bluuebunny/crossref_metadata_2025 huggingface dataset:
The British National Formulary for Children: an important milestone
Authors: Novak Barbara
Published: May 2014

The specialist field of paediatric practice is both vast and complex often requiring physicians and other health care practitioners to draw on extraordinary amounts of diverse knowledge and expertise in order to establish the most appropriate diagnosis and implement the best treatment option that their patients may require. The timely publication of the new British National Formulary for Children (2005) provides health professionals with a comprehensive compendium of information about the use of medicine in the treatment of children.
Using blended learning techniques: perspectives on distance learning
Authors: Burgess Joan , Brooksby Ann , Ashworth Jenny
Published: May 2014

Extended independent and supplementary nurse prescribing commenced at the University of Winchester in 2004 via a distance learning route, incorporating e-learning. The programme leader, a personal tutor and a past student provide their perspectives and reflection on the delivery of the current programme.
Antimicrobial resistance: a unique situation in therapeutics
Authors: McKinnon John
Published: May 2014

Antimicrobial resistance poses a serious threat to public health. This article describes the pharmacodynamics of antimicrobial groups and the aligned mechanisms of resistance that have developed. The routes of resistance spread are illustrated. There is a discussion of the factors that contribute to the increase of resistance spread. Recent research findings are critically compared with public perception of antimicrobials. Monitoring resistance, infection control in clinical areas and prescribing behaviour are considered in relation to public health policy and the potential in current innovative pharmaceutical research is examined.
Evaluating nurse prescribing in mental health patients: a pilot study
Authors: Snowden Austyn
Published: May 2014

This article describes the process of piloting a questionnaire designed to establish certain demographic, quantitative and qualitative information about the impact of nurse prescribing in Greater Glasgow and Clyde. The questionnaire was sent to a random sample of about 10% of the nurse prescriber database held by the lead nurse in Greater Glasgow and Clyde and elicited themes on which to base further research. The aim is to explore these themes in interviews with patients.
Legal requirements for prescribing, supply and administration of medicines
Authors: Griffith Richard
Published: May 2014

Although the introduction in May 2006 of nurse independent prescriber status saw an increase in the range of medicines available to nurse prescribers, it still falls short of the comprehensive prescribing authority given to doctors. As the Department of Health (2006) points out, nurse independent prescriber status is one of six procedures that a nurse may need to adopt in order to prescribe, supply or administer a medicine to a patient. Each procedure has its own legal requirements, scope and limitations. As they have to adopt different procedures depending on the clinical needs of the patient and medicine to be used, nurses will be vulnerable to accusations of misconduct and unlawful practice unless they ensure that they have the necessary authority to use a particular medicine for the benefit of their patient. This article outlines the procedures by which nurses may prescribe, supply or administer medicines to patients and the requirements that must be met in order to do so lawfully.
A repeat prescription for pharmacists
Authors: Ainsworth Steve
Published: May 2014

When members of the Society of Apothecaries were granted the right to charge for advice, as well as medicines, they broke away from their chemist shops and established themselves as GPs. Now pharmacists in chemists shops and hospitals have been granted similar rights and history appears to be repeating itself, as Steve Ainsworth discovers.
Questions and Answers
Authors: Peniston-Bird Fiona
Published: May 2014

My question is on the issue of putting the prescribing role into job descriptions. At the local University, the students undertaking the prescribing training are told that it is vital that they do this; however, I am now being asked by their managers why there is a need to change an existing job description. Is there any legal requirement? Is it an NMC guideline/standard?
Is mental health nurse prescribing qualitatively different?
Authors: Snowden Austyn
Published: May 2014

A total of 365 nurse prescribers (11 registered mental nurse (RMNs), 354 non-RMNs) in NHS Greater Glasgow and Clyde returned a questionnaire (55% response rate) on the impact of nurse prescribing. Thematic analysis using NVivo7™ elaborated on the earlier quantitative findings that RMNs differed from their colleagues in terms of attitude and experience of nurse prescribing. It is suggested that this may be a result of different approaches to the therapeutic relationship. This paper describes the process of arriving at that conclusion. This and other themes originating in these data will be explored further in the next phase of the study. This will involve a grounded theory approach beginning with semi-structured interviews with patients, mental health nurse prescribers, GPs and consultant psychiatrists.
Obesity: beating the battle of the bulge
Authors: Ainsworth Steve
Published: May 2014

Obesity is now the most common nutritional disorder in western industrialised countries. Defined as a body mass index of greater than 30, the prevalence of obesity in the US and Europe is reaching epidemic levels and it is estimated that over 30 000 deaths a year are caused by obesity in England alone. Steve Ainsworth explains.
Should Viagra be available OTC?
Authors: O'Connell Nicola
Published: May 2014

The news of Viagra (sildenafil) becoming available over-the-counter on Valentine's Day might have left many men feeling disappointed. Given the hype and headlines leading up to the story, men could be forgiven for going into any number of Boots stores seeking the erectile dysfunction (ED) treatment, not realizing that in fact only three branches of Boots in Manchester were involved in the pilot scheme.
Non-medical prescribing: the doctor-nurse relationship revisited
Authors: Avery Graham , Todd Jennie , Green Gill , Sains Katherine
Published: May 2014

This paper reports a study that was commissioned to evaluate non-medical prescribing in one health authority in the south-east of England. A questionnaire was distributed to all nurses and pharmacists who held a non-medical prescribing qualification, and this was followed up by semi-structured interviews with nurses, pharmacists, doctors and managers. The findings confirmed that the majority of respondents were very experienced, and that they were making good use of the qualification. In addition, there were clear signs that patient care was being enhanced, but this was more evident when there was a close working relationship with the doctor. In the absence of this relationship, there is a need for the organization to develop a clear strategy for the implementation of non-medical prescribing, which should incorporate the views of all key stakeholders.
Inpatient psychiatry: three methods to detect medication errors
Authors: Dickens Geoff
Published: May 2014

This article presents three methods to audit medication administration errors in psychiatric inpatient care. For each approach, an audit methodology is outlined, examples are given of the error types likely to be detected by the method, and actions suggested that can be taken to reduce error reoccurrence. Some of the specific difficulties of medicines administration in psychiatry are discussed.
Improving drug concordance in patients with COPD
Authors: Barnett Margaret
Published: May 2014

Chronic obstructive pulmonary disease (COPD) is a chronic lung condition that causes the patient to slowly deteriorate over time, with increasing symptoms such as breathlessness, cough, wheeze and production of sputum. To obtain optimal control of symptoms, patients should be prescribed various pharmacological treatments, such as inhaled therapy and oral medication. However, for one reason or another, as with any chronic illness, a significant proportion of patients fail to take their medication as prescribed. To improve concordance, health professionals need to develop an understanding of patients' reasons for not taking their medication as prescribed.
Prescribing in pregnancy and lactation: factors to consider
Authors: Anwar Anila
Published: May 2014

Prescribing in pregnancy and lactation is not as seamless as prescribing in other groups. There are limited data in the use of newer drugs and most drugs are not licensed in this category. However, this predicament can be overcome by researching in-house and wider studies from previous practice. This article explores, in a simple manner, factors to consider both in pregnancy and lactation.
Communication skills: revisiting the fundamentals
Authors: Timmins Fiona
Published: May 2014

In the UK, nurses are increasingly involved in medication management with both independent and supplementary prescribing being common practice. While specific mandatory training and education exists, there is little development by way of continuing professional development, although this is deemed important. In this context, nurses who are keen to evaluate or develop their skills may appreciate revisiting the key communication requirements of the nurse prescribing role. In the first of of a series of three, this article aims to provide a brief overview of fundamental theory in relation to communication skills, as the first step to address knowledge gaps that may exist. This will be followed in parts two and three with a more in-depth look at information giving and the communication challenges that may exist.
Putting mental health nurse prescribing into practice
Authors: Bradley Eleanor , Wain Patricia , Nolan Peter
Published: May 2014

The introduction of supplementary prescribing formed part of an attempt to modernize the NHS, break down barriers across and within professions and enable patients to gain faster and easier access to medicines. Mental health nurses have been slower than other nursing specialities to take on the prescribing role. A number of reasons have been proposed for this including fears that the use of non-pharmacological interventions in mental health nursing could be marginalized. This focus group study set out to examine a group of mental health nurse prescribers working within a single organization and examine why some of these nurses put their prescribing role into practice and others did not. Findings suggest that organizations need to be clear about the scope and role specification of these prescribing roles. The availability and support of role models is important as the prescribing training course may generate, rather than abate, uncertainty about prescribing ability. In the absence of a critical mass of non-medical prescribers the prescribing initiative is being rolled out unevenly across teams, creating service inequities. Collaboration, particularly within teams, is vital for nurse prescribers to feel supported. Finally, to appreciate the true impact of the nurse prescribing role, any evaluation of benefits should be widened beyond the mere counting of scripts.
Research and development round-up: September 2008
Authors: O'Connell Nicola
Published: May 2014

New data shows that RAD001 (everolimus) more than doubles time without tumour growth after failure of standard treatment in patients with advanced kidney cancer. The findings further support the potential for RAD001 (proposed brand name ‘Afinitor’)— the first and only agent with established clinical benefit for the treatment of renal cell carcinoma (RCC) after therapy with sunitinib or sorafenib—to address an unmet medical need.
Miscarriage risk: how important are diet and exercise?
Authors: O'Connell Nicola
Published: May 2014

Most pregnant women are prepared to be as cautious as possible to reduce their risk of miscarriage, but many new findings and recent advice can leave women confused and unsure about what they should and shouldn't be doing to protect their unborn fetuses.
Open all hours
Authors: Otway Christine
Published: May 2014

This Summer has been slow to start, but is now in full swing with higher temperatures and blue skies. Despite outside distractions, the work goes on and one key publication has so far dominated the Summer. The publication of the Darzi report (Department of Health (DH), 2008) has caused much debate, both among NHS staff and the general public. One of the most controversial issues being discussed is the need for increased access to health services. With 1.3 million staff in the NHS, one would expect debate and as some of the solutions may be unpopular we are unlikely to agree. My guess is that one of the likely solutions is that non-medical prescribing will continue to expand, which can only be good news for nursing.
Could nurses prescribe blood products?
Authors: Pirie Elizabeth , Green Jan
Published: May 2014

A collaborative project between the NHS Blood and Transplant (NHSBT) and the Scottish National Blood Transfusion Service (SNBTS) explored the feasibility of nurses extending their role to prescribe blood components. As a first step, a UK-wide survey to identify current practice and canvass the opinion of nurses and doctors was undertaken. The survey identified that there was support for further investigation into how this imitative could be taken forward. An update will be provided of progress to date.
Osteoarthritis: management and treatments
Authors: Lucas Brian
Published: May 2014

Osteoarthritis (OA) is a degenerative joint disease which may result in pain and reduced function. This article outlines the aetiology of the disease, its signs and symptoms, and aids to diagnosis. The conservative treatments, including pharmacological and surgical options are outlined and the evidence for each discussed. The importance of patient education and involvement in their care is highlighted.
Child obesity: a manageable condition
Authors: Swain Caroline , Sacher Paul
Published: May 2014

Obesity is a major challenge facing the nation’s health, and preventing and treating the condition is a complex undertaking. Nurses and other health professionals have a central role to play in identifying overweight and obesity in children, assessing the family’s readiness to change, and where appropriate, signposting them to appropriate sources of treatment and support.
Prescribing for incontinence and nocturnal enuresis
Authors: Waterfield Jon
Published: May 2014

This article provides an overview of the main drugs used for the treatment of incontinence and nocturnal enuresis. There is particular reference to the prescribing issues associated with antimuscarinic drugs in relation to cautions, contraindications and side effects. The clinical guidelines for the treatment of nocturnal enuresis in children and the use of desmopressin are highlighted. The reader has the opportunity to self-check their own knowledge with a pre-reading self-assessment.
A survey of therapy areas in which nurses prescribe and CPD needs
Authors: Courtenay Molly , Gordon John
Published: May 2014

Approximately 39 000 nurses across the UK are qualifi ed to prescribe medicines, and around 14 000 are able to prescribe any licensed medicine (including some controlled drugs) within their area of competence. In order that these nurses are able to maintain and develop their professional knowledge and competence, it is important that appropriate support and education is available. This study aims to provide an overview of the therapy areas in which nurses prescribe medicines and their continuing professional development needs. An online questionnaire was sent to 878 nurses, 546 (62%) of which were completed. This article reports on the fi ndings of these 546 nurses. The high number of nurses who reported that pharmacological educational needs, and that e-learning is their preferred method of learning, should be considered by those involved in the development and delivery of continuing professional development for nurse prescribers. In addition, the large numbers of nurses prescribing for respiratory conditions and pain, and the high percentage of these nurses reporting continuing professional development needs, should be borne in mind by those involved in undergraduate training.
Nurses' and doctors' views about the prescribing programme
Authors: Courtenay Molly , Stenner Karen , Carey Nicola
Published: May 2014

This article aims to explore the views of doctors and nurses, who care for people with diabetes, about the prescribing programme. Interviews with 10 nurse prescribers, nine doctors and three non-nurse prescribers were conducted in nine case study sites across England between October 2007 and September 2008.

Prescribing was seen as a natural extension of advanced nursing roles adopted by nurses caring for people with diabetes. Nurses considered it important to obtain sound knowledge in areas in which they intended to prescribe before undertaking the course. Variation across prescribing programmes with regards to the level of work required of students and the way in which courses were run were reported. Most doctors thought it beneficial for nurses to be involved in mentorship, although doctors' continued involvement was considered necessary.

Prescribing supports advanced nursing practice in the care of people with diabetes. Nurses considering undertaking the prescribing course need to beaware of the variations across prescribing programmes with regards to the level of work required. There is support for joint mentorship between nurse prescribers and doctors for students undertaking taking the prescribing course.
Why prescribe antibiotics for otitis media in children?
Authors: Philp Andrew , Winfield Louise
Published: May 2014

Otitis media (OM) is a common illness in children, characterized by a short-term inflammation of the middle ear for which antibiotics provide little benefit in a large proportion of children. It is a condition that is largely self limiting and complications are likely to be rare if antibiotics are withheld. The aim of the study is to understand why nurse practitioners in primary care prescribe antibiotics for some cases of OM. The objectives were to describe evidence-based guidelines nurse practitioners use in their prescribing practice, to explore how they perceive this guidance, explore how they think through their prescribing practice and influences upon this and to explore perceptions they hold about their prescribing practice when treating otitis media in children. An interpretative qualitative research approach was used in primary care settings with a purposive sample group of eight primary care nurse practitioners who consented to individual audio taped interviews. Thematic analysis to participants' responses to questions during semi-structured interviews was undertaken.
Non-medical prescribing in secondary care: an audit
Authors: Crew Suzanne
Published: May 2014

The author, an orthopaedic night sister working in a centre for elective orthopaedic surgery, undertook an audit of her work as an independent non-medical prescriber. The audit focused on the medications prescribed—including rationale for prescribing and frequency of prescribing, as well as problems encountered—and on the effectiveness of the role within this secondary care setting—analysing, in particular, the interactions between medical and nursing staff.
The nurse's role in the management of atrial fibrillation
Authors: Greener Mark
Published: May 2014

Atrial fibrillation (AF) is the most common sustained arrhythmia. Despite increasing overall mortality by up to 90%, many health professionals do not regard AF as a modifiable cardiovascular risk factor, a view this article challenges. Nurses can make several potentially influential contributions to the detection and management of this increasingly common disease. AF predominantly develops among older people, who often receive nursing care. Furthermore, numerous diseases, conditions and risk factors managed by nurses cause or contribute to AF, including cardiac and metabolic conditions, certain surgical procedures, diet and lifestyle. As most episodes are asymptomatic, nurses should consider AF in any patient with an irregular pulse, and refer suspected cases for an electrocardiogram. AF management aims to alleviate symptoms and prevent complications using antithrombotics, cardioversion, antiarrhythmics, or ablation therapy. Traditional antiarrhythmic drugs are only moderately effective in AF and can cause potentially serious adverse effects. Future and recently launched AF medications may offer improved efficacy and safety.
Palliative care, pain control and nurse prescribing
Authors: Creedon Rena , O'Regan Patricia
Published: May 2014

Pain is a significant source of anxiety and distress, and perhaps the most debilitating symptom that is feared the most by cancer patients at the end of life, and requiring expert palliative care. Nurses in palliative care need to have advanced knowledge on treatments and symptom management in order to address pain appropriately. Nurse prescribers in palliative care can address the issue of inadequate pain management by facilitating access to medications in a more timely manner.
Safe management and prescribing for fever in children
Authors: Paul Siba Prosad , Mayhew Joseph , Mee Abigail
Published: May 2014

Fever should not be automatically considered as harmful in children, although it may cause distress and discomfort. Efforts should be first made to differentiate a well child from the unwell one. There is no clear evidence that antipyretics prevent the onset of febrile convulsions. Where a fever is causing significant distress to a child, ibuprofen or paracetamol may be used as a single agent. Each prescription should be carefully monitored.
The tragedy of congenital abnormalities
Authors: Greener Mark
Published: May 2014

Around 15% of newborn babies show minor congenital anomalies, while 2–3% are born with major structural abnormalities. Health professionals recognize major congenital anomalies in another 2–3% of children by 5 years of age, and birth defects cause around one fifth of infant deaths. Investigations fail to reveal a cause for between 40% and 60% of congenital anomalies. Environmental factors, chromosomal abnormalities and gene mutations underlie 10%, 7% and 8% of major birth defects, respectively. Many congenital anomalies are unavoidable. However, nurses can help prevent some common birth defects. For example, alcohol consumption during pregnancy can cause numerous structural, developmental, cognitive and behavioural anomalies. Nurses should, therefore, routinely inform expectant mothers about the risks of alcohol consumption and refer as appropriate. As many pregnancies are unplanned, nurses could recommend that women of childbearing age take 400 µg of folic acid daily to reduce the risk of neural tube defects. While not associated with a high risk of teratogenicity, smoking during pregnancy increases the risk of, for example, miscarriage, impaired fetal growth, low birth weight and infant mortality, underscoring the need to ensure that nicotine-addicted expectant mothers engage with cessation services. Infections can result in devastating congenital anomalies, highlighting the importance of vaccination (e.g. rubella) as well as remaining vigilant for and offering advice to prevent toxoplasmosis. Finally, nurses should ensure that drugs taken by expectant mothers or women planning pregnancy are not associated with birth defects. However, nurses need to remain up-to-date with the literature, especially as important studies continue to emerge in relatively well-studied areas.
Managing impulse control disorders
Authors: Greener Mark
Published: May 2014

Growing evidence links some treatments for Parkinson’s disease (PD) and restless leg syndrome (RLS) to a range of ‘impulse control disorders’ (ICDs), including pathological gambling, hypersexuality, compulsive shopping and binge eating. ICDs are relatively common. In one study, 13.6% of patients with PD showed ICDs. In another study, 17% of patients with RLS taking dopaminergic agents developed ICDs. Prescribing dopaminergic therapy at the lowest effective dose helps reduce the risk. Nurses should remind and educate patients— and, when possible, their families—about the risk of ICD. While the likelihood of developing ICDs is highest during the first few months of treatment with dopamine agonists, nurses should remain alert for the complication during each clinical encounter. ICDs may be managed through, for example: reducing the dose of or withdrawing the dopamine agonist; cognitive behavioural therapy; and support from self-help groups. Dysphoria appears to contribute to, and helps maintain ICDs, and nurses should manage depression, mood changes and sleep disturbances. Nurses need to remain vigilant for this complex, enigmatic, but fascinating condition.
An overview of atrial fibrillation
Authors: Yaldren Jo
Published: May 2014

Atrial fibrillation (AF) is the most common cardiac arrhythmia and the incidence of AF is increasing. AF is typified by an irregular heart rate caused by rapid irregular depolarisation of the atria. The subsequent loss of regular atrial contraction can lead to stagnation of blood in the atria and the potential for thrombus formation; consequently, AF is a major cause of stroke. AF is often undiagnosed because some people with AF are asymptomatic; therefore, manual pulse checks should be performed whenever the opportunity arises, to increase the incidental finding of this rhythm. Management priorities for AF are symptom control — through rate control and rhythm control — and reduction of risk of a thromboembolic event and heart failure, using guidelines and risk-assessment tools. Nurses are in an ideal position to identify patients with AF, to ensure risk stratification is undertaken and to include the patient in the decision-making process regarding their treatment options and holistic care. abs>
Pharmacology and safe prescribing of metformin
Authors: Apampa Bugewa
Published: May 2014

Metformin is thought to exert its antihyperglycaemic effect through the activation of adenosine monophosphate-activated protein kinase enzyme, which is expressed in many tissues. This results in the lowering of blood glucose level in patients with diabetes. Its positive impact on the macrovascular complications of diabetes, good safety profile and wide patient acceptability has established its position as a first-line diabetes medication. Adverse effects associated with its use are generally mild and usually involve transient gastrointestinal symptoms. Lactic acidosis is rare and can be avoided by strict adherence to prescribing guidelines.
Anaemia management on a haemodialysis unit
Authors: Gerrish Martin
Published: May 2014

Patients with chronic kidney disease (CKD) require polypharmacy to manage dialysis treatment. This can be complex, and involves the management of fluid balance, blood pressure, calcium and phosphate levels, anaemia, diabetes, anticoagulation and infection prevention. In the UK, renal services are increasingly being provided at district hospitals, within ‘satellite’ outpatient dialysis units attached to larger regional specialist units. Patients within these units do not always have access to a medical practitioner; therefore, non-medical prescribing (NMP) plays an important role. This article will focus on NMP within a 14-station haemodialysis unit in Lincolnshire where NMP has been successfully established since 2003 when the appropriate legislation was introduced.
Educating for capability in NMP education and training
Authors: Banning Maggi
Published: May 2014

Non-medical prescribing (NMP) education and training was first introduced in 2006. The current evaluation of NMP indicates that existing education and training is fit for purpose. However, nurses and pharmacists require additional education and training in assessment and diagnostic skills. A deficiency in these process knowledge forms and skills can pose difficulties for nurse prescribers in fulfilling prescribing function and roles. A current weakness in the education and training of NMPs is the preference for using competences to assess physical assessment skills and prescribing practice. Although competence-based approaches are used to assess performance in vocational programmes, they are fraught with difficulties because they assess the ability of the individual to undertake a set of skills at one point in time and have limited assessment of professional performance or the holistic nature of clinical practice. By educating for capability, NMPs should be able to integrate both cognitive and psychomotor ability within the clinical context. This approach to education and training requires the use of transformational and situational approaches to learning, rather than self-directed learning.
Managing preschool wheezing in the community
Authors: Paul Siba Prosad , Mee Abigail , Crosby Laura
Published: May 2014

Wheeze is common in preschool-aged children. Most often these episodes are intermittent, and all that is necessary is intermittent bronchodilator therapy. However, quite often this group of children are treated with asthma therapies, such as inhaled corticosteroids with or without an established diagnosis of asthma. The preschool wheeze involves neutrophillic cytology with a degree of fixed airflow obstruction, and therefore it is unlikely to respond to standard asthma therapies. It is important that a proper diagnosis is established and discussed with the family, and that the only rationale for using a prophylactic therapy in preschool wheezers is to improve the quality of life for the child. Also, it should be remembered that this is not a disease-modifying therapy and does not stop the development of asthma in some of these children in late childhood.
Protecting the antibiotic miracle
Authors: Greener Mark
Published: May 2014

A combination of infection control measures, improved sanitation, and antibiotics have rendered some infections feared by our ancestors manageable. However, the growing number of resistant bacteria threatens the antibiotic miracle. Bacteria can become resistant to antibiotics in numerous ways. Bacteria may employ alternative metabolic pathways to bypass the disruption caused by an antibiotic. They do this by secreting enzymes that destroy antibiotics or altering cell wall composition. In general, bacteria acquire these resistance mechanisms through changes to their genetic code, offering an example of natural selection in action. Spontaneous chromosomal mutations occur once in 100 million microorganisms, but the enormous numbers of bacteria in the human body means that the absolute number of mutations is relatively high, providing ample opportunity for a bacterial strain to acquire antibiotic resistance. This article explains how genetic resistance to antibiotics develops in bacteria, and how nurses can help reduce the emergence of ‘super’ bacterial strains resistant to common antibiotics.
Asthma: assessment, diagnosis, and treatment adherence
Authors: Kaufman Gerri
Published: May 2014

Asthma is a chronic inflammatory disorder of the airways that is associated with a high level of morbidity. Evidence-based guidelines and effective treatments are available for the management of asthma, but achieving control can be difficult for the majority of sufferers. A careful clinical history and objective measurement of lung function are essential for diagnosis of the condition. Pharmacological therapy should follow a stepwise approach to treatment, and choice of inhaler device and inhaler technique are central to symptom management. Partnership between asthma patients and health professionals is essential to promote patient-centred care and adherence to medication.
Diagnosis and treatment of gestational diabetes
Authors: Webb Jackie
Published: May 2014

Gestational diabetes is defined as glucose intolerance first detected in pregnancy ( World Health Organization, 1999 ). Globally, and in the UK, the prevalence of gestational diabetes is increasing owing to multiple factors. Women with previous gestational diabetes are more likely to develop type 2 diabetes later in life. In recent years, several landmark studies have been performed with the intention of defining the most appropriate treatment for gestational diabetes. The aim of this article is to explore the available treatments for gestational diabetes in the UK, although the author acknowledges that treatment modalities vary throughout the UK and remain largely dependent upon the prescriber's experience within the context of what is determined to be accepted safe practice.
Self-assessing competence in non-medical prescribing
Authors: Nuttall Dilyse
Published: May 2014

Competence is a fundamental requirement for health-care practice and not least in relation to prescribing. Practitioners have a responsibility to ensure they are competent and to confirm this competence in order to maintain registration with their professional body. However, it is recognised that self-assessment of competence can be problematic and has potential to be ineffective. This article aims to alert prescribers to some key considerations to enable them to undertake a more effective self-assessment of prescribing practice which not only confirms competence but also supports development.
Leadership and management skills in health care
Authors: Ellis Peter , Abbott Jane
Published: May 2014

This article introduces the concept of leadership, different styles of leadership and some of the skills good leaders may have or aspire to. It explains that good leaders do not not have to be a manager, but that a good manager of people and teams is also a good leader.
Research roundup: January 2014
Authors: Greener Mark
Published: May 2014

In brief

▪ Smoking cessation aids do not increase the risk of serious cardiovascular disease events ▪ Taking statins with other medications that inhibit their metabolism increases the risk that patients will suffer muscle pain ▪ Carrying excess weight increases the risk of hearing loss ▪ Poorly controlled pre-existing diabetes increases the risk of foetal and infant death ▪ No link between topical corticosteroids in pregnancy and adverse outcomes
Understanding palliative care in residential and nursing homes
Authors: Katz Jeanne , Komaromy Carol , Sidell Moyra
Published: May 2014

The concept of palliative care is not very widely understood in nursing and care homes. Jeanne Katz, Carol Komaromy and Moyra Sidell describe their study into this area of nursing care.
Customer Feedback
Authors: Ashurst Adrian
Published: May 2014

Adrian Ashurst discusses the importance of regular customer feedback and suggests that residents, their relatives and staff can all have a positive influence on the development of a care home's approach to customer services.
Pharmacotherapy of anxiety and insomnia
Authors: Morinan Alun
Published: May 2014

Alun Morinan reviews a number of drugs used for the treatment of anxiety and insomnia and discusses their pharmacological actions and side effects.
Using electronic aids to assist people with dementia
Authors: Penhale Bridget , Manthorpe Jill
Published: May 2014

Bridget Penhale and Jill Manthorpe outline ways in which electronic aids can be used to assist people with dementia and discuss some of the ethical issues relating to the use of such technology.
A multisensory programme: evaluating effects on agitation
Authors: Jackson Graham A , Sterling Rebekah , Russell Kenny , Templeton Gavin
Published: May 2014

Graham A Jackson, Rebekah Sterling, Kenny Russell and Gavin Templeton report on a study that investigated the benefits of the Sonas aPc programme on client behaviour.
Incorporating food and drink into stimulating activities
Authors: Wenborn Jennifer
Published: May 2014

Cooking and baking is not only enjoyable for many clients, it is also a valuable way to stimulate the senses, encourage interaction, and provoke reminiscence.
Finding the right response to people with dementia
Authors: Kerr Diana , Cunningham Colm
Published: May 2014

Diana Kerr and Colm Cunningham examine the current evidence on how medication is used as a response to challenging behaviours in people with dementia.
Aspects of holistic terminal care in severe dementia
Authors: Hedley Kathleen , Hughes Julian
Published: May 2014

In the second article in the series, the authors present and comment on a case study which highlights the holistic nature of terminal care in severe dementia.
Promoting good hygiene among older residents
Authors: Hampton Sylvie
Published: May 2014

Hygiene is vital, but over-cleansing or incorrect use of skin cleansers can affect the balance of skin flora and may damage vulnerable tissues. Sylvie Hampton looks at best practice.
Different forms of psychological interventions in dementia
Authors: James Ian , Douglas Simon , Ballard Clive
Published: May 2014

Continuing the series on palliative care and dementia, the authors examine a wide range of psychological therapies, including traditional and some newer approaches.
Drugs used to relieve behavioural symptoms of dementia
Authors: Ballard Clive , Hulford Lisa
Published: May 2014

Difficult behaviour is often treated with drugs. Continuing the series on palliative care, this article assesses the evidence and points towards the disadvantages of using this approach.
Safe moving and handling: A guide to hoists
Authors: Nazarko Linda
Published: May 2014

People cared for in homes often have mobility problems and require assistance to move. Linda Nazarko updates you on legislation and equipment available to enable you to move individuals safely.
Part two: Choosing an individual reminiscence approach
Authors: Heathcote Julie , Hong Chia Swee , Quinn Patricia , Plummer Margaret
Published: May 2014

In the second part of this series on reminiscence, Julie Heathcote et al focus on the value of one-to-one activities and recollection, using a person-centred approach.
Part two: Carrying out a thorough assessment
Authors: Nazarko Linda
Published: May 2014

Linda Nazarko explains how holistic assessment and documentation enable us to plan wound care effectively, improve quality of life and reduce workload.
Recognizing the signs and symptoms of dementia
Authors: Nazarko Linda
Published: May 2014

An estimated three quarters of a million people in the UK suffer from dementia. The incidence of dementia is growing and as people live longer, it will become one of the major health issues of the 21st century. Dementia is the fourth leading cause of death after heart disease, cancer and stroke (Bolla et al, 2000).
NHS: Improved efficiency
Authors: Sims Beccy
Published: May 2014

The National Institute for Health and Clinical Excellence (NICE) has announced that it is to embark on a new quest to improve the effectiveness of the NHS and to reduce inequalities throughout the health service.
Managing continence in palliative care
Authors: Switzer John
Published: May 2014

Some older people living in care homes may be fortunate enough to remain continent during their final years. However, many residents suffer from incontinence as a result of the effects of their long-term illness:

‘Incontinence is still a taboo in our society, and it is a condition that causes distress, secrecy and poor quality of life.’ (Haggar, 2001)
Caring for the older ostomate: An update
Authors: Burch Jennie
Published: May 2014

Jennie Burch aims to help health-care assistants to look after older people with a stoma. With increased understanding of stomas, simple problems may be overcome or prevented.
Managing medicine for residents with swallowing problems
Authors: Griffith Richard
Published: May 2014

Richard Griffith reviews the need for caution when crushing or advising residents to crush tablets in response to a swallowing difficulty when taking medicines.
How to control the risk of MRSA infection
Authors: Nazarko Linda
Published: May 2014

Methicillin-resistant Staphylococcus aureus (MRSA) infection is a serious national and global problem. Linda Nazarko looks at the effects of MRSA and the ways in which care home workers can prevent its spread.
Dietary considerations for the older ostomate
Authors: Burc Jennie
Published: May 2014

Working with elderly people can prove to be a challenging experience with regard to the provision of adequate nutrition. For those older people with a stoma (ostomates) there may be some additional concerns. There may be worries about what to do if there is a problem with the stoma such as constipation, a stoma blockage, loose faeces or a urinary tract infection. This article explores dietary advice to assist the health-care assistant to provide appropriate care and manage potential nutritional difficulties for the older person with a stoma.
Malignant fungating wounds
Authors: Nazarko Linda
Published: May 2014

Around 5–10% of people with advanced cancer develop malignant fungating wounds (Haisfield-Wolfe and Rund, 1997). These may develop during the last few months of life or be present for a number of years. Fungating wounds rarely heal. The goal of care is to control distressing symptoms and maintain or improve the person's quality of life. This article explains the management of the four most common symptoms associated with fungating wounds: pain, exudate, bleeding and malodour.
Moving and handling, Part two: Risk management
Authors: Rinds Gitte
Published: May 2014

Applying the right risk management strategies in care homes can reduce injury and increase employee satisfaction. Gitte Rinds explains the importance of valuing staff and using appropriate training, and equipment.
Understanding visual and auditory loss
Authors: Swann Julie
Published: May 2014

Julie Swann introduces the problems encountered in deafblindess, and describes the various interventions that care staff can employ to assist in maintaining independence and wellbeing of residents.
Relocation to a care home, part two: exploring helping strategies
Authors: Newson Pauline
Published: May 2014

Last month's article discussed the various emotional effects that relocation can have. In the concluding article, Pauline Newson explores the helping strategies that staff can take in supporting older adults and their families through their distres.
Dermatological care for stoma patients
Authors: Cronin Elaine
Published: May 2014

Elaine Cronin introduces two of the most common dermatological conditions in stoma care and discusses the importance of diagnoses and treatment in providing the best possible care.
The prevention and management of skin tears
Authors: Lloyd-Jones Menna
Published: May 2014

Menna Lloyd-Jones discusses the important role that care assistants can play in preventing and managing skin tears, which are a painful commmon problem for frail older people.
Good positioning: the importance of posture
Authors: Swann Julie
Published: May 2014

The way we sit, stand and walk has a long-term effect on our musculo-skeletal system. Julie Swann discusses the effects of bad posture, and offers advice on assisting residents with posture and positioning.
Gardens: enabling residents to continue their hobby
Authors: Swann Julie I
Published: May 2014

Altering ways of doing tasks can help residents to take an active part in gardening, particularly if raised beds and easier-to-manage gardening tools are provided.
Prevention and treatment of depression in care homes
Authors: Wright Kerri
Published: May 2014

With up to 40% of residents in care homes experiencing depression, it is vital to be aware of its signs and symptoms. A personcentred care plan should then be undertaken. Kerri Wright explains
Ensuring older residents retain their unique identity
Authors: Cook Glenda
Published: May 2014

Older people want more than to simply exist. Yet moving to a care home can lead to ‘social death’, where the individual continues to function biologically but ceases to be an active agent in their own life.
Basic essentials: why elderly skin requires special treatment
Authors: Voegeli David
Published: May 2014

Don't let bad habits and daily rituals take their toll on the skin of your residents. How soap and roughly laundered towels can be abrasive, and when to use emollients and creams.
A cost-effective pressure damage prevention strategy
Authors: Large Jenny
Published: May 2014

Here, tissue viability clinical specialist Jenny Large describes the development of a pressure ulcer prevention strategy and its effects on the incidence of pressure ulcers in a nursing home.
Dementia care: sensory environments
Authors: Cook Glenda
Published: May 2014

People with dementia can become anxious and enjoy life less as they misinterpret aspects of their surroundings. However, changes to their environment can help to compensate for perception changes
The role of the carer and patient in stoma care
Authors: Black Pat
Published: May 2014

Stoma care becomes increasingly difficult when the individual has more incapacities to cope with. Pat Black explains how care and nursing staff can assist a person with a new or existing stoma.
Dementia care: involving people in alzheimer's cafes
Authors: Jones Gemma MM , Miesen Bère ML
Published: May 2014

Alzheimer's Cafes support people with dementia and their significant others in a safe, social café-like setting. This article explains how they are hosted, and how care staff are involved with them.
Great expectations: feedback from relatives and residents
Authors: Darton Robin
Published: May 2014

The media has distorted many people's perception of care services provided across the country. robin Darton found out what residents and their families really think and how staff can better accommodate these views
Ageing and musculoskeletal disorders
Authors: Swann Julie
Published: May 2014

Physiological changes occur as we age that affect our appearance, and our abilities to function and respond to daily living activities. Julie Swann continues the ageing anatomy series
How to … manage, assess and care for the older person's skin
Authors: Payne Drew
Published: May 2014

Skin is the largest organ of the human body. It is important in touch and sensation, controlling body temperature and protection against noxious substances. But breaks or damage to the skin can impair or reduce any of these functions
Maintaining continence for people with dementia
Authors: Bardsley Alison
Published: May 2014

Maintaining continence relies on mobility, mental capacity, manual dexterity and motivation. Alison Bardsley considers some of the options for managing this distressing problem through a multidisciplinary and holistic approach
Meeting food safety requirements at mealtimes
Authors: Green Danielle
Published: May 2014

Danielle Green discusses the diploma optional unit that assesses the health and social care worker's knowledge and skills in meeting food safety requirements when preparing, serving, clearing away and storing food
Assessing and monitoring the quality of service provision
Authors: Navekar Pravin
Published: May 2014

Pravin Navekar encourages providers to focus on Outcome 16 to improve the quality of service in their care homes and ensure that the experience of residents is positive and supported by appropriate systems and staff
Moving and handling: supporting bariatric residents
Authors: Sturman-Floyd Melanie
Published: May 2014

Care and support of a bariatric resident is complex and will require robust and in-depth risk assessment. Melanie Sturman-Floyd explains that moving and handling can be challenging but risks can be reduced with bespoke equipment and mechanisation
Marketing in the care industry: a definitive guide
Authors: Quiggin Katryna
Published: May 2014

Applying a simple marketing framework can help determine what activities are effective under what circumstances, and help grow your business. This article by Katryna Quiggin explains what tools are needed and when, to help you succeed
Achieving culture change: a whole organisation approach
Authors: Sheard David
Published: May 2014

Managers of dementia care homes face conflicting messages in different models of care, in types of work cultures and in meeting the demands of compliance requirements. David Sheard outlines how care homes can be guided through this confusion
Sickle cell disease
Authors: Eboh Winifred
Published: May 2014

It is important to dispel the myth that sickle cell can only be found in the black and ethnic groups, says Winifred Eboh.