bluuebunny/crossref_metadata_2025 huggingface dataset:
Can intuitive knowledge be taught in midwifery practice?
Authors: Barnfather Tracey
Published: May 2014

This paper critically analyses the notion of midwifery epistemology and the ontological view that intuitive knowledge, while in built, develops into tacit knowledge. through pre-registration midwifery programmes learning strategies are identified that enable students to develop tacit knowledge. the art of midwifery education, both pre-registrationand lifelong, is to learn to believe in an individual's intuition. intuitive knowledge is a type of knowing, the art of midwifery that is difficult to articulate but fundamental for best practice. Midwives rely on the model that childbirth is a normal phenomenon. the learner has to travel a complex and exciting journey, meeting academic requirements, fulfil Women's expectations and learn to listen to her/his inner self. through this process of learning, theoretical knowledge, developing clinical acumen and awareness of self, the sum of the parts is more than the whole.
Critical incident analysis of the effect of self-efficacy on coping strategies in labour
Authors: Erwin Elaine
Published: May 2014

The ability to critically analyse and learn from experience is considereda vital component of professional development; thus critical analysisis frequently employed by student midwives. In reviewing an incident experienced as a student midwife, the author was inspired to explore personal qualities that enable women to cope with labour. A brief review of the theory of self-efficacy and the impact it can have on labouring women is followed by an assessment of the implications for practice. the majority of clinical benefits are obtained by antenatal education, from parentcraft to birthing ball exercises. However, positive birth storiescan inspire self-efficacy beliefs while midwives can aid by focusing on a woman's ability to cope rather than the pain she is experiencing.
Prevalence, pathophysiology and current management of dehisced perineal wounds following childbirth
Authors: Dudley Lynn , Kettle Christine , Ismail Khaled
Published: May 2014

Each year, approximately 60 to 70% of women in the UK experience perineal suturing following childbirth, which equates to approximately 1000 women per day. the majority of sutured perineal wounds will heal fairly quickly by primary intention with minimal morbidity. However, for those women whose perineal wound dehisces (breaks down), the healing process takes considerably longer and is associated with increased morbidity. the exact incidence of perineal wound dehiscence is currently unknown; figures of 0.1% to 5.5% have been reported. a large proportion of dehisced wounds are managed expectantly (left to heal by secondary intention) whereas some are re-sutured during the early postpartum period. Currently, the management of dehisced wounds varies according to individual practitioner’s preferences and hospital policy as there are no robust research evidence or clear guidelines to inform best practice.
The impact of the BASNEF educational programme on breastfeeding behaviour in Iran
Authors: Akbarzadeh Marzieh , Bahmani Nasrin , Moatari Marzieh , PourAhmad Saeede
Published: May 2014

This study examines the impact of an educational programme on the breastfeeding attitudes and behaviour of pregnant women. It is a case-control study of 100 pregnant women in two hospitals affiliated to Shiraz University of Medical Sciences. The samples were randomly divided into a case and control group. The study looked at the effects of an educational programme based on the BASNEF model, which is a simplified approach to understanding behaviour focused on the beliefs, attitude, subjective norms and enabling factors of participants. The model was applied initially and after four educational sessions mothers’ behaviour towards breastfeeding was analysed. The results were analysed using statistical tests. The independent t-test showed that there were significant differences in the awareness mean score, mothers’perceptions of behaviour results, the score of attitudes towards working and the mean score of immediate enabling factors post-educational intervention, and at one and four months post-intervention (p<0.0001).The scores of subjective norms between the two groups was only significant for the medical staff (p=0.031). Compared with traditional education, model-based learning has been found to have a positive impact on improving behaviour; therefore, it is suggested that it should be employed in the clinical education of medical teams, especially midwives.
Are you packing? The use of placement packs to enhance learning in practice
Authors: Moore Susie
Published: May 2014

The lived experience of attending a new clinical placement can provoke anxiety for many student midwives and, if left unresolved, there is evidence that this can inhibit effective learning. Mentors are often extremely busy with several competing demands and the needs of a new student may not be viewed as a priority. Additionally, many students perceive their mentors to be overburdened practitioners and are conscious of the time it takes to be orientated to a new environment. This article presents the introduction of placement learning packs to enhance the experience of new students on placement as well as to assist midwives in their role as mentors. The effectiveness of the resource was evaluated by means of a questionnaire. The findings suggest that when used effectively the learning packs can be an invaluable resource for the eager to learn student midwife and her busy mentor in practice.
Women's experiences of care during labour in a midwifery-led unit in the Republic of Ireland
Authors: McNelis Margot
Published: May 2014

The first two midwifery-led units (MLUs) in the Republic of Ireland were opened in July 2004 in the north east of the country. This study explores women's experiences of a midwifery-led model of care during labour in a midwifery-led unit in the Republic of Ireland. Methods: A descriptive qualitative research study ( Sandelowski, 2000 ) using an interpretive phenomenological analysis and Colaizzi's (1978) process of phenomenological data analysis was used to explore and interpret women's experiences of a midwifery-led model of care during labour in an MLU in the Republic of Ireland. Individual in-depth semi-structured interviews were undertaken with eight women who had given birth in the unit. The interviews were transcribed verbatim. Findings: The themes that emerged were condensed and the findings focused on two categories: homely atmosphere and woman in control. Within the homely atmosphere, the women felt at ease in the MLU and were able to relax, which encouraged them to labour in their own time in their own way. Women felt in control of both the pain of their labour and in their ability to make decisions as they were encouraged to make choices throughout their labour, which served to empower them and provided them with a positive birthing experience. Conclusion: This research study provides a revealing insight into the components of midwifery-led care that are essential to women accessing this model. This includes them having the freedom to do their own thing, progressing their labour in their own way, and receiving support and assistance when requested from a supportive midwife. All of the women reported a thoroughly positive experience of giving birth in the MLU. These components of midwifery-led care could possibly be transferred to other models of maternity care provided the women were in the low-risk category.
Provision of information and support to women who have suffered an early miscarriage
Authors: Robinson Joanne
Published: May 2014

Miscarriage is a common complication of pregnancy and often occurs before 20 weeks gestation. It can be a unique, traumatic and distressing experience with the consequential response for women being both physical and psychological. Psychological aspects are often given priority over the physical by health professionals but both are equally important and can be interlinked. Much emphasis is given to inadequacies of care which includes attitudes, lack of information and support. Women are often ignorant about miscarriage and therefore dependent on health professionals for specialist treatment and care. Expectations of support are sometimes difficult to establish and awareness and acknowledgment by others is often lacking. Provision of information is fundamental as is having specialist knowledge and skills to improve experiences while reducing the risk of long term complications such as depression and complicated grief. However, there are many factors to consider and therefore early miscarriage remains complex and ambiguous, and a challenge for all involved.
Introducing an obstetric emergency training strategy into a simulated environment
Authors: Hughes Clare , Anderson Gail , Patterson Dorothy , O'Prey Mary
Published: May 2014

Midwifery educators are challenged to produce registrants who are fit for practice at the point of registration with competence at the heart of this expectation. In addition to achieving expertise in normal pregnancy, it is recognised that students need to have the skills of critical decision making where normal processes become adversely affected.

An evaluation was undertaken with final year direct entry midwifery students using questionnaires and focus group interviews to determine whether simulated learning, such as the Practical Obstetric Multi-Professional Training (PROMPT) package, for emergency obstetric training would enhance self-efficacy and confidence levels in preparation for post-registration practice. The main themes that emerged from the study indicate that this style of learning increased midwifery students’ feelings of self-efficacy; highlighted the importance of a safe learning environment; reduced their anxiety regarding their ability to make decisions in clinical practice and reinforced confidence in their level of knowledge.
Arthritis and rehabilitation: developments in the nurse‗s role
Authors: Nolan Mike , Nolan Janet
Published: May 2014

This article is the third in a series concerned with the nurse's role in rehabilitation dealing with both individuals and their family carers facing the challenges posed by a number of chronic conditions. This article focuses on arthritis. Following the format of earlier articles attention is first turned to patients' experiences of arthritis. This is then followed by consideration of a range of psychosocial interventions. It is suggested that the nurse's role in arthritis care is reasonably well established; however, further developments, particularly in the community, are briefly explored.
What direction for mental health research?
Authors: Cutcliffe John R
Published: May 2014

The drive towards evidence-based practice is one of the current issues facing mental health nurses. Chambers (1998) goes as far as to say that evidence-based practice is one of today's ‘buzz words’, a point of view that is supported by the recent upsurge in nursing literature concerned exclusively with empirical evidence.
Moving and handling practice in neuro-disability nursing
Authors: Billin Susan Lynn
Published: May 2014

This article examines the challenge of implementing a safer handling policy in an environment which caters for the needs of people who have complex and profound disability. It explores how a moving and handling educational strategy has been developed and the effectiveness of the strategies employed. The impact of changing practice at ward level and the difficulties encountered will be discussed in light of the patients' complex needs. The effects of the strategy are outlined with regard to accident reporting and the impact of legislation regarding moving and handling in an environment where patients’ needs have to be balanced with staff safety are considered.
Current feeding policies for patients with stroke
Authors: Haye Jane Christine
Published: May 2014

It is well known that policies for feeding patients who have suffered a recent stroke vary enormously. The choice of method used may depend on the severity of the stroke, i.e. swallowing ability, conscious level, ability to communicate and the level of sensory and motor dysfunction. Other considerations may include age and previous nutritional status. However, in the absence of evidence from controlled clinical trials, the preferences of individual physicians and nurses may have a significant influence. As part of the preparatory work before the start of a clinical trial of different feeding policies, the author wished to assess both the degree of variability of feeding practice on wards in the same hospital and also whether there were reasons other than lack of evidence which influenced feeding policies. One nurse from each of 19 wards (one neurology, nine medical and nine care of the elderly) in two hospitals of the same trust was interviewed to ascertain their current feeding practice for patients with stroke. The results showed the expected variability in feeding practice, possibly reflecting the uncertainties felt by physicians and nurses in this area. However, many comments revealed the concerns that nurses have in trying to meet the nutritional needs of their stroke patients in busy acute general hospitals.
From specialist practice role to level of practice
Authors: Castledine George
Published: May 2014

The UKCC's ongoing work on a higher level of practice is starting to generate some interesting findings. The first phase of this work, which was called the specialist practice consultation process, highlighted the current confusion that exists in relation to specialist practice among consumers, employers and, not least, the profession itself. It also identified the urgent need for the UKCC to show leadership and bring clarity to what is rapidly becoming a postregistration qualification structure nightmare.
Breast awareness project for women with a learning disability
Authors: Cowie Marie , Fletcher John
Published: May 2014

In 1995/6, while conducting a quality assurance evaluation in a residential group home for adults with a learning disability, the subject of breast screening and the importance of early detection of breast abnormalities was raised by a member of staff. At this time, the Mulberry Trust had a quality standard that women between 50 and 64 years who are supported in continuing care should attend breast screening clinics on a 3-yearly basis if they wish. A pilot scheme was devised based on the premise that breast awareness for service users should be promoted. It was decided that the scheme should include a breast examination, conducted on a monthly basis, ideally by the service users themselves, or by suitably trained staff on their behalf. The pilot scheme was implemented using available research and training was provided for qualified nursing staff within the trust. The training covered breast cancer prevention and breast awareness. After 7 months the scheme was evaluated and changes were made to policy and practice, including consultation with the trust's ethics panel regarding implementation of procedures. Training for staff in breast awareness continues and the scheme is slowly being introduced across the trust to enable all service users to be involved, both in residential homes and community settings. However, in future, the emphasis will be on identifying changes in the breast during normal care routines, such as bathing and dressing, as opposed to formal, clinical examination.
Nursing urgently needs a professional academy
Authors: Castledine George
Published: May 2014

I have started to become disillusioned with the established bodies who are supposed to be looking after our professional interests and welcome the calls for radical change. The limitations of the UKCC, National Boards and unions were highlighted in the review of the legislation governing nurses, midwives and health visitors (JM Consulting, 1998):
Cardiac rehabilitation: structure, effectiveness and the future
Authors: Noy Karyn
Published: May 2014

Despite advances in the investigation and treatment of angina and myocardial infarction, and increased knowledge of the factors associated with the development and progression of ischaemic heart disease, it remains the leading cause of death and morbidity in the majority of industrialized countries. Cardiac rehabilitation provides a means of modifying lifestyle and other risk factors in patients presenting with established, symptomatic coronary artery disease, thereby reducing the risk of further cardiac events. It has also been proven to be cost-efficient.
NVQ care workers or licensed practical nurses?
Authors: Glasper Edward Alan , Rushforth Helen
Published: May 2014

The discontinuation of the enrolled second level training occurred in 1992 as part of the Project 2000 initiative and the nursing professions drive to achieve a single level of registration. This led to the introduction of the NVQ healthcare assistant who was intended to compensate for the supernumerary status of Project 2000 students, and the phasing out of enrolled nurse training.
Nursing says ‘yes’ to higher level practice
Authors: Castledine George
Published: May 2014

The UKCC's proposals for recognizing a higher level of practice within the postregistration regulatory framework (UKCC, 1998) has received overwhelming support from the profession.
Personal, professional and practice development: clinical supervision
Authors: Cutcliffe John R , Burns Jo
Published: May 2014

This article investigates current research concerns in relation to clinical supervision and offers a rationale for using case studies as a means of evaluation. Three case studies are used to illustrate how development and growth can occur as a result of clinical supervision. The use of case studies as a means of evaluation is analysed. Case studies provide unique insights into the dynamics and processes of clinical supervision. Any improvement in practice ought to bring about improvements in client care, thus case studies can add to the accumulating, qualitative data that support the link between clinical supervision and improved client care. This article recommends that more case studies should be carried out and that the findings are compiled on a centralized database in order that evidence supporting the widespread use of clinical supervision is readily accessible.
Prison nursing: working at the cutting edge
Authors: Parrish Alan , Norman Ann
Published: May 2014

At present there is a shortfall of skilled nursing staff within the NHS. This shortage also affects the prison healthcare service (Home Office, 1998a,b). Recruitment in this area is often made more difficult by a lack of understanding of the prison healthcare service and, in particular, the role of nurses practising within it.
BRCA1 gene testing for breast and ovarian cancer in one family
Authors: Crosbie Aileen , Brewer Carole , Campbell Karen , MacKay James
Published: May 2014

Most breast cancer is multifactorial in origin, but dominantly inherited genes are implicated in the development of approximately 5–10% of breast cancer as a whole. The identification of the BRCA1 gene, thought to account for 2% of all breast cancer and be present in almost all families affected by breast and ovarian cancer, makes testing for susceptibility to breast and ovarian cancer possible for the few families in which researchers have identified a gene mutation. Genetic counselling, by medically qualified geneticists, is available for people with rare genetic conditions caused by gene mutations. In this article, the authors describe their first experience of BRCA1 gene testing in 23 family members. They identify a unique role within a new specialty, cancer genetics, for specialist nurse practitioners in genetic testing and counselling.
How can nurses avoid negligence claims?
Authors: Dimond Bridgit
Published: May 2014

Frank Dobson, in the recent press release Keeping Lawyers Out of Hospitals; Keeping Doctors Out of Court (Department of Health (DoH), 1998) states that clinical negligence is costing the NHS around £200 million a year. In order to stop that figure rising he wants to reduce the amount of negligence and substandard work and points to the new institutions envisaged in the White Paper (DoH, 1997), i.e. the National Institute for Clinical Excellence and a Commission for Health Improvement. He has asked for views on how negligence could be reduced and has initiated a consultation process.
Learning-disabled people's experience of general hospitals
Authors: Hart Susan L
Published: May 2014

As more people with learning disability move from long-stay hospitals into the community, contact with general hospital services will increase. Yet, how people with learning disability experience general hospital settings has remained a largely unresearched area. Despite the Department of Health's (DoH's) 1992 guidelines regarding learning-disabled people's access to hospitals, research reveals several areas where the needs of people with learning disability have not been considered. This small-scale study sought to hear from learning-disabled people themselves about their hospital experiences. Thirteen interviews were conducted over 3 months. The interviews were then transcribed and, using grounded theory, a series of key concepts developed. Findings highlighted that, particularly in the areas of ‘fears about treatment’, ‘communication’, ‘general nursing’, ‘consent to treatment’ and ‘doctors’, learning-disabled people had a lot to say, much of which was critical of service provision.
Link between the arts and the experience of nursing
Authors: Castledine George
Published: May 2014

Ihave always believed that there is a close link between the arts and health, in particular nursing. Over the last 20 years, there has been an increase in the promotion of the arts in health settings.
Do not resuscitate: an ethical dilemma for the decision-maker
Authors: Birtwistle Jon , Nielsen Angela
Published: May 2014

Since its introduction in the 1960s, cardiopulmonary resuscitation (CPR) has been universally available to all hospital patients unless the consultant in charge has specified a ‘do not resuscitate’ (DNR) order. The public perception of CPR has tended to be one of overoptimism, but this is not matched by the low survival to discharge ratio of approximately 1:10. In addition, there is the risk of prolonging suffering, compared with the quick and relatively painfree alternative offered by cardiac arrest. Decisions about resuscitation pose many ethical dilemmas for those involved and should take into consideration the patients wishes, prognosis and quality of life.
Euthanasia: intent is the key issue not outcome
Authors: Wilks Michael
Published: May 2014

The recent acquittal of a GP, Dr David Moor, on a charge of murder, has thrown the spotlight back onto the issue of euthanasia. In truth, the spotlight rarely strays for off this and other end of life topics. Some commentators have seen the verdict as representing a further step towards the eventual goal of legalized, voluntary, euthanasia. A more prevalent, and measured view is that the verdict does no more than clarify the existing legal position.
Sexual health 2: an overt approach to sexual health education
Authors: Crouch Shirely
Published: May 2014

An individual's sexuality is not always understood and recognized by healthcare workers. Some nurses have conservative and rigid attitudes regarding sexuality and undertake nursing interventions that may have a detrimental effect on a client's sexual health. If nurses are to take a responsible approach to their nursing interventions they need to reflect upon their knowledge, skills and understanding in relation to their own sexuality and the sexuality of others, and identify ways of rectifying shortfalls. The first of this two-part article discussed issues relating to sexuality in health care (Vol 8(9): 601–6). This part will use a sexual health model to highlight nurses' learning needs. Nurse educators need to include sexual health more overtly within the curriculum. It is important that nurses do not try to be sexual counsellors. Nurses need to acknowledge their limitations and the harm that inappropriate interventions can produce. If sexual health is to be included in nursing curricula, it should not be trivialized. A planned progressive model is required which acknowledges that the human condition is diverse and individual.
How to organize a study day: a practical account
Authors: Thomas Vinice
Published: May 2014

Organizing a memorable study day is a great challenge. A good study day has the potential to stimulate innovative ideas and improve nursing practice. It is therefore imperative that study days are of high quality, are relevant and well organized. This article highlights some valuable lessons that were learnt from the experience of organizing a study day at a London hospital. It discusses the processes involved including brainstorming, programme preparation, advertising and the provision of care for delegates. The areas that could have been improved are also highlighted.
Family carers 4: designing services to support family carers in Sweden
Authors: Lundh Ulla
Published: May 2014

This, the last of four articles focusing on family caregiving in Sweden, considers ways in which services can be designed to better support and complement care provided by the family. Drawing on the results presented in the previous three articles (Vol 8(9): 582–8; Vol 8(10): 647–52; Vol 8(11): 735–40) the need to provide flexible and responsive services will be highlighted. While acknowledging the importance of services which help with the physical aspects of caring, emphasis will be placed on the need to develop an expanded range of interventions which recognize and respond to the social and emotional impact of caring.
Ethics and nursing research 1: development, theories and principles
Authors: Noble-Adams Rae
Published: May 2014

This article, the first of two looking at nursing ethics and research, outlines the foundations and development of an ethical framework for nursing research. The two dominant theories of ethics — utilitarianism and deontology — are described as they relate to the rights of individuals undergoing the research. Each of these approaches has limitations and in some instances choosing the right action may be difficult. The guiding ethical standards of beneficence/non-maleficence, respect for human dignity, justice, informed consent and vulnerable subjects are reviewed for the reader as they relate to undertaking research. This knowledge will help nurses conduct, participate in, or use research that is based on ethically sound principles. The second article will explore and explain the relationship between these guiding principles and the elemental steps of the research process.
Infectious diseases: statutory notification and surveillance
Authors: Peate Ian
Published: May 2014

The notification of infectious diseases has evolved over a number years and will continue to do as practices change or are modified. This article gives an insight into how the system for notification has developed. It outlines the process and purpose for notification and how the accumulation of data gathered can help nurses, midwives and health visitors make strategic plans for intervention and prevention of further outbreaks of disease. The nurse, midwife or health visitor has a central role to play in ensuring that diseases are notified to the ‘proper officer’. Furthermore, if nurses, midwives and health visitors were given the power to notify diseases, the number of diseases notified may increase. This would result in a clearer and truer account of the number of notifiable diseases.
Ethics and nursing research 2: examination of the research process
Authors: Noble-Adams Rae
Published: May 2014

In this article, the second in a series on ethics in nursing research, the author explores the relationship between the guiding ethical principles and the steps of the research process. In the first article (Vol 8(13): 888–92) the two dominant theories of ethics, utilitarianism and deontology, along with the guiding principles of beneficence/non-maleficence and respect for human dignity, justice, informed consent and vulnerable subjects were discussed as they relate to the rights of individuals undergoing the research. In this article, the author describes the association between these principles and the elemental steps of the research process which are: the selection of the research problem; data collection; sampling; informed consent; data analysis; and research presentation. The ethical conduct of many of these research steps is guided by ethics committees but for those that are not nurses need to rely on their own integrity, honesty and committment to the current prevailing ethical principles.
No patient should be considered untreatable
Authors: Beckford-Ball Jason
Published: May 2014

The Government has released proposals which attempt to deal with the threat to public safety posed by the ‘dangerous severely personality disordered’ (DSPD) (Home Office, 1999). Home Secretary, Jack Straw, said: ‘There is a very small group of very dangerous people who currently fall outside both the law and mental health provisions.’ The most controversial of the measures involves the creation of a new specialized service which could impose ‘indeterminate detention’ (Home Office, 1999). This could mean that, irrespective of any crime being committed, DSPD individuals would be detained in special units, and released only when it is considered that they no longer pose a risk to the public.
Improving the nutrition of patients using Entera Fibre Plus
Authors: Kemp Sarah
Published: May 2014

This article examines the role of fibre in the diet with a special focus on Entera Fibre Plus, a new high energy, fibre-containing sip feed. Early enteral feeds were all fibre-free or ‘low residue’. In the last 10 years fibre-containing feeds have become available, mostly designed for tube feeding and containing a single fibre source. Entera Fibre Plus contains a mixed fibre source, providing both soluble and insoluble fibre types, including inulin. This helps provide the full range of fibre benefits, which include reduction of constipation and diarrhoea, maintaining the health of the gut and encouraging beneficial gut bacteria to assist the body's defence systems. Inulin has a specific role in the latter. Entera Fibre Plus provides 300 kcal and 5 g of fibre per 200 ml pack and is available in six flavours. It is a convenient and palatable way of improving the nutritional status of patients who are malnourished and may be of particular benefit to elderly people, those on long-term supplements and those who suffer from chronic constipation or diarrhoea. Entera Fibre Plus is approved by the Advisory Commitee on Borderline Substances (ACBS) and is available at retail pharmacies or on prescription.
Prison health care: what is it that makes prison nursing unique?
Authors: Norman Ann
Published: May 2014

Nursing in the prison service is an emerging area of practice and is becoming increasingly recognized for the benefits nurses provide to patient/prisoner care. This article, the second in a series of articles on prison nursing, highlights some of the current issues that face prison nurses. Also one person's experience of shadowing a prison nurse is described.
Hallucinations and delusions 2: a dual diagnosis case study
Authors: Holland Mark , Baguley Ian , Davies Tom
Published: May 2014

This article, the second of two parts, describes how evidence-based psychological interventions were used to help a client suffering from treatment-resistant delusions and substance misuse, allied to a chaotic lifestyle, that had previously presented a substantial challenge to services. The first part (Vol 8(15): 998–1002) investigated how the neurobiological, social and environmental factors involved in the course and treatment of schizophrenia have helped to establish a pathway to recovery or remission that does not involve pharmacological therapy alone.
Confidentiality 7: human fertilization and embryology issues
Authors: Dimond Bridgit
Published: May 2014

A woman who was having in-vitro fertilization (IVF) treatment was involved in a road accident. Her sister, a nurse, who was with her at the time, knew the drugs which she was taking as part of the IVF treatment and passed this information on to those caring for her in the accident and emergency department. Subsequently, the patient complained that this information should not have been passed on. She did not want anyone else to know that she was receiving fertility treatment. What is the law?
Peach report reaffirms traditional nursing values
Authors: Castledine George
Published: May 2014

For me, the report of the UKCC Commission for Nursing and Midwifery Education, chaired by Sir Leonard Peach (UKCC, 1999) did not so much state new values for nursing as restate the importance of what have always been the traditional core principles of nursing. For many nurses, the key issues facing preregistration education relate to the link with higher education institutions (HEIs) and the clinical support and teaching that students should be receiving in clinical areas.
Validity of the Walsall Community Pressure Sore Risk Calculator
Authors: Chaloner Donna M , Franks Peter J
Published: May 2014

The Walsall Community Risk Score Calculator has been in use for the past 8 years. Outcomes from a trust-wide prevalence audit identified that this assessment tool may benefit from re-evaluation. This study examined the tool's validity and reliability and has resulted in some changes being made to the original score. To assess validity, a cross-sectional study of 720 patients was undertaken looking at the incidence of pressure damage, despite intervention, over a 12-week period. Using logistic regression analysis new weightings for each category were developed. This also led to the removal of one factor (bodily pain) which did not appear to contribute to increased risk of pressure damage. The updated score shows an improved prediction of pressure sore development compared with the existing method.
Nurses must be wary of their role in walk-in clinics
Authors: Scott Helen
Published: May 2014

The Government has recently announced plans to increase the number of ‘walk-in clinics’ as a way of providing convenient access to primary healthcare services. Nurses must be careful not to get carried away by this latest Government initiative.
Eco-maps: facilitating insight in learning-disabled sex offenders
Authors: Ferguson Dave
Published: May 2014

The assessment of risk in relation to men who have learning disabilities and who sexually offend can be difficult as innovative means for eliciting information or presenting it to them require careful consideration. A risk assessment model has been designed which introduces an interactive tool called an ‘eco-map’ as a means of gathering important information from the offender as well as presenting the identified risks. The author explores the use and development of the eco-map from its crude beginnings to its use in practice. The tool enables offenders to rationalize and understand the often complicated concepts which contribute to their behaviour and allows them to be actively involved in the risk assessment process.
Mental health and cancer: is there a missing link?
Authors: Cooley Candy , Morris Mervyn
Published: May 2014

There is a body of research that identifies lifestyle as having an impact on susceptibility to cancer (Cancer Research Campaign (CRC), 1995). Lifestyle habits such as smoking, alcohol consumption, diet and stress have an impact on an individual's risk of ill health, particularly cancer. However, there are many individuals for whom smoking or alcohol are a means of coping with stress.
A critical evaluation of the use of nutrition screening tools by nurses
Authors: Arrowsmith Helen
Published: May 2014

Malnutrition remains a problem in hospital and community patients, the consequences of which have deleterious effects on the sick individual and cost implications for healthcare providers. Provision of nutritional support has been shown to improve patient outcome in those at risk of malnutrition; therefore, the detection and treatment of malnutrition is paramount. Nurses have been identified as being in an ideal position to carry out routine nutritional screening to detect patients at risk of malnutrition and hence refer to the dietitian for detailed nutritional assessment and provision of nutritional support. Therefore, many nutritional screening tools have been developed to guide nurses in basic nutritional screening. However, for a tool to be effective certain criteria must be met including ease of use, cost-effectiveness, the presence of an action plan and prior testing for validity, reliability, sensitivity and specificity. Six such tools are critically evaluated in this article to establish whether they meet these criteria. Surprisingly, none of the screening tools demonstrated a beneficial effect on clinical outcome or met all of the above criteria. It is therefore essential that these tools are refined and retested before becoming part of established nursing practice.
Autonomy and the developing role of the clinical nurse specialist
Authors: Cutts Beverley
Published: May 2014

The role of the clinical nurse specialist has developed in response to social, technological and political changes that have impacted upon the delivery of health care. Nursing has traditionally been associated with femininity and in a paternalistic health structure the concept of nursing care can be devalued because autonomous nurses may threaten the balance of power. Autonomy is a multi-faceted concept and yet, if nurses have the courage to embrace both the traditional values of nursing and the expertise that their caring role brings to health care, they will be able to develop their own competence and autonomous practice. Nurses may not need autonomy in order to enhance their roles but they do need to concentrate on the concept of care as a team phenomenon. This notion is included in the UKCC's higher level of practice initiative which may direct specialist practice in the future. A negative element to nurse specialization is that nursing care can become fragmented, thus compromising the continuity and accountability of patient care.
Importance of the nursing practice environment
Authors: Castledine George
Published: May 2014

The practice environment is constantly changing because peoples health needs are never static. The nature of the change, however, may be exacerbating some of the current anxieties and problems in nursing. Some healthcare trusts have had to respond to adverse economic pressures by restructuring in ways that have significantly reduced the numbers of registered nurses engaged in direct patient care.
Indeterminate detention for innocent psychopaths
Authors: Dimond Bridgit
Published: May 2014

On 15 February, 1999, the Government announced in the House of Commons its proposals for dealing with the risk presented by psychopaths. The Home Secretary, Jack Straw, stated that:
Rationalizing the purchase and use of gloves in health care
Authors: Ross Sue
Published: May 2014

The last two decades have seen a substantial increase in the use of protective gloves in healthcare establishments. This is attributed to the widespread publicity regarding the risks of transmission of human immunodeficiency virus and hepatitis B and C from blood and body fluid contact. Further, directives from official agencies stressing the need to protect staff from blood-borne viruses in the workplace led to the introduction of a variety of disposable gloves, each claiming total or adequate protective ability. The resulting sensitization to latex in some users has caused concern. This article reports on the process used within one NHS trust to explore glove use and determine the level of latex sensitization among staff. The audit identified an irrational approach to glove purchasing as well as inappropriate use of different types of gloves. The audit was followed by a trial aimed at rationalizing both the purchase and use of gloves.
UTI in patients with urethral catheters: an audit tool
Authors: Penfold Patricia
Published: May 2014

This article presents an audit tool for the evaluation of practice relating to urinary tract infection in hospital patients with indwelling urethral catheters. It has been formulated primarily because urinary tract infection is a known complication of catheterization, and because studies have shown practitioners' knowledge in this area to be poor. Although health professionals have an obligation to ensure their practice is evidence based, this requires substantial time and skills in critical appraisal. The standard presented here is based on evidence from an extensive literature review on how best to minimize urinary tract infection during catheter insertion, meatal hygiene and management of the drainage system. The audit tool offers the potential for improved practice and demonstration of clinical effectiveness through measurable reduction in rates of urinary tract infection. Moreover, it provides an ideal opportunity for nurses to take the lead in clinical audit activity, which is so often medically led. The supplementary information will also provide a useful guide for nurses to undertake and initiate clinical audit activity in the future.
A practical guide to venepuncture and management of complications
Authors: Campbell Hilary , Carrington Michelle , Limber Carol
Published: May 2014

For years many nurses have felt that if they had the ability to perform skills such as venepuncture they would be able to provide a more holistic and efficient service. The culture in which nurses and doctors have traditionally worked has often made it difficult for nurses to become competent at such skills. However, the boundaries of medical and nursing roles have started to change and a culture of shared roles is emerging which has many benefits for patients, medical staff and nursing staff. This article provides a practical guide to venepuncture. It highlights the structure of a vein and the veins that are suitable for venepuncture. It also addresses the prevention and management of potential complications.
Is the sexuality of people with a learning disability being denied?
Authors: Aylott Jill
Published: May 2014

This article explores how the nursing profession has become more liberal in its attitudes towards sexuality as a consequence of and a response to HIV/AIDS. This liberal attitude has, however, failed to be generalized towards people with a learning disability. The continued use of labelling terms for people with a learning disability serves as an excuse to either justify the control of people's sexuality and fertility, or a rationale to argue that people with a learning disability do not have a sexual identity. Developments in the self-advocacy and advocacy movement provide opportunities for people with a learning disability to have a say in the development of sexuality policies to guide the practice and philosophy within an organization.
Understanding clinical supervision from a nursing perspective
Authors: Sloan Graham
Published: May 2014

During the last 10 years there has been an increase in the amount of nursing literature dealing with clinical supervision. As a result, there has been a gradual growth in the use of clinical supervision to provide support, increase clinical competence and improve client care. Unfortunately, there has not been a comparable increase in research and as a result the amount of empirical knowledge is minimal. This article will discuss the key empirical studies that have focused on identifying the outcomes of supervision and isolating the characteristics that make a good clinical superviser. Recommendations for practice and research will be suggested.
Urinary catheter management: minimizing the risk of infection
Authors: Parker Lynn J
Published: May 2014

With catheterization comes the risk of infection and therefore people should not be catheterized unless their clinical condition dictates that it is absolutely necessary. Nurses are responsible for both inserting catheters and the subsequent management of the catheterized patient. A high level of nursing knowledge and skill is required to achieve effective and safe management. This article continues the infection control series by reviewing the principles of catheter management with regard to controlling infection.
Catheter valves: a special focus on the Bard Flip-FloTM catheter
Authors: Addison Ray
Published: May 2014

This article examines catheter valves with a special focus on the Bard Flip-FloTM. Catheter valves were first introduced into the UK in 1986. Ten years later, seven catheter valves were available of which three, including Flip-Flo, were available on prescription. Catheter valves are suitable for both males and females and both short- and long-term urethral or suprapubic catheters. Catheter valves can combine with urinary drainage bags to form link systems. The benefits of catheter valve usage, many of which are perceived but not well researched, include reduced urinary tract infection and maintenance of bladder tone and capacity. Current opinion indicates that patients with detrusor instability, impaired bladder sensation or confusion may find catheter valves unsuitable. Catheter care, including health education and monitoring, are required for catheter valve patients as well as conventional leg bag users. The Bard Flip-Flo catheter valve offers many benefits and is an established product within the UK.
Evaluation of an Australian miscarriage support programme
Authors: Jacobs Jane , Harvey Joan
Published: May 2014

Miscarriage is a frequent and distressing event for women who often require admission to a gynaecology unit for the evacuation of the products of conception. Most women are admitted for day surgery or an overnight stay. The short time frame limits the time nursing staff have to provide support and information for women who have experienced loss through miscarriage. This article presents the qualitative evaluation of a telephone follow-up service provided as part of the Miscarriage Support Programme of Care conducted by staff of the gynaecology inpatient services in an Australian public hospital. The data from this evaluation indicate that miscarriage does have a varying degree of impact on a woman’s inpatient experience and emotional recovery. The primary themes of emotional recovery, support after discharge, inpatient experience of care, and usefulness of the literature given to women before discharge, will guide the ongoing development of support and discharge planning by staff of gynaecology inpatient services for women who have experienced miscarriage.
Healthcare practitioners’ perceptions of clinical guidelines
Authors: Tingle John
Published: May 2014

This article gives an update on developments in the field of clinical guidelines with particular reference to guidelines issued by the General Medical Council and the Clinical Negligence Scheme for Trusts. It also focuses on a recent academic study on healthcare professionals’ perceptions of clinical guidelines (Cotton and Sullivan, 1999) and introduces the National Guideline Clearing House which is based in the USA.
Medilan: a hypoallergenic lanolin for emollient therapy
Authors: Stone Lynette
Published: May 2014

Lanolin has been used for thousands of years for its emollient properties. For the past two decades it has had an ill-deserved reputation as an important sensitizer. Medilan is an ultra-purified hypoallergenic medical grade lanolin that has been shown to cause almost zero sensitization. As well as its occlusive properties it has also been shown to penetrate the skin and help to store water in the stratum corneum. The hypoallergenic nature of Medilan combined with its soothing and hydrating properties make it a valuable ingredient in emollient preparations used to treat eczema and other dry skin conditions.