment, or can other methods be used? An in-depth literature review in this paper will highlight different approaches to learning, assessment and clinical competence.
Early psoriatic arthritis: facing the challenge
Authors: Palmer Deborah , Miedany Y El
Published: May 2014

Early diagnosis and initiation of therapy has become a primary objective in clinical rheumatology. As psoriatic arthritis causes deformities and joint damage leading to impaired quality of life and function as well as increased mortality risk, there was an urgent call for action aiming at inducing remission of the active inflammatory process. Until the year 2000 there were no treatments that led to a reduction in progression of joint damage. However, with the advent of anti-tumour necrosis factor agents, it is now possible to arrest the progression of damage in these patients. Therefore, the concept of window of opportunity, that is early assessment and management in specialist clinics, has been extended to psoriatic arthritis with successful outcomes among psoriatic arthritis patients similar to those with rheumatoid arthritis. Although all this sounds plausible, early psoriatic arthritis assessment remains limited to research as setting up this type of service in standard clinical practice faces several challenges that would need tackling. The objective of this article is to provide an overview of these challenges and suggest a paradigm for use in standard clinical practice to identify early psoriatic arthritis patients.
Service user and carer participation in an endoscopy nursing programme
Authors: Martin Daphne , Hoy Leontia , Hoy Karl N
Published: May 2014

This article reports an initiative to improve students' insight into service user and carer experience of endoscopy, particularly those with severe disability, such as spinal cord injury. This insight has the potential to improve the information provided and level of person-centred care in an endoscopy service. It was evident in the feedback from the classroom encounter that the teaching and learning strategy had a positive outcome, which will allow us to integrate the approach into future curriculum development and delivery, bringing the lived experience from the service user and carer perspective into the classroom. Students engaged in discussion and used their reflective skills to develop sensitivity to those with physical disability and complex needs requiring endoscopy procedures.
Management of death rattle at end of life
Authors: Twomey Shelagh , Dowling Maura
Published: May 2014

Noisy breathing or death rattle is a common clinical sign in the final days of life. When it occurs, the level of consciousness is usually low and it is generally assumed that patients are not distressed by it. Despite the assumption that patients are not distressed, death rattle is usually actively treated in palliative care settings through a combination of pharmacological and non-pharmacological measures. Anti-cholinergic or anti–muscarinic medications are the drugs of choice in practice, even in the absence of patient distress, despite there being no conclusive evidence to suggest that any drug is superior to placebo. In addition, a recent Cochrane review suggested that there is a lack of supporting evidence for the use of anti-cholinergics to treat death rattle (Wee and Hillier, 2010). The choice of drug is based on the various properties of the drug and the desired effects. However, treatment is focused on alleviating the perceived distress of family members rather than aimed specifically at benefiting the patient. Moreover, anti-cholinergic drugs can result in unpleasant side-effects such as urinary retention and dry mouth for patients who are probably unable to report symptoms. Recent research calls for prescribers to consider carefully why they are treating death rattle. Moreover, families need to be reassured and have it explained to them that it is unlikely that the patient is distressed and why this is the case.
Integrated health care for patients with motor neurone disease
Authors: Brewah Helen
Published: May 2014

This article presents the findings from a study trip to Kaiser Permanente (KP), a private healthcare provider in the USA. The aim of the trip was to understand how healthcare integration is managed in KP and how this might help patients in the UK with motor neurone disease (MND). This article makes reference to the American and British healthcare systems, identifying the simple differences between health economies, and their impact on health care, with specific reference to MND. The trip was undertaken as part of the author's ongoing work on how patients with MND rate services delivered by the multidisciplinary team (MDT) in the UK. The author's community matron role involves caring for patients with long-term conditions (LTCs) including long-term neurological conditions (LTNCs). In executing this role and in service delivery to patients with LTNCs, specifically MND, the author noticed a lack of robust integration, highlighting the need to consider and address the various contributory factors. This article presents a literature review and analyses the role of the MDT including specialist neurological professionals in executing duties and in delivering healthcare services to patients diagnosed with MND. The implications for practice are also presented along with areas for practice development.
Lung transplantation assessment in a patient with COPD: a case study
Authors: McCurry Mandy , McDermott Anne , Crouchen Nicky
Published: May 2014

This article focuses on the lung transplant assessment process for a patient with chronic obstructive pulmonary disease (COPD). It explains the investigations undertaken and their relevance in the context of transplantation. For a patient to be accepted onto the lung transplant waiting list, it is important to establish that their lung disease is severe enough to warrant transplantation, while ensuring that the patient is well enough to undergo the procedure with the potential for a good subsequent quality of life. The article also explores the importance of supportive care, symptom management and psychosocial assessment in potential lung transplant recipients.
Is the quality of care in England getting better?
Authors: Tingle John
Published: May 2014

John Tingle discusses the QualityWatch 2013 annual assessment of the quality of Government-funded health and social-care services.
Living with faecal incontinence: follow-up to a research project
Authors: Wilson Mary
Published: May 2014

This paper reports on a descriptive qualitative five-year follow-up to an initial UK-based grounded theory study entitled ‘Living with Faecal Incontinence.’ Both studies collected data using in-depth guided interviews. The aim of the follow-up study was to identify any changes including adaptation and establish determining factors for people with faecal incontinence. Of the 22 participants in the original study, 11 joined the follow-up. Of these, nine participants demonstrated degrees of adaptation, assisted by symptom improvement using practical means or accepted what cannot be changed, downgrading their aspirations. One, having progressed, had become static in an intermediate position, while another displayed little adaptation. Health professionals can assist adaptation by being aware of clinical interventions to improve symptoms and practical means available. Where appropriate, the use of role models may help. Role model effectiveness, together with further long-term investigation into living with faecal incontinence, provide topics for future research.
Visual symbols in healthcare settings for children with learning disabilities and autism spectrum disorder
Authors: Vaz Irene
Published: May 2014

Children with learning disabilities (LD) and autism spectrum disorder (ASD) get anxious while attending healthcare settings as it is not part of their usual routine. They often understand visual symbols better than speech. Many of these children are accustomed to using symbols at school and at home to support their verbal understanding. A list of commonly conducted physical examinations, medical investigations and treatment procedures was compiled by the author with the help of parent support groups for ASD and Down's syndrome.In total, 150 visual symbols were developed for use in healthcare settings in consultation with parents, special needs teachers and a software company. Overall, 50 health professionals from 12 clinical areas in the hospital and community were consulted for their views on introducing symbols in healthcare settings. All had experienced difficulties in gaining cooperation from this group of children and strongly endorsed the use of symbols. They suggested using symbols in clinics and sending visual symbols home before the appointments to improve the children's understanding and cooperation.
The experiences of nurses who insert central venous access devices
Authors: Kelly Linda J , Young Beverley , Ellis Gordon
Published: May 2014

There has been much role expansion in nursing in the last two decades, with advanced nurses now performing minimally invasive surgery such as central venous access device insertion. However, there is a lack of research exploring the perceptions of nurses performing these procedures. This study explored the lived experiences of nurses who perform minimally invasive surgery, namely central venous access device insertion. Three key themes emerged from this analysis: stress associated with the unpredictable nature of the procedure, coping with responsibility and a patient-focused approach. Although the practitioners experience a degree of stress in the role, they also experience job satisfaction and feel that their roles have a positive impact on the patients in their care. The study findings provide information to managers and nurses performing these roles, and suggest how stress and burnout can be prevented.
Interrater reliability of the Glamorgan Scale: overt and covert data
Authors: Willock Jane
Published: May 2014

The Glamorgan Paediatric Pressure Ulcer Risk Assessment Scale (Glamorgan scale) had been developed using statistical analysis of patient data. The aim of this study was to assess the reliability of the Glamorgan scale using overt and covert methods. Method For the overt data collection, randomly selected trained nursing staff were invited to participate. Twenty-seven trained nursing staff assessed 27 children and young people within 10 minutes of an assessment by the researcher. For the covert part of the data collection the researcher and the paediatric tissue viability (TV) link nurse risk assessed inpatients on wards and units where the overt data collection had taken place, their findings were compared with the last recorded assessment by the clinical nurses. Results In the overt data collection 24 out of 27 nurses agreed with the researcher (88.9% agreement, kappa 0.867). In the covert data collection, 41 out of 55 risk assessments had been completed. Of the 41 completed assessments 34 agreed with the researcher and tissue viability link nurse (82.9% agreement, kappa 0.763). Conclusion The level of agreement was good for overt and covert interrater reliability data.
Larval therapy applied to a large arterial ulcer: an effective outcome
Authors: Rafter Linda
Published: May 2014

This article is a review of larval therapy and includes a case study that uses larval therapy in the treatment of complex leg ulcer wounds. Complex wounds require careful management from the multidisciplinary team and present clinicians with intricate challenges to save the limb. Wound-bed preparation and debridement needs to be as effective and non-traumatic as possible for the patient. Larval therapy removes the devitalised tissue effectively with minimal tissue trauma. This case study reports on a patient with a non-progressing, full-thickness wound with exposed tendon following reconstructive surgery at a local vascular unit. The patient was left with very limited treatment options, as traditional dressings for the arterial ulcer nearly resulted in amputation due to the deterioration in the wound. As part of the patient’s management, she was treated with larval therapy in an attempt to salvage her limb. This article follows the progress of complex leg ulcer wounds employing BioFoam® dressing (BioMonde, Bridgend) for larvae debridement therapy over a 4-week period and incorporating five applications of three BioFoam dressing bags. This care pathway ensured the patient’s safety by promoting effective wound healing with the larval therapy leading to excellent clinical patient outcomes.
Needlestick injuries and safety syringes: a review of the literature
Authors: Higginson Ray , Parry Andy
Published: May 2014

Needlestick injuries are a serious concern for nurses and other healthcare workers. One of the main clinical risks from needlestick injury is the possible infection by blood-borne diseases, such as hepatitis and HIV. A number of different measures have been introduced to minimise the risk and impact of needlestick injuries, including the use of fixed-needle safety syringes. However, some healthcare workers refuse to use such devices, for reasons that include the perceived need to change syringe needles between drawing up a medicine and its administration to a patient. This paper will explore the literature relating to needlestick injuries and the reasons commonly given for not using fixed-needle safety syringes.
Reducing pressure damage: care bundles and collaborative learning
Authors: Evans Alison M , Barklam Dwynwen , Hone Karen , Ellis Gemma , Whitlock Joy
Published: May 2014

Reduction of hospital-acquired pressure ulcers is a patient and nursing priority. Although evidence-based interventions to prevent such ulcers are well known, reducing this healthcare burden has proven consistently difficult. Via case studies, this article describes how a bundle approach to pressure ulcer prevention may be adapted for use within different clinical areas. It illustrates how collaborative learning may facilitate the spread of improvement work across a health board and build improvement skills within nursing.
Pre-diabetes and capturing opportunities to raise awareness
Authors: Phillips Anne
Published: May 2014

This article explores the high risk of diabetes and cardiovascular diseases in adults over 18 years of age and recognises, through the literature, the potential role for nurses in engagement with diabetes prevention strategies in their everyday practice. It considers the latest international projections for diabetes, a critical review of evidence of how diabetes can be prevented and how effective methods of detection of pre-diabetes can be employed with every clinical encounter with adults who perhaps previously were not considered to be ‘at risk’ of developing type 2 diabetes. Effective consultation approaches to raise diabetes awareness within populations and to enable tailored approaches to public health lifestyle advice are explored, to encourage each practitioner to ‘think diabetes’ in every clinical encounter.
Health and safety in the NHS
Authors: Griffith Richard
Published: May 2014

Accidents at work cost the NHS some billion pounds every year. Over half of these accidents are due to avoidable slips and falls—the most common cause of claim for compensation faced by the NHS. Under the Management of Health and Safety at Work Regulations 1999, the NHS as an employer and nurses as employees have a legal obligation to manage health and safety and to ensure that others are not put at risk by work-related activities. The first of a series, this article on health and safety law sets out the duties imposed on NHS organisations and their employees.
A ‘symptom-triggered’ approach to alcohol withdrawal management
Authors: Murdoch Jay , Marsden Janet
Published: May 2014

In acute hospital settings, alcohol withdrawal often causes significant management problems and complicates a wide variety of concurrent conditions, placing a huge burden on the NHS. A significant number of critical incidents around patients who were undergoing detoxification in a general hospital setting led to the need for a project to implement and evaluate an evidence-based approach to the management of alcohol detoxification—a project that included a pre-intervention case note audit, the implementation of an evidence-based symptom-triggered detoxification protocol, and a post-intervention case note audit. This change in practice resulted in an average reduction of almost 60% in length of hospital stay and a 66% reduction in the amount of chlordiazepoxide used in detoxification, as well as highlighting that 10% of the sample group did not display any signs of withdrawal and did not require any medication. Even with these reductions, no patient post-intervention developed any severe signs of withdrawal phenomena, such as seizures or delirium tremens. The savings to the trust (The Pennine Acute Hospital Trust) are obvious, but the development of a consistent, quality service will lead to fewer long-term negative effects for patients that can be caused by detoxification. This work is a project evaluation of a locally implemented strategy, which, it was hypothesised, would improve care by providing an individualised treatment plan for the management of alcohol withdrawal symptoms.
Nurses' role in clinical commissioning
Authors: Olphert Anne-Maria
Published: May 2014

One year since the launch of clinical commissioning groups (CCGs), Anne-Maria Olphert looks at how CCGs have changed the nursing landscape, at the role of nurses in CCGs, and at the new challenges that nurses face
Primary care for deaf people with mental health problems
Authors: Levine Jack
Published: May 2014

There are approximately 10 million people in the UK who have some form of hearing loss, and the prevalence of mental health problems among deaf people appears to be significantly higher compared with the wider population. Deaf people find it harder to establish good relationships with health professionals and, sadly, many of the issues arise from discrimination and practical obstacles faced within the healthcare system. Some of these issues include a lack of awareness, funding, and prioritisation within the wider political and healthcare agenda. This article provides an overview of the background of hearing loss and mental ill health, policy and current access to mental health services for deaf people, what has changed and recommendations for the future.
Graft-versus-host disease in oncology nursing practice
Authors: Lieow Yukki , Christensen Martin
Published: May 2014

Introduction:

Gastrointestinal graft-versus-host disease (GI-GvHD) is extremely debilitating and is multifactorial in its causative factors, management and treatment. It is an exaggeration of normal physiological mechanisms wherein the donor immune system attempts to rid itself of the host. The inflammatory process that follows has the benefit of providing an anti-tumour effect for many diseases, but unfortunately in patients undergoing human stem-cell transplantation, the nature of the inflammation can result in disability, wasting and death.

Aim:

The aim of this article is to discuss the pathophysiology of this often misunderstood or misdiagnosed condition, as well as its signs and symptoms, management and considerations for nursing care.

Considerations for nursing practice:

While the medical management is aimed at minimising GvHD through the reduction of T-cell production and proliferation and gastrointestinal decolonisation, the nursing care is often focused on the signs and symptoms that can have the most prominent impact on patients.

Conclusion:

GI-GvHD has serious life-threatening complications, namely wasting syndrome, diarrhoea and dehydration. The basis of signs and symptomology is easily recognisable owing to the stages of progression through the human stem-cell transplantation process. Oncology nurses are in a prime position to identify these serious risks, initiate treatment immediately and collaborate effectively within the multidisciplinary team to minimise GvHD onset and provide expert support to patients, family and caregivers.
The outcomes of barrier protection in periwound skin and stoma care
Authors: Stephen-Haynes Jackie
Published: May 2014

This article considers the anatomy and physiology of the skin, wound healing, excoriation, maceration, peristomal skin and the importance of periwound protection. The results of a 54-patient study of the use of barrier film forming skin protection in periwound skin are presented and a 10-patient healthy volunteer experimental evaluation. The results confirm the effectiveness of barrier protection in healthy skin in an experimental evaluation and a 54-patient study requiring periwound protection.
Using the exudate decision algorithm to evaluate wound dressings
Authors: Gove Julie , Hampton Sylvie , Smith Glenn , Hedger Carol , Topley Barbara
Published: May 2014

Nurses have shown a weakness both in recognising different types of exudate and in choosing an appropriate dressing (Smith and Gibson, 2011). In order to support nurses in identifying the correct dressing choice, an exudate wound decision algorithm has been developed. The algorithm suggests the type of dressing required for bleeding and infected wounds is a calcium alginate dressing with a silver component. This study has examined the efficacy of calcium alginate dressings with silver in bleeding and infected wounds, selected through the use of the exudate wound decision algorithm. Over four consecutive dressing changes the results show a consistent improvement in all parameters of wound measurement. This demonstrates that the choice of a calcium alginate with silver dressing in the exudate wound decision algorithm will, in appropriate circumstances, provide nurses with an effective dressing choice.
Breaking the cycle and mastering the art of problem-solving
Authors: Wilson Sophie
Published: May 2014

Having embarked on a journey towards recovery, Sophie Wilson, below, has learned to embrace routines and stop mulling over past events. Oh, and she’s happy to be called a ‘patient’
A rhythm for life: drumming for wellbeing
Authors: Chadwick Hilary Bungay
Published: May 2014

Since 2004, the Sidney De Haan Research Centre for Arts and Health has been researching the impact of music and the arts on wellbeing. Hilary Bungay reflects on the benefits of a series of drumming workshops that took place last year
Mental health and smoking: effects on wellbeing
Authors: Robson Debbie
Published: May 2014

High rates of smoking are the cause of the majority of the excess morbidity and mortality in people with a severe and enduring mental illness. This article discusses the impact of smoking on wellbeing, some of the factors that influence smoking behaviour, evidence based interventions to stop smoking and integrating stop smoking services in mental health settings.
Recognising anorexia nervosa
Authors: O'Hara Caitlin B
Published: May 2014

Overview

This article discusses anorexia nervosa (AN) and common approaches to treatment of the condition. The mental health professional's role in recognising the clinical features of AN will be explored. The article includes some self-assessment to test the reader's knowledge
Anxiety and post-traumatic stress disorder in cardiac patients
Authors: Copland Claire , Joekes Katherine , Ayers Susan
Published: May 2014

Research has established that anxiety and post-traumatic stress disorder (PTSD) are risk factors for the development of heart disease in healthy populations. In addition, anxiety and PTSD are associated with further morbidity in people with existing heart disease. This article considers whether anxiety and PTSD influence onset and recovery from heart disease. Clinical implications for health-care professionals are considered, including screening, treatment, and referral on to specialist services.
Improving the physical health of people with severe mental illness
Authors: Hardy Sheila
Published: May 2014

This article describes a project in Northampton that aims to train clinicians in primary care and their link community mental health nurse how to deliver physical health checks to people with severe mental illness. It endeavors to reduce the mortality of people with severe mental illness (SMI), improve their physical and emotional health, improve their medication concordance, increase their support network and provide a more skilled workforce through data sharing and collaborative working.
Medicine-taking and recovery-focused mental health practice
Authors: Marland Glenn , McNay Lisa , McCaig Marie , Snowden Austyn
Published: May 2014

This article was inspired by the need to revisit medicine-taking within the context of recovery-focused practice in mental health. Practice based on compliance is unlikely to succeed and is not resonant with the principles of recovery. Mental wellbeing associated with recovery is promoted, however, when service users and mental health workers collaborate in a therapeutic alliance to reach concordance in medicine-taking. This is because the collaborative processes involve choice, self-determination and empowerment. The aim of the therapeutic alliance is to maintain an optimal therapeutic effect from medicine-taking, not to inculcate compliance. Unfortunately concordance, compliance and adherence are still used interchangeably. Conceptual clarity is needed to drive recovery-focused practice in relation to medicine-taking.
Diabetes: using a psychological approach in primary care
Authors: Hardy Sheila
Published: May 2014

This article recommends and describes some brief psychological approaches and interventions for health-care professionals particularly in primary care settings. Used pragmatically, these will serve to provide the patient with holistic care without creating extra workload for the practice nurse during the annual review
Dementia in primary care
Authors: Hardy Sheila
Published: May 2014

The government has developed the National Dementia Strategy ( Department of Health, 2009 ) to tackle the increasing incidence of dementia, a condition which has a devastating effect on the person affected and the families who care for them. This article explains how practice nurses can identify dementia in their patients and help them to receive the most appropriate treatment following the principles set out in the strategy
Website for children with OCD launched
Authors: Heyman Isobel
Published: May 2014

Isobel Heyman, head of the OCD Service for children and adolescents at the South London and Maudsley NHS Foundation Trust, gives an insight into the debilitating world of obsessive compulsive disorder (OCD) and a new website hoping to make school easier for those with OCD
The importance of activity in recovery from first episode psychosis
Authors: Hutcheson Catriona
Published: May 2014

The prodomal phase of schizophrenia is characterised by changes in behaviour, mood, cognitive functioning and possibly neurobiological and neurocognitive changes. Symptom improvement following psychotic illness is not always matched by functional recovery, and remains disabling and problematic for the individual and his/her family. Social roles and goals and employment are often affected by psychosis. Strategic healthcare guidance recommends the provision of educational, vocational and social recovery following first episode psychosis. Offering activity as a platform to re-engage in mainstream activities, leisure pursuits and vocational activities provides opportunities to overcome stigma, re-build self-esteem and aid recovery from first episode psychosis. Activity should be offered as a core intervention in the rehabilitation of individuals following first episode psychosis.
Health needs assessment: an holistic nursing approach
Authors: Lancaster Kath
Published: May 2014

School nurses have the potential to improve public health practice and it is widely accepted that the provision of health services should be informed by an assessment of health needs. This is part one of a health needs assessment model designed to identify those pupils in need of support.
Why do young people self-harm?
Authors: Preece Paula , Jowett Sarah
Published: May 2014

School nurses have unique access to the school–aged population and are often the first port of call for young people. An understanding of self–harm is essential. This article is part one of a series and examines the definitions of self-harm, the size of the problem and the underlying causative factors.
Preventing sickness absence from early years education
Authors: Croghan Emma
Published: May 2014

As much as 6% of a child’s school time can be lost through sickness absence. Correctly teaching children how to wash their hands could reduce the amount of sick leave children take according to a study of 4–6 year olds carried out in 2003.
Consent and children: The law for children under sixteen
Authors: Griffith Richard
Published: May 2014

Consent upholds the principle of autonomy and a person’s right to decide whether or not to have treatment. With school-aged patients it is essential that school nurses are able to assess whether the child in their care has the necessary capacity to make decisions about their treatment.
Promoting better breast awareness in teenagers
Authors: Harris Jacqueline , Graham Helen , Light Miriam
Published: May 2014

In response to many requests from school nurses for breast awareness and breast cancer information suitable for teenagers, Breast Cancer Care undertook a study into teenagers information needs, and developed and piloted a resource pack.
The importance of teaching hygiene and hand washing skills
Authors: Lamb Suzanne
Published: May 2014

Good hygiene and hand washing are essential skills to help control the spread of infections. It is important to teach these at an early age so that children can adopt lifelong healthy habits. School nurses are in an ideal position to do so through fun and infomative PSHE lessons.
Pupils’ perspectives on preventive health dialogues
Authors: Golsäter Marie , Sidenvall Birgitta , Lingfors Hans , Enskär Karin
Published: May 2014

Aim:

The aim of the study was to understand pupils’ perspectives on health dialogues with school nurses.

Background:

A preventive health dialogue with a school nurse is offered to pupils in grades 4 and 7 in compulsory school and during their first year of upper secondary school in Sweden. The dialogue has been developed by school nurses as a method in health prevention work, but knowledge of how it is experienced from the pupil’s perspective is scant.

Method:

A total of 15 focus group interviews comprising 74 pupils altogether were performed. The data was subjected to qualitative content analysis.

Results:

The results emerged in four categories: Preparation creates preparedness and Adaptability creates dialogues based on wishes and needs, which were seen as prerequisites for a satisfactory health dialogue; the health dialogue benefits were Providing opportunity for knowledge and insight about health and lifestyle and Providing opportunity to develop a trustful relationship with the school nurse, which could result in a satisfactory outcome of a health dialogue.

Conclusions:

These results highlight that it is essential to create a respectful and open atmosphere in the encounter between pupil and school nurse. The pupil can gain insight into his or her health situation and get advice based on his or her individual needs if the nurse can adapt to the pupil’s wishes and needs through the dialogue.
Smoking part 3: Young people and cessation
Authors: Edwards Sarah Matthes
Published: May 2014

Currently, a total of 6% of 11–15-year-olds regularly smoke, which shows a substantial decrease since 1997 when prevalence stood at 13%.

There is still much to do to bring the level further down and it is important that comprehensive approaches to tobacco control are not disinvested in, as this could result in the smoking rates going up again.

This article will briefly reflect on the importance of cessation as part of the wider tobacco control interventions aimed at young people.
School nursing in regional and rural Queensland
Authors: Baigrie Karina Ann
Published: May 2014

The importance of school health and school health nursing (SHN) continues to be acknowledged within Australia and internationally. Since its inception in Queensland in 1911, SHN has been regarded as an important innovation in public health nursing, particularly in regional and rural settings.

A number of issues that have an impact on the ongoing development and effectiveness of the SHN role can be identified from the available literature, including a lack of standardized position descriptions and corresponding role and function of SHNs; and a lack of overall understanding of and evidence to support the depth and breadth of SHN scope of practice. These factors, in turn, hinder greater recognition and support for the SHN role. Such factors also affect the ability of SHN roles to address key policy and program initiatives in rural and regional areas.
What does the tobacco control plan mean for school nurses?
Authors: Croghan Emma
Published: May 2014

The Government has recently published the Tobacco Control Plan for England, which was announced in the Public Health White Paper. BJSN’s consultant editor provides an overview and looks at how this could influence school nurse practice in smoking prevention and cessation.
Assessing and evaluating students on placement
Authors: Sherwin Sarah , Muir Faith
Published: May 2014

The role of the practice teacher is pivotal in supporting the development of students undertaking Nursing and Midwifery Council (NMC) approved Specialist Community Public Health (SCPHN), School Nursing programmes. It is a mandatory requirement that students of school nursing are supported and assessed by a named practice teacher, who must have met the requirements defined within the practice teacher standard ( NMC, 2008a ).

In the fourth article of this series Faith Muir and Sarah Sherwin discuss the practice teacher’s role in assessing and evaluating SCPHN students on placement with the school health team.
Promoting the role of the school nursing service
Authors: Glasper Alan
Published: May 2014

The government's recently published new vision and model for school nursing emphasises the crucial role school nurses can play in the health and social care of children and young people. In this article Professor Alan Glasper provides a critical overview of the document.
Multi-disciplinary care in juvenile-onset systemic lupus erythematosus
Authors: Kelly Jane , Dunnage Jane , Beresford Michael W , McCann Liza J
Published: May 2014

Juvenile onset systemic lupus erythematosus (JSLE) is a chronic autoimmune disease that can affect any part of the body including skin, joints and organs and can be associated with significant morbidity and mortality.

Multi-disciplinary care of children and young people with JSLE is essential, in close partnership with schools. Aggressive treatment prescribed and monitored by a specialist team (usually a paediatric rheumatology team) is key to treating this difficult and life-threatening condition. There may be times when a child needs to be reviewed by other specialist teams including nephrology, neurology, haematology and cardiology. The school nurse is one of the key partners in supporting these children and families in the school environment.
A successful approach to reduce youth smoking in Leicestershire
Authors: Thomson Heather
Published: May 2014

Smoking is a leading cause of ill-health and premature death in the UK, and an important public health issue. However, there is little evidence for effective smoking cessation programmes aimed at young people, particularly school-based.

This article reviews the findings of a 3-year local area agreement to reduce the prevalence of smoking in young people and adults, and improve the health and wellbeing of the local population in Leicestershire, including some areas of substantial deprivation.
Increasing interactivity: Using mini whiteboards
Authors: Faber Krista
Published: May 2014

In this series of articles aimed at school nurses new to teaching, Krista Faber provides some advice on teaching effective PSHE sessions. This month's article looks at increasing interactivity in your lessons by using mini whiteboards effectively.
Itching in young children: Looking at potential causes
Authors: Watkins Jean
Published: May 2014

Pruritis is a common dermatological symptom which can be caused by a range of conditions. Itching can cause distress and affect a child's sleep and concentration, it may also be a symptom of a serious condition. It is therefore important that school nurses are aware of some of the more common causes and are able to support children and their family.
Raising awareness of brain tumour symptoms in children
Authors: Walsh James
Published: May 2014

Every year hundreds of children are diagnosed with a brain tumour and early diagnosis can help improve outcomes. James Walsh comments on The Brain Tumour Charity's awareness campaign, HeadSmart.
Supporting blind and partially sighted students in school
Authors: Wright Susan
Published: May 2014

It is important for school nurses working in special schools but also in mainstream education to ensure that blind or partially sighted students have access to adequate support and resources. Susan Wright explains the role of the qualified teacher of the visually impaired.