bluuebunny/crossref_metadata_2025 huggingface dataset:
Family carers 2: sources of satisfaction among Swedish carers
Authors: Lundh Ulla
Published: May 2014

This is the second of four articles about family caregiving in Sweden. The previous article in the series (Vol 8(9): 582–8) considered the difficulties and problems that carers experience, highlighting the often stressful and demanding nature of care. In contrast, this article focuses on a relatively neglected area of the caregiving literature — the potential satisfactions and rewards of care. The data suggest that sources of satisfaction are numerous and diverse and that, contrary to popular belief, the majority of carers experience some feelings of reward. While not seeking to deny the difficult aspects of caring, it is important to understand potential satisfactions if a more complete picture of the caring dynamic is to emerge.
Confidentiality 3: making sense of the Data Protection Act 1998
Authors: Dimond Bridgit
Published: May 2014

Assistant director of patient services, Ron Grey RGN, was the liaison officer with a computer firm for the automated processing of all patient records. He was asked to explain to a group of nurses the significance of the Data Protection Act 1998 and the legal requirements in respect of access to and use of the computerized records.
Cardiopulmonary resuscitation: are practitioners being realistic?
Authors: Hayward Mike
Published: May 2014

Cardiopulmonary resuscitation (CPR) is now established medical practice for all in-hospital cardiac arrests except where a specific ‘do not resuscitate’ (DNR) order is in place. This article explores many of the ethical and moral issues surrounding CPR and the use of DNR orders. It examines the success rate of in-hospital CPR and raises the question of what constitutes outcome success by illustrating that at best only 15% of resuscitated patients survive to hospital discharge. The article proposes that both patients and healthcare professionals grossly overestimate the success of CPR and suggests that many elderly patients might choose not to be resuscitated if they were allowed to make an informed choice. It concludes by suggesting that further work needs to be undertaken with regard to early assessment of all in-hospital patients, combined with realistic and frank communication between healthcare professionals and patients if futile, undignified and costly deaths are to be avoided.
The selection of female urinals: results of a multicentre evaluation
Authors: Fader Mandy , Pettersson Lena , Dean Graham , Brooks Rodney , Cottenden Alan
Published: May 2014

Female urinals are designed to enable women to empty their bladders while not on the toilet and are therefore potentially useful in preventing incontinence. However, there is little published information to guide product selection. Therefore, an evaluation of these products was undertaken by the Continence Products Evaluation Network (funded by the Medical Devices Agency). All 13 reusable female urinals available in the UK in March 1997 were evaluated. Each urinal was evaluated by 28–32 community-based women. Preliminarily, each subject tested all urinals by trying to place them in one or two of their preferred positions, to establish if the urinals were suitable for full testing. Each of the urinals that were selected for full testing were then used for 1 week each. During this week the subjects kept a diary to record leakage or spillage when using the urinal. At the end of the week a product evaluation form was filled in to record product performance. The results from full testing indicate that all urinals were successful for some subjects. However, some urinals were found to be successful for all four main positions (e.g. Petal Female Urinal) while others were successful mainly in one or two positions (e.g. Bridge Saddle Pan and Subaseal). Many urinals were successful in the standing/crouching and sitting on the edge (of chair or bed) positions, while comparatively few urinals were successful in the lying position. It was found that the chances of finding a suitable urinal increased with levels of independence. This means that subjects with higher levels of dependency found fewer urinals to be suitable for their needs when used without assistance. The results of this evaluation provide guidance for product selection. However, it is recommended that continence specialists keep samples of the full range of female urinals to enable women to experiment with urinals in order to find one that best suits their needs.
Inflammatory bowel disease 3: importance of partnership in care
Authors: Rowlinson Annette
Published: May 2014

In the preceding articles (Vol 8(13): 858–62; Vol 8(14): 926–30), the pathogenesis and aetiology of inflammatory bowel disease (IBD) and its medical and surgical treatment options were considered. In this final part of the series, the concept of an alliance between the patient with IBD and healthcare professionals in terms of healthcare choices is examined. The article explores the role of the clinical nurse specialist in IBD in relation to education, psychological support and compliance with treatment regimens. There is also a discussion of the social and psychological impact of IBD on the patient, and an exploration of the positive effects such a participatory relationship may have on health and quality of life.
Is there a risk of cross-infection from laundered reusable bedpads?
Authors: Cottenden Alan M , Moore Katherine N , Fader Mandy J , Cremer Allan WF
Published: May 2014

The risk of cross-infection from reusable incontinence bedpads was assessed by determining their microbial content after one night's use by incontinent adults and after laundering using the standard foul wash procedure specified by the NHS Executive (NHS E, 1995) (which includes heat disinfection at 71° C for 3 minutes). Measurements were made on a total of 145 bedpads from five different product designs. It was found that effective laundering destroyed all known pathogenic organisms, although some commensal flora were isolated in small numbers (mean 12.2 colony forming units/ml). It is concluded that laundering reusable incontinence pads using the foul wash procedure leaves pads safe for multiple patient reuse with no demonstrable risk of cross-infection.
Treatment of a patient with a deep leg ulcer using Biatain Adhesive
Authors: Pritchard Verna
Published: May 2014

This article looks at the use of Biatain Adhesive, a new foam dressing from Coloplast which is manufactured by incorporating 3D polymer structures within the central pad. It is now available on the Drug Tariff. The article discusses the treatment of exuding wounds and highlights the benefits of Biatain Adhesive by focusing on the case of an 84-year-old woman who had a history of long-standing leg ulcers where previous dressings had failed to promote healing.
Radiation-induced reactions 1: an examination of the phenomenon
Authors: Noble-Adams Rae
Published: May 2014

In this article, the first in a series of three, the author examines the phenomenon of radiation-induced skin reactions. This includes a description of the theoretical aspects of radiation and its effect on the skin, the prevalence and significance of skin reactions seen in clinical practice and a summary of the assessment tools that have been used in their evaluation. From this information, an analysis of the key signs and symptoms of radiation-induced skin reactions is presented. These clinical indicators and descriptors are then available to be used as the basis for the development of a comprehensive yet specific assessment tool. In part two, these descriptions are integrated into an assessment tool to measure radiationinduced skin reactions and the radiation-induced skin reaction assessment scale (RISRAS) is described. In part three the methods and results from the initial evaluation of the RISRAS are reported.
Improving primary health care for people with learning disabilities
Authors: Bollard Martin
Published: May 2014

‘Signposts for Success’ (Department of Health (DoH), 1998a) states that specialist learning disability services (SpLDS) must promote liaisons with, and offer specialist advice to, primary healthcare teams (PHCTs). With the advent primary care groups (DoH, 1998b), genuine collaboration and partnership-forging is necessary and timely to prevent people with learning disabilities being excluded from healthcare services. The project described in the article had three broad aims: first, to establish a practice register of people with learning disabilities in all practices involved in the project; second, to enable practice nurses (PNs), with support, to carry out a systematic health check within the practice of people with learning disabilities; and third, to enable the project nurse to act as a crucial link between SpLDS and the PHCT. The health checks highlighted unmet health and social needs, which were then met through appropriate referral and intervention, mainly to specialist services. Follow ups were conducted to measure any health gain as a result of the applied interventions. Evidence of health gain was revealed, pointing to the clinical effectiveness of performing such checks within the PHCTs.
Role of the cardioprotective diet in preventing coronary heart disease
Authors: Wasling Carol
Published: May 2014

Diet is a significant feature in the prevention of primary and secondary coronary heart disease (CHD). Obesity management is crucial because of its direct influence on many CHD risk factors, angina symptoms and capacity to exercise. Much evidence is available on the best dietary and nutritional intake for maximum cardiac protection. The dietary habits enjoyed by the Mediterranean countries appear to confer the best health benefits. These involve eating plenty of fruit, vegetables, pulses, nuts, cereal products, olive oil and fish and only small amounts of meat and dairy foods. The Mediterranean diet does not contain the amounts of animal fats, margarines, cakes, sweets, biscuits and manufactured foods that are characteristic of the British diet. Nurses, in their professional capacity, can motivate and support patients to change their eating habits.
Evidence-based health care: its place within clinical governance
Authors: McSherry Robert , Haddock Jane
Published: May 2014

This article explores the principles of evidence-based practice and its role in achieving quality improvements within the clinical governance framework advocated by the recent White Papers ‘The New NHS: Modern, Dependable’ (Department of Health (DoH), 1997) and ‘A First Class Service: Quality in the New NHS’ (DoH, 1998a). Within these White Papers there is an emphasis on improving quality of care, treatment and services through employing the principles of clinical governance. A major feature of clinical governance is guaranteeing quality to the public and the NHS, and ensuring that clinical, managerial and educational practice is based on scientific evidence. This article also examines what evidence-based practice is and what processes are required to promote effective healthcare interventions. The authors also look at how clinical governance relates to other methods/systems involved in clinical effectiveness. Finally, the importance for nurses and other healthcare professionals of familiarizing themselves with the development of critical appraisal skills, and their implications for developing evidence-based practice, is emphasized.
One from the heart for people with a learning disability
Authors: Caan Woody , Matthews Sue Hampton
Published: May 2014

Health inequalities are a major concern of the UK government which provides a good opportunity to look at the equity of access to health services for people with learning disabilities. To investigate how the whole system of care can be improved, this article will focus on a common problem that spans both primary and secondary care: heart disease. It uses access to a potentially life-saving procedure, the coronary artery bypass graft, as an indicator of equity. Opportunities can arise for nurses to overcome inequality for their clients, e.g. through nursing involvement in commissioning by primary care groups.
Migraine: helping clients choose treatment and identify triggers
Authors: Cunningham Sheila M
Published: May 2014

Migraine is a common complaint causing untold difficulties or aggravation for the sufferer. Clients with migraine can have very real fears of possible pathologies and the nurse is in a strong position to dispel these fears with information and reassurance. This article discusses information and knowledge which nurses can use to enable clients to take control over their migraine: from the range of choices about treatment to the identification of triggers that precipitate migraine or identification of factors to inhibit attacks. Treatments may be broad ranging from nonpharmacological to pharmacological approaches, which may be either symptomatic or prophylactic. Pharmacological treatments are presented in detail indicating the range of types from analgesia to antidepressants.
Total bed management: the way forward in pressure sore prevention
Authors: Preece Jane
Published: May 2014

King's College Hospital, London, is the first trust to implement total bed management (TBM) to assist in the reduction and prevention of pressure sores. TBM is a new concept, whereby the tissue viability, manual handling and therapy needs of the trust are met at reduced costs through a partnership with a contractor. The introduction of a large number of electric bed frames and foam mattress replacements, with the availability of dynamic pressure-relieving equipment and a service agreement, has led to an expected trust saving of £86 000 in 1998/1999 and £100 000 in 1999/2000 onwards. This article outlines the perceived benefits of this approach.
Reflection demystified: answering some common questions
Authors: Cooney Adeline
Published: May 2014

There is a growing body of literature related to reflection. However, few authors address how to reflect at a practical level. This article aims to answer some of the more common questions about reflection: What is reflection about? What is its value for nursing practice? What skills are needed to be a reflective practitioner? Where to start? There are doubts concerning the effectiveness of reflection and there is little research evidence regarding its benefits. Despite this, it is argued that reflection has the potential to raise nurses' awareness of practice.
Relationship between students' locus of control and satisfaction
Authors: Ponto Maria T
Published: May 2014

This article describes a study that was undertaken to examine the influence of the ‘locus of control' (LOC) on perceived satisfaction of nursing students. LOC is an internal, dynamic capacity of an individual which influences how one deals with everyday outcomes. Rotter (1966) proposes that the degree to which people believe their lives are under their own control is an important variable of personality which varies from person to person. People with an internal orientation believe they have control over what happens to them, whereas people with an external orientation attribute what happens to them to fate, luck, chance or powerful others. Three groups of 50 students in first, second and third years of the nursing diploma course were tested on LOC (Rotter, 1966) and satisfaction (Betz et al, 1970; Pennington et al, 1989) questionnaires. It was anticipated that the students would become more internal on the LOC orientation over time and would therefore perceive greater satisfaction with time on the course. The effects of LOC on satisfaction were analysed using t-tests, analysis of variance and Pearson's product-moment correlation. Results showed that students with internal orientation on LOC perceived greater satisfaction than students with an external orientation. However, no significant differences in LOC were found between the groups. The nursing students tested were found to be more external in their LOC orientation than other student populations have been in the past. The implications of this and the other findings for future research are discussed.
National strategy for carers: the way forward?
Authors: Nolan Mike
Published: May 2014

Several recent reports have highlighted the difficulties that family carers still experience in accessing basic support (Banks, 1998; Henwood, 1998; Warner and Wexler, 1998). The launch of the first ever national strategy for carers (National Strategy for Carers, 1999) was intended to provide ‘a new substantial policy package for carers’ that would address their needs.
The management of patients with venous leg ulcers: new guidelines
Authors: Williams Clare
Published: May 2014

The RCN Institute, the Centre for Evidence-based Nursing, and the University of York have recently produced guidelines on the management of patients with venous leg ulcers. These guidelines make recommendations with regard to assessment, compression therapy, cleansing, debridement, dressings, contact sensitivity, training/education and quality assurance (Cullum et al, 1998). They are evidence-based (Effective Health Care Bulletin, 1997), have been informed by expert opinion and are reflective of current good clinical practice. It is envisaged that they will be updated every 2 years. This article provides an outline of these guidelines. However, healthcare professionals must note that guidelines can simplify clinical decision making and this must be acknowledged when the guidelines' recommendations for practice are being implemented.
Nursing development units: factors influencing their progress
Authors: Gerrish Kate , Ferguson Alison
Published: May 2014

Nursing development units (NDUs) have long been advocated as ‘test-beds’ for pioneering leading-edge practice development. This article reports on the findings of a study examining factors influencing the development of NDUs, and, more recently, established multidisciplinary practice development units (PDUs). Individual and focus group interviews were undertaken with key stakeholders involved in six NDUs/PDUs accredited by the University of Leeds. The findings from the study highlight a number of internal and external factors that have impacted upon the progress made by these units. Importantly, the role of the clinical leader, the staffing establishment, organizational infrastructures to facilitate dissemination and the nature of the support from managers and medical staff have all influenced the success of the NDUs/PDUs. In order to ensure the long-term viability of an NDU/PDU it is essential that practice development is planned and managed in a systematic and coordinated way with a full appraisal undertaken of the human, physical and financial resources necessary to implement and disseminate change and that the work of the NDU/PDU is incorporated in the trust's strategic plans in order to ensure organizational support.
Autonomy and clinical practice 3:Issues of patient consent
Authors: McParland J , Scott PA , Arndt M , Dassen T , Gasull M , Lemonidou C , Valimaki M , Leino-Kilpi H
Published: May 2014

In this, the last in a three-part series considering how the concepts of autonomy, privacy and informed consent are articulated in nursing and the related literature, the authors focus on the notion of consent. Definitions of consent are considered, as are the legal elements of valid consent. Obtaining a patient's consent to treatment has several important functions. This article looks at some of these functions, such as safeguarding patient autonomy and encouraging patient participation in health care. Finally, a number of the difficulties in obtaining an informed consent from patients are considered. Some empirical studies which consider patients' understanding of the information and consent process are also discussed. From a review of the literature it appears that the issue of informed consent is very much tied up with the perceived power struggle between doctors and nurses and doctors and their patients.
Spiritual healing as adjunct therapy for rheumatoid arthritis
Authors: Gallez Patricia le , Dimmock Susan , Bird Howard A
Published: May 2014

At the request of the Confederation of Healing Organizations (CHO) the addition of spiritual healing (SH) to conventional therapy has been compared with conventional therapy alone in 29 patients with rheumatoid arthritis (RA) using a parallel group design. Clinical and biochemical assessments were recorded at intervals while subjects received a 6-month course of spiritual healing. Initial psychological assessment was also performed. The addition of SH produced no significant improvement in any of the relevant clinical or laboratory parameters assessed; although groups were not exactly matched at the start, those requesting SH had more active disease. Between-group comparison showed only an improvement in summated change score (SCS) in favour of SH at week 16, which was lost by week 24. Individuals displaying the most improvement in pain score or SCS with SH did not have a significantly different psychological profile from those patients who showed the most deterioration. Although our study was small the results do not persuade us to proceed to a larger study for which there would be difficulties in study design.
Self assessment and the concept of the lifelong learning nurse
Authors: Gopee Neil
Published: May 2014

Nurses appear to be taking an increasing interest in the concepts of lifelong learning, learning organization and a learning society. With expanding roles and their direct relevance to clinicians' different clinical grades and capacities, lifelong learning becomes an essential component in the achievement of clinical expertize. Lifelong learning is based on the self-assessment of clinical knowledge and competence. However, there are advantages as well as possible problems with both peer and selfassessments, and therefore further development and research is required.
Understanding children with autism: exploding the myths
Authors: Aylott Jill
Published: May 2014

The incidence of autism is increasing in both the USA and in Britain. There is still controversy over what causes autism and even greater controversy over selecting a preferred method of intervention and support (as there is no treatment for autism). Although there is now a general consensus that individuals may have a genetic predisposition to develop autism, it is also acknowledged that this may be off set by a range of environmental and/or biological factors. The understanding of the causation of autism is now considered in much the same way as we understand cerebral palsy, in that there can be a range of different reasons for causation and prevalence. This article, the first of two parts, will explore how an awareness and understanding of autism can enable nurses working with children with autism to provide more child-centred nursing care based on fact as opposed to stereotype and mythology surrounding autism. The second part will concentrate on adults with autism.
The utilization of the healthcare assistant role in intensive care
Authors: Hogan Jacqueline , Playle John F
Published: May 2014

The increasing role of healthcare assistants (HCAs) in intensive care in relation to patient monitoring has raised concerns among some clinical managers, particularly where such roles are not underpinned by a sound knowledge base and critical reasoning ability. This article describes a study which was undertaken in an attempt to identify how HCAs are currently utilized within the general intensive care environment. The results show a wide variation between units in relation to the activities undertaken by HCAs, their training and the levels of remuneration. This article seeks to open up the debate as to whether or not nurses should be challenging the nursing care that is now delivered by non-nurses and makes recommendations for the way forward in this area.
Autism in adulthood: the concepts of identity and difference
Authors: Aylott Jill
Published: May 2014

It was not until 1980 that autistic spectrum disorders were officially recognized as disorders of development and not of psychoses (Wing, 1996). (In this article the term ‘autism’ will be used to refer to all ndividuals diagnosed across the autistic spectrum, including people with Asperger syndrome.) There will be many adults with autism aged over 20 years of age who are not appropriately diagnosed and who are not receiving relevant care (Trevarthen et al, 1998). Many will have been the victims of a medical model of treatment as opposed to receiving the necessary education and support. This article, the second of a two-part series (the first article (Vol 9(12): 779–84) dealt with children with autism) will explore how contemporary knowledge can help healthcare professionals to support adults with autism in the development of positive self-identities.
Communication is the essence of nursing care 2: ethical foundations
Authors: Chauhan Geeta , Long Ann
Published: May 2014

This is the second of two articles analysing the communication themes that emerged from a role play situation in the classroom where a group of MSc nursing students carried out a nursing role play. Feedback from the entire group of 19 students was obtained and discussed openly following the presentation of the scenario. The first article examined the following communication issues: breaking bad news; giving information through exploring, questioning, and reassurance; touch; and empathy and humanism (Vol 9(14): 931–8). Attempts were made to give examples of how these key issues could be applied to nursing practice. This second article involves the examination of the ethical issues of truth-telling and autonomy that emerged in the role play and again attempts to integrate the theoretical underpinnings with nursing practice in the knowledge that the arguments advanced are neither right nor wrong. This deduction is based on the fact that each human being is unique; therefore, each interaction that occurs between two people is also unique. Nursing can strive to provide better, more effective and more sensitive communication because ethical communication is, it is argued, the realm in which nurses toil.
Interventions in forensic psychiatry: the caregiver's perspective
Authors: MacInness Doug
Published: May 2014

Although a number of official reports have identified the needs of the caregivers of mentally disordered offenders (forensic clients), there has been limited research in this area. However, some consistent themes have started to emerge from the literature. The burdens being faced by healthcare professionals working with forensic clients are distinct from that of those working with non-forensic clients, with levels of violence directed towards the former being much higher. Levels of professional and social contact are also much reduced for healthcare professionals working in forensic psychiatry. New research seems to show that illness representations (beliefs) have an effect on the coping responses employed by the caregivers of forensic clients. This may be an area that caregivers can focus on in the future to both develop interventions and improve levels of contact and satisfaction with healthcare professionals.
Developing an oral assessment and intervention tool for older people: 1
Authors: Roberts Josephine
Published: May 2014

This is the first in a series of three articles relating to oral care for older people. The first article underlines the importance of oral assessment and evidence-based intervention for older people. It describes influences which can affect older people's ability to maintain oral healthcare practices. There is a need to examine closely issues surrounding poor oral hygiene practices and their associated ramifications for the older person. Identifying and implementing an appropriate oral assessment tool for older people should provide the foundation for the maintenance and improvement of standards of oral care practices within the clinical practice setting. The second article critically analyses oral care interventions; the third article critiques a number of published oral assessment tools with a view to developing and implementing a workable oral assessment tool for the practice setting.
Pathways for continence care: development of the pathways
Authors: Bayliss Valerie , Cherry Maggie , Locke Rachel , Salter Liz
Published: May 2014

This article is the second in a series of three covering a project into the use of care pathways for continence care undertaken by the authors. Loddon NHS Trust, Wiltshire and Swindon Healthcare NHS Trust and Salisbury Healthcare NHS Trust collaborated and supported their continence advisers in moving from financially driven assessment data to writing evidence-based care pathways and supporting patient information. The first article (Vol 9(9): 590–6) described the issues facing the continence advisers and the background to their decision to use full evidence-based care pathways. It also gave the results of an audit demonstrating that high quality equitable continence care was not reaching each patient. This article covers the literature search and the problems encountered in the setting up of a database and the development of a generic pathway, a symptom profile and specific pathways. It describes how each pathway evolved and was underpinned with the relevant evidence. It further describes the supporting information and design problems. Finally, it gives information on piloting the care pathways.
NHS Direct: examining the challenges for nursing practice
Authors: Glasper Edward A , Lattimer Val , Thompson Fiz , Wray Denise
Published: May 2014

This article examines the impact of the launch of NHS Direct which was part of the Government's vision for a modern and dependable NHS. In particular, the challenges for nursing practice are detailed within a healthcare strategy which seeks to provide fast access primary health care to the whole population. The strengths and weaknesses of NHS Direct are discussed and its interface with other agencies explored. As NHS Direct will cover the whole of England by October 2000, the evidence to underpin its effectiveness must be considered in the light of media criticisms which indicate that the quality of advice given to callers is sometimes less than optimum.
Pancreatic exocrine insufficiency and type 1 diabetes mellitus
Authors: Canaway Sara , Phillips Ian , Betts Peter
Published: May 2014

Studies in adults suggest that some patients with type 1 diabetes mellitus have pancreatic exocrine insufficiency (PEI). The primary aim of this study was to explore the association between pancreatic exocrine function and type 1 diabetes in young people under 17 years. The secondary aim was to evaluate the relationship between PEI in patients with diabetes, their clinical symptoms and blood glucose control. The importance of providing a highly trained multidisciplinary support network are also discussed.
Developing an oral assessment and intervention tool for older people: 2
Authors: Roberts Josephine
Published: May 2014

This is the second of a series of three articles relating to oral care for older people. The first article highlighted the importance of effective oral care for older people (Vol 9(17): 1124–7). This article critically analyses a number of oral care agents and interventions to identify evidence-based practice relating to oral care for older people. Recommendations for practice are highlighted to guide practitioners in implementing safe and effective nursing interventions within oral care. The third article will critique a number of published oral assessment tools and describe an oral assessment and intervention tool that has been developed.
Management of long-term urethral catheters: minimizing complications
Authors: Godfrey Helen , Evans Ann
Published: May 2014

Urinary tract infections, tissue damage and encrustation of the catheter, which may cause blockage, are all complications that can arise during long-term catheterization. It is important for nurses to provide effective catheter care in order to minimize the incidence of these complications. There is still controversy in the nursing literature about certain aspects of catheter management. This article explores a number of aspects of catheter care and suggests a rationale for effective and safe management, including the choice of catheter, choice of drainage system, care of the individual and the care of catheter and drainage system.
What will it mean to have a flatter team-based NHS structure?
Authors: Rushmer Rosemary
Published: May 2014

The Government has identified that the NHS should move towards flatter, devolved structures, more participation and flexibility. This article, the first of a two-part series, has two aims: first, to outline the effects that these changes may have on the organizational structure of the NHS; second, to identify the management ‘buzzwords’ associated with these changes and to place them in context and demystify their meaning, thus opening up the issues to debate. It also presents an overview of current changes in the NHS and explores their potential future ramifications.
Antibiotic resistance: a growing and multifaceted problem
Authors: Clark Lynn
Published: May 2014

Antibiotic resistance is an increasing problem worldwide that is exacerbated by the overuse and misuse of antibiotics. Patients, pharmaceutical marketing, and the use of antibiotics in veterinary medicine and animal husbandry are important factors to consider in the emergence of resistance. Infection control measures to prevent the spread of antibiotic-resistant bacteria are compromised by poor compliance to basic measures such as handwashing and standards of environmental cleanliness. Wider epidemiological factors such as global travel and complacency towards public health must also be considered. This article aims to improve understanding of antibiotic resistance and suggests ways in which nurses can contribute towards the strategy to address the problem.
An evaluation of the impact of lecturer practitioners on learning
Authors: Driver John , Campbell John
Published: May 2014

The aim of this study was to determine if nursing diploma students recognized a difference in the nature of classroom teaching between lecturer practitioners and university-based senior lecturers in nursing. The study generated both qualitative and quantitative data from a sample of 117 student nurses completing an elderly care module. Analysis of the data suggested that the students associate lecturer practitioners with a realistic, evidence-based presentation of contemporary nursing practice, which they found both academically liberating, and efficacious to their practical training. Such associations were less apparent when analysing student responses to senior lecturer teaching. The study underlines the potential of lecturer practitioners to make a positive and far-reaching contribution to the future of nurse education.
The use of Clinisan in the skin care of the incontinent patient
Authors: Cooper Pam
Published: May 2014

The use of skin care regimes for the cleansing of skin when a patient has been incontinent is becoming accepted practice in maintaining healthy skin. Clinisan, produced by Venture Healthcare, is a soap-free, pH balanced foam which has been specifically formulated to cleanse the skin of incontinent patients who are vulnerable to skin breakdown.
Understanding coeliac disease: symptoms and long-term risks
Authors: McPhillips Jenny
Published: May 2014

Coeliac disease is a chronic, potentially life-threatening condition affecting as many as one in 300 men and women in the (UK). The Coeliac Society currently has more than 36 000 members. Essentially, coeliac disease is a complication of the gastrointestinal tract. Coeliac patients must avoid gluten in food products in order to avoid debilitating symptoms which include diarrhoea and iron deficiency. This article looks at the patients who are likely to be ‘at-risk’ of having coeliac disease and how they should be treated via adherence to a permanent gluten-free diet. The article focuses on osteoporosis, a common long-term condition associated with coeliac disease, and the risks coeliac patients face. The aim of this article is to provide background information on coeliac disease and its treatment, related conditions, and supporting patient and professional organizations.
Accountability: a fundamental component of nursing practice
Authors: Rowe Jonathan Andrew
Published: May 2014

The nursing care of the patient makes great demands on nurses' knowledge and skills; the care given must be competent, efficient and effective. In order to achieve this, nurses must have the necessary authority to manage and control their practice. This article seeks to examine the concept of accountability and relates its relevance to everyday nursing practice. A theoretical and critical incident approach is employed to demonstrate the principles surrounding accountability within nursing.
The cleansing of superficial traumatic wounds
Authors: Bianchi Janice
Published: May 2014

Patients with skin injuries account for 15% of accident and emergency (A&E) admissions (Leaman, 1991). Although there is evidence to suggest that wound cleansing is not always necessary (Thomlinson, 1987), no diagnostic test exists to allow healthcare practitioners to identify whether the bacterial load in the wound is capable of causing infection (Chrisholm, 1992). For this reason, all wounds in A&E should undergo some form of cleansing to decrease the bacterial inoculum in the wound to levels that can be managed by host defences (Chrisholm, 1992). Heyworth (1997) postulates that sucessful management of the contaminated wound must remove contaminants while inflicting minimal injury to tissue. This article reviews the research on the preparation and cleansing of superficial lacerations. Wound closure and indications for oral antibiotics will not be discussed.
The link nurse system in relation to the specialty of tissue viability
Authors: Tinley Paula
Published: May 2014

This article discusses the advantages and disadvantages, for both clients and healthcare professionals, of the link nurse system as used in conjunction with tissue viability. The advantages of such a system of care, i.e. what it actually provides in the way of evidence-based practice and its cost-effectiveness, will be analysed. The article also addresses the disadvantages of the link nurse system, primarily by examining literature responding to negative attitudes shown by both hospital and ward managers. It will also question why the link nurse system is considered by some critics as one that may, in fact, deskill ward nurses rather than enhance their practice. Finally, this article will make suggestions as to how these disadvantages can be addressed.
Sleep disorders in Parkinson's disease: the nursing role
Authors: Crabb Lesley
Published: May 2014

The quality of life of people with Parkinson's disease (PD) and their carers is often made worse by impaired sleep. Sleep problems are common in PD and there are several causative factors in their aetiology including the ageing process, anti-Parkinson's disease medication, the disease process itself, and concomitant factors such as nocturia, anxiety and immobility. Non-pharmacological approaches are the most desirable method to treat sleep-related problems. The nurse can have an important role in assessing sleep, providing support, offering practical advice, and making appropriate referrals. This article will discuss the various sleep problems experienced in PD, the underlying aetiology, and the role of the nurse.
Millennial nursing: a look back on the past year
Authors: Castledine George
Published: May 2014

One cannot help but think that last year nothing went quite as well as predicted. The year started with serious worries about staffing and recruitment, the quality of general nursing care given to elderly people in hospital and the adequacy (or not) of the funding of the NHS. However, pay awards for nurses were soon announced and Tony Blair promised an increase in NHS funding over the next 6 years so that the UK would be brought in line with the average of other European nations.
Is nursing care losing its holistic focus?
Authors: Castledine George
Published: May 2014

Awell-worn phrase is that nursing is about ‘caring for the whole person’, i.e. holistic care. This may be true in theory but, in reality, we still have much to achieve. The basic principles of holistic health care have been around for thousands of years, particularly in the healing traditions of Chinese medicine. Holistic health care can be defined as ‘the art and science of healing that addresses the whole person, body, mind and spirit — by integrating conventional and alternative therapies to prevent and treat disease and to promote optimal health’ (American Holistic Medical Association (AHMA), 2001).
Central venous catheters: infection and patient susceptibility
Authors: Rickard Norman AS
Published: May 2014

Infection is a major cause of morbidity in haemodialysis patients, of which between 25% and 50% of infections are related to vascular access, most commonly central venous catheters (CVCs) (Kessler et al, 1993). The morbidity associated with CVC infection provides a focus for research investigation, as there is limited knowledge available in relation to physiological and psychological parameters that may increase the probability of haemodialysis patients acquiring a CVC-related infection. This study explores these issues and discusses various factors that influence infection. It then describes how organisms which live on and inside our bodies can become parasitic, thus causing an infection. The precautions taken by healthcare professionals to reduce colonization and infection are enumerated, and the value of considering patients' physiological and psychological parameters alongside the more traditional extrinsic infection control approaches is discussed.
The concept of total pain: a focused patient care study
Authors: Greenstreet Wendy
Published: May 2014

This article considers the care of a patient admitted into a hospice environment for pain management and respite care. The concept of ‘total’ pain is discussed together with the need for a multidimensional assessment of pain to enable effective management to be accomplished. A multiprofessional approach to care along with inclusion of both the patient and her husband in decision making achieved the best possible quality of life for them both. A palliative care approach requires healthcare professionals to focus on the achievement of quality of life for all patients whose disease is not responsive to curative treatment. This is achieved by providing relief from pain and other distressing symptoms, including psychological, spiritual and social aspects of care, together with the acknowledgement of patient and relative autonomy. Hence, the study also exemplifies contemporary palliative care in action.
Sources of health information for people with cancer
Authors: Biley Anna , Robbe Iain , Laugharne Charles
Published: May 2014

The aim of this study was to examine how patients with cancer accessed information about their health. A convenience sample was taken from patients attending the outpatient department in a cancer hospital in the UK. Descriptive analysis was based on responses to a structured questionnaire. Of the 160 respondents, word of mouth was the commonest source of information (n=67; 42%) followed by leaflets, television and newspapers. Computer-based information was the least common source (n=13; 8%). Nearly one third of respondents had access to computers and 15% (n=24) expressed an interest in learning more about their health from computers. Fourteen per cent (n=22) do not have a personal contact to help them obtain computer-based information. The study concluded that there should be a review of the provision of written information. There is a potential to develop computer-based information. The generalizability of the results should be examined with other groups of patients who may have persistent, chronic conditions, particularly those in the age group 18–40.
Tempur-Med®: choosing the correct pressure area care system
Authors: Marino Jane
Published: May 2014

The prevention and treatment of pressure ulcers is a major concern for hospital nursing staff. Selection of the appropriate equipment for pressure area care can prove difficult, as a great many different systems are available. Tempur-Med® provides a simple and cost-effective solution to this problem with a range of products ensuring continuity of care in all areas of the hospital.
Recognizing the feet as being at risk from pressure damage
Authors: Bale Sue , Price Patricia , Rees-Mathews Sally , Harding Keith G
Published: May 2014

This article reports the findings of a survey and an audit undertaken to investigate the provision of foot support in a university teaching hospital. Phase I surveyed strategies employed to support feet and phase II audited the use of the Repose Foot ProtectorTM, manufactured by Frontier Therapeutics, specifically designed to provide pressure support for the feet. Patients with reduced mobility, nursed out of bed in a chair, have been highlighted as a group potentially at risk of tissue damage to the heels. This survey of current strategies employed to support feet included 289 patients. Patients included were from both hospital and community settings. The survey reported a lack of specialist equipment for the heels of patients with reduced mobility sitting in a chair. Only 67 (23.2%) patients were allocated foot support (typically a stool, with or without a pillow) to use while seated out of bed in a chair. The audit of requests for a new device to protect feet included 100 patients. The main reasons for requesting this device included pressure relief (81 occasions), to treat ‘foot drop’ (32 occasions) and in promoting comfort (31 occasions). There was a significant improvement in the skin condition of the heels and comfort (P < 0.0001) from study entry to exit. This audit indicated a high level of both staff and patient satisfaction.
The pharmaceutical industry and mental health nursing
Authors: Ashmore Russell , Carver Neil
Published: May 2014

Mental health nurses (MHNs) have a long and varied relationship with the pharmaceutical industry, including the attendance of educational seminars and the acceptance of promotional material. This article presents evidence that suggests MHNs may need to review this relationship regardless of their beliefs about the role of pharmacological interventions in the treatment of mental illness. It also explores the influence of advertising within professional journals and calls for greater debate on this issue.
Changes in diet following the formation of a colostomy
Authors: Bulman Jane
Published: May 2014

The main aim of this small study was to discover if the formation of a colostomy could adversely affect the long-term dietary intake of patlents. Whlle it would seem that there were few adverse effects on nutrient intake after surgery, it became apparent that patients had a need for clear dietary advice. It seemed that this area of their care was lacking. Because of the small number of patlents recrulted for the study statistical validation was not possible. Therefore, this study is only able to point the way forward for further research into the dletary needs of colostomy patients and the health professional role in this area of care.
Vacutex TM: a dressing designed for patients, tailored by nurses
Authors: Deeth Michelle , Pain Lucy
Published: May 2014

VacutexTM is a new rapid capillary action dressing comprising three layers: two 100% polyester filament outer layers, and a 65% polyester and 35% cotton woven inner layer. The outer surfaces are fused in such a way as to prevent micro fibres shedding within the wound bed. No two wounds are alike, and wounds are often located in difficult-to-dress areas. This article will describe how VacutexTM, when used with creativity, addresses many of the challenges of wound management.