bluuebunny/crossref_metadata_2025 huggingface dataset:
Macrodantin in the treatment of urinary tract infections
Authors: Couling Rowena
Published: May 2014

Nitrofurantoin is a long-established and proven antibacterial agent used for the treatment and prophylaxis of uncomplicated lower urinary tract infections caused by the most common uropathogens. Macrodantin is a macrocrystalline formulation of nitrofurantoin. The macrocrystalline formulation retards the absorption of the drug from the alimentary tract. Studies (e.g. Kalowski et al, 1974) have shown that it has the same high cure rates and low resistance profile as generic nitrofurantoin but with the additional benefits of reduced gastrointestinal side-effects and potential increased patient compliance.
Antiemetics: uses, mode of action and prescribing rationale
Authors: Bennett Stephen
Published: May 2014

Vomiting, and the associated sensation of nausea, are very distressing symptoms that may be experienced by patients as the result of a disease process or its treatment. The specific causes of episodes of nausea and vomiting can be many and varied but fortunately there are a wide range of potential therapies available that may help. This article focuses on the different pharmacological groups of antiemetic medications that may be tried and provides information on their mechanisms, side-effects and uses.
Questions and Answers
Authors: Peniston-Bird Fiona
Published: May 2014

I work as a Nurse Independent Prescriber in palliative care. What is the current legislation regarding prescribing mixed medicines by nurses?
Research and development round-up: January 2009
Authors: O’Connell Nicola
Published: May 2014

Two new studies, published in Neurology, show that hormone therapy for women is linked to brain shrinkage, but not to the small brain lesions that are the first sign of cerebrovascular disease.
Tackling migraine in the UK
Authors: Anthony Alli , Rickarby Liz
Published: May 2014

The impact of migraine and headache on a sufferers life should not be underestimated. Migraine is an episodic neurological condition. The person experiences attacks of multiple symptoms over decades of their lives. It is characterized by a set of specific symptoms including nausea, throbbing headache visual disturbance, photo phobia and phono phobia. There are a range of treatments available for migraine but no standard cure. Other headaches can be just as devastating and are equally underdiagnosed and under treated. This article looks at some of the most disabling primary headache disorders.
Understanding the principles of drug metabolism
Authors: Greener Mark
Published: May 2014

As a rule, metabolism converts relatively lipidsoluble drugs into more water-soluble, inactive metabolites. In some cases, however, metabolism produces an active metabolite. The liver is the richest source of metabolic enzymes and the cytochrome p450 system is the most important group of metabolic enzymes. Cytochrome p3A4 alone metabolizes around 45% of prescription medicines and accounts for about 60% and 70% of the liver’s and intestine’s ability to metabolize drugs respectively. Patterns of metabolism can differ markedly—even within the same therapeutic class and between patients. Polymorphisms raise the prospect of analysing a patient’s genetic profile to ascertain the pattern of enzymes they express, and to tailor the dose or drug much more accurately. Drug–drug interactions account for up to a third of deaths from adverse drug reactions. Nurses and non-medical prescribers need to be aware of the clinically significant interactions for each drug they prescribe.
The need for V150 prescribing
Authors: Hogg Dianne , Schelowok Carole
Published: May 2014

Since its nationwide introduction into mainstream community nursing practice, nurse prescribing has enabled the establishment of complete nurse-led care in many services. This article looks at the success of community practitioner nurse prescribing and its impact on patient care delivery and the delivery of the V150 programme.
Are vitamin supplements more harmful than healthy?
Authors: O’Connell Nicola
Published: May 2014

Considering recent findings on supplementation use, the results of a major multivitamin study, published in February, could be regarded as encouraging—despite the fact that multivitamins were not associated with any benefi ts. Th e study showed that longterm multivitamin use has no impact on the risk of common cancers, cardiovascular disease or overall mortality in postmenopausal women (Neuhouser, 2009).
Understanding the principles of drug distribution and excretion
Authors: Greener Mark
Published: May 2014

This article, the final in a series of three examining key pharmacokinetic concepts, introduces distribution and excretion. Distribution refl ects the dispersal of a drug from the site of absorption, its movement around the body and into the various compartments, such as the blood, central nervous system, and peripheral tissue. Excretion refers to the removal of the drug and its metabolites, most commonly by the kidney and liver. Understanding distribution and excretion can help nurses appreciate the rationale for a drug’s regimen and why they need to adapt dosing in certain circumstances. These principles also help nurses avoid potentially serious, and occasionally exploit valuable, interactions. Half-life is a key pharmacokinetic parameter linked to elimination. After four or five half-lives, the body has eliminated around 95% of the initial dose. The half-life also infl uences whether patients require a loading dose or would benefit from a modifiedor sustained-release formulation. Taken together, the three articles illustrate that understanding the principles of pharmacokinetics can help nurses in their everyday practice. Nevertheless, even the most sophisticated pharmacokinetic analysis is still a mathematical model. Nurses need to be aware that polymorphisms can create discordance between blood concentrations and the expected therapeutic effect.
Questions and Answers
Authors: Peniston-Bird Fiona
Published: May 2014

What are your thoughts on nurse independent prescribers prescribing antibiotics for dental patients who may present at a walk-in centre setting, stating they are unable to get a dentist appointment? Obviously it would be for a dental abscess. In my view nurse independent prescribers are NOT dentists nor do they have any dental training, and therefore would be prescribing outside of their scope of practice.
Research and development round-up: April 2009
Authors: O’Connell Nicola
Published: May 2014

A randomized placebo-controlled trial of head-to-head comparisons of single and combination pharmacotherapies for smoking cessation reveals that combination nicotine replacement therapy (NRT) is more effective in helping smokers to achieve initial cessation and maintained abstinence rates than monotherapy NRT. ‘Th ere is very little direct evidence of the relative efficacy of different pharmacotherapies and very little head-to-head comparison within a particular study. And without that information, it is hard for clinicians and smokers to select between the different treatments,’ said lead study author Megan Piper.
Management of acne vulgaris
Authors: Watkins Jean
Published: May 2014

Eighty five per cent of teenagers and young adults develop acne vulgaris to a greater or lesser degree. It comes in the difficult years of ‘growing up’ when peer acceptance and finding work are of major importance. Acne mars their appearance and self-esteem drops to a low. As health professionals we need to recognize those that need advice and understand when and how to treat the condition. Mild acne may be helped by topical applications such as benzoyl peroxide that can be obtained over the counter. Moderate acne may respond to topical antibiotic or retinoid or oral tetracycline. What we want to ensure is that the more severe acne and acne that fails to respond to simpler methods are taken seriously. This article covers the aetiology of the condition, types of acne and the management options that are available.
Mesalazine for ulcerative colitis: evidence for use
Authors: Greveson Kay
Published: May 2014

Ulcerative colitis is a chronic, idiopathic inflammatory disease of the colon characterized by periods of exacerbation and remission. Medical treatment aims to provide rapid effective relief from symptoms, modify the disease process and improve quality of life. Many oral preparations use multiple daily dosing regimens which can be inconvenient and affect treatment adherence leading to increased morbidity and risk of symptomatic relapse. This article examines the issues surrounding the use of mesalazine in ulcerative colitis, focusing on Mezavant XL (MMX mesalazine), a once-daily dosing formulation with patented multi-matrix system. The reader will gain an understanding of the pharmacology of the drug, evidence base for its use and implications for prescribing practice.
Chronic fatigue syndrome: believing in ME
Authors: Pinching Anthony
Published: May 2014

Chronic fatigue syndrome (CFS/ME) presents very major challenges to both the patient and the clinician, whether in diagnosis and treatment, or in the wider personal and social impact that this pervasive illness frequently has. This article reviews current perspectives on the illness, and goes on to outline the main clinical features, diagnosis, strategies for clinical management, including activity management, adjustment and symptom control. Above all, the care of people with CFS/ME encompasses the essence of being a clinician - listening, interpreting, explaining, guiding and supporting people through their personal journey of illness.
Understanding polycystic ovary syndrome
Authors: Raisbeck Elspeth
Published: May 2014

Polycystic ovary syndrome (PCOS) affects up to 20% of women in the UK but it is often un-diagnosed, misdiagnosed or dismissed by the medical profession. However, the now-established link between the insulinaemia in PCOS, hyperlipidaemia and heart disease, and the risk of endometrial cancer, mean that this is not acceptable. In addition patients need support in tackling the cosmetic consequences of the condition which affect their self-esteem. This article discusses the manifestations of the syndrome, the causes and the treatments available.
Nitrates: uses, actions and prescribing rationale
Authors: Panchmatia Shailesh
Published: May 2014

This article discusses the pharmacology and prescribing issues around the nitrates in stable angina. Topics discussed are mechanisms of action, pharmacokinetics, adverse drug reactions, tolerance, drug interactions, cautions and patient counselling points.
Management and treatment of STIs: chlamydia
Authors: Keefe Alison
Published: May 2014

Sexually transmitted infections (STIs) are infections primarily transmitted through sexual contact. Globally, for women aged 15–44 years, STIs (excluding HIV) are the second most common cause of healthy life lost after maternal morbidity. This public health issue continues to be far-reaching, despite improvements in detection, and treatment. The onward consequences of neglecting sexual health are significant in terms of misery, complications and monetary cost. This article covers the management of chlamydia infections, the importance of nurse-led clinics and details a case study in a 22-year-old female presenting after the breakdown of a long-term relationship.
Ibuprofen for mild to moderate pain, inflammation and fever
Authors: Lovatt Penny
Published: May 2014

This article is a short profile of the NSAID ibuprofen. Pharmacodynamic and pharmacokinetic properties will be examined, alongside the vulnerable patient groups that deserve thorough consideration prior to prescription. These include patients with hepatic and renal impairment, pregnant women and nursing mothers, and the elderly. In examining ibuprofen from a pharmacodynamic and pharmacokinetic point of view, a safe prescribing approach should be used to ensure best practice among prescribing members of staff.
Assessing the quality of nurse prescribing
Authors: Hall Jason
Published: May 2014

A model for ‘good prescribing’ should have four aims: to maximize effectiveness; to minimize risk; to minimize costs; and to respect patient choice. Evidence points to nurse prescribing being as good as medical prescribing in terms of effectiveness, risk reduction, and cost minimization. It has also been well received by patients, which is an indication that nurses respect patient choice. Only a few studies, however, have assessed the quality of nurses' prescribing decisions. A possible over-reliance on information originating from the pharmaceutical industry, and problems with history taking and record keeping could all have a negative impact on the quality of prescribing. There is a need for further work on how nurse prescribers use evidence-based medicine in their decision-making.
Prescribing beta-adrenoceptor blocking drugs
Authors: Panchmatia Shailesh
Published: May 2014

This article aims to provide the reader with a brief overview of the use of beta blockers in a variety of clinical situations. The basic physiology of beta receptors and the pharmacology of beta blockers are covered. The use of beta blockers in hypertension, angina, arrhythmias, heart failure, myocardial infarction, and other miscellaneous conditions is discussed. Finally, the major adverse effects of beta blockers are discussed.
Nurse prescribing of chemotherapy: docetaxel in early breast cancer
Authors: Lennan Elaine , Roe Helen
Published: May 2014

Capacity issues and streamlining of processes are important to the modernization of chemotherapy services; however, the role of the nurse prescriber is also a key consideration. To undertake an effective prescribing role in chemotherapy, the nurse must understand the evidence base not only for the treatment itself, but also for the management of the associated toxicities. This article explores these issues from the point of view of docetaxel-based chemotherapy for early breast cancer.
A spoonful of sugar
Authors: Black Peter
Published: May 2014

NHS spending is ringfenced—who would have thought? The NHS budget has been protected from the 25 percent cuts demanded elsewhere across government. But this is no time for celebration; the NHS will still need to tighten its belt while it faces increasing strain on its services from an ageing population and demand for new and expensive treatments. As David Cameron said at the beginning of June 2010, ‘Spending cuts will change everyone's way of life’.
Co-codamol: safely using an effective analgesic
Authors: Greener Mark
Published: May 2014

Co-codamol (codeine and paracetamol)—which is available in several formulations, including Codipar—is one of the most popular choices for pain management. Co-codamol begins to alleviate pain after 20–30 minutes and analgesia persists for about 4 hours. Adding codeine to paracetamol increases the proportion of patients that report a reduction in pain of at least 50% over 4–6 hours by 10–15%, increases the time to use rescue medication by about 1 hour and reduces the proportion of participants that need rescue medication by about 15% compared with paracetamol alone (Toms et al, 2009). Co-codamol is contraindicated in some groups of patients, causes a variety of adverse events, and misuse can lead to analgesic-related headaches and codeine addiction.Thus, prescribers should remind patients to not ingest more than 4 g paracetamol in 24 hours and not to take over the counter co-codamol for more than 3 days or, in the case of prescription-only formulations, for longer than directed by the prescriber. Despite these caveats, Codipar and other co-codamol formulations are generally well-tolerated and effective members of the analgesic armamentarium. This article aims to help nurse prescribers use Codipar and other co-codamol formulations safely and effectively.
Prescribing in thyroid disease
Authors: Hall Sandra M
Published: May 2014

Thyroid disease is a relatively common endocrine disorder that affects women more frequently than men. The use of a thyroid function test in conjunction with the patient's clinical symptoms makes the diagnosis of both hypothyroidism and hyperthyroidism relatively straightforward. Most patients with hypothyroidism can be managed in primary care but patients with hyperthyroidism require specialist input and should be referred for secondary care confirmation of diagnosis and initiation of treatment. Continuing monitoring and evaluation of the treatment of both diseases is essential.
Research and development roundup: August 2010
Authors: O'Connell Nicola
Published: May 2014

Depression is commonly reported in people with Alzheimer's disease and its precursor, mild cognitive impairment, with several studies suggesting that having a history of major depression may nearly double the risk of developing dementia later in life. However, it has been unclear if depression is a symptom of the disease or a potential cause of the disease.
Non-medical prescribing action research: questionnaire study
Authors: Turner Steve , Broom Wendy , O'Kelly Allison , Richardson Keith
Published: May 2014

This report outlines a small-scale service evaluation carried out in Cornwall Partnership NHS Foundation Trust examining views of staff on non-medical prescribing (NMP). It follows a study conducted prior to the implementation of NMP in the trust, where clinicians identified the potential benefits and pitfalls. The main findings were that, across the board, those familiar with NMP felt it to be beneficial. The doctors surveyed showed increased confidence in non-medical prescribing, but some expected benefits had not yet been achieved. Conclusions from the study included limited knowledge of NMP among those who did not work with non-medical prescribers; and that concerns expressed in the earlier study about patient safety had not been realized.
Questions and Answers
Authors: Peniston-Bird Fiona
Published: May 2014

I would like some information on the prescribing of controlled drugs (CDs) in the neonatal unit.
The art and science of prescribing
Authors: Otway Christine
Published: May 2014

This Bank holiday weekend has been an exciting one for our family, with the arrival of our first grandson. I was privileged to be with my daughter through most of her labour, and to experience a whole range of emotions. Throughout it all, we were supported by a fantastic midwife who cared for us all with great skill and compassion. The NHS is the object of such bad press at times that I am pleased to report that the art of midwifery is still very much alive here in Leicester.
Using pharmacotherapy to optimize quit rates in smokers
Authors: Bostock-Cox Beverley
Published: May 2014

The evidence-based pharmacological interventions for smoking cessation, including nicotine replacement therapy (NRT), varenicline and bupropion, are discussed. Approaches to behavioural change in smoking cessations are also presented. Regimens should be tailored to fit each individual patient, bearing in mind the level of addiction, previous attempts to quit smoking, and personal circumstances and preferences.
Managing constipation in adult patients
Authors: Kyle Gaye
Published: May 2014

Constipation is a common, unpleasant and often distressing symptom that can happen to anyone at any time. Yet the treatment is often far from satisfactory. This article discusses the evidence base for both non-pharmacological and pharmacological management of constipation.
Pharmacist prescribing in oncology and haematology
Authors: Clarke Vicki
Published: May 2014

I have been a pharmacist prescriber in oncology and haematology since 2006. I prescribe oral and intravenous chemotherapy and supportive medicines for a variety of cancers, mainly colorectal and breast cancer. I also prescribe treatment for patients with myeloproliferative disorders (MPDs) such as polycythaemia rubra vera and essential thrombocythaemia. Being a prescriber has presented me with some difficult challenges and situations that I did not anticipate when I embarked on the prescribing course, but reflecting on these experiences has made me a better prescriber and enabled me to deal with other problems more confidently. As a pharmacist I was quite ‘medicine-focused’, and perhaps did not appreciate enough the emotional impact of cancer both on the patient and on their relatives. Talking to nurse prescribers has certainly helped me develop my skills in this area, and I feel the roles of pharmacist and nurse prescribers are complementary. It is important for pharmacist and nurse prescribers to be able to demonstrate that they are competent, and the National Prescribing Centre has produced a useful competency framework to use as CPD. I am always looking for ways to improve my practice and move forward, and am keen to expand my role by prescribing different chemotherapy regimens, extending the MPD service and improving the inpatient chemotherapy pathway.
Intermediate care: the nursing contribution
Authors: Nazarko Linda
Published: May 2014

Older people often attend accident and emergency departments and many older people with ill-defined conditions are admitted to acute hospitals. However, this may not be the best care for these patients, as inappropriate admission to hospital can be detrimental to them, particularly in the case of those with dementia. In this article, the author describes how one former primary care trust set up an intermediate care ward led and staffed by nurses, including independent nurse prescribers, to prevent unnecessary acute care hospital admissions and provide enabling care to older people in Ealing, London. The ward is called Magnolia, and it is now an established and much needed service.
The future for mental health non-medical prescribers
Authors: Oldknow Helen , Gillibrand Warren , Lawton Mark , Schofield Sharon
Published: May 2014

The NHS Plan ( Department of Health, 2000 ) envisaged that widening the scope of nurse prescribing would offer service improvement by reducing delays incurred through waiting for a doctor to prescribe. To date, 14% of the mental health nurse prescribers in Rotherham, Doncaster and South Humber NHS Trust are prescribing independently. The Transforming Community Services initiative, with its transfer of community practitioners, has highlighted differences in prescriptive authority. This article describes how research into non-medical prescribing within Rotherham, Doncaster and South Humber NHS Foundation Trust has been used to inform service delivery.
Self-refection assessment on prescribing and patient satisfaction
Authors: Milligan Fiona
Published: May 2014

This article describes a self-reflective exercise on how non-medical prescribers consult, and if patients are satisfied. This was carried out as part of continuing professional development by non-medical prescribers using informal audit and patient satisfaction tools to assess their prescribing practice and potential benefits of non-medical prescribing to patient care. The exercise found that non-medical prescribers provide appropriate and pertinent information relating to medications, and that if no prescription is issued, the prescriber offers information on why a prescription is not needed. It also found that non-medical prescribers prescribe appropriately and safely, therefore meeting consultation and prescribing guidance provided by the Nursing and Midwifery Countil (NMC). It also found that there is a high level of patient satisfaction with non-medical prescribing, and with the information provided to patients during the consultation. The author concludes that with the evolving role of the autonomous practitioner, non-medical prescribing contributes to the provision of a holistic and seamless care pathway.
Assessing fracture risk and preventative strategies in older people
Authors: Leyland Sarah
Published: May 2014

Osteoporosis is a condition that occurs when bones are fragile and break easily as the result of an imbalance in the normal processes of ‘bone formation’ and ‘bone resorption’ that work together to maintain bone strength. Fragility fractures are fractures that result from mechanical forces that would not ordinarily result in fracture. Diagnosis of osteoporosis on a bone density scan is an important predictor of fracture risk, but the use of other risk factors improves the predictive value of the assessment. Decisions to prescribe drug treatments are now based on the assessment of fracture risk, rather than just a diagnosis of osteoporosis. Prescribing drugs appropriately to those at the highest risk of fragility fracture and providing practical advice about taking them effectively and safely will help patients to have fewer disabling fractures. In addition, advice about lifestyle changes to maintain bone strength and strategies to reduce the risk of falling in older people will contribute to fracture risk prevention.
Creating an effective weight management plan
Authors: Cook Debbie
Published: May 2014

Obesity is a physical sign of potential long-term disease. Over half of the UK population are now overweight or obese. Serious health conditions caused by overweight and obesity include type 2 diabetes, ischaemic heart disease, arthritis, sleep apnoea, cancer and depression. Overweight and obesity are diagnosed simply by use of the body mass index, which is calculated by dividing the weight in kg by the square of the height. Most health professionals agree that calorie restriction together with an increase in physical activity is the preferred method of weight loss. However, weight loss is not necessarily that easy; behaviour change on a mass scale requires collaborative thinking across multiple agencies, with long-term directives put in place.
Trimethoprim and a case of lower urinary tract infection
Authors: Nash Louise
Published: May 2014

This article discusses the use of trimethoprim in the treatment of uncomplicated lower urinary tract infections (LUTI) in adult women. It takes the form of a case study and will explore the pharmacological dynamics of the drug, as well as comparing it to others also used in the treatment of LUTI. Trimethoprim is considered the gold standard for treatment and the three-day course has become the usual recommended treatment for non-complex LUTIs and for empirical treatment of cystitis with a 90% eradication rate (Salvatore et al, 2001; Scottish Intercolleguiate Guidance Network, 2006). This article describes the presenting symptoms, possible differentials, treatment, and rationale for the treatment chosen.
Antidepressants: current mechanisms and new hopes
Authors: Greener Mark
Published: May 2014

Modern drugs for depression—including tricyclic antidepressants, monoamine oxidase inhibitors and selective serotonin reuptake inhibitors—improve mood and motivation by influencing a relatively small repertoire of ‘monoamine’ neurotransmitters released from pre-synaptic nerve terminals. While current antidepressants prevent considerable suffering, around 30% of patients do not respond adequately to treatment. Furthermore, patients usually need to take conventional antidepressants for several weeks before the hopelessness, helplessness and suicidal ideation of depression abate. Against this background, the recognition that ketamine, used as an anaesthetic and a ‘recreational’ drug, rapidly improved severe depression that did not respond to other antidepressants was, according to Science, ‘arguably the most important discovery [in depression] in half a century’. Studies into the mode of action of ketamine along with investigations to ascertain why total sleep deprivation alleviates depression in about 60% of patients, raise the prospect of overcoming the frustrating and potentially dangerous delay in the onset of action with conventional antidepressants and offer new hope to patients resistant to current drugs. Moreover, these studies help to characterise the subtle neurochemical basis of this common psychiatric condition. This article examines the pharmacology of current antidepressants, as well as some of the research that promises to transform the prospects for people living with this devastating disease who do not respond to current agents.
Smoking cessation: The heart of the matter
Authors: McEwen Andy , Grothier Lucy
Published: May 2014

Smoking is the single biggest cause of preventable mortality and morbidity, doubling the risk of developing heart disease and other cardiovascular diseases. Smoking cessation significantly improves current and future health, but it is not easy to achieve due to the addictive nature of nicotine. Offering patients who smoke very brief advice on smoking can motive them to make a quit attempt; ensuring that a quit attempt takes place with the help of medication and behavioural support from a trained stop smoking practitioner will maximise the chances of these quit attempts being successful. Nurses are ideally placed to deliver these life-saving interventions. Training for health professionals in how to deliver very brief advice is available through the National Centre for Smoking Cessation and Training.
Improve the environment: improve quality of life
Authors: Brown Joyce H
Published: May 2014

Joyce Brown describes the orientation problems facing elderly residents with dementia and highlights the design factors considered in the refurbishment of the Lynedoch nursing home in Edinburgh.
Health & Safety
Authors: Jones Phil
Published: May 2014

In the first of a series of regular columns, Phil Jones considers the importance of an awareness of health and safety legislation in care homes, and the implications of this for daily practice.
Parkinson's disease: myths and misconceptions
Authors: McCall Bridget
Published: May 2014

Bridget McCall explores some of the common misconceptions which surround people with Parkinson's disease, a complex condition which is frequently misunderstood.
Pets welcome: a feasible nursing home policy?
Authors: Ashurst Adrian
Published: May 2014

Adrian Ashurst discusses the benefits and problems of residents keeping pets in nursing and residential care homes, and outlines an award system for ‘pet-friendly’ homes.
Risk assessment, violence and dangerousness in the workplace
Authors: Brennan Walter
Published: May 2014

Walter Brennan considers the issues involved in risk assessment and differentiates between risk and dangerousness. He looks at clinical risk assessment, and discusses how health-care professionals can predict and manage aggression and violence.
Giving people the lift they need: platform stair-lifts
Authors: Durham Neil
Published: May 2014

Neil Durham outlines the approach that Wessex Medical is taking to enable people to conform to the Disability Discrimination Act 1995.
Making a difference: the client with sensory loss
Authors: Gee Gillian
Published: May 2014

Gillian Gee highlights the skills and approach required to meet the needs of a person with sensory loss in a residential environment.
An overview of seating for use by people with a disability
Authors: Jones Liz
Published: May 2014

Liz Jones describes the extensive choice of chairs available for use by people with a disability, and highlights the points for consideration when selecting a chair.
Residential care for adults with learning disabilities
Authors: Edwards Lisa
Published: May 2014

Lisa Edwards gives a personal perspective of the role of a home manager within the field of learning disabilities.
The power of television
Authors: Ashurst Adrian
Published: May 2014

Recently readers may have seen the moving television documentary Malcolm and Barbara - a Love Story (ITV, 24 June 1999). This remarkable journey, illustrating clearly the devastating effects of Alzheimer's disease, was sensitively produced and filmed by Paul Watson, maker of the ‘fly on the wall’ documentary The Family.
Providing support for victims of violence
Authors: Brennan Walter
Published: May 2014

Walter Brennan highlights the need for care homes to demonstrate their commitment to staff by supporting them sympathetically through the aftermath of a violent incident.
The aftermath of violence: can we survive?
Authors: Cork Margaret
Published: May 2014

Margaret Cork argues that there are many ways in which violence in a health-care setting can be predicted and prevented and highlights some of the ways in which individuals can be helped when a violent incident does occur.
Assessment of pain in an elderly population: practical difficulties
Authors: Weir Evelyn C , Burrow J Gordon , Bell Frank
Published: May 2014

Evelyn C Weir, J Gordon Burrow and Frank Bell outline the various methods used to assess pain in an elderly population and outline the complexities which may be encountered.
An inspector calls
Authors: Ashurst Adrian
Published: May 2014

In the last of the present series, Adrian Ashurst reflects on two key areas of the inspection process and their impact on nursing and residential practice.
Nurse knows best?
Authors: Dimon Carol
Published: May 2014

Carol Dimon discusses the possible solutions to a common dilemma facing nursing and residential care staff.
Positive Customer Care
Authors: Ashurst Adrian
Published: May 2014

Adrian Ashurst describes the importance of providing potential customers with the relevant information when enquiring about your nursing or residential care establishment.
Preparing for the festive season
Authors: Ashurst Adrian
Published: May 2014

Adrian Ashurst offers some practical guidance for nursing and residential homes as they prepare for the millennium. He suggests that careful planning can ensure that everything runs smoothly and that residents, staff and relatives have as enjoyable a time as possible.
Nursing and residential homes provide ‘haphazard’ care
Authors: Lishman Gordon
Published: May 2014

Vulnerable older people get a poor service from the NHS, according to a new report published jointly by the Royal College of Physicians, the Royal College of Nursing and the British Geriatrics Society.
SELF-DIRECTED Learning
Authors: Yonwin Helen
Published: May 2014

This article by Helen Yonwin relates to unit CL2 of the NVQ syllabus: overcoming communication differences.
Dementia: a clinical overview
Authors: Goward Peter
Published: May 2014

Understanding the clinical features of dementia can help to provide a better level of support for those in your care. In this article, Peter Goward gives an overview of the different types of dementia and discusses implications for care.
The role of the arts in dementia care
Authors: Killick John
Published: May 2014

People with dementia often have communication difficulties. Arts programmes, whether they involve painting, sculpture, music or any other art form, allow these people to express themselves perhaps more clearly than they could verbally. John Killick discusses the implementation and effects of a number of pilot art projects for people with dementia.
Promoting independence in dementia care
Authors: Dent Vicky
Published: May 2014

Involving carers in providing activity-based care and improving independence and functional activity in people with dementia are areas of interest to many nursing and residential care facilities. A project trialled at Ashminster House, Ashford, involving the use of the Pool Activity Level instrument, aimed to do just that.
Autogenic therapy: a lesser known treatment
Authors: Crowther Dorothy
Published: May 2014

Dorothy Crowther introduces autogenic therapy, one of the lesser known complementary therapies, which involves simple mental exercises which help individuals take control of their lives.
Are residents' relatives customers, too?
Authors: Burton-Jones Julia
Published: May 2014

Homes are developing customer care practices which reflect the position of residents as consumers, but, asks Julia Burton-Jones, do they see residents' friends and relatives as their customers, too?
Clinical skills training in the nursing home
Authors: Hatcher SL , Chamberlain JA
Published: May 2014

SL Hatcher and JA Chamberlain describe their roles as trainers in an 18-month initiative designed to teach clinical skills to all the qualified nurses employed in the nursing homes throughout Cornwall.
Abusers: a personal construct psychology perspective
Authors: Allen Diane
Published: May 2014

Diane Allen explores personal construct psychology and examines how the approach can be used to demonstrate the views held by some perpetrators of child sexual abuse and their victims.
A ‘headstart’ for paediatric brain injury rehabilitation
Authors: Weekes Penny
Published: May 2014

Penny Weekes describes the setting up of ‘Headstart’, a specialised service that aims to accommodate the needs of brain-injured children and their families to establish comprehensive provision of rehabilitation.
Disabling practice? Enabling nurses
Authors: Scullion Philip
Published: May 2014

Philip Scullion reports from a recent conference entitled Disabling Practice? Enabling Nurses and details the important issues and main points raised.
Positive customer care
Authors: Ashurst Adrian
Published: May 2014

Adrian Ashurst illustrates the importance of management support for front line staff in order for them to achieve agreed service standards,and highlights what can go wrong if staff do not receive support.
Psychotropic drug use in nursing and residential homes
Authors: Hughes Carmel M
Published: May 2014

Carmel Hughes investigates the use of psychotropic medication in nursing and residential homes and the ways of controlling its often-controversial prescription.
Headway — the brain injury association
Authors: Ashurst Adrian
Published: May 2014

Adrian Ashurst highlights Headway and discusses their progression towards better standards of treatment and support for the victims of brain injury and their families.
Leg ulceration: an update
Authors: Henn Gill
Published: May 2014

Gill Henn outlines some of the factors that influence the development of leg ulcers in patients and looks at some methods of treatment.
Managing dementia in nursing and residential care homes
Authors: Mangan Paul , O'Broin Kate
Published: May 2014

Paul Mangan spoke to Kate O'Broin of the Alzheimer's Society, the leading charity in the field, to talk through what they do and to give some idea of the sort of advice and support they can give to a carer at this difficult time.
Talking Back
Authors: Metcalfe Judith
Published: May 2014

Welcome to our new regular feature, which gives our readers the opportunity to respond to issues raised in our pages. If there is an issue you feel strongly about, please let us know at TalkingBack, Nursing and Residential Care, Mark Allen Publishing, Croxted Mews, 288 Croxted Road, London SE24 9BY.
Induction and foundation standards
Authors: Banks Richard
Published: May 2014

Richard Banks describes the new induction guidelines from The Training Organization for Personal Social Services in England. Their aim is to give recently appointed workers a good grounding in their new roles.
Constructive dismissal: a guide for employers and employees
Authors: Richardson Barbara
Published: May 2014

Barbara Richardson looks at the circumstances in which a resignation can amount to a claim for unfair dismissal.
Care of residents with post-stroke communication problems
Authors: Horton Terri J
Published: May 2014

Terri Horton discusses different kinds of communication difficulties that people may experience after a stroke and suggests ways to help residents with these problems communicate.
Book Reviews
Authors: Stainton Audrey A
Published: May 2014

It is well recognized that the multidisciplinary approach is the way forward in managing chronic illness, so it is gratifying to see this approach reflected in this book. Patient education, support and the identification and anticipation of care needs are important factors in ensuring quality of life and preventing complications in Parkinson's disease.
An update on skin care for elderly people
Authors: Webber Robin , Davies Ann
Published: May 2014

The skin is the largest organ of the human body. In older people, it can become prone to damage through lack of hydration as well as accidental injury. In this article, Robin Webber and Ann Davies describe a variety of methods for keeping the ageing skin healthy.
Grieving within a care home
Authors: Pickersgill Marion
Published: May 2014

Marion Pickersgill discusses how care homes can best offer support to those who are grieving after the death of a resident, whether they are relatives, staff or other residents.
Pressure-reducing equipment 4: turning patients and reducing risk
Authors: Maylor Miles E
Published: May 2014

In the final article of this series, patient turning, the place of risk assessment and ‘stepping down’ are considered. A warning note is sounded in that comfort does not necessarily equate with safety.
Equipment to prevent pressure ulcers in low-risk residents
Authors: Hampton Sylvie
Published: May 2014

Sylvie Hampton discusses the use of comfort in the prevention of pressure ulcers in low-risk residents of nursing and residential homes.
Getting the best assessment and delivery methods for NVQs
Authors: Barham Bob
Published: May 2014

In this article, Bob Barham looks at methods of delivery and assessment of NVQs and the role of different support resources.
Update on enteral tube feeding in the care home
Authors: Collier James
Published: May 2014

Enteral tube feeding has become a widely used health-care technology, both in the hospital and community setting. Its increasing use is associated with a range of different routes and systems for nutrition delivery. However, the fact that more patients are being fed in the community is not matched by education and training for those providing care.
Problems of undernutrition in nursing and residential care
Authors: Sandars John
Published: May 2014

Undernutrition is frequently found in the elderly and is associated with increased physical and psychosocial problems. There are additional economic and workload considerations. An evidence-based systematic approach to identification and management is recommended in this article by Dr John Sandars.
How to… Maintain good hand hygiene
Authors: Merchant Roger
Published: May 2014

A simple hand-washing programme that is adequate and necessary for preventing the transfer of pathogenic microorganisms is described in this article by Roger Merchant.
Continence care in nursing and residential homes
Authors: Buswell Chris
Published: May 2014

Chris Buswell discusses the importance of being aware of all possible factors which could cause incontinence in care home residents and highlights the need for a holistic approach to care.
Keeping skin healthy: problems and solutions
Authors: Hampton Sylvie , Collins Fiona
Published: May 2014

Sylvie Hampton and Fiona Collins outline the different structures that make up the skin, look at ways in which normal nursing practices such as cleaning can cause skin problems and detail some ways in which these problems can be overcome.
Antidepressants and the biology of depression
Authors: Morinan Alun
Published: May 2014

Alun Morinan outlines the biochemical basis of depression and discusses the ways in which this knowledge has been used to develop the different drugs which are available to treat depression.
Preventing and treating pressure ulcers in residential care
Authors: Bull Mary
Published: May 2014

The prevention and treatment of pressure ulcers is a major concern for staff in nursing and residential care homes. Selection of appropriate equipment can prove difficult, with numerous systems available. Tempur-Med provides a simple, cost-effective solution with a range of products ensuring continuity of care throughout the nursing home.
Identifying clients' needs
Authors: Ashurst Adrian
Published: May 2014

In this article, Adrian Ashurst discusses the importance of carrying out a standard preadmission assessment of a client's needs.
The management of diabetes in adults
Authors: Olive Sue
Published: May 2014

Diabetes is a costly disease in terms of human suffering and cost to the NHS. Good management will reduce the risk of long-term complications. Sue Olive tells you how.
From hanging baskets to herbaceous borders
Authors: Hayden Elizabeth
Published: May 2014

Gardening is a relatively easy way for residents to maintain their independence and undertake activities of daily living. Elizabeth Hayden discusses ways in which gardening can be facilitated by staff.
Meeting the needs of people with learning disabilities
Authors: Thompson David
Published: May 2014

People with learning disabilities are often placed in residential services for older people. This article describes how their needs may be different from other residents' needs and how they can be best supported.
Advocacy and the power of attorney
Authors: Richardson Barbara
Published: May 2014

Barbara Richardson looks at the current rights of adults who lack mental capacity and some proposed changes in this area.
Implications of the Employment Act 2002: 1
Authors: Richardson Barbara
Published: May 2014

Barbara Richardson discusses some of the contents of the Employment Act 2002 in the first of a two-part series.
Best practice in fall minimization among wandering clients
Authors: Hughes Michael
Published: May 2014

Initiatives to aid fall minimization must be supported by a clear multidisciplinary strategy. Michael Hughes explains best practice in the field of reducing the risk of falls.
The facts about administering medicines in altered forms
Authors: Bonner MC
Published: May 2014

Dr MC Bonner looks at the nature of solid oral dosage forms, the absorption of drugs into the body from them and highlights instances where the crushing or breaking of them may not be suitable.
Review of current management of essential hypertension
Authors: Kennedy Susan
Published: May 2014

Susan Kennedy discusses the identification, treatment and management of raised blood pressure, reducing the risks of coronary heart disease and stroke.
Management of difficult stomas
Authors: Pullen Mandy
Published: May 2014

Expert nursing care for the ostomy patient is crucial. This update on difficult stomas is particularly concerned with stoma care for patients in the community.
Assessing and managing risk in health-care environments
Authors: Makinson Geoff
Published: May 2014

This article examines various definitions of risk and why and how risk is assessed and managed in health-care settings and offers an insight into the risk management process and how to develop effective risk policies.
Obesity: a modern epidemic
Authors: Webb Geoffrey P
Published: May 2014

Geoffrey Webb reviews the adverse health and social consequences of obesity and discusses its causes and some of the ways in which it can be prevented and treated.
Choice denied or choice discovered?
Authors: Morgan Hazel
Published: May 2014

Hazel Morgan presents some of the aims and activities of the Foundation for People with Learning Disabilities, stressing the importance of enabling people to make real choices for themselves.
Application of business planning processes to health care
Authors: Makinson Geoff
Published: May 2014

This article discusses the issue of business planning processes specifically in relation to how they can be applied in health-care organizations.
Aids to low vision
Authors: Derrington David
Published: May 2014

David Derrington looks briefly at the extensive variety of help which is available to those who have poor or failing vision.
The need for a greater emphasis on fall prevention
Authors: Hughes Michael
Published: May 2014

This article explains the need for a multidisciplinary approach to fall prevention in order to meet the requirements of the national service framework for older people.
Community-acquired and aspiration pneumonia
Authors: Kuitert Lieske
Published: May 2014

Lieske Kuitert discusses the symptoms, management and prevention of community-acquired pneumonia and aspiration pneumonia.
Improving meals for older people in care homes: the new National Minimum Standards
Authors: Stanner Sara
Published: May 2014

Sara Stanner discusses the government's new National Minimum Standards relating to the provision of good, wholesome food for care home clients.
The implications of the Data Protection Act 1998
Authors: Wright Kerri
Published: May 2014

Kerri Wright outlines the details of this Act which was introduced in March 2000 to protect both the movement and processing of personal information about individuals.
What's new in stoma appliances?
Authors: Pullen Mandy
Published: May 2014

Mandy Pullen gives an update on stoma care appliances for health professionals of all levels, to enhance the care of clients with a stoma living within the community.