bluuebunny/crossref_metadata_2025 huggingface dataset:
Promoting partnership working for undergraduate students
Authors: Markey Kathleen , Barnes Charmagne
Published: May 2014

Interprofessional working is an important NHS policy aim (Department of Health 2000; Barrett et al 2005), which has meant that interprofessional education (IPE) is an increasingly important topic for higher education institutions (Caldwell and Atwal, 2003; Barr and Ross, 2006). The argument for IPE is based on the assumption that it will enhance interprofessional working and assist in ameliorating many of the challenges of contemporary health-care. However, there is a dearth of evidence of the effectiveness of IPE in the UK, particularly at undergraduate level. This does not necessarily mean that IPE is ineffective, but suggests the need to explore ways of introducing and evaluating IPE locally for undergraduate students. This article reports on an evaluation of a pilot IPE initiative for undergraduate students from different disciplines, in an attempt to consider how sustainable IPE could be introduced in one institution.
Using a reflective framework to assess skills – taking a manual BP
Authors: Chauhan Amisha , Noble Helen
Published: May 2014

>This article explores the skill of taking a manual blood pressure (BP) using a stethoscope and sphygmomanometer. Achieving competence in this area has become more difficult since the introduction of electronic BP monitors and less opportunity to practice manually. A reflective framework was used to guide the authors’ thoughts and actions related to this skill, as they learned how to competently undertake it. A particular learning style, which the authors identified as helpful is also discussed.
Knowing what to do in a fire is every nurse’s responsibility
Authors: Castledine George
Published: May 2014

As part of my mandatory update for working in the NHS, I recently went to a routine fire lecture. I was not looking forward to it as, probably like most nurses, I find them peripheral to other more interesting clinical nursing topics, and not very stimulating. But, I have to admit that on this occasion the lecture really made me think. The speaker was not your usual ex-fireman who bored you with past stories of famous fires, and spoke in traditional firefighter jargon. Instead, he took us through the session with a concerned and caring approach, highlighting the key points and then encouraging us to discuss any worries.
A sickle cell milestone
Authors: Oni OBE Dr. Lola
Published: May 2014

Sickle cell disease was once considered to be the preserve of a few inner city specialists. Today, it is arguably the most common genetic condition in the UK, with as many cases reported as cystic fibrosis in England. The disease affects an estimated 13,000 people with an estimated 240,000 carriers. Screening and care for the disease, historically a neglected area, is now part of the mainstream within the NHS. This recognition was cemented by the recent celebration of the first UN designated World Sickle Cell Day on 19 June, thus acknowledging the significance of sickle cell disease as a global health issue.
Informed patients are not a threat
Authors: Beckford-Ball Jason
Published: May 2014

We’ve all been there; the embarrassing realisation that, despite being a socalled health-care professional and the supposed fount of all knowledge, a patient or relative knows more about a condition than we do. Some of us can take it on the chin and defer, after all, the internet and modern media has made access to information that much easier – anyone with a PC and a spare half an hour can find out exactly how Dengue fever is transmitted (by the Aedes aegypti mosquito, in case you are interested). Not everyone can be that magnanimous though – as a student, I remember being intensely annoyed by a woman who told me that I was being impatient with her husband, a man with Alzheimer’s, and that I needed to adopt a calmer approach when I took him to the toilet. She was right, of course – but I was simply furious.
Exciting times for the Defence Medical Services
Authors: Elaine Bell Lt Cdr , Wink Major Peter
Published: May 2014

The last dedicated military hospital in the UK, the Royal Hospital Haslar in Gosport, Hampshire, closed in May 2007. This was the final stage in a radical change in the delivery of health care for armed forces personnel. The change saw the opening of Ministry of Defence hospital units across the UK, which are fully integrated within the NHS (for example, the Royal Centre for Defence Medicine, located in Birmingham alongside the University Hospital Birmingham Foundation Trust).
Tomorrow’s nurse graduate, today: the change in undergraduate education
Authors: McKinnon John
Published: May 2014

This article argues for a new kind of nurse graduate, equipped for the global challenges to health in the 21st century. The author points to the correlation between the public health role of a nurse in the 19th century and community health patterns of modern times to justify the shape of a recently installed undergraduate nursing studies programme at the University of Lincoln. The universal adoption of a public health philosophy by nurses is shown to be mutually advantageous to practitioners, to practice and to service users alike. In addition to research into the health inequalities and the patient experience, theoretical frameworks of learning and social policy are resourced to give direction to future nurse education and leadership among vulnerable individuals, communities and groups.
The Darzi report: implications for tissue viability nurses
Authors: Cutting Keith , White Richard
Published: May 2014

'Transforming community services’ (Darzi, 2009) is the second healthcare report to be authored by Lord Ara Darzi, which was published in July 2009. As the title suggests, it targets community services and includes specific, and sometimes disingenuous, implications for tissue viability in the community setting.
Regulating organ transplantation: A case for reform?
Authors: McHale Jean
Published: May 2014

Organ transplantation has been one of the great medical miracles: from the first kidney transplant, through to Christian Barnard’s first heart transplant in the 1960s, to face transplants. However, the need for organs for transplant has never been matched by a ready supply. It has been argued by some commentators that the shortage could be radically reduced or even eradicated by legal reform, such as the introduction of ‘opt-out’ legislation or a market in organs. This article explores the current law regulating organ transplantation and the case for reform. It suggests that to focus upon legal reform as a means of addressing the transplant ‘crisis’ may be an unduly simplistic response. The shortage of organs for transplantation cannot be easily resolved by a single piece of legislative reform.
Contradictions at the end of life
Authors: Castledine George
Published: May 2014

There are many contradictions and opposites in health care today, and yet none as topical and controversial as the present situation concerning the quality of life for patients with chronic illnesses and debilitating conditions. On the one hand, there are people queuing up to go to Swiss assisted-suicide clinic, Dignitas, to die. On the other, there are many people with chronic conditions wanting to be resuscitated despite how futile such an exercise may be.
Urinary tract infection: diagnosis, treatment and prevention
Authors: Nazarko Linda
Published: May 2014

Healthcare interventions can be episodic, and a target-based culture can lead to clinicians focusing on treating and discharging a person in a certain time frame to meet targets. When health care is delivered in pressurized acute environments, a holistic approach to a person’s health may be lost. Urinary tract infection is the most common healthcare-acquired infection in the UK, and treatment in an acute setting may be episodic. This case study of an 85-year-old female with a urinary tract infection illustrates how viewing each episode of care in isolation can lead to sub-optimal care that does not address the underlying causes of problems. Drawing on the evidence regarding best practice in diagnosis, treatment and prevention of urinary tract infection, it shows how holistic evidence-based care can address underlying problems, reduce the risk of infection and adverse events, provide high quality care and deliver successful patient outcomes.
Join the debate and help shape the future of nursing
Authors: Black Peter
Published: May 2014

Issuing guidance is only part of improving practice; subsequent implementation needs to be supported and monitored.
Let’s work together
Authors: Castledine George
Published: May 2014

The trend over the last decade has been to encourage interdisciplinary working in health care, but has it really produced the results we hoped it would? In theory, interdisciplinary working abounds with good practice, yet the clinical environment remains littered with examples of failing teams. It seems that although there are more members of the healthcare team working side by side, and the importance of good communication is continually highlighted, there is still a reluctance by many workers to seek the integration which would truly enhance clinical care.
Opting in vs opting out
Authors: Noble Helen
Published: May 2014

The need to obtain family consent is a major barrier to organ procurement. Helen Noble discusses whether mandated choice for organ donation could work.
Let’s talk about sex
Authors: Warriner Jason , Power Lisa
Published: May 2014

In a bid to ensure UK adults know the facts when it comes to sexual health, the Department of Health and the Department for Children, Schools and Families, together with the National Chlamydia Screening Programme have launched the ‘Sex. Worth Talking About’ campaign. Jason Warriner and Lisa Powerexplore the crucial role that nurses can play in educating and empowering young adults.
Higher education: help or hindrance?
Authors: Karstadt Lyn
Published: May 2014

Fresh from the Chief Nursing Officer’s summit, Lyn Karstadt contemplates the public’s less than supportive attitude to all-degree nursing, and outlines what nurses can do to change this.
A call to nursing action
Authors: Reid Jane
Published: May 2014

Can anything be more important to nurses than the safety of our patients? Probably not, unless we count nursing’s commitment to deliver quality patient care. That said, should nurses ever separate the concepts of quality and safety? I suggest not - care can never be regarded as being of good quality, if a patient is unsafe, or suffers harm, whilst in our care.
The Purpose Of The Nhs
Authors: Castledine George
Published: May 2014

Amid all the publicity about the inauguration of Barack Obama as President and the troubles in Gaza, it would have been easy to overlook the launch of the NHS ‘constitution’ (Department of Health, 2009). The Government claims that much effort and research has gone into producing this constitution. Within the document itself, it is described as being ‘concise and enduring’ and it pledges much. It not only emphasises the importance of involving and personalising the care of patients, but also the quality of care of staff.
Holistic approach to pre-operative assessment for cataract patients
Authors: Lockey John , Hassan Masud-Ul
Published: May 2014

When patients agree to have cataract surgery it is important that they are fully assessed to determine their fitness for surgery. This article discusses the benefits of a nurse-led holistic approach to patient assessment, which, in practice, should be more than simply a ‘tick-box exercise’. Essential components of the assessment include obtaining valid informed consent and performing biometry – the process by which the required dioptric power of an intraocular lens (IOL) implant is calculated prior to cataract surgery. It is a highly skilled procedure, which involves the measurement of corneal curvature and the axial length of the eye using either ultrasound or optical methods of biometry. This article examines the vital nursing roles aimed at improving the quality and efficiency of the patient’s ‘journey’.
NICE is making life difficult for cancer patients
Authors: Spall Kate
Published: May 2014

Each year, more than 7,000 people in the UK are diagnosed with kidney cancer, of which 1,700 will have the advanced form of the disease. In September 2000, the government announced the NHS Cancer Plan, a comprehensive programme of action linking prevention, diagnosis, treatment, care and cancer research to ensure the best quality outcomes for patients. However, in 2006, cancer survival rates in the UK were still among the lowest in Europe. In December 2007, Prime Minister Gordon Brown and Health Secretary Alan Johnson launched a comprehensive five-year Strategy to further improve NHS cancer services, setting clear goals for cancer care that should be achieved by 2012. This Strategy outlined four key drivers for delivery:
Understanding changes in cardiovascular pathophysiology
Authors: Chummun Harry
Published: May 2014

Cardiovascular pathophysiological changes, such as hypertension and enlarged ventricles, reflect the altered functions of the heart and its circulation during ill-health. This article examines the normal and altered anatomy of the cardiac valves, the contractile elements and enzymes of the myocardium, the significance of the different factors associated with cardiac output, and the role of the autonomic nervous system in the heart beat. It also explores how certain diseases alter these functions and result in cardiac symptoms. Nurses can benefit from knowledge of these specific changes, for example, by being able to ask relevant questions in order to ascertain the nature of a patient’s condition, by being able to take an effective patient history and by being able to read diagnostic results, such as electrocardiograms and cardiac enzyme results. All this will help nurses to promote sound cardiac care based on a physiological rationale.
A commission for nurses in England: so, what now?
Authors: Castledine George
Published: May 2014

When a government comes up with new proposals for nurses towards the end of its term of office, one is naturally suspicious about its intentions, particularly as health-care is, and will continue to be, a key political subject at every election. But let us not be too cynical at this end-stage of Gordon Brown’s term of office, which will end in a general election by June 2010.
Religion is no substitute for medical care
Authors: Castledine George
Published: May 2014

Recently, there have been some interesting issues involving the religious and health needs of individuals, such as the nurse who offered to pray for her patient (Mooney, 2009), concerns about death and dying ‘well’ (Castledine, 2008), and most recently, the furore caused by the Pope’s comments on the use of condoms. The latter caused the Lancet to accuse Pope Benedict XVI of distorting science in his remarks on condom use. The Pope, on his recent visit to Africa, said that HIV was a tragedy that could not be overcome by money alone, or the distribution of condoms, which could even increase the problem. Several EU states supported the Lancet and criticized the Pope, suggesting that the Roman Catholic church’s position would make matters worse.
The use of medical orders in acute care oxygen therapy
Authors: Wong Ming , Elliott Malcolm
Published: May 2014

The life of every living organism is sustained by the presence of oxygen and the acute deprivation of oxygen will, therefore, result in hypoxia and ultimately death. Although oxygen is normally present in the air, higher concentrations are required to treat many disease processes. Oxygen is therefore considered to be a drug requiring a medical prescription and is subject to any law that covers its use and prescription. Administration is typically authorized by a physician following legal written instructions to a qualified nurse. This standard procedure helps prevent incidence of misuse or oxygen deprivation which could worsen the patient’s hypoxia and ultimate outcome. Delaying the administration of oxygen until a written medical prescription is obtained could also have the same effect. Clearly, defined protocols should exist to allow for the legal administration of oxygen by nurses without a physician’s order because any delay in administering oxygen to patients can very well lead to their death.
Haywood case shows NMC is out of touch
Authors: Higginson Ray
Published: May 2014

Margaret Haywood has recently been removed from the NMC’s register after claims that she violated patient dignity and confidentiality by secretly filming for the BBC’s Panorama. Head of the NMC’s advisory panel, Linda Read, said Haywood’s actions constituted a ‘major breach’ of the nursing Code of Conduct.
Off-site expert support for nurses undertaking ECGs in primary care
Authors: Weatherburn Gwyn , Ward Stephen , Johnston Glenis , Chisholm Sally
Published: May 2014

One of the aims of the Department of Health is to respond to patient needs by considering how services can be delivered in more innovative ways, including more services being provided in primary care and increased activities being undertaken by nursing staff. These activities may have previously been undertaken by the GPs, or patients would be sent elsewhere, such as the local hospital, for tests/investigations. Some general practices are already using cardiac telemetry while others are awaiting feedback from system users before deciding whether to purchase services from independent providers. However, identifying how generalized results and predicted benefits will apply in a specific practice is not always straightforward. This article aims to assist the decision-making process by providing the results of an audit from eight general practices and two walk-in centres in which the electrocardiograms (ECGs) were already being undertaken by nurses. The results, which are shown for each centre, showed that the frequency of use varied between one and 27 per month, depending upon the practice. As a result of the 373 patients who had an ECG performed in practice, 76 had altered management decisions, 14 were saved hospital referral (11 of these from one walk-in centre), 18 were admitted to an acute hospital (10 from the same walk-in centre), and another 24 were referred to hospital for investigation.
Exploring the range of needs of the ostomist
Authors: Willams Julia
Published: May 2014

As the speciality of stoma care nursing has grown over the past 35 years, the need to explore and understand the complex physical and psychological needs of the ostomist has deepened. The incidence of stoma complications is diffi cult to identify (Cottam et al, 2007), although literature does suggest the creation of a stoma is related to up to 50% of complications, the main cause being attributed to general stoma management and stoma position (Baxter and Salter, 2000; Taylor 2001).
Understanding patients’ wound pain is crucial
Authors: Benbow Maureen
Published: May 2014

In general terms, insufficient attention is still given to comprehensive acute pain assessment and management (Marquie et al, 2008). The multifaceted, subjective and complex nature of pain, particularly chronic pain, often makes it difficult to pinpoint the actual cause. The situation can be further amplified by emotional factors, anticipation and anxiety, all of which may worsen the patients’ perception of pain and drastically impact on their quality of life.
Gentle foam dressings: interim results of an evaluation of the Allevyn range
Authors: Grothier Lorraine
Published: May 2014

An understanding of how wounds heal is vital to any practitioner involved in wound management, and an understanding of how dressings function and perform while on a patient’s wound is important in the decision-making process of dressing selection. This article outlines the interim results of an international multi-centre clinical in-market evaluation, and demonstrates the benefits to the patient of using the Allevyn Gentle range of dressings (Smith & Nephew). These include excellent exudate management, comfort and conformability. These results were supported by the findings that clinicians rated the performance of Allevyn Gentle at 97.3% for the indication treated, while 100% felt that Allevyn Gentle Border was easy to apply.
Promoting wellbeing: productive and healthy working conditions
Authors: Glasper Alan
Published: May 2014

In light of the recently published NICE guidelines on workplace wellbeing, Alan Glasper examines the reality behind the rhetoric, and highlights just how much pressure job-related stress really puts upon the NHS
EROMIA in inflammatory arthritis: the next step in standard practice
Authors: Palmer Deborah , El Miedany Yasser
Published: May 2014

Patient reported outcome measures (PROMs) have been increasingly recognized as important tools in rheumatoid arthritis. PROMs add up to a composite score that directly reflects changes in outcomes of immediate importance to patients on a daily basis, such as pain, sleep, fatigue, functional impairment and quality of life. Prospective collection of the patients’ information in databases has been attempted, mainly in research studies. This work was carried out to assess the possibility of systematically collecting and aggregating a focused set of clinical data in the standard clinical practice, directly and comfortably from the point of care and on an ongoing basis, using EROMIA software. Recording the patients’ data electronically has significantly (P<0.01) saved time in comparison with written paper format. It also significantly (P<0.001) saved time in retrieving patients’ recorded data. In addition to the traditional disease outcome measures, disease comorbidities such as falls and cardiovascular risks could be recorded. Recording tender and swollen joints individually was made possible. EROMIA offered a hospital-based integrated monitoring database that echoes daily clinical practice. It does not require advanced computer knowledge
Managing adverse events associated with sorafenib in renal cell carcinoma
Authors: Edmonds Kim , Spencer-Shaw Andrea
Published: May 2014

Sorafenib, a multi-targeted kinase inhibitor, is approved in Europe for the treatment of patients with advanced renal cell carcinoma whose treatment with an interferon or interleukin-2-based therapy has previously failed, or who are unsuitable for such therapy. Unlike some first-generation anti-cancer therapies, sorafenib is generally associated with moderate and manageable adverse events. Some of the most common adverse events include a hand-foot skin reaction, diarrhoea and rash. As nurses provide an interface between the patient and the clinical team, it is important that they understand how sorafenib-related adverse events impact on patients. It is equally vital that nurses are able to recognize and manage these adverse events. Our experience has shown that with patient education, early reporting, monitoring and treatment, the adverse events of sorafenib therapy can be easily and effectively managed. Optimal adverse event management helps ensure treatment compliance and ensures that patients receive maximum benefit from therapy
A new government - a new start?
Authors: Karstadt Lyn
Published: May 2014

Lyn Karstadt reflects on the possible effects of future change in policy and practice, and how funding changes might affect students.
Advancing the role of minor surgery for nurses
Authors: Dunlop Nicola
Published: May 2014

This article describes the development of the nurse specialist role in an ophthalmology setting. The nurse specialist was trained to carry out incision and curettage of chalazion – a firm, usually non-tender, localized nodule under the pretarsal skin. The aim of the nurse-led chalazion service is to provide prompt, high quality care to patients during their surgical episode, while offering job satisfaction to the nurse. The article outlines the training involved and the outcome of an audit conducted of the service. Risk management procedures and the benefits of the advances to the nursing role, to patients and to the nursing professional are explained
What do patients in NHS hospitals think about their care?
Authors: Tingle John
Published: May 2014

This article reports on some of the findings of the Care Quality Commission’s recent survey of NHS inpatients, where information was gathered with regard to standards of quality and safety
Lip service from Lansley
Authors: Hill Rosalind
Published: May 2014

Last week, Health Secretary Andrew Lansley announced that NHS targets will be replaced with hundreds of new quality measures. Three areas in particular were identified as starting points for patients in the NHS in England
Getting it right for people with a learning disability
Authors: Dawkins Beverley
Published: May 2014

There are over 1.5 million people with a learning disability in the UK. By law, all health professionals must ensure that people with a learning disability have access to good quality health care and nurses have a crucial role to play in making this happen. When people with a learning disability have access to the health care they need, illnesses can be picked up early, misunderstandings and distress minimized, and better health outcomes achieved
XMRV: does this virus hold the key to myalgic encephalomyelitis/CFS?
Authors: Crowhurst Greg
Published: May 2014

In October 2009 a team of researchers from the Whittemore Peterson Institute, in association with the National Cancer Institute and the Cleveland Clinic in the USA, made a discovery that could potentially open the door to useful treatments for myalgic encephalomyelitis/ chronic fatigue syndrome (ME/CFS). The researchers, led by Judy Mikovits, discovered a significant correlation between ME/CFS and an infectious retrovirus called xenotropic murine leukaemia virus?related virus (XMRV). XMRV is classified as a gammaretrovirus, belonging to the same broad family as HIV, but more closely related to a group of viruses that cause cancers such as leukaemia. XMRV is the first member of the gammaretrovirus genus of retroviruses to be found in humans; the research to fully understand the connection between ME/CFS and XMRV, as well as what it means to have the virus, is ongoing. The disastrous impact of AIDS on human health has significantly raised the profile of retroviruses as human pathogens, and XMRV has potentially serious health implications not only for patients, but also for those caring for people with ME/CFS
Let them eat kale: tackling dietary inequality in deprived areas
Authors: Glasper Alan
Published: May 2014

Professor Alan Glasper discusses the NHS Change4Life campaign to improve nutrition in economically deprived areas by promoting sales of fruit and vegetables in convenience stores
Humanitarian nursing aid
Authors: Castledine George
Published: May 2014

Having read many reports of the Haitian earthquake disaster, I am sure there are many nurses who would like to help but feel totally inadequate to volunteer. First of all, there is the problem of gaining relevant training and experience. There is no doubt that UK nursing education, even at degree level, is unlikely to prepare you adequately for the situations or conditions you will meet. There are some short courses around, but the real problem comes in gaining the right sort of experience to feel confident, and be of value to a humanitarian disaster team.
Negligence: the different focus of medical and legal concerns
Authors: Hodgson John
Published: May 2014

This article looks at additional areas where medical practice has been instrumental in developing the law. These cases do not involve malpractice, but do highlight how the different concerns, priorities and methodologies of medicine and law can produce problems and anomalies. One focus is on causation in relation to industrial disease, and the other on liability for negligently inflicted psychological harm
Emergency nursing must respond to audit report
Authors: Davies Kevin
Published: May 2014

In light of the National Audit Office’s damning report on the state of trauma care in England, Kevin Davies suggests we may be able to learn some valuable lessons from the military.
The future of front line care
Authors: Burrows James
Published: May 2014

This month Anne Keen MP published her findings from the first comprehensive review of our profession since 1972, Front Line Care: the future of nursing and midwifery in England (Keen, 2010). It sets out a future for a profession central to healthcare, with more responsibility to plan, deliver and monitor services. In amongst the many issues covered, one proposal does now seem at odds with the looming constraints on public services.
Time for a national strategy for men’s mental health?
Authors: Peate Ian
Published: May 2014

You should read this editorial, it concerns you, whether you are a man, woman, transgender, nurse (adult, learning disability, child or mental health), midwife, husband, wife, girlfriend, boyfriend, aunt or uncle. Men’s mental health, unlike women’s, has been in the shadows for far too long. Consider this:
Ovarian cancer online tool
Authors: Jones Annwen
Published: May 2014

Annwen Jones of Target Ovarian Cancer speaks out about a new learning tool
Lymphoedema in children: an overview
Authors: Todd Marie
Published: May 2014

Lymphoedema in children is rare and poorly recognized. Children with lymphoedema have great difficulty accessing appropriate services and treatment. The long term global consequences of living with this incurable condition are under-estimated. This article outlines the causes, effects and treatment of lymphoedema in children. Recommendations are made that all children with lymphoedema should be referred to a lymphoedema specialist as soon as swelling develops.
Healthcare workers’ uniforms: roles, types and determining policy
Authors: Cole Mark , Jackson Rachelle
Published: May 2014

Demonstrating reductions in healthcare-associated infection has become a political and clinical priority in the NHS. A plethora of strategies have received the attention of evidence-based practice, one of which is the healthcare worker’s uniform and the extent to which it may be implicated in the transmission of infection. Although existing evidence suggests that this risk is low, public opinion believes that such a correlation exists. However, it is difficult for researchers to quantify the level of risk, and organizations should be wary about developing uniform policies based on tenuous infection control evidence. Although professional standards dictate that healthcare workers perform their duties in a well-groomed, appropriately attired manner, it is infection control that should underpin an organization’s uniform policy; patients should be well-informed and reassured by this.
Nurse-led pharmacological stress testing: an overview
Authors: Jevon Phil , Hodgkins Lucy
Published: May 2014

Myocardial perfusion imaging (MPI) is a noninvasive diagnostic tool that can provide valuable information on coronary blood flow at rest and during stress. Dynamic exercise is the stress technique of choice with patients who can achieve an acceptable workload; for those unable to do so, pharmacological stress testing with adenosine or dobutamine can be used. Nurses trained in ECG interpretation and advanced resuscitation skills are increasingly involved in supervising pharmacological stress tests. This article provides an overview of nurse-led pharmacological stress testing.
The future of surgical nursing and enhanced recovery programmes
Authors: Mitchell Mark
Published: May 2014

Patients undergoing surgery in the UK are seeing a rise in the development of enhanced recovery programmes as a result of increasing medical advances. Enhanced recovery is concerned with helping patients get better sooner after an operation by following a meticulous regime of care. The practical application of these programmes is undertaken largely by nurses, despite encompassing explicit, medically-driven protocols. However, beyond the professional knowledge and skills required to aid the programmes, nursing knowledge has contributed little to this rapidly developing aspect of surgery to date. Nursing has much to offer through future creation of centrally coordinated, surgical nursing units focusing on patients' holistic experience. This article will briefly describe enhanced recovery, identify aspects of nursing knowledge that can have a positive influence, and outline practical changes to assist the development of such programmes, thereby benefiting all patients undergoing elective surgery.
Incontinence-associated dermatitis:protecting the older person
Authors: Beldon Pauline
Published: May 2014

As the older population in the UK continues to grow, so too will the number of people presenting with dermatological problems. Older people's skin is subject to dehydration internally and environmental factors externally. If, in addition, the individual suffers continence problems, he or she is at risk of painful incontinence-associated dermatitis, or even formation of a moisture lesion. The use of an effective barrier cream that gives protection while not interfering with continence pad efficacy can be an invaluable means of comfort to the older person.
The nursing and midwifery contribution to public health
Authors: Glasper Alan
Published: May 2014

Professor Alan Glasper discusses the latest Department of Health initiative to enhance the public health role of nursing and midwifery in improving health and wellbeing in society
Wound care and learning disabilities: use of the Avance NPWT system
Authors: Porter Michelle
Published: May 2014

Over the past two decades, topical negative pressure wound therapy has gained wide acceptance as a genuine strategy in the treatment algorithm for a wide variety of acute and chronic wounds ( Bovill et al, 2008 ) and over 1000 peer-reviewed publications describing the clinical efficacy and safety of negative pressure wound therapy (NPWT) for all wound types have been published over this period ( Vig et al, 2011 ). Wound care and learning disabilities are very rarely discussed as joint issues. This case study aims to highlight the successful use of topical NPWT on a patient with moderate learning disabilities and examines how wound management should be individualised to meet the needs of the patient.
Medical simulation with a twist
Authors: Sharma Neel
Published: May 2014

Neel Sharma wrote in to BJN about the importance of medical simulation opportunities for nurses.
Using exercise to improve quality of life for people with heart failure
Authors: Milligan Fiona
Published: May 2014

In the current economic climate within the NHS, behavioural-change interventions in chronic disease such as exercise programmes will be time-limited within acute hospital facilities. The challenge is to deliver cost-effective, participatory, population-specific health interventions that result in measurable benefits. Methodology: A mixed-methods study was undertaken to assess the benefits of participation in a structured exercise programme for patients with heart failure. Primary outcomes were improvements in functional capacity and quality of life. Secondary outcome measures related to patient satisfaction and sustainability of the intervention post study. Results: Overall significant improvements were not found in quality of life or functional capacity; some participants demonstrated significant improvements with others showing minor improvement or no improvement in one or both domains. Conclusions: Anecdotal evidence of perceived benefit was expressed in participant satisfaction responses. Secondary outcomes were met in relation to sustainability with commissioning of hospital- and community-based programmes on completion of the study.
The CQC's new approach to the inspection of NHS acute hospitals
Authors: Tingle John
Published: May 2014

John Tingle discusses the Care Quality Commission's (CQC) initial findings from its Wave 1 pilot inspections.
National findings from the CQC 2013 inpatients survey
Authors: Tingle John
Published: May 2014

John Tingle discusses the Care Quality Commission (CQC) national survey of patients' experiences of hospital from admission to discharge.
Nurse of the Year: Helen Dinham
Authors: Dinham Helen
Published: May 2014

Helen implemented a service improvement project to bring surgical site infection incidence down to zero for patients who are operated on in Royal Gwent Hospital orthopaedic theatre. She also led a process mapping exercise to bring Credits 4 Cleaning compliance up to 100%, and achieved 100% patient and staff satisfaction with environment cleanliness and infection control standards. As a result of her work, improved practice has been rolled out across all theatres in Aneurin Bevan Health Board and 100% Credits 4 Cleaning compliance has been achieved in all 17 theatres of Royal Gwent Hospital
Polymeric membrane dressings for radiotherapy-induced skin damage
Authors: Scott Audrey
Published: May 2014

Radiotherapy is one of the mainline treatments for cancer. One of the side effects associated with radiotherapy includes skin problems, which range from mild (dull erythema and tightening of the skin) to severe (moist desquamation resulting in open wounds that can be very painful associated with sloughy and, in some severe cases, necrosis). The increased use of advanced radical treatments, such as intensity-modulated radiotherapy treatment (IMRT), can also result in a higher number of patients experiencing skin reactions. It is estimated that approximately 87% of patients will experience a moderate-to-severe skin reaction ( Harris et al, 2011 ) An evaluation was undertaken in 20 patients with head and neck cancer following a prescribed treatment of radiotherapy to compare a polymeric membrane dressing (PolyMem®) against the standard treatment. The standard treatment consisted of topical aqueous cream at the start of radiotherapy with the addition of paraffin gauze when moist desquamation occurred. A bespoke evaluation form was completed for a period of 4 weeks or until healed. Patients were asked to complete both qualitative descriptions and numerical scores of pain for symptoms and procedural pain. Analgesia and sleep patterns were logged and, in addition, free text diaries were provided for up to 4 weeks. Common themes were identified and qualitative data analysed.
Wellbeing, the Arab spring, the impact of emerging technologies and enhanced therapeutics: don’t panic!
Authors: Green Barrie
Published: May 2014

Barrie Green responds to Chris Lee’s commentary on wellbeing, rage and the Arab Spring
Anxiety disorders: an introduction
Authors: Gournay Kevin , Rogers Paul , Curran Joe , Darling Jennifer
Published: May 2014

Overview

This article focuses on anxiety disorders, which affect many people during the course of their lives. It offers illustrative examples, an overview of the various types of anxiety disorders and some self assessments to test the reader’s knowledge
Healthy eyes: School-aged children
Authors: Blakeney Susan
Published: May 2014

It is very important that children get their eyes tested from a young age as the earlier any problems are detected, the more likely it is that they can be corrected. School nurses can help to spot any potential problems, and promote certain points to parents.
Anaphylaxis part 1: Common causes and symptoms
Authors: Reading David
Published: May 2014

In this first article of a series on anaphylaxis, David Reading provides an overview of the condition and outlines some of the common causes and symptoms.
Diagnosis of head lice in the community
Authors: Ibarra Joanna
Published: May 2014

Accurate diagnosis of head lice is crucial to the effective management of pediculosis capitis. Joanna Ibarra looks at screening methods and the importance of the whole-school approach.
Supporting young people suffering from depression
Authors: Weston Frances
Published: May 2014

In this article, part of a series on different mental health issues affecting children and young people and counselling, Frances Weston looks at different forms of depression, and signs and symptoms.
Presentation and management of eczema in children
Authors: Watkins Jean
Published: May 2014

Eczema is a common skin condition, which can have a serious impact on children and young people's wellbeing. It is therefore important that school nurses are able to support pupils with the condition and offer appropriate advice to them and their family.

This article provides an overview of eczema in children and young people, including the potential impact of the atopic and contact eczema, presentation, complications and management.
Electronic cigarettes and young people—Should we be worried?
Authors: Croghan Emma
Published: May 2014

Electronic cigarettes have recently come under scrutiny following the MHRA annoucement in June that the products should be licensed as medicines and also regulated by 2016. Emma Croghan looks at the facts.
Developing school asthma services: A case study
Authors: Hall Joy
Published: May 2014

Asthma is the most common chronic medical condition in childhood and can have an impact on the child's education and school life. The school nursing service is in a key position to advise schools on the management of children with asthma. In Stoke-on-Trent the school nursing service has developed a training programme and asthma care plans for use in schools. It has also been proactive in providing information to the Department of Health in support of the supply of emergency asthma inhalers to schools.
The specific challenges facing students with mixed race
Authors: Emery Hilary
Published: May 2014

How many times have you heard Barack Obama described as the first black US president?

Dr Hilary Emery warns that it is very easy to label people with mixed race in ways that do not reflect their particular heritage or identity and explains the serious consequences this can sometimes have.
Resources to ensure high standards in school hygiene
Authors: Forward Catherine
Published: May 2014

This series of articles aims to gather a number of resources on specific themes relevant to school nursing practice. This month, Catherine Forward looks at hygiene.
Choosing a stairlift, platform lift or through-floor lift
Authors: Kelsall Ann
Published: May 2014

For people who are unable to use the stairs, various types of lift are available for installation in private houses or public buildings. Platform lifts, through-floor home lifts, and stairlifts are used widely to move between floors, get up and down the stairs, or overcome a change in level where there is insufficient space for a ramp. They can be used independently or with assistance by ambulant disabled people and wheelchair users. The equipment must be chosen with care to suit the needs of individual or multiple users as required, and to fit appropriately into the building. This article outlines the range of equipment available, giving points to consider when selecting a lift.
A collaborative approach to slower stream mental health rehabilitation: Kelfield House rehabilitation hostel
Authors: Hale S , Mobsby I
Published: May 2014

The following article aims to explore how slow stream mental health rehabilitation can be provided, first through a working model that allows occupational therapy and mental health nursing to work together more collaboratively and, second, how a hostel environment can be used to increase the functional independence of people with enduring mental health problems.
Exercise therapy: a key component of pulmonary rehabilitation
Authors: Causey Jennifer
Published: May 2014

Exercise therapy is considered an important component in the care of the chronically breathless patient. Improvements in exercise capacity and wellbeing are the commonly reported benefits. However, further research is needed if we are to understand more about the mechanism of improvement and the contribution that exercise therapy alone makes to the patient's overall performance.
Conductive education for people with Parkinson's disease
Authors: Brown Melanie , Read Janet
Published: May 2014

In a previous article, Read and Sutton (1995) gave an overview of conductive education for adults with motor disorders. The philosophy and practice were described and an account given of the development of conductive services in the UK for people with Parkinson's disease, multiple sclerosis, cerebral palsy, head injuries and stroke. This paper offers a more specific description of the practice with service users with Parkinson's disease at the Foundation for Conductive Education in Birmingham.
Splinting the rheumatoid wrist and hand: evidence for its effectiveness
Authors: Adams Jo
Published: May 2014

This article reviews the literature and research that examines the effectiveness of hand splinting in rheumatology. For therapists there is an increasing emphasis on evaluating treatment regimes for their effectiveness, yet there still seems to be little consensus on the effect that splints can have in preventing deformity and increasing hand function for both the acute and the chronic rheumatoid hand.
Identifying evidence in emotionally-determined situations
Authors: Willson Moya
Published: May 2014

In a very diverse session the uniting theme was the identification of evidence in situations dominated by the emotional experience of the individual. Each presenter, however, demonstrated differences not only in the focus of their topic but also in their approach to critical evaluation.
Research and evidence-based practice in arts therapies
Authors: McKernon Margaret
Published: May 2014

In paper session three there was an opportunity to focus intensively on research and evidence-based practice within the arts therapies. This was taken up by a large number of delegates who heard a stimulating array of papers, gathered from work in a wide variety of situations.
Evidence-based practice: exploring the implications for research within the therapy professions
Authors: Pringle Eve
Published: May 2014

The participants of this workshop came from a wide range of clinical and professional backgrounds. The afternoon began with a 30-minute presentation. Five questions related to the development of EBP within the context of the current NHS research and development (R&D) strategy were posted. A 45-minute discussion among the participants followed which provided an opportunity for individuals to relate different aspects of EBP to their own clinical and managerial experience.
Physiotherapy effects on disability levels of stroke patients at 1 year
Authors: Warburton FG , Richardson E , Wolfe CDA
Published: May 2014

A stroke register has enabled the amount of physiotherapy received by residents of a rural health authority in Southern England to be estimated. The study provides a unique overview of who receives therapy, the quantities received and the relationship between physiotherapy and disability 1year after a stroke.
Foot function and its association with lower limb injuries in golfers
Authors: Ashford Robert L , Ross Fergus
Published: May 2014

Abnormal foot function has been linked to a wide range of injuries in numerous sports. Golf is perceived as being a rather benign game in relation to sports injury. However, poor function in golf could be strongly associated, as it is in other sports, with lower limb injuries.
The role of the car in the mobility chain
Authors: Cornwell Morigue
Published: May 2014

In spite of government moves to make public transport accessible to elderly and disabled people, the car remains a vital link in the mobility chain for those with a significant level of mobility impairment. Information and advice concerning vehicle choice, suitable driving controls and appropriate training are needed to avoid an unnecessary increase in handicap, likely wastage of money and possible jeopardy of safety.
Reminiscence: implications for use in occupational therapy
Authors: Robertson Julie
Published: May 2014

The aging process is a continuation of normal development where the individual reflects on his/her life to integrate the past with current reality. There is a need to share thoughts and experiences with others and reminiscence groups may fulfil these needs. Reminiscence is compatible with a humanistic framework and occupational therapists should research its benefits further.