bluuebunny/crossref_metadata_2025 huggingface dataset:
Last orders – calling time on Britain’s drinking culture
Authors: Beckford-Ball Jason
Published: May 2014

My first real experience of the damage done by alcohol was in the late 1980s, when as a young RMN student I was placed on an acute admissions unit in Torquay. One of the quieter patients was an older man who seemed out of place with the younger patients sat around him. He was confused, dishevelled and sat in a corner not talking to anybody – he also shook constantly. I couldn’t understand why he wasn’t on the adjoining elderly care ward. It was only when I asked why the man hadn’t been transferred that I found out he was only 50 and had Korsakoff ’s syndrome, a form of dementia that can be brought on by long-term alcohol abuse.
Advertising puts stroke top of the health-care agenda
Authors: Barrick Jon
Published: May 2014

Strokes are the number one cause of severe disabilities and the third major cause of death in the UK, yet the majority of the population are unaware of the symptoms, and how to react to a stroke. This February, the Department of Health launched a large-scale advertising campaign to begin to tackle this problem. They adopted The Stroke Association’s FAST test – Facial weakness, Arm weakness, Speech problems, Time to call 999; a simple way of recognizing the symptoms of stroke. This advertising is the first public-facing evidence of the new 10-year National Stroke Strategy. To coincide with this, The Stroke Association havelaunched a report – Getting Better: Improving Stroke Services Across the UK.
Managing lymphoedema in palliative care patients
Authors: Todd Marie
Published: May 2014

The development of lymphoedema in advanced disease is distressing for patients and their carers and can prove difficult to manage for health-care professionals involved in their care. This article will provide an overview of co-morbidities that cancer patients face that will have an impact on the development, progression or management of lymphoedema. The principles of assessing and managing lymphoedema in palliative care patients is presented, based on the Scottish government’s action plan Living and Dying Well.The need for collaboration with other members of the multi-disciplinary team to provide the seamless, patient-centred service advocated in this action plan is also presented.
Nurse research and the law in competent adults
Authors: McGuinness Sheelagh , Wilkinson Ruth
Published: May 2014

This article is a summary of issues which nurses face when carrying out research involving competent adults. A recent case of a nurse in Teeside who was struck off as a result of irregularities in conduct during a clinical research trial highlights the importance of standards of care in research being met. The authors focus on two aspects of research – the problems of the consent procedure and the different obligations that might arise from involvement in research. Nurses have a very important role to play in the conduct of research. They, like any other health-care professionals, must make sure that they conduct themselves in accordance with the standards of care of their profession and are accountable for their research conduct.
Providing effective evidence-based catheter management
Authors: Nazarko Linda
Published: May 2014

Around a quarter of people admitted to hospital are catheterized at some point, however, urinary catheterization can have catastrophic effects on the bladder and a person’s ability to regain continence in the future (Patel and Arya, 2001). Although most urinary catheters are used for a short-term period, bladder drainage complications, such as pain or bypassing, can occur (Niël-Weise and van den Broek, 2005). Sometimes, when these problems develop, or if the catheter is expelled, nurses react by changing the catheter, even though this is not necessarily the most appropriate solution. In fact, catheter-related problems provide nurses with the opportunity to evaluate the clinical indications for continued catheterization and to remove catheters that are not clinically indicated. When catheters are clinically indicated, nurses who use an evidence-based approach to diagnose and treat problems provide more effective care and reduce the risk of patient discomfort and recurrent problems.
Quality of life is starting to take precedence
Authors: Benbow Maureen
Published: May 2014

At last, quality of life issues in relation to wound management are finally rising to the top of the tissue viability agenda, with comfort and pain being explored in greater depth than ever before. This is demonstrated by the number of consensus documents and guidelines published over the past decade and is a welcome move away from the domination of economics and cost-effectiveness (although these still have to be carefully considered in times of increasing pressure on health-care budgets)
Assessing the risk of pressure ulcer development
Authors: Benbow Maureen
Published: May 2014

Assessing patients in all care settings for their risk of pressure ulcer development has become the foundation on which appropriate clinical interventions should be based. This article will explore the current drivers and guidance for conducting pressure ulcer risk assessment and the practical issues and problems surrounding best practice. It will define ‘risk’ in relation to pressure ulcer development, identify the purpose and benefits of using a pressure ulcer risk assessment scale, discuss evaluating pressure ulcer risk, identify some of the interventions that can be implemented based on the patient’s risk assessment score, and examine nurses’ professional responsibility for the safety of patients.
A healthy lifestyle for the ostomist in relation to exercise
Authors: Varma Sarah
Published: May 2014

Stoma surgery results in significant changes for the patient. These are both physical and psychological. Not only must the patient get used to the loss of control over elimination, but they must adapt to their altered physiology and may lack confidence in participating in everyday and sporting activities. Such surgery can have a profound effect on their pyschosocial wellbeing. In today’s society, we are encouraged to maintain a healthy lifestyle, which includes exercise. As healthcare professionals, we should be encouraging the ostomist to resume a healthy lifestyle as part of their rehabilitation and adaption to their new stoma, as well as encouraging social interaction; however, their is a lack of clarity in the literature as to how appropriate sport and exercise are for the ostomist. To date, evidence-based literature relating to ostomists and stoma-related injuries is sparse, and anecdotal evidence from healthcare professionals may be discouraging ostomists from taking part in sport and exercise. This article explores sporting and exercise issues among ostomists. A variety of strategies are offered, which the stoma nurse can use to encourage ostomists to engage in gentle exercise and to participate or return to physical sports that they once enjoyed prior to their surgery.
Tissue viability and the Quality Accounts agenda
Authors: Ousey Karen , White Richard
Published: May 2014

The terms ‘Quality Accounts’ and ‘QIPP’ (quality, innovation, productivity and prevention) may not be familiar to all, but, over the course of the coming year, their impact will be felt by all who are engaged in the delivery of health care.
Breaking taboo: dilemma of whistle blowing
Authors: Black Peter
Published: May 2014

It’s that time of the year again. Everyone seems to have something wrong with them. Aches and pains, paying off crediting cards, squeezing into tighter clothes, and no bank holiday on the horizon. Me, I’ve got a little tickle at the back of my throat. Professor Cary Cooper from the University of Lancaster aptly named such feelings of gloom: acute post-bank holiday depression syndrome
A nursing guide to surviving a radiological dispersal device
Authors: Williams Geraint , Williams Elisabeth
Published: May 2014

A radiological dispersion device, or ‘dirty bomb’, is created by combining radioactive material and conventional explosives with the aim of causing both blast injuries and the psychological fear of lingering radiation. Future use of such a device by terrorist organizations operating in the UK is not unlikely. Both surgical and accident and emergency nursing staff may become involved in the management of patients involved in this type of disaster. This article summarizes the likely sequence of events, defines the nursing tasks emergency department personnel can expect to become involved with, and highlights specific issues of personal safety for this disaster scenario. Up-to-date, accurate information, and skills and training in this type of event can not be underestimated. Nursing teams equipped with the appropriate safety and procedural skills are more likely to respond positively to this type of event
Treatment for acute leukaemia: elderly patients’ lived experiences
Authors: Meenaghan Teresa , Dowling Maura
Published: May 2014

Aim: The aim of this study was to explore the lived experiences of elderly patients with acute leukaemia receiving chemotherapy. Method: Seven elderly patients were interviewed and van Manen’s approach to data analysis was used in interpreting the participants’ interview transcripts. Findings: Three main themes were interpreted from the study participants’ narratives: emotions experienced upon diagnosis; the need of support from family, friends, and healthcare professionals; and the importance of information. Conclusion: Although some of the findings are similar to those of previous studies examining patients with other cancers, this is the first known study to examine the lived experience of elderly patients receiving chemotherapy for acute leukaemia. All participants experienced shock and fear at diagnosis. Despite their advancing age, all participants expressed the hope that treatments would provide a good quality of life and, in some cases, even cure. With good support from family, friends and healthcare professionals, participants revealed that they learnt to cope with the diagnosis and its treatments
A guide to appeals within the English legal system
Authors: Hodgson John
Published: May 2014

This article provides an overview of the various forms of appeal which are available within the English legal system. It discusses why appeals are necessary, what form they take and some of the fundamental aspects of the legal structures and principles which are applied by the judges. The criminal and civil appeal systems are separately outlined and the discretionary nature of further appeals explained. The place of statutory appeals from regulatory bodies is briefly indicated.
Realism in nursing in 2010
Authors: Castledine George
Published: May 2014

The New Year (2010) has arrived and with it come hopes and predictions for the future. There is no doubt that the current recession will dominate the headlines, and the general election will bring little cheer to one of the most serious crises faced by this country since the end of the Second World War.
Keep calm and carry on
Authors: Williams Julia
Published: May 2014

Julia Williams comments on the future of stoma services
Procedure for recording a standard 12-lead electrocardiogram
Authors: Jevon Phil
Published: May 2014

The 12-lead electrocardiogram (ECG) is an essential diagnostic tool, particularly in the management of coronary heart disease. It records the electrical activity of the heart from 12 different viewpoints or ‘leads’ by attaching ten cables to the patient’s limbs and chest. The procedure for recording a standard 12-lead ECG is described, including preparation of the patient and of the equipment. It is important that the nurse is familiar with the manufacturer’s recommendations regarding the use of the electrocardiograph before commencement of the ECG. Guidance is given on how to accurately locate the intercostal spaces to ensure correct positioning of the chest leads (V1–V6); alternative placements are also given. It is essential that connection or placement of the ECG electrodes/leads is accurate to prevent misdiagnosis. The ECG trace needs to be clear to enable accurate and reliable interpretation. Standardization of the procedure is important to achieve comparable results
Age-related macular degeneration: a case study
Authors: Kerr Elizabeth
Published: May 2014

This case study concerns a patient undergoing treatment for age-related macular degeneration (ARMD) by intravitreal injections of ranibizumab (Lucentis). ARMD is the leading causing of blindness in people over 50 in the western world, and seriously affects individuals’ ability to carry out basic aspects of daily living. Ranibizumab is a relatively new treatment for ARMD, and research on it is continuing. The author was required to expand her knowledge of the subject as her role in the care of patients with ARMD was growing. This case study highlights the importance of patient education in achieving positive outcomes for clinical treatment. This case study concerns a patient undergoing treatment for age-related macular degeneration (ARMD) by intravitreal injections of ranibizumab (Lucentis). ARMD is the leading causing of blindness in people over 50 in the western world, and seriously affects individuals’ ability to carry out basic aspects of daily living. Ranibizumab is a relatively new treatment for ARMD, and research on it is continuing. The author was required to expand her knowledge of the subject as her role in the care of patients with ARMD was growing. This case study highlights the importance of patient education in achieving positive outcomes for clinical treatment
Simple writing skills for students, part one: structure and clarity
Authors: Wright Kerri
Published: May 2014

Good academic writing depends not just on the content of the work, but on how this content is expressed. Knowing how to write and structure a piece of work is an essential academic skill and ensures that relevant ideas and arguments are not lost, but are clear and visible to the reader. This article discusses the importance of writing with the reader in mind and taking them through the points and arguments in the work. This involves appropriate use of paragraphs, introductory sentences and signposting so the reader is always alert and prepared for the information being presented. This article is the first in a series of three looking at academic writing skills. Part two will look at literature searches and referencing and using other people’s work; part three will focus on how to use information
The need for best practice in catheterization
Authors: Woodward Sue
Published: May 2014

Catheterization is a common procedure undertaken hundreds of times every day in a variety of healthcare settings. It is estimated that approximately 25% of the 9 million adults treated by the NHS every year will be catheterized at some point (Nazarko, 2009). The majority of these catheterizations are performed by nurses and nursing students. As this is such a common procedure, it is very easy to become complacent and blasé, yet this is one of the most intimate procedures that we, as nurses, can carry out
NHS Direct: to scrap, or not to scrap?
Authors: Hoey Richard
Published: May 2014

Richard Hoey speculates on the future of NHS Direct, the effectiveness of which may soon be subject to a full review
Health tourism and the UK: some new developments
Authors: McHale Jean
Published: May 2014

Pre-empting the implementation of the EU draft Patient’s Rights directive, the UK Government has issued regulations governing the reimbursement of costs of treatment to patients seeking treatment overseas. This article explores the new regulations and how they may impact on NHS resource allocation in the future
A journey too far?
Authors: Hill Rosalind
Published: May 2014

In the week that ex-PM Tony Blair released his memoir, A Journey, in which he admits that the amount he drank had become a ‘prop’, research has revealed that there is a divide between the North and South of England, more commonly known as the ‘North–South divide’
Patient safety in the NHS: the tides of change
Authors: Tingle John
Published: May 2014

John Tingle discusses the Department of Health’s recent report on the review of arm’s-length bodies (ALBs), particularly in relation to the National Patient Safety Agency (NPSA) which, along with several other ALBs, is set to be abolished
The winter of discontent
Authors: Hill Rosalind
Published: May 2014

Now is the winter of our discontent made glorious summer by this son of York’. William Shakespeare wrote these opening lines to the play Richard III in 1591, and they were famously used to depict the winter of 1978–1979, during which there were widespread strikes by local authority trade unions demanding larger pay rises for their members, and because the government of James Callaghan sought to hold a pay freeze to control inflation
Using vignettes to explore work-based learning: Part 1
Authors: Wareing Mark
Published: May 2014

This is the first of two articles exploring the use of vignettes as an alternative method of presenting the data arising from interviews. The interviews were carried out as part of research into work-based learning: both articles are based on findings from a hermeneutic phenomenological study into the lived experience of foundation degree mentors and their students—healthcare assistants undertaking a foundation degree in health and social care in order to become assistant practitioners. Part 1 presents a vignette of a notional workplace mentor (Staff Nurse Sophie) that describes her lived experience supporting two equally notional foundation degree students. Sophie’s perspective will be a distillation of data arising from interviews with eight workplace mentors, all employed on acute wards within a large NHS hospital trust. The vignette attempts to demonstrate the role of the workplace mentor in the support of work-based learning, and the interprofessional factors that determine the landscape of workplace learning for foundation degree students. The potential of a vignette to assist in a deeper hermeneutic understanding of meanings arising from data will be explored, and the limitations of the approach considered.
Vitamin D: the sunshine vitamin
Authors: Quinn Catherine
Published: May 2014

Vitamin D has recently attracted a considerable amount of media attention. This article investigates whether the notion of a widespread vitamin D deficiency is justified in the UK, and what effect it might have on the general populace. Also considered are which physiological systems vitamin D affects in addition to bone remodelling, as well as the latest findings as to how this vitamin can benefit the body. Reasers are also given information as to which medications might adversely affect vitamin absorption, which patient groups are most at risk of deficiency, and the most practical and cost-effective means to treat patients suffering from a lack of vitamin D.
Using vignettes to explore work-based learning: Part 2
Authors: Wareing Mark
Published: May 2014

This is the second of two articles exploring the use of vignettes as an alternative method of presenting the data arising from interviews. The interviews were carried out as part of research into work-based learning: both articles are based on findings from a hermeneutic phenomenological study into the lived experience of foundation degree mentors and their students—healthcare assistants undertaking a foundation degree in health and social care in order to become assistant practitioners. Part 2 presents a vignette of a notional assistant practitioner, Michelle, that describes her lived experience as a foundation degree student. Michelle’s perspective is a distillation of data arising from interviews with 11 former foundation degree students. The vignette attempts to demonstrate the features of ‘knowing’ and ‘becoming’ in the practice of foundation degree students, and the impact that being a work-based learner has on students’ perceptions of lifelong learning.
The Government’s eight-point plan for improving end-of-life care
Authors: Glasper Alan
Published: May 2014

Professor Alan Glasper appraises the Government’s end-of-life care strategy, and highlights the key part nurses will play in improving care for the growing number of people approaching end of life in the UK.
Cinderella service to health service priority: infection control in the UK
Authors: Cole Mark
Published: May 2014

Reducing the morbidity, mortality and economic burden of healthcare-associated infection has become an NHS priority. However, this has not always been the case. The problems associated with hospital infection have been well known for some considerable time but historically the topic has been afforded scant resources, and relegated to ‘Cinderella’ status. This began to change when seminal epidemiological studies of the 1970s and 1980s identified the scale of the problem, and accelerated when adjustments to the management of the NHS throughout the 1990s encouraged Trusts to reposition infection control among their priorities. Since the turn of the century, infection control has become increasingly politicized and regulated. There are some suggestions that standards are improving and rates of meticillin-resistant Staphylococcus aureus and Clostridium difficile are falling. Whether or not Trusts are capable of bringing about change through a process of self-regulation, or whether meaningful change will inevitably require regulation and enforcement from outside agencies is an interesting point.
Limitations of confidentiality
Authors: Castledine George
Published: May 2014

How far should we go in keeping secret what our patients tell us and in what they want us to tell others? This potential moral dilemma is well illustrated in a new and revealing Channel 4 drama about Mo Mowlam, the former Northern Ireland secretary who suffered a brain tumour while she was in office. The story of how Mo Mowlam misled everybody, including the-then prime minister Tony Blair, is the subject of Neil McKay’s latest investigative film. The fascinating and pertinent point of the story for nurses is the fact that ‘honest Mo’, as she was known, refused to tell the truth about her condition to those who voted for her and trusted her in what was an important point of the Northern Ireland peace talks.
World AIDS Day: ‘Universal Access and Human Rights’
Authors: Peate Ian
Published: May 2014

The HIV epidemic remains a significant public health challenge, with over 33.4 million people living with HIV worldwide (World Health Organization (WHO), 2010). 1 December is World AIDS Day, the theme of which is ‘Universal Access and Human Rights’
Writing for professional publication. Part 4: Supporting your statements
Authors: Fowler John
Published: May 2014

Motivation, appropriate content and making good use of the author guidelines were topics covered in the first three articles of this series of writing for professional publication. In this fourth part, John Fowler, an experienced nursing lecturer and author, discusses the importance of avoiding unsupported statements in writing for professional publications
Venous thromboembolism: no longer a silent killer
Authors: Carter Kim
Published: May 2014

Up to 80% of Venous thromboembolism deaths occur ‘silently’ – without any prior obvious symptoms. In light of this shocking statistic, Kim Carter explains the importance of all nurses becoming familiar with the new NICE guidelines: Venous thromboembolism - reducing the risk.
Does an all-graduate profession demand another look at skills mix?
Authors: Karstadt Lyn
Published: May 2014

Lyn Karstadtdiscusses how an all-graduate profession will affect the skills set of nurses
The Care Quality Commission Criteria for assessing NHS Trusts
Authors: Glasper Alan
Published: May 2014

Professor Alan Glasper looks closely at the Care Quality Commission’s new criteria for assessing Trust performance, and deciphers how these new standards will affect quality of care, patient satisfaction, and of course, nurses at every grade.
Procedure and outcomes of Roux-en-Y gastric bypass
Authors: Furtado Luís Carlos do Rego
Published: May 2014

Bariatric surgery is an effective intervention for weight loss in the morbidly obese patient and can result in resolution of associated comorbidities. However, it is a complex area of practice and care, these patients suffer a series of comorbidities that can compromise outcomes after surgery. Nurses must be aware of these comorbidities and anticipate the required interventions to ensure timely and effective treatment, and to minimize potential problems. This article reviews the technical procedures of the laparoscopic Roux-en-Y gastric bypass (LRYGBP) — which is considered the gold standard in bariatric surgery — and outlines its complications and outcomes. Other forms of bariatric surgery are briefly discussed in comparison to the LRYGBP. With knowledge in this area, nurses are in a ideal position to educate and prepare patients for life after surgery, and to diminish their anxiety during adaptation to this new phase of life.
Patient safety and health quality: recent reports from the CQC
Authors: Tingle John
Published: May 2014

John Tingle highlights key findings from two important reports by the Care Quality Commission (CQC) which maintain important implications for patient safety and provide a ‘real time view’ of patient care in the NHS.
Observing your patient
Authors: Castledine George
Published: May 2014

The importance of the nurse being with her patient and observing them has been emphasized many times, especially by Florence Nightingale:
Grounded by fear
Authors: Kelly Jacinta
Published: May 2014

A the summer rolls in we all look forward to an extended break, with many of us wanting to escape to far flung exotic corners of the globe. Air travel makes the great escape breezily possible. More than that, it has become a weekly commuting necessity for many - assuming that there’s no volcanic interruption, and that you don’t have a fear of flying.
The assessment and treatment of wound pain at dressing change
Authors: Bell Cassandra , McCarthy Geraldine
Published: May 2014

Pain is a common reason for patients with acute or chronic wounds seeking hospital admission, but it appears to be under-treated by health professionals. A quantitative descriptive study was conducted to investigate nurses’ knowledge with regard to dressing change and wound pain. Data were collected from registered nurses (n=94). Analysis indicated a low level of knowledge with regard to pain assessment and strategies to overcome pain at dressing change, but a good knowledge of factors that contribute to pain at dressing change.
A review of maggot debridement therapy to treat chronic wounds
Authors: Hall Sarah
Published: May 2014

This literature review aims to clarify whether using maggot debridement therapy (MDT) for the removal of devitalized and infected tissue in chronic wounds is a valuable tool for healing. To undertake a literature review, the British Nursing Index, Ovid-Medline and the CINAHL databases were searched from January 1960 to June 2010 using the following terms:maggot debridement therapy, chronic wounds, granulation,infection, and cost-effective. The evidence suggests that MDT is more effective than other methods of debridement for wound bed preparation, although it has not been proven to eliminate problems associated with recurrent infections. This therapy has also not been proven to accelerate the healing process; however, more research needs to be undertaken into this and the cost-effectiveness of treatment.
Evaluating skin care problems in people with stomas
Authors: Williams Julia , Gwillam Brandon , Sutherland Norma , Matten Jane , Hemmingway Julie , Ilsey Helen , Somerville Mary , Vujnovich Angela , Day Stephanie , Redmond Caroline , Cowin Caroline , Fox Kathy , Parker Theresa
Published: May 2014

Aim:This study aimed to identify actual and potential peristomal skin problems in relation to the use of different types of stoma appliances and accessories. It also compared ostomists’ perceptions of their peristomal skin condition with those of stoma care nurse specialists. Background Maintaining skin integrity is a basic skill that ensures good stoma management. It is widely accepted that from time to time a patient with a stoma will seek clinical advice about a peristomal skin problem. Little is known about how often patients present with these problems, the clinical course of peristomal skin problems, and how patients manage them. Method:A multi-centred descriptive study was conducted among 80 ostomists. Fieldwork took place over 13 months. The sample was drawn from a UK home care delivery database. Using structured questionnaires, ostomists were interviewed by a stoma care nurse specialist. A digital photograph was taken of their peristomal skin and their answers compared with nurse assessment using the Stoma Care Ostomy Research index scoring system. Findings:Of the interviewees 32% had healthy peristomal skin both via questionnaire and at observation. At observation, 68% were observed to have peristomal skin problems, of whom 44% had irritated skin, 12% had ulcerated skin, 9% had an apparent allergy and 3% had macerated/eroded skin. In addition, 21% had an ill-fitting appliance at observation. Half (50%) were observed to have a parastomal hernia, although only 24% reported having one. These findings demonstrate significant differences between the perception of skin problems among ostomists and actual skin problems observed by stoma care nurse specialists. Conclusions: Peristomal skin problems are common among ostomists. The difference between ostomists’ and nurses’ perceptions of peristomal skin condition led to the identification of educational needs for the new ostomist. Education and regular follow-up by the stoma care nurse specialist is imperative.
Writing for professional publication. Part 6: Writing the abstract
Authors: Fowler John
Published: May 2014

How to get your work published is the essence of this series on writing for professional publication. The first four articles focused on the preparation required before you start writing a potential article, and the previous article examined the importance of creating interest in the reader’s mind. In this sixth part of the series, John Fowler, an experienced nursing lecturer and author, discusses the importance of writing the abstract. It examines the content to include and also the importance of writing it in a way which encourages others to read the full article.
IV therapy and infection control in patients in the community
Authors: Higginson Ray
Published: May 2014

Universal precautions and general infection control measures need to be considered when undertaking any clinical procedure, but when administering intravenous (IV) therapy (medicines and/or maintenance fluids), specific measures need to be considered. This is especially important for vulnerable patients or if administering IV therapy in the home environment. There are many reasons why patients may need to receive IV therapy in the community, and these will all present nurses with specific problems. This article discusses some of the infection control procedures one must undertake when administering IV therapy to patients in the community.
Burn injuries among children from a region-wide paediatric burns unit
Authors: Alnababtah Khalid M. , Davies Paul , Jackson Craig A. , Ashford Robert L. , Filby Mike
Published: May 2014

Burns are known to be a cause of the most severe childhood injuries. The purpose of this retrospective study was to investigate socio-demographic and other factors involved in children being presented to a burns unit for treatment. This is the first reported comprehensive audit of burns admissions highlighting factors that may relate to the occurrence of burns in children. Raw data was obtained from the data service unit (DSU) and the ward registers of a paediatric burns unit. Of 1249 admissions, 1156 cases (92.5%) had clearly specified causes. The number of annual admissions ranged from 225 to 281 with a mean of 250 ± 25 per year. Eighty-eight percent of burns were superficial and covered less than 10% of body surface area. The majority of cases were males (744 cases; 60%). The mean age of cases was 4 years ± 1.8 years. The major causes of burns were ‘spill’ (765 cases; 61%) and ‘contact’ (150 cases; 12%). The largest group was white British (787 cases; 63%) followed by Asian (353 cases; 28%). Mixed and African population groups made up the remaining 9%. The risk of burns injuries is higher among younger children, during the early evening, and is disproportionately high in the Asian/ Asian British groups. It is suggested that there is a need to increase injury prevention towards those at greatest risk.
Caring for a child with cystic fibrosis: the children's nurse's role
Authors: McCullough Cheryl , Price Jayne
Published: May 2014

This article presents a narrative literature review of the psychosocial impact on family life of caring for a child diagnosed with cystic fibrosis. Diagnosis of long-term illness in a child causes major upheaval in the lives of both the child and family. Normal family life is often emotionally, socially, physically and financially disrupted. Amid such disruption, parents attempt to cope by creating a semblance of order in their lifestyle. Within an interdisciplinary approach to caring, the children's nurse plays a pivotal role in supporting families to establish such order and reconstruct their lives, while coming to terms with the knowledge that their child could die prematurely. In addition, the nurse, in his/her role as teacher and educator, empowers parents, children and young people with the knowledge to make informed decisions and assists parents in developing the skills (often technical) to care for their child. Cystic fibrosis is one such condition in childhood, and this article explores the main psychosocial issues experienced by families caring for their child following diagnosis of CF, as raised in the literature.
Evaluation of three commonly used pressure ulcer risk assessment scales
Authors: O'Tuathail Claire , Taqi Rebecca
Published: May 2014

Pressure ulcers are a huge concern for health professionals, cause suffering to patients and are associated with increased morbidity.

Aim:

This literature review provides an overview of the literature on the three most commonly used pressure ulcer risk assessment scales — the Waterlow scale, the Braden scale and the Norton scale.

Method:

A search was undertaken through the databases CINAHL, MEDLINE, British Nursing Index, ProQuest and Cochrane Library. Key terms included pressure ulcers, pressure sores, risk assessment, Braden scale, Norton scale and Waterlow scale.

Results:

While risk assessment scales are beneficial they should not be used without the aid of nurses' clinical judgment. Over-predicting pressure ulcers is a common problem when using risk assessment scales. However, ethical considerations preclude investigation into the predictive capacity of a scale. Ongoing education in the prevention and management of pressure ulcers is essential for nurses. Risk assessment scales should be adapted to suit the needs of the clinical setting in which they are used.

Conclusion:

The Waterlow scale is the most widely used risk assessment scale in the UK and Ireland, even though there is no evidence to suggest it is more effective than the other most commonly used scales.
Effective management of peristomal pyoderma gangrenosum
Authors: Hanley Judy
Published: May 2014

Peristomal pyoderma gangrenosum (PPG) is a skin disorder which manifests as painful exudating, ulcerative lesions. It is generally associated with inflammatory bowel disease (IBD) when affecting patients with a stoma. Patients with PPG typically present to the stoma care nurse (SCN) in the first instance, when the discharging ulcers cause pain, prevent effective stoma appliance application and result in leakage.

Anecdotal evidence suggests that clinical nurse specialist posts, such as that of the SCN, are being diluted within some trusts, with a demand for staff to work on wards to cover clinical shifts. As a consequence there is a possibility that these patients will not receive a prompt diagnosis and treatment plan.

This article will examine the role of the SCN in managing the patient with PPG, including the use of effective topical treatments. The importance of early diagnosis to prevent escalation of PPG and subsequent prolonged patient discomfort—and the SCN's crucial role in this—is discussed.
Musculoskeletal US: examining the joints
Authors: Miedany Yasser El , Palmer Deborah
Published: May 2014

Musculoskeletal ultrasound (US) is an excellent tool to diagnose muscle, tendon and ligament injuries, cystic structures and peripheral nerve compression, as well as soft tissue masses, without the risk of ionizing radiation. Musculoskeletal US is now routinely used by a growing number of rheumatology and sports medicine centres throughout UK. In standard clinical practice, US has an extremely useful application in differentiating fluid from soft tissue and identifying the severity of joint inflammation. The work described in this article was carried out to assess patients' feedback regarding the use of US guidance for intra-articular injections and/or the removal of fluid from their inflamed knee joints in a nurse-led clinic. Nineteen patients who had US-guided knee joint injection/aspiration in the clinic were asked to complete a questionnaire regarding their satisfaction with the procedure, and to rate their joint pain and patient global assessment (using numerical visual analogue scale) before the US-guided procedure, and 1 month after. Results revealed a significant improvement (p<0.001) of the joint injection outcome measures and the patients' satisfaction of the US-guided procedure. Therefore, musculoskeletal US can improve two fundamental clinical skills: the clinical diagnosis of joint inflammation, and the accuracy of joint injection/aspiration. This study supports the concept that incorporating musculoskeletal US into clinical practice leads to significant improvements in patient care. It also reveals that US-guided procedures are appreciated by patients.
Intellectual disability nursing assessment: student reflections
Authors: Doody Owen , McInerney Paula , Linnane Lynda
Published: May 2014

Nursing students, Paula and Lynda, reflect on their first academic assessment of their 4-year intellectual disability nursing course. The reflection is conducted by the second and third authors of this article, and is guided by Gibbs' (1998) cycle, highlighting the positive and negative aspects of their ‘workbook’ assignment during their first academic semester. Overall, the use of the workbook as an assessment method enabled the students to discover the importance of time management, attendance at lectures, database searching, referencing and academic writing. The assignment enabled the students to be more prepared for clinical practice placement, and develop a basis for future learning and knowledge of intellectual disability.
Simulated practice learning in a preregistration programme
Authors: Ricketts Barry , Merriman Clair , Stayt Louise
Published: May 2014

Following the publication of the Nursing and Midwifery Council's (NMC) (2007) Simulation of Practice Learning Project, simulated practice learning opportunities are now to be incorporated into preregistration undergraduate nursing programmes across the UK. Since 2008, the Faculty of Health and Life Sciences at Oxford Brookes University has incorporated simulated practice learning into their curriculum to contribute towards students' 2300 direct clinical care hours. This paper presents the findings of an evaluation project that was conducted by academic staff within the faculty to ensure that they could continue to meet the principles set out by the NMC for auditing simulated learning environments used by higher education institutes (HEIs), and to meet the Essential Skills Clusters ( NMC, 2010a ) for registration as part of the quality assurance processes. The evaluation took place over 2 days, with a total of 52 participants, including practice partners, mentors, practice educators, academic staff and students from all four branches of nursing (adult, mental health, learning disability and children). Results indicated that the support of direct care hours through simulated practice learning can permit students to practice essential clinical skills in a designated clinical skills suite. These learning experiences can also offer positive outcomes and the opportunities to maintain partnership for students, placement partners, and mentors.
Student perceptions of sudden cardiac arrest: a qualitative inquiry
Authors: McDonough Annette , Callan Krista , Egizio Katelyn , Kenney Kaye , Gray Gillian , Mundry Gillian , Re Gillian
Published: May 2014

Sudden cardiac arrest (SCA) is the number one cause of death in young athletes in high school and university settings. Survival and outcomes of SCA is dependent on appropriate recognition of symptoms and immediate cardiopulmonary resuscitation (CPR), along with a shock from an automatic external defibrillator (AED). The three aims of the authors' study presented in this article were: to describe university students' perceptions and beliefs about sudden cardiac arrest, to describe university students' understanding of an AED and their level of preparedness to recognize and respond to a life threatening emergency event, and to identify university students' experiences of responding to handling life-threatening emergency events. Qualitative methodology was employed using semi-structured interviews and thematic analysis. Three major themes emerged from data analysis: confusion, uncertainty, and fear/uncomfortableness. These themes characterised participant's perceptions about SCA. The authors concluded that a lack of understanding of what SCA is and participants' inability to respond to an emergency event was evident.
What's new in vascular access devices and technology?
Authors: Sansivero Gail Egan
Published: May 2014

Creative individuals use a variety of strategies to improve clinical outcomes. These may include different methods of assessment, novel approaches to intervention or development of new clinical tools and devices. Each of these strategies can be employed to improve a patient's experience, reduce complications or promote better device performance. This article focuses on new strategies, tools and products in the field of vascular access devices, and considers ways in which nurses can foster innovation in practice to improve patient outcomes.
Catheter valves: a welcome alternative to leg bags
Authors: Woodward Sue
Published: May 2014

Catheterisation is commonly used to manage long-term bladder drainage. If intermittent catheterisation is not possible an indwelling urethral or suprapubic catheter will be used. There are a choice of drainage systems for use with indwelling urinary catheters including bed bags, link systems and catheter valves. Catheter valves are not suitable for everybody and patient assessment is vital: only patients with the cognitive ability and manual dexterity to operate a valve should be offered this option for bladder drainage. Catheter valves offer a number of advantages over drainage bags including improved privacy and dignity, prevention of bladder-neck trauma, reduced catheter encrustation and maintenance of normal detrusor muscle function. A number of catheter valves are available, including the EZ-Flow valve, and patient choice is important when selecting an appropriate product.
Enhancing adolescent care
Authors: Louise Botten Emma
Published: May 2014

Emma Botten is a third year mental health nursing student. In her column, she offers some advice on ways to approach adolescent patients. She discusses the importance of implementing understanding, compassion and effective communication.
Chronic illness and wellbeing: using nursing practice to foster resilience as resistance
Authors: Edward Karen-leigh
Published: May 2014

Chronic non-communicable diseases such as heart disease, cancer and diabetes are the biggest killers worldwide. Chronic conditions include heart disease, stroke, diabetes, cancer, chronic respiratory disease and are often comorbid with mental illness. Over 60 years ago, the British Medical Journal reported an association between mental illness and poor physical health ( Philips, 1934 ). Comorbid mental illness and physical illness incrementally worsens health compared with mental illness alone or any of the chronic non-communicable diseases such as cardiovascular diseases, cancers, chronic respiratory diseases and diabetes alone. This paper aims to open the dialogue related to optimising, through nursing intervention, a patient's self-righting and self-management factors in the context of comorbid chronic conditions such as heart disease, stroke, diabetes, cancer, chronic respiratory disease, with mental illness. Self-managementand self-righting capabilities are now being considered integral to reducing the negative impact of chronic conditions such as mental illness. Personal characteristics associated with resilience comprise optimism, an active or adaptable coping style and the ability toelicit social support. Existing resilience factors can be assessed forby nurses and optimised through interventions when patients with chronic conditions are in care. Representing over 70% of the global health workforce, nurses are well positioned to enact such practice enhancements to facilitate better outcomes for patients.
South American legal perspective on professional nursing
Authors: Cirino Campos Fagner Alfredo Ardisson , Nekrassovski Oleg
Published: May 2014

This study involved a literature review aimed at describing the professional duties, stipulated in federal legislation, of nursing professionals in South America. According to the federal legislation that regulates the professional nursing practice, nurses are supposed to apply their skills and knowledge in an autonomous and secure way. Since it is through this legislation that professional competence of nurses is determined, the laws of each South American nation were consulted, to see how professional nursing functions differ according to each. In general, according to the South American federal nursing legislations, professional nursing practice must be grounded in quality patient care and good nursing administration.
Making caring a career: the role of the healthcare assistant
Authors: Glasper Alan
Published: May 2014

Professor Alan Glasper discusses the implications of the independent review into healthcare assistants (HCAs) and support workers in the NHS and social care settings undertaken by Camilla Cavendish, associate editor of The Times newspaper
Cognitive behavioural therapy for psychosis and anxiety
Authors: Welfare-Wilson Alison , Newman Rebecca
Published: May 2014

This article discusses the effectiveness of a cognitive behavioural therapy (CBT) group for clients with a first episode of psychosis, who were also experiencing comorbid symptoms of anxiety. Clients of 18–35 years of age who reported anxiety symptoms, either as a direct or indirect result of psychotic symptoms, were invited to attend a 12-week CBT-based group. The effectiveness of the intervention was evaluated at screening and 3-month follow-up with the Depression, Anxiety and Stress Scale (DASS-21) ( Lovibond and Lovibond, 2004 ). The results showed a statistically significant improvement in symptoms (depression, p=0.06; anxiety, p=0.05; stress, p=.014), sustainable at 3-month follow-up. The authors concluded that a CBT group for people with a first episode of psychosis that focuses on the management of anxiety can be an effective and viable means of reducing levels of anxiety and associated stress and depression. This model is recommended for use by community mental health teams.