bluuebunny/crossref_metadata_2025 huggingface dataset:
Public health campaign to increase awareness of the risks of high blood pressure
Authors: Chamberlain Douglas , Edwards Melanie J , Khengar Rajeshree H , Smith Sarah-Jane , Mohammed Daryl
Published: May 2014

The traditional role of the ambulance service as an emergency medical provider has evolved in recent times, with an emerging role being the promotion of public health. The current study explores this concept by evaluating one event in the ‘know your blood pressure’ (KYBP) campaign, conducted across Greater London by the London Ambulance Service NHS Trust (LAS) in April 2010. The event allowed members of the public to have blood pressure (BP) measurements and to receive advice on the health risks of high BP including stroke. Attendees with BP ≥ 140/90 were referred to their general practitioners (GPs).A subsequent telephone survey was conducted to assess campaign effectiveness. The event was attended by 2 274 people, 23% of whom had a high BP measurement. Overall 625 individuals participated in the telephone survey, over half of whom were referred for further medical attention. More than half of these individuals (56%) contacted their GP's surgery as advised. A number of individuals were either prescribed antihypertensive medication for the first time or were subsequently put on a higher dose or an alternative antihypertensive agent. An increase in knowledge of the risks of high BP was also reported. The positive findings demonstrate that ambulance services can have a role in promoting public health.
A good death: key conceptual elements to end of life care
Authors: Brady Mike
Published: May 2014

Humanity is aware that death is an unavoidable inevitability of life; however, for most it is not a subject that overwhelms our everyday lives. For patients with life limiting, palliative, and end of life conditions, however, this is different, and with what little control they do retain over their health, experiencing a “good death” remains a priority. Paramedics in their capacity as community workers are frequently called to assist end of life care patients and their families, and whilst they may be au fait with practical and clinical elements of practice, such as pain relief, the conceptual and philosophical elements are perhaps less well known.

This article introduces the concept of a “good death” before expanding on epistemology, existentialism, death anxiety, spiritual pain, grief, as well as the role of person and family-centred care, and empowerment. In addition, this article draws upon the author's personal experience of end of life care, in the hope that paramedics might have a better holistic understanding of the concepts related to those dying patients and families with whom we come into contact, ensuring a high quality, family centred, peaceful death for all.
Seasonal variations effect on trauma admissions: Myth or reality?
Authors: Makrides Panos , McArthur John , Subbu Raj , Pattison Giles
Published: May 2014

It has been long hypothesised that the volume of trauma is related to the weather. This hypothesis has been strongly supported by various studies showing this relationship both in adult and paediatric populations. Projection of admission figures based on weather forecasting has the potential to become a significant tool in predicting the short to medium term workload and therefore improve the provision of emergency care. To achieve that, there is a need for more accurate weather forecasting and a better understanding of how weather affects workload. This would allow for evidence based changes in the allocation of resources.
Understanding the correct assessment and management of lightning injuries
Authors: Mallinson Tom
Published: May 2014

While relatively rare in the United Kingdom, lightning injuries are potentially fatal and certainly serious occurrences. They are also an area of pre-hospital care with which practitioners may be less familiar. Possibly due to their rare nature, lightning strikes have also generated a number of myths and misconceptions, which may adversely affect the care given to patients and the safety of rescuers. This article discusses some of the aspects of keraunomedicine, the study of lightning injuries, and how best to manage victims of lightning strikes. This article provides an overview of the assessment and management of such patients during the immediate pre-hospital and in-hospital phases.
Clinical placements in residential care facilities part 2: negative experiences
Authors: Lucas Peter , McCall Michael , Lea Emma , Eccleston Claire , Stratton Brigit , Crisp Elaine , Robinson Andrew
Published: May 2014

Objective: This paper analyses clinical placements undertaken by final year undergraduate paramedic students in residential aged care facilities. Barriers to effective teaching and learning are identified in order to tailor such placements to better meet future health system demands.

Design: The research employed qualitative methodology using thematic analysis to identify key themes in the data.

Setting: A cohort of final year paramedic undergraduate students (n=17) completed a five-day clinical placement in one of two residential aged care facilities in Tasmania, Australia.

Method: This component of the research involved the collection and analysis of qualitative data from student and mentor feedback meetings during placement.

Results: Barriers to teaching and learning while on clinical placement were identified and categorised into a number of key themes. These include: a lack of clarity of the placement structure, inadequate clinical liaison support, and limited contact with residents and facility staff.

Conclusions: Developing placements that consider the barriers to effective learning identified in this research will facilitate further development of quality, evidence-based, best practice models of undergraduate paramedic student learning in residential aged care facilities.
Decision making for refusals of treatment—a framework to consider
Authors: Jones Steven , Williams Barry , Monteith Paul
Published: May 2014

Challenges to practice are encountered on a daily basis by paramedics that often share many common recurring themes around consent or refusal to treatment. The benefits of training and open debate acknowledge the often complex decisions relating to consent and mental capacity and reduce opportunities for future legal challenge. How the law should be integrated into everyday decision making will be examined and a framework proposed to assist practice for defendable decision making. This article was inspired following joint training undertaken with paramedics and local critical incident managers from the police, which highlighted a need for a practical decision-making framework to be available for application during incidents and for use as an analytical tool to aid post-decision reflection and learning at debrief.
Ketosis in dairy cattle
Authors: Cooper Richard
Published: May 2014

Ketosis and its subclinical form is a common disease of dairy cattle, impacting on health, fertility and production efficiency. This article discusses the aetiology and pathogenesis of ketosis, associations with reduced animal and herd performance, diagnostic challenges and potential management and dietary interventions.
ORCA: a new tool for the review of medication in asthma management
Authors: Chapman Stephen
Published: May 2014

Asthma care places a significant financial burden on the NHS at both national and local level. This article describes a rational method for the review of local asthma management called Optimising Resource Conflicts in Asthma (ORCA). ORCA is a tool that could be used by nurse prescribers to help ensure that their prescribing practice is both cost effective and accords with evidence-based asthma management, as outlined in the 2003 guidelines from the British Thoracic Society and the Scottish Intercollegiate Guidelines Network.
Nurse prescribing in palliative care: putting training into practice
Authors: Kinley Julie , Hancock Deborah , Casterton Jane
Published: May 2014

This article represents a journey made by three specialist Macmillan nurses through both the extended nurse prescribing and supplementary prescribing course. It highlights some of the positive aspects and problems encountered both in the training and since qualification. The overall conclusion made by this team is that the way forward with nurse prescribing is for the Department of Health to consider enabling prescribers to prescribe from the full Drug Tariff but within their competency, rather than to focus on extending supplementary nurse prescribing.
Professional issues for the future of nurse prescribing: a qualitative study
Authors: Travers Janette
Published: May 2014

This article details the results of a small study which looked at the views and experiences of extended formulary nurse prescribers in one primary care trust. Among other interesting findings, the study showed that levels of confidence in prescribing varied among the participants, with those having advanced or specialist knowledge displaying a larger degree of confidence. Support from medical colleagues was also seen as an important factor which contributes to the success of the nurse prescribers. In addition, the study highlighted how professional development issues are important for the future of nurse prescribing.
Pressure area care and the use of topical negative pressure vacuum therapy
Authors: Curbishley Diane
Published: May 2014

The management of chronic, infected pressure ulcers presents health care workers with many difficulties and dilemmas. This paper aims to identify and compare ways of addressing these problems, including methods of debridement, management of wound infection, control of exudate and promotion of secondary intention healing in a cavity wound. It reports on the choices of wound management made in the case of a 68-year-old woman with a chronic pressure ulcer consisting of a small, punched-out area, with undermining, high levels of exudate and signs of infection. The paper focuses on the benefits and disadvantages of using surgical debridement followed by topical negative pressure vacuum therapy (TNP).
When not to prescribe: the challenges of walk-in centre consultations
Authors: Wayman Judy
Published: May 2014

Working as a nurse practitioner and independent prescriber in a busy walk-in centre has its challenges : not least trying to find out what medication people are taking, their ongoing medical problems and allergy profile. We share the same frustrations of not having access to patients' medical records as our colleagues working in A&E departments and out-of-hours' services.
Prescribing in prison: a different perspective
Authors: Wayman Judy
Published: May 2014

Prescribing is a skill based on patient need, evidence and risks versus benefit. Risk is a potent factor that should be reassessed each time a prescription is generated. In the prison environment there is another element of risk that has to be factored into the equation-that of security.
Diagnosis and management of inflammatory bowel disease
Authors: Nightingale Allison
Published: May 2014

Inflammatory bowel disease (IBD) is a chronic condition characterized by unpredictable relapses and periods of remission. The cause is uncertain, but genes interacting with environmental triggers may play a part. Symptoms of IBD vary according to the disease site and severity. Accurate diagnosis is critical and is made through a combination of symptom history review, clinical features and laboratory tests. Treatment strategies focus on resolving symptoms as well as improving quality of life. A number of treatment options are available including 5-ASAs, corticosteroids, immunomodulator and biological therapies, and should be discussed with each patient. Where appropriate, a full nutritional assessment should be performed. Patient support and education are essential to improve concordance with treatment, and IBD nurses, where present, are crucial to care and optimizing treatment.
Prescribing in heart failure
Authors: Kirk Mary
Published: May 2014

Heart failure is recognized to be a chronic disease. Many patients are treated in the primary care setting once a clear diagnosis has been confirmed. Nurses are involved in the monitoring and management of this patient group. Nurses are best placed to treat and ensure concordance of treatment by negotiating with patients regarding their medication. Nurses are well placed to support patients and up-titrate medication. Correct management and treatment improves patient outcomes.
Spotlight on CPD
Authors: Otway Christine
Published: May 2014

This summer we have seen the publication of continuing professional development (CPD) standards by the Nursing and Midwifery Council (NMC) (2008). These have been long-awaited and I must be honest and say that, quite frankly, I am disappointed with them. The NMC (2008) circular, which introduces the guidance, quite rightly states that the NMC has a statutory responsibility to safeguard the public, and that the Shipman enquiry recommended that there should be mandatory CPD requirements for all prescribers. It also goes on to say that public opinion nowadays demands that trust in healthcare must be underpinned by objective assurance. Indeed, the NMC leaflet for patients (NMC, 2006), detailing what to expect from a nurse or midwife prescriber, says that the public can be assured that nurses who prescribe are updated regularly.
Prescribing vaccines in a travel health consultation
Authors: Umeed Margaret
Published: May 2014

The increasing number of travellers from the UK has resulted in an increase in travel health-related consultations in a variety of locations. Providers of a travel health service must be competent not only in prescribing, but also in the processes of risk assessment and administering a variety of live and inactivated immunizations. Providers of such a service should ensure they have undertaken appropriate training and are involved with ongoing continued professional development.
Adverse Drug Reactions: A Handbook for Prescribers
Authors: V. Novak Barbara
Published: May 2014

This user-friendly book consists of an extensive range of chapters, each of which is committed to groups of drugs commonly used in the management of systemic illness and disorders. Rather unusually, the book begins with defining some commonly used acronyms (abbreviations), then provides a fairly comprehensive index of named drugs and where possible, relevant drug categories. The introductory chapter draws attention to important aspects of pharmacokinetics, pharmacodynamics and pharmacogenetics, which set the scene for the next 18 chapters of the book. Factors that may induce drug interactions are highlighted and attention is drawn to substantial variability in patients' response to their prescribed treatment (medicine).
Pharmaceutical marketing and the non-medical prescriber
Authors: Adams John
Published: May 2014

The relationship between pharmaceutical companies and non-medical prescribers is a complex one, but it has as yet received relatively little attention in the literature. The provision of gifts and hospitality to prescribers is endemic, and runs the risk of damaging public confidence in the integrity and impartiality of the prescribing process. In this article, it is argued that both utilitarian and deontological ethical frameworks have proved to be inadequate, and that an approach based on virtue ethics would be more appropriate. It concludes that a complete ban on the acceptance of gifts and hospitality should be considered.
Advances in the management of Crohn's disease
Authors: Cronin Elaine
Published: May 2014

Crohn's disease (CD) is the most common inflammatory bowel disease (IBD) apart from ulcerative colitis and familial adenomatous polyposis. It currently affects over 100 000 people in the UK, and the numbers are steadily growing. It is a chronic, transmural, remitting and lifelong condition that can affect people of all ages, although it is more prevalent in those aged 15–30 years, with a second onset in those 60 years and older. This article explores the journey that a patient suspected of having Crohn's disease, or indeed someone already living with it, may experience during the course of a lifetime with the disease.
Co-codamol: formulating a solution to pain
Authors: Greener Mark
Published: May 2014

This article illustrates the importance of considering the most appropriate formulation for each patient when prescribing co-codamol (codeine and paracetamol) after paracetamol alone fails to alleviate pain adequately. For example, guidelines for managing low back pain recognize the importance of considering patient preference when choosing analgesics ( NICE, 2009 ). Because many patients prefer capsules to tablets (Goldshield personal communication; Overgaard et al. 2001 ), Codipar capsules offer an effective option for moderate pain that helps prescribers meet patient preferences. Furthermore, pain is under-recognized and under-treated in the elderly, who may also be especially susceptible to analgesics’ adverse events ( BPS/BGS, 2007 ). Moreover, up to 60% of elderly pesle experience problems swallowing tablets or capsules, reflecting the interplay between physiological senescence, pharmacological factors and age-related diseases as causes of dysphagia ( Strachan and Greener, 2005 ; Wilkinson and de Picciotto, 1999 ). Medication-related dysphagia commonly results in non-adherence. Yet many health professionals are probably unaware that swallowing difficulties contributed to non-adherence ( Wright et al, 2006 ; Strachan and Greener, 2005 ). Against this background, the recent launch of effervescent Codipar offers a potentially valuable addition to the analgesic armamentarium.

This product focus is supported by a grant from Goldshield Pharmaceuticals and abbreviated prescribing information for Codipar can be found on page 547
Childhood Vaccination
Authors: Driver Carolyn
Published: May 2014

Immunisation is one of the most important public health measures that primary care offers the population. All health professionals, regardless of whether they administer vaccines or not, should be well informed about this topic and should know where to get the latest information on the UK national schedule and evidence-based guidelines on the use of vaccines. Nurse prescribers are in a particularly good position to make the most of opportunistic encounters, to ensure that individuals who have missed routine or recommended vaccines are able to catch up without delay.
ANP News
Authors: Daniels Lowri
Published: May 2014

Nurse prescribing: is change the only constant? Some of the most hotly debated issues that currently affect nurse prescribers were discussed at the ANP Annual Conference, which was held at the Wellcome Collection Conference Centre on 19 October
Changes to the rules on pharmaceutical marketing
Authors: Adams John
Published: May 2014

The revised version of the ABPI Code of Practice for the Pharmaceutical Industry—published on 1st January 2011, with its changes coming into force on 1st May 2011—now restricts the giving of gifts to prescribers to notebooks, pens and pencils, provided only in connection with a meeting. It is argued that this change is to be welcomed as it is likely to promote public confidence in the integrity of the prescribing process.
Research and development roundup: April 2011
Authors: Brown Harry
Published: May 2014

In brief

▪ The diagnosis of sarcoidosis may be difficult, and steroids are still the mainstay of therapy ▪ Folic acid supplementation to prevent neural tube defects should be promoted to increase use in women of childbearing age ▪ Polypharmacy: a pressing prescribing issue ▪ The risk of cardiovascular morbidity rises after first exposure to antipsychotic treatment
ANP News
Authors: Daniels Lowri
Published: May 2014

Hello and welcome to the first issue of ANP News, which will appear six times a year within the pages of Nurse Prescribing, as a result of an exciting collaboration announced recently between the ANP and Mark Allen Healthcare.
Understanding pharmacogenomics: applications in prescribing
Authors: Chummun Harry
Published: May 2014

People are different because of their genetic make-up. These differences are made up of variations in proteins inherited from their parental genes or developed through mutations. If these differences occur in the enzymes (cytochromes P450) associated with drug absorption, metabolism and elimination, the person may eliminate the drug very quickly from the body, reducing its potency and requiring larger doses for therapeutic effect. Conversely, the drug may become more potent, requiring smaller doses to avoid side-effects. Presently, many drugs are prescribed first and their levels adjusted later following assessment of their blood levels—which may take several days. Pharmacogenomics, a science which explores people's drug response based on their genetic make-up and lifestyle, offers clinical tests, some which may be performed in the surgery, to identify many of the differences in a person's cytochrome P450 enzymes, so that the correct drug, amount and frequency may be prescribed from the start for maximum beneficial effects with minimum side-effects. Pharmacodynamics offers nurses an advanced theoretical and clinical understanding of these variations, the effect these may have on drug absorption, therapeutic effects and elimination process. Such knowledge empowers nurses and midwives to become more accountable and responsible, and ensure their patients/clients receive the correct drug, amount and frequency, as prescribed by the NMC.
Non-adherence to warfarin: a case study
Authors: Duke Natasha
Published: May 2014

Atrial fibrillation (AF) is a major risk factor for stroke, requiring monitoring and treatment. If there are no significant risk factors, warfarin therapy may be prescribed for some types of AF, but necessitates compliance, careful monitoring and dose adjustment. Many factors influence the effectiveness of warfarin therapy, including alcohol consumption, dietary constituents, herbal supplements, and prescribed or over-the-counter medicines. Compliance, in turn, can be affected by factors such as the presence of dementia or cognitive impairment. As exemplified in this case study, a structured approach for the management of warfarin should be adopted, ensuring factors affecting compliance or drug effectiveness may be identified and appropriate action can be taken.
Management and treatment of proteinuria
Authors: Morris David
Published: May 2014

Proteinuria is the presence of protein, most commonly albumin, in the urine. Proteinuria can have renal tract or systemic causes and is a sensitive marker of underlying renal disease. It can also be a useful prognostic indicator for the progression of renal disease and a marker of increased cardiovascular risk. Treatment for proteinuria aims to prevent progression to end-stage kidney failure, and control of hypertension is of paramount importance. Referral to a renal specialist may be required in advanced cases.
Bacterial vaginosis: diagnosis and treatment
Authors: Powell Karen
Published: May 2014

Bacterial vaginosis is the most common cause of abnormal discharge in sexually active women between the ages of 15–45 years. It is experienced by 10% of women over a lifetime and is a common cause of acute vaginitis. This article discusses the diagnosis, and the different treatment options. Prevention strategies are also suggested.
Prescribing for superficial fungal skin and nail infections
Authors: Van Onselen Julie
Published: May 2014

Nurse prescribers encounter patients with superficial skin and fungal infections on a regular basis. Nurse prescribers can provide patients with information and education on fungal infections, advice on general skin care and measures to reduce recurrence of infections. Nurse prescribers can offer treatment options for superficial skin and nail fungal infections, and advise when referral is necessary. In order to achieve this, they need to expand their knowledge of skin and nail fungal infections, fully understanding how to recognize and screen for fungal infections, as treatment needs to be advised and prescribed according to the type of causative fungi organism.
Antiviral drugs: an important part of the defence against flu
Authors: Greener Mark
Published: May 2014

Public health and infection control measures are the first line of defence against pandemic, epidemic, and seasonal influenza, which spreads when patients inhale infectious droplets spread by sneezing, coughing, or talking. Patients can also contract influenza from viruses picked up from surfaces, particularly those that are hard. In addition, antiviral drugs are an important therapeutic option. Neuraminidase inhibitors, which block an enzyme that releases viral particles from host cells, shorten the duration of symptoms by approximately 1 day. However, some authors comment that limitations in the evidence base complicate analysis of the possible effects of the neuraminidase inhibitor oseltamivir on complications and transmission. While neuraminidase inhibitors are well tolerated, one child develops vomiting for every 17 treated with oseltamivir. Amantadine works through a different mechanism of action (ion channel inhibition), but it is currently not recommended by the National Institute for Health and Clinical Excellence for either prophylaxis or treatment. Although drug companies are developing new antiviral drugs for influenza, judicious use remains essential to reduce the risk of resistance.
Reflection on facilitation of an NMP drug calculation class
Authors: Davies Sheena
Published: May 2014

In this article, the author describes how the facilitation of a drug calculation class was changed as a result of an experiential learning event. Instead of dictating how students should work out drug calculations, a problem-based learning approach is now used to help students consolidate their own methods for obtaining the correct answers. The aims and objectives of the class were also reviewed in order to relate the content of the lesson to its purpose: developing the competence of students in working out drug calculations in their own way. Learning is a continuous process; we should make the most of reflecting and learning from our personal experiences to improve our future behaviour in the workplace, whether we are non-medical prescribers or non-medical prescriber educators. It is very important to minimize error in drug calculations, as error is associated with harm to patients ( Wright, 2008 ).
Dabigatran etexilate in non-valvular atrial fbrillation
Authors: O’Donovan Kate
Published: May 2014

Atrial fibrillation is the most commonly sustained arrhythmia and carries a risk of embolic stroke. Traditionally, vitamin K antagonists were pivotal in stroke prevention but were associated with increased bleeding, challenges in achieving therapeutic international normalised ratios, and problems with adherence. More recently, direct thrombin inhibitors, such as dabigatran etexilate, have been developed and have proven to be as effective as warfarin in stroke prevention in patients with non-valvular atrial fibrillation. The main advantage of this therapy is that there is no routine anticoagulation monitoring.
Overview of peripheral nervous system pharmacology
Authors: Laight David
Published: May 2014

This article outlines and explains in simple terms some of the foundational principles of the anatomy, physiology and pharmacology of the autonomic nervous system, with particular emphasis on its principal chemical neurotransmitters/ mediators: noradrenaline, adrenaline, and acetylcholine. It also provides an overview of the pharmacology of acetylcholine at the neuromuscular junction as part of the somatic nervous system. The neuronal synthesis, storage, release and re-uptake/inactivation of noradrenaline and acetylcholine are considered along with the major receptor types and subtypes that mediate the physiological responses to autonomic neurotransmission in target tissues. Furthermore, how such neurotransmission may be pharmacologically modulated is presented, along with clinical indications and applications of therapeutic agents where appropriate.
Adherence to asthma medication
Authors: Clayton Sadie
Published: May 2014

Adherence to treatment regimens in long-term conditions is a global challenge. Asthma is an intermittent, reversible airways disease that requires the long-term prescription and administration of medication. Patients with asthma are notoriously bad at taking their asthma medication with rates of non-adherence ranging from 30–70%. Poor asthma control imposes significant risk of death, negatively impacts on the patient's quality of life and places a huge financial burden on social and health care systems. Patients need to engage in appropriate self-management strategies and health professionals need to deliver asthma services that acknowledge and reflect the patient's perspectives and needs.
The management of constipation in adults
Authors: Gardiner Angela , Hilton Andrea
Published: May 2014

Definitions of constipation vary, but in general are related to straining at stool, reduced frequency of defecation and/or a sensation of incomplete bowel emptying. These definitions are reflective of the effectiveness of colonic transit (movement of contents around the large bowel) and emptying, and may also be associated with irritable bowel syndrome. This paper provides an overview of constipation, its classification, and management approaches commonly used in an attempt to relieve symptoms. An exploration of pharmacological agents provides an overview of current evidence based practice surrounding the prescribing of medicines suitable for individuals (adults) presenting with constipation, in addition to more conservative methods such as lifestyle and dietary modification.
The benefits of Aquacel Hydrofibre wound dressing
Authors: Williams Clare
Published: May 2014

Clare Williams presents the findings of research carried out using Aquacel, a hydrofibre wound dressing, produced by ConvaTec.
Choosing bathing, showering and toileting equipment
Authors: Collins Fiona
Published: May 2014

There is a vast range of bathing, showering and toileting equipment available which can help residents with different levels of ability. Fiona Collins outlines some of the options.
Reflecting on practice
Authors: Ashurst Adrian
Published: May 2014

Reflecting on your practice is an important part of continuing professional development as it allows you to learn from your experiences. Adrian Ashurst outlines how aspects of reflective practice can help provide positive customer care.
Helping residents live with a colostomy
Authors: Plant Catherine , Brierley Rosemary
Published: May 2014

Catherine Plant and Rosemary Brierley discuss what can be done to help colostomates come to terms with their stoma and become involved in its management.
Safer handling practice 2: putting theory into practice
Authors: Wilson Christine Brown
Published: May 2014

Christine Brown Wilson explores practical strategies to support staff in implementing the theories and concepts of safer handling practice.
Pressure-reducing equipment 1: general testing issues
Authors: Maylor Miles E
Published: May 2014

This article is the first in a short series reviewing the evidence behind the use of pressure-reducing equipment. It sets the scene for later discussions about the use of pressure relief for patients at high risk of pressure ulcer development, for those with existing ulcers and for those at little risk of pressure damage.
Using equipment to solve residents' bathing problems
Authors: Jane Evans Mary , Jepson Jill
Published: May 2014

Jill Jepson and Mary Jane Evans look at problems that can arise when helping clients to bathe, and advise on important considerations when choosing equipment.
Clinical issues in stoma care practice
Authors: Taylor Penny
Published: May 2014

Penelope Taylor looks at the needs of residents with stomas, and why staff need to develop a thorough understanding of the care that this client group requires.
What kind of leaders do we need in our care homes?
Authors: Chambers Naomi , Tyrer Jane
Published: May 2014

Running a care home effectively is a difficult balancing act. This article considers the relevance of leadership theories, and assesses what works best for all those involved.
Aspects of health and safety in the workplace
Authors: Weaver Dawn
Published: May 2014

Health and safety and minimizing risks are central to the worker's role. Dawn Weaver gives an overview of key areas that should be closely monitored in care home environments.
Providing music for individual requirements
Authors: Pickles Vernon
Published: May 2014

The value of music in a care home is undoubted, but one problem is how to provide for the many individual requirements. Vernon Pickles examines the problem and some possible solutions.
Managing continence and minimizing complications
Authors: Nazarko Linda
Published: May 2014

In cases where urinary incontinence is not treatable, the aims of care are to minimize complications and maintain dignity at all times. This article will help you to manage continence effectively and reduce the risk of complications.
Caring for the skin of older residents: a practical guide
Authors: Hampton Sylvie
Published: May 2014

Many older people are not getting the right treatment for their skin. Sylvie Hampton offers some advice for carers and names a variety of useful products.
Managing pneumonia in the care home setting
Authors: Booker Rachel
Published: May 2014

Nursing and care home residents are more likely to develop pneumonia and die from it than individuals living independently in the community. This article explores the disease in this high-risk population.
Enabling residents to enjoy showering
Authors: Swann Julie
Published: May 2014

Julie Swann explores the concept of showering, describing how to make it safe and pleasurable for residents and staff.
The role of health-care assistants in supporting student nurses
Authors: Wright Kerri
Published: May 2014

The current debate on the standards of mentoring received by pre-registration nurses fails to acknowledge the role of the health-care assistants (HCAs) in supporting students in their placement area (Nursing and Midwifery Council (NMC), 2004).
Palliative care: An introduction
Authors: Fernandes Tanya
Published: May 2014

With more choice being given to residents living in care homes as to where they wish to spend the final months, weeks or days of their lives, care staff must now be prepared for the reality that at some point or another, the provision of palliative care will be necessary.
Keeping up appearances
Authors: Swann Julie
Published: May 2014

Every day people undertake personal grooming tasks including hair care, tending to nails, putting on make-up and shaving. Several activities are concerned with hygiene while others are connected with appearance. Often considerable time and energy is spent on these activities, particularly when preparing for an important event or going somewhere special. Many routines are satisfying in themselves and considered pleasurable ‘pampering sessions’, providing a sense of general well being and improving self-esteem.
Costs and benefits of using urinary catheters
Authors: Pomfret Ian , Nazarko Linda
Published: May 2014

A urinary catheter is a hollow tube that is inserted into the bladder, either intermittently or indwelling, for the purpose of draining urine or instilling fluids into the bladder. Urinary catheterization has been practised for thousands of years. The first recorded use of urethral catheters was from ancient Egypt, where papyrus reeds were used to artificially drain the bladder.
The use of emollients in managing eczema
Authors: Ward Sue
Published: May 2014

Eczema and dry skin are common problems in older people. Sue Ward explains how nurses can manage the condition and provide effective skin care.
Swallowing difficulties in stroke patients
Authors: Nazarko Linda
Published: May 2014

Many stroke survivors have swallowing difficulties, which may increase the risk of chest infection, malnutrition, dehydration and tissue breakdown. The identification and effective management of such difficulties reduces associated risks and improves quality of life.
A day in the life of a… Hotel Services Manager and a Maintenance Technician
Authors: Ingham Chris , Killilea Michael
Published: May 2014

Chris Ingham and Michael Killilea discuss their roles within The Fountains Independent Hospital.
Reducing shear and friction: Parafricta undergarments
Authors: Kerr Andy
Published: May 2014

Andy Kerr discusses the role that Parafricta undergarments can play in reducing the potential for pressure ulcers in immobile patients.
Improving nutritional status using fortified foods
Authors: Edmonds Jane
Published: May 2014

Fortifying familiar foods can help to improve the nutritional status and wellbeing of older adults in care, it can also give food records more meaning for the staff using them. Jane Edmonds discusses the priniciples of fortification and offers some simple suggestions.
Project management in nursing and residential care: an introduction
Authors: Marshall Robert , Hughes Rhidian
Published: May 2014

Project management has application at any scale in the management of resources. Robert Marshall and Rhidian Hughes introduce the principles of using PRINCE2 in the nursing and residential care context.
Days are getting darker—light the candles
Authors: Jennings Sue
Published: May 2014

Autumn has closed in. All the colours of the leaves are changing, winter is approaching, yet we have some warm, sunny days. The autumn feels damp and there is a strong peaty smell as we plant the bulbs for the spring. Everything is changing, everything is contrast. In some countries snow is already falling, and in Norway the large moose scratch themselves against tree trunks as they watch it. Little wood mice run around trying to find warmth.
Let's keep our hearts light!
Authors: Jennings Sue
Published: May 2014

It is winter for us now and the days are short. The weather can be foggy and damp. Shall we have snow this year? Always we ask the question yet we have not had ‘real snow’ for many years. Usually we think about the word light as the opposite of dark. Today we are thinking about light as the opposite of heavy. What can help us feel light-hearted especially if winter seems a bit gloomy?
A practical guide to the new immigration rules
Authors: Mear Katie
Published: May 2014

Changes to the UK immigration are set to affect the care home industry. Katie Mear explains the changes and the process that managers and those in charge of recruitment must follow to comply with the new rules, and ensure homes are not left short staffed.
Managing incontinence products effectively
Authors: Bennett Margaret
Published: May 2014

The management of incontinence products for residents living within residential care homes is an important issue for nurses and care staff. Adrian Ashurst and Maggie Bennett introduce a systematic approach.
News Analysis
Authors: Sims Beccy
Published: May 2014

Beccy Sims investigates a new report which shows that those refused access to state supported social care are becoming increasingly disadvantaged.
The what, whys and wherefores of rheumatoid arthritis
Authors: Hill Jackie
Published: May 2014

Jackie Hill discusses the signs and symptoms of rheumatoid arthritis, and the various interventions that can be implemented by staff assisting residents with this condition.
Managing depression among older people in care homes
Authors: Morris Charles , Thompsell Amanda
Published: May 2014

Charles Morris and Amanda Thompsell discuss the management of depression in their concluding article on depression among older people in care homes. Drug-based treatment, psychological therapies and social interventions are discussed.
Why we MUST screen for malnutrition
Authors: Merriman Sheila
Published: May 2014

Malnutrition is frequently unrecognized and untreated. The Malnutrition Universal Screening Tool (MUST) is an effective, reliable, tool that not only identifies nutritional problems, but also suggests appropriate interventions.
News Analysis
Authors: Sims Beccy
Published: May 2014

Beccy Sims reports on a nationwide tour to ensure dignity and respect for older people using the health and social care system has been launched by the government.
Gerontorheumatology: facing the challenge
Authors: Palmer D , Miedany Y El
Published: May 2014

Deborah Palmer and Yasser El Miedany discuss the challenges presented by rheumatic diseases in the elderly population and summarizes the methods in which such challenges can be addressed.
Dysphagia: implications of stroke on swallowing
Authors: Morris Heather
Published: May 2014

Dysphagia can lead to inadequate intake of nutrition and dehydration, and can impair quality of life. Heather Morris discusses the multidisciplinary approach that staff can employ when managing dysphagia after a stroke.
Dressed to impress: dressing in dementia
Authors: Nazarko Linda
Published: May 2014

By developing an understanding of why the person with dementia has difficulties dressing, staff are able to provide high quality, personal care which promotes and increases independence of residents.
Legal issues: dismissing a nurse or care worker
Authors: Leadbetter Farha
Published: May 2014

The implications of new dismissal procedures currently in consultation are discussed by Farha Leadbetter.
Career progression: improving communication
Authors: Ashurst Adrian
Published: May 2014

Active listening and positive feedback are crucial to ensuring that staff, residents and relatives feel they are having their needs heard. Adrian Ashurst discusses the importance of effective communication for all living and working in the care home setting.
NVQ series: the complete level two in care explained
Authors: Whitehead Elizabeth
Published: May 2014

Elizabeth Whitehead presents the first of a new series of articles explaining the fine points of the NVQ level two in health and social care, and how the course will work around the care that you give.
Caring for people with age-related macular degeneration
Authors: Bremridge Tom
Published: May 2014

Age is the biggest risk factor in the development of macular degeneration. Tom Bremridge discusses the effects of the condition and introduces the treatments and management strategies which can be employed by care home staff.
Rhythm of life: applying music to the care home setting
Authors: Swann Julie
Published: May 2014

Using music in everyday caring and group activities can enhance mood and atmosphere in the care home. Julie Swann explores the ways in which care staff can use music to improve and maintain the wellbeing of residents.
Learning from reflection
Authors: Swee-Hong Chia
Published: May 2014

In one of last year's reflective sessions, a student talked about her work with an older person from the Chinese community. The student felt she had addressed the cultural needs presented by the client, who expressed satisfaction when she was able to resume some of her daily living tasks such as frying noodles and sharing them with her fellow residents in the care home. However, the student wondered if she could claim to be holistic in her approach because she did not address the religious needs of the client, who was a Taoist. The student could not understand why the client had a large photograph of her late parents with a battery operated candle in her bedroom. The candle, which was placed in front of the photograph, was switched on from time to time
A practical guide to foot care for older adults
Authors: Wright Kerri
Published: May 2014

Foot care is a neglected area of nursing care, yet can have huge benefits for individual residents. This article describes the structure and function of the foot, common problems affecting the feet and how to give basic foot care to residents.
Understanding the impact of ageing on male sexuality
Authors: Peate Ian
Published: May 2014

Care should address the whole person, and that includes their sexual health needs, argues Ian Peate. In this article, he sheds light on the issues men face in relation to their sexuality as they age.
Understanding points-based immigration in the care sector
Authors: O'Malley Polly
Published: May 2014

Many UK care homes employ staff from outside the European Economic Area. New immigration rules mean that they will need to apply to become a registered sponsor. Polly O'Mally provides an overview.
Respect the diversity and difference of individuals
Authors: Weaver Dawn
Published: May 2014

Dawn Weaver discusses respecting diversity and differences that make us unique as individuals.
Dying trajectories and palliation in a care home setting
Authors: Nazarko Linda
Published: May 2014

Nursing homes are dealing with larger numbers of residents with palliative care requirements. Linda Nazarko discusses dying trajectories and how to support residents with palliative care needs.
Negative pressure wound therapy for older residents
Authors: Nazarko Linda
Published: May 2014

Negative pressure wound therapy is a non-invasive treatment which is believed to promote healing in many types of wounds. Linda Nazarko explains the concept of the therapy and the various systems available.
Understanding audit: methods and application
Authors: Hughes Rhidian
Published: May 2014

Rhidian Hughes reviews the range of audit methods that can be applied in healthcare settings to change and improve the quality of nursing and residential care services.
The contribution of care home staff to nutrition and hydration
Authors: Ullman Sue
Published: May 2014

Many factors can affect the nutritional intake of residents. Sue Ullman describes how good nutrition, hydration and enjoyable mealtimes can dramatically improve the health and wellbeing of older people.
News Analysis
Authors: Sims Beccy
Published: May 2014

Beccy Sims reports on the latest report from the CSCI into the state of social care in England. The report shows that around one third of homes are struggling to meet national minimum standards.
The impact of falls on residents and staff: managing risk
Authors: Mitchell Eileen
Published: May 2014

A resident's fall can impact greatly on the person's health and self-esteem. Eileen Mitchell discusses the prevention of falls in older people and the importance of education and training.
The dragon of Glastonbury Tor
Authors: Jennings Sue
Published: May 2014

Dragons seem to be becoming popular again and naturalists now think that there were dragons once upon a time! There are many stories about the Tor especially associated with the permanent spring water that tumbles into two wells: the white spring, and the red spring (so called because it has lots of iron that causes red mineral deposits). Both types of water are said to contain healthy minerals. Glastonbury is also knows as Avalon or the Island of Apples from the days when the surroundings were under water.
NVQ explained: the external verifier's final visit
Authors: Whitehead Elizabeth
Published: May 2014

Presenting your evidence in its best light will make your portfolio stand out on the day of inspection. Elizabeth Whitehead talks about the external verifier's final visit and concludes the current series
Minimizing pain and promoting comfort for older adults in care
Authors: Weaver Dawn
Published: May 2014

Care assistants have an important role to play in responding to the needs of the people that they care for. Promoting residents' comfort, and assisting in minimizing any pain is discussed by Dawn Weaver.
Putting dignity at the heart of care
Authors: Dean-Osgood Laura
Published: May 2014

Dignity is central to the delivery of personalized care of older people. It is something that is not easily defined, and it is often easier to identify when it has been lost, rather than when it is being maintained (Holdsworth et al, 2009). Though cases of undignified care are frequently highlighted, it is fortunate that there are many people working hard to rectify this situation. Care home residents should be able to live and be cared for in a dignified manner—they wish to be treated as individuals, to feel as independent as possible, to have privacy, and not made to feel like a burden to staff.
Assessment and management of dysphagia after stroke
Authors: Morris Heather
Published: May 2014

The early detection and treatment of dysphagia in patients who have sustained stroke is critical. Heath Morris discusses the assessment of swallowing ability and management of disorders in residents following a stroke.