bluuebunny/crossref_metadata_2025 huggingface dataset:
A study to determine the qualities of a learning disability practitioner
Authors: McCray Janet , Carter Sid
Published: May 2014

In recent years, a number of research studies have explored the role of key professionals in the field of learning disability. These have been predominately large studies, nationally commissioned and offering a broad structural picture of the professionals' current function. This article explores a localized research study undertaken in the Avon, Gloucestershire and North Wiltshire area of the south-west of England. While acknowledging the national context in which both learning disability nurses (RN(LD)s) and social workers operate, this study offers a more intimate insight into what form of future practitioner would be most effective. The qualitative research study included a series of topic-focused interviews and focus groups comprising professionals, people with learning disabilities, carers and representatives from the voluntary and independent sectors. Findings established that the desired future practitioner would maintain the specialist way of thinking of the RN(LD), together with the care management facilitation role of the social worker. For the research participants the optimal choice of practitioner was a dually qualified RN(LD)/social worker. Although the study was set in a particular locality, the researchers suggest that the outcomes both endorse and identify tensions in the proposed national developments for professional education, at a crucial point for the delivery and design of health and social care learning disability services.
The concept of hope in nursing 6: research/education/policy/practice
Authors: Herth Kaye A , Cutcliffe John R
Published: May 2014

This article, the last in the series, focuses on future international research, education, policy, and practice issues that centre around the concept of hope. While a growing literature is accumulating, it needs to be acknowledged that the area of hope and hope inspiration remains underresearched and is consequently not well understood. However, this article highlights future research questions around hope which have been grouped under the broad headings of: (1) the structure of hope (2) the assessment of hope (3) the enhancement of hope, and (4) the potential outcomes of hope. The article also declares how our current body of knowledge relating to hope has had limited visibility outside professional journals, has not received the funding necessary, and has not been reflected in relevant policies within our healthcare and educational institutions. If the goal is to conduct interdisciplinary research across countries and to gain a global understanding of hope, then greater resources are needed. There is a need to prepare nurses and other healthcare professionals to deal with the challenge of enhancing and maintaining hope in those that they care for in their practice, as well as in themselves.
Recovering from subarachnoid haemorrhage: patients' perspective
Authors: Jarvis Anne
Published: May 2014

Healthcare professionals generally accept that a good recovery following subarachnoid haemorrhage (SAH) equates to one where there is an absence of physical deficit. There does not appear to be a general acceptance of the impact of the less obvious invisible or psychological difficulties. Therefore, this study aimed to illuminate the experience of recovery from SAH. Using a qualitative methodology, eight participants were interviewed using a semistructured approach. Individual data were handed to the participant for the purpose of confirming the accuracy of the summary made by the author. Data were then analysed for similar and contrasting themes. As a result, the study offers an insight into how common psychological difficulties may impact on a person's abilityto make a full and complete recovery following SAH. In conclusion, the main themes generated by the data are presented and recommendationsfor practice in meeting the needs of participants are offered.
Job satisfaction of registered nurses working in an acute hospital
Authors: Price Martine
Published: May 2014

The links between job satisfaction and the retention of nurses are well established in the literature. Given the current difficulties experienced by the NHS in recruiting and retaining sufficient numbers of nurses, the need to understand how satisfied nurses are in their jobs becomes clear. This study set out to measure the job satisfaction of registered nurses working in adult acute medical and surgical specialties using the Mueller McCloskey (1990) Satisfaction Scale, a 31-item Likert questionnaire. Data were collected from 141 E-grade nurses working in a ward environment. In addition to providing a general outline of reported job satisfaction, the findings of this study identify key areas of reported job satisfaction around peer socialization and dissatisfaction with childcare facilities and control over work conditions. Based on these findings, recommendations are made that may affect positively nurse retention and suggestions put forward for future use of the Mueller McCloskey Satisfaction Scale.
Lymphoedema 1: components and function of the lymphatic system
Authors: Board Jane , Harlow Wendy
Published: May 2014

Lymphoedema is an incurable and debilitating condition which has a negative impact on the quality of life of the sufferer and his/her family. Information with regards to diagnosis and treatment is often scarce and conflicting in nature. The following series of articles should enable nurses to recognize the condition, provide basic information to a patient and instigate treatment through referral. The first article describes the anatomy, physiology and functions of the Iymphatic system. The focus is on the parts of the Iymphatic system which are specific to the condition of Iymphoedema and aims to place subsequent articles in context. The following articles describe the different types of Iymphoedema and the four main elements of treatment that are central to the management of the condition.
Health visitor risk assessment for preventing falls in elderly people
Authors: Kinn Sue , Clawson Denise
Published: May 2014

This study was undertaken to look at the feasibility of a health visitor risk assessment for falls at the time of the routine health check for people aged 75 years and above. A total of 162 people were eligible for inclusion in the study. The standard over-75 assessment check was carried out either in the GP surgery or the person's home. A questionnaire was developed to obtain additional information not collected in the routine health check. The results identified two key risk areas: a history of polypharmacy and living in sheltered housing. There were no differences for a range of physical, emotional and environmental factors between people who had fallen and those who had not. A larger study is required to look at the identification of risk factors for falling at the routine over-75 health check, and appropriate referrals that can be put into place to deal with any problems uncovered. Education of health professionals on the risk factors of falls is also required.
Health and safety regulations in relation to manual handling
Authors: Diamond Bridgit
Published: May 2014

Poppy was a staff nurse on duty at night on an orthopaedic ward. Thomas, who had just been removed from traction, asked Poppy to assist him to go to the toilet. Poppy went to help him out of bed but, as she was helping him, she felt her back ‘go’ and cried out. She has subsequently been off work and is wondering about the legal situation.
Caffeine reduction education to improve urinary symptoms
Authors: Bryant Charmaine M , Dowell Caroline J , Fairbrother Greg
Published: May 2014

Caffeine reduction is an internationally accepted treatment strategy for patients with urinary symptoms. However, there is little trial evidence in support of a caffeine/urinary symptom effect. A prospective randomized trial was conducted among 95 consecutive adult patients with urinary symptoms presenting to two nurse continence advisers. Frequency, urgency and leakage outcomes were tested 1 month postenrolment. Trial findings indicate that caffeine intake was reduced (P<0.0001) in the experimental group and that urgency (P = 0.002) and frequency (P = 0.037) outcomes were significantly improved. Caffeine practices and habits were surveyed and self-reports of caffeine effects indicate that urinary symptoms figured prominently as a reported effect but less so as a driver of caffeine reduction.
Emotional and psychological preoperative preparation in adults
Authors: Walker Jennie April
Published: May 2014

Emotional and psychological surgical preparation plays an important role in many areas of nursing. However, it varies greatly in terms of its perception and delivery. The aim of this article is to familiarize the reader with the concept of emotional and psychological preparation for surgery and to explain how this may be achieved in nursing practice. It highlights that gender, age and previous experiences are predisposing factors to preoperative anxiety, as is fear of the unknown and fear of harm. It is recommended that information should be given verbally with written supplements and that the patient should be encouraged to ask questions. Diversion therapy such as music, humour and guided imagery have been shown to be effective in reducing patients' preoperative anxiety.
MMR and autism: an overview of the debate to date
Authors: Phelan Anastasia T
Published: May 2014

The ongoing controversial debate about the measles mumps rubella (MMR) vaccine and its links to regressional autism and specific bowel disorders appears to experience ‘peaks and table troughs’ of public interest correlated with specific media attention at any one time. It is not the intention of this article to either refute or substantiate the ongoing controversy, as this is obviously a scientific debate, but rather to offer an overview of the studies to date in the interest of helping practitioners in the frontline to engage in informed debate with concerned parents. The conclusions from this review stem from two major studies conducted by the Institute of Medicine (IoM, 2001) in the USA, and the Medical Research Council (MRC, 2001) in the UK. Both conclude that although epidemiological studies so far do not support a link between MMR and autism, nonetheless the studies have been too imprecise to rule out the prospect of the vaccination being involved in a small number of cases, and the need for further research has been pointed out.
Mepore Ultra and Alldress: primary and secondary dressings
Authors: Gray David G , Russell Fiona , Flett Alison , Cooper Pam J
Published: May 2014

Expenditure on wound care continues to rise in the UK as new products and innovations are introduced. Nurse specialists in tissue viability are at the forefront of many of these advances and therefore it is vital that they consider both the clinical and economic benefits of each new treatment. In this article, the authors use a case study methodology to evaluate primary and secondary wound dressings. The aim was to focus on the opportunity for reducing overall costs in wound management without compromising clinical outcomes. Given the initial results observed there appears to be ample scope for a debate within the tissue viability specialty with regard to achieving best value for money in wound care. The authors suggest that the time has come to consider this area in greater detail and depth.
Successful inclusion of a child with a stoma in mainstream schooling
Authors: Rodgers June
Published: May 2014

The inclusion of children with medical issues, such as stomas, in schools has caused much disruption and anxiety in the past. Many of the problems have been the result of misconceptions and lack of understanding of the issues involved, along with an often irrational fear of ‘bodily fluids’. By developing closer links with the education department and opening up clear lines of communication it has been possible to raise awareness and reassure school staff regarding related issues. This article discusses the inclusion of a child with ulcerative colitis, following stoma formation, into mainstream school, and demonstrates how appropriate staff training and the development of a structured individual care plan enabled inclusion to proceed smoothly.
The British National Formulary and other medicine indexes
Authors: Dimond Bridgit
Published: May 2014

Brenda, a staff nurse on the children's ward, noticed that a junior doctor had written a patient up for a drug of which she had not heard. She asked the ward sister whether she should administer it. The ward sister said that she was not familiar with the drug but that she could trust that doctor and therefore should administer the drug. What is the law?
Changes in infection control practice to reduce MRSA infection
Authors: Myatt Rebecca , Langley Sue
Published: May 2014

An increase in the incidence of methicillin-resistant Staphylococcus aureus (MRSA) led to a review of infection control practice within the cardiothoracic directorate in a South London teaching hospital. Several changes in aspects of care were implemented including educational initiatives, extension of the admission screening policy, a specific isolation nursing team and the development of a care pathway. This led to a considerable reduction in cross-infection rates. It was recognized that high-quality, high nurse-to-patient ratio and education on fundamental aspects of barrier nursing were necessary to maintain the low infection rates.
Coeliac plexus block for upper abdominal cancer pain
Authors: Chambers Pauline C
Published: May 2014

The use of coeliac plexus block (CPB) to relieve intractable pain owing to upper abdominal malignancy is well established. Significant relief of pain is reported in 70–90% of patients, allowing a reduction in opioid use and in the occurrence of opioid-related side-effects (Eisenberg et al, 1995; Prasanna, 1996). Duration of relief varies, but the majority of patients experience relatively pain-free deaths (Patt, 1993). CPB is a relatively safe procedure, and although it is associated with common adverse effects such as diarrhoea, hypotension and local pain, these are mostly transient. However, severe complications, including paraplegia, have been reported. When CPB is performed, nurses should be aware of these potential complications and their management.
Elvarex compression garments in the management of lymphoedema
Authors: Hampton Sylvie
Published: May 2014

Lymphoedema is a progressive and debilitating disorder, caused by malfunction of the lymphatic system. It is characterized by chronic swelling, usually of a limb but it can also affect other parts of the body. It is not curable but can be reduced and controlled. The mainstay of management is physical decongestive treatment, of which compression therapy is one of the four elements. The simplest and most cost-effective method of applying compression is with elastic compression garments. Essential for their success are a perfect fit and appropriate selection of compression class and stocking material. Elvarex, manufactured by JOBST, is a range of custom-made compression garments for both upper and lower limbs, available in a wide variety of styles and options. The flat knitting process provides superior fit and effective long-term management of lymphoedema.
The policy position within Irish nursing
Authors: MacLellan Kathleen
Published: May 2014

With reference to Sheelagh Wickham's article ‘Development of nurse specialists/advanced practitioners in Ireland’ (BJN Vol 12(1): 28–33) we wish to clarify a number of points.
Critical thinking at the bedside: a practical perspective
Authors: Edwards Sharon
Published: May 2014

This article provides a comprehensive review of critical thinking from both a theoretical and, more importantly, a practical perspective. The theoretical detail with regard to critical thinking is extensive. The many models developed from the literature are often too complex and difficult to interpret in relation to clinical practice situations. If theory cannot be integrated into practice then its value to nursing should be questioned. The task now is to formalize and cement the connections between the two concepts at the bedside.
Autonomy, privacy and informed consent 2: postnatal perspective
Authors: Anne Scott P , Taylor Anne , Vlimki Maritta , Leino-Kilpi Helena , Dassen Theo , Gasull Maria , Lemonidou Cryssoula , Arndt Marianne
Published: May 2014

The nursing and healthcare ethics literature over the past 10 years has focused on issues of patient autonomy and patient rights. Despite the growing volume of literature exploring such topics, there is little empirical work investigating what is actually happening in clinical nursing or midwifery practice in relation to patient autonomy, privacy or informed consent, from the perspective of either patients or staff. This four-part series reports the results of a Scottish study that formed part of a multisite comparative research project funded by the European Commission, investigating issues of patient autonomy, privacy and informed consent. This article, the second of four, explores the issues of autonomy, privacy and informed consent in maternity care. The research questions asked were: (1) What is the perception of mothers' autonomy, privacy and informed consent in Scottish NHS hospitals, from the point of view of both mothers and midwives?; (2) Are there differences in the perceptions of mothers and midwives on these issues?. Data were collected by a self-completion questionnaire for mothers (n=243) and staff (n=170) on postnatal units in both district general and university teaching hospitals. Results indicated that there are differences between the perceptions of mothers and midwives in relation to mothers' autonomy, privacy and informed consent. Most differences were found in the information-giving and decision-making elements of autonomy.
The problems of interprofessional healthcare practice in hospitals
Authors: Caldwell Kay , Atwal Anita
Published: May 2014

This article outlines the problems of interprofessional practice in the hospital setting. It examines the difficulties associated with competing ideologies and aims, inequalities in power relations, communication and role confusion and overlap. Within the hospital setting such problems often arise although the roots of the problem may go unacknowledged. The ways in which the problems occur in the hospital setting are considered as is the underlying cause of such problems. Case studies will be used to analyse how the problems arise and ways in which they might be addressed.
Dedication and problems of nurses in Palestine
Authors: Castledine George
Published: May 2014

Whether you call it Israel, Palestine or the Holy Land (whatever title suits you), this is a fascinating and frightening place where nursing and nurses need support and help. In my travels around the world, the universality of nursing never fails to amaze me. It is so important to understand the commonalities that unite us.
Mental health nursing students' rationales for self-disclosure: 1
Authors: Ashmore Russell , Banks David
Published: May 2014

This study explored mental health nursing students' rationales for choosing whether or not to self-disclose in therapeutic encounters with patients. Using a two-item questionnaire, data were collected from a convenience sample of 162 preregistered students recruited from two universities in the UK. Content analysis of the data produced three categories for using self-disclosure: ‘building a therapeutic relationship’, ‘similar experiences’ and ‘appropriate information.’ Reasons for not self-disclosing fell into four categories: ‘crossing the line’, ‘unhelpful’, ‘name, rank and serial number’ and ‘students’ vulnerability'. The research findings suggest that both therapeutic and personal reasons are involved in the decision to use self-disclosure. This article, the first of a two-part series, outlines the background, research methods and nurses' reasons for using self-disclosure. The second article will present students' reasons for not using self-disclosure and a discussion of the findings and their implications.
Comparing evidence-based practice of nurses and physiotherapists
Authors: Palfreyman Simon , Tod Angela , Doyle Jane
Published: May 2014

Evidence-based practice has become an ubiquitous concept within nursing. However, there is little comparative data of nursing with other professions on attitudes to evidence-based practice. This article reports on a survey of nurses' and physiotherapists' sources of knowledge and perceived barriers to evidence-based practice within a large teaching hospital. A total of 324 questionnaires were sent to nurses and physiotherapists. The results showed that both physiotherapists and nurses accessed a wide variety of sources of knowledge. However, nurses were more likely to use policy and procedure manuals and discussions with medical staff than physiotherapists. Both professions have problems with overcoming the barrier of time. Nurses were more likely than physiotherapists to rate themselves as having poor evidence-based practice skills.
Medicinal products and consent to treatment by the older person
Authors: Dimond Bridgit
Published: May 2014

Iris was in the early stages of Alzheimer's disease and on occasions appeared to be completely rational and then at other times appeared to lack competence. She had to be admitted to hospital for an ulcerated hiatus hernia but was refusing to take any medication, including pain killers, even though she was clearly in severe pain. Could Iris be compelled to have treatment?
The nursing care of common raw and bleeding skin conditions
Authors: Hampton Sylvie
Published: May 2014

The skin is the largest organ in the body, is vital to the maintenance and balance of the body and is an indispensable structure for human life. The maintenance of healthy skin depends on factors such as moisture, the nutritional status of the patient and mechanical forces. Clever use of barrier films, barrier creams, emollients, steroid cream and observation of the patient's tissues over time, will protect the skin from external stimulants.
General nurses must ensure they have mental health skills
Authors: Castledine George
Published: May 2014

The trouble with dividing nursing up into specialties is that no-one looks at the whole person anymore. For example, general nurses ignore mental health factors in patient care and psychiatric nurses neglect physical aspects of health. Of course, nursing textbooks are full of models of nursing which stress the importance of the holistic approach and treating the individual patient's physical, psychological, social and spiritual needs. In practice, however, it is often very different, as evidenced by looking through the care plans and identified needs of patients nursed in either general or psychiatric hospitals.
Clinical skills: assessing and treating shock: a nursing perspective
Authors: Bench Suzanne
Published: May 2014

This article outlines the pathophysiology associated with hypovolaemic, cardiogenic and distributive shock, and discusses how each of these might present clinically in the patient. Nursing assessment of a patient in shock is explored, and the use of tools such as the pulse oximeter are examined. The evidence base for a variety of interprofessional interventions is analysed, including fluid therapies such as blood transfusion, the use of crystalloids and colloids, and drug therapies such as the use of inotropic and vasoactive agents. The nursing role in managing the patient in shock is considered throughout. The importance of recognizing the clinical presentation of shock is highlighted, with an emphasis on understanding the pathophysiology and potential systemic effects. Treatment is discussed and covers: providing optimal oxygen therapy, appropriate patient monitoring and location of care, using effective communication skills, assisting with activities of living, psychological support, and working collaboratively to maximize the overall quality of patient care delivered.
Information-seeking behaviour among people with motor neurone disease
Authors: O'Brien Mary R
Published: May 2014

This qualitative study employed indepth, semistructured audiotaped interviews with seven people with motor neurone disease (MND) to explore their desire for information about MND and their experiences in seeking and obtaining such information. Factors affecting their information-seeking behaviour were identified through a process of interpretative phenomenological analysis. Three distinct information-seeking categories emerged. Active seekers personally acquired information from a variety of sources. Selective seekers had access to information but often relied on ‘buffers’ to filter out unsuitable material. Information avoiders almost always used a ‘buffer’ to pre-screen any information to which they were exposed. All participants described negative effects on being exposed to unsolicited information, often in the form of media coverage. This work highlights the impact of unsolicited information on people with MND, an area not previously studied.
The use of combination treatments and dressings for a traumatic wound
Authors: Derbyshire Adam
Published: May 2014

With demographics, an ageing population and faster hospital discharges against us, district nurses are likely to be faced with more complicated wounds that require specialist attention. With national and local guidelines, the restriction of cost implications, patient compliance and ‘best practice’ to achieve, the nurse can find the task of choosing the correct course of treatment a daunting one. Nurses must not only consider the patient holistically, assess the wound and the predisposing factors that may be present, but also prescribe an effective treatment while being aware of what effects the treatment may have and be prepared to justify their actions when called to task. This article takes one case study detailing a traumatic wound and follows through the whole assessment and evaluation process to demonstrate how all of these demands were met. Dressings used in the case study are Promogran, Actisorb Silver 220 and Tielle Plus manufactured by Johnson & Johnson.
Dietary pattern of self-care among Asian and Caucasian diabetic patients
Authors: Meetoo Danny
Published: May 2014

Diabetes mellitus is a growing pandemic and its self-care management rests primarily with the individual. This qualitative case study investigated the self-care dietary pattern among a group of 25 Asians and 24 Caucasians diagnosed with type 1 or type 2 diabetes. Data collected from a semistructured interview and a 7-day health diary explored the self-care activities undertaken by the participants to establish metabolic control. From an analytical perspective, the collective responses were placed on a continuum ranging from strict adherence, moderately flexible adherence to very flexible adherence. The findings suggest that most of the participants were located in the latter two categories of diet related to self-care. Implications for healthcare professionals in promoting self-care will be discussed.
The role of the healthcare assistant in nursing
Authors: Castledine George
Published: May 2014

The drive towards the modernization of the NHS is not only resulting in new innovative services, but also creating new opportunities for nurses. However, many of these developments are creating concerns about the traditional role of the nurse and questions in relation to who is carrying out some of the core principles of nursing care.
Learning about teamwork in operating room clinical placement
Authors: Silén-Lipponen Marja , Tossavainen Kerttu , Turunen Hannele , Smith Ann
Published: May 2014

The aim of nursing students' operating room (OR) clinical practice is to gain experience of the perioperative nursing process and to develop skills related to the practice within OR teams in a variety of situations. However, it has previously been problematic to get enough practical experience within OR teams because of the general urgency, e.g. rapid turnover and flow of emergency cases, and preceptors' multiple responsibilities related to their simultaneous need to work as team members. This study describes how Finnish, British and American nursing students (n=30) experienced learning about teamwork during their OR placement period. The critical incident technique was used for data collection, and data were analysed using a descriptive phenomenological method. Three types of teamwork emerged based on the students' perceptions: functional manifestation of OR teamwork, gaining OR team membership and technical orientation of OR teamwork. The findings are discussed in relation to OR practice, education and research on ways to improve teamwork while maintaining a satisfactory OR learning context and stimulating interest in perioperative nursing.
Living with sickle cell disease: the perspective of young people
Authors: While Alison E , Mullen Jean
Published: May 2014

The study aimed to explore the lived experience of young people with sickle cell disease as they transferred to adult services. A cross-sectional study using semistructured questionnaires is described. Eleven young people (12–16 years) attending a sickle cell and thalassaemia centre as they approached transition from paediatric to adult services were successfully recruited to the study. Sickle cell disease was reported to interfere with various aspects of their ‘normal’ lives. Fatigue and pain were common symptoms. Reported adherence to prophylaxis was variable. It was concluded that young people with sickle cell disease require support drawing on a range of expertise and that the medical model of service delivery may not meet all their needs.
The human right to dignity v. physical integrity in manual handling
Authors: Fulbrook Suzanne
Published: May 2014

In the case of The Queen v. East Sussex County Council and The Disability Rights Commission [2003] the position in English and European Law with regard to the rights of disabled people to be lifted manually in their homes was reviewed. The judgment also reviewed the position with regard to the risks posed to carers when they manually lift. The judgment stated that where the human rights of disabled people were in issue — where their Article 8 right to ‘dignity’ was offended — then carers would in certain situations have to find ways to lift those people manually. This article reviews and challenges the findings in this case. A conclusion is reached that a reading of English and European law does not suggest that nurses and carers can be expected to be caused a physical harm to their persons, in order to assuage the ‘dignity’ rights of those they lift. Further, that issues such as insurance and compensation, possibly owing to a nurse who manually lifts, have not been settled, and that all of these issues have not been determined where lifting occurs manually in a hospital setting.
Decisions by nurses in acute care to undertake expanded practice roles
Authors: Rushforth Helen , McDonald Heidi
Published: May 2014

Since 1992, expanded practice has been an important issue in the career progression of the qualified nurse. Its contemporary relevance in the early years of the 21st century is underpinned by recent and ongoing national initiatives to blur the boundaries between healthcare providers, and to regulate practice at a higher level. This article reports the findings of a survey and indepth, semistructured interviews conducted with nurses from across the UK, which explores their views and experiences in terms of decisions regarding whether or not to undertake expanded practice roles. Insights are gained in a variety of domains of expanded practice including preparation for the role, competency verification, perceptions of accountability and liability, effects on patient care, role refusal and utilization of evidence to underpin expanded practice. These reported views and experiences have important implications for current practice and future research.
Disposal and preparation of the body: different religious practices
Authors: Dimond Bridgit
Published: May 2014

Ray had always lived with his mother. When his mother became ill she was admitted to hospital, but died within a few days. Ray wanted her to be buried under her favourite tree in their garden. What is the law?
Disrupted lives: investigating coping strategies for non-healing leg ulcers
Authors: Hopkins Alison
Published: May 2014

The aim of this study was to explore the lived experience of people who have non-healing venous ulcers using hermeneutic phenomenology. Unstructured interviews were carried out with five people who also completed a diary. Interpretative phenomenological analysis was utilized to identify themes and patterns. The core themes identified through analysis were biographical disruption, ways of coping, social implications and therapeutic relationships. The emergent themes reveal the impact of chronicity in participants' experience of chronic leg ulcers, their various emotional and problem-focused coping strategies and the positive role the district nurse plays in their lives.This study places leg ulceration within the body of literature on chronicity, linking nursing theory with the insights offered from health psychology.
Specialists must accept challenge of improving clinical outcomes
Authors: Gray David
Published: May 2014

Since its launch in 2001 the British Journal of Nursing Tissue Viability Supplement has sought to inform specialist practice in the UK. As its consultant editor I have been fortunate to work with very supportive colleagues at MA Healthcare and many enthusiastic authors and to all I offer my thanks and best wishes for the future. During this time we have seen a rapid increase in the number of nurse specialists in post, a new specialist conference Wounds-UK and the launch of a new specialist organization the Tissue Viability Nurses' Association (TVNA). As the new consultant editor of the supplement Alison Finnie indicates in her editorial, it is time for many more specialists to accept the challenge and play a more active role in developing specialist practice in the field of tissue viability. There is a need for consolidation in the field with each organization confirming its own role and specialists seeking to share and reflect on their practice so as to improve the clinical outcomes in the UK.
Clinical nursing rounds part 1: matrons' rounds
Authors: Close Ann , Castledine George
Published: May 2014

To improve patient care, involve patients more and to improve communication, clinical rounds are being re-introduced to the Dudley Group of Hospitals. This article describes matrons' rounds, which can provide senior nurses with the opportunity to achieve key aspects of their role. These include ensuring professional and clinical nursing standards, improving infection control and cleanliness by implementing ‘A Matrons’ Charter: An Action Plan for Cleaner Hospitals' (Department of Health, 2004), being visible and having a high profile for patients, and sorting out their concerns and supporting nursing staff in the clinical areas. Later articles will cover the other rounds.
Clinical nursing rounds part 2: nurse management rounds
Authors: Close Ann , Castledine George
Published: May 2014

Clinical rounds are being introduced in the Dudley Group of Hospitals to improve patient care, involve patients and improve communication. There are four types of rounds: matrons' rounds, nurse management rounds, patient comfort rounds and teaching rounds. This article describes nurse management rounds, which involve the nurse in charge of the shift seeing each patient. This gives the nurse manager an overview of the condition and needs of all the patients on the wards and the ability of staff to meet these needs. These rounds have potential benefits for patients, relatives, for the nursing team and for other healthcare professionals.
Strangers in a British World? Integration of international nurses
Authors: Winkelmann-Gleed Andrea , Seeley Janet
Published: May 2014

This article, based on research carried out in 2002–2003, examines the experiences of recently internationally qualified migrant nurses to Britain and explores their stories with the aim of understanding aspects of their work-related identities. The migrant nurses' encounters at work may highlight their difference to the majority, namely the British qualified nurses. Despite attempts on behalf of some healthcare employers of embracing diversity, the process of achieving acceptance and respect as a migrant worker can be a taxing one. Findings indicate that the nurses' identity as a ‘migrant’, rather than as a ‘man’ or ‘woman’, drew most comment in their day-to-day work. While the nurses encountered some prejudice because of their foreign origin, they also experienced fair and respectful interactions. The study highlights the complexity of work-related identities among international migrants, a group of employees which, despite nursing shortages in the NHS, has attracted little research interest and poses a challenge to management.
Restoring pelvic floor function in men: review of RCTs
Authors: Dorey Grace
Published: May 2014

The male pelvic floor muscles support the abdominal contents, are active during breathing, maintain urinary and faecal continence, increase local blood supply and are active during sexual intercourse. It was hypothesized that weak pelvic floor muscles would compromise these functions in men and lead to urinary and faecal incontinence and sexual dysfunction and that pelvic floor muscle strengthening would restore normal function. After a literature search of randomized controlled trials was undertaken, it was found that weak pelvic floor muscles compromised normal pelvic floor function and led to urinary incontinence and erectile dysfunction. Strengthening the pelvic floor muscles was shown to significantly improve post-prostatectomy urinary continence, post-micturition dribble and erectile function. It would be prudent for all men to exercise their pelvic floor muscles to maintain normal pelvic floor function.
Sustained silver-releasing dressing in the treatment of diabetic foot ulcers
Authors: Rayman G , Rayman A , Baker NR , Jurgeviciene N , Dargis V , Sulcaite R , Pantelejeva O , Harding KG , Price P , Lohmann M , Thomsen JK , Gad P , Gottrup F
Published: May 2014

This study investigated the clinical performance and safety of a sustained silver-releasing foam dressing, Contreet Foam, in the treatment of diabetic foot ulcers. Twenty-seven patients with diabetic foot ulcers of grade I or II (Wagner's classification) were followed for 6 weeks: 1 week run-in using Biatain dressings, 4 weeks' treatment with Contreet Foam non-adhesive dressing, and 1 week follow-up with Biatain dressings. Four ulcers healed during the 4-week treatment with Contreet Foam and the relative ulcer area was reduced by a mean of 56% or by 56% in average. Contreet Foam showed good exudate management properties and was considered easy to use. Only two infections occurred in study ulcers. An evaluation of non-study ulcers in the same patients showed that all six of the non-study ulcers developed an infection during the study. All ulcers (study ulcers as well as non-study ulcers) were treated according to good practice of diabetic wound care. There were no directions for the treatment of secondary wounds. No device-related adverse events were observed. This study demonstrated that Contreet Foam is safe and easy to use and effectively supports healing and good wound progress of diabetic foot ulcers.
Midwifery Records and legal issues surrounding them
Authors: Dimond Bridgit
Published: May 2014

Midwives are subject to statutory supervision and the Midwives' Rules. The Nursing and Midwifery Council has set out very special and very strict rules on how midwives records should be kept, stored, handled and supervised. Rule 9 sets out stipulations in relation to the keeping of midwifery records. Rule 10 requires them to permit the inspection of their records by the supervisor, the local supervising authority and the NMC.
Purposeful dehydration in a terminally ill cancer patient
Authors: Maxwell Lesley-Ann
Published: May 2014

The management of terminally ill patients who are unable to maintain their own hydration, or who express a wish to discontinue artificial hydration, is a significant controversial topic among healthcare professionals, patients and families. Evidence-based research suggests a number of medical and nursing indications and contraindications for dehydration. The purpose of this article is to review the current research, consider the factors involved in decision-making and clarify the complex issues which have implications for nursing surrounding the management of dehydration in terminally ill patients. The article uses the case of a patient nursed by the author and is written as a reflective account of practice.
Explanatory models of diabetes among Asian and Caucasian participants
Authors: Meetoo Danny , Meetoo Linda
Published: May 2014

Difference in explanatory models (EMs) between the person and the healthcare professional has been suggested as one reason for non-adherence to a recommended treatment regimen. The aim of this study was to explore the EMs of diabetes by a group of Asian and Caucasian participants. A total of 25 Asians and 24 Caucasians were recruited from a local diabetic clinic and subsequently interviewed about their personal EMs of diabetes. Responses to the tape-recorded semistructured interview questions about the perceived cause, time and mode of symptom onset, pathophysiology, course of illness and treatment were analysed and categories of response established and compared across the two groups. Although the results indicated some similarities of EMs of diabetes between the groups, certain differences were identified. It is suggested that nurses who include EMs in their care planning are more likely to enhance adherence among people with diabetes.
Flocath quick: a new hydrophilic-coated catheter for intermittent use
Authors: Doherty Willie
Published: May 2014

The following article looks at the new Flocath quick intermittent catheter, which has been developed with the aim of improving the quality of lives of clients and carers who undertake intermittent catheterization. Teleflex Medical (formerly Rüsch UK) provides an extensive range of intermittent catheters in both male and female lengths, as well as a range of indwelling catheters widely used throughout the community, hospitals and private nursing facilities.
The pre- and postoperative nursing care for patients with a stoma
Authors: Burch Jennie
Published: May 2014

This article revisits the various issues that surround the nurse caring for a patient with a stoma (colostomy, ileostomy or urostomy). Understanding the basic anatomy, reasons for stoma formation and the surgical operations, including variations such as continent stomas, can assist the nurse in caring for this patient group. The article discusses briefly the various stoma appliances that can be used by the nurse or ostomate (person with a stoma). Practical tips on pre- and postoperative nursing care of the patient with a newly-formed stoma are provided for the nurse. In some cases, unfortunately, complications may occur following stoma-forming surgery; these are discussed and nursing advice provided. One of the most important ways in which the nurse can support the patient is to teach the patient his/her stoma care, ensuring independence before discharge and showing empathy and compassion.
Teaching stoma-management skills: the importance of self-care
Authors: O'Connor Gloria
Published: May 2014

Patients undergoing stoma formation have to make major physical and psychological adjustments following surgery. Research indicates that the early promotion of stoma-management skills may significantly enhance the psychological adjustment to stoma formation. Teaching stoma-management skills is, therefore, a critical concern for the hospital-based stoma care nurse. This article aims to explore how the stoma care nurse specialist can best utilize teaching opportunities in the pre- and postoperative periods. Teaching should be approached in an organized manner, underpinned by sound principles of teaching and learning using teaching plans where appropriate to ensure that no vital aspects are omitted. Realistic learning outcomes should be established in consultation with the patient according to his/her readiness and ability to learn. An organized exchange of information between hospital and community will ensure that teaching and support are continued following discharge from hospital promoting positive adjustment to stoma formation and thus facilitating successful rehabilitation.
Writing for publication: adapting academic work into articles
Authors: Heyman Bob , Cronin Patricia
Published: May 2014

This article discusses how to transform material worthy of dissemination into a form that leads to successful publication. It focuses on publication of systematic and literature reviews, empirical studies and conceptual analyses undertaken as part of a course of academic study. An increasing number of nurses and midwives are undertaking healthcare-related courses at BSc, MSc, MPhil and PhD level. Many of their theses are ultimately left to gather dust on library shelves, and are only read by examiners. The authors have worked with many novice writers whose attempts to write up their theses have been unsuccessful for a number of reasons. These are explored in this article. Suggestions for avoiding the many pitfalls that can prevent publication are offered.
Clinical treatment options for peristomal pyoderma gangrenosum
Authors: Vujnovich Angela
Published: May 2014

Pyoderma gangrenosum is a rare debilitating skin disease of unknown aetiology that manifests itself as painful lesions and is often associated with inflammatory bowel disease. Stoma care nurses will encounter it directly around the stoma as peristomal pyoderma gangrenosum (PPG). There are many case reports of varying methods of treatment for PPG, although none have proven to be efficacious in all circumstances. When these lesions develop in the peristomal area, treatment must be balanced with the need to maintain an intact stoma appliance.
Kuwait: first world wealth, third world nursing
Authors: Chase Lynne
Published: May 2014

I am an American emergency nurse, and have been living in Kuwait for about 2years. I just read a statement from George Castledine (BJN, 14(18)): ‘Recently Jean Clarke (senior nursing lecturer) from Dublin and I were sharing our experiences of nursing in third world countries when she suddenly said, ‘the trouble with “care” is that you only recognize it when it is not present…’ I couldn't agree more.
No pain, no gain: pain behaviour in the armed forces
Authors: Harper Phil
Published: May 2014

Pain is a unique phenomenon that is difficult to express and is influenced by many different factors, including cultural expectations. A dichotomy exists within the British Armed Forces between pain being seen as necessary – the ‘no pain, no gain’ view – and the opposite image of stoical service personnel who suppress their emotions – the ‘roughie-toughie’ image. This dichotomy was explored through an ethnographic study of pain behaviour experienced during a training course. Pain behaviour was found to be consistent with cultural expectations and this supported the ‘no pain, no gain’ perspective. Physical and psychological pain were expressed differently, reinforcing the western, scientific mind–body dichotomy. In addition, personnel frequently tried to suppress their pain and this supported the ‘roughie-toughie’ philosophy. Thus, pain expression varies according to the context in which it occurs. Nurses need to be aware of this to ensure they interpret and manage their patients’ pain appropriately.