bluuebunny/crossref_metadata_2025 huggingface dataset:
Children's perceptions of asthma: establishing normality
Authors: Ireland Lorraine M
Published: December 2014

This qualitative research study explores children's perceptions of having asthma. The research methodology utilized a grounded theory approach. The study aimed to identify the beliefs and attitudes held by asthmatic children regarding their illness and to consider how this influences their asthma management. Ten asthmatic children, boys and girls, aged between 9 and 12 years, were interviewed. The transcribed interviews were analysed using the constant comparative method. Analysis revealed four major categories and a core variable identified as ‘establishing normality’. These themes influenced each child's appraisal and response to having asthma. The findings show that their concern to establish normality and to be ‘normal’ does have benefits, but in some circumstances also encourages the acceptance of suboptimal control.
The Pegasus Overture alternating-pressure mattress overlay
Authors: Fox Carolyn
Published: December 2014

Pressure sores affect approximately 10% of the adult population and occur in various hospitals and community settings (Department of Health, 1992). It is therefore essential to adopt a logical approach when selecting the optimum piece of equipment for patients at risk of pressure sore development. Alternating-pressure mattresses have been used for many years in both hospitals and community environments to prevent and treat pressure sores. in September 1995, Pegasus Airwave Limited launched a new alternating-pressure mattress overlay, the Overture. It is designed for use with patients who have mobility problems and are at low to medium risk of developing pressure sores or have superficial tissue damage. This article describes the features of the overture and its suitability for use in different care settings.
The challenges and benefits of job sharing in palliative care education
Authors: Cooper Jan , Spencer Debbie
Published: December 2014

This article examines the authors' experience of job sharing a post in palliative care education. It discusses the concept of job sharing and examines factors such as power sharing, compatibility and other people's perception of the job sharing role. Effective communication is identified as a key issue. Benefits such as reduced professional isolation, increased job satisfaction and the opportunity to offer the knowledge and skills of two people are highlighted. The authors identify the factors which they consider to be crucial to the success of job sharing.
Barriers to evidence-based nursing care
Authors: Castledine George
Published: December 2014

Values resources and evidence are the three factors that influence decision-making with regard to health care. In the past, decisions about patients were based solely on the opinions of doctors.
New deal for people with learning difficulties
Authors: Parrish Alan
Published: December 2014

It is not often that service users, carers, and people involved with learning difficulties services can get excited, and it is certainly unusual to get news such as the Health Secretary's announcement of new guidance and advice for the NHS on how best to improve health care for people with learning difficulties (Department of Health (DoH), 1997).
IV therapy: selection, use and management of infusion pumps
Authors: Morling Simon , Ford Lyn
Published: December 2014

A locally agreed, coordinated policy is essential for the selection and purchase of Infusion pumps, and should form part of overall policy for medical device management. When developing a purchasing policy the core needs of all relevant professional groups should be addressed, to ensure that an informed, integrated strategy evolves. This will enhance the wider responsibilities alloclated with, for example, device training and education, and medical device maintenance, at well as the basic clinical requirements of the infusion pump. The Medical Devices Agency provides guidance on the selection and purchasing of infusion pumps through its medical device evaluation programme, which uses evidence-based systems that categorize devices by clinical infusion risk.
Why should acute trusts be interested in cardiac rehabilitation?
Authors: Willamson Graham R
Published: December 2014

This questionnaire survey of 100 ex-coronary care unit (CCU) patients in the Royal Devon and Exeter Hospital NHS Trust sought to determine patients' views (i.e.consumers' rather than professionals' views) regarding their perceived need for individual or group support following myocardial infarction, and whether the information received in hospital was adequate for their needs. A literature review of the evidence suggesting that cardiac rehabilitation is effective is included, Responses indicated that 42 of the 62 patients who responded (67.7%) felt that they would have benefited from a relaxation and/or support group, with 40 (69%) stating that they would have attended such a facility after discharge. The nature of the information offered by nursing staff while patients were in hospital was clearly that which was ‘convenient’ and ‘unthreatening’ for nurses to deliver. Only 35 respondents (56.4%) agreed that this information was adequate for their needs. These results indicate the preferences of our local consumers, whose views should be paramount in the contemporary NHS. There is a significant unmet demand for such services, which acute sector staff have the expertise to meet.
Future directions for learning disability nursing
Authors: Parrish Alan , Sines David
Published: December 2014

Over the past decade learning disability nurses have had to make many changes in the way they practice. Changes in attitude towards the way in which people with learning disabilities are cared for has meant that nurses have had to adjust their practice to address different expectations in the way these services are delivered. Nursing now provides opportunities for people with learning disabilities to express themselves and become involved in decision-making that affects their lives. For nurses this is a totally new way of working with this client group. Learning disability nurses have risen to the challenge that has resulted from moving into community care and forming links with primary healthcare teams.
Malnutrition in hospital: detection and consequences
Authors: Arrowsmith Helen
Published: December 2014

Malnutrition in hospital is not a new concept. Studies carried out over 20 years ago identified that 60% of surgical patients (Hill et al, 1977) and 44% of medical patients (Bistrian et al, 1978) showed evidence of malnutrition. A more recent study demonstrated that the problem still exists (McWhirter and Pennington, 1994). This research showed that 40% of patients were undernourished on admission to hospital and 78% of these suffered further deterioration in their nutritional status during their hospital stay. This article, the first in the series, aims to identify patient groups which are likely to become mainourished during hospitalization and outlines how nurses and doctors can detect mainutrition and/or potential mainutrition in patients. The consequences of mainutrition and the current issues surrounding the reported problems of patients who do not receive enough food and drink while in hospital (Association of Community Health Councils, 1997) are discussed. The article also explores what measures can be taken to improve patients' nutritional intake while in hospital. It describes the way forward in terms of clinical practice, current projects and the information and training available to nurses and other members of the multidisciplinary team. The author's overall aim is to improve healthcare professionals' knowledge within this field and to raise the profile of nutritional care.
Correspondence
Authors: Barrett Janice , Anderton Paul , Sharu Debra
Published: December 2014

I read with interest the comment piece entitled ‘Should we reshape nurse education yet again’ (Vol 6(16): 906). This article discussed the RCN's new leaflet Shaping the Future of Nursing Education (RCN, 1997).
The abuse of specialist nursing titles must stop
Authors: Castledine George
Published: December 2014

One of the most significant factors to emerge so far from the UKCC's specialist practice steering group, which I am chairing, is that working in a specialist field does not equate with being a specialist. Many nurses fail to grasp this point and, after qualifying from diploma-level preregistration courses, seek to undertake specialist nursing courses at degree level as a career step towards becoming specialist nursing practitioners. Specialist academic courses do not make practitioners specialists. In this country, the criteria for specialist nursing practice have been abused and one hopes that the UKCC will clarify this situation as soon as possible.
Self-directed and student-centred learning in nurse education: 2
Authors: Nolan Janet , Nolan Mike
Published: December 2014

Based on a study of student nurses' expectations at the start of their Project 2000 training, this article, the second of two, argues for the need to develop a new approach to self-directed learning. Tenned the cooperative model, it places emphasis on tutors providing initial direction and leadership so that students can gradually develop the skills needed to become self-directed. This requires the use of pedagogical approaches which recognize the value of didactic as well as experiential teaching strategies. The characteristics of the cooperative model, which is located within the continuum of self-directed learning suggested by D'A Slevin and Lavery (1991), are outlined.
Patient representatives: a new role in patient advocacy
Authors: Mallik Maggie
Published: December 2014

Patient representatives advocate the consumer interests of hospital patients. The initiation and development of this role in hospitals in the USA during the mid-1970s is now being mirrored in the UK. Patient representatives in both countries have been supported by powerful hospital associations, receive their authority to act through hospital management and deal with similar patient issues. Occupational boundary disputes have occurred with other healthcare professionals who feel that they are the patient's advocate. It is important to differentiate between this new full-time professional role and other claims to patient advocacy made by the nursing profession.
Arglaes Controlled Release Dressing in the control of bacteria
Authors: Williams Clare
Published: December 2014

It has been known for many years that sliver has antimicrobial properties. Arglaes is a film dressing that provides a continuous and controlled release of sliver ions and is produced by Maersk Medical. The name is derived from argentum, which is Latin for sliver, and Ag, the chemical symbol for sliver. Since the emergence of resistant organisms, topical antibiotics are best avoided. Arglaes has been developed in the light of this and appears to control the bacteria in wounds and prevent bacterial contamination. Arglaes also provides a moist environment for the healing process and is suitable for many wound types.
Single-case experimental designs 2: common examples
Authors: Behi Ruhi , Nolan Mike
Published: December 2014

This article describes and discusses some commonly used single-case experimental designs, including reversal and non-reversal designs. The A-B-A-B design is recommended for use when reversal designs can be used and when the patient's treatment phase needs to be maintained. The B-A-B design is used in situations when studying an intervention or treatment which is already in progress. The A-B1-A-B2-A-Bn design is useful when the aim of the researcher is to study the effects of different levels of a specific independent variable. Two types of non-reversal multiple baseline designs are discussed here.
Networking: putting research at the heart of professional practice
Authors: Leighton-Beck Linda
Published: December 2014

Nursing staff in Scotland have access to five local multidisciplinary health services research Networks. These offer nurses guidance, advice and support on relevant but unanswered questions relating to their clinical practice, thus helping them to take forward their enquiry. This article explores the origin, usefulness and developing role of these Networks with particular reference to the North of Scotland Network. Networking is recommended as an effective intervention to facilitate the development of research, to promote the quality, quantity and usefulness of research, and to place research into patient care at the heart of nursing practice.
Continuity of care vs the role of agency nurses
Authors: Castledine George
Published: December 2014

Continuing education is widely accepted as being crucial to the future development and enhancement of nursing practice. Continuity in nursing care, however, does not seem to be taken as seriously. A recent documentary on Channel 4 (Dispatches, 9 January, 1997) highlighted the extent to which hospitals are reliant on agency nurses, are the expense of continuity in nursing care.
Using research to develop care for patients with Huntington's disease
Authors: Skriton Heather , Glendinning Neil
Published: December 2014

Huntington's disease (HD) is a progressive neurodegenerative disorder affecting approximately 5–10 per 100 000 people in the UK (Harper, 1992). This dominantly inherited genetic condition causes movement disturbance (especially chorea), depression and dementia. The complex physical, mental, psychological and social problems caused by HD can result in particular difficulties in care. The course of the disease may span 15–20 years from diagnosis to death, necessitating long-term nursing care. The NHS and Community Care Act 1990 has made statutory provision for patients to be cared for at home if they so wish, placing a greater onus of care on the primary healthcare team. A survey of 25 patients in Somerset who had been diagnosed with HD was recently undertaken to ascertain the health and social care needs of patients and their carers. Of a possible 300 care needs in 12 categories (e.g. housing, dietary advice, carer support), 73 unmet needs were identified in this group. Using the survey as a basis, this article describes the steps taken in Somerset to ensure that the future needs of this group of patients are fulfilled. This model may be appropriate for the care of patients with other complex long-term diseases.
Learning disability nursing and primary healthcare
Authors: Parrish Alan , Birchenall Peter
Published: December 2014

This article addresses the issues surrounding the role of learning disability nurses and their relationship with primary healthcare colleagues. It highlights opportunities in general practice for the learning disability nurse who has become a key player in shaping services for this client group as services swing towards primary healthcare. The NHS Executive document NHS Priorities and Planning Guidance 1997-98 is explored and the opportunities that this gives the community learning disability nurse are discussed. The article stresses the need for learning disability nurses to obtain quality research-based evidence on effective caring interventions. The importance of clinical audit and outcome measurements from interventions are highlighted. Finally, the importance of good communication and being able to respond to this client group's needs is emphasized.
Self-image and people with learning disabilities
Authors: Markwick Anne , Sage John
Published: December 2014

Self-image arises from a complex interaction of intrinsic and extrinsic factors. This article explores the importance of people with a learning disability attaining a positive self-image. It discusses the effect of society's perception of people with learning disabilities, and questions the willingness of the community to accept such people in a non-judgmental way. It argues that staff caring for this client group have a vital role to play in how people with learning disabilities are perceived by others and discusses the effects that a market philosophy (Fromm, 1978) and the popular media have on society regarding people with learning disabilities. Self-worth is important to everyone; however, the article concludes that a person with a learning disability is seriously disadvantaged in this respect. This aspect of care therefore requires insight, support and skills on the part of those healthcare professionals caring for this client group.
Bandages: indications for use and Drug Tariff status
Authors: Griffiths Elizabeth , Williams Katherine
Published: December 2014

Community nurses need to have an up-to-date knowledge of which bandages are available on NHS prescription (i.e. on Drug Tariff) so that they can select the most appropriate bandage for their patient from those currently available. It seems that, for many years, both doctors and nurses have selected bandages for their patients without any clear knowledge of how the materials in the bandage will perform or what effect they will have (McCollum, 1992). Ideally, the nurse would first carry out an accurate assessment of the wound and then use this information to select an appropriate bandage, based on a full knowledge of its components, indications for use, and correct application technique. A bandage that is applied incorrectly can cause serious tissue damage. This article presents an up-to-date guide to the bandages currently available on Drug Tariff. However, since the Drug Tariff status of wound care products is constantly changing, community nurses need to keep up to date with the changes if they are to provide optimum care for their patients.
Transfoam Wave: the new addition to the Transfoam range
Authors: Williams Clare
Published: December 2014

There are many types of support surfaces available. Selection of a suitable support surface for an individual patient is best done by first identifying the patient's risk of pressure sore development. Transfoam was originally developed in 1990 and is designed for the medium-risk patient. The new design Transfoam Wave combines increased comfort with lower interface pressures, to provide another mattress in the Transfoam family. This product focus examines the original Transfoam mattress produced by Karomed and looks at the design and results of early testing of the new Transfoam Wave.
Lower limb amputation 3: the role of the nurse
Authors: Donohue Samantha Jane
Published: December 2014

This article, the third in a series on lower limb amputation, examines the role of the nurse in the pre- and postoperative care of patients undergoing amputation. The nurse has an integral role not only in providing care but also in liaising with other members of the multidisciplinary team in order to ensure that the person undergoing the amputation feels prepared for both the operation and discharge home. Amputation may greatly distort an individual's vision of him/herself as a person, a partner and a parent; ways in which this distortion can be minimized are explored.
Obesity: prevalence, causes, health risks and treatment
Authors: Green Sue M
Published: December 2014

This article reviews the latest research on the prevalence, causes, health risks and treatment of obesity. The attitudes and beliefs of nurses about obesity are also examined. Obesity is an increasing health problem. Contributing factors to the development of obesity include a genetic disposition to gain weight, a high fat diet and a lowered energy expenditure. Obesity is a risk factor for a number of chronic diseases and therefore weight loss is usually advisable. Treatment of obesity can take several approaches and requires a change in dietary intake. Changing dietary habits to reduce the health risks associated with obesity should be viewed differently from normal weight individuals dieting to achieve a cultural ideal. Nurses, health visitors and midwives should be knowledgeable about the possible causes, associated health risks and current treatment of obesity in order to provide appropriate care and support within the multidisciplinary team for their patients/clients. They should also be aware of their own personal attitudes and beliefs about obesity as these could affect the care given to patients and clients.
The Softform pressure-reducing mattress for high-risk patients
Authors: Fox Carolyn
Published: December 2014

This article highlights the fundamental difference between pressure-relief and pressure-reduction. The limitations of the conventional hospital mattress will be discussed in terms of lack of support properties and life expectancy. The need for a coordinated mattress replacement programme will be outlined and the advantages of the Softform pressure-reducing mattress will be described in detail.
Correspondence
Authors: Knape John , Barley Audrey
Published: December 2014

Your editioral on the disappointing turnout in the 1997 UKCC election (Vol 6(18 ): 1032) is premised on some fundamental misconceptions about the role of the UKCC and the way it is perceived by registered nurses, midwives and health visitors.
Improved community care needed for older people
Authors: Castledine George
Published: December 2014

At one time institutionalization was the only alternative to home care for elderly people with long-term or acute care needs because there were no community-based programmes in existence. Today, however, hospitalization is no longer considered the best option for dealing with this client group.
Quality infection control within existing resources
Authors: Horton Rozila
Published: December 2014

At a recent symposium on health at York University, Dr Kenneth Calman, Chief Medical Officer, Department of Health (DoH), and Professor Trevor Sheldon, Senior Research Fellow, Centre for Health Economics, delivered a clear message to senior health service managers: make more effective and efficient use of existing resources rather than relying on extra money from the Government. Noone would blame health service staff, irrespective of grade, discipline and responsibility, for feeling frustrated at what appears to be a direct challenge to the way in which they provide care. However, we must respond to this challenge.
Intravenous therapy: current practice and nursing concerns
Authors: Campbell Tanya , Lunn Denise
Published: December 2014

The field of intravenous (IV) therapy has been subject to major change, with increasing numbers of nurse taking on the high profile, technical aspects of care. The transfer of previously medicalized tasks such as cannulation has been welcomed by nurses who are keen to develop practical skills in order to embrace the concept of holistic patient care. This literature review aims to clarify the role of the nurse in IV therapy, exploring cannulation as a specific issue. Legal and professional aspects are discussed in terms of extended/expanded practice and practical aspects in terms of IV access and maintenance. Discussion focuses on a team approach to the management of IV therapy. Finally, the nursing process is applied to an IV therapy scenario. Exploration of the nursing issues enables practitioners to justify the expansion of individual practice in order to deliver holistic care and improve standards of service. The review concludes that nurse cannot afford to lose sight of the caring component of their role as a result of immersion in the culture of technical skill acquisition.
Catheterization: a need for improved patient management
Authors: Winson Linda
Published: December 2014

The complications arising from catheterization of the urinary bladder have been extensively researched and reviewed. It is widely accepted that, because of inherent risks, catheterization is a last resort in the management of urinary incontinence. However, anecdotal evidence suggests that the incidence of long-term catheterization for this purpose is increasing, particularly for the management of highly dependent patients in the community. Although catheterization is a common procedure, a high level of nursing knowledge and skill is required to achieve effective and safe management. This article reviews the principles of catheter management and the nurse's responsibility to the catheterized patient.
Outreach interventions for the homeless mentally ill
Authors: Jones Adrian , Scannell Tony
Published: December 2014

There has been a steady rise in the number of homeless mentally ill in Britain. This article reviews the scale of the problem and identifies the need for change within mental health services in order to address this challenge. It is argued that mainstream psychiatric services need to become more diverse and open in their approach to this potentially isolated group of users. The authors suggest that this could be achieved by embracing assertive outreach interventions. Innovative projects using a range of care providers, including voluntary workers, past users of the service and professional mental health workers, are discussed as an alternative framework to traditional services. In conclusion, the article highlights some of the professional and social implications for psychiatric nurses and mental health practice.
Primary healthcare workers: training needs in mental health
Authors: Ford Kelvin , Middleton John , Palmer Bob , Farrington Andy
Published: December 2014

Particular attention is currently being given to the role of primary healthcare workers in supporting people with mental health problems in primary care (McFadyen et al, 1996). The aim of this study was to survey the views of primary healthcare workers regarding their previous mental health training and to identify their current perceived mental health training needs. A sample of 200 primary healthcare workers within Trent Health Region were interviewed using a short semi-structured interview schedule. Forty-six completed questionnaires were also received. An additional 22 respondents participated in exploratory in-depth interviews. Respondents included GPs, health Visitors, practice nurses, district nurses, midwives and community psychiatric nurses. The need for further training in communication skills, particularly basic counselling skills, was highlighted. Respondents also perceived a need for additional training in coping with their own personal stress, the assessment and treatment of depression and stress/anxiety management in clients. Several themes which developed from the research were explored, including communication skills training, problems with collaborative working, coping with personal stress, the prevention of burnout and depression training. The reason why some respondents had no mental health training needs whatsoever was also addressed.
Conference Report
Authors: Cutcliffe John R
Published: December 2014

The Network for Psychiatric Nursing Research (NPNR) held two conferenes in 1997, in Oxford and Edinburgh. Delegates were able to participate in 12 key note presentations and over 20 Concurrent Sessions presented by a wide range of clinicians, educationlists and researchers. Despite the diverse nature of these presentations, two particular themes emerged from the conference.
Is the quest for evidence-based care detrimental to children's nursing?
Authors: Glasper Edward Alan , Ireland Lorraine
Published: December 2014

Evidence-based care and the expanded role of the nurse are inexorably linked. Facets of this are found in every specialist area of nursing. Children's nurses are no exception and they have proved their commitment to family-centred care over a period of many years. However, within the ranks of nurse educationalists now employed by the universities and not the NHS new tensions have emerged. The researchled ethos of the universities demands that nurses demonstrate expertise in the field of scientific enquiry. Although the philosophy of caring and research are not incongruent, there exists the potential that family empowerment may take a back seat to academic prowess. This article examines the background to this dilemma.
Nurse occupational stress research 4: the prevalence of stress
Authors: Wheeler Herman H
Published: December 2014

This article, the fourth in a six-part series on nurse occupational stress, reviews the prevalence of nurse stress. It will attempt to address questions which are both critical and crucial to an examination of the prevalence of nurse stress. Does the evidence support the claim that the levels of nurse stress within the new NHS are increasing? Does current nurse stress research methodology permit like-for-like comparisons of nurse stress methodology in relation to issues such es frequency and degree of stress? Are certain areas of nursing more stressful than others?
The nurse lecturer's lot is not a happy one
Authors: Castledine George
Published: December 2014

With all the current attention focusing on the role and function of the clinical nurse specialist, it is easy to forget about the nurse teacher. A recent survey by NATFHE (1997), the University and College Lecturers' Union, highlighted some disturbing trends in relation to the working conditions and contracts of lecturers.
The nurse's duty of care outside hospital premises
Authors: Dimond Bridgit
Published: December 2014

It was recently reported that nurses failed to assist a man who was having a heart attack 50 yards from the hospital because their trust had instructed them not to treat people outside hospital premises as it was not covered by its indemnity cover for such actions (Stokes, 1997). The trust has now changed its policy.
Handwashing: still a neglected practice in the clinical area
Authors: Gilmour Jean , Hughes Roisin
Published: December 2014

This article is an adaptation of the winning essay in the pre-registration section of the National Board for Northern Ireland Research Awards 1996. The authors conducted a literature review of handwashing after discovering during Clinical placements that, despite being well documented, handwashing is still not performed as necessary. The aim of handwashing is to remove transient microorganisms and prevent their transfer to susceptible patients. Inadequate training, lack of resources, chapped hands and poor reinforcement were identified by nurses as factors that accounted for poor handwashing. The Code of Professional Conduct states that ‘the professional has a duty to promote and safeguard the interests of clients.’ It is only a matter of time before major litigation occurs because of poor handwashing practice. It is concluded that all staff (trained and untrained) require regular educational updating to sustain good handwashing practices. Managers are responsible for ensuring the provision of adequate facilities and supplies of handwashing agents for all nurses in all clinical settings.
The digestive system: linking theory and practice
Authors: Hoyle Terence
Published: December 2014

This article, the second in the nutrition series, presents an outline of food chemistry and the digestion of energy-producing foods. It is hoped that this will facilitate understanding of some of the principles of nutrition. A number of ‘clinical points’ are highlighted to emphasize the link between theory and practice. The processes by which the chemical building blocks (carbon, oxygen, hydrogen and nitrogen) are formed into more complex molecules such as proteins, carbohydrates and fats are explained. The gross anatomy of the digestive system is outlined and the sites where digestive enzymes are secreted are identified. Regulation of the digestive system by endocrine secretions and the nervous system is described and tabulated.
Rehabilitation in multiple sclerosis: the potential nursing contribution
Authors: Nolan Mike , Nolan Jance
Published: December 2014

This article, the second in a series focusing on aspects of rehabilitation, considers the potential nursing role in relation to multiple sclerosis (MS). It begins with a brief description of the experience of MS as recounted by the individuals affected, which is then contrasted with current interventions which focus primarily on physical aspects of care. A number of areas of potential improvement are outlined, together with suggestions for a more comprehensive nursing role.
Surgeons' assistants: a new role for operating theatre nurses?
Authors: Hind Martin
Published: December 2014

In the current climate of changing nursing and medical roles, discussions about the role of the operating theatre nurse have been rekindled, with particular emphasis being placed on the role of the nurse as ‘assistant’ to the surgeon. This article examines perioperative roles and identifies and discusses the factors that have stimulated their development. It is argued that these roles are not necessarily new and that their recent re-emergence may have as much to do with the sustained drive to reduce junior doctors' hours as the need to enhance the quality of patient care. However, they may offer operating theatre nurses clearer direction and purpose to practice. Provided they can improve the quality of patient care and are given careful consideration, they may prove to be an opportunity worth exploiting.
An educational initiative in anaesthetic nursing practice
Authors: Martin Daphne , McCartney Anne
Published: December 2014

The National Board for Nurses, Midwives and Health Visitors in Northern Ireland (NBNI) has adopted the principles of the UKCC's recommendations for specialist nursing practice and incorporated these within their continuing education framework. Stage two of this framework decrees the standard required for specialist nursing practice (NBNI, 1995) and, as a result, a specialist anaesthetic nursing course has been instigated. The course extends over 44 weeks and includes 8 weeks of consolidation practice, comprising seven modules at degree and diploma level. The course gives the students an opportunity to deepen their knowledge, skills and attitudes in the field of anaesthetic nursing. Nurses were taught the necessary skills to work in collaboration with other professionals, patients and families in order to coordinate a patient-centred approach to perianaesthetic care. The role of the anaesthetic nurse specialist should be viewed as complementary to that of the anaesthetist. This course facilitates and encourages practitioners to move beyond registered practice on qualifying to a more specialized role where care is delivered in an innovative and creative manner.
The dilemma for service managers: which degree programme for their staff?
Authors: Murray Cyril , Thomas Mike
Published: December 2014

Service managers frequently ask us what the differences are between the ENB Higher Award and specialist practitioner qualifications. No answer has been forthcoming from the statutory bodies which has quetionably added to the mystique surrounding the differences between the two qualifications. It is easy to understand the reasons for the question. Nurse managers wish to balance the skill mix of their workforce to meet client need while providing advice to staff on how to develop their professional practice and career prospects. Clarity is required and therefore we would like to offer our perspective of the approach service managers should consider using to address these elements.
Lower limb amputation 4: some ethical considerations
Authors: Donohue Samantha Jane
Published: December 2014

For some people the prospect of amputation may offer an escape from the constant pain, infection and disability which have been part of their lives for many years. However, others may regard death as a preferable option. Denying treatment when the alternative prognosis is death causes much debate among healthcare professionals, families and carers. Ultimately, however, healthcare professionals must listen to the person in need of the amputation. The first article in this series illustrated the care pathway of a vascular patient, the second studied the surgical process of amputation and the third highlighted the importance of the nurse's role in the amputee's physiological, psychological and social care. This article, the last in the series, discusses the issues surrounding the person's decision not to have an amputation.
Nursing in war-time Guernsey: a preliminary review
Authors: Birchenall Peter
Published: December 2014

The research for this article was carried out in the Channel island of Guernsey during 1996-97 and focuses on the remarkable resilience of a small group of nurses as they strove to provide an emergency hospital service to the civilian population of Guernsey between 1940 and 1945, during which time German forces were in occupation. Inslghts are provided into a unique period of nursing history, giving a flavour of the harsh environment in which care was provided. Hospital records at the time described a nurse as ‘someone who earns her living nursing’, therefore the title ‘nurse’ is used collectively to describe both the qualified State Registered Nurse and the unqualified junior staff. The article is part of an ongoing oral history project representing a collaborative venture between the Department of Health Studies at the University of Lincolnshire and Humberside, and the School of Healthcare Studies at the University of Leeds. Data for this study were obtained from a series of semi-structured audio-taped interviews with 13 former nurses who worked at the States of Guernsey Emergency Hospital during the occupation. Supporting data were derived from official archives, news reports and other published literature. The article is based on the author's inaugural lecture delivered at The University of Lincoln Campus, Friday 30 May 1997.
Correspondence
Authors: Mummery Jane , Farmer ES
Published: December 2014

I was interested to read your editorial ‘Should the Government pay for long-term care’ (Vol 6(20): 1152). Quite understandably you did not attempt an answer. The arguments over how to fund long-term care for the elderly are part of the much wider debate of how the NHS can continue to cope with the rising demands placed upon it. But the needs of the vulnerable, such as the frail elderly, bring the reality underpinning this sometimes overly political debate into stark focus.
The importance of nursing in continuing care
Authors: Castledine George
Published: December 2014

It is not surprising that the UKCC has come to the conclusion in its latest report on the nursing and health visiting contribution to continuing care for older people that: ‘Continuing care remains an ambiguous concept both in its definition in professional and policy literature and in its operationalization in practice.’
The Legal Concept of Medical Negligence
Authors: Stauch Marc
Published: December 2014

Where a patient suffers injury in the course of receiving medical care, he/she may resort to legal action in order to gain compensation. If it can be shown that he/she did not really consent to the procedure, then an action in battery may lie. Much more often, the patient's complaint will be that the particular treatment administered was, in terms of its execution, deficient in some respect. Here, at least for NHS patients, this will involve bringing a claim in medical negligence. (For patients in the private sector, an alternative would be to bring an action for breach of contract; however, the salient legal principles remain virtually the same.)
Working in partnership to end ageism in mental health
Authors: Adams Trevor
Published: December 2014

Over the last 20 years, considerable changes have occurred within the specialty of dementia care nursing. First, there has been the development of new therapies which have shifted the emphasis away from keeping people ‘fed and cared for’ to enhancing personhood (Miller and Gwynne, 1971). Second, there has been the move into the community with the development of community psychiatric nursing services for people with dementia, day hospital and respite care.
The nursing management of MRSA on a spinal injuries unit
Authors: Tyler Claire
Published: December 2014

The aim of this article is to encourage nurses to question their actions when caring for patients with methicillin-resistant Staphylococcus aureus (MRSA). Some of the main effects of isolation are discussed with reference to specific problems encountered by spinal cord-injured patients in isolation. The advantages and potential problems of a policy for the management of MRSA in a spinal injuries unit are outlined. It concludes that it is not always necessary to isolate all patients who are colonized/infected with MRSA; provided that basic infection control measures are followed carefully, and staff, patients, and visitors are educated on the risks of MRSA, it is safe to nurse some of these patients on an open ward.
Drug therapy in the management of Parkinson's disease
Authors: Stevenson Tamsin
Published: December 2014

Parkinson's disease affects mainly the elderly population and is characterized by tremor, bradykinesia, rigidity and postural abnormalities. As the disease progresses, drug therapy is inevitable and the strategies used aim to correct the imbalance of neurotransmitters in the CNS. Antimuscarinic drugs counteract the excessive effects of acetylcholine while levodopa, dopamine agonists, selegiline and amantadine supplement or enhance the effects of dopamine. Although initally effective, these therepies are not without problems which include tolerance and long-term effects. This article aims to augment the reader's knowledge of the disease and the drug therapies available, including their place in therapy and their potential side-effects.
Biofeedback: a first-line treatment for idiopathic constipation
Authors: Storrie Julie B
Published: December 2014

This article defines the various types of defecatory problems which could be termed idiopathic constipation, and outlines the main diagnostic tests used to identify its origins. It highlights the limited role that laxatives, increased dietary fibre, and surgery can play in the management of this condition. It suggests the use of biofeedback and associated non-invasive strategies as the treatment of first choice in idiopathic constipation. The article stresses that as there is often a significant psychological cause or contribution to this condition, the counselling, discussion, and listening which biofeedback therapy entails are just as important as training patients to coordinate their defecatory muscles during straining.
Issues in user feedback on health services for elderly people
Authors: Brooker Dawn JR
Published: December 2014

This article highlights a number of difficulties experienced when collecting consumer feedback from elderly service users and offers suggestions as to how many of these problems can be overcome. Structured interviews would appear to provide the most reliable form of feedback for this client group. The importance of good communication and the fact that ageist and stereotypical attitudes need to be overcome before effective feedback can occur is emphasized. Finally, more research needs to be carried out on elderly clients' expectations of health care and which factors make the health service a positive or negative experience for them.
The Neuman Systems Model: application in a Canadian HIV setting
Authors: Mill Judy E
Published: December 2014

In healthcare research, education and practice there is evidence of a paradigm shift away from disease and illness towards an emphasis on wellness and health. The Neuman Systems Model (NSM) is a nursing model that has been used in a variety of settings with individuals, families and communities. The focus of this model on the prevention of illness and the promotion of health is congruent with the paradigm shift that has occurred in all areas of health care. A review of the literature revealed limited information on the use of nursing models in the clinical area of human immunodeficiency virus (HIV) or acquired immunodeficiency syndrome (AIDS). This article describes the application of the NSM in an HIV practice setting with reference to the current and future trends in health care in Canada.
Evaluation of the new Cairwave Therapy System in one hospital trust
Authors: Hampton Sylvia
Published: December 2014

The Pegasus Airwave mattress has been used for many years in the Eastbourne NHS Trust and has proven its efficiency in the prevention of pressure sores. Pegasus has now produced a new, improved, model: the Calrwave Therapy System. This article looks at criteria that may be used to determine whether the new model is suitable for patient care. The evaluation took the form of a randomized controlled study in which 12 mattresses were randomly allocated to patients — six Airwave mattresses and six Calrwave Therapy Systems — over a 4-month period. The results of the evaluation showed that patients found the mattress comfortable. An encompassing cover reduced the risk of cross-infection, rehabilitation was supported by the firm edges of the bed and patient movement was easier due to the soft cover. During the trial all patients remained free from pressure sores.
A study of out-of-hours telephone advice from an A&E department
Authors: Dale Jeremy , Williams Susan , Crouch Robert , Patel Anita
Published: December 2014

A prospective analysis of telephone calls to an accident and emergency (A&E) department during weekday evenings/nights and weekends was undertaken over a 3-month period. A telephone consultation record (TCR) proforma was developed to record information about each call for advice. The volume of calls, characteristics of callers and patients, nature of presented problems, and advice given were analysed. An average of 9.3 calls were documented during each weekend 24-hour period, and 3.3 calls during each weekday evening/night. Junior nurses took 93% of calls. Advice was sought for a broad range of problems, of which only 11% were musculoskeletal conditions or injuries. Twenty-six per cent of patients were advised to attend A&E, 35% were given self-care advice, and the remainder were advised to contact or see their Gp. There is considerable potential to develop a nurse-provlded telephone advice service, but the need for staff training and guidelines has to be addressed.
Evidence-based practice and nursing: the new panacea?
Authors: White Suzanne J
Published: December 2014

Evidence-based practice (ESP) is a method of problem solving which involves identifying the clinical problem, searching the literature, evaluating the research evidence and deciding on the intervention. The best evidence is thought to be that obtained from controlled experimental work, and the least value is attached to the authority and clinical experience of the practitioner. While the term appears to have emerged largely from the McMaster University Medical School in Canada, it is increasingly linked with cost-effectiveness in today's NHS. There are a number of difficulties with the approach. Not all nursing problems are capable of being reduced to a clear issue that can be solved by scientific means and many require artistry to find a solution. There is a limited experimental research base from which to select interventions, and researchers applying tor funding for non-experimental research may be disadvantaged. There may also be a temptation to use ESP to Justify restricting the choice of interventions tor both practitioner and patient.
Assessing the future of nursing research
Authors: Castledine George
Published: December 2014

The recent research assessment exercise (RAE) probably went unnoticed by most nurses, despite nursing's poor performance. To many it was just another academic rating exercise, exclusive to universities and institutions of higher education. However, this 4-year-long review of the state and progress of research revealed some interesting and important questions for the future of nursing research.
Paradoxical policies and their impact on mental health care
Authors: Townend Michael
Published: December 2014

A contemporary view of mental health services in the UK is that they should be community focused, integrated, and with a seamless interface between the community and hospital. However, a series of high profile inquiries (Ritchie and Lingham, 1994; Davies et al, 1995) have highlighted the shortfalls in such lofty ambitions by emphasizing difficulties in policy implementation.