bluuebunny/crossref_metadata_2025 huggingface dataset:
ARTICLE REVIEW
Authors: Cutcliffe John R , Ward Martin F
Published: May 2014

This study investigated differences between general nurses, psychiatric nurses and lay people, in relation to their personal standards concerning, and beliefs about, how they should respond to people with schizophrenia. Evidence of these differences is examined in the following three domains: thinking, feeling and behaving. Significant differences were identified between the response types and the different response domains. Significant interaction effects were also identified based on participants' professional status in nursing. The authors argue that their results support Devine's (1989) theory concerning the automatic activation of stereotypes and their controlled inhibition in favour of different personal beliefs. The authors additionally argue that professional socialization in psychiatric nursing facilitates this process in relation to people with schizophrenia.
An alternative sectional bedding system: the Nightingale Smart bed
Authors: Williams Clare
Published: May 2014

This article describes the Nightingale Smart Bed, a unique three-sectional automatic profiling system from Nightingale Care Beds. It is a two-in-one system in that it aids in the prevention and management of pressure sores while also helping nursing staff to move and handle patients. It maintains patients' independence, dignity and comfort and provides an alternative to alternating-pressure systems.
Supporting family carers using interative multimedia
Authors: Hanson Elizabeth Jane , Tetlely Josephine , Shewan Jane
Published: May 2014

ACTION (Assisting Carers using Telematic Interventions to meet Older persons' Needs) is a nursing led Pan-European project (1997–2000). Its primary aim is to maintain the autonomy, independence and quality of life of frail older and disabled persons and their family carers by the application of telematic technology. This article describes the development of two multimedia programmes created as part of the ACTION project. Programme 1 ‘Planning ahead’ helps family carers and frail older people to think about and plan for the future. Programme 2 ‘Break from caring’ assists carers and older people to explore the range of respite care options available. Both programmes have been developed using a multimethod, user-centred approach. Preliminary evaluation data have indicated that frail older people and their carers have used the programmes to assist them when making difficult decisions such as selecting a nursing home, or exploring the use of respite care facilities.
Protecting the public through self-regulation
Authors: Hill Alison P
Published: May 2014

Hardly a day goes by without high-profile media coverage of medical incompetence and wrong doing. Recent opinion polls have shown that, despite all this adverse publicity, the public still holds nurses and GPs in high regard. Nevertheless, there is strong political pressure for health professionals to demonstrate their trustworthiness through open accountability to the public.
Information booklets for patients with major bowel resection
Authors: Taylor Claire , Norton Christine
Published: May 2014

This article highlights the importance of providing information that meets the needs of surgical patients. Focus group interviews were used to ask patients who had undergone major bowel surgery what information they felt was required to help prepare someone for this experience. A group of patients who had recently had bowel surgery were interviewed by two facilitators. This technique allowed the participants to identify and verify the issues of concern and to originate new ideas through group discussion. The participants identified many issues that would not have been considered by the authors, issues that were used to form the content of three information booklets for patients having bowel surgery.
Staff ratios in intensive care: are they adequate?
Authors: Hogan Jacqueline
Published: May 2014

The Department of Health (DoH) (2000) review of adult critical care services recommends a move away from the rigid 1:1 nurse/patient staffing ratio that operates within intensive care units (ICUs) to a more flexible system based on the assessment of nursing workload.
Accepting the diversity of overseas nurses
Authors: Castledine George
Published: May 2014

Never before in the history of nursing registration has there been such an increase in applications from nurses and midwives trained outside the UK. One of the main reasons for this has been the need to fill the large number of vacancies that exist. It is important not only to monitor the effects of this influx of new staff but also to evaluate and consider the ways in which it is affecting and changing professional nursing in the UK. The mechanisms for considering applications from nurses and midwives trained outside the UK are set out in statutory rules which require the UKCC to check carefully the background of each applicant.
Web Watch
Authors: Beckford-Ball Jason
Published: May 2014

Welcome to Web Watch, where we try to highlight some of the most valuable resources available to nurses on the world-wide Web. Linking in with our editorial (p. 816) this edition focuses on multiple sclerosis. There are many sites devoted to this topic on the world-wide Web, providing a valuable resource for both sufferers and nurses in contact with people who have multiple sclerosis.
Leg ulcer after care: the role of compression hosiery
Authors: Williams Clare
Published: May 2014

The management of venous leg ulcers is an important issue for many healthcare professionals. However, the care and management does not stop when the ulcer has healed. Prevention of recurrence and lifelong compression is an important issue that is often neglected. This article reviews the anatomy and physiology of the venous system, investigates the causes of venous leg ulcers and describes the principles of graduated compression. Compression hosiery and its role in the treatment of varicose veins is also looked at as well as deep vein thrombosis and preventing recurrence of the venous leg ulcer.
An evaluation of the Parema four-layer bandage system
Authors: Ballard Kate , McGregor Fiona , Baxter Helena
Published: May 2014

This article gives an overview of the treatment and causes of venous leg ulcers and focuses on a new four-layer bandage system (K-Four from Parema) which can be used in the treatment of these ulcers. The article features preliminary observations of this new system, which was used on 10 patients who had previously worn multilayer compression.
Reviewing The Scope of Professional Practice
Authors: Castledine George
Published: May 2014

Recently, I had the pleasure of launching the Irish Scope of Nursing and Midwifery Practice Framework for An Bord Altranais (An Bord Altranais, 2000), the statutory body responsible for the regulation of the practice of nursing and midwifery in Ireland. The timing of the Irish launch was very appropriate, given that the UKCC has recently published a report (UKCC, 2000) into the application and impact of The Scope of Professional Practice (Scope), which was launched in 1992 (UKCC, 1992).
Coming to terms with the death of a child
Authors: Castledine George
Published: May 2014

One party that I attended over the Christmas period will remain in my memory for the rest of my life. It was organized to commemorate the death of a child and was a very moving and enjoyable experience. For several months I had been involved in counselling a family who had lost the youngest of their two sons, Joey. He had suffered from a rare heart and lung condition. He was two and a half years old when he died. His parents were referred to me some 6 months later by the local funeral director who had followed their progress and felt I may be able to help them.
National standards or pseudo-competencies?
Authors: Chapman Paul
Published: May 2014

Arecent BBC Panorama programme (17 January) highlighted worrying variations in paramedic training across the UK. However, the same thing is set to happen to nursing. Both the DoH’s nursing strategy and the UKCC’s Education Commission have targeted healthcare assistants (HCAs) as a key group for future development. They advocate HCAs fast-tracking nurse training, and the wider use of National/Scottish Vocational Qualifications (N/SVQs) to encourage HCAs into the profession.
Self-injurious behaviour: reviewing evidence for best practice
Authors: Gates Bob
Published: May 2014

This article brings together some of the research literature from the last 15 years concerning self-injurious behaviour (SIB) in people with learning disabilities. There is a focus on medical, biological and psychological research literature because of the important contribution these disciplines have made to the understanding of such behaviours. The article also explores contemporary evidence for the management of people with learning disabilities who present with SIB. The care and management of this group of people presents learning disability nurses with distinctively distressing challenges. Within the article definition, prevalence, topography, causation and evidence for best practice are outlined. The article concludes with a brief exploration of the role of the learning disability nurse in contributing to the health and wellbeing of this group of people.
Ombudsman highlights complaints about NHS
Authors: Tingle John
Published: May 2014

The Health Service Ombudsman's (HSO's) reports always make interesting reading as they provide a view of the patients' experiences in today's NHS. Most of the time care in the NHS goes well, but there are some occasions when it goes wrong, sometimes quite seriously. The HSO reports provide a useful analytical window on these situations as well as providing nursing accountability and patient care teaching tools.
Network For Psychiatric Nursing Research Journal Club
Authors: Cutcliffe John R , Ward Martin F
Published: May 2014

This study attempted to describe the work of a clinical case management core team. The researchers gathered information through non-participant observation and went on to produce transcripts which were subsequently examined. From these transcripts the authors produced seven categories of activity which were felt encompassed the range of activities practised by the team:
Pets as therapy: effects on social interaction in long-stay psychiatry
Authors: Hall Pauline L , Malpus Zoey
Published: May 2014

Many studies have suggested that health and social benefits may be derived from pet ownership or visitation and research has included investigation of the effects of pet visitation upon interaction levels within severely mentally ill populations. The study featured in this article aimed to examine further this relationship while attempting to control for the effects of an extraneous variable (the human dog handler) using an A-B-C-A reversal design. The article concludes that the presence of a pet does, indeed, promote social interactions within a long-stay psychiatric population.
Care of women having termination of first-trimester pregnancy
Authors: Murphy Fiona , Jordan Sue , Jones Lynn
Published: May 2014

The care of women having termination of pregnancy has always presented social, ethical and legal concerns to nurses and other healthcare professionals. Women having first-trimester termination of pregnancy may have the choice between medical and surgical methods. The process and procedure of these two approaches are discussed and the implications for nursing practice identified. There is now research evidence that explores women's experiences of these various methods and gives some insight into what the woman may experience. Nurses must have knowledge of these methods of termination to enable women to make the correct choices. The challenge for nurses then is to provide and evaluate information that is as effective as possible in meeting the needs of the individual woman.
A comparison of healing rates on two pressure-relieving systems
Authors: Russell Linda , Reynolds Tim , Carr Judy , Evans Amanda , Holmes Margaret
Published: May 2014

The authors have previously reported the preliminary results of a randomized-controlled trial comparing the relative efficacy of two pressure-relieving systems: Huntleigh Nimbus 3 and Aura Cushion, and Pegasus Cairwave Therapy System and ProActive Seating Cushion (Russell et al, 2000). Although both the mattresses and cushions were effective treatments for pressure ulcers, the Huntleigh equipment was demonstrated to be statistically more effective for heel ulcers, but no differences were demonstrated for sacral ulcers. This article gives a more detailed analysis of the 141 patients assessed using computerized-image analysis of the digital images of sacral ulcers captured during the trial and specifically discusses the healing rates and other patient characteristics. Ninety-eight per cent of ulcers examined were deemed superficial (Torrance grade 2a, 2b, 3). Precision of image analysis assessed by within- and between-batch coefficients of variation was excellent: calibration CV 0.93–1.84%; area CV 4.61–5.72%. The healing rates on the two mattresses were not shown to be statistically different from each other.
Web Watch
Authors: Ancell Bill
Published: May 2014

Welcome to this regular column of the British Journal of Nursing. The idea behind Web Watch is to bring together in each issue a collection of world-wide Web pages that can be found on the Internet. The content of the Web sites provided will hopefully contain information that might be useful or interesting to nurses.
Gerontological nursing 4: age-related hearing explored
Authors: Tolson Debbie , Nolan Mike
Published: May 2014

In the previous three articles in this series (Vol 9(1): 39–42; Vol 9(2): 103–6; Vol 9(3): 157–60), nurses have been challenged to reconsider their approach towards the care of older people. To facilitate this it is helpful to provide specific examples of how expert practice might be achieved. Using one of the most prevalent but neglected problems of old age, hearing disability, the authors describe how nurses can contribute to the health of older people and maximize the therapeutic component within gerontological nursing.
A nursing career in the RAF
Authors: Mace Sergeant Susan
Published: May 2014

In 1918, the Royal Air Force (RAF) nursing service was formed. Today, the Princess Mary's Royal Air Force Nursing Service (PMRAFNS) has 291 qualified trained nurses and provides invaluable nursing and aeromedical support to the RAF wherever it serves. In addition, the PMRAFNS offers qualified nurses a wide variety of professional and personal opportunities both within the UK and abroad.
An exciting future or has nursing been betrayed?
Authors: Scott Helen
Published: May 2014

Recent headlines have been dominated by the £2 billion cash injection the Government has promised for the NHS (see p. 390). However, Mr Blair has warned healthcare managers and professionals that the extra money will come with major strings attached: ‘You challenged us to come up with the money and we have done so. We rose to your challenge and now we ask you to rise to ours.’
Educational leave for lecturers to regain clinical competence: 1
Authors: Gopee Neil
Published: May 2014

The clinical credibility and clinical competence of nurse lecturers have presented interesting debate for some years in nursing. While some argue that being clinically competent is an unavoidable necessity for nurse lecturers, others are either ambivalent or believe that they do not have to be clinically competent, being clinically credible should suffice. This article distinguishes between the two terms and presents an analysis of how the latter can be developed through the use of paid educational leave. Such leave, known also as a sabbatical, is one of the possible benefits of being a nurse lecturer within higher education in the UK, and it can be used opportunely as a means of regaining and further developing one's clinical skills and knowledge, if this is perceived as a need. If nurse lecturers value the retention and development of one's own clinical skills and knowledge, then some mechanism should be in place for them to achieve this aim. Johns' (1998) model of structured reflection is used for reflecting on one such experience. The article is in two parts.
Who is responsible for quality improvement?
Authors: Glasper Edward A , Pogson Delia
Published: May 2014

At the 5th European forum on quality improvements in health care it was postulated that the role of total quality management was primarily to protect the patient from harm (Bisognano, 2000). The quality of health care, however, is only as good as the nurse, doctor or therapist who delivers it.
Complications of central venous catheters: nursing care
Authors: Drewett Sarah R
Published: May 2014

There are increasing numbers of patients, both at home and in the hospital, receiving intravenous therapy via long-term central venous catheters. Although fairly commonplace, there are many potential complications associated with the insertion and use of these catheters. This article describes the insertion and postinsertion-related complications of these devices. The article will give the nurse the information and confidence required for observing, detecting, preventing and/or treating promptly any complication to ensure the best possible nursing care.
Autonomy and clinical practice 1:identifying areas of concern
Authors: McParland J , Scott PA , Arndt M , Dassen T , Gasull M , Lemonidou C , Valimaki M , Leino-Kilpi H
Published: May 2014

This article, the first of three parts, presents an analysis of the use of the concept of autonomy in the nursing and healthcare ethics literature in the UK. It commences by considering some definitions of autonomy as they appear in the literature. Some of the confusions with the use of autonomy in the nursing literature are also identified and discussed, e.g. the frequent lack of clarity regarding how closely the concept is tied to notions of freedom. In addition, it also examines the lack of any indications in the nursing literature and that when one is considering the notion of autonomy it is also useful to consider the idea of constraining factors. In the nursing literature, discussions of autonomy largely appear to centre around the power imbalance between nurses and doctors. Issues of patient autonomy thus appear to be often of only secondary concern.
Your child has diabetes: home or hospital at diagnosis?
Authors: Lowes Lesley , Lyne Patricia
Published: May 2014

Historically, children with diabetes have been hospitalized at diagnosis, but increasingly, newly diagnosed children are being cared for entirely at home. The management of this chronic condition usually involves the whole family, with children often taking responsibility for much of their own care. However, this article focuses specifically on the needs of parents, forming part of an extensive literature review informing a study exploring parents' experience of home management and coping over the first year with childhood diabetes. A search of the literature revealed a scarcity of evidence overall about hospitalization or home management from a parental perspective, and none in relation to childhood diabetes. This article provides a critical appraisal of the appropriateness of these two approaches to care for parents of children with newly diagnosed diabetes. First, a brief introduction to home management in childhood diabetes is followed by an examination of the small amount of research found about home management and hospitalization from the point of view of parents. Then, the possible benefits and disadvantages of both approaches are discussed and subsequently scrutinized in the context of childhood diabetes. Finally, preliminary conclusions are drawn and suggestions made for the direction of future research in this area.
Autonomy and clinical practice 2: patient privacy and nursing practice
Authors: McParland J , Scott PA , Arndt M , Dassen T , Gasull M , Lemonidou C , Valimaki M , Leino-Kilpi H
Published: May 2014

This article, the second in a series of three considering issues of autonomy, privacy and informed consent in nurse/patient interactions, focuses on the wider conceptions of patient privacy and confidentiality. Given that patients in institutional care are likely to suffer intrusions into their privacy which would be considered unusual in normal social interaction, it is interesting to note the dearth of literature in this area. Some definitions of privacy are considered in an attempt to begin to raise readers' awareness of the complexity of this notion. It can be argued that privacy is a pertinent notion to consider, both in order to gain a greater understanding of what is meant by the term and in terms of the implications of this understanding for clinical practice.
Case study: the treatment or palliative care of pressure ulcers
Authors: Hampton Sylvie
Published: May 2014

As nurse education increases there are reduced justifications for the existence of pressure ulcers. Patient assessment, along with rationalization of equipment and repositioning techniques, reduces the potential for pressure ulcer formation. Therefore, the future for pressure ulcer prevention will rely on nurse education and motivation. The patient featured in this case study suffered unnecessarily from pressure ulcers as, after her admission to a new nursing home where she was given the appropriate pressure-relieving and wound-dressing treatment, the ulcers were showing signs of healing.
Above the knee amputation wound which dehisced following surgery
Authors: Stringfellow Sandra C , Cooper Pam J
Published: May 2014

This case study describes the wound care of Mrs A, a female patient whose above the knee amputation wound dehisced after surgery. The management of this wound was complex and challenging and required that many members of the multidisciplinary team to work together to achieve a satisfactory outcome.
Short Reports
Authors: Wood Karen , Pope Linda , Boon Helen
Published: May 2014

This short report describes the care of an extensive wound in a terminally ill patient and specifically draws attention to the role of the Oasis Fluidized Bead Bed (Figure 1) (Huntleigh Healthcare) in promoting the healing process and patient comfort.
Legal aspects of consent 8: children under the age of 16 years
Authors: Dimond Bridgit
Published: May 2014

In the last article of this series it was explained that there was a statutory right for a young person of 16 and 17 years to give consent to treatment (Vol 10(11): 732-3). There is no such right for those under 16 and the law there has been laid down by the courts (common law or judge-made law). The leading case is that of Mrs Gillick, the facts of which are set out in the ‘Case scenario’ box.
Factors affecting how patients sleep in the hospital environment
Authors: Reid Erica
Published: May 2014

Promoting an environment conducive to sleep in hospital is a challenge. Although patients may appear to sleep in hospital, it may not be refreshing or restorative. The reasons for this can be categorized into three groups: environmental, physiological and psychological. These factors can work concomitantly, making sleep virtually impossible for some patients. Nurses can help their patients by understanding what influences sleep patterns and acting on this knowledge. This may include a variety of interventions, from allowing patients to carry out their own bedtime routine, to explaining to elderly people how their sleeping patterns change with age.
Caring for men with breast cancer: causes, symptoms and treatment
Authors: Peate Ian
Published: May 2014

Male breast cancer is relatively rare when considering more common cancers that affect men such as lung cancer. Approximately 200 men are diagnosed each year in the UK with breast cancer. This article outlines some of the causes of male breast cancer: physiological changes, oestrogen-producing tumours, and certain drugs. Risk factors such as a particular hereditary gene, age, ethnic factors, and geographical variations are discussed. Symptoms that men may present with are described and nurses are asked to encourage men to seek early advice if they have any concerns regarding their breasts. Treatment options are outlined; these treatments are very similar to those offered to women with breast cancer. However, it must be noted that because male breast cancer is uncommon it is difficult to accumulate extensive data concerning the condition. Finally, the important role the nurse plays in supporting men with breast cancer is discussed. Nurses often act as advocates for women with breast cancer and this article suggests that they are in an ideal position to do the same for men with breast cancer.
Doctors' education needs to be more holistic
Authors: Castledine George
Published: May 2014

The response that has been generated by the public inquiry into children's heart surgery at Bristol Royal Infirmary heralds the new dawn of future health care in this country. Some of the strongest comments relate to the ‘club culture’ which pervades British medicine. Sir Barry Jackson, the outgoing President of the Royal College of Surgeons, asked: ‘How did this culture of paternalism and evasion among surgeons develop?…’ (Jackson, 2001).
Legal aspects of consent 11: compulsory Caesarean sections
Authors: Dimond Bridgit
Published: May 2014

Miss MB required a Caesarean section in order to save her fetus. However, while she gave consent to the operation, she suffered from a needle phobia which caused her to panic and refuse the preliminary anaesthetic. The trust applied for a declaration that the Caesarean section could take place on the grounds that the needle phobia rendered her mentally incapacitated and therefore the operation should proceed in her best interests (Re MB (an adult: medical treatment), [1997]).
Legal aspects of consent 13: organ donation from live donors
Authors: Dimond Bridgit
Published: May 2014

Alice is now 12 years old and has been receiving dialysis for over 3 years. Her long-term chance of survival depends upon a kidney transplant and she has been on a waiting list for several years. Her condition is deteriorating and Bob, a close friend of her family, has offered to donate her a kidney. What is the law?
Triggers that prompt people with urinary symptoms to seek help
Authors: Brittain Katherine R , Perry Sarah , Williams Kate S
Published: May 2014

Urinary symptoms are fairly common among the adult population yet only a small percentage report them as bothersome. There are many reasons why people do not seek help for urinary symptoms, e.g. the embarrassment felt by those experiencing them. Little research, however, has looked at the reasons why some people seek healthcare professional help for urinary symptoms. This article describes a study aimed to identify the triggers that prompt a person with urinary symptoms to seek help. The findings suggest that health promotion campaigns play an important role in both raising awareness and demand for services. Furthermore, this study highlights the personal and social reasons why people seek help for urinary symptoms. It is important, therefore, that healthcare professionals take these personal and social circumstances into account when carrying out any assessment to ensure that a successful management of symptoms is achieved.
Introducing the pressure support surfaces from Kaymed
Authors: Pritchard Barbara
Published: May 2014

The range of support surfaces available is quite varied. It is important that both the purchaser and the users are satisfied with the quality, comfort and the pressure-reducing properties of the mattress. The mattress needs to be versatile, in that it can be used both in a patient's home or in a hospital or nursing home and also on profiling beds. The Kaymed range of mattresses offers increased comfort with low interface pressures for patients up to and including high risk. This product focus examines the Kaymed mattress and looks at the design and results of tests performed on the visco-elastic foam used in the manufacturing of the mattresses.
Introducing a professional doctorate in nursing and midwifery
Authors: Ingleton Christine , Ramcharan Paul , Ellis Lorraine , Schofield Patricia
Published: May 2014

The convergence of a number of factors has led to the emergence of what has come to be known as the ‘professional doctorate’. This new doctoral education diverges from the model of research doctorates that have historically predominated for more than a century. The background to these changes and the impetus for the development of this relatively new approach to doctoral preparation is outlined in this article. The infancy of the professional doctorate means little empirical data exist about their operation or their success. In this light, the development of an evaluative framework is described in relation to the implementation of a new professional doctorate for nurses and midwives that has been introduced at the University of Sheffield.
Emergency nurse practitioners: should the role be developed?
Authors: Dealey Carol
Published: May 2014

Trusts have to face a number of challenges in the provision of accident and emergency (A&E) services. One suggested way forward is to introduce the emergency nurse practitioner (ENP) role into A&E. However, this is not without controversy. Thus, this review has been undertaken in order to identify and assess any available evidence. A total of nine studies met the inclusion criteria. The studies fell into a number of categories, e.g. overall evaluation of the role, the use of radiography, and patient satisfaction. Several studies monitored transit times though A&E and there was some limited cost-benefit analysis. Overall, there was little difference found between the performance of ENPs in comparison with that of senior house officers (SHOs). The studies available for review are of poor quality, which limits the conclusions that can be made. At best, it would be reasonable to state that there is no evidence to demonstrate that ENPs are better or worse than SHOs in seeing, treating and discharging patients with minor injuries in A&E.
The repercussions of the organ retention scandal
Authors: Castledine George
Published: May 2014

I do not think anybody could have predicted the effect of the report of the inquiry into the Alder Hey Children's Hospital organ scandal (Department of Health (DoH), 2001). At the time it seemed that politicians were using the publicity to deflect attention away from their own shortcomings, and the media was obsessed with exposing yet another weakness in the NHS.
Newly qualified staff nurses' perceptions of the role transition
Authors: Whitehead Jane
Published: May 2014

This article describes the findings of a research project that explored the perceptions of staff nurses (who had been qualified for a maximum of 1 year) on the role transition from student nurse to newly qualified staff nurse. A convenience sample of six staff nurses employed by one NHS trust was studied. Data were collected by using audiotaped semistructured interviews. The findings revealed that the transition phase from student nurse to staff nurse is a fraught time and that a perceived lack of knowledge and support during the transition phase was a major cause of anxiety. The research has demonstrated that there is a need for support during the transition phase from student to newly qualified staff nurse. It is recommended that a structured preceptorship programme on qualification is essential (UKCC, 1999).
Helping patients to master correct inhaler techniques: nursing role
Authors: Coakley Ann-Louise
Published: May 2014

The use of inhalers is widespread for asthma and conditions such as chronic obstructive pulmonary disease and yet many people have difficulties in mastering correct inhaler technique. Elderly people and children have specific problems with inhaler use and require both targeted and appropriate help in order to improve their inhaler technique and minimize waste of inhaled medication and therefore lack of therapeutic effect. Nurses need to be able to not only demonstrate correct inhaler technique themselves, but also identify what is going wrong and be knowledgeable concerning the various options available. Frequent assessment of inhaler technique needs to become a regular feature of health promotion for all patients using these devices.
The resuscitation status of a patient: a constant dilemma
Authors: Dean Janet A
Published: May 2014

Since the first description of closed chest cardiac massage in 1960, healthcare has evolved considerably. The modern-day skill and expertise of both doctors and nurses in cardiopulmonary resuscitation (CPR) techniques are now supported by an advanced medical technology. Indeed, CPR is now perceived as the definitive life-saving procedure. However, paradoxically, it has also prolonged the process of dying and denied many patients a dignified and peaceful death. It has also denied the patient's loved ones the opportunity to be present at the time of death. The main focus of this article is to explore the current ethical issues in clinical practice relating to determining the resuscitation status of patients. Attention will also be given to patient advocacy, and the nurse's role in supporting this concept.
Pressure ulcer prevention and wound management in Bulgaria
Authors: Collins Fiona , Hampton Sylvie
Published: May 2014

This short report describes the author's involvement in the first ever wound management conference, held in Bulgaria, from original concept through to the event, and examines how Bulgaria intends to apply the latest clinical findings, given the difficulties with obtaining all types of products for tissue viability.
Debating the relative unimportance of pressure-reducing equipment
Authors: Maylor Miles E
Published: May 2014

This article examines some assumptions underlying the provision of pressure-reducing equipment, and argues that failure to ‘act first and ask questions later’ may be a key source of pressure damage. Indeed, it is argued that prevention of pressure damage can be simplified by identifying three groups of patients: those who have pressure ulcers; those who will develop them if action is not taken; and those who will not get them. The linkage of risk assessment scores and guidelines is challenged as erroneous and misleading.
Use of vacuum-assisted closure therapy following foot amputation
Authors: Ballard Kate , McGregor Fiona
Published: May 2014

This case study highlights the use of vacuum-assisted closure (VAC) in a diabetic man following a partial transverse amputation of his foot. In this situation infection-free healing is imperative in order to salvage the limb and prevent further trauma. VAC therapy facilitates rapid granulation of wounds and reduces bacterial colonization rates. This method was adopted as a suitable therapy for treatment of a patient who suffered from a complex wound at high-risk of reinfection.
Developing an equipment library: the solution to increasing demand
Authors: Heather Newton
Published: May 2014

Within the clinical practice arena there appears to be an increasing reliance on the use of dynamic pressure-relieving mattress systems to prevent and treat pressure damage. This has increased the financial burden for many trusts despite the efficacy and effectiveness of such products being largely unknown. Cullum et al (2000) suggest that studies that evaluate specific products or types of products to prevent or cure pressure ulcers are limited in size and quality. This article describes the experiences of an acute NHS trust in managing the increasing demand for pressure-relieving equipment. By setting up an equipment library, resources have been effectively managed, traditional cultures regarding ownership of equipment have been challenged, and financial benefits have been demonstrated.
Will health care change for the better in 2002?
Authors: Castledine George
Published: May 2014

The year 2001 will be remembered for the events of 11 September more than anything else. In Britain, the year was also dominated by the foot and mouth outbreak, which had major repercussions for the rural health services. As the disease lingered on and the stress and mental agony increased in the farming community, so the NHS was put under more pressure.
The importance of nursing values in interprofessional collaboration
Authors: Kenny Gerard
Published: May 2014

Nursing values are fundamental to the practice of nursing. They guide standards for action, provide a framework for evaluating behaviour and influence practice decisions. Despite the importance that can be attributed to nursing values, acknowledgement of them is difficult to find in the current debate about how interprofessional working is changing the healthcare system in which nurses currently work. This article argues that the profession needs to demonstrate that values are not only a theoretical concept but also that they can, and do, have a profound impact on the practical working life of nurses delivering care in collaboration with other professions.
The concept of hope in nursing 2: hope and mental health nursing
Authors: Cutcliffe John , Herth Kaye
Published: May 2014

This article is the second in a series of six that explores the nature of hope, reviews the existing theoretical and empirical work in several discrete areas of nursing, and provides case studies to illustrate the role that hope plays in clinical situations. In this article we focus on hope within the formal area of psychiatric/mental health nursing. The article points out that there is a limited empirical literature covering several aspects and issues of hope, hopelessness and hope inspiration within the domain of psychiatry. However, despite these studies many questions still remain unanswered. The bulk of this empirical literature focuses on hopelessness, and in the main hopelessness associated with suicide/depression. As a result of these investigations, a range of interventions have been identified for inspiring hope in different client groups with mental health problems, and a summary of these is given. Importantly, however, the basic social process of hope inspiration for each of these client groups is fundamentally the same, in that the process remains subtle, unobtrusive and associated with the therapy/relationship. We conclude by indicating key areas/questions for future research, and raise key questions regarding future policy/education issues.
The concept of hope in nursing 3: hope and palliative care nursing
Authors: Herth Kaye A , Cutcliffe John R
Published: May 2014

This article is the third in a series of six that explores the nature of hope, reviews the existing theoretical and empirical work in several discrete areas of nursing, and provides case studies to illustrate the role that hope plays in clinical situations. This article focuses on hope within the specialty area of palliative care nursing. Nurse researchers have been instrumental in our current early understandings of hope in palliative care. Studies of hope in palliative care, over the past decade, have focused primarily on those individuals in the advanced stages of cancer and the human immunodeficiency virus. Studies using quantitative methodology have focused on exploring hope levels across the dying trajectory and the relationship between hope and other psychosocial variables while those using qualitative methodology have focused on the meaning of hope and elucidating how terminally ill individuals maintain and engender their hope. Research supports that the clinician is an instrument through which hope can be assessed and administered. There is a need for further rigorous investigation of the role of hope during the terminal phase of an illness with specific emphasis on capturing the intangible inner experiences of hope and on the validation of interventions/strategies that develop and maintain hope for both the terminally ill person and his/her family caregivers and significant others.
Integrated care pathway for carotid endarterectomy patients
Authors: Goodall Sharon
Published: May 2014

Modern day health care should incorporate strategies for controlling both the cost and quality of clinical interventions, to ensure that care is evidence based, outcomes are monitored, and any areas of poor practice are improved. An integrated care pathway for an area of vascular surgery was devised with these issues in mind. The chosen pathway was for patients undergoing surgery to remove atheromatous plaques from the carotid artery. The evidence base for the interventions detailed in the pathway are given and potential advantages and disadvantages of utilizing care pathways offered. Utilizing this form of structured care, health professionals may be able to ensure cost containment combined with high-quality patient care.
Occupiers' Liability Acts 1957 and 1984: children and trespassers
Authors: Dimond Bridgit
Published: May 2014

Violet was a practice nurse and was on duty in a GP health centre when a child who was accompanying his mother wandered unnoticed into the cleaner's room, opened a cupboard door and started drinking from a bottle of bleach. The child suffered considerable harm and the parents wish to obtain compensation from the health centre. What is the legal situation?
High-dependency care: developing a joint surgical recovery unit
Authors: Richardson Lesley Y
Published: May 2014

High-dependency care is a rapidly expanding specialty. The focus of this article will be on the joint development between military and NHS staff of a surgical recovery unit offering high-dependency care to patients following major surgery. Pitfalls, benefits and indicative points to be learnt from this development will be identified. In addition, the staff training necessary and learning opportunities available will be highlighted. The position of the unit one year after opening, and future plans, are outlined. Throughout the development of the unit it became clear that an organized, well established plan of action was needed. Staffing must be in place at the earliest opportunity and appropriate staff training is essential with adequate support from the relevant areas being imperative. Communication is the key to the efficient functioning of the unit. It is clear that an area never ceases to develop as the findings of this article show. Further collection and auditing of data are essential in the future to ensure a useful, viable quality service.
Clinical negligence and the need to keep professionally updated
Authors: Tingle John
Published: May 2014

Nurses and doctors are under a legal duty to keep reasonably up to date; this is a fundamental aspect of their legal duty of care to their patients. A nurse or doctor could be negligent if a patient is harmed because of ignorance of well accepted and known published nursing and medical research findings. It is all a question of fact and degree and cases will turn on their own circumstances. There are a number of reported court cases which explore this issue and which contain useful guidance. These cases are discussed within the context of the new NHS and the Government's emphasis on health quality, and increasing healthcare litigation.
Esteem® one-piece closed pouch in the management of stomas
Authors: Skipper Gill
Published: May 2014

There has been a dramatic improvement in recent years in the production of stoma appliances to enable the ostomist to lead a normal active life. This article will review the components required of a one-piece closed appliance and appraise ConvaTec's Esteem® one-piece closed pouch.
Importance of continence advice for people with multiple sclerosis
Authors: Griffith Gwen
Published: May 2014

Bladder and bowel problems are a common feature in patients with multiple sclerosis (MS). This article demonstrates how patients benefit from specialist input relating to continence as part of a multidisciplinary neurological rehabilitation service (MNRS). The implementation of the MNRS has offered a ‘one-stop’ referral system for people with an acquired or progressive neurological condition. The patient's condition should be such that active and effective rehabilitation can take place. One of the key aims of the service is to enable people to function as independently as possible by improving/maintaining their physical, social, and psychological wellbeing through appropriate assessment and treatment regimes. The Multiple Sclerosis Society recommends the involvement of specialist nurses and specialist multidisciplinary teams in the management of patients. The recommended standards suggest that people with MS should be put in contact with a specialist multidisciplinary team in their area where appropriate treatment in relation to tone management, posture, fatigue management and continence can be provided. Without specialist advice, patients may develop more serious and intractable problems in the longer term. The author will describe how working in a specialized team has moved towards meeting these recommendations and in so doing has enhanced care for people with MS.
There is no such thing as a child receiving ‘a good smack’
Authors: Powell Catherine
Published: May 2014

Nurses who work with children and their families have indicated that they are promoting and upholding the fundamental principles of the 1989 United Nations (UN) Convention on the Rights of the Child (Fulton, 1996; Doyle and Maslin-Prothero, 1999). These include involving children in decision making at a variety of levels and respecting their rights to autonomy, privacy and dignity in healthcare settings. What is less clear, however, is the degree to which nurses are embracing article 19 of the Convention, which calls for the child's fundamental right to protection from physical violence. Indeed, mention ‘corporal punishment’ to groups of nurses and the response tends to be either embarrassed silence or vigorous defence.
Clinical negligence and causation and remoteness of damage
Authors: Tingle John
Published: May 2014

In this, the final article of this series on understanding negligence law, the causation and remoteness of damage is discussed. The final element that needs to be established in a negligence case is that the defendant's breach of duty was the cause of the claimant's loss and that this loss was not too far removed or remote from the actions of the defendant. The law involved in this area can be quite difficult to understand as some of the principles used are uncertain and the cases can be quite hard to draw together and reconcile.
Web Watch
Authors: Mangan Paul
Published: May 2014

This edition of Web Watch looks at sites relating to chronic pain. 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.
Government response to Bristol inquiry: is it too ambitious?
Authors: Tingle John
Published: May 2014

The Bristol heart tragedy has driven healthcare quality reform along at a fast rate. An analysis of the Government's response (Department of Health (DoH), 2002) to the original inquiry (DoH, 2001) reveals that proposed reform will affect all health carers and patients for years to come. We can only speculate as to whether or not these health reforms would have arisen if Bristol had not happened.
Contemporary issues in the care of sick children and their families
Authors: Glasper Edward Alan
Published: May 2014

This article considers the response of children's nurses to contemporary change in the management of sick children and their families throughout the last decade. In recognizing the rich and diverse history of children's nursing the impact of those factors which have led to the development of operational strategies to manage children's services will be considered. The quest, not always successful, to coordinate care as a seamless web of services to children and their families will be investigated, as will the role dimensions encompassed by specialist children's nurses and their interface with interprofessional colleagues. A range of nurse-led services in a variety of contemporary child health settings will be explored.