bluuebunny/crossref_metadata_2025 huggingface dataset:
Pressure ulcer prevention and treatment: the Transair range
Authors: Gray David
Published: May 2014

The Transair range has been updated as a result of clinical and technical advances. The Transair 500 cushion system utilizes foam and air technology to minimize disturbance to the user. Clinical trials suggest that this cushion is of benefit in both the prevention and treatment of pressure ulcers. The Transair 1001 alternating pressure air overlay and the Transair 2002 mattress replacement have both been revised to provide improved performance and both have been subjected to clinical trials. The results of these trials suggest that both have a role in the prevention and treatment of pressure sores in the individual in the high/very high risk group. This article examines these innovations in the Transair mattress and seating systems.
The Sims Portex Catheter Valve: an alternative to the leg bag
Authors: Doherty Willie
Published: May 2014

It is often assumed when a patient is catheterized that leg bags and night drainage bags are the most appropriate method of management. This decision is frequently taken with no regard for the patient's mental state, mobility or comfort.
The nature of health promotion in acute and community settings
Authors: Whitehead Dean
Published: May 2014

Since the late 1980s, there has been a consistent call from nursing's advisory and legislative bodies to incorporate the discipline of health promotion into the nursing profession. On reflection, however, evidence indicates that despite these calls there has not been a universal uptake of health promotional activity into the profession. What is evident is that where health promotional activity does take place, it occurs more in the community than in the acute setting. This article sets out to explore the reasons for this. It suggests that certain current and future activities may help to further promote the universal adoption of health promotion within nursing practice.
The Diana community nursing team and paediatric palliative care
Authors: Davies Ruth E
Published: May 2014

This article describes the work of the Diana community nursing teams, a new nurse-led service funded by the Department of Health (DoH) to commemorate the life and work of Diana, Princess of Wales. It identifies paediatric palliative care as an emerging specialty within children's nursing and discusses how children and young people with life-limiting/threatening conditions and their families may benefit from this new service. It is anticipated that the Diana teams will work with existing services such as children's hospitals, outreach services, children's hospices, social services and education and voluntary agencies. A key element of this service will be the ability of Diana team members to work across professional and organizational boundaries to provide a seamless care service and promote the concept of ‘joined-up working’ (Hyman, 1998). Education in this specialty, preferably multidisciplinary education, is needed so that healthcare professionals in this field can share knowledge, skills and research findings and deliver up-to-date care based on clinical effectiveness.
The use of urinary dipstix in children with high-risk renal tracts
Authors: Poole Cathy
Published: May 2014

Urinary tract infection (UTI) is one of the most common acute illnesses found in infants and children and up to 5% of girls and 1% of boys will experience one or more episodes. Babies and children with abnormal renal tracts are at risk of developing scarred kidneys as a result of recurrent UTl, leading to an increased risk of hypertension and end-stage renal failure in later life. It seems logical, therefore, to place high priority on the early detection, prompt treatment and adequate follow up of children with high-risk renal tracts. This article describes the use of home urine testing for the early detection of UTI in children with high-risk renal tracts.
Confidentiality 1: nurses' duty to respect patient confidentiality
Authors: Dimond Bridgit
Published: May 2014

Trust is at the heart of the nurse/patient relationship, yet many nurses find themselves in situations where they are torn between their duty of confidentiality to the patient and other duties. This series of articles seeks to analyse the source of the duty of confidentiality and discusses individual situations giving rise to conflict within the statutory law context.
Health and safety in the NHS
Authors: Wilson Jo
Published: May 2014

With the increase in the number of employer liability claims there is a need for all healthcare organizations to demonstrate that they can meet the requirements of NHS health and safety issues (HSG(97)6). The NHS is the second biggest employer in Europe and is currently paying out in excess of £30 million on employer liability cases. Health and safety strategy should aim to remedy the current situation, enabling healthcare providers to meet legal and common law duties of care. A clear and focused programme for action can be established, building on the current momentum for change and development.
Children need protecting in death as well as life
Authors: Glasper Edward A , Powell Catherine
Published: May 2014

The last decades of the 20th century have been particularly malevolent for some children, e.g. those abandoned in Romania, the victims of Beverly Allitt and, now, the children who were dismembered after death. These will continue to haunt the nursing profession whose maxim is ‘first do the patient no harm’.
CORRESPONDENCE
Authors: Gebhardt KS
Published: May 2014

I read with interest Professor Castledine’s column ‘General nursing does not seem to have progressed’ (Vol 8(21): 1470) and while I recognize that it was written from personal experience and agree with some of the points expressed, I must also beg to differ on others.
Confidentiality 12: the problems posed by suicide and euthanasia
Authors: Dimond Bridgit
Published: May 2014

Jenny White, a hospice nurse, is caring for Peggy who is in the terminal stages of motor neurone disease. Peggy lives at home and is cared for by her husband John with support from the community health team and social services. John confides to Jenny that he has promised his wife that when her suffering becomes unbearable he will help her to end her life. Afterwards, John says he will have no further desire to continue life alone. Should Jenny respect the confidential nature of this information?
Patients deserve trust not surveillance cameras
Authors: Beckford-Ball James
Published: May 2014

The recent exposure of Dr David Southall and his colleagues in a report from the NHS Executive (2000) has once again highlighted issues of consent and personal freedom in health care. The report deals primarily with the controversy surrounding Dr Southall's use of children in the clinical trials of experimental ventilator equipment, where parents alleged that correct procedures were not followed in the procurement of consent and that their children suffered long-term brain damage and even death.
The development of a standardised approach to wound care in the ICU
Authors: Hadcock Janet L
Published: May 2014

Reflection and evaluation of wound care administered within the intensive care unit where the author is based suggested that an inadequate level of care was being provided. No structured approach existed; documentation was poor, with practitioners struggling to make decisions on appropriate care. A research study supported these reflections, and implied that wound care was delivered on an ad hoc basis. Results indicated that this was due to the limited knowledge base of practitioners in relation to the wound healing process, and wound management. Few staff had ever received any training on this topic and most knowledge was acquired through trial and error. No evidence-based approach to wound care was in place: thus, care was random and outdated. The results from the research study stimulated the development of a comprehensive evidence-based reference guide on the topic of wound care, which was designed for use in the clinical setting, and has allowed the development of a structured approach to wound care.
Academic research must be relevant to clinicians
Authors: Curzio Joan , Kinn Sue
Published: May 2014

Many clinical nurses feel that academic research frequently lacks credibility and relevance to them in clinical practice, as much of the published nursing research has focused on nursing theory or other nursing academic issues. For practitioners, research credibility is about whether the project is attempting to answer a practice-based question and whether the results are communicated in an understandable way.
Integrated nursing in primary care and analysis of nurses' caseloads
Authors: Headland Cheryl , Crown Nicola , Pringle Mike
Published: May 2014

Over the past two decades both government and professional bodies have continually emphasized the need for an integrated approach to nursing. In reality, however, a review of the literature provides little evidence to suggest that this has been achieved. What it does show, in fact, are the complexities involved in the establishment of such an approach. This study was designed to develop an integrated nursing team within Collingham Medical Centre and to describe a methodology, which could be replicated by other teams. Studies have described the benefits and pitfalls of this integrated working but this is the first description of its implementation.
WEB WATCH
Authors: Mangan Paul
Published: May 2014

Welcome to Web Watch, where we try to highlight some of the most valuable resources available to nurses on the world-wide web. This edition focuses on paediatric nursing. You will note that there are many thousands of web sites devoted to children's nursing or paediatrics (or pediatrics in the American spelling). We offer these as a starting base. Please note that we have retained the spelling offered by the web site as in some cases this is important in retrieving the site from the Internet.
Assessment of eating and drinking in a child with a gastostomy
Authors: Sharpe Geraldine
Published: May 2014

During periods of short-term (respite) care a full and comprehensive assessment is essential if the wellbeing of a child with complex healthcare needs is to be maintained or advanced in the parents' absence. Eating and drinking is just one component of an holistic assessment carried out at The Children's Trust in Tadworth. There is an increasing use of different gastrostomy devices, feed products and regimes to meet the individual needs of a child and his/her family. The assessment tool used reflects the tension of using an holistic approach while trying to unravel or breakdown complex care needs into manageable ‘chunks’ for documentation purposes. The role of the parents is pivotal in ensuring the success of the assessment process.
Pharmacological interventions in type 2 diabetes: the role of nurses
Authors: Rodgers Jill
Published: May 2014

Type 2 diabetes is complex and difficult to treat, and patients often present with hyperlipidaemia and hypertension. We now have compelling evidence that adequate treatment of hyperglycaemia, together with tight blood pressure control, can reduce the risk of developing long-term complications of diabetes. This article explores the syndrome of type 2 diabetes, including some of the causal mechanisms. The various forms of treatment are explored: diet, exercise, different oral hypoglycaemic agents and insulin therapy. Finally, the importance of the nurse in assessing the most suitable therapeutic intervention for people with type 2 diabetes is outlined.
Reducing the spread of tuberculosis in the homeless population
Authors: Rayner Diana
Published: May 2014

Tuberculosis (TB) is an old infectious disease that has re-emerged in recent years and is responsible for many deaths throughout the world. Homeless people residing in shelters and hostels within inner city areas of the UK and the USA are at risk from this serious disease. Interventions to control the spread of TB are described in the literature researched; these include the introduction of inducements to encourage participation in screening programmes and the recommendation of directly observed therapy. The literature reflects the partial success of these programmes in the UK and USA. Targeting homeless persons most at risk is challenging as is gaining accurate information on those who are affected by TB. Effective coordination of care by healthcare providers in hospital and the community is imperative. It appears that healthcare professionals are becoming more prescriptive in their approach which is relinquishing the homeless population from taking responsibility for their own health care.
Article Review
Authors: Cutcliffe John R , Ward Martin F
Published: May 2014

This study attempted to illicit the knowledge and attitudes of mental health nurses to electroconvulsive therapy (ECT). A total of 167 questionnaires containing attitude/knowledge scales were returned from the 345 sent out. The author discovered limitations in the reliability of the instrument and thus reliable measures of the respondents' knowledge of ECT were not obtained. The author's findings indicated correlations with higher levels of knowledge and (a) length of experience and (b) area of clinical practice. He also noted significant variations in knowledge of cognitive side-effects. The author concludes that nurses' knowledge of ECT requires improvement in many cases and that this has implications for nurse education.
A staff support mechanism: the transformational partnership
Authors: Cushen Noreen , Wigens Lynne
Published: May 2014

There have been many changes in nursing over the past decade, e.g. the movement of nursing education into higher educational sectors and the generation of many new nursing roles. The development of senior roles within nursing could potentially lead to isolation and, consequently, there may be calls for complementary support mechanisms. A transformational partnership is advocated, whereby nurses working in different organizations/specialties can provide mutual support. Existing support mechanisms for senior nursing can be variable and a transformational partnership can complement these as well as providing mutual clinical support. There are many advantages to this form of partnership which include professional and personal development as well as time out to reflect on practice. It requires commitment to the validity of the concept of professional support across traditional boundaries. A framework based on Holt's (1994) change theory is suggested as a method of implementing this initiative more widely within neighbouring organizations.
Web Watch
Authors: Mangan Paul
Published: May 2014

Welcome to this edition of Web Watch. This time we look at the world of mailing lists. These are often a good way to ask specific questions, or seek advice from specialist colleagues around the world. The list serve mechanism is usually used by sending an e-mail to a specific address with the words ‘subscribe me’ in the e-mail title. Once you have become a member of one or more lists you and all other members of the list will be able to receive all mail sent concerning your chosen subject.
Respite care innovations for carers of people with dementia
Authors: Longshaw Sharon , Perks Anne
Published: May 2014

The importance of family carers to making a reality of community care policy is now widely recognized. The central role of carers was recently confirmed by the launch of ‘The Carers' National Strategy’ (Department of Health (DoH), 1999). In his foreword to this document, the Prime Minister, Tony Blair, acknowledged carers as the ‘unsung heros of British life’ and pledged to raise the level and quality of the support that carers receive. Although the primary responsibility for meeting carers' needs still rests with local authorities the strategy charges everyone involved in the caring services with paying greater attention to supporting family members. In allocating monies to move the strategy forward the Government identified the provision of short breaks as one of the major priorities. This article describes the development of an innovative service for people with dementia and their carers in Sheffield. The service evolved following a research study on the views of carers and of people with dementia which identified the need for the provision of short breaks which were flexible, responsive and person-centred.
A new matron: a positive initiative for nursing?
Authors: Castledine George
Published: May 2014

Much has been made of the Government's wish to bring back matron. In the early days the matron was a subordinate official. For example, in 1752, at St Thomas' Hospital, her duties were to ‘take care that nurses do their duty diligently and that they lodge in the appropriate house’ (Graves, 1947). From 1755 she was paid £60 per year and was considered little more than a superviser and housekeeper under the direction of the lay administration. She ordered the food and watched over the female staff. In those days nurses were not trained and needed close supervision and control.
Biogel Reveal: a puncture indication system from Regent Medical
Authors: Parker Lynn J
Published: May 2014

Gloves provide an essential barrier against contamination and are an important item of personal protective equipment. Gloves used in clinical practice do leak although there is no direct evidence that such leaks result in transmission of infection. Double-gloving is recommended in theatre as a means of reducing hand injury during surgical procedures. Biogel Reveal is a double-glove puncture indication system that shows punctures as a visible green colour when damaged.
From ‘nits’ to ‘crabs’?: school nurses and sexual health
Authors: Evans David T
Published: May 2014

The state of education and service provision relating to young people and sex, sexualities, and sexual health is currently a major national challenge. Nurses working in the compulsory education sector are at the direct interchange between clients and their obvious experiential and academic needs, and attitudes and systems that frequently seem to fail them. From concerned parents and members of the public, through the teaching and nursing professions, to the UK Government, the message is the same: something must be done to improve the current status quo. The problem lies in the different beliefs about what to do and how to do it. School nurses are in a prime position to improve sexual health education and services for young people. However, it is unreasonable to expect school nurses, who are frequently overburdened with task-oriented jobs, to be effective with an additional remit for sexual health education without adequate support, resources and effective professional training. This article explores the role of school nurses as it develops to encompass numerous aspects of sexual health care. In order to enhance and promote these changes in line with client needs the article examines the strengths, weaknesses, opportunities and threats (SWOT analysis) of this changing role.
A model of independence for children with learning disabilities
Authors: Laverty Helen , Reet Mary
Published: May 2014

This article outlines the work undertaken to find a suitable model for planning respite care for children with disabilities. The model ‘This is Me’ and the informal life events assessment tool ‘Hello, This is Me!’, which supports it, are described. The use of a person-centred care planning system is well documented in the care of adults with learning disabilities (Sanderson, 1997). This process should begin at the start of a person's life, as recommended by The Children Act 1989, and the documents ‘Signposts for Success’ (NHS Executive, 1998) and ‘Don't Forget Us’ (Mental Health Foundation, 1997). The article describes the development of a person-centred approach to respite care which is underpinned with a basic care premise.
Use of Pressurease and Airform mattresses in pressure ulcer care
Authors: Collins Fiona , Hampton Sylvie
Published: May 2014

Large cell dynamic air mattresses are effective in the prevention of pressure ulcers but they still have inherent problems, e.g. the ability of the mattresses to move patients along the mattress through the inflation and deflation of the cells. Also, there have been reports that the inflation and deflation of cells can cause motion sickness. This article reviews two mattresses from Sareo Healthcare Ltd: a static system, Pressurease; and a unique dynamic system, Airform. These two systems offer a cost-effective and clinically effective method of pressure ulcer prevention and therapy.
The use of Askina saline in the wound cleansing process
Authors: Williams Clare
Published: May 2014

After the removal of a dressing from a wound, wound cleansing is often the first action to be taken by the nurse. Saline or tap water is often used to loosen the dressing and therefore help to remove it. It can also be used for the subsequent cleansing of the wound if required. B/Braun Medical has a range of modern wound care products for all healing phases of acute and chronic wounds and this article will look at their saline range.
Handwashing facilities in the clinical area: a literature review
Authors: Ward Deborah
Published: May 2014

Handwashing is without doubt the most important intervention in the control of cross-infection. However, many healthcare staff do not comply with the procedure. One of the factors that contributes towards this is a lack of adequate and appropriate handwashing facilities. This article looks at the literature relating to handwashing and identifies what adequate and appropriate facilities actually are, with recommended standards for clinical areas. It concludes by highlighting that a greater commitment is needed from managers in this area in order to improve compliance with handwashing and therefore reduce infection rates.
Web Watch
Authors: Mangan Paul
Published: May 2014

Welcome to this edition of Web Watch. This time we look at sites of particular interest to nurses working in the area of critical care. The range of Internet sites by nurses and for nursing is almost overwhelming and those we present here are necessarily a cross-section of the material available. As ever we urge you to take into account that you should use your professional judgment about any material you receive from the Internet, just as you would when reading material in print.
The same complaints are still made about the NHS
Authors: Tingle John
Published: May 2014

In the last edition I highlighted some of the issues that were raised in a recent Health Service Ombudsman's (HSO) report (Vol 9(21): 2198). The latest HSO report (HSO, 2000) shows the same errors being repeated; complaints include inpatient and outpatient hospital care, family health services, the work of NHS conveners and the conduct of independent reviews. Poor recording and patient complaint handling are also emphasized yet again.
Web Watch
Authors: Mangan Paul
Published: May 2014

Welcome to Web Watch, our regular guide to resources on the world-wide Web. This is a special issue reflecting the recent change in Dutch law, which has made Holland the first country in the world to legalize euthanasia. While the subject sharply divides opinion, we feel that it is important that nurses are able to come to their own decisions after reading arguments from both sides of the debate.
How nurses can build trusting relationships with clients
Authors: Cutcliffe John R , Ward Martin F
Published: May 2014

This article presents another review from the Network for Psychiatric Nursing Research (NPNR) National Journal Club. The article reviewed was Repper et al's (1994) ‘How can nurses build trusting relationships with people who have severe and long-term mental health problems? Experiences of case managers and their clients.’ The collated feedback comments from the regional journal clubs is based on the format proposed by Cormack (1991). The views expressed in this review are those of the journal club members and not necessarily those of the NPNR.
A nursing career in the Army
Authors: Lancaster Captain Andrea
Published: May 2014

This is the first in a series of three career focus articles discussing nursing in the armed forces. The first concentrates on the Army and subsequent issues will describe nursing in the Royal Navy and the Royal Airforce.
Nursing needs defining: new initiative launched
Authors: Castledine George
Published: May 2014

There is an urgent need to review what is meant by the term ‘nursing’. Definitions of nursing vary according to who is using them and how individual nurses see their role. Most of us would probably accept the best known definitions in principle, but would argue that they need reviewing and are not very realistic.
WEB WATCH
Authors: Ancell Bill , Mangan Paul
Published: May 2014

Welcome to this regular column of the British Journal of Nursing. The idea behind Web Watch is to bring together in each issue a collection of world-wide Web pages that can be found on the Internet. The content of the Web sites provided will hopefully contain information that might be useful or interesting to nurses.
Wound care: Askina Transorbent and Askina Biofilm Transparent
Authors: Williams Clare
Published: May 2014

Selecting the correct dressing for a wound can be complicated as there are so many products from which to choose. The selection process is made easier once the healthcare professional has performed a holistic assessment. This article discusses some of the principles of wound management and the efficacy of Askina Transorbent and Askina Biofilm, two new products from B/Braun. Both of these maintain the moist environment required for optimum wound healing to take place.
Prescribing must not be at the expense of nursing
Authors: Scott Helen
Published: May 2014

The Government has just announced that nurses are to be allowed to prescribe beyond the limited nurses' formulary. These powers will initially be given to nurses caring for patients with chronic conditions and nurses working in A&E departments and walk-in centres. Details of exactly who will be prescribing what have yet to be agreed and there is to be a 6-week consultation period (see p. 322).
Contraception: what has changed over the past decade?
Authors: Andrews Gilly
Published: May 2014

The past decade has seen major advances in contraceptive technology. These have resulted in the launch of several new highly effective methods of contraception and also significant improvements in existing methods. The main purpose of this article is to review how the contraceptive field has changed over the past 10 years, explain the new methods that have become available, e.g. hormone-releasing intrauterine systems, hormone implants and female condoms, re-examine existing methods, and mention new research and how this has affected clinical practice over the past decade. When discussing contraception, clients should be given up-to-date and accurate information on currently available methods: their efficacy, advantages, disadvantages and how the method works. As with any other specialty in medicine, nurses offering contraceptive advice should ensure they regularly update their knowledge and are aware of new developments and research in order to facilitate their clients in making an informed choice. New research and developments affect the choices and potentially the health of a large part of the population.
Factors influencing nurses' inferences about patient pain
Authors: Loveman Emma , Gale Anthony
Published: May 2014

This study examined the factors that influence nurses' perception of patient pain. Sixteen vignettes were constructed on the basis of interviews with nurses about factors affecting their perception of patient pain and previous published literature. Four variables were systematically varied within a factorial design: diagnosis (surgery vs oncology), level of patient mobility, presence or absence of physical and behavioural signs, and patient gender. Twenty-seven nurses rated each vignette for degree of inferred patient pain and degree of patient psychological distress. Mobility and positive signs of pain had statistically significant effects on nurses' judgments of inferred pain (P<0.001), but diagnosis had no main effect. Significant interactions showed that: inferred pain in male patients was seen to be greater when immobile while mobility had no effect on the inferred pain of female patients (P<0.003); oncology patients (compared with surgical patients) had greater inferred pain when displaying positive signs (P<0.024); and positive signs yielded higher ratings where patients were immobile (P<0.001). Female patients were perceived to experience higher psychological distress than men (P<0.037) and oncology patients were perceived to experience higher distress than surgical patients (P<0.005). Ratings of perceived pain and distress were significantly correlated but did not differ in magnitude. Offered a choice of analgesics to relieve pain for each of the patients depicted, nurses typically chose those with the lowest strength.
Confidentiality 15: child protection and unsuitable employees
Authors: Dimond Bridgit
Published: May 2014

Mavis Brown learnt that Bob Downs was applying for the post of care assistant to work in the paediatric ward. She knew him from her home town where he had a reputation as a child abuser. What action should she take?
To record or not to record: documentation in clinical supervision
Authors: Cutcliffe John R
Published: May 2014

Despite the continued interest of nurses in clinical supervision there remain many unanswered questions and unresolved issues. One such key issue is that of record keeping within clinical supervision. Consequently, this article reviews the limited literature that addresses this issue. It is evident that there are three principle discrete positions regarding recording in supervision and these are summarized as (1) the superviser records minimum data to meet the needs of audit (2) the supervisee makes extensive notes for his/her learning journal, reflective diary and (3) the superviser records headings or key words to be used as an aide-mèmoire. The article then uses three case studies to illustrate particular concerns that the trainee supervisees have raised with regard to record keeping that centre around these three positions, and discusses the issues that arise from these concerns. As a result of this discussion, the author reasons that, when entering supervision, either as a new superviser or as a supervisee, it may well be necessary and beneficial to give mind to issues of recording. While it is unlikely that there is one ‘perfect way’ that will suit every practitioner, the article concludes with some general guidelines which may help in this deliberation.
InstantCath from Hollister: pre-lubricated self-catheterization
Authors: Easton Susie
Published: May 2014

Clean intermittent self-catheterization (CISC) is not a new concept. Although some of the earliest references date back 30 BC the technique did not gain popularity or acceptance until the mid 1970s. An American team of urologists led by Lapides was responsible for the definitive research into the technique. With reference to urinary tract infection the team found there was no advantage in using a sterile technique over a clean one and that patient compliance was reduced when a sterile technique was required (Lapides et al, 1974).
A nursing career in the Royal Navy
Authors: Smyth Roberta
Published: May 2014

In 1987, after having worked for 12 months in a busy Birmingham hospital, I decided to do something challenging by joining the Queen Alexandra's Royal Naval Nursing Services (QARNNS).
More emphasis must be put on resuscitation skills
Authors: Scott Helen
Published: May 2014

Recent reports relating to the ‘do not resuscitate’ order that was written by a junior doctor in the case notes of a 67-year-old woman with cancer before consulting the patient or the patient's family make for disturbing reading. These reports have led Age Concern to reiterate its worries that age discrimination is rife in the NHS.
Early intervention programme for infants with Down's syndrome
Authors: Katz Shire
Published: May 2014

This article describes an early intervention programme for infants with Down's syndrome (DS) implemented by a registered nurse. The purpose of this programme was to help the families cope with the realities of raising a child with DS and help the infant fulfil his/her maximum potential. Small groups of three–four families with their infants met weekly with the nurse for 2-hour sessions. Each session was divided into two parts: exercises and discussion of issues relating to DS. Implications for nursing practice, education and management are discussed.
Professional commitment of nurses when off-duty
Authors: Castledine George
Published: May 2014

To what extent does nurses' professional commitment affect their lives outside the work environment? The UKCC's (1992) Code of Professional Conduct states: ‘Each registered nurse, midwife and health visitor shall act, at all times, in such a manner as to: safeguard and promote the interests of individual patients and clients; serve the interests of society; justify public trust and confidence; and uphold and enhance the good standing of the professions.’
Good practice guidance for continence services
Authors: Williams Kate
Published: May 2014

The Department of Health (DoH) has just published Good Practice in Continence Services (DoH, 2000). This review of continence services was instituted in 1998 to update the existing guidance on continence services set out in An Agenda for Action (DoH, 1991). The message is clear: incontinence is a treatable condition and nurses are most likely to be at the forefront of service provision.
Ageism and the abuse of older people in health and social care
Authors: Ward Deborah
Published: May 2014

Ageing is a natural process and yet ageism, ageist practice and abuse of older people occur among not only the general public but also in health and social care settings. Recent media reports have highlighted delays in meeting the needs of older people, physical and psychological abuse and that decisions are being made about whether or not to resuscitate an older patient without consultation with the patient and his/her family (e.g. British Journal of Nursing, 2000). This article looks at ageism and the abuse of older people and discusses what can be done to achieve quality care for older people while dealing with obstacles such as poor collaboration between agencies, a lack of support for carers and the belief that the needs of older people are less important than those of the young.
Treating mixed aetiology ulcers in a man undergoing drug rehabilitation
Authors: Butcher Martyn
Published: May 2014

Lower leg ulceration is a condition which is generally associated with the older population; however, medical conditions and social circumstances can place some clients at increased risk. This case study looks at the treament of a patient undergoing drug rehabilitation whose leg ulceratiuon developed as a direct result of his previous intravenous habit. It demonstrates that with correct assessment and management mixed aetiology ulceration can be successfully treated.
The community care of a patient with a fungating wound
Authors: Boon Helen , Brophy Joanne , Lee Janice
Published: May 2014

This case study will discuss the treatment of a malignant fungating wound and the effects that it had on a patient and his family. The article also demonstrates how interprofessional working has benefits for patients, carers and staff.
Sharing information and clinical experiences
Authors: Gray David
Published: May 2014

Welcome to the second issue of the BJN supplement for nurse specialists in the field of tissue viability. Many thanks to all those who communicated their thoughts on the first issue and to those who have suggested ideas for articles.
A case study in evidence-based wound management
Authors: Patten Joyce
Published: May 2014

On the first of July 1998, Frank Dobson, the then Secretary of State for Health, revealed the consultation document ‘A First Class Service’ (Department of Health (DoH), 1998). This article describes a wound management case study which showed how a first class service was provided for a patient with very severe pressure ulcers and complex medical problems. A multiprofessional approach to her complex and challenging problems was maintained. Evidence-based guidelines for the prevention and management of pressure damage were followed, supported by modern researched-based wound management and pressure relief. In addition, risk management strategies were observed, and provided the basis for planning and evaluating her individualized care.
The formation of a new tissue viability nurses' group
Authors: Haughton Bill
Published: May 2014

In recent years, there have been several attempts to develop a national organization to represent the professional interests of tissue viability nurse specialists. These attempts have, for various reasons, proved unsuccessful, and the group, which came to be known as the National Association of Tissue Viability Nurse Specialists, never attained the status that everyone involved hoped it might.
Biogel Skinsense N: surgical glove management for latex allergies
Authors: Tanner Judith
Published: May 2014

Healthcare staff with a high occupational exposure to latex gloves, such as those who work in the operating theatre, have a higher than average incidence of latex allergies. Certain patient groups are also known to be considered ‘high risk’ for latex allergies. When wearing gloves, staff allergic to latex and those working with patients allergic to latex must wear latex-free gloves to protect themselves and their patients. Of all the different types of gloves available — examination, medical or diagnostic — surgical gloves have to meet the highest standards, offering both protection and comfort. However, latex-free surgical gloves have previously lacked some of the ‘comfort’ qualities of natural latex. This article describes appropriate glove management for latex allergies and looks at the new generation of latex-free surgical gloves.
What constitutes good care for people with dementia?
Authors: Ericson Iréne , Hellström Ingrid , Lundh Ulla , Nolan Mike
Published: May 2014

Person-centred care for people with dementia is an aspiration of both family and professional carers, but what constitutes person-centred care and how it can be achieved is less clear. This article describes a Swedish study in which in-depth interviews were completed with both family and professional carers of people with dementia with the purpose of exploring what they considered to be ‘best care’. Important areas of similarity and difference were identified and the results suggest that both groups of carers need to work closely together if person-centred care is to become a reality.
Postoperative nausea management and patient-controlled analgesia
Authors: Bibby Paul F
Published: May 2014

Following the establishment of an acute pain service in one UK acute NHS trust, including the introduction of patient-controlled analgesia (PCA), pain scoring, and a rationalization of the use of simple analgesics, attention was drawn to an apparent increase in postoperative nausea and vomiting (PONV) among women given PCA following abdominal hysterectomy. Audits were conducted into clinical practice and patient satisfaction and it was agreed that an evaluation of the evidence should be conducted to ensure that the correct direction for development in the management of PONV could be established. This article discusses the evidence surrounding the issues regarding the management of PONV in patients who have been given PCA. The possibility of adding antiemetics to the analgesic solution, and the choice of antiemetic drugs, are investigated. Other factors that can affect the incidence of PONV in patients with PCA are also discussed, and an auditable framework for the evaluation of clinically effective practice is suggested.
Web Watch
Authors: Gibson Sue
Published: May 2014

Welcome to Web Watch, our regular guide to resources on the world-wide web. This issue looks at sites concerning continence and continence promotion from the UK and abroad.
Dansac Invent convex in the management of flush ileostomy
Authors: Mckenzie Frances D , Ingram Victoria A
Published: May 2014

This article examines the use of the Dansac Invent convex drainable stoma appliance. A review of the literature highlights the indications for use of convexity and discusses the potential contraindications. A short case study describes the use of convex appliances in a patient with a flush, high-output ileostomy.
The management of ischaemic and periamputation pain
Authors: Duncan Fiona , Haigh Carol , Marshall Joanne , Wriggley Paula
Published: May 2014

This article describes the development and pilot application of a management tool designed to support healthcare practitioners in the management of ischaemic and periamputation pain. The ischaemic management periamputation care (IMPAC) guidelines have been piloted in the authors' clinical area and early results suggest that there are positive benefits accruing to patients and ward staff.
Role of CarboFlex in the nursing management of wound odour
Authors: Williams Clare
Published: May 2014

Managing wound malodour is one of the most difficult challenges facing healthcare professionals. This article looks at the causes of wound odour, methods of assessment and strategies for management. It examines the structure of CarboFlex odour control dressing manufactured by ConvaTec, its indications for use, application technique and the research that demonstrates its ability to adsorb odour and absorb exudate.
Psychological wellbeing of patients with rheumatoid arthritis
Authors: Read Elizabeth , McEachern Clare , Mitchell Theresa
Published: May 2014

The impetus for this multiphased project was the realization that rheumatoid arthritis (RA) is not only physically debilitating, but also a cause of severe psychological distress, which is often unacknowledged. A small sample of patients (n=15) were interviewed to identify their main areas of psychological distress caused by RA, and data were analysed thematically. These themes formed the basis of a questionnaire that was distributed to a random sample of inpatients and outpatients with RA. This larger sample (n=140) prioritized the areas of distress that were identified by the interviewed sample of patients. This led to the development of an education programme for nurses.The authors describe the impetus for the project, the activities and processes associated with data collection, and the development and evaluation of the education programme.
ARTICLE REVIEW
Authors: Cutcliffe John R , Ward Martin F
Published: May 2014

The above paper reports on a study that interviewed 17 care providers about their caring experiences on a hospital psychiatric ward, and attempted to illicit the meaning of this work. The study used Ricoeur's (1976) phenomenological hermeneutic method, and induced three themes which illuminated the meaning of care provided. These were described as: being in the midst of human storage, moving towards a human care of relations, and struggling with the ‘old and the new’. The authors then interpreted and discussed these findings in the light of a previously published interview study (Pejlert et al, 1995), which obtained the experiences of the patients who lived on a long-term psychiatric ward. The authors conclude that attending to ingrained attitudes of the past and their influence on the new approaches to care is essential to understand changes in ways of doing nursing tasks and ways of relating to clients.
Development of clinical guidelines for the sedation of children
Authors: Smith Jo , Callaghan Linda
Published: May 2014

Young children may be unwilling or unable to cooperate if they are required to remain motionless for a prolonged period of time. In the hospitalized child, investigative procedures perceived as painful or threatening may need the administration of a sedative. Clinical guidelines, within a large teaching hospital NHS trust in the North of England, were implemented in an attempt to reduce the diversity of the practices of healthcare professionals caring for the child requiring sedation. The guidelines were formulated by a multidisciplinary team and, in conjunction with active dissemination strategies, resulted in a change in practice that included: (1) improved communication and cooperation between departments (2) implementation of starvation times before the administration of a sedative, and (3) the appropriate referrals to a senior paediatrician to seek advice if contraindications to sedation were identified. Audit was integral to the process, facilitating the comparison of actual practice with the standards developed from the guidelines and ensuring a continuous monitoring programme.
A falls risk-assessment tool in an elderly care environment
Authors: Kinn Sue , Hood Kay
Published: May 2014

Falls are a major cause of morbidity and mortality among elderly people. In an inpatient setting it has been suggested that the introduction of risk-assessment tools may be an important way of managing the issue. The study reported in this article was carried out in two stages. First, fall incidents were identified retrospectively using 'falls incident forms' and nursing notes, and the characteristics and management of patients who had fallen were compared with those who had not fallen. A risk-assessment tool and care plan were developed and evaluated prospectively. By analysing the data in stage one it was found that falls incidence reporting was poor and patients who had fallen had more evidence of previous falls than those who had not fallen. In stage two staff found the risk-assessment tool and care plan easy to complete; however, there was little documentation about whether any appropriate interventions, specific to the individuals risk score, were carried out. Appropriate interventions identified on the risk-assessment tool were put into place inconsistently. As a result of this work the hospital has set up a multidisciplinary group to look at falls management.
The new learning disabilities White Paper: did it forget something?
Authors: Aylott Jill
Published: May 2014

One of the exciting developments in the new learning disabilities White Paper (Department of Health (DoH), 2001) is that it involved extensive consultation with service users. Its underpinning principles of civil rights, independence, choice and inclusion have generated some innovative goals for people with a learning disability for the future.
A nurse's aid to clinical selection of pressure-reducing equipment
Authors: Stanton Julie
Published: May 2014

The selection of appropriate pressure-relieving equipment for individuals in the community is an important process in the prevention of pressure ulcers. The clinical decision is made by community nurses who are accountable for their actions and who therefore have to have clear rationale for the decisions they make. Risk tools are not a completely reliable or valid method of assessing patients. The current national guidelines (National Institute for Clinical Excellence (NICE), 2001) are not specific in relation to the selection or choice of equipment. This article explores how these decisions are made.
Tissue viability nurses must have a united front
Authors: Ballard Kate
Published: May 2014

There are an estimated 500 tissue viability specialists practising throughout the UK, and thousands of nurses with organizational responsibility for the speciality. These nurses make key decisions for their trusts and face clinical dilemmas and managerial challenges unique to their specialty on a daily basis. However, a new Audit Commission report on ward staffing has issued a challenge for nurses, particularly clinical nurse specialists, to prove their worth (Audit Commission, 2001). The Audit Commission report states that even though many trusts now employ specialist nurses, it is not clear what their impact is, and the report questions whether nurse specialists have deskilled ward-based nurses and caused discontent.