bluuebunny/crossref_metadata_2025 huggingface dataset:
Tricyclic antidepressants: pharmacological profile
Authors: Lovatt Penny
Published: May 2014

This second article in the series on antidepressants reviews the tricyclic antidepressants (TCAs). After observing that chlorpromazine, an antihistamine drug, also had neuroleptic qualities, imipramine, a derivative of this pioneering compound, was introduced to the pharmaceutical market in the 1960s. Using the monoamine theory of depression to help conceptualize the mechanism of action of this class of antidepressants, this article will consider the ADME properties of TCAs before discussing the vulnerable populations requiring caution in prescribing. The alternative therapeutic uses of TCAs will also be highlighted.
Lipid-lowering therapies: a prescribing guide
Authors: MacMahon Zofia , Wierzbicki Anthony S
Published: May 2014

Dyslipidaemia accounts for 55% of population-attributable risk for cardiovascular disease (CVD). Lipid levels should be measured as part of a comprehensive CVD risk assessment. Calculation of 10-year CVD risk should be performed, except for patients with pre-existing CVD, diabetes or a familial hyperlipidaemia, who are considered high-risk by definition. Initial therapy is with a statin in almost all cases. Other therapies are used for statin intolerance or where a residual dyslipidaemia persists after statin therapy.
Development of a diabetes nursing competency framework
Authors: Hill Jill
Published: May 2014

Abstract

This article describes the development of a dynamic document detailing a competency framework for nurses and unregistered practitioners working with people with diabetes in a variety of health care settings. The first competency framework was produced by the now defunct UK Association of Diabetes Specialist Nurses in 2005. In response to feedback from diabetes nurses, against a background of major changes in the way diabetes care is being delivered, the document has been revised twice to incorporate additional competency topics to reflect the evolving role of the diabetes nurse.
Prescribing for mild-to-moderate psoriasis in adults
Authors: Van Onselen Julie
Published: May 2014

Psoriasis is an inflammatory condition that manifests in the skin and joints. People with severe psoriasis are at high risk of developing other associated comorbidities, such as cardiovascular disease, metabolic syndrome, diabetes, and other systemic inflammatory conditions. All severities of psoriasis can impact on a person's quality of life. Nurse prescribers have the potential to provide support in managing psoriasis and educating on general skin and joint care as well as topical treatments. Nurse prescribers can offer treatment options for mild-to-moderate psoriasis, and advise on referral for severe psoriasis and any type of childhood psoriasis. In order to achieve this, nurse prescribers need to expand their knowledge of psoriasis and evidence-based topical treatments. These need to be advised and prescribed according to the severity of the condition and the new National Institute for Health and Clinical Excellence (2012) guidelines.
Pharmacology in the musculoskeletal system
Authors: Williams Anwen Siân , Goodfellow Rhian
Published: May 2014

Musculoskeletal diseases (also called rheumatic diseases) are a major cause of morbidity throughout the world ( World Health Organization (WHO), 2003 ); they encompass a wide spectrum of disorders that are propagated by a plethora of biological factors. There are over 200 such rheumatic diseases that span from various types of arthritis to systemic connective tissue diseases ( European League Against Rheumatism (EULAR), 2009 ). They constitute a diverse group of conditions from those of acute onset and short duration (e.g. gout, tendonitis and bursitis) to chronic progressive disorders such as osteoarthritis, rheumatoid arthritis and systemic lupus erythematosus. Rheumatic diseases represent an important social and economic problem inflicting enormous costs on health and social care systems. In Europe, nearly 25% of adults are affected by long-standing musculoskeletal problems that limit daily activities ( Lidgren et al, 2005 ). By virtue of their inconsistent pathophysiology; each musculoskeletal disease demands a different approach to its management in the clinic. Therefore, there is no single medication or treatment that is optimal for everyone. In many rheumatic diseases pain is a common symptom and its management is one of the most important aspects of patient care.
Assessment and management of acute sore throat
Authors: Shepherd Alison Burton
Published: May 2014

Acute sore throat is a very common presenting complaint in general practice and is often associated with benign conditions including pharyngitis, laryngitis and tonsillitis ( Stevens, 2008 ). However, it is important to note that a sore throat may be the early onset of a more serious life-threatening condition. Therefore, a thorough patient history and examination are vital in order to establish the correct diagnosis. This article will highlight the causes of acute sore throat and provide some guidance as to how to manage this common condition.
Medication reviews in primary care
Authors: Morris David
Published: May 2014

Medication reviews are becoming increasingly important in primary care, as the need to reduce the wastage of medications in order to save money increases. It is estimated that 50% of drugs are not taken as prescribed, and 5–17% of hospital admissions are a consequence of adverse reaction to medication ( Department of Health (DH), 2001 ). A medication review may be conducted by a nurse, doctor or pharmacist, provided they have the appropriate therapeutic knowledge and clinical experience. There are three levels of medication review. Level 1 is a prescription review. Level 2 involves a review of medicines using the patient's notes. Level 2 enhanced also includes a telephone discussion with the patient. Level 3 is a clinical medication review, involving face-to-face contact with the patient. Medication reviews are important for concordance, as they enable a patient to understand why they are taking a particular medication. Given the pressure on appointments in primary care, level 3 reviews may not always be feasible and indeed in many cases would be inappropriate and could annoy patients. Medication reviews should target those most likely to benefit. This would include the frail elderly with multiple co-morbidity and polypharmacy and those with frequent hospital admissions.
A case of catheter-related contact dermatitis in an elderly patient
Authors: Nazarko Linda
Published: May 2014

Age related skin changes lead to increased vulnerability, resulting infection and dermatitis. This article describes the management of contact dermatitis in an elderly patient caused by a urine leg bag, and discusses the measures taken to prevent its recurrence.
Prescribing errors: taking the human factor into account
Authors: Robson Wayne
Published: May 2014

Prescribing errors are relatively common and this is a substantial risk for nurse prescribers as it is for their medical colleagues. Many of the reasons behind these errors appear to be related to non-technical skills or human factors, such as: slips in attention, memory lapses, the effects of workload and environment, interruptions, hierarchies and poor communication. Technical knowledge of drugs and good clinical skills are not enough by themselves to prevent prescribing errors. Eliminating avoidable harm to patients is a key priority for all healthcare systems and a greater awareness of human factors by nurse prescribers may help avoid some of the errors. This article will explore prescribing errors from a human factors perspective and aims to encourage debate and discussion among nurse prescribers about this area of prescribing practice.
Cost-effective prescribing in chronic obstructive pulmonary disease
Authors: Hickey Steven
Published: May 2014

This article highlights the cost implications when prescribing the different delivery devices available for salmeterol/fluticasone (Seretide, Allen & Hanburys) in patients with chronic obstructive pulmonary disease (COPD). The prescribing licence for combination inhalers in COPD is specific to both drug dosing and delivery device. The perception amongst some practitioners is that patients with moderate to severe airflow obstruction (FEV1 <60%) are unable to generate sufficient inspiratory flow to adequately use the Accuhaler. This audit found this not to be the case and recommends that independent prescribers can prescribe the licenced device confident that patients with COPD can generate sufficient inspiratory flow. The cost savings are significant if patients can be changed from the Evohaler to the Accuhaler.
Human papillomavirus vaccination and public health
Authors: Cadman Louise
Published: May 2014

Human papillomaviruses include over 100 types of DNA virus which affect the epithelial cells. The causal relationship between persistent infection with high-risk types of human papillomavirus (hrHPV) and squamous cell cervical carcinoma has been well established ( Walboomers et al, 1999 ). Cervical cancer is the fourth most common cancer amongst women worldwide, with an estimated 528 000 new cases in 2012 and 266 000 deaths. These facts have led to the establishment of HPV vaccination programmes in order to reduce the number of cases of cervical cancer. This article provides an overview of current HPV knowledge in relation to cervical cancer prevention and vaccination.
Preventing pressure sores: a culture of responsibility
Authors: O'Brien Mark , Bennett Gerry
Published: May 2014

Mark O'Brien and Gerry Bennett argue that nurses both in hospital and community must accept responsibility for actions or omissions that lead to pressure sore development and gain knowledge through objective assessment of each incident.
Conscientious record keeping: its role in effective care
Authors: Wright Kerri
Published: May 2014

Nurses need to be aware of the reasons why and how they record information about clients in order to maintain the quality of care they give, and account for their actions.
The misconceptions and reality of Parkinson's disease
Authors: Scott Sheila
Published: May 2014

Caring for people with Parkinson's disease is a rewarding challenge. Sheila Scott gives an update on the impact of the disease, side-effects, and current treatment options.
The role of the nurse in the management of spasticity
Authors: Jarrett Lou
Published: May 2014

Lou Jarrett outlines the unique contribution that nurses can make to the ongoing management of an individual's spasticity, and looks at potential treatment methods.
An innovative route to better psychiatric input
Authors: Jackson Graham A
Published: May 2014

How can appropriate high quality psychiatric care for older people in nursing homes best be achieved? Here, the author describes a model of care that is provided in Glasgow.
The roles and responsibilities of the care worker
Authors: Pritchard Jacki
Published: May 2014

Jacki Pritchard argues that care workers have a vital role in delivering care to service users, but explains that it is also a very complex role with many responsibilities.
Oteoporosis: The importance of maintainig good bone health
Authors: Nazarko Linda
Published: May 2014

Osteoporosis will affect 50% of women and 20% of all men during their lifetime. This article explains how to maintain bone health and how osteoporosis is diagnosed and treated.
Employing overseas workers
Authors: Forsyth Lisa , Exten-Wright Jonathan
Published: May 2014

Lisa Forsyth and Jonathan exten-Wright examine the law regarding the employment of overseas workers.
Verification of expected death: The role of the nurse
Authors: Vaughan Carol A
Published: May 2014

This article explores the emerging role of the nurse in the care of the dying.
Coming in from the cold
Authors: Sims Beccy
Published: May 2014

Beccy Sims reports on efforts to ensure that older people stay safe and well during the winter months.
Down but not out
Authors: Sims Beccy
Published: May 2014

Beccy Sims reports on a national charity's attempts to raise awareness and stamp out discrimination in the treatment of older people with depression.
NVQ series, part 4: unit HSC21—Communication
Authors: Whitehead Elizabeth
Published: May 2014

Communication is fundamental to quality care, and features as a key component of the NVQ level two in care. Elizabeth Whitehead explains how recording your communication with residents and colleagues will help you meet the requirements of unit HSC21.
Advice for the influenza season: infection control in the care home
Authors: Stanwell-Smith Rosalind
Published: May 2014

Preventing the spread of infection in the care home can be as simple as washing hands properly and containing coughs and sneezes. Dr Rosalind Stanwell-Smith reviews the methods of infection control for influenza and other acute upper respiratory infections.
A good night's sleep part two: disordered sleep
Authors: Wilson Sue
Published: May 2014

Sue Wilson discusses the importance of recognizing the sleep disorders that can the treated, and applying simple behavioural measure to minimize symptoms of those that can not.
Evaluating and improving practice
Authors: Weaver Dawn
Published: May 2014

Dawn Weaver discusses the importance of evaluating practice, and the important implilcations this can have on caring standards and career development.
Numeracy skills for nurses: revision and review
Authors: Wright Kerri
Published: May 2014

Kerri Wright introduces a revision and working examples of the numeracy skills key to the role of nurses working with older people in nursing and residential homes.
Cause for complaint?
Authors: Sims Beccy
Published: May 2014

A new simplified complaints system is being promoted as a route to better services for health and social care users. Beccy Sims investigates.
Recognition and management of common causes of itchy skin
Authors: Levell Nick J
Published: May 2014

Nick Levell discusses the challenges of identifying the causes of itchy skin in older adults, and describes the various skin disorders that can be difficult for staff and residents to manage.
Continence care for older adults in care homes
Authors: Foxley Sue
Published: May 2014

Assessment and accurate documentation is paramount to the deilvery of effective and effi cient holistic continence care to all residents in need. Sue Foxley discusses.
Rhythm of life: understanding movement disorders
Authors: Swann Julie
Published: May 2014

Physical activity can significantly enhance mobility and independence and improve quality of life. Julie Swann dicusses disorders of movement and the interventions than can help maintain mobility and rhythmic movement.
Designing homes for people with dementia
Authors: Joy Helen
Published: May 2014

When creating a caring environment for those living with dementia it is important to consider the effects that the illness may have on carrying out everyday tasks, and orientation. Helen Joy discusses the importance of designing for dementia.
How Betty Blue weighed in and saved the day
Authors: Ansah Liz
Published: May 2014

Liz Ansah was concerned at the high levels of weight loss among dementia patients in the nursing home she managed. So she devised the ‘Betty Blue’ diet management plan. Here, she tells us how it works.
Diagnosing common skin conditions in a care home
Authors: Wheeler Tracey
Published: May 2014

The diagnosis of common skin conditions begins with a thorough skin assessment coupled with a detailed history. Care workers can play an important role in this process.
Managing fire safety in care homes
Authors: Griffith Richard
Published: May 2014

Fire safety regulations can sometimes appear confusing, with responsibilities unclear. Richard Griffiths explains the current fire regulations and the role of care home proprietors, managers and staff in ensuring fire safety.
Preventing and managing falls in residential care settings
Authors: Pountney David
Published: May 2014

National Falls Awareness Day highlighted the physical and psychological damage that falls can cause to older people and the importance of effective falls prevention. Dr David Pountney discusses the measures that can be taken to prevent falls.
Recognising and managing dysphagia
Authors: Nazarko Linda
Published: May 2014

Stroke victims often develop dysphagia—difficulties in swallowing. Linda Nazarko explains how this can be managed, and how sufferers can be helped to remain well nourished and hydrated.
Assessing perception problems in older people
Authors: Swann Julie
Published: May 2014

By making use of observation skills and non-standardised perceptual tests, care staff can play a vital role in identifying the difficulties experienced by older people.
A case for reform
Authors: Bellingham Lynda
Published: May 2014

I know all too well the devastating effect that dementia can have on a person and the people they love. Having seen my mother die with this condition, I have learnt the hard way. However, as ambassador for the Alzheimer's Society I have also learned that this cruel reality is not one that we have to accept.
A silver-lined strategy to control the spread of infection
Authors: Bissett Linda
Published: May 2014

From hands to laundry, catheters to bed linen, and furniture to surfaces, bacteria can spread across environments. Linda Bissett on advancements being made in the fight against germs.
Choosing appropriate dressings for leg ulcers
Authors: Smithdale Rachael
Published: May 2014

The huge choice available means selecting a dressing is never easy. Here, Rachael Smithdale describes how the TIME concept can aid decision-making
Follow the leader: safe negotiation of the environment
Authors: Swann Julie
Published: May 2014

In the last of the series, Julie Swann provides practical ideas for care staff to help residents who have perceptual problems to manage in their environment
Situation vacant? How to use a recruitment agency
Authors: Hedger Karen
Published: May 2014

Many managers find they need to work with an agency to recruit a professional in a specialized area. How efficient preparation and planning will save you money in the long run.
Are you effectively monitoring and supplementing food?
Authors: Merriman Sheila
Published: May 2014

Dietary monitoring and supplementation are not only essential to some frail older people's nutrition, but are part of CQC outcome five. Do you know how it should be done?
Continence during progressive neurological disease
Authors: Mangnall Joanne
Published: May 2014

Residents with progressive neurological disease are very likely to experience continence problems. Joanne Mangnall explains how to adapt continence care as the disease progresses
How to avoid medication errors on your drug round
Authors: Banning Maggi
Published: May 2014

With the impact of drug errors being potentially very serious and nursing staff taking day-to-day responsibility for drug rounds, Maggi Banning explains how you can minimize the risk of errors.
Pressure ulcer or moisture lesion—what's the difference?
Authors: Voegeli David
Published: May 2014

Both pressure and moisture cause skin damage, but the early stage of each appear very similar. How can the PUCLAS tool help you differentiate between the two types of damage?
Natural moments: a breath of fresh air in dementia care
Authors: Heathcote Julie
Published: May 2014

Interacting with plants and other living things can be therapeutic for people with dementia. in this article, Julie Heathcote gives you practical ideas on how to implement this in your care home
Staff training levels linked to improved inspection scores
Authors: Farrell Zoe
Published: May 2014

Zoe Farrell Reports on how training levels may improve inspection scores and other factors that help.
Is nasogastric feeding an option in nursing homes?
Authors: Wilson Neil
Published: May 2014

With the high prevalence of malnutrition among residents, there is a need for a range of transitional options in nutritional care. Neil Wilson discusses when nasogastric feeding might be considered.
Some simple solutions to wound debridement
Authors: Hampton Sylvie
Published: May 2014

Although it can require a high level of training and skill, there are simple forms of debridement that care homes can use to help wounds heal. Sylvie Hampton explains why they are used and how.
Supporting sight loss and dementia
Authors: Barrand Julia
Published: May 2014

Sight loss plays a major role in people's experience of dementia, yet it is absent from many models of care. Julia Barrand from the RNIB explains how you can help to support residents experiencing this.
Recruit and manage personnel who uphold excellence
Authors: Bones Nicki , Sweetbaum Barry
Published: May 2014

SweetTree services ranked as having the second most listening management from the top 100 in the country. They explain how their ethos of managing people enables this achievement.
Preventing and dealing with allegations of abuse
Authors: Davies Julie
Published: May 2014

After Panorama revealed the appalling cases of staff behaviour at Winterbourne View, Julie Davies explains how managers can protect their residents, what the legal procedures are and the role of whistleblowers.
Drive to improve diabetes management and treatment
Authors: Learner Sue
Published: May 2014

A fresh initiative has been launched to investigate standards of care for residents affected by diabetes in homes across england. sue learner investigates
Implementing a quality catering system
Authors: Oliver Karen
Published: May 2014

It is the duty of care providers to ensure that adequate nutrition and hydration is provided to residents. Karen Oliver outlines the policies and procedures that need to be implemented
National minimum wage: paying the price
Authors: Piper Jason
Published: May 2014

In the month of October providers have to be aware of the change in wage for their staff. Jason Piper explains common problems that the social care sector can avoid through setting up the appropriate systems
COPD and asthma: optimising inhaled therapy
Authors: Barnett Margaret
Published: May 2014

Residents should be supported to perform correct procedures to activate inhalers. Margaret Barnett provides a guide for staff on the drugs and various types of inhalers commonly used
Mapping memories of the letchworth community
Authors: Heathcote Julie , Duncan Lindsay
Published: May 2014

Julie Heathcote and lindsay Duncan report on a project that encouraged residents to take part in a creative reminiscence process. They explain how you can set up a similar project with support from the local community
Contracts of employment and CRB checks
Authors: Godfrey Colin
Published: May 2014

Colin godfrey talks through the benefts of supplying written contracts to avoid disputes should conficts arise between workers and employers, and to establish the obligations and duties of staff
Immigration regulation: employing overseas workers
Authors: Godfrey Colin
Published: May 2014

Changes have taken place that affect the employment of overseas workers in the care industry. Colin godfrey talks through the sponsorship steps under the changes in immigration regulation
Skin failure and wound debridement
Authors: Young Trudie
Published: May 2014

Debridement methods should achieve timely, optimal, pain-free removal of non-viable tissue. Trudie Young outlines the current debridement options available
Decision making for residents with dementia
Authors: Piffaretti Eve
Published: May 2014

Care suppliers have a duty to preserve the freedom of action for clients. eve Piffaretti revisits the basics of the Mental Capacity act 2005 to help decision makers keep the resident’s best interests at heart at all times.
Preventing thromboembolic events and stroke
Authors: Potts Katherine
Published: May 2014

New drugs are likely to replace agents like warfarin that are commonly used to reduce clot formation. Katherine Potts outlines the development in treatment guidelines
Equality and inclusion in recruitment
Authors: Godfrey Colin
Published: May 2014

Balancing business needs and compliance with the equality regulations can be difficult. Colin godfrey sets out clear parameters to help homes adopt a fair interview process to ensure they get the right person for the job
Communication and swallowing problems after stroke
Authors: Richards Emma
Published: May 2014

Speech and language therapists play a vital role to prevent a decline in quality of life. Emma Richards outlines the benefits of assessment and intervention with the nursing home population
It is never too late to build healthy bones
Authors: Stone Sister Debbie
Published: May 2014

Staff play a vital role in encouraging older people to employ a healthy lifestyle. Debbie Stone explains how this can significantly reduce fractures in people with osteoporosis
Staff development and support: a return on investment
Authors: Dallinger Tim
Published: May 2014

Staff are the most valuable asset in the provision of health and social care. In the second part of this series on training, Tim Dallinger explains how managers can get the most out of their staff through training and ensure that this benefits residents in the home
Hidden in the home: supporting same-sex partnerships
Authors: Hutchins Thomas
Published: May 2014

By allowing lesbian, gay and bisexual older people and their partners to remain hidden in health and social care, nurses risk ignoring their specific needs, which encompass a variety of biological and psychosocial issues, as Thomas Hutchins explains
How do vaccines work to protect people from disease?
Authors: Nazarko Linda
Published: May 2014

Infectious diseases ravaged humanity for millennia until we learnt how to prime the immune system with antigens to enable the body to respond to diseases. Linda Nazarko explains how the immune system works and the benefits of vaccination
Working with optometrists to combat common eye problems
Authors: Hayes Kerry
Published: May 2014

Older people in care homes might not be diagnosed with sight loss or their condition may have been forgotten about. Kerry Hayes concludes her two-part series highlighting how staff can support residents' vision after a domiciliary optometrist has paid a visit
Protecting residents:no safety, no business
Authors: Patterson Victoria
Published: May 2014

How are concerns regarding health and safety addressed in your care home? Victoria Patterson provides some guidance on the law and offers practical tips to help you deal with whistleblowing
Assessment and management of airway and breathing
Authors: Higginson Ray , Jones Bridie
Published: May 2014

Maintaining the airway and facilitating breathing is the main priority in an emergency situation. All health professionals need to be able to undertake airway management after thorough assessment
Relatives' low expectations of dementia services
Authors: Learner Sue
Published: May 2014

Sue Learner discusses the latest survey published by the Alzheimer's society on the public image of care homes and what providers can do to change it
Manual handling: assessment of the environment
Authors: sturman-Floyd Melanie
Published: May 2014

Moving and handling are an integral part of our daily lives, at home and in all areas of health and social care. This article is the third in a three-part series focusing on the assessment of the resident
Uses, interactions and side effects of aspirin in older people
Authors: Robertson Deborah
Published: May 2014

Aspirin's longevity as a therapeutic medicine can be attributed to its effectiveness and multiplicity of uses. Deborah Robertson advises that this drug, despite its versatility, must be used with caution, particularly in the elderly population
Prevention and control of viral gastroenteritis
Authors: Beckett Gail , Bright Janice
Published: May 2014

Norovirus, a cause of viral gastroenteritis, is spread easily from one person to another. Prompt and effective prevention and control of norovirus can significantly reduce the effect of infection on residents and staff, as Gail Beckett and Janice Bright explain
The ethical issues of telecare: a help or a hindrance?
Authors: Dewsbury Guy , Ballard Debbie
Published: May 2014

Most telecare devices, if used appropriately, have the potential to benefit a person. However, as Guy Dewsbury and Debbie Ballard explain, the ethical dimension of any telecare device in relation to what the person expects from its use should be considered
First chief inspector of adult social care
Authors: Learner Sue
Published: May 2014

Sue Learner looks at the reactions to the appointment of Andrea Sutcliffe and how this new role will contribute to a more cohesive way of working between health and social services
Venous ulcers: assessment and wound dressing selection
Authors: Yarwood-Ross Lee
Published: May 2014

Nurses should have a good understanding of the different characteristics of venous ulceration and be able to carry out an initial comprehensive assessment. Lee Yarwood–Ross outlines the basic principles of assessment and choosing wound dressings
Management of angina in the older adult
Authors: Tierney Paul , McKenna Niall
Published: May 2014

Angina is a common chronic condition that affects a significant number of older adults. Paul Tierney and Niall McKenna explore the management and treatment options of stable angina available to residents
A new Care Certificate: a bid to drive up standards
Authors: Learner Sue
Published: May 2014

Following Robert Francis QC's report into the failings at Mid Staffordshire Hospital, a new Care Certificate will be introduced from 2015 in a bid to drive up standards, as Sue Learner explains
Nature and the outdoors: stimulating those with dementia
Authors: Clark Patrick
Published: May 2014

With the numbers of people being diagnosed with dementia rising, it is important to offer different ways to stimulate those affected. The opportunity to take part in outdoors activities offers a variety of benefits and can even trigger forgotten memories
How to … prevent, manage and treat pressure ulcers
Authors: Payne Drew
Published: May 2014

Approximately 20% of care home residents will develop a pressure ulcer, yet the Department of Health states that they are preventable and avoidable ( Bangova, 2013 ); so how do we this? Drew Payne outlines seven important steps to take
Who wants to be a millionaire? Fundraising strategies and ambitions
Authors: Finn Adharanand
Published: May 2014

West Bridgford School in Nottingham is a fundraising success story. In the last year alone it has raised £750,000. Headteacher, Rob McDonough, who only took up his post in September 2005, said the key has been to make fundraising part of the school's ethos.
Schizophrenia: The carer's perspective
Authors: Worthington Alan
Published: May 2014

In the last of this series, Alan Worthington explains what primary care teams can do to support those caring for schizophrenia sufferers at home.
Mental health care in the community
Authors: McFadyen John , Farrington Andy
Published: May 2014

The revolution in psychiatric care has changed the role of the community mental health nurse. John McFadyen and Andy Farrington explore the implications.
Infectious disease and the law
Authors: Dimond Bridgit
Published: May 2014

Could you sue if you became infected with hepatitis at work? And what if you then infected a patient? Bridgit Dimond explains the legislation relating to infectious disease.
Five-a-side therapy
Authors: Flavelle Eileen
Published: May 2014

Football is far more than just a kick around a pitch for one group of people with learning disabilities. Eileen Flavelle looks at a model for sport therapy.
CFC inhaler ban: Speaking too soon?
Authors: Blatt Barry
Published: May 2014

All asthma patients using metered dose inhalers (MDIs) may have to change their medication by the year 2000. MDIs are aerosols that rely on gas propellants called chlorofluorocarbons (CFCs) which are in the process of being banned by international treaty.
Defining specialism in asthma
Authors: Thompson Sue
Published: May 2014

Sue Thompson completes her series on the asthma clinic by asking: What is the role of the specialist asthma nurse?
Drug compliance: A continuing problem
Authors: Edwards Marilyn
Published: May 2014

Why do some patients go to their doctors and then not take their medicines properly? Are they just being stubborn or are there logical reasons for not taking their medication? Marilyn Edwards examines the issues around non-compliance.
Patient power or consumer confusion?
Authors: Hayward Annabel
Published: May 2014

Equipping patients with information about their health could arguably be time- and cost-effective and empowering. But as Annabel Hayward discovers, it is not that straightforward.
Oral anticoagulation therapy
Authors: Murray Ellen , Fitzmaurice David
Published: May 2014

Ellen Murray and David Fitzmaurice describe an innovative nursing model for management of oral anticoagulation therapy in primary care.
Delivering the future
Authors: Blatt Barry
Published: May 2014

The third and last White Paper on primary health care has been released by the Department of Health. Barry Blatt reviews the implications for practice nurses.
Telemedicine Now
Authors: Blatt Barry
Published: May 2014

Telemedicine has given three nurse practitioners in Central London the chance to revolutionise primary care.

Barry Blatt finds out how.
Caring for Patients with Psoriasis
Authors: Penzer Rebecca
Published: May 2014

Patients with psoriasis face many psychological as well as physical problems. Rebecca Penzer looks at the role of the practice nurse in their care.
Malaria Prophylaxis
Authors: Taylor Sue
Published: May 2014

The media attention regarding mefloquine side effects has meant that many travellers are concerned about taking anti-malarial drugs even for high risk areas.
Readers Respond
Authors: Dodd Patsy
Published: May 2014

Specialist practitioner - why bother?
Protocols and the Law
Authors: Holland Caroline
Published: May 2014

You may not feel like a victim of your own success, but nothing illustrates how rapidly the role of the practice nurse has grown as well as the fraught issue of practice protocols. These were introduced because the scope and scale of the practice nurse's workload meant that she could not always seek direction from her GP employer and they enabled her to supply and administer medicines without seeking prior authorisation for each and every patient.
Where will the Buck Stop?
Authors: Richards Sue
Published: May 2014

UKCC Council member Sue Richards gives sound advice on dealing with unsound mangement practices.
The Next Generation: Breaching the Final Frontiers of Practice
Authors: Blatt Barry
Published: May 2014

This year's practice nursing conference will look at the new opportunities in advancing clinical practice and new ways of working in primary care. Barry Blatt surveys the final frontier.
Understanding Osteoporosis
Authors: Cassy Catherine
Published: May 2014

Osteoporosis is now recognised as a major public health problem, causing pain, disability and premature death. It affects 1 in 12 men and 1 in 3 women, with the incidence increasing to 1 in 2 women over 70 years of age. This results in more than 150 000 fractures each year. It is a symptomless condition until complications such as fractures or spinal deformity occur. After the menopause in the first 10 years 15-20% of spinal bone may be lost. After this, age-related bone loss averages a little over 1% per annum, thereby when a woman reaches 80, 40% of bone density could be lost in regions which are vulnerable to fracture (National Osteoporosis Society and Advisory Group on Osteoporosis Report, 1994a).
Elder Abuse and the Role of the Practice Nurse
Authors: Kingston Paul , Penhale Bridget
Published: May 2014

Paul Kingston and Bridget Penhale look at the ways practice nurses can help older people suffering abuse and neglect.
Time = Money Except at the UKCC
Authors: Richards Sue
Published: May 2014

Sue Richards discusses the money problems faced by hard-working nurses who become even harder working council members.
Clinical News
Authors: Owen Olwen Glynn
Published: May 2014

Hayfever sufferers warned anti-histamines cause car crashes

Psoriatic arthropathy needs solution to treatment dilemma

Encephalitis vaccination
Practice Nurses and Confidentiality
Authors: Dimond Bridgit
Published: May 2014

Bridgit Dimond looks at confidentiality and when it is acceptable to disclose patient information.
Preventing Heart Disease
Authors: Quilligan Sally
Published: May 2014

Practice nurses play an important role in heart disease prevention. Sally Quilligan describes the CHD clinic.
Running a Cardiac Rehabilitation Programme
Authors: Vella Tamara
Published: May 2014

The exercise programmes and the opportunity to meet people in the same predicament are seen as positive by patients, Tamara Vella explains.
Introducing spirometry into General Practice
Authors: Haggerty Sharon
Published: May 2014

It is claimed that Sunderland's population health status compares poorly with the rest of the country (Sunderland Health Improvement Programme, 1999). It has a legacy of long-term unemployment, previous heavy industry (shipbuilding and coal mining) and its subsequent decline, poor housing conditions, and an unhealthy lifestyle. Single district figures, although generally very worrying, hide pockets of poor health and significant inequalities in health. Sunderland experiences a particularly high incidence of disability and long-standing illness, especially respiratory disease (Sunderland Health Improvement Programme, 1999).
Constipation
Authors: Fisher Pam
Published: May 2014

Constipation is relatively common, especially in the very young and those over 50 years old, although its prevalence is difficult to estimate as people often seek individual help
The value of training in male sexual health
Authors: Jamieson Steve
Published: May 2014

Steve Jamieson considers the benefits of an RCN-accredited course for nurses on diagnosing erectile dysfunction and communicating with patients.
Setting up and running a spirometry clinic
Authors: Green Rosemary
Published: May 2014

Rosemary Green discusses the rationale for setting up a spirometry clinic in Bournemouth and explains how it can improve the treatment of COPD patients.
Hosiery to prevent venous thrombosis
Authors: McCullough Hazel
Published: May 2014

Hazel McCullough considers the risk of deep vein thrombosis and describes Activa Airsock compression hosiery, designed to prevent venous blood clots in those at risk.
Multiple sclerosis: How practice nurses can help
Authors: Burgess Megan
Published: May 2014

Megan Burgess explains the pathology and diagnosis of multiple sclerosis, and suggests how practice nurses can help give people diagnosed with MS the special advice and care they need.
Tick-borne encephalitis
Authors: Howell Karen
Published: May 2014

Travellers should take precautions against tick-borne encephalitis if travelling to forested areas of the world where the disease is endemic. Karen Howell explains the nature of the disease and ways to prevent it.
Letters
Authors: Smail June
Published: May 2014

This month June Smail brings readers' attention to the changes occurring in the Welsh NHS and the implications for primary care.
Coeliac disease and its complications
Authors: O'Broin Fionna
Published: May 2014

Fionna O'Broin discusses the diagnosis, risks and complications of coeliac disease and provides a guide to long-term treatment with a varied glutenfree diet.
‘Stop it, you're making me itch.’
Authors: Johns Suzanne
Published: May 2014

Suzanne Johns reveals what it is like to suffer the constant, everywhere-itch of eczema and to succumb to ‘nail abuse’. She argues that sufferers require more support to manage depression and eczema's impact on relationships while searching for a cure.
CLINIC Diabetes
Authors: Beckwith Sue
Published: May 2014

Depression occurs quite commonly in diabetics. Charles Black, the lorry driver we met in the August clinic, has converted successfully to insulin, but is showing signs of depression. Sue Beckwith follows up his story.
Mumps: The risks of non-prevention
Authors: Watkins Jean
Published: May 2014

Dr Jean Watkins explains how to recognize mumps, an illness whose suffering and potentially serious complications can be prevented by vaccinating children with the combined measles, mumps and rubella vaccine.
Sourcing reliable evidence on medicines
Authors: Courtenay Molly
Published: May 2014

Molly Courtenay discusses the usefulness, quality and accessibility of information available to nurse prescribers, whose prescribing decisions need to be evidence based.
New dietary advice on diabetes good for many
Authors: Buttriss Judy , Stanner Sara
Published: May 2014

Many aspects of the ideal diet for people with diabetes also apply to the population in general. Dr Judy Buttriss and Sara Stanner review new nutritional guidelines from the American Diabetes Association.
Academic or practical? Tensions in course design
Authors: Crossman Sue
Published: May 2014

Sue Crossman discusses the tensions between preparing safe, competent practice nurses and achieving academic rigour in university training programmes
How to detect and control lice
Authors: Cook Elizabeth
Published: May 2014

Head lice (Pediculus humanus capitis) are tiny insects either grey or brown in colour, no larger than the head of a pin. They live on the hair and feed from the human scalp by sucking blood from the skin. When the lice lay their eggs, they glue them to the strands of hair so that they cannot be easily removed (Figure 1). It takes about 1 week for the eggs to hatch, leaving empty, pearly white eggshells (nits).
Auditing to prevent heart disease in Scotland
Authors: Andrew Mandy , Black Shona , Fletcher Karen
Published: May 2014

Mandy Andrew, Shona Black and Karen Fletcher explain the work of HEARTS, a nurse-led initiative in Tayside, Scotland, working with general practices on secondary prevention of coronary events.
Immunosuppression
Authors: Townend Mike
Published: May 2014

Having a suppressed immune system should not necessarily prevent a person travelling, but such travellers are particularly prone to infection and need special advice about vaccinations and precautions, argues Mike Townend
CLINIC Women's Health
Authors: Watkins Jean
Published: May 2014

Deep vein thrombosis and pulmonary embolism are not on Mary's mind when she brings her daughter to the practice with a grazed knee. Dr Jean Watkins reveals how the practice nurse suspects a problem with Mary.
Understanding the work of plant phytochemicals
Authors: Buttriss Judy
Published: May 2014

Dr Judy Buttriss unwraps the uncertainty about the meaning and effects of phytoestrogens and other compounds found in edible plants
Promoting wakefulness for daytime sleepiness
Authors: Crawford Ewan
Published: May 2014

Modafinil received a licence extension last year for the treatment excessive daytime sleepiness associated with obstructive sleep apnoea/hypopnoea syndrome. Dr Ewan Crawford reviews its potential clinical benefits
Ear irrigation: The law and informed consent
Authors: Haas Fiona
Published: May 2014

Fiona Haas discusses the legal importance of ensuring that a patient gives informed consent for ear irrigation
Dermatology Clinic
Authors: Watkins Jean
Published: May 2014

Herpes simplex and herpes zoster are common skin infections causing painful or uncomfortable symptoms. Dr Jean Watkins explains how to distinguish, diagnose and treat these two conditions.
Practice nursing around the world
Authors: Lowe Mary
Published: May 2014

Mary Lowe is about to take up a new practice nurse post in Rotorua, New Zealand. She spoke to Lucy Jolin.
Fracture prevention in the frail elderly
Authors: Ruddick Sheila , Scollen Christine
Published: May 2014

Sheila Ruddick and Christine Scollen describe how two north-eastern PCTs have organized a service to help prevent osteoporotic fractures in the frail elderly
Old adages prove true
Authors: Richards Sara
Published: May 2014

I recently attended the Fourth Nutrition and Health Conference, an excellent event which should be a must for all practice nurses. The message from this year’s conference was just what our grandmothers taught us: ‘eat up your greens’, ‘fish is good for your brain’ and ‘eat a mixed diet’
COPD and the new GMS: Part 1
Authors: Booker Rachel
Published: May 2014

In the first of a new series, Rachel Booker considers diagnosis, screening and disease registers for COPD under the new GMS contract and looks at Pete’s case
Not simple at all: Herpes simplex virus
Authors: Nicholson Marian J
Published: May 2014

Marian Nicholson explores the transmission, diagnosis and management of the herpes simplex virus and offers advice to give to patients
Updating your practice for the flu campaign
Authors: Daniell Karen
Published: May 2014

Karen Daniell reviews the target groups for influenza vaccination, and outlines the points available for flu vaccination under the new GMS Contract
Epilepsy: Diagnosis and support for people with epilepsy
Authors: Bingham Ena
Published: May 2014

Ena Bingham gives an overview of what epilepsy is, how it is diagnosed and what advice and support is needed by people with this condition
Meeting cholesterol targets in diabetes care
Authors: McCallum Carol
Published: May 2014

Carol McCallum explains how practice nurse-led diabetes clinics can help practices meet cholesterol targets in the new GMS contract
Weight loss strategies in type 2 diabetes patients
Authors: Bunn Emma
Published: May 2014

Obesity significantly increases the risk of diabetes and diabetes complications. Emma Bunn looks at some strategies to help patients lose weight
Backpackers
Authors: Willcox Adrienne
Published: May 2014

In the first of a new series of articles on travel risk assessment, Adrienne Willcox examines what information is needed about backpackers’ plans and how to advise them accordingly
Cholera
Authors: Chiodini Jane
Published: May 2014

Jane Chiodini explains the transmission of cholera and discusses prevention, management and advice for travellers
Enduring mental illness and physical health care
Authors: Allen Doreen , Harvey Sheila , Marstin Penny , Smith Steve , Wadhawa Suky
Published: May 2014

Research has shown that people with long-term mental health difficulties often suffer poor general health and are at risk of premature death. An audit in primary care showed that these patients had low rates of access to physical health screening and health promotion. Practices worked with colleagues in the community mental health team to encourage patients to attend for an annual check with a practice nurse. Outcomes are sent to the mental health team so that they can promote concordance with follow-up tests or treatment. Attendance rates have been high and unmet need has been revealed. Practice nurses and mental health staff are developing a better understanding of each others' roles.
Agenda for Change
Authors: Malone Beverly
Published: May 2014

I appreciate this opportunity to restate the RCN's strong messages on the need for GP employers to adopt the Agenda for Change pay and careers package for practice nurses. I also want to reaffirm the high respect in which GPs and their leaders are held by the RCN. They were among the first to realize that unlocking the potential of nurses would help shape and deliver ever better standards of innovation and excellence in patient care.
Encouraging adherence to asthma treatment
Authors: O'Connor Brian
Published: May 2014

Brian O'Connor looks at the use of a new inhaled corticosteroid for asthma, ciclesonide.
Pensions: Effort in vain?
Authors: Jones Mark
Published: May 2014

For many practice nurses the notion of having a pension provided by their employer was but a pipe dream until determined and consistent action forced the government to provide access to the NHS superannuation scheme. But with the pension review now on us, was all this effort in vain?
Encouraging testicular self-examination by men
Authors: Lowson Paula
Published: May 2014

Paula Lowson looks at the importance of raising men's awareness of testicular cancer and testicular selfexamination and considers the practice nurse's role
In the tsunami's wake
Authors: Driver Carolyn
Published: May 2014

Carolyn Driver considers the advice that can be given to different types of traveller to the regions affected by the Indian Ocean tsunami
One airway, one approach
Authors: Siddall Rhonda
Published: May 2014

Rhonda Siddall reports on the latest scientific thinking about the links between asthma and rhinitis