bluuebunny/crossref_metadata_2025 huggingface dataset:
Safety Express: a strategic health authority's approach
Authors: Morris-Thompson Trish , Aldred Vicky , Clark Nicola , Marks-Maran Di
Published: May 2014

The Safety Express programme is a national workstream within the Quality, Innovation, Productivity and Prevention (QIPP) programme that is designed to improve health outcomes and quality care, as well as reduce costs associated with the following four patient harms: pressure ulcers, falls, urinary tract infections in patients with catheters and venous thromboembolism (VTE). NHS London developed a pilot project to implement Safety Express across London. This paper presents case studies of the outcomes of the Safety Express pilot in three locations in London. Findings from the pilot showed that the proportion of patients who were harm-free from pressure ulcers, falls, urinary infections (in patients with a catheter) and new VTE compares favourably with the national average, with an overall decrease in all four.
Reconstruction for breast cancer in a nutshell
Authors: Harmer Victoria
Published: May 2014

Breast cancer is a disease many will experience. Depending on the size of the cancer, the size of the host breast, and whether it is multi-focal, a mastectomy may be recommended as part of the treatment. If this is the case, an immediate breast reconstruction may be offered. This article will describe the three main types of breast reconstruction and discuss pertinent issues regarding this, including complications, surgery to the other (contraleteral) breast and potential psychological implications of this surgery.
Patient and public involvement to support liver disease research
Authors: Hull Diana , Barton Darren , Guo Kathy , Russell Christina , Aucott Bernadette , Wiles Donna
Published: May 2014

Patient and public involvement (PPI) has become increasingly important to ensure the needs of patients are fully considered when they participate in clinical trials. Most funders now require a plan for PPI in grant applications. When fully embraced and correctly implemented, PPI adds an important dimension to clinical trials, and its continuing development is critical if we are to maintain the public's support for clinical research. The development of a PPI panel for the National Institute for Health Research Birmingham Liver Biomedical Research Unit (NIHR BRU) has helped to: promote research locally and nationally; improve recruitment to and participation in trials; promote public engagement and education activities; and improve the quality and relevance of consent forms and information sheets for participants. The NIHR BRU has the support of a PPI panel which constantly champions the research being undertaken to the wider community. This paper describes how the panel was established and why it is so effective.
Developing a clinical academic career pathway for nursing
Authors: Coombs Maureen , Latter Sue , Richardson Alison
Published: May 2014

Since the publication of the UK Clinical Research Collaboration's (UKRC, 2007 ) recommendations on careers in clinical research, interest has grown in the concept of clinical academic nursing careers, with increased debate on how such roles might be developed and sustained ( Department of Health, 2012 ). To embed clinical academic nursing roles in the NHS and universities, a clear understanding and appreciation of the contribution that such posts might make to organisational objectives and outcomes must be developed. This paper outlines an initiative to define the potential practice and research contribution of clinical academic roles through setting out role descriptors. This exercise was based on our experience of a clinical academic career initiative at the University of Southampton run in partnership with NHS organisations. Role descriptors were developed by a group of service providers, academics and two clinical academic award-holders from the local programme. This paper outlines clinical academic roles from novice to professor and describes examples of role descriptors at the different levels of a career pathway. These descriptors are informed by clinical academic posts in place at Southampton as well as others at the planning stage. Understanding the nature of clinical academic posts and the contribution that these roles can make to healthcare will enable them to become embedded into organisational structures and career pathways.
Proxemic communication between HIV-infected mother-child pairs
Authors: Rebouças Cristiana , de Souza Paiva Simone , Costa Enia , Lima Ivana Cristina Vieira , Pagliuca Lorita Marlena Freitag , Galvão Marli Teresinha Gimeniz
Published: May 2014

Proxemic communication (behaviours and relations of human interaction) offered by the mother in an HIV-infected mother-child pair during infancy was analysed to determine which proxemic factors promote the exchange of affection. This study, conducted in an experimental laboratory in 2007, included mother-child pairs in which the mother was HIV-positive and the children, under 6 months of age, were born exposed to the virus. Video recordings of the mother-child interaction were analysed according to proxemic factors. Of the 364 interactions recorded for analysis of proxemic communication between the mother-child pair, the most significant proxemic factors were axis, contact behavior, visual code, and tone of voice. The mothers developed communicative strategies such as closer proximity, touch, vocalisation, and smiling to promote the exchange of affection when engaging in maternal care.
‘This is Nursing’: an initiative to reshape the vision of nursing
Authors: Glasper Alan
Published: May 2014

Professor Alan Glasper discusses the new RCN initiative to raise the profile of nursing in contemporary society through seven key areas pertinent to the development of the profession
The role of the nurse practitioner within the Hospital at Night service
Authors: Clark Susan , Paul Fiona
Published: May 2014

The Hospital at Night (HaN) service uses a multidisciplinary approach to prioritise the care of acutely ill patients overnight. Nurse practitioners (NPs) play a key role in coordinating this service and provide support to ward-based staff. Despite evidence that HaN can positively impact on patient care, it may be met with scepticism owing to changes in how acutely ill patients are assessed overnight. The aim of this study was to identify the perceptions held by nursing and medical staff on the NP role within HaN. A sample of 46 nurses and 52 doctors in an acute hospital completed questionnaires, which were developed based on components of the nurse practitioner role description. Staff's perceptions were generally similar regarding most role components. However, some variations were identified about components such as patient assessment and teaching. Scheduled education sessions can potentially increase staff awareness of NP roles and improve staff collaboration around patients' care overnight.
Reforming the law concerning assisted dying
Authors: McHale Jean V
Published: May 2014

The question of whether English law should be reformed to legalize assisted dying has been the cause of heated debate over many years. The courts have consistently rejected challenges to change the law in the area. However in 2009 Debbie Purdy achieved success in requiring the Director of Public Prosecutions to produce prosecution guidelines on assisted suicide. This paper explores the current law in the area and examines the proposals for reform of the Falconer Commission which were published in January 2012.
A liquid-film forming acrylate cream for the treatment of anal pruritus
Authors: Tomi Nordwig , Weiser Rudolf , Strohal Robert , Mittlboeck Martina
Published: May 2014

Pruritus ani is a hidden but frequently occurring clinical condition, with a large impact on patients' quality of life. Currently, therapeutic options are scarce, offering mainly limited success. The authors performed a prospective, open-label, two-centre pilot study to analyse the efficacy and safety of a liquid-film forming acrylate cream for the treatment of pruritus ani and peri-anal skin irritation. A total of 28 patients were included and applied the cream to the cleansed anal and peri-anal skin once daily for a study period of 3–4 weeks. The primary outcome measure was the reduction of pruritis ani, comparing day 0 to day 28 results. For this purpose, a visual analog scale (VAS) was used. Secondary parameters included the physician global assessment score (PGA) of peri-anal skin condition, assessment of patients' quality of life using a specifically designed quality of life scoring tool, and patient satisfaction with the treatment regimen. The application of the acrylate skin protection cream resulted in a fast and substantial improvement of all study parameters, with a high score for patient satisfaction. The cream was well tolerated without any adverse events noted during the study period. The authors' pilot study has generated initial evidence that the acrylate skin protection cream may be effective for the treatment of pruritus ani. However, further randomized controlled studies are needed to confirm the authors' findings.
What the patient needs to know before stoma siting: an overview
Authors: Cronin Elaine
Published: May 2014

Stoma siting is often regarded as the most important aspect of pre-operative stoma preparation ( Readding, 2003 ; Rutledge et al, 2003 ), however, time spent with the patient discussing the finer points of surgery and what can be expected throughout the process is also crucial. Having the opportunity to meet with individual patients prior to surgery allows for the advanced exchange of information and the ability to discuss stoma formation from conception to ultimate patient management in its entirety. This arms the patient with the relevant information before surgery ever takes place, and prepares him or her for the time ahead. This article looks at the steps taken by the stoma care nurse (SCN) in preparing the patient for such surgery.
Intellectual disability nursing and transcultural care
Authors: Doody Owen , Doody Catriona M
Published: May 2014

In today's healthcare environment, nurses are urged to use up-to-date research evidence to ensure better patient outcomes and inform nursing decisions, actions and interactions with patients. Within the practice setting, there is an increasing challenge to provide care to patients from minority ethnic groups. In order to deliver care to different cultural groups, nurses need to recognize and empathize with patients' belief systems, being mindful of their diverse cultural needs. This article presents the concept of transcultural care and identifies issues within intellectual disability nursing through a focus on the components identified by Campinha-Bacote (2002 ; 2003 ) and Cortis (2003) : cultural awareness, cultural skill, cultural knowledge, cultural encounter and cultural desire. It highlights the issues which are relevant to nursing practice, cultural care and service provision for persons with intellectual disability from ethnic minorities in Ireland.
Patient safety in the developing world: new frontiers
Authors: Tingle John
Published: May 2014

John Tingle discusses the World Health Organization'sAfrican Partnership for Patient Safety (APPS) project.
The Sexual Offences (NI) Order 2008: implications for nurses
Authors: Daniels Pauline , McAlinden Orla
Published: May 2014

This article outlines the changes to the definition of sexual offences in Northern Ireland following the implementation of the Sexual Offences Northern Ireland Order 2008 in 2009, and its implications for nurses working with sexually active children in a range of clinical settings. The paper outlines the key changes for practice and addresses the needs of children in three different age groups with emphasis on children aged 13–15 years, and reviews mandatory reporting, the difference between the rights of children to consent and confidentiality, developmental sexual experimentation and sexual health protection. It reviews related policy and guidance and makes clear the differences between sexual abuse and exploitation, and experimentation. It seeks to advise the Safeguarding Committee of the Department of Health Northern Ireland on how best to support nurses working with sexually active children and when this activity should be discussed with line managers and safeguarding specialists or referred to the safeguarding authorities.
Striking the balance: night care versus the facilitation of good sleep
Authors: Eyers Ingrid , Young Emma , Luff Rebekah , Arber Sara
Published: May 2014

This article presents the key findings from an extensive research project aiming to identify the determinants of poor sleep in care homes. A mixed methods study was conducted in 10 care homes in South East England. This included 2-week daily diaries completed by 145 older residents and interviews with 50 care-home staff. This research demonstrated that the regular surveillance by qualified nurses and care assistants at night seriously impedes the quality of sleep experienced by older people living in care homes. However, nurses and social care workers have a duty of care, which would not be fulfilled if regular checks were not undertaken at night. There is a need for care-home staff to strike a balance between enabling older people living in care homes to have a good night's sleep and adhering to their own professional duty of care.
Sex selection and abortion: a case for legal re-evaluation?
Authors: McHale Jean V
Published: May 2014

This question of sex selection and abortion in the UK was highlighted by recent reports in a national newspaper. This paper explores the current legal position and whether there is a case for reforming the law to align the situation of abortion with that of sex selection in the context of pre-implantation genetic diagnosis.
What are pre-registration nurses taught about caring for children?
Authors: Nicholl Honor , Begley Thelma , Murphy Maryanne , Hollywood Eleanor , King Carole
Published: May 2014

Nurse education curricula have to be continually reviewed to ensure that content remains applicable to contemporary healthcare developments. In this article, the authors report the findings of a research study that investigated the children's nursing component taught in all non-children's BSc Nursing degree programmes in Irish colleges. The aim of the study was to identify how European Union directives and national curriculum guidelines are interpreted in colleges, and to clarify the preparation that non-children's pre- registration nursing students receive with respect to caring for children. The authors explored aspects related to children's nursing in all non-children's undergraduate pre-registration programmes, including curriculum content and its delivery, assessments and practice experiences. Data were collected by a specifically designed questionnaire based on the Requirements and Standards for Nurse Education Programmes ( An Bord Altranais, 2005a ; b ). A university ethics committee provided ethical approval. The response rate was 54% (n=7), and data were analysed using SPSS 16 and content analysis. The authors' findings illustrated that the requirements and standards of all nursing programmes are interpreted in a variety of ways regarding children's nursing. Nationally, nursing content related to children needs to be reviewed in all nursing programmes to ensure consistency among providers. Healthcare requirements for children and families need to be heightened within curricula for all disciplines.
Venepuncture and cannulation: considering the ageing vein
Authors: Gabriel Janice
Published: May 2014

Venepuncture and cannulation are among the most widely performed invasive procedures in health care today; yet little attention has been paid to the effects increasing age has on our venous systems and the challenges this creates for the health care professional, as well as the discomfort and potentially distressing experience for the patient ( Powers, 1999 ; Schelper, 2003 ; Dougherty, 2008 ; Gabriel, 2011 ). A review of the literature has identified that there has been little published work in the area of the effects of ageing on the patient's venous system. The aim of this paper is to increase awareness, with the overall objective of improving the quality of patient care.
NPWT and moist wound dressings in the treatment of the diabetic foot
Authors: Yarwood-Ross Lee , Dignon Andree Marie
Published: May 2014

Objectives:

To compare the use of negative pressure wound therapy (NPWT) and conventional wound dressings in the treatment of diabetic foot wounds. This article reviews research that compares the two treatments on partial foot amputations, foot ulcers, infected wounds and dehisced post-surgical wounds.

Methods:

A systematic literature search was carried out using CINAHL, MEDLINE and the Cochrane Library to locate and critique key studies comparing NPWT and conventional wound dressings to determine their quality.

Findings:

NPWT was found to be more effective in treating diabetic foot wounds compared with conventional wound dressings. NPWT was quicker at forming granulation tissue, achieving wound closure, removing infection from foot ulcer beds and decreasing wound dimensions. Data also showed greater incidence of amputations in those patients treated with moist wound dressings.

Implications:

Findings suggest that NPWT could be used as a primary treatment for diabetic foot wounds. Factors such as cost effectiveness and patient acceptability may have an impact on this treatment and will need to be investigated in implementing NPWT into practice.
The impact of policy and screening on cervical cancer in England
Authors: Bryant Elizabeth
Published: May 2014

There has been a significant statistical decrease in the incidence of cervical cancer since screening programmes have been introduced. This article will explore and evaluate the impact of the Cancer Reform Strategy on cervical screening in England, which preceded the Government's policy for cancer care announced in January 2011. The Strategy raised the initial age of screening from 20 to 25 years of age. This left a group of the population who could not access screening while also not being eligible for vaccines against cervical cancer. Although this caused concern for many people, the media coverage and reaction to the human papilloma virus (HPV) vaccine and the death of Jade Goody, for example, encouraged women to consider cervical screening. The barriers to screening have been identified but overall the Cancer Reform Strategy was found have a positive impact both economically and socially. The Strategy has led the way for the Government's policy for cancer care, which needs to continue achieving the same positive outcomes.
Ventilator-associated pneumonia, liver disease and oral chlorhexidine
Authors: Oshodi Titilayo O , Bench Suzanne
Published: May 2014

As part of the ventilator care bundle, the Department of Health (DH) in the UK recommends the use of chlorhexidine (CHX) for oral care to prevent the occurrence of ventilator-associated pneumonia (VAP) in all mechanically ventilated patients. Due to the heterogenous nature of this population, however, it is important to consider whether such recommendations are also relevant to specific critical care patient population groups. This article reviews the available scientific evidence on the use of CHX in the prevention of VAP, with a focus on critically ill mechanically ventilated patients who have liver dysfunction. Findings will be discussed with reference to the wider research literature in order to make recommendations for future practice.
Receiving group clinical supervision: a phenomenological study
Authors: Taylor Claire
Published: May 2014

This study examined the process of group supervision as experienced by one team of biofeedback therapists working in the south of England. A phenomenological study was undertaken to examine the team's perceptions of attending group supervision over time. Ten one-to-one in-depth interviews were conducted, six of which were with biofeedback therapists currently receiving supervision, three with nurses who used to receive this supervision and one interview with the supervisor.

A four-stage model detailing how supervisees' experiences changed as a consequence of continued group supervision was developed. Study data revealed how this process allowed the biofeedback therapists to examine their clinical interventions and align their approach and perspective alongside other team members. This was a valuable and safe way of learning ‘on the job’ for the newer members of the team. The opportunity for free-thinking and reflection on practice supported clinical decision-making and therapeutic nursing. The more experienced supervisees demonstrated how their continued attendance of the group supervision sessions not only confirmed their expertise in role, but also facilitated their colleagues' development, which enhanced role satisfaction. The data also indicated some of the essential supervisory features of this process.
Caring for young adults on a paediatric ward
Authors: Heaton Paul AJ , Routley Christine , Paul Siba Prosad
Published: May 2014

The need for adolescents and young adults (AYA) to have suitable age-specific inpatient facilities has been recognised for many years, yet has received relatively little attention. This article reports the successful introduction of an inpatient facility for AYA, aged 17–24 years, on a general paediatric ward in a small district general hospital. From December 2010, a young person's unit (YPU) consisting of an 8-bed area was opened within a 24-bed children's ward. Nursing care was provided by the ward staff, all of whom had been trained in the care of young adults. Policies regarding admission criteria, safeguarding, patient choice, visiting and ‘house rules’ were drafted, implemented and modified as necessary. Discussions with the adult clinicians (for medical care) and site managers were held to ensure smooth running of the system, and to address any concerns or difficulties. Paediatric patients had priority of admission at times of bed crisis. During 2012, there were a total of 2351 inpatient admissions to the paediatric ward, of whom 379 (16%) were YPU patients aged from 17–24 years. Median length of stay was 2 days for patients aged 17–24 years as compared with 1 day for patients aged ≤16 years. Patients who chose admission to the paediatric ward tended to be younger, in transition from paediatric to adult services for chronic conditions, or with special needs. Patient surveys showed a high level of satisfaction with the facility. Young adults can be cared for safely and effectively on a paediatric ward with minimal additional costs. The essential ingredients for success include discussion with affected parties to address specific concerns, and the establishment of a clear, simple and unambiguous admission policy.
Determining what is in the best interests of a critically ill child
Authors: Griffith Richard
Published: May 2014

Controversy over the use of end-of-life pathways with terminally ill patients has now extended to their use with critically ill children and babies ( Boyd and Murray, 2012 ). At the centre of the present controversy is the claim that parents feel coerced into agreeing that it is in their child's best interests to be placed on the pathway ( Ford Rojas, 2012 ). In this article, Richard Griffith reviews the development of the best interests test adopted by the courts when dealing with cases of seriously ill children and babies, and argues that the test should inform the decision on when continued care and treatment become futile and the use of an end-of-life care pathway should be considered.
Student nurses' intention to get the influenza vaccine
Authors: Cornally Nicola , Deasy Elizabeth Ann , McCarthey Geraldine , McAuley Catherine , Moran Joe , Weathers Elizabeth
Published: May 2014

Introduction: There is no national or international recommendation for nursing students to receive the influenza vaccine. Nurses are among the group of health professionals who traditionally have a low uptake of the vaccine and who arguably have the closest contact with patients.

Aim: To investigate the uptake of influenza vaccination among student nurses, explore reasons for either declining or receiving it in the past, and establish if and to what extent the theory of planned behaviour (TPB) can explain vaccination behaviour.

Methods: A quantitative, descriptive, correlational design was used. Data were collected with a researcher-developed questionnaire; 131 student nurses participated. Ethical approval was gained.

Results: 79% (n=104) had never received the vaccine. The most common reason was ‘I don't need it as I rarely get ill’. Low mean ‘intention’ scores indicated that students were unlikely to get the vaccine once qualified. Past behaviour was significantly associated with future intentions. The TPB explained 41.9% of the variance in intention. Attitude emerged as the greatest predictor.

Conclusion: Student nurses do not have strong intentions to get the vaccine. Results serve to guide future educational and occupational health initiatives, which would benefit from a framework based on TPB.
Lost in transition: child to adult cancer services for young people
Authors: McInally Wendy
Published: May 2014

Cancer nursing care across the UK has dramatically improved for children and young people with cancer over the past 20 years ( Department of Health, 2007 ). Around 70% of young people diagnosed with cancer survive into adulthood, albeit with long-term health complications (Scottish Government, 2012). This raises the contemporary concern of how best to transition these patients to an adult-focused care regime ( National Cancer Survivorship Initiative, 2012 ). With support from a Florence Nightingale Foundation Travel Scholarship in 2012, this study compared the various transition models currently in use across the UK, Finland and the USA with a clear focus on individual patient choice, staff education and preparation to care for this group of patients and their families. The findings revealed wide discrepancy in current nursing practices across the globe. This article presents a series of findings and recommendations to improve further the overall cancer experience for young people living with and beyond a cancer diagnosis.
Preparing for and conducting focus groups in nursing research: part 2
Authors: Doody Owen , Slevin Eamonn , Taggart Laurence
Published: May 2014

Focus group interviews are widely used in health research to explore phenomena and are accepted as a legitimate qualitative methodology. They are used to draw out interaction data from discussions among participants; researchers running these groups need to be skilled in interviewing and in managing groups, group dynamics and group discussions. This article follows Doody et al's (2013) article on the theory of focus group research; it addresses the preparation for focus groups relating to the research environment, interview process, duration, participation of group members and the role of the moderator. The article aims to assist researchers to prepare and plan for focus groups and to develop an understanding of them, so information from the groups can be used for academic studies or as part of a research proposal.
Spiritual coping in rehabilitation– a comparative study: part 1
Authors: Baldacchino Donia , Torskenaes Kristina , Kalfoss Mary , Borg Josette , Tonna Aaron , Debattista Clifford , Decelis Neville , Mifsud Rodianne
Published: May 2014

Chronic illness is defined as a long-term disease that challenges a person's physical, psychological and spiritual wellbeing. However, individuals may adapt to their condition by adopting spiritual coping strategies that may or may not include religiosity. Part 1 of this article presents the methodology of this cross-sectional comparative study, which explored the spiritual coping of patients with chronic illness receiving rehabilitation services in Malta (n=44: lower limb amputation n=10; chronic heart disease n=9; osteoarthritis—in an institution n=10 and in the community n=15); and in Norway (n=16: post-hip/ shoulder surgery n=5; chronic heart disease n=5; chronic pain n=6). Data were collected from seven purposive samples during focus group sessions. Roy's Adaptation Model (1984) and Neuman's Systems Model (2010) guided the study. While acknowledging the limitations of this study, the findings presented in Part 2 identify commonalities in the spiritual coping of patients irrespective of cultural differences between Malta and Norway. A set of recommendations address clinical practice, education and further research.
Child development and the scope of parental responsibility: part 1
Authors: Griffith Richard
Published: May 2014

The scope of parental responsibility has once again come under scrutiny following the case of Neon Roberts ( Walker, 2012 ) whose mother objected to treatment for his brain tumour. This first of two articles considering the scope of parental responsibility sets out the key provisions and discusses the right of the court to overrule a parent's decision to refuse medical treatment for their child.
Focus group interviews part 3: Analysis
Authors: Doody Owen , Slevin Eamonn , Taggart Laurence
Published: May 2014

The use of focus group interviews as a means of qualitative data collection has gained popularity in health service research in recent years. Despite their popularity, analysing qualitative data—particularly focus-group interviews—poses a challenge to most researchers. This article follows the authors' previous articles on; focus group theory, and the preparation and conduct of focus group interviews. Despite the publications on conducting focus groups, little information exists regarding the analysis of data gathered in such groups in health services. The present paper focuses on the concepts and application of data analysis and the use of analysis frameworks. The article aims to assist researchers and provide practical steps for the analysis of focus-group data. Thus, the authors provide a framework for analysing focus group data through identifying data analysis techniques suited for the study of these data.
Placements: stepping stones to excellent care
Authors: Easby Deborah
Published: May 2014

Deborah Easby is in her third year of a nursing degree at Sheffield Hallam University, with just 6 months to go until graduation. Throughout her studies she has been sent on various placements and here she talk about some of her experiences and looks to her future as a registered nurse.
NICE guidelines for new chest pain: comparison of new and old services
Authors: Rabasse Praba , Johnson Collette , Malik Nadim
Published: May 2014

In 2000 the National Service Framework for Coronary Artery Disease (CAD) prompted the development of rapid-access chest pain clinics (RACPCs). The aim of such clinics is to provide prompt assessment of chest pain to identify CAD with the use of an exercise tolerance test. In 2010, the National Institute for Health and Clinical Excellence (NICE) guidelines recommended using imaging studies based on CAD risk scoring and not an exercise tolerance test to exclude angina in patients with no previous history of known CAD. A comparison of the use of the 2010 NICE guidelines for the management of new-onset chest pain within a well-established exercise-based RACPC service is undocumented. The new recommendation moves the focus towards discharging low-risk patients, imaging studies/invasive procedure (angiogram) for the moderate-risk group and initiating anti-anginal treatment for the high-risk group. To phase the new recommendations into clinical practice in a district general hospital, the new guidelines were implemented in one out of three RACPC sessions per week. A retrospective assessment was carried out over a 4-month period to evaluate the new service implementation. A total of 160 patients attended the RACPC service, of which 56 (35%) were offered treatments according to the newer NICE guidelines and 104 (65%) were managed with the aim of exercising on the treadmill. This review gives an insight into the benefits of the new recommendations in practice, as well as highlighting some of the immediate limitations and barriers encountered.
Implementing a pressure ulcer prevention bundle into practice
Authors: Downie Fiona , Perrin Anne-Marie , Kiernan Martin
Published: May 2014

The implementation of a care bundle approach to delivering fundamental care in practice is now a recognised and effective way of translating research into practice, offering consistent care with resulting positive outcomes for the patient. A care bundle consists of a relatively small number of interventions for every patient to whom the bundle is applied. However, there must be evidence behind each individual intervention to indicate, if delivered, how it will reduce the risk to the patient. This paper reports on a strategy for developing and implementing a pressure ulcer (PU) combined prevention care bundle/care plan into practice. The effectiveness of the care bundle can be measured when it is in use in the practice setting with an audit tool.
Reducing avoidable harm caused by pressure ulcers
Authors: Harrison Tarnia , Kindred Jane , Marks-Maran Di
Published: May 2014

This article reports on the successful work undertaken within one NHS trust to reduce the incidence of pressure ulcers. The tissue viability nursing team at Medway NHS Foundation Trust devised, implemented and evaluated a strategy to reduce the incidence of pressure ulcers. This involved devising a comprehensive database, intensive monitoring using root cause analysis, writing action plans using high-impact actions (HIAs) and innovative thinking to address and reduce the incidence of pressure ulcers and staff training in the use of the SKIN acronym. This work identified pressure ulcers on the ears of patients receiving oxygen therapy as a particular problem. An evidence-based and multiprofessional strategy was devised to deal with this particular problem, which resulted in no further incidence of pressure ulcers on the ears of patients receiving oxygen therapy. The entire pressure ulcer reduction strategy was positively evaluated and proved to be sustainable.
Determining fever in children: the search for an ideal thermometer
Authors: El-Radhi A Sahib
Published: May 2014

Body temperature measurement is most commonly taken to confirm the presence or absence of fever. Many decisions concerning the investigation and treatment of children are based on the results of temperature measurement alone. Determining the presence of fever in young children is particularly important. A missed fever is serious, but a false-positive fever reading can result in unnecessary septic workups. The axillary, rectal, oral and tympanic membrane sites are most commonly used to record body temperature, and electronic and infrared thermometers are the devices most commonly used. Each site and device has numerous advantages and disadvantages, which are described in this article. The search for the means of measuring body temperature that best combines accuracy, speed, convenience, safety and cost-effectiveness goes on. The infrared thermometer and the tympanic site appear to offer such a combination. Electronic thermometers are also suitable when used orally or at the axilla in newborn babies.
‘Is elderly care affected by nurse attitudes?’ A systematic review
Authors: Hanson Ruth M
Published: May 2014

Background:

The world's population of older people is increasing, The World Health Organization (WHO) (2013a) defines ‘elderly’ as those 65 years and older. Currently there are deficits in good basic care, partially resulting from the negative attitudes of some nursing staff.

Method:

This systematic review was conducted by searching the CINAHL and MEDLINE databases, which produced 119 results. Three original research papers were extracted, the fourth was obtained from a reference list and the final paper was taken from the internet.

Results:

Both student and qualified nurses can portray a negative attitude towards older people, thus negatively affecting care. The reasons for these negative attitudes are numerous, although lack of knowledge of the ageing process and gerontology prevail.

Conclusion:

Further research is required and in-depth interviews to establish why some nurses portray negative attitudes. Strategies need to be implemented to address these issues, so encouraging better care provision.
Older people and barriers to self-reporting of chronic pain
Authors: Gammons Victoria , Caswell Glenys
Published: May 2014

Too many older adults live with the negative consequences of chronic pain and its detrimental impact on quality of life. To explore this, an extended literature review was conducted to identify barriers the older person encountered in the self-reporting of their chronic pain. Four themes were found to mediate help-seeking behaviour. Attitudes such as stoicism, beliefs such as pain being a necessary part of ageing, and the external barriers generated by health professionals, all have a multidimensional relationship with the ‘decision’ to seek help for pain. Personality and the perceived importance of independence were found to influence these responses. The findings imply that communication between the health professional and patient needs to improve during the more comprehensive assessment of chronic pain. To achieve such improvements, it is first necessary to eradicate ageist attitudes held both by the elderly and within health care.
Psychosocial barriers to sexual intimacy for older people
Authors: Garrett Dawne
Published: May 2014

A review of the literature relating to the psychosocial barriers to sexual intimacy in older people reveals wide-ranging influences on people aged 75–85 years. These influences include: a lack of positive social policy, a lack of research, partner availability, negative media portrayals, psychological factors, relationship factors, and difficulties in interactions with health professionals. Stereotypical attitudes about sexual intimacy and older people remain a cultural norm. A high value is placed on a gold standard of sexual performance, which can reinforce negative esteem and set unrealistic expectations and measures for older people. This article focuses on the majority of the older population who do not require residential care. It examines major influences emerging from a review of the literature from 1995 to 2013, which informs a working definition for sexual intimacy in people over the age of 75 years. The article concludes with key recommendations for nurses working with older adults.
Effects and impacts of Productive Ward from a nursing perspective
Authors: White Mark , Waldron Michelle
Published: May 2014

The Productive Ward: Releasing time to care (PW) initiative is predominantly a nurse-led quality improvement (QI) offering, designed to streamline ward work processes and clinical environments in an attempt to ‘release time to care’. It has been implemented widely in the UK, recently attracting international interest. This paper systematically reviews the literature relating to the PW initiative, highlights and ranks the reported effects and impacts from a nursing perspective. Nine themes emerged from our content analysis. This paper examines the three most reported themes—empowerment, leadership and engagement—exploring how they may influence the opportunities for implementing and sustaining the initiative. This study brings some experience, learning and insight from the PW initiative to those currently involved in implementation. It also highlights some elements of change not being delivered by PW. The comprehensive list of reported impacts and effects, from a nursing perspective, adds value to senior nurses attempting to cultivate a culture of QI.
Management of Menopausal Symptoms for Breast Cancer Patients
Authors: Daniel Bethan , Mitchell Helen , Higham Philip , Timpson Joanne , Foy Sharon
Published: May 2014

Background:

Menopausal symptoms are commonly experienced in women treated for breast cancer. This project aimed to identify the types and prevalence of menopausal symptoms women experience and assess how well such symptoms are managed by means of a clinical audit. The authors also wanted to identify whether patients and health professionals require further education in this area to enhance patients' quality of life.

Method:

A pilot audit was initially undertaken. Twenty women were recruited from medical and clinical oncology clinics spanning a 2-week period. The main audit was conducted over a 3-week period (19 March 2012 to 6 April 2012). A total of 215 patients were surveyed from 11 consultant-led and 1 nurse-led clinic per week. A menopause rating scale (MRS) developed by Heinemann et al (2003) was used to assess the types and severity of symptoms.

Results:

Findings from the main audit provided preliminary evidence that certain breast cancer treatments can cause either the early onset of menopausal symptoms in pre-menopausal women or the return or aggravation of menopausal symptoms in peri-menopausal or post-menopausal women. This indicated that, for many women, symptoms are inadequately managed and supported.

Discussion:

A more detailed exploratory study of the management of menopausal symptoms is needed. Health professionals should consider discussing such symptoms when patients start treatment and assess these symptoms at follow-up appointments to identify potential interventions.
Challenges for the clinical nurse specialist in uro-oncology care
Authors: Anderson Beverley
Published: May 2014

Cancer is a complex illness that over the years has provoked much fear and speculation for patients, their relatives and health professionals. Emphasis has been placed on cancer management from the point of diagnosis, as well as treatments and their associated risks. As a result of increased technology and improved treatment modalities, more people are now surviving cancer and go on to live longer and healthier lives. While such an achievement is commendable, it places a significant strain on the healthcare economy. The Cancer Reform Strategy acknowledges that the management of cancers in the UK warrants clear definitive protocols and guidelines, to ensure a strategy that is capable of achieving the desired outcomes for those individuals who are affected by the disease. Integral to this objective is the multidisciplinary team, in which the role of the cancer nurse specialist is fundamental to achieving holistic patient outcomes. However, this article addresses the challenges of a uro-oncology clinical nurse specialist from a conceptual, as well as a personal, perspective. It focuses on the role that is specific to the management of patients who are diagnosed with urological cancers.
Medical honey and its role in paediatric patients
Authors: Weissenstein Anne , Luchter Elisabeth , Bittmann Stefan
Published: May 2014

Background: The use of complementary medical treatment in wound management has continued to grow throughout the world. There is a large body of evidence that supports the use of honey as a wound dressing for a wide range of wound types. The authors present an update of present knowledge about honey as a form of complementary medicine in paediatric wound management.

Methods: The literature cited was found by searching the PubMed, BIOSIS and ISI Web of Science databases for the phrase ‘honey and wound’. Papers where honey was used in a mixture with other therapeutic substances were excluded. Randomised controlled trials as well as case studies were taken into consideration.

Results: This paper reviews data on the effectiveness of honey in wound healing; 80 citations or references were found that matched the criteria. Furthermore, the wound-healing properties of honey are described and the mechanism of action discussed. The authors' data show that honey induced enhanced epithelialisation, minimised scar formations and had an anti-microbiotic effect.

Conclusion: These results should encourage the use of medical honey in the field of paediatrics. It is a safe and natural substance that induces wound healing at a greater rate than conventional methods.
The debt we owe Thomas Szasz
Authors: Barker Phil , Buchanan-Barker Poppy
Published: May 2014

Future historians will cast Thomas Szasz as the great moral philosopher of psychiatry: the 20th century’s most intrepid campaigner for the blindingly obvious. People do not have ‘mental illnesses’, as they suffer from cancer or diabetes, but experience a wide range of moral, interpersonal, social and political ‘problems in living’. Today, Szasz remains misrepresented and misunderstood—cast as a ‘mental illness denier’ or an ‘antipsychiatrist’.
Human libraries: removing stigma
Authors: Russell Esther , Linsley Paul
Published: May 2014

Esther Russell and Paul Linsley discuss how ‘human library’ events can offer insight into the experiences of mental health service users
The impact of mental health problems in the workplace
Authors: Walsh Lynne
Published: May 2014

Mental wellbeing is important for everyone. The need to raise awareness of mental health and wellbeing in the workplace is of utmost importance due to the current economic situation and the potential emotional impact of job losses due to the recession. It is not only those who may lose their jobs that may become stressed and depressed, but also those remaining in the workplace who are having to undertake increased workloads and responsibilities within their working day. Both employers and employees have a responsibility to look after both themselves and each other in the workplace.
An audit of child health nursing records in NHS Grampian
Authors: Allan Elaine , Clark Caroline , Farquhar Ainsley , Haxton Jenni , Kirk Liz , Lieberum Pauline
Published: May 2014

Accurate record keeping is important for many reasons, including demonstrating and recording activity and enabling safe transfer of care between professionals. An audit of child health records in Aberdeen and Aberdeenshire showed much good practice, but also areas for improvement.
Meals, carbohydrate intake and school performance
Authors: Benton David
Published: May 2014

The brain relies almost exclusively on glucose as its source of energy and if breakfast is missed, reports have shown that memory and mood are poorer. Children require a constant source of energy and should eat little and often but some foods are more beneficial than others.
Senior lecturer in community nursing
Authors: Coverdale Gill
Published: May 2014

Gill Coverdale describes a hectic week as a senior lecturer in community nursing and course leader for the Specialist Community Pulblic Health Nursing (SCPHN) degree at Leeds Metropolitan University, as well as being a member of the British Journal of School Nursing editorial board.
School nursing in Cornwall: planning to protect the future
Authors: Godson Rosalind
Published: May 2014

On Thursday 1 February 2007 crunch talks with managers at the Cornwall and Isles of Scilly Primary Care Trust took place over the deteriorating situation of school nurses. Rosalind Godson provides an overview of the issues and suggests changes that could be made.
The media don’t help us get the obesity message across
Authors: Tomlin Charlotte
Published: May 2014

Dear Editor,

An aquaintance of mine was talking about the obesity strategy that is being conducted in schools. Her main concern was that she had heard on the news or GMTV etc that parents were going to be reported to social services for having an overweight child. Her own daughter is slighty overweight and has a very limited healthy diet, but not for the want of trying to encourage healthy eating. I tried to reassure her that any phone call or letter from a school nurse would not include a referral on to social services and attempted to explain this new public health agenda to her. However the fact that it had been on the television had already made her defensive with regard to any school nurse communication.
A school nurse community practice teacher
Authors: Robinson Caron
Published: May 2014

Caron Robinson has a busy week travelling between both primary and secondary schools to carry out the range of responsibilities she has as a community practice teacher. Along with these duties she also makes time to complete a Masters programme in Professional Education.