bluuebunny/crossref_metadata_2025 huggingface dataset:
A review of the Medical Agency Services Confor-Med range
Authors: Russell Linda
Published: May 2014

Medical Agency Services Ltd (MAS) has, since 1994, been involved in the design and development of mattresses and overlays manufactured from visco-elastic polymer foam, which is currently utilized in the manufacture of domestic, automative and specialist bedding and seating products. The foam is fire retardant and satisfies the BS 5852 (Part 2) ignition source 5. The foam is a heat and weight sensitive, visco-elastic polymer, giving a high performance, pressure redistributing surface that ‘moulds’ to the patient giving simultaneous muscular/skeletal support and allowing the patient to feel comfortable. The Confor-Med mattress offers a sensible alternative for patients with high Waterlow scores who have no pressure sores, but require early intervention to prevent pressure sores developing. A case study is included in this review of the products.
The role of voluntary workers in health care
Authors: Castledine George
Published: May 2014

It is not until you work in other countries that you really appreciate the differences in healthcare systems. My recent experience of working in Scandinavia has helped me to realize the important contribution that volunteers and voluntary organizations play in the British welfare system. Everywhere in the UK there is evidence of past and present charitable acts. For example, many hospitals, schools, public buildings, almshouses and parks were built or set up by philanthropic men and women. Life was very tough before the present ‘Welfare State’ and those in need had to rely entirely upon the goodwill and charitable feelings of others. Gradually, as society became more cohesive and self-aware, it began to accept that it had a responsibility for its less fortunate members, either by voluntary action or through government intervention.
Nocturia, nocturnal polyuria and secondary nocturnal voiding
Authors: Addison Ray
Published: May 2014

Getting up once to the toilet at night is normal. Getting up more than once may be abnormal. Potential causes include: nocturia, which is bladder related; nocturnal polyuria, which is cardiac in origin; and being awake for a variety of reasons that are not linked to the bladder. Bladder problems, therefore, are not always the reason for frequency in micturition at night and treatment will only be effective if the correct cause and/or causes are identified. The most useful investigation to help with diagnosis is a frequency volume chart linked to an assessment identifying causes of secondary nocturnal voiding and nocturnal polyuria. Getting up to the toilet at night will not always be successfully treated by anticholinergics. Charting is the key to diagnosis, appropriate interventions and successful outcomes. This article will focus on working definitions, prevalence, causes, investigations and treatment options for nocturia, nocturnal polyuria and secondary nocturnal voiding.
Running a nurse-led nebulizer clinic in a district general hospital
Authors: Porter-Jones Gary , Francis Siwsan , Benfield Grant
Published: May 2014

The widespread home use of nebulizers for delivering bronchodilating medication in patients with a variety of respiratory conditions is well documented, as is the lack of appropriate assessment before this form of treatment is prescribed (Cochrane et al, 1985). When it is considered that the use of nebulizers at home is increasing (Drug Information Bulletin, 1994), it is essential that appropriate assessment is undertaken in line with British Thoracic Society recommendations in order to ensure that the degree of benefit is sufficient to justify the inconvenience, potential dangers and high cost of nebulizer therapy in the home. This article examines a nurse-led nebulizer assessment clinic that was set up as part of a service for providing home nebulization for long-term use in patients with chronic obstructive pulmonary disease or chronic severe asthma.
The ‘Teaching Care Home’: new concept, old lessons
Authors: Nolan Mike , Davies Sue
Published: May 2014

The report by the Royal Commission on Long Term Care will no doubt provide the stimulus for improvements in an important sector which rarely receives the recognition and status it deserves (Royal Commission, 1999). The scope for innovation and development is considerable.
Clinical governance and self-regulation in nursing
Authors: Castledine George
Published: May 2014

Much is being made of clinical governance in health care at the moment. It is seen as the way in which organizations can ensure the provision of high quality clinical care by making individuals accountable for setting, maintaining and monitoring their performance standards (please also refer to Iain Crinson's article on p. 449). The Department of Health (1998) defines it as ‘a framework through which NHS organizations are accountable for continuously improving the quality of their services and safeguarding high standards of care by creating an environment in which excellence in clinical care will flourish’.
Clinical governance: opportunity for nurses?
Authors: Castledine George
Published: May 2014

The professional development of British nursing has always been hampered by: the lack of a brief, concise and precise statement that communicates to the public and other professions what nurses do; the difficulty in motivating nurses to agree on an agreed purpose; the fact that many professional organizations and official bodies, e.g. the UKCC, national boards and unions, instead of working together, compete with each other and duplicate activities unnecessarily; and nurses' lack of authority because they find it difficult to mobilize their resources and influence change in the healthcare system.
Doctors are not gods: a few just think they are
Authors: Castledine George
Published: May 2014

Often, it is the media who has the greatest influence on healthcare reform. Recently, The Times (Baldwin and Frean, 2000) carried a front page article stating: ‘Dangerous and incompetent doctors will be swiftly banned from practising under new measures that will challenge the medical profession's traditional independence.' Although the media claims to be objective, it tends to look for the most sensational aspect of the story under scrutiny. At the moment, the media's favourite topic is doctors.
Nurses must not let themselves be used
Authors: Scott Helen
Published: May 2014

In a recent speech at St Thomas' Hospital in London, Tony Blair stated that ‘appropriately trained’ nurses should have greater powers to order X-rays, blood tests and other diagnostic procedures, to interpret their results, give medication and discharge patients. In other words, Mr Blair thinks that nurses should act as doctors.
Confidentiality 14: powers of the police and access to information
Authors: Dimond Bridgit
Published: May 2014

Staff nurse Paula Rose was on duty in the accident and emergency (A&E) department early one Sunday morning when a police constable came in asking for details of any patient who had been brought in and for whom there was evidence of a fall from height. The constable explained that a girl had been assaulted and raped while in her bedroom by an assailant who came in through the window. Her screams brought help, but he made his escape from the window and she believed that he had fallen and may have suffered fractures or bruises.
Gastrointestinal Nursing awards 2012
Authors: Gardner Sophie
Published: May 2014

Salary costs account for 60% of the NHS budget and given that nurses make up the largest professional group, it is no wonder that they are coming under increasing scrutiny for efficiency savings. This is why, in the last few issues of Gastrointestinal Nursing, we have been emphasizing the importance of proving your worth as a nurse.
Expanding tissue viability practice through telemedicine
Authors: Newton Heather , Trudgian Julie , Gould David
Published: May 2014

Telemedicine can be defined as the electronic transfer of medical information to remote sites in order to support patient care and medical education (Norton et al, 1997). The concept of telemedicine has been around for more than 20 years; however, with the advantages of affordable technology it is set to play a major role in the future of health care. The use of telemedicine within the field of dermatological practice is well documented in the literature but the use of this referral system by clinical nurse specialists in tissue viability appears to be in its infancy. This article seeks to dispel the myths around the use of technology to enhance clinical practice and uses the authors' personal experience to describe its effectiveness for referring patients with complex tissue viability needs.
Should there be random drug tests for nurses?
Authors: Castledine George
Published: May 2014

There is a strong possibility that random testing of staff for drink and drugs will be implemented in the NHS. Trusts are holding talks with companies specializing in testing for substance abuse in the workplace and the NHS Confederation has confirmed that pilots for tests will be part of a review of work and safety procedures. This should not come as any surprise because today there are increasing concerns about drug and alcohol abuse in our society. Although parents, peers and other environmental influences are important in shaping drinking behaviour, numerous studies document that children and adolescents are greatly influenced by alcohol advertising (Grube and Wallack, 1994).
Hirschsprung's disease: diagnosis and management in children
Authors: Rogers June
Published: May 2014

Hirschsprung's disease is a congenital abnormality of the bowel which results in loss of peristalsis, and is one of the main reasons why an infant may require a stoma soon after birth. Various stages of surgery may be required to resect the affected part of the bowel, including formation and closure of the stoma. Following surgery, the perception of many families is that their child is now ‘normal’ and that all previous problems of managing their child are now resolved. However, there are a variety of postoperative complications and issues relating to bowel control which can affect the child in the long term. This article looks at how potential postoperative long-term problems can be identified early, and thus minimized, by healthcare staff being aware of possible problems, taking a proactive approach to management and advising families about the issues involved.
Legal aspects of consent 6: the mentally incapacitated adult
Authors: Dimond Bridgit
Published: May 2014

In the last article in this series (Vol 10(9): 614-15), the tests for determining mental capacity were discussed. This article considers the law which relates to the care of a person who lacks the necessary mental capacity to make a valid decision.
Impact on professional carers of structured interviews with families
Authors: Lundh Ulla
Published: May 2014

This article describes a Swedish study exploring the impact of a structured assessment process on both family and professional carers. A total of 20 professional carers conducted in-depth assessments with 245 family carers and were later interviewed about their experiences. The interviews indicated that the assessment process had provided valuable new insights and had challenged many existing preconceptions. They also afforded carers the opportunity to explore difficult emotional issues, suggesting the need to develop services to help carers deal with their feelings.
Pregnancy anxieties and natural recognition in baby-switching
Authors: Davis Joan DiPasquale , Moran Mark K , Horger EO , Dajani Aref N
Published: May 2014

Recent media reports in the USA of baby-switching at birth have caused anxiety for a number of maternity patients. Although alternative precautionary procedures are being implemented by hospitals to prevent baby-switching, ways to allay the maternity patient's anxiety must alsobe considered. While maternity patients can be expected to recognize their neonates, it is less clear how well they perform recognition under specified conditions. An American team of researchers noted postpartum mothers' anxiety levels and their natural cues to recognize crying sounds and garment smells of their babies as preventive measures against baby-switching. An experimental study design was used to conduct this research. Participants completed a demographic form and Levin's pregnancy anxiety instrument, followed by three recognition challenges for hearing and smelling cues. Ten per cent of mothers reported anxiety about baby-switching, 65.9% recognized their babies from recorded crying, and 52.3% recognized their babies by smell. Mothers do have the natural ability to recognize the cries or smells of their babies, even when anxious about baby-switching. Educating new mothers, acknowledging their natural ability for baby recognition, and promoting the use of private rooms with same-room (couplet) care can serve as extra safeguards.
Use of Exu-Dry in the management of a variety of exuding wounds
Authors: Edwards Jacky
Published: May 2014

Exu-Dry is a relatively new product that is designed to manage a variety of exuding wounds. It is a one-piece, multilayer, highly absorbent, non-adherent wound dressing. It is unique in construction, and incorporates a non-adherent wound contact layer which, it is suggested, makes dressing changes less painful and traumatic. This article explores the use of Exu-Dry in wounds, including heavily exuding wounds, burns, pressure ulcers, skin grafts, donor sites and fungating wounds.
Sexuality: meaning and relevance to learning disability nurses
Authors: Wheeler Paul N
Published: May 2014

The author posits the view that, while there has been considerable growth in the quantity of published material on the subject of sexuality, few authors have attempted to define what is meant by ‘sexuality’. It is suggested that because the concept is intangible and ill defined many nurses find it difficult to approach this aspect of holistic care. In an attempt to address this problem, the main body of this article seeks to explore the concept of sexuality and in so doing seeks to provide the reader with clarification as to what the concept entails. The latter part of the article considers the concept of sexuality in relation to the author's client group, namely persons with learning disabilities. In doing so, the author seeks to demonstrate the relevance of the subject to nurses working with people with learning disabilities.
Opsite Plus™ in the management of low to moderate exuding wounds
Authors: Fear Mair
Published: May 2014

This article discusses the use of OpSite Plus™ (formerly known as OpSite Post-Op™) in the community setting. This semipermeable film dressing with an absorbent pad was evaluated by the community hospital and by practice and district nurses within Plymouth's NHS Primary Care Trust.
Nurses must enhance care in the wake of Bristol
Authors: Glasper Edward Alan
Published: May 2014

Long before the 3-year public inquiry into children's heart surgery at the Bristol Royal Infirmary was finally published (Department of Health (DoH), 2001), healthcare professionals were acknowledging that the old health service needed reform.
An enduring monument to a crude injustice
Authors: Cardy Peter
Published: May 2014

Since last December, when NICE announced its Christmas present to people with multiple sclerosis (MS) of yet another unforeseen stage in its appraisal of the first disease-modifying drugs for MS, the voices of people phoning the MS Society have changed. From tones of anxiety, hope or quiet wistfulness about whether the licensed drugs will be available, we now hear anger and outrage after one device after another seems to be employed to keep the drugs out of reach. The outrage is often altruistic; people who know they are not eligible for treatment because they have got the wrong kind of MS are scandalized that those who meet the clinical criteria should be debarred.
Women's health in prison must be improved
Authors: Parrish OBE Alan
Published: May 2014

The challenges encompassing the care and control of prisoners have stretched the minds and intellect of many from areas as diverse as politicians, professionals, lay people and academics. Providing good quality health care is an ongoing struggle for any multidisciplinary team in prison health care. The complexity of the relationship between professionals and the patient is amplified because of the unique environment and the prison culture.
Legal aspects of consent 14: organ removal, retention, storage
Authors: Dimond Bridgit
Published: May 2014

Sarah was born with a congenital heart condition. Unfortunately, the subsequent operation proved unsuccessful and Sarah died. Sarah's parents were asked if they would agree to a postmortem being performed to assist in research so that in future such conditions could be successfully operated upon. The parents agreed and subsequently they were notified that the body was available for disposal. They decided upon a cremation. Several years later, following an inquiry into the pathology services of the hospital, they were notified by the Chief Executive's department that Sarah's heart, lungs, liver and other organs had been retained. The parents were shocked. What is the law?
Personal care: basic, simple and dispensable?
Authors: MacAlister Lanette I
Published: May 2014

Recent publications emanating from the Department of Health (DoH) would seem to suggest that there is some considerable confusion, at Government level, concerning what is and what is not deemed to be nursing care.
Reform of mental health law must not be rushed
Authors: Dimond Bridgit
Published: May 2014

Mental health law attempts to balance public safety with protecting the rights of those suffering from mental disorder. Before 1959, the emphasis was on public safety which led to unjustifiable long-term detention for many people.
Web Watch
Authors: Gibson Sue
Published: May 2014

Welcome to Web Watch. The last edition looked at the newly launched NHS Web site and its useful links. This time we offer other Government sponsored sources of information and advice. As ever we urge you to bear in mind that you should use your professional judgment over any material you receive from the Internet, just as you would when reading material in print.
Legal aspects of consent 16: statutory provisions and living wills
Authors: Dimond Bridgit
Published: May 2014

Mary had cared for her invalid mentally infirm mother for many years and was determined that if she ever lost her own mental capacity she would not wish to be kept alive. She drew up a document, witnessed by her sister, that stated in the event of her suffering from any form of mental incapacity she would not wish to be fed or have any medical or nursing intervention. Some years later she began to suffer from the early signs of Alzheimer's disease. Her sister had died, but staff were aware that Mary still carried this living will on her person. She is now refusing all food. What is the law?
ARTICLE
Authors: Cutcliffe John JR , Jones Julia , Jackson Ann
Published: May 2014

The above article describes a cyclic model of violence to psychiatric nurses and reports on a partial test of the model. It argues that stress induced by exposure to violence leads to impaired staff performance and adoption of behaviours which make the reoccurrence of violence more likely. It proposes that certain staff behaviours (e.g. expressing verbal hostility) would be associated with an increased risk of assault. It reports that there was some evidence of the proposed association and discusses the implications of these findings for psychiatric nursing.
Learning disability nursing needs theory and practice experience
Authors: Jukes Mark
Published: May 2014

It has been suggested that few social service managers have the experience to appreciate the value of community learning disability nurses (CLDNs) (Messant and Caan, 2000). According to Messant and Caan, due to the broad spectrum of health and social needs required by the population, ‘activity and outcomes are difficult to quantify and aggregate’. These observations are made in relation to the current climate of some social service departments taking over the management of CLDNs. They also follow in the wake of joint investment plans being realized where social care teams and community nurses are working together. This has led, in some cases, to the operational role and clinical skills of CLDNs being either ignored or diluted or CLDNs being recommended to adopt a quasi-care management function rather than a ‘hands-on’ approach (Greig, 1999).
Legal aspects of consent 1: the mentally competent adult
Authors: Dimond Bridgit
Published: May 2014

Following a road accident, Ralph, a 25-year-old man, has been told that his hand has been so badly injured that it cannot be saved and he therefore needs to have it amputated. He says that he would prefer to die than have an artificial ‘hook’. The ward sister arranges for him to be visited by a young woman who has had a similar amputation following injury and has learnt to use a prosthesis. Ralph still refuses. He is visited by a psychologist who considers that he has the necessary mental capacity to make his own decisions. His family and girlfriend plead with the surgeons to carry on regardless of his refusal, since he is too young and immature to understand the implications of his decision. He repeats to the nursing staff that he knows he will probably die without surgery, but he has made up his mind.
Nurses need to sort out their system of care
Authors: Castledine George
Published: May 2014

As nurses we often use clichés such as ‘total patient care’, ‘holistic care’, ‘individualized nursing’, ‘named nurse’, ‘nursing process’, ‘patient-centred care’ and ‘primary nursing’. What is meant by these terms, or what actually happens when these words are put into practice, varies widely.
Judges and politicians want a patients' revolution
Authors: Tingle John
Published: May 2014

When Britain's Lord Chief Justice, Lord Woolf, and the Secretary of State for Health, Alan Milburn, make statements about doctors, it is sensible to listen. The medical profession has had a bad press recently and fundamental change has been called for in the way doctors are disciplined. It is common knowledge that health litigation has gone up in recent years and that the courts are playing an increasing role in solving the nation's ethical health dilemmas. Judges and politicians are clearly a very influential force in the everyday running of the NHS.
New benchmarking toolkit reveals nursing's essence
Authors: Castledine George
Published: May 2014

The disproportionate amount of time nurses have to spend on medical tasks and administration seems to be inhibiting the quality of nursing care in the UK. When in conversation with registered nurses over the introduction of the Government's latest benchmarking initiative to improve standards of nursing care (Department of Health (DoH), 2001), I was told: ‘We haven't got time for this, especially now that we have to do some of the doctors' work.’
Ambitious plans for people with learning disabilities
Authors: Scott Helen
Published: May 2014

Any initiative that aims to improve the lives of people with learning disabilities is to be welcomed. The new White Paper, Valuing People: A New Strategy for Learning Disability for the 21st Century (Department of Health (DoH), 2001), which was written in consultation with people with learning disabilities, intends to reduce the social exclusion and discrimination experienced by people with learning disabilities and their families.
Nursing must not lose the tradition of the lamp
Authors: Scott Helen
Published: May 2014

In early May many nurses celebrated the lives of two nursing pioneers. A commemoration of Mary Seacole took place at St Mary's Catholic Cemetery, London, on 5 May, and the life of Florence Nightingale was celebrated at Westminster Abbey in London on 9 May.
Prison health care: is it a crisis waiting to break?
Authors: Parrish Alan
Published: May 2014

Anew report from the British Medical Association on prison health care, entitled Prison Medicine: A Crisis Waiting to Break, is an excellent exposition of the difficulties and challenges facing doctors and other healthcare staff as they carry out their duties when working in prisons (British Medical Association, 2001).
Prevention of pressure damage at the Queen's Medical Centre
Authors: Eyers Gill
Published: May 2014

The Wound Management Policy Group is a sub-committee of the Nursing and Midwifery Development Group and has an important role at Queen's Medical Centre, both in providing support to the tissue viability clinical nurse specialist and in providing a multiprofessional perspective on the development and evaluation of policies, protocols, strategies and guidelines in all aspects of tissue viability. The four major recent projects are: the Nottingham Wound Care Formulary and wound management guidelines; the strategy for the prevention and management of pressure damage; the policy and procedure for obtaining pressure-relieving equipment; and the development of group protocols. These projects are described below. The Wound Management Policy Group promotes the use of evidence-based practice across Queen's Medical Centre to ensure the provision of high-quality care in all aspects of wound management.
Short Reports
Authors: Kingsley Andrew
Published: May 2014

The issue of strikethrough of mattress covers has been causing much debate and concern among tissue viability nurses (TVNs), mattress manufacturers and the Medical Devices Agency (MDA) in the last few years, particularly with regard to infection risk and foam performance following fluid ingress. The words ‘hydrolysis’ and ‘delamination’ have entered the industry vocabulary. These refer to the breakdown of the cover, thus allowing ingress of body fluids into the foam beneath.
Influencing clinical practice: evidence-based wound care
Authors: Towler Jo
Published: May 2014

Influencing clinical practice increasingly requires quality evidence to support recommendations and guidelines. Review of the evidence for wound care interventions provides practitioners with several challenges. Randomized controlled trials are scarce and have many limitations with respect to wound care, while other sources of evidence are often flawed because of the complexities of the wound-healing process or are limited by their methodology. This article attempts to explain some of the benefits and problems associated with different types of evidence, all of which need to be considered in order to influence wound management.
Strikethrough: review of research on mattress cover performance
Authors: Russell Linda
Published: May 2014

During the past few years there have been increasing concerns regarding the performance of pressure-reducing foam mattress covers. Initially, a small number of people observed these problems. However, recently, many more people have begun to identify similar problems with their covers. This article is the result of a collaboration between Medical Support Systems and members of the editorial board of the British Journal of Nursing Tissue Viability Supplement. Medical Support Systems commissioned research from Nottingham Trent University and Cardiff University. The research findings were then passed to members of the editorial board for consideration and the development of this article. The article will present the rationale for the research and the results will be highlighted. It is hoped that it will help inform us and assist those currently working towards a resolution of this problem. The full benefit of this new information will only be felt after an extended debate of not only the results, but also their wider implications.
RCN and NMC have both reached crucial stages
Authors: Castledine George
Published: May 2014

Confidence in the UK's two largest nursing institutions may well be waning. Both the Nursing and Midwifery Council (NMC) and the Royal College of Nursing (RCN) are, it seems, in trouble. Recent highly publicized events have started to question their future directions.
New evidence reaffirms the safety of the MMR vaccine
Authors: Glasper Edward Alan
Published: May 2014

New research overwhelmingly rejects a link between measles, mumps and rubella (MMR) vaccination and inflammatory bowel disease, autism or developmental regression in young children (Donald and Muthu, 2002). This latest and comprehensive systematic review should finally lay to rest the ghost of the MMR controversy; but will it?.
Foetal programming and coronary heart disease in later life
Authors: Jones Chris
Published: May 2014

The maternal environment has traditionally been seen as having the utmost importance for the developing foetus. However, a debate has been raging within medicine for the last decade, which points to the key role of the mother's state of health for the subsequent health of the baby. In particular, her nutritional state has been argued to be of critical importance to the health of her offspring not only in infancy but also as it approaches middle age. Evidence has been accumulating that the baby's state of intrauterine nutrition will determine the likely health problems that the mature individual will exhibit. This proposition has enormous implications for anybody involved in health promotion and for public policy. This article aims to summarize the main points in this debate and to draw tentative conclusions for the practising nurse, midwife, and health visitor.
How we use language and its value in nursing
Authors: Castledine George
Published: May 2014

Over the past few years I have noticed an increase in the number of professional conduct cases involving nurses using inappropriate language with patients. An example of this is the misconduct case which appears in our misconduct series on page 855.
Prioritizing care is an essential nursing skill
Authors: Castledine George
Published: May 2014

It is a tough world in nursing practice these days and the key to surviving is getting your priorities right. Top of the priority list, of course, are the patient's problems; sorting out which problem to deal with first is critical to achieving the right outcomes for the patient.
Responsibilities in relation to controlling hazardous substances
Authors: Dimond Bridgit
Published: May 2014

Daisy, the ward manager in the children's ward at Roger Park Hospital, was on duty one morning when she heard a scream and rushed to the cleaner's room. She saw one of the patients with a bottle in his hand clearly in considerable pain and distress. It was subsequently discovered that the boy, aged 5 years, had wandered from the main ward and found a bottle of cleaning fluid in a cupboard in the cleaner's store room and had taken a drink from it. At the time of the incident, the ward staff had thought that his parents were supervising him.
Pressure area management: a static-led approach
Authors: Thomas Janet , James Jane
Published: May 2014

An increase in expenditure and inappropriate use of pressure-relieving equipment, along with high-prevalence figures, initiated the evaluation of current practice of pressure damage prevention in an acute general hospital. This evaluation started with the organization of a project group, who (after a baseline clinical audit) identified and procured the resources required to introduce and manage an effective pressure damage prevention programme. The investment in high-quality static mattresses for all patients including those who are at high risk of developing pressure damage was based on available clinical evidence. This investment meant a reduction in the amount of dynamic systems needed as many of those patients are at high risk of pressure damage, and are now successfully managed on a static system. The development of a local policy including documentation facilitated regular reassessment of risk level based on a risk assessment tool and clinical rationale. This static-led approach has reduced not only costs but also improved the appropriate allocation of pressure-relieving/reducing equipment. The approach has also simplified the choice of equipment for staff who were previously expected to match patients' need with varying levels of dynamic mattress efficiency. This article highlights the action taken from the initial identification of a specific need through to the effective implementation, management and monitoring of this innovative practice.
Web Watch
Authors: Redmayne Jon
Published: May 2014

This edition of Web Watch looks at sites relating to learning disability nursing. While we have been careful to list only sites that have been recommended by specialists in the field, we re-emphasize our usual warning about evaluating any material you get from the internet in the same way that you would with materials you find anywhere else.
An introduction to clinical negligence: nurses and the law
Authors: Tingle John
Published: May 2014

Clinical negligence is a serious problem in the NHS, with claims and costs rising steadily. In order to understand the system fully, reference must be made to the increasingly complex and developing NHS quality regulation and management structure and the law must be considered in this context. This series of articles will look at the concept of clinical negligence and examine some of the legal issues that arise.
Understanding the legal duty of care in the course of negligence
Authors: Tingle John
Published: May 2014

The first article in this series gave an introduction to clinical negligence (Vol 11(15): 1033–5). This article begins with a discussion of the law of negligence within the context of the law generally. What must be established in order to bring a legal claim for compensation in negligence is also discussed along with the important concept of owing a legal duty of care. The duty of care concept is illustrated through two cases.
Web Watch
Authors: Mangan Paul
Published: May 2014

This edition of Web Watch looks at sites relating to critical care. While we have been careful to list only sites that have been recommended by specialists in the field, we re-emphasize our usual warning about evaluating any material you get from the internet in the same way that you would with materials you find anywhere else.
Challenge of raising the status of gerontological nursing
Authors: Nolan Mike , Brown Jayne , Davies Sue , Nolan Janet
Published: May 2014

The National Service Framework (NSF) for Older People (Department of Health (DoH), 2001) has aroused considerable interest, and one can imagine the frenzied activity now occurring the length and breadth of the country. No doubt in trusts throughout the land older people's ‘champions’ are doing their utmost to ensure that the standards set in the NSF are being addressed. One of the enduring and fundamental challenges is to raise the status and value accorded to working with older people. Unless this is achieved, all else is likely to be in vain.
The role and power of safety representatives and committees
Authors: Dimond Bridgit
Published: May 2014

Doreen, who had been a union member for many years and more recently had become a union officer in her local branch, was asked by the union if she would like to take on the role of being a health and safety representative. She was hesitant to accept as she was not sure what would be involved.
Legal aspects of consent 20: research/children/incapable adults
Authors: Dimond Bridgit
Published: May 2014

James is 10 years old and is suffering from leukaemia. He has had a bone marrow transplant which at first appeared to succeed, but has now failed. The health authority has refused, in the best interests of James, to fund further chemotherapy and a second bone marrow transplant. However, the pioneer of a new treatment for leukaemia has offered to provide treatment for James without any cost to the family. The family is tempted by the possibility of James’ life being saved. What is the law?.
Whistle-blowing and the Public Interest Disclosure Act 1998
Authors: Dimond Bridgit
Published: May 2014

Dave worked in the intensive care unit and was concerned at the staffing levels. On several occasions over a weekend he had been compelled to look after more than one ventilated patient at the same time and he feared that a serious tragedy was imminent. What action could he take?
Web Watch
Authors: Mangan Paul
Published: May 2014

This edition of Web Watch looks at sites relating to diabetes. While we have been careful to list only sites that have been recommended by specialists in the field, we re-emphasize our usual warning about evaluating any material you get from the internet in the same way that you would with materials you find anywhere else.
Network For Psychiatric Nursing Research Journal Club
Authors: Cutcliffe John JR , Jones Julia , Jackson Ann
Published: May 2014

This article attempts to investigate the relationship between alcohol/drug abuse and the frequency of religious service attendance in adolescents within south eastern USA. The authors used a survey to collect data from a total sample of 217 adolescents aged between 12 and 19 years. The sample comprised both a non-clinical and clinical group. The results indicate that as attendance at religious services increased, alcohol and drug abuse decreased. The authors conclude that spirituality is a concept that warrants further study in order to determine if its inclusion within treatment programmes could help enhance recovery or reduce recidivism.
Generating dialogue in nursing
Authors: Farmer Elizabeth
Published: May 2014

Winnie the Pooh said ‘Where are we going to, I don't know, anywhere, anywhere, I don't know’ (AA Milne). Upon scanning the pages of most nursing journals one might be forgiven for thinking that the discipline of nursing is in great shape. Specialist and consultant nurses abound, the benefits of lifelong learning are extolled, and the future looks generally rosy. However, there is little evidence to support this view and, indeed, the literature tells a different story.
National Service Framework for Older People: promoting health
Authors: Biley Anna
Published: May 2014

In March 2001, the National Service Framework (NSF) for Older People set out standards for the care and treatment of the over 60s in England. In Wales, a strategy for older people is expected in 2002. The eight standards of the NSF for Older People include strategies to reduce falls, strokes and poor mental health among older people as well as improving general and intermediate care. The final standard ‘Promoting health and active life in older age’ is an overarching theme. As well as strategies to promote health in older people, the NSF requires service providers to develop long-term strategies to promote health throughout life in order to prevent chronic illness. This should include the prevention and treatment of osteoporosis. In promoting positive role models, the NSF for Older People is reflecting social trends in tackling ambivalence about ageing. Key themes of the standard include empowerment and improving quality of life for older people. Patient-centred care and the appointment of older people's champions are possible routes towards this aim. Although there is evidence of some patient-focused models of health promotion, a review of the literature suggests that these are limited.
Paediatric oncology research nursing: improving the service
Authors: Beane Carol , Auld Liz
Published: May 2014

This article focuses on a paediatric oncology research nursing team, who highlighted potential gaps in their service provision because of the fact that both team members were part time. It discusses the processes undertaken once issues that were essential to maintain the smooth running of the service were highlighted. In today's climate of clinical governance, which facilitates the improvement and maintenance of high standards of patient care, nurses are required to demonstrate evidence of providing a high-quality service. By producing new documentation, and consequently two standards, the oncology research team provided evidence of its endeavour to not only deliver a high level of care to children and families partaking in research studies, but also show written evidence of so doing. This evidence could be audited as a way of measuring service provision, to allow the team to make further developments and changes.
Support the new Tissue Viability Nurses' Association
Authors: Finnie Alison
Published: May 2014

As a new nursing specialty, tissue viability has come a long way in the last 15 years. Beginning from a handful of substantiated posts, there now appears to be around 400 appointed nurse specialists and some nurse consultants in tissue viability. Many others are either acting within a post, developing a proposal for a post, or have moved from working as a tissue viability nurse (TVN) into teaching or research within the specialty area. However, until now, there has not been a UK-wide body to represent the interests of TVNs.
Announcement of launch of the Tissue Viability Nurses' Association
Authors: Eyers Gill
Published: May 2014

The Tissue Viability Nurses' Association (TVNA) has been formed recently to represent the professional and political interests of tissue viability nurses. This article discusses the evolution of the new Association and the developments to date. The TVNA's constitution is published, and potential and future developments of the Association are discussed. It is imperative that tissue viability nurses have a voice. The TVNA intends to be a recognized, democratic, representative and active body with whom governmental and other organizations can collaborate and consult. This will enable tissue viability nurses to influence policy and practice.
Deep Cell Prime™: preventing and healing pressure ulcers
Authors: Gray David
Published: May 2014

One method of pressure ulcer prevention is the use of alternating pressure air mattresses. This article outlines the Talley Medical Deep Cell Prime™ mattress replacement system, which is used in conjunction with Trinity HR Dynamic™ cushion, in order to provide 24-hour pressure relief.
An exploratory survey into primary care nurses and dementia care
Authors: Bryans Michelle , Keady John , Turner Steve , Wilcock Jane , Downs Murna , Iliffe Steve
Published: May 2014

This article introduces findings from the first phase of a randomized controlled trial of educational interventions in primary care. The focus of the article is the knowledge, attitudes and confidence of primary care nursing staff to the diagnosis and ongoing management of dementia. A total of 78 nurses with a mean age of 46.4 years and a mean time since qualification of 23.0 years were recruited in 36 practices in central Scotland and in London. Disciplines represented by this sample were predominantly district nurses, health visitors, practice nurses and community staff nurses. Each practitioner was administered an extensive self-completion questionnaire before the educational interventions were introduced to measure baseline knowledge, confidence and perceived difficulties in dementia care management and attitudes. Results from the quiz indicate lower levels of knowledge about epidemiology and diagnosis, but slightly higher levels about management strategies. Self-reported ratings of confidence were also low and were directly related to ratings of difficulty in identifying dementia and dealing with coexisting behavioural and mental health problems. Lower scores on all domains were recorded for practice nurses than for district nurses or health visitors.
Violence against nurses in hospitals: prevalence and effects
Authors: Al-Sahlawi KS , Atawneh FA , Zahid MA , Shahid AA , Al-Farrah MH
Published: May 2014

There is abundant evidence to suggest that violence in healthcare settings, especially in emergency departments (EDs) and psychiatry, is escalating and that nurses are particularly vulnerable. The authors, therefore, investigated the prevalence and effects of violence against nurses in an ED in a general hospital setting in Kuwait. A 12-item frequency-weighted, questionnaire was used to measure rates, frequency and severity of violence. The questions related to the experience of violent incidents during the past year. Seventy out of 81 nurses experienced verbal insults or threats of imminent violence and 13 were also physically attacked during the 1-year period. Sixty-seven out of 70 nurses suffered from one or more after-effects, including flashbacks, sleeplessness, fearfulness, depression, or taking time off work. Violence in healthcare services often reflects the community in which service is provided. Our findings suggest that doctors experience more violence but nurses suffer from more after-effects of violence at work.
Attitudes of staff towards mothers affected by substance abuse
Authors: Raeside Lavinia
Published: May 2014

The purpose of this study was to explore the influence of education and experience on the attitudes of neonatal nurses/midwives when caring for mothers and infants affected by substance abuse. A self-report questionnaire was completed by 50 nurses/midwives. The attitude of nurses/midwives towards mothers affected by substance abuse was generally negative/judgmental, and their knowledge base was low. The most experienced nursing staff generally had a more negative attitude than those nurses/midwives with less neonatal experience. Formal neonatal education did not appear to have a positive effect on knowledge base or attitudes; however, results implied that inservice education on substance abuse may have a mildly positive effect on attitudes. Results indicate a need for formal education on substance abuse and its effect on the neonate and mother, and that specialist education on substance abuse may influence attitudes.
Routine use of systemic antibiotics must stop
Authors: White Richard
Published: May 2014

Much has been written in recent years about the gross overuse of both topical and systemic antibiotics and the problems of bacterial resistance (Weinstein, 2001; Livermore et al, 2002). This has led to the re-emergence of untreatable infectious diseases, such as tuberculosis, which we had thought consigned to medical history. The problems have not been restricted to hospitals and nosocomial infections; community methicillin-resistant Staphylococcus aureus (MRSA) and cross-infection have been described (Cookson, 2000). The situation has been termed a ‘crisis’ in the USA (Colsky et al, 1998), and this is reflected in the UK (House of Lords, 1998).
The challenges of wound management in palliative care
Authors: Chaplin Jackie
Published: May 2014

Wound management in the context of palliative care presents a number of challenges that are different from wound management in other situations. Regardless of whether care is being provided in a hospital ward, the patient's own home, a nursing home or a hospice, the primary goal of palliative care is the achievement of the best quality of life possible for both the patient and the family.
A nurse-led, patient-centred mitoxantrone service in neurology
Authors: Harrison Emily , Porter Bernadette
Published: May 2014

Multiple sclerosis (MS) is an autoimmune disease of the central nervous system for which there is no known cure. There are licensed treatments available to influence the disease course, but for a small group of patients, progression of the disease may continue at an alarming rate. Mitoxantrone, a cytotoxic agent normally used in the treatment of cancer, has been shown to reduce disease activity in patients who have this more aggressive form of MS. However, the immunosuppressive action and side-effect profile of mitoxantrone mean that this drug should be used with caution. This article describes a MS nurse-led initiative where an evidence-based, integrated care pathway was designed to ensure a safe, high-quality service provision for this select patient group.
The coroner's jurisdiction 1: the current law in the UK
Authors: Dimond Bridgit
Published: May 2014

Ray Dobson fell downstairs during the night and was rushed to hospital by ambulance. He died shortly after his admission and his widow, Mary, was advised that the death was being reported to the coroner. She was concerned at the implications for herself and whether it would delay a funeral and cremation. What is the law?.