bluuebunny/crossref_metadata_2025 huggingface dataset:
Statins: time to treat low-risk patients?
Authors: Greener Mark
Published: May 2014

In brief

▪ New study says that statins should be offered to low risk patients as well as high-risk patients ▪ Mixing atenolol with apple juice could reduce its efficacy ▪ A proactive approach to medicine management reduces inappropriate prescribing and medication-related problems ▪ Nurses want clearer guidance on when medicines can be administered with food or drink ▪ Taking probiotics can reduce antibiotic-related diarrhoea
Incretin therapies for type 2 diabetes: what nurses need to know
Authors: Capaldi Brenda
Published: May 2014

There are many patients with type 2 diabetes in the UK, and controlling blood glucose levels in these patients can be challenging. In this article, the use of incretin-based therapies (such as glucagon-like peptide-1 receptor agonists and dipeptidyl peptidase-4 inhibitors) in the management of type 2 diabetes is reviewed. The clinical utility and role of such therapies in the management of type 2 diabetes are discussed, and a direct comparison of the various incretin-based therapies is provided. The role of the specialist nurse in the use of incretin-based therapies is described. Overall, the use of incretin-based therapies as add-on therapy to conventional treatments improves glycaemic control in selected patients with type 2 diabetes and is generally well tolerated.
Dronedarone: the new kid on the block
Authors: O'Donovan Kate
Published: May 2014

Dronedarone is a new anti-arrhythmic drug with similar properties to amiodarone. It is indicated in the maintenance of sinus rhythm following successful cardioversion of atrial fibrillation or flutter but is recommended to be prescribed only after alternative treatment options have been considered. The recommended dosage is 400 mg twice daily taken with food. Although efficacious in the treatment of atrial fibrillation or flutter, concern exists regarding its use in patients with poor left ventricular function owing to its potential to exacerbate heart failure symptoms and cause myocardial decompensation. Although it does not possess the same toxic adverse event profile as amiodarone, particularly in relation to the thyroid gland, gastric disturbance is commonly reported following start of treatment, which is usually self-limiting. Its efficacy and impact on the patient from a rhythm management perspective, and its impact on patients with heart failure, have been investigated in several randomized, controlled trials, the largest of which was ATHENA. From a nurse prescribing perspective, baseline assessment and follow-up is integral to the optimal care of patients receiving dronedarone, particularly in relation to its effect on the conduction system, the renal system, and the hepatic system. Patient education is the cornerstone in identifying early-onset heart failure and liver injury as well as potential for drug interactions.
CRPS: diagnosis, management, and the nurse's role
Authors: Grieve Sharon , McCabe Candy
Published: May 2014

Complex regional pain syndrome (CRPS) is a little-known condition that may occasionally be encountered by nurses. The lack of knowledge about this condition may lead to delays in diagnosis and initiation of important rehabilitation strategies. The aim of this article is to raise awareness of CRPS and to provide information on how to diagnose and manage it. How nurses can play a role in identifying the condition promptly and initiating referral to specialist services will be demonstrated.
The ethics of prescribing in pregnancy for women with bipolar affective disorder
Authors: Graham Judith
Published: May 2014

This article explores ethical aspects of prescribing decisions in mental health nursing practice, specifically focused upon prescribing in bipolar affective disorder for women of childbearing age. The article uses an ethical framework to analyse prescribing considerations, providing focus upon potential problems in both prescription and non-prescription for this client group.
Eczema: A common skin condition in older people
Authors: Van Onselen Julie
Published: May 2014

Nurses can support older people with eczema by understanding the condition and treatment principles, including the use of emollients to prevent acute flares.
Nurse prescribing in a breast care unit
Authors: Day Shirley
Published: May 2014

Breast cancer has been the most common cancer in the UK since 1997, and now accounts for 31% of all new cancer cases in females (Cancer Research UK, 2012). To provide seamless care for the patients seen in the breast clinic at University College London Hospital, the author has become a nurse prescriber as part of her role as an advanced nurse practitioner. This allows autonomous practice in cancer follow-up clinics, where she can initiate therapy agreed by the multidisciplinary team and help the women to have a greater understanding of their treatment and the drug being prescribed. A thorough knowledge of the disease process and the pharmacology of the medications in common use is essential to be able to acheive safe and excellent practice.
Challenges of living with diabetic peripheral neuropathy
Authors: Fitzpatrick Ann
Published: May 2014

Diabetic peripheral neuropathy has received little attention from healthcare professionals in terms of recognition and treatment. Disease-modifying drugs for diabetic peripheral neuropathy are still in their infancy, but appropriate treatment of diabetes should help to alleviate some of the symptoms for the patient. Living with diabetic peripheral neuropathy impacts negatively on quality of life, and current medications available have many unwanted side effects and provide only moderate pain relief. From a nurse prescriber perspective, treating the patient with the appropriate drug poses a challenge because of the unwanted side effects of these medications.
Understanding individual reactions to opioids in pain management
Authors: O’Connor Laserina
Published: May 2014

Opioids are important analgesics in the management of acute and chronic pain. They can be very effective and, if they are used judiciously and with a detailed understanding of their pharmacology, safe. Pharmacotherapy is one of the mainstays of treatment of all forms of pain. This article focuses on opioids, inclusive of various routes of administration, and highlights the difference in their distinct parameters that need to be considered relative to the individual features of patients' pain. The potential for drug-drug interactions is explored in the context of opioids. Importantly, prescribers need to expect variability in patient responses to opioids and therefore notice each and every individual's response in order to achieve better therapeutic outcomes.
Common herbal-drug and food-drug interactions
Authors: Prieto-Graica Jose M
Published: May 2014

This article gives a general overview of the most common herb-drug interactions, their different mechanisms and an update on the regulatory framework which regulates herbal medicines in the UK. It proposes strategies and information sources to support professional advice and therapeutic choices in everyday prescribing practice.
How to… Supervise a general bath
Authors: Switzer John
Published: May 2014

In this article, John Switzer describes the importance of meeting residents' expectations when providing them with a general bath. A step-by-step approach can ensure that staff promote a systematic approach to this task that is often taken for granted.
Group psychotherapy for people with dementia
Authors: Cheston Richard , Jones Kerry , Gilliard Jane
Published: May 2014

Dr Richard Cheston, Kerry Jones and Professor Jane Gilliard report on the success of the Dementia Voice Group's psychotherapy project for people with dementia.
Altering medication forms: what you should know
Authors: Wright David J
Published: May 2014

Carers will often experience difficulties in giving medicines to clients with a condition affecting the swallowing reflex. What are the implications of altering a medicine's formulation?
What does quality of life mean for frail residents?
Authors: Susan Tester , Hubbard Gill , Downs Murna , MacDonald Charlotte , Murphy Joan
Published: May 2014

Frail older people have rarely been asked about their quality of life. The authors discuss the findings of a study on what quality of life means to this client group.
Quality of life in care: The resident's perspective
Authors: Kydd Angela
Published: May 2014

Angela Kydd reports on a study that asked older people about their lives. Of those surveyed, 13 were in hospital waiting to be moved to a care home and eight were in settled care home environments.
Communicating effectively with service users
Authors: Blood Rachel
Published: May 2014

The way in which we communicate has a huge influence on how others perceive us. Both verbal and non-verbal communication should always be positive and respectful to the people we are connecting with. Rachel Blood explains.
Enabling residents to bath easily and safely
Authors: Swann Julie
Published: May 2014

Julie Swann provides solutions to common problems surrounding this activity and offers a guide to the latest special bathing equipment on the market.
Understanding multiple sclerosis
Authors: Swann Julie
Published: May 2014

Multiple sclerosis generally starts in early adult life and affects more women than men. National Institute of Health and Clinical Excellence (NICE) (2003) estimates that ‘between three and seven people per 100,000 population are diagnosed with MS each year’. The Multiple Sclerosis Society (2005) describes it as ‘The most common neurological disorder among young adults, and affects around 2.5million people in the world, and 85 000 people in the UK. Every week around 50 people in the UK are diagnosed with MS. Diagnosis is usually between 20 and 40 years of age – rarely under 12 or over 55 years of age.’
Improving hydration: an issue of safety
Authors: Lecko Caroline
Published: May 2014

The National Patient Safety Agency (NPSA) has identified dehydration as a safety issue with the potential to cause harm to individuals in all healthcare settings.
Fall prevention is everyone's responsibility
Authors: Swann Julie
Published: May 2014

A fall can cause serious physical and psychological damage. Julie Swann discusses the factors involved in falling in older adults and the important role that staff can play in preventing further falls and serious injuries.
Career development: the preceptorship process
Authors: Ashurst Adrian
Published: May 2014

Newly qualified nurses require support and ongoing feedback to maintain confidence in their skills and improve their application of theory to practice. Adrian Ashurst describes the role of the preceptor in supporting those embarking on their nursing career.
Care of the older ostomate in the residential care setting
Authors: Black Pat
Published: May 2014

Some age-related illnesses can complicate stoma care. Pat Black considers the importance of self-care and maintaining independence for ostomates living in residential care.
The Hungry to be Heard campaign: tackling malnutrition
Authors: Russell Esmee
Published: May 2014

Two years after its launch, Esmee Russell of Age Concern talks about the charity's Hungry to be Heard campaign and its impact on reducing malnutrition in a number of care services.
Privacy and dignity in continence care: research review
Authors: Alaszewski Helen , Holdsworth Laura , Billings Jenny , Wagg Dr
Published: May 2014

People with incontinence problems are particularly vulnerable to feeling a loss of dignity. A recent study on dignity in care settings explored the factors important to residents in maintaining dignity during continence care.
Invest in training and enable staff to fulfil their potential
Authors: Thomas Oliver
Published: May 2014

Excellence in care is not a tick-box exercise, says Oliver Thomas. It's about creating the right culture, retaining staff, and giving people the tools to do their job.
Structured assessments of diabetic residents
Authors: Beckwith Sue
Published: May 2014

Every home must be aware of how to assess and plan for new and diabetic residents. This helps prevent complications and can detect previously undiagnosed diabetes. Sue Beckwith explains
Reducing variable consistency in thickened drinks
Authors: Payne Clare , Methven L. , Bell A.E. , Fairfield C.A. , Gosney M.A.
Published: May 2014

Clare Payne's study found large variations in the consistency of thickened drinks, which can cause aspiration or dehydration. Here she discusses what to consider when thickening drinks.
Relationship centred leadership and management
Authors: Blackburn Sharon
Published: May 2014

Sharon Blackburn explains how supervision, investing a keen interest in the development of your staff and maintaining the right attitude to coaching them enables them to flourish and improves care.
Improving mental health through learning
Authors: March Melissa
Published: May 2014

Learning can contribute to mental wellbeing in later life. Melissa March, Director of L4A, explains how volunteers, care homes, coordinators, friends and family can facilitate learning.
Dementia care: family and significant others
Authors: Keady John , Swarbrick Caroline
Published: May 2014

Residents with dementia and their relatives rate relationships as the most important determinant of their quality of life. Here, the authors explain how care homes can help support and understand these relationships.
The ‘I am’ film for modern care
Authors: Whittle Beccy
Published: May 2014

When it comes to promoting dignity in care, residents and staff from four Norfolk care homes are showing the rest of the country how it's done. Beccy whittle reports.
How to assist residents with sight loss in your home
Authors: Cattan Mima
Published: May 2014

Among the very old, sight loss often compounds other impacts of ageing much more than previously thought. Mima Cattan explains why and how findings from her research can help you to pinpoint the best way to help residents with sight loss in your home.
Could local authority social care cuts really affect you?
Authors: Collier Robert
Published: May 2014

Legal expert Robert Collier tells us about the different ways that local authorities could cut funding and what legal angles care homes can use to contest any proposed changes.
Understanding and identifying balance disorders
Authors: Swann Julie
Published: May 2014

Everyday in care homes you will see signs of poor balance and coordination, but how does it all work? Here, occupational therapist Julie Swann explains here why the different balance problems occur.
Managing dressing after having a stroke
Authors: Swann Julie I
Published: May 2014

A stroke can cause a loss of physical function, sensory, perceptual, and cognitive deficits. This all affects dressing, here we look at the processes involved in dressing and how care staff can assist residents to dress.
Corporate manslaughter and care: who is responsible?
Authors: Cave Tabitha
Published: May 2014

A recent prosecution under the Corporate Manslaughter act was a landmark case. Tabitha Cave explains how health and safety in the care sector may be affected by this and how to protect your residents.
How to provide nutritional snacks for your residents
Authors: Baic Sue
Published: May 2014

Research suggests that snacking is increasingly important to our diet with age. Dietitian Sue Baic explains why this is and gives practical advice about nutritionally optimizing snacking.
How the latest mental health strategy can guide practice
Authors: Harrison Deborah
Published: May 2014

Mental health problems such as depression are common but often undiagnosed in care homes. Deborah Harrison explains how care homes such as yours can facilitate good mental health using the strategy
Part two: The role of the health and social care worker
Authors: Newson Pauline
Published: May 2014

In the second part of the unit on the role of the health and social care worker, pauline Newson explains working relationships and how to work in ways to facilitate effective outcomes

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Practical care: Creative strategies for bathing
Authors: Johnson Roxanna H.
Published: May 2014

Sometimes bathing can be a difficult care task when the person has dementia and becomes resistant to care, yet there are many strategies that can help. roxanna Johnson, director of aging Consultants, explains what to do.
Understanding assessment and management of lymphoedema
Authors: Coulborn Anna , Hampton Sylvie
Published: May 2014

With help from a multidisciplinary team and with further education and training, nurses and care assistants can reduce swelling in lymphoedema. Anna Coulborn and Sylvie Hampton explain
Supporting individuals with learning disabilities
Authors: Veselinova Claire
Published: May 2014

This unit is designed to provide health and social care workers with the knowledge to explore the meaning of learning disability and to consider issues closely linked with learning disability support

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Trading places: staff at the receiving end of care
Authors: Harrison Denise , Spearing Emily , Cleal Megan
Published: May 2014

Denise Harrison talks to Emily spearing and Megan Cleal about their experience as service users in a Belgian home and how this has influenced their practice to ensure that residents’ dignity is maintained
Drug administration errors in diabetes
Authors: Wright Kerri
Published: May 2014

Receiving the wrong prescription or dose can have severe or even fatal consequences for residents. Kerri Wright discusses how staff can avoid making common mistakes
Assessing discomfort during dressing changes
Authors: Fletcher Jacqueline
Published: May 2014

Jacqueline Fletcher provides the tools for accurate evaluation, suitable product choices and individualized analgesic regimens to help achieve maximum comfort for residents
A multidisciplinary approach to person-centred practice
Authors: Elbourne Heather , May Andrée le
Published: May 2014

Dr Heather elbourne and Dr andrée le May collate research from a facility providing intermediate care and outline what nursing homes can learn from this service model and working with a rehabilitation team
Practising the principles of the Mental Capacity Act
Authors: Daniel Dionne , Dewing Jan
Published: May 2014

Dionne Daniel and Jan Dewing suggest practical steps to take to ensure that individuals are consulted with regard to health plans and daily activities. Consent ensures that the dignity of the client is maintained
Reducing administration errors: a case study
Authors: Johnson Karen
Published: May 2014

Karen Johnson describes the process of improving services following an unannounced inspection, through educating staff, auditing and providing correct documentation to ensure best practice
Safety and suitability of premises and equipment
Authors: Wharvell Tracy , Sheldon Jan
Published: May 2014

Service providers must continually review records, and comply with current legislation, to ensure that all people who enter the setting are not at risk of harm. Tracy Wavell and Jan Sheldon explain how
Making life richer: creating a compassionate community
Authors: Hall Deborah , Shucksmith Janet
Published: May 2014

Deborah Hall and Janet Shucksmith ask how staff can enable residents to be part of a compassionate community, and how struggling care homes can be encouraged to achieve this basic requirement
Diabetic foot ulcers: your questions answered
Authors: Newton Veronica , Roberts Peter
Published: May 2014

This article will detail the scale of diabetic foot problems in nursing and care homes and provide a series of five questions to help shape your assessment and management of DFUs
State of care: failing to meet minimum standards
Authors: Learner Sue
Published: May 2014

The Care Quality Commission's (CQC) report examines all care sectors for the first time and explores why some care services are failing to meet standards
Living with the ‘black dog’: depression in care homes
Authors: Beary Thomas
Published: May 2014

Depression is not a normal part of ageing, it affects old and young alike. Person-centred care is paramount when considering treatment and care delivery, as Thomas Beary explains
Skill mix: how to ensure safe and effective services
Authors: Dallinger Tim
Published: May 2014

What is the right mix of staff and what skills should they have to ensure safe, effective and efficient service provision? Hm Dallinger provides some practical checklists
Engaging the community through social media
Authors: Upward Tony
Published: May 2014

Do you want to promote the high-quality care you provide and get the community involved in events? tony Upward explores the different avenues in social media to help market your services
Changes to third-party harassment law
Authors: Cave Tabitha
Published: May 2014

Tabitha Cave explains the legal changes in third-party harassment and outlines the ways in which alternative claims can be made against employers who do not provide adequate support and protection for staff
Balancing the books: how to ensure financial viability
Authors: Nazir Sughra
Published: May 2014

Providers must ensure that they are compliant with regulations that require them to remain financially viable. sughra Nazir shares how providers can improving care quality businesses to
Contracts by email: the risks and how to avoid them
Authors: Young Anthony , Burnell Emma-Jane
Published: May 2014

Anthony Young and emma-Jane Burnell advise caution when care providers enter into contracts. It is importantto understand the obligations that may be subject to scrutiny by a third party
The benefits of gardens for people with dementia
Authors: Grove Kim
Published: May 2014

Gardens have great therapeutic benefits for people with dementia. Kim Grove explains what these benefits are and how nursing and care staff can assist people with dementia to use the garden safely
The development of evidenced-based falls assessment in Ireland
Authors: Duffy Anita
Published: May 2014

Residential care nurses caring for older people in Ireland are required to demonstrate clinical competence when assessing and managing falls. Legislation, policy and education require a multidisciplinary-team approach. Anita Duffy addresses the nursing priorities
Art therapy: stimulating non-verbal communication
Authors: Stevenson Melanie , Orr Kayleigh
Published: May 2014

Art therapy, a psychological intervention, uses art as a method of communication and is being embraced within residential care homes. Melanie Stevenson and Kayleigh Orr explain how art therapy can provide a creative, enhanced life for the older adult
Bored to death: tackling lack of activity in care homes
Authors: Boyd Andrea , Payne Joanne , Hutcheson Catriona , Bell Sheena
Published: May 2014

This article outlines how the provision of training for care home staff facilitates grading of activities to ensure they are appropriate to each resident's ability and interests. Boyd et al highlight how this reduces the risk of discouragement and hostility from residents
Credence to Creeds
Authors: Boyd Kenneth
Published: May 2014

The majority of people in Britain today are not formal members of churches or other religious organisations, but most people believe in God. Religious thoughts and emotions, if not beliefs and practices, are important to many ∼ especially when they are ill, dying or bereaved
Malaria Prophylaxis
Authors: Cook Gordon
Published: May 2014

As millions of new malaria infections occur each year and multiple drug resistance rises, it looks like malaria is here to stay. Gordon Cook decribes the current prophylaxis.
Electronic ambush on the superhighway
Authors: Richards Sue
Published: May 2014

UKCC Council member Sue Richards gives us a glimpse of data protection documents currently under the UKCC's scrutiny.
Skin, summer and sun
Authors: Saunders Diana
Published: May 2014

Have you noticed how the weather forecast gives health warnings these days? On sunny days many of the weather reports on the radio and television tell the public how long they can be in the sun, without a sunscreen, before their skin (normal skin type) will react adversely. It is a message that is constantly reinforced, not only by the weathermen but also by health care professionals. It is an important message to get across. The incidence of skin cancer is rising and there needs to be a national campaign publicising prevention and recognition of symptoms to encourage early diagnosis and cut mortality rates.
Ethics of Immunisation
Authors: Baird Anne
Published: May 2014

The immunisation of children is an emotive issue that arouses strong feelings and opinions among certain sections of the population. The anti-vaccination lobby was active 200 years ago when Jenner first introduced the smallpox vaccine (Department of Health (DoH), 1996) and remains active today.
Why Patients Sue: No-One Says Sorry
Authors: Tingle John
Published: May 2014

All health-care professionals now practise in an environment where patients increasingly resort to litigation and formal complaints to resolve disputes
HRT: Why do Women Give up?
Authors: Hughes Liz
Published: May 2014

Despite the well documented advantages of hormone replacement therapy (HRT) the majority of peri-menopausal and post-menopausal women do not use it. Of those who commence HRT a high proportion discontinue within a year, and a national opinion poll (NOP) survey of the UK in 1991 showed that 25% of women stopped taking HRT within 6 months, often without discussion with their GP (NOP, 1991).
Achieve Utopia Through DIY
Authors: Richards Sue
Published: May 2014

A vision of utopia; no cross-professional boundaries and the latest technology available to aid diagnosis and treatment.
Contraception and Safer Sex
Authors: Ellerby Katherine
Published: May 2014

Teenage sexual health, in the light of the Government's Health of the Nation report (1992) and amendments to the 1993 Education Act, is a cause for concern. This study examines the knowledge of contraception, safer sex practices and family planning services among a group of 16-18 year old sixth form students.

The quantitative study used a structured questionnaire adapted for self-completion by a non-probability convenience sample of 250 sixth form pupils. Data were collected during morning tutorials, analysed manually.

The overall findings of the study demonstrate a limited knowledge of local family planning services, with poor perception of GP services and confidentiality. A lack of clear knowledge of the methods of contraception in relation to prevention of pregnancy and safer sex was also demonstrated with evidence of risk taking behaviour.

The implications of the findings are considered in relation to the need for further research into the sexual behaviour of 16–18 year olds. Also demonstrated was the need to improve the educational and family planning services available.
Prescribing practice: A need to change old habits?
Authors: Ainley Harriett
Published: May 2014

It has been argued that UK prescribers are often reluctant to prescribe new drugs. What are the implications for those practice nurses who will soon gain prescribing rights? Harriett Ainley investigates.
Letters
Authors: Smith Catherine Gordon , Charlton Rodger , Thomas Monica , Young Lynn
Published: May 2014

The revisiting venesection article in the November issue has provoked one reader to raise some important questions about this procedure. One of the authors of the venesection article responds with some thought-provoking points of his own.

The debate about practice nurses' pay continues. One reader questions the difference between the way doctors and nurses are rewarded for their training and experience. Lynn Young from the RCN responds.
Vaccinations
Authors: Driver Carolyn
Published: May 2014

Vaccinations have few contraindications and have so successfully prevented some diseases that people forget the suffering and death that once was common. Carolyn Driver explains how vaccines work and reviews some important considerations when assessing travellers' risk.
Caring for patients who provoke strong feelings
Authors: Franks Vicky , Griffiths Peter
Published: May 2014

Vicky Franks and Peter Griffiths explain how understanding patients' unconscious reactions can help nurses give better care and cope with the pressures of the modern NHS.
Supplementary prescribing: Workable in practice?
Authors: Baird Anne
Published: May 2014

Anne Baird reviews the consultation document on supplementary prescribing in the light of findings from qualitative interviews with nurses and doctors.
Sex, COPD and nursing's Dr Ruth
Authors: Haggerty Sharon
Published: May 2014

Sharon Haggerty spoke to Naomi Kempner about how she advises her COPD patients to enjoy a fulfilling sex life
Sourcing reliable information on cancer
Authors: Charman Fiona
Published: May 2014

Fiona Charman has set up a cancer information service in London. She reveals how to access reliable information for people with cancer
Reducing the misery of constipation in children
Authors: Rogers June
Published: May 2014

June Rogers outlines the causes and management of childhood constipation, which she argues is an often-overlooked problem that can cause a lot of misery
Supporting patients with long-term conditions
Authors: Saville Marianna , Humphrey Claire , Mama Jubin
Published: May 2014

Marianna Saville, Claire Humphrey and Jubin Mama discuss the experience of pilots in Southwark Primary Care Trust whose aim is to improve the care of people with long-term conditions
Letter
Authors: Szymanski Belinda
Published: May 2014

We have received further correspondence on the removal of qualifications from the NMC Statement of Entry, suggesting that these concerns are more widespread than many may have realized.We will seek further clarification from the NMC.To have your say, please e-mail liam@markallengroup.com
Janet Johnson: A calling to care
Authors: Johnson Janet
Published: May 2014

Janet Johnson received her calling to practice nursing in 1978. She spoke to Liam Benison about her passion and career
A method for assessing digestive symptoms
Authors: Leeds Anthony
Published: May 2014

Anthony Leeds highlights the key considerations in the assessment of digestive illnesses including constipation.
Erythroderma
Authors: Watkins Jean
Published: May 2014

This elderly woman had suffered with psoriasis since her teens. She had coped with it well over the years and successfully managed several exacerbations with the help of her local practice and occasional visits to the hospital. This time things were not going well. She had developed a generalized reddening of the skin which, after a couple of days, was flaking and peeling. In herself, she was beginning to feel unwell and was running a slight fever. A diagnosis of erythrodermic psoriasis was made and she was admitted to hospital.
Does size matter?
Authors: Martin Jeannett
Published: May 2014

The Department of Health in England has set a clear requirement for all primary care trusts (PCTs) to implement universal practice-based commissioning (PBC) by December 2006. PCTs are trying to do this at the same time as they are setting in motion a process to reconfigure themselves and, as part of a massive restructure, possibly also divest themselves of their provider function.
Occupational asthma
Authors: Mukherjee R , Burge PS
Published: May 2014

R Mukherjee and PS Burge outline the risks of occupational asthma and how to recognize those patients who may be suffering.
Our health, our say
Authors: Young Lynn
Published: May 2014

The White Paper, Our Health, Our Care, Our Say (Department of Health, 2006), is being much discussed in primary care and with good reasons. The main criticism is that it is far too long—230 pages could have been reduced by 25% without losing any of the plot. Thankfully, there are no surprises, but it will act as a catalyst for opening up the market to competition in primary care. This, for the main part, is new territory for primary care folk, and we are already seeing action taking place which indicates that new players are moving in and taking over the manage-ment of traditional general practice.
Letter
Authors: Cooper Maggie
Published: May 2014

Maggie Cooper writes with some concerns about last month's article on human papillomavirus. The author was invited to reply, but has not responded.
Better management of COPD between primary and secondary care
Authors: Wolstenholme Roger J
Published: May 2014

Roger Wolstenholme explains how some nurse-led initiatives are improving the management of patients with chronic obstructive pulmonary disease (COPD) across the primary–secondary care interface
Emergency contraception
Authors: Watkins Jean
Published: May 2014

Mary was a fit, healthy 15-year-old who came to the surgery asking to be seen urgently. The receptionist questioned the need to be seen that day but Mary was too embarrassed to explain. It had taken all her courage to make this demand and fearing judgment, she accepted an appointment for the next week and left. When she returned, it was too late. She was already pregnant.
Consider long-acting contraceptive methods
Authors: Padbury Vicky
Published: May 2014

Vicky Padbury highlights nurses’ need to ensure that they can fully inform women about longacting reversible contraceptive (LARC) methods or refer women on for further help
Discover the difference: Research, audit and evaluation explained
Authors: Foley Claire
Published: May 2014

Claire Foley defines the difference between research, clinical audit and service evaluations, and discusses the key ethical and regulatory considerations for each
A new way to provide oxygen for COPD
Authors: South Gail
Published: May 2014

Gail South explains the new system for providing oxygen therapy to patients with COPD and the implications for general practice
Bev Cox: Knowledge is power
Authors: Cox Bev
Published: May 2014

Bev Cox must have a double. She is module leader for heart failure and COPD at Education for Health (formerly the NRTC) in Warwick, Nurse Practitioner at Edgwick Medical Centre in Coventry, a special visiting lecturer at Coventry University, nurse representative on the professional executive committee (PEC) of Coventry Teaching PCT, and she recently accepted an invitation to join the Practice Nursing editorial board. So when does Bev sleep? ‘Any time when I should really be doing housework,’ she says.
Working together for excellence in diabetes
Authors: Vanterpool Grace E
Published: May 2014

Grace Vanterpool outlines the aims of MODEL, a team of professionals which aims to improve standards of care in diabetes
Red faces: Making the diagnosis
Authors: Watkins Jean
Published: May 2014

A variety of infectious diseases occur in childhood, such as measles, rubella and scarlet fever. Although children are the most often affected, non-immune adults are also at risk of these infections. Most remain common, but some, thanks to the advent of routine immunization, are rarely seen in the UK. However, unfounded fears about the measles, mumps and rubella (MMR) vaccination, have allowed immunity in the community to drop and some cases are beginning to recur.
Fit for purpose?
Authors: Benison Líam
Published: May 2014

The Council for Healthcare Regulatory Excellence (CHRE) has completed its review into the Nursing and Midwifery Council (NMC) requested by Health Minister Ben Bradshaw on 14 March in response to allegations raised in parliament. The CHRE (2008) has found that, while the NMC is carrying out its statutory functions, it is failing to meet the standards the public has a right to expect of a regulator of health professionals.
Supporting vulnerable adults
Authors: Wood Julie
Published: May 2014

Julie Wood explains how personalized care planning and multidisciplinary working can improve outcomes for a person who is housebound, dependent and has complex needs. She explores the experience of Bhahimbi
Care of adolescents in transition
Authors: Gelder Carole
Published: May 2014

Teenagers diagnosed with diabetes as children have special needs as they grow in independence and transfer from the care of the paediatric diabetes team. Carole Gelder considers the practice nurse’s contribution
Ocular history-taking skills in primary care
Authors: Gibbons Helen , Amro Raed , Cox Carol
Published: May 2014

Health professionals need to be able to obtain a thorough history from a patient presenting with eye symptoms to enable prompt diagnosis and treatment
Recognizing the signs of dehydration
Authors: Benelam Bridget
Published: May 2014

Bridget Benelam explains why good hydration is important for health and how to recognize the signs in at-risk groups
A brief guide to pneumococcal vaccination
Authors: Martin Jeannett
Published: May 2014

Jeannett Martin reviews the risks of pneumococcal disease and the indications for vaccination
Atrial fibrillation part 1: pathophysiology
Authors: Cottrell Christine
Published: May 2014

Christine Cottrell discusses the physiological basis of atrial fibrillation and considers its causes and risk factors Alliance group
The diagnosis and assessment of COPD
Authors: Loveridge Chris
Published: May 2014

COPD is currently the fifth biggest killer in the UK. Chris Loveridge highlights the importance of clinical history and assessment in the diagnosis of COPD alongside objective lung function testing
A short-term fix with long-term problems
Authors: Moulton Cathy
Published: May 2014

Cathy Moulton supports the contention that cuts to nursing numbers is a shortsighted policy
Paul Jeffrey: Chase what you want
Authors: Jeffrey Paul
Published: May 2014

Paul Jeffrey has over 30 years' experience as a nurse in general practice. He highlights the need to be informed and have a wide skill set
Assessing the signs of dementia
Authors: Weatherhead Ian , Courtney Carol
Published: May 2014

Ian Weatherhead and Carol Courtney discuss the assessment of signs of disordered cognition, memory and mood, which may indicate dementia
Point-of-care testing for coeliac disease
Authors: Kurien Matthew , Sanders David
Published: May 2014

The presentation of coeliac disease in general practice can be varied, and delay in diagnosis reduces patients’ quality of life. Matthew Kurien and David Sanders look at the evidence for point-of-care tests, which may help speed up diagnostic times
A review of the current nutritional guidelines for diabetes
Authors: Mellor Duane , Phillips Anne
Published: May 2014

Duane Mellor provides an overview of the latest Diabetes UK guidelines on nutrition and the influence of weight control and carbohydrate counting on the management of diabetes
Managing obesity in young adults
Authors: Avery Amanda
Published: May 2014

The transition from the teenage years to young adulthood involves changes that can have a negative impact on food choices. Amanda Avery identifies the problems associated with obesity in young adults and possible ways to intervene
Patricia Mcintosh: Ensuring safe practice
Authors: Mcintosh Patricia
Published: May 2014

Patricia Mcintosh emphasizes the need to ensure nurses are receiving the support that they require to be competent, confident, and professional
Smoking cessation in adults who are homeless
Authors: Bigelow April , Stepka Denyse
Published: May 2014

To identify the perceived barriers to smoking cessation and guide future interventions, a cross-sectional study was conducted in southeast Michigan to describe the smoking characteristics of adults who are homeless. Demographics: The study included survey data from 43 homeless adults who were current smokers, had an interest in attempting to quit smoking, and had visited or had been residing in a local homeless shelter. Conclusions: Descriptive analysis revealed that the majority of the population were caucasian, male, and had a mean age of 40 years. Approximately 63% of the population smoked 0.5–1 pack of cigarettes daily. Just over two thirds (67%) had attempted to quit smoking in the past, but only 16.2% was able to abstain for more than 3 months. Cravings for tobacco, personal stress, and weight gain were perceived as the greatest barriers to quitting. Implications for practice: These findings suggest a need to initiate smoking cessation programmes among smokers who are homeless. Morbidity and mortality linked to smoking-related illness among homeless adults may be reduced by the introduction of tailored, nurse-led smoking cessation programmes. Social support programmes aimed at smoking cessation may be more effective than pharmacological intervention in this population.
Understanding the mechanisms of autism
Authors: Evans Paul
Published: May 2014

Paul Evans gives an insight into the mechanisms at work in autism. A good understanding can help with planning support and interventions in different settings
Injustice in the workplace
Authors: Hooper Roz
Published: May 2014

Roz Hooper explains how RCN lawyers can help a nurse file a claim against an employer for an employment injustice or dismissal
Practice nurses want their leads and advisers' support to continue
Authors: Benison Liam
Published: May 2014

Aim: To explore practice nurses' views of the practice nurse lead/adviser role and find out if they want this role to continue after the abolition of primary care trusts in England on 31 March 2013. Method: An online survey was conducted via SurveyMonkey®. One open-ended and four closed questions were asked to investigate practice nurses' views of the lead/adviser role. The survey was advertised in Practice Nursing journal, the Practice Nursing Update email newsletter, on the Practice Nursing website, in the Independent Nurse email newsletter and by word of mouth. Results: A total of 248 responses were received, of whom 184 (74.2%) reported having a practice nurse lead/adviser in their local area and 239 (96.4%) wanted the lead/adviser role to continue. Conclusions: Practice nurse respondents to this survey voiced overwhelming support for the practice nurse lead/adviser role to continue, with 92.7% taking the opportunity of this survey to express their views on the role's value and the consequences of losing it. Policy-makers, decision-makers and commissioners should take note of the strength of practice nurses' opinion on this issue (albeit from a small sample) and act to ensure that at least an equivalent level of professional support as that provided by PCTs is put in place for practice nurses across England as soon as possible after 1 April.
Nikki Henson: Leading from the CCG
Authors: Henson Nikki
Published: May 2014

Nikki Henson enjoys combining her clinical work with providing professional support for her colleagues through her CCG
QOF: new headlines, new rewards
Authors: Champion Gillian
Published: May 2014

With recent revisions to the Quality and Outcomes Framework (QOF), Gillian Champion looks at the changes and considers the implications for practice nurses' workload
Preventing the spread of measles
Authors: Watkins Jean
Published: May 2014

Jean Watkins considers the prevention and management of measles in light of the recent outbreak
Using CDs and tapes
Authors: Harding Jacqueline , Iannuzzelli Paul
Published: May 2014

Recorded stories, music, songs and rhymes are all fun and easily accessible to children of all ages. Jacqueline Harding and Paul Iannuzzelli look at how to make the most of CDs and tapes, what might appeal to different ages and how you might use them
Feeling loved and wanted
Authors: Lindon Jennie
Published: May 2014

Affectionate relationships are not an optional extra in childcare. Babies and toddlers do not switch off their need to feel cherished and welcome just because they are with a non-family carer. Jennie Lindon explains
Displaying children’s work
Authors: Harries Judith
Published: May 2014

Do you enjoy painting and other creative activities with your children? Are your walls and kitchen cupboards groaning under the strain of children’s artwork? Is the fridge buried under pieces of paper? Here are some new ideas on how to display children’s work and show how much you value their efforts
Exploring balls and boxes
Authors: Jackson Caroline , Miller Collette
Published: May 2014

Babies and young children love to explore objects around them. The simplest resources, such as empty boxes and a few balls, can provide entertainment as well as encourage an understanding of basic mathematical ideas
Having fun with wrapping paper
Authors: Jackson Caroline , Miller Collette
Published: May 2014

Add a seasonal touch to your activities this month by giving children Christmas wrapping paper to scrunch. Any kind of paper will do but metallic paper is shiny and can be explored to the full without being torn
When children rely on comforters
Authors: Riddall-Leech Sheila
Published: May 2014

Many children have a favourite blanket or toy that they carry with them wherever they go. Sheila Riddall-Leech explains why they can become so important to some children and what you need to do about it
What to do when children wet or soil themselves
Authors: Hardcastle Lindy
Published: May 2014

If you care for children in your own home, it can be difficult to cope with puddles on the carpet and damp patches on the sofa. So how do you deal with a child who is slow to become reliably toilet-trained, or even worse, the one you thought was home and dry who then regresses?
Words you need to know: Children's centres
Authors: Griffin Sue
Published: May 2014

One of the cornerstones of central government policy for children and families in England is now children’s centres. Sue Griffin explains the aims and aspirations of this policy, and raises some of the uncertainties surrounding it
Staying safe in winter
Authors: Barratt Juliet
Published: May 2014

It’s cold, it’s dark – but children still want to play outside special precautions you need to take in winter?
Puppets and pantomimes
Authors: Warner Maureen
Published: May 2014

January is the traditional month for pantomimes and theatre trips. Here are three ways of celebrating the start to a new year that should appeal to all ages. Younger children may need some help
When ‘no’ means ‘no’
Authors: Tassoni Penny
Published: May 2014

Most people agree that children need to be taught that ‘no’ means ‘no’. They will also tell you how children today don’t know the meaning of the word! Penny Tassoni talks about the importance of ‘no’
What to do when children swear
Authors: Tassoni Penny
Published: May 2014

Working with children presents a multitude of dilemmas. What to do about children who swear or use bad language is one of them. Penny Tassoni looks at your options, whatever the age of the children you care for
Good hygiene practice: beds, linen and towels
Authors: Walker Miranda
Published: May 2014

Good hygiene procedures are crucial to maintaining the health and safety of children. Standard 7 says that childcarers must take ‘positive steps to prevent the spread of infection’. So what does this mean in practice when it comes to choosing and using towels, bedding and mattresses?
Food intolerance: what carers need to know
Authors: Harrod-Wild Kate
Published: May 2014

Food allergies and intolerance are more likely to emerge in infancy so if you provide full day care for babies and young children it could easily be you who spots the first signs. But do you know what to look for? And how do you care for a child who has a food intolerance?
Growing vegetable tops and seeds
Authors: Jackson Caroline , Miller Collette
Published: May 2014

This activity introduces children to the process of growing. Using vegetable tops as well as seeds not only makes it affordable but means children can predict and compare how each grow
Making the most of cuddly toys
Authors: Jones Caroline , Lord Lorraine
Published: May 2014

Soft toys are part and parcel of a young child’s life. From the day a child is born well meaning adults bring cuddly gifts, often the bigger the better. But do they have a place outside the bedroom or are they simply a nuisance? Caroline Jones and Lorraine Lord look at their educational benefits
Making fruit bottles
Authors: Jackson Caroline , Miller Collette
Published: May 2014

Fruit bottles are easy to make and will last long after your summer fruit activity. They give children the chance to use their senses to explore summer fruit in an unusual way
Encouraging good behaviour
Authors: Fawcett Alison
Published: May 2014

What do we mean by good behaviour? Isn’t it just a case of knowing what is acceptable or appropriate in different circumstances? But how do we help children to learn this? Alison Fawcett explains