bluuebunny/crossref_metadata_2025 huggingface dataset:
Health workers around the world: Haiti
Authors: Gerdie Neptune Marie
Published: May 2014

Marie Gerdie Neptune is an Assistant Nurse in Haiti. Marie, 30, worked at St Charbel Hospital before it was destroyed in the country's devastating earthquake on 12 January this year. Luckily Marie was at home that fateful day. She is now working in and around the capital Port-au-Prince for Merlin, a British aid agency specialising in health. The disaster left as many as 230,000 people dead and 1.2 million displaced and living in temporary shelters.
Wound care: crucial clinical skills for support workers
Authors: Andrews Hilary
Published: May 2014

With healthcare assistants (HCAs) and assistant practitioners (APs) becoming ingrained members of the nursing team, they are increasingly likely to be involved in the care of patients' wounds. This article will provide a brief guide to aid the understanding of tissue viability; wound terminology, the physiology of wound healing and techniques to aid wound healing. An outline of the role of HCAs and APs in the provision of safe and effective wound care will also be discussed.
Celebrating diversity
Authors: Hughes Rhidian
Published: May 2014

This February sees the annual celebration of Lesbian, Gay, Bisexual and Transgender (LGBT) history month. Until recently, many LGBT people preferred to avoid attention, for fear of negative stereotypes, discrimination and feeling undervalued or excluded in society. And unfortunately some people still do.
Understanding and choosing stoma appliances
Authors: Black Pat
Published: May 2014

Surgery to the bowel or bladder that results in a stoma, whether temporary or permanent, is designed to improve the patient's current situation in removing disease, reducing pain and improving health. The ability of the patient with a stoma to adapt to physical and psychological trauma of stoma surgery is demonstrated by many patients who return to their everyday activities and relationships. Today there is an extensive array of stoma appliances available. Modern stoma appliances are continually changing and being updated and this article will look appliance options for the patient with a bowel or bladder stoma.
Employers' internet policies prevent antisocial networking
Authors: Peate Ian
Published: May 2014

Many organizations, including health and social care organizations, have become increasingly dependent upon their information technology (IT) systems to support their everyday business operations. These systems can, however, become vulnerable and may be at risk of abuse from a variety of perspectives. Processes and procedures are put in place to counteract abuse and to ensure that they are operated in accordance with the purposes for which they have been provided, as well as ensuring that they protect the people they serve, their staff and that they are compliant with legislation. You must ensure that in carrying out your duties you adhere to any policy that your employer has provided with regards to the use of IT systems. This article discusses the use of the internet at work and when used in your own time, and the implications this may have for you as an employer or a healthcare worker. It should be noted that the internet is a fast-moving and ever-changing medium, and as such it would be impossible to cover all circumstances.
Catherine's diary
Authors: Himsworth Catherine
Published: May 2014

My name is Catherine, and I am a healthcare assistant (HCA) at Health E1 Medical Centre, where we only register homeless and temporarily housed patients. This is a population group with a unique set of needs.
Sensing problems
Authors: Hand Tanis
Published: May 2014

Well, I have finally admitted that my arms aren't long enough any more to hold a book so I can read it! I know that it's a fact of life that our eyesight deteriorates as the years go by, but like many others, I thought it was never going to happen to me.
Improving the quality of life of people with deafblindness
Authors: Swann Julie
Published: May 2014

This final article in the series on sensory loss concentrates on helping deafblind patients to communicate more easily, improve their mobility and manage the practical activities of daily living. Healthcare staff have an important role to play in helping deafblind people access local services and in providing support. They can help to maximize a deafblind person's residual vision and hearing by checking that low-vision aids and hearing aids are provided. Profound loss of sight and hearing also affects a person's mobility. By ensuring that appropriate equipment is provided, healthcare staff can enhance patients' lives by helping them to manage their mobility and activities of daily living more easily. There are a number of charities that provide information to help healthcare staff to support their patients; details of some organizations are given at the end of the article.
What if...? Reflective practice
Authors: Grainger Angela
Published: May 2014

All of us have come across, or have been involved in situations, which have made us feel uncomfortable and which have tested our abilities to cope, or to respond in an appropriate way. The purpose of the ‘What if....?’ series is to present scenarios that are commonly encountered and experienced by healthcare professional groups, including healthcare assistants and assistant practitioners, and to help you to consider appropriate ways of handling and responding to these.
Avoiding slips and trips
Authors: Swann Julie
Published: May 2014

Most accidents to patients, visitors and staff occur because of slips and trips. This article explores ways that healthcare assistants (HCAs) and assistant practitioners (APs) can help to prevent slips and trips within and outside of their workplace by ensuring that fall risks are reduced in the ward, clinic and a person's home environment.
The benefits of self care
Authors: Richards Sara
Published: May 2014

In previous editions of British Journal of Healthcare Assistants (Wrixon, 2010), this journal has reported the huge cost to the NHS of the dependency culture around minor ailments and the call from professionals in primary care to encourage greater self care. In March, self care moved firmly onto the national agenda with the publication of a new report, Self Care: An Ethical Imperative (Self Care Campaign, 2010).
Catherine's diary
Authors: Himsworth Catherine
Published: May 2014

My name is Catherine and I am a healthcare assistant (HCA) at Health E1 Homeless Medical Centre.
Making appraisals work for you
Authors: Peate Ian
Published: May 2014

The key purpose of the Knowledge and Skills Framework (KSF) is to define and describe the knowledge and skills required by NHS staff to carry out their work in order to deliver a high quality service. This is the first part of an article which provides healthcare assistants (HCAs) and the assistant practitioners (APs) working in the NHS with tips to help them get the most out of their annual appraisal. The article offers a brief overview of the KSF and the evidence required for appraisal. Practical tips are provided for before, during and after appraisal. Finally, a check list is presented.
Respect and communicate
Authors: Hand Tanis
Published: May 2014

You may have read in my last column about my plans to bungee jump. Well, I did it! What an experience. I' m still excited when I think about it, and am now wondering what the next challenge will be.
Understanding bariatrics
Authors: Swann Julie
Published: May 2014

Across all age groups throughout most of the developed world, the incidence of overweight and obesity is rising. The impact of this on a person's health and, in particular, the management of over-sized patients affects service delivery within hospitals, clinics and a person's own home. Obesity is a risk factor for several diseases that are major causes of morbidity and mortality. This article, the first in a series, discusses the differences between people who are overweight, obese or bariatric and explores the ways obesity impacts on a person's health.
What's in a name?
Authors: Hand Tanis
Published: May 2014

Lately I have received several letters addressed to ‘Ms Tanis Hand’ and I must say that I really do not like this title. I do not feel particularly angry about it, but I certainly do not feel happy either. It is just that I would much prefer to be called ‘Mrs’. But why is this of any importance? It's just a title, and a generic one at that-developed to encompass all women who do not want their marital status known.
The roles we play
Authors: Williams Joe
Published: May 2014

Healthcare assistants (HCAs), as much as anyone, will be aware how much the roles we play in life matter, whether in our profesional or personal incarnations. It is perhaps inevitable that my own role at work, as steward of a title so inextricably linked to the concept of health, has of late inspired in me a much keener interest in my own wellbeing. Every month, articles covering a broad range of conditions and treatments remind me of the importance of exercise in warding off the difficulties of illness and physical deterioration. For this reason, despite it being many years since my last outing, I was recently more than happy to accept an invitation from a colleague to don shin pads and astroturf boots once more to reprise a role I had almost forgotten since school: playing for a football team, proudly trotting out for the company in a five-a-side competition in Dulwich.
Pain-induced stress in wound care, part 1
Authors: Solowiej Kazia
Published: May 2014

Pain can cause stress for patients with wounds, which can lead to delayed wound healing. This article, the first of two in a series, reviews the literature that demonstrates the relationship between stress and wound healing with a specific focus on the influence of pain.
Supporting people with sight loss in their own homes
Authors: Labbett Simon
Published: May 2014

Many people cite the onset of blindness as one of their greatest fears. The Royal National Institute of Blind People (RNIB) claims that some 100 people start to lose their sight every day. Getting prompt access to good advice, emotional support and rehabilitation is crucial, but knowing how can be difficult. The article examines the role of the visual impairment rehabilitation officer (ROVI) and suggests some strategies that healthcare assistants can use to support this work.
Widening participation in pre-registration nursing
Authors: Gasper Alan
Published: May 2014

This article discusses the implications of the Departments of Health's (DH' s) latest guidance on how widening access to pre-registration nursing can be achieved. This guidance has been issued because of fears that the move to all-graduate nursing that will start in the autumn of 2011 may not be able guarantee sufficient numbers of registered nurses to maintain current and projected levels of skilled nursing care delivery to patients. The proposals to widen access to pre-registration nursing have profound implications for healthcare assistants and assistant practitioners. They also offer new and exciting opportunities for those who aspire to enter the nursing profession.
Fingers crossed for summer
Authors: Hand Tanis
Published: May 2014

At last the summer is upon us, and it is great to have warm days at last. As I write this, I am looking forward to a couple of weeks' leave and a well overdue visit to my homeland to visit family and friends. Like many others, I am hoping for fine weather and keeping my fingers firmly crossed.
Explaining the symptoms of pain
Authors: Swann Julie
Published: May 2014

Pain is a subjective sensation that generally alerts the body to an area that requires attention, protection or rest. It is a common-and often the main-symptom of many conditions. This article explores the causes and effects of pain. It also provides details of various forms of pain assessment.
Inhalers and helping patients cope with asthma
Authors: Jevon Phil
Published: May 2014

It is important for healthcare assistants (HCAs) and assistant practitioners (APs) to be able to assist patients with asthma. In order to do so, HCAs and APs should understand the correct use of inhalers.
A quick guide to vocational education and qualifications
Authors: Hood Adele , Evans Christine , Jolly Sara
Published: May 2014

A myriad of vocational qualifications and other forms of education are available for healthcare assistants and assistant practitioners to access. When engaging with education programmes for the first time, understanding the different qualifications can be quite daunting. Aneurin Bevan Health Board in Gwent has therefore developed guidance based on the Education Levels in the Credit and Qualifications Framework for Wales. The board introduced a quick reference guide for support workers, registered staff, lead trainers and managers. The quick reference guide has been beneficial in outlining in a succinct format an overview of vocational qualifications.
Career pathways at Hillingdon Hospital
Authors: Chapple Jennifer
Published: May 2014

Hillingdon Hospital in West London is midway through a project that developed an team-based approach to education and training opportunities for staff in Agenda for Change bands 1-4 in rehabilitation areas. The project aims to improve training opportunities and career pathways set out to develop a whole team approach to service improvement and skills development. This article discusses progress at Hillingdon since the launch of this foundation degree.
The law of the letter
Authors: Williams Joe
Published: May 2014

I love getting letters. As Tanis discusses in her column, the rise of computing has ensured that they are something of a dying art, particularly the sense of formality and propriety-words like ‘sincerely’ and ‘faithfully’-that accompanies their stylized greetings and valedictions. As a result of letters' absolute rarity, the few I receive sometimes feel like they are sent from another age. It is a romantic vision; to sit, fountain pen in hand, behind a leather-topped desk in a candle-lit study, taking time after dinner to catch up on correspondence with distant cousins, telling stories of an amusing incident during Viscount Melville's visit involving a napkin in a gazebo, orchestrating financial affairs with a representative in the capital, or gossiping wildly over the nuptial affairs of a local wool magnate.
Personal health budgets
Authors: Hughes Rhidian
Published: May 2014

After three months in goverment, the coalition is now seeking to change the relationship between citizens and the state. The extension of involvement and choice for people using health services is central to the Government's health reforms. This includes an individual's choice of provider and the further development of a personal health budgets program.
Health risks in undiagnosed or poorly-controlled diabetes
Authors: Nazarko Linda
Published: May 2014

Diabetes mellitus is a chronic disease caused by inherited and/or acquired deficiency in production of insulin by the pancreas, or by the ineffectiveness of the insulin produced. With the incidence of diabetes rising worldwide, it is important for support workers to have a clear understanding of type 1 and type 2 diabetes, symptoms, management, and the risks of ill-health and disability.
Reflective practice: Caring for those with chronic ill-health
Authors: Grainger Angela
Published: May 2014

Some patients living with a disability or a chronic ill-health problem may have been receiving care from a range of health professionals for some time. Such patients may come to feel that the advice given can be patronising, overly protective and even domineering. Consequently, some patients come to resent health care provision rather than optimize its potential, and health staff can experience difficulties and frustration in trying to care for these patients. By using reflective practice, this article encourages further use of empathy and highlights the factors to be considered in caring for people with a disability or long-term health problem.
Abnormal movement: understanding why this occurs
Authors: Swann Julie I
Published: May 2014

Within many clinical settings, healthcare assistants (HCAs) and assistant practitioners (APs) encounter patients who present with movement patterns that may deviate from what are considered to be normal fluid movements. Abnormal movements may occur at rest, during an activity, or be present all the time. This article describes how movement is controlled, why abnormal movement patterns emerge and how HCAs and APs can help patients.
Sexually transmitted infections: 2/6—Gonorrhoea
Authors: Peate Ian , Collins Emma
Published: May 2014

Sexually transmitted infections (STIs) can have a devastating impact on individuals, communities and society; the healthcare assistant (HCA) and assistant practitioner (AP) can help people who may have an STI or who may be at risk of developing one if they understand the key issues associated with infection, transmission and the harm these infections may cause people. In this article the STI gonorrhoea will be discussed. An overview of the prevalence of the infection is provided, the signs and symptoms people present with are described and the methods used to make a diagnosis will be discussed. The treatment options available and preventative activities offered will be outlined.
Sexuality, Relationships and People with a Learning Disability
Authors: Barber Chris
Published: May 2014

Sexuality, relationships and sex in the domain of people with a learning disability is often a neglected area of study and work. Yet those with a learning disability will have the same sexual needs and feelings as anyone else. This article sets out to discuss the areas of sexuality, sex, relationships, family planning and health promotion, within the framework of rights, dignity and respect.
Podiatric medicine unravelled
Authors: Hayes Catherine , Bussey Sonia
Published: May 2014

Podiatry, formerly known as chiropody, is a fundamental discipline within medicine, with its own regulatory processes. Opportunities are emerging for healthcare assistants and assistant practitioners to play a significant role.
Maternity focus: techniques to support breastfeeding
Authors: Surtees Ann , Kelleher Denise
Published: May 2014

This article describes the breastfeeding toolbox used in the maternity wing of the University College London Hospitals. It provides a checklist to support breastfeeding, including initiation, maintenance and ongoing care. Several techniques are described to assist both mother and those caring for her within the maternity setting to ensure that the baby feeds. The most suitable situation for each techique to be used is explained.
New employer-led vocational qualifications now available
Authors: Blinko Lucy
Published: May 2014

This article explores Skills for Health’s newly developed Qualification and Credit Framework qualifications for the sector. It explains how the framework works, looks at the range of new qualifications available and answers key questions about transferability, assessment and validity of previous NVQ learning. It will help readers picture how to use the new qualifications and units to give staff members the skills and knowledge they need to do their jobs.
Supporting patients with kidney disease
Authors: Mulryan Chris
Published: May 2014

The kidneys are tremendously important yet potentially difficult organs to understand. They are essential to life, being one of the principal organs out of which the body's waste is excreted. While most people are aware of the functions that the kidneys fulfil in filtering the blood and producing urine, significantly fewer individuals are aware of some of the less obvious yet equally important roles that the kidneys play in maintaining blood pressure, regulating body water, acid and electrolyte levels as well as governing the rate at which red blood cells are manufactured in the body.
Taking electrocardiographs: a guide for support workers
Authors: Rawles Zoe
Published: May 2014

Electrocardiographs (ECGs) are important diagnostic tools and support workers are often responsible for performing them. Understanding what the ECG is, how a recording is taken and how the test is performed as accurately as possible are essential aspects of knowledge for many support workers. This article provides a brief history of ECGs and explains what these recordings mean. It outlines the correct procedure and optimum placing of the electrodes and describes other important factors to consider.
Dangerously misunderstood: men and eating disorders
Authors: Peate Ian
Published: May 2014

Eating disorders can have a devastating effect on individuals, families and communities and affect both sexes. However, they are most commonly associated with women. The causes, effects and treatment are similar for both sexes, but such conditions are often more difficult to identify in males. As a result, men are less likely to receive adequate treatment. This article aims to raise awareness of how eating disorders affect men. It outlines three different forms of eating disorder and discusses the role of support workers in identifying, understanding and diagnosing these conditions. The complications and impact on a man's health and wellbeing are also explained.
Urinary tract infections: causes and management
Authors: Mulryan Chris
Published: May 2014

Those with a urinary tract infection will often seek advice on their health. While the condition can be treated simply and effectively in a primary care setting when uncomplicated in form, it can become more complex and necessitate hospital admission. To help support workers to care for patients with urinary tract infections, this article provides an overview of the anatomy of the urinary tract. It defines urinary tract infections and explains who is most likely to be affected by the condition. The management of patients with urinary tract infections is explained, along with the important role that support workers can play in recognizing patients with worsening conditions who may be developing a complicated urinary tract infection or sepsis.
Retirement age changes: implications for health services
Authors: Regan David
Published: May 2014

Recent changes to the law over retirement will affect support workers and other health practitioners within the NHS and in other health and social care settings. This article explains the implications of these changes for managers and individuals in such environments, and explores how the workforce as a whole may be effected.
The microorganisms that cause infection in humans
Authors: Mulryan Chris
Published: May 2014

The infections that occur in health service settings are extremely topical issues in both the professional and popular press. Much of what is written about infection prevention and control is focused on the assessment of the size of the problem and the education of health practitioners in methods of modifying clinical practice to reduce the incidence of these infections. In contrast, little is written about the actual microorganisms that are responsible for these infections outside specialist microbiology texts. This article provides an accessible overview of the main groups of microorganisms that cause disease in humans. It provides an explanation of the different broad classes of microorganism that cause infection in humans, their characteristics, how they bring about disease and how the main groups of medicines operate to rid the human body of infection.
Death, dying, bereavement and people with a learning disability (1/2)
Authors: Barber Chris
Published: May 2014

Death, dying and bereavement are natural and normal life events that happen to each and every person, no matter who they are. This article, the first of two that focus on these specific areas of life in relation to those with a learning disability, will briefly explore the meaning of death, dying and bereavement and the various forms of death and bereavement that relate to people with a learning disability. The death of family members and friends will also be briefly explored
Change management: a tool for support workers
Authors: Stonehouse David
Published: May 2014

Within this article, the author will examine a number of the main ideas and theories of change management, together with a change tool, ‘The Model for Improvement,’ which support workers can use to deliver successful change. Change is often a state that is forced upon us, often with little or no warning or forward planning. Having an awareness of the theory behind change and which tools are available will enable the change to be planned and executed in a controlled and positive way. When change is required, it should be to improve the quality of the care delivered or the clinical environment for both patients and staff. It is therefore important that the change goes ahead as smoothly as possible and support workers play a major part in helping to achieve this. It is vitally important that staff are involved in all stages of the change process. Support workers are the staff best placed, being closest to their patients and clients, to recognise where service delivery needs to be improved. They can identify what changes can be made and how these can be put in place. It is therefore vitally important that managers support staff in developing change-management skills and experience.
Taking the tablets to work: how technology helps HCAs
Authors: Dewsbury Guy , Ballard Debbie
Published: May 2014

Healthcare assistants (HCAs) and assistant practitioners (APs) can be using technology for much of the time during their working day, without really thinking about the technology itself. This article looks at some of the ways in which technologies will be part of the new care provision as well as technologies that can be used to assist caring for someone.
Spirituality at end of life: where the HCA/AP can help
Authors: Barber Chris
Published: May 2014

The issues around end-of-life care and spirituality affect not only the elderly but all people from before birth through childhood and adulthood onwards. This short article will focus on end-of-life care, including spiritual care, of the person reaching or at the end of their life regardless of the age of the person.
Role of an occupational therapy technician in A&E department
Authors: Price Sian
Published: May 2014

This article will outline the role of the occupational therapy technician in A&E, specifically dealing with falls assessment, initial interviews and home visits. The role aims to assist the qualified occupational therapist with facilitating safer discharge and avoidance of unnecessary admission to hospital
Mental health nursing—an overview of its development
Authors: Chatterton Claire
Published: May 2014

This article seeks to give an overview of the history and development of mental health nursing and in particular the role of health care assistants. It will explore how the building of large Victorian asylums led to the recruitment of large numbers of men and women to become asylum attendants. Little, if any, training was provided until a national training scheme for attendants (or the new title of mental nurses) was established in 1891. Nurses’ registration followed in 1919 but the distinction between registered and unregistered or trained and untrained was not really made until after the Second World War, when the role of nursing assistant or orderly became recognised as complementary to but different from that of a registered nurse.
Cerebral palsy: challenges of a unique caseload for HCAs
Authors: Hayes Catherine
Published: May 2014

This article aims to build capacity between healthcare assistants (HCAs) in highlighting the unique challenges that caring for people with cerebral palsy (CP) and their carers brings. It is written from the perspective of an allied healthcare practitioner and provides a medical insight into how the condition is classified and diagnosed within the context of primary and secondary health care settings, which is of significance to the hospital and community pharmacist. The complexities of brain development in CP patients are discussed at length, with consideration of the key aetiological contributors to the incidence of the condition. The article also briefly discusses issues of political correctness in labelling people with cerebral palsy and the significance of this to everyday practice for all staff within health care, regardless of their health care discipline. A straightforward approach to unravelling the classification of movement disorders in CP is adopted. The article concludes with an overview of a multidisciplinary approach to the management of CP in practice, with the nurse and the HCA at the centre of a holistic approach to patient care, which is pivotal to future healthcare provision.
Sexually transmitted infections (5/6): Chlamydia
Authors: Peate Ian , Collins Emma
Published: May 2014

Chlamydia is one of five key sexually transmitted infections (STIs). The other four are: gonorrhoea, syphilis, warts and herpes. Poor sexual health in the UK causes serious concern with the rising numbers of STIs, high rates of teenage pregnancies and increasing numbers of HIV. Genital Chlamydia trachomatis is the most common STI diagnosed in the UK. This article discusses the epidemiology concerning chlamydia, the aetiology and signs and symptoms associated with the infection. A discussion is undertaken concerning the National Chlamydia Screening Programme and its functions. The signs and symptoms associated with the infection are highlighted, care and treatment options are outlined and the role of the healthcare assistant and assistant practitioner (HCA and AP) described.
Palliative and end-of-life care: Bolton's AP foundation course
Authors: Smith Joanne , Brown Trish
Published: May 2014

There is nothing more certain in life than death. How we as individuals approach this challenging event will be influenced by personal experiences of the care we receive from health and social care providers. To ensure those experiencing the end of life receive a high-quality service, a fully trained and competent workforce is essential to turn the policy rhetoric into practice. Provision of excellence by the workforce is clearly linked to continuing professional development (CPD) and the education of frontline workers. As assistant practitioners (APs) have an important role to play in the provision of end-of-life care, accessing education and training in this aspect of their role is essential.

The University of Bolton Foundation Degree in Health and Social Care Programme currently has a cohort of students who are undertaking a two-year foundation degree programme. This cohort of students works in 4 distinct areas—hospice inpatient services; hospice at home; day care services; and nursing homes in the north-west—and these students will specialise in palliative and end-of-life care in their second year.

In this article, the first of four, the aim is to discuss provision of palliative and end-of-life care and how the AP will be enabled to access the knowledge and skills required to ensure the diverse and holistic needs of palliative and end-of-life patients are met.
Confidentiality, genetic testing and the right not to know
Authors: Yeomans Paul
Published: May 2014

Predictive genetic testing is throwing up a wide range of issues for individuals, including fears they may not get insurance. In healthcare, issues of consent to testing and the right to know or not to know the results are creating the need for all healthcare workers to tread with extreme care.
Role of healthcare assistant as nutritional champion
Authors: Potterton Joan , Thatcher Carol
Published: May 2014

Nutritional care is one of the most fundamental aspects of healthcare, yet concerns continue to be raised about the inadequacy of nutritional care provided in healthcare organisations, particularly for elderly patients who are most vulnerable ( Age UK, 2010 ; Abraham, 2011 ). Healthcare assistants (HCAs) and assistant practitioners (APs) have a key role in providing good nutritional care to patients. This article aims to provide HCAs and APs with a greater understanding of the prevalence and causes of malnutrition and the essential elements of good nutritional care, with particular reference to care of elderly patients. It also showcases how two HCAs, working in an acute care trust, have undertaken the role of nutrition champions in two very different clinical environments.
Learning disability: 175 years of legislation and reports
Authors: Barber Chris
Published: May 2014

This article seeks to highlight and outline the various Acts of Parliament, government reports and White Papers that have impacted upon and helped to shape the lives of those who live with a learning disability over the past 175 years
Abertawe Bro Morgannwg UHB and the Open University
Authors: Williams Julie , Hughes Louise , Suffin Majella
Published: May 2014

Delivery of appropriate education and training is imperative in an ever changing and developing NHS. Professional Development for Health Care Support Workers (HCSWs) is a particular priority in Wales as we look to service change through role redesign and a significant shift from secondary care to community and primary care.

Difficulties releasing staff from clinical care cannot be ignored and distance learning and ‘e’ learning becomes increasingly attractive to employers and employees alike.

The experience of working with the Open University in Wales (OU), www.open.ac.uk/wales , has proven invaluable in meeting the demands of education, service change and staff support. There has been positive evaluation of the impact of the learning on the professional development and practice of HCSWs.
Future directions of learning disability care (13/13)
Authors: Barber Chris
Published: May 2014

This article, the last in a series of 13, will provide a brief summary of the preceding articles and will look to the potential and possible future of learning disability care and services. The implementation of the ‘Valuing People’ White Paper will serve as the starting point for this look into the future.
Curvature of the spine - in health and illness
Authors: Swann Julie I
Published: May 2014

The spine is at the centre of the skeletal structure. It supports the body and, together with the ribcage, protects vital organs. The spine contains a neurological structure that can be damaged if spinal problems occur. This article explains the structure of the spine and the problems that can arise due to curvature.
Integration of APs-using the critical incident technique
Authors: Jones Colin , Waller Caroline
Published: May 2014

It is unquestioned that the assistant practitioner (AP) is a valuable member of the healthcare team; however, some APs have reported challenges in being accepted into their roles. Using a critical incident technique, a purposive sample of 5 assistant practitioners took part in a study, which explored their experiences of working within a multidisciplinary team. More specifically, the objectives of the study were to identify examples of good practice and also to uncover those areas that could be improved.

Four key themes emerged from the data: Being acknowledged; professional put-downs; role ambiguity; expectation boundaries.

Despite being small-scale, the study concluded that the integration of the AP role is fraught with challenge. The study also concluded that the critical incident technique is a valuable method when undertaking research in this area.
Care and treatment following a fall
Authors: Nazarko Linda
Published: May 2014

Each year, 1.57 million older people fall more than three times and 310 000 sustain a bone fracture; 75 000 of those are hip fractures ( NICE, 2011 : Woolf and Akersson, 2003). As our population ages and frailty levels increase, the rate of hip factures is predicted to double within the next 40 years (Walker-Bone, 2011). In NHS acute hospitals, 280 000 falls are reported every year ( NPSA, 2010 ). Care and treatment following a fall is vitally important. Staff must seek help, check for injury, carry out a post-falls review and complete appropriate documentation. This article explains the how staff can provide the best possible post fall care and reduce the risk of further falls.
Developing the role of the AP in NHS Scotland
Authors: Booth Lesley
Published: May 2014

The following article provides a description of the NHS Tayside Assistant Practitioner Project. It discusses the background as to why the project was undertaken and describes the actions and key outcomes. This may be of interest to HSWs as an indication that there is scope for further development of the Assistant Practitioner (AP) role, providing opportunities for career progression.
How to reduce risk of injury if a person remains at risk of falls
Authors: Nazarko Linda
Published: May 2014

Certain groups of people-those who are frail, have balance problems, multiple health conditions and impaired safety awareness - are at high risk of falls. Sometimes, the factors that increase a person's risk of falls cannot be changed and the person remains at risk of falling. In such circumstances, the best we can do is minimise the risks of harm when falls occur. This article, the last in the series, discusses how to reduce the risks of injury when a person remains at risk of falls.
Red dignity pegs used in stroke unit to enhance patient dignity
Authors: Walsh Annie
Published: May 2014

Dignity is fundamental to nursing care. This article considers a practice to enhance dignity, introduced for the first time, in the stroke unit of a hospital. One problem affecting patients, that was often complained about, was interruptions during care-giving. This has been reduced by the introduction of prominent red pegs for bed curtains, which remind staff not to enter the bed area at these times. It has proved a successful way to improve the dignity of patients, in line with hospital policy.
Can't pay? Won't pay!
Authors: Ollosson Marc
Published: May 2014

Our survey question asking if HCAs/APs would be prepared to pay for registration struck a raw nerve with one reader. Let us know your opinion ( bjhca@markallengroup.com ). The BBC Health News story below had 30 000 visits.
Increasing skills and confidence in caring conversations: a course
Authors: Dosser Isabel , Smith Tracy
Published: May 2014

This paper describes a service development in healthcare support workers (HCSWs) across departments in a large Scottish teaching hospital. In any healthcare setting, communication can be complex and challenging. Many healthcare support workers and ward clerks are often the first face seen by patient or family entering the ward. As junior members of the team, this task can appear daunting, particularly as there is limited access to formal training or support. There are also few chances to reflect on practice and develop skills, such as communication.

The course was designed to fill this gap and give 15 support workers an opportunity to practise and reflect in a supported manner using patient, staff and family stories as a vehicle for deeper learning. Evaluation of this course, which was highly valued, showed that this was a successful method of encouraging reflection and self-awareness, as a way of improving their communication skills.
Here comes the ‘bloody nurse’
Authors: Ruiz Keith
Published: May 2014

Keith Ruiz works as a member of a small but dedicated team of staff who provide phlebotomy services to the people of Gibraltar, its visitors and the daily influx of migrant workers. He was nominated by Ian Peate, Head of the School of Health Studies, Gibraltar Health Authority: ‘Observing Keith at work and his interacting with patients and staff demonstrates how dedicated he is to the work he does and the people he provides services to.

‘He goes that extra mile with people, explaining in detail in a language they understand (literally and metaphorically) what is to be done; he makes sure his patients are safe and comfortable before, during and after the procedure. He truly adopts a holistic approach. Keith Ruiz is a skilled, confident, competent, considerate and kind practitioner, respected by patients and staff alike. He has outstanding communication skills and adopts a positive attitude to all he takes on.’
Pathophysiology series 1: iron deficiency anaemia
Authors: Peate Ian , Jones Noleen
Published: May 2014

This article considers the issue of iron deficiency anaemia. Iron deficiency anaemia is the most common form of anaemia in the UK. This article provides an overview of blood composition and an explanation of a full blood count.

There are many reasons why a person may be iron deficient. Some of the causes of iron deficiency anaemia are discussed; in the UK, the most common cause of iron deficiency is menorrhagia (heavy menstrual periods). Other causes include gastrointestinal bleeding, pregnancy and the side effects of certain medications.

Tests and investigations required to determine the cause of the anaemia are described, along with the signs and symptoms and the impact the condition can have on the person's health and wellbeing. Treatment options are discussed; treatment is aimed at correcting the anaemia. A glossary of terms is included.
In Sweden, it takes three years to become a support worker
Authors: Bradley Peter
Published: May 2014

The Swedish educational system offers a three-year upper school (16–19) vocational programme in health and social care. It qualifies students to become a healthcare assistant on graduation, or to go straight on for higher studies at university. In this article, four final year students explain their views on the course and their prospects.
New quality, new danger? Political pipedream is gaining critical mass
Authors: Taylor David
Published: May 2014

Is the Government's emergent approach to quality management on course? This article looks for pointers in the Queen's speech and considers the main professional concerns.
Mystery of Hutton's appointment linked to co-habitation habits
Authors: Roth Andrew
Published: May 2014

It does not look good on a politician's CV to say he secured his job because a secretly homosexual Cabinet Minister was mugged at knifepoint on Clapham Common. Nor does it look good if his appointment came not because of his own professional qualifications or political interests, but because of a shared flat.
To be or not to be a priority? ...is not the real question
Authors: Maynard Alan
Published: May 2014

The Government machine has identified and appointed a chair for the National Institute for Clinical Excellence. What now? Are we experiencing a pregnant pause or a vacuum?
A chance to make real progress or another opportunity to be missed?
Authors: Dunning Michael
Published: May 2014

Drawing on the evidence gathered by the PACE programme, this article suggests what changes in management thinking might be required by this new accountability framework.
Brotherhood of clinicians prescribe self regulation as best medicine
Authors: Hawker Peter
Published: May 2014

This article suggests that several major pieces of the clinical governance jigsaw are still missing, and that self regulation must be accepted as the only effective way forward.
Book Reviews
Authors: Chambers Ruth
Published: May 2014

Another afternoon in Cumbria, the wind howling around, the clouds obscuring the fell tops and the rain lashing down. What better time to put another log on the fire and settle down to review a book on clinical effectiveness? I paint this backcloth to come clean about the fact that I was in a benevolent frame of mind when I read this book. But I have to say that, in truth, this is a stupendously good book. In fact, I would go so far as to say that is should be compulsory reading for all those doctors (and others) who are newly appointed to Primary Care Groups (PCGs).
Distilling solutions for pharmacists – managing contamination risks
Authors: Gandy Rob , Cumming Ian , Beaumont Ian , Lee Gerard
Published: May 2014

Following several serious national incidents, how to reduce the risk of patients receiving contaminated pharmaceutical products has become an important clinical governance question. One recently addressed by trusts in the North West of England.
‘What's up doc?’ - re-designing services around customer needs
Authors: Hale Richard , Fleming Linda
Published: May 2014

Every year the winter brings to the Royal Hospital for Sick Children at Yorkhill hundreds of children suffering from respiratory illnesses and particularly the Respiratory Syncytial Virus. This article describes a project undertaken to develop an effective plan to deal with this influx of patients.
NHS management development: is there a third way in training?
Authors: Hewison Alistair
Published: May 2014

The NHS needs skilled and competent managers as much as ever, but the recent introduction of concepts like lifelong learning has left many wondering how to develop them. This article outlines the issues.
At long last decision making could be ‘confused’ by facts
Authors: Maynard Alan
Published: May 2014

The Government machine has identified and appointed a chair for the National Institute for Clinical Excellence (NICE). What now? Are we experiencing a pregnant pause or a vacuum?
The winter of our discontent
Authors: Ham Chris
Published: May 2014

What a great start to 1999. Papers bursting with stories describing ‘trolley jams’ in the corridors of many of the country's hospitals as patients wait several hours before an appropriate in-patient bed becomes available; the relatives of patients being asked to help ease the workload on nurses by washing, dressing and feeding patients themselves, and there seems little dignity for the deceased either with refrigerated lorries being employed by hospitals with overflowing mortuaries.
The role of satellite clinics in the new NHS
Authors: Gandy Rob
Published: May 2014

There is a great deal of inconsistency in how satellite clinics are dealt with. This article examines ways of improving clarity and consistency — essential to support the commissioning and management of future ‘hub and spoke’ arrangements.
BOOK REVIEWS
Authors: McFadyen John
Published: May 2014

The primary aim of the book is, in the authors' words, ‘to convey a whole system managerial view of mental health services’. The book is intended to assist managers to understand the mental health service environment and to adapt and develop effective services to meet the needs of their local populations.
Total FM - are we on the right wavelength?
Authors: Bennett John
Published: May 2014

Total Facilities Management (FM) is being hailed as the solution for the 1990s, but is the ‘one stop shop’ treatment the right route for health care management?

This article argues that the sector is too specialist for a total FM approach and recommends a separate focus on hard, soft and specialist FM divisions as the way forward.
‘Wealthy makes healthy’ say wise
Authors: Maynard Alan
Published: May 2014

There is a great British ‘tradition’ of creating health care reform proposals without any reference to evidence and with little involvement of ‘experts’. A tradition Blair has shown no signs of dispensing with by concentrating power in the Number 10 Downing Street Policy Unit (DSPU). In the DSPU advisers initiate and develop policies which are then revealed to Ministers. Often initiatives take Ministers by surprise, particularly when they are distributed by the Policy unit without ministerial clearance.
Milburn already makes his mark
Authors: Halpern Stephen
Published: May 2014

So the National Health Service bids farewell to the ministerial equivalent of Status Quo. And, just like their pop music equivalents, Messrs Dobson and Jowell have completed their performance well before the first interval... or have they?
Milburn steps up to take on ‘forces of conservatism’ within the NHS
Authors: Roth Andrew
Published: May 2014

The changing of a skipper, particularly of a ‘giant supertanker’ staffed by a million people, is a great moment. When it is the NHS (important to the whole population) it is difficult to overestimate its impact. Even more when he is tasked by the PM to take on the British Medical Association's (BMA) ‘forces of conservatism’.