bluuebunny/crossref_metadata_2025 huggingface dataset:
Challenges facing newly qualified community nurses: a qualitative study
Authors: Maxwell Claire , Brigham Lindsay , Logan Jennifer , Smith Ann
Published: May 2014

This article describes a qualitative study that set out first to explore the challenges facing recently qualified nurses working in community and intermediate healthcare settings, and their perceptions of role and professional identity, and then to propose effective support structures. Data were gathered using individual interviews which were recorded, transcribed and analysed through categorization using four key themes: transition work; new learning; support and supervision; professional identity and integration. It was concluded that transition can be challenging and stressful but, despite the level of independent working in the community, participants can be helped to develop resilience by a supportive environment in which their developmental needs are identified and met. Recommendations are made concerning the need for a more structured and planned approach to induction and preceptorship.
An integrative treatment for lower limb lymphoedema in India
Authors: Bose Kuthaje Subhaschandra , Aggithaya Guruprasad Madur
Published: May 2014

Lymphoedema is a chronic disease which requires frequent visits to therapist in developed countries. In most developing countries, it is the disease of rural area caused by lymphatic filariasis (LF). The aim is to develop a low cost home-based self-care protocol using the combinations of locally available treatment modalities. The integrated treatment has the elements of therapy from modern dermatology, Ayurveda and yoga, administered by the doctors of respective system of medicine on the basis of pathophysiological understanding in lymphology. The sequence of treatment components that each patient followed is skin wash, soaking the limb in herbal Phanta solution, care of bacterial entry points, a set of yoga exercises, Indian manual lymph drainage and compression bandaging. A total of 1209 limbs in 889 patients were treated using integrated medicine during October 2004–May 2011. All patients received an initial 14 days of supervised treatment and training for self-care and home-based treatment to be continued for life. Patients followed up twice. Volume reduction for large sized limbs at 3 months following treatment was 41.1%, with a confidence interval (CI) of 5.7–6.9 litres. Reduction was 25.7 % for small limbs with a CI of 1.5–1.7 litres. Entry points were present in 86.2% limbs at baseline and in 71.7% limbs at the end of 3 months. Inflammatory episodes reduced from 80%–8.6%.
Malignant fungating wounds: a review of the patient and nurse experience
Authors: Taylor Carole
Published: May 2014

Malignant fungating wounds do not occur frequently; however, the impact they can have on patients and those caring for them can be overwhelming and devastating. The literature has identified that the worst aspect for patients is the suffering caused by malodour and excessive exudate levels, and has also described how nurses struggle to manage these symptoms. Understanding the patient experience and the difficulties nurses are faced with when they care for patients with a wound of this type can help to provide support and guide practice. The disfiguring and unpleasant nature of these wounds can leave nurses with lasting memories of the experience. Outcomes must be patient-focused and decided in conjunction with health professionals, concentrating on what really matters to the patient.
An investigation of food provision and consumption in a care home setting
Authors: Cunneen Sinead , Jones Jacklyn , Davidson Isobel , Bannerman Elaine
Published: May 2014

Background: Malnutrition and dehydration are life-threatening conditions affecting a large proportion of the elderly community in care homes. Despite the provision of guidelines aimed at ensuring the nutritional requirements of individuals are met, the prevalence of malnutrition remains particularly high in institutionalized older adults. This article describes a study carried out in one Scottish care home to assess food and fluid provision and consumption among care home residents and also identify the contribution different eating occasions make to food intakes.

Participants: Participants for the study were recruited from a private long-term care home facility in the Edinburgh locality. Individuals receiving palliative treatment were excluded from this study. Participants needed to reside full time at the nursing home for inclusion to the study.

Study Design: Cross-sectional observational study (case study) to determine food provision and also food consumption of care home residents. Dietary intake of each participant was recorded and analyzed for a 24 hour period using plate-wastage methodology. All foods and fluids throughout the day were weighed using calibrated scales (1.0 g) both before foods were served to residents and any leftovers were weighed following consumption. Foods were recorded as per each eating occasion, namely breakfast, lunch, evening meal and also any snacks or drinks. Estimated energy, fluid and macronutrient content of the food provided and consumed was estimated using Windiets dietary analysis software ( 2005 ) and then compared to FSA Guidelines ( FSA 2007 ) using one sample t-tests (P < 0.05 indicated statistical significance).

Results: Food provision and consumption for a total of 25 residents was measured (n = 3 males: n = 22 females); mean (SD) age 86(8) years. There was no significant difference between energy provided (mean ±SEM) 2001 ± 59 kcal compared with recommended provision 1955 kcal (FSA, 2007). However, significantly less energy than recommended (mean ± SEM) (1634±72 kcal) was consumed (P < 0.01). More than 95% of snacks provided were consumed, as a result these contributed an equivalent proportion to overall energy intake as breakfast and lunch, but these were not rich in protein.

Conclusion: Provision of food and fluids within the care home meets FSA guidance, but residents tended to consume significantly less than what was provided thus nutritional deficiencies may exist. Further investigation into snack provision is warranted.
Wound care: ensuring a holistic and collaborative assessment
Authors: Benbow Maureen
Published: May 2014

Wound assessment has developed into a specialized and complex area of nursing practice. Care plans and interventions are based on the initial assessment, which must therefore be accurate and clearly documented to support correct ongoing wound care and patient management. It is vital that the underlying and contributing patient factors to both wound development and healing, delayed healing or non-healing are considered throughout the process. Evaluation of interventions must be regular and consistent. This article will discuss the importance of holistic and collaborative assessment for the patient with a wound, exploring factors affecting healing and considerations to be made on initial and continous levels.
Diabetes: support for those at risk of malnutrition in the community
Authors: Hughes Siobhan
Published: May 2014

Diet is the cornerstone of treatment in diabetes and dietary advice should be tailored to the individual and their circumstances. This article focuses on patients with diabetes who are identified as being at risk of malnutrition and community nurses are ideally placed to meet patients' continuum of health needs. Emphasis should be put on nutritional support, encouraging food fortification (some recipes will need adapting), full-fat products and high-energy snacks. Diabetes treatment will need to be reviewed regularly to reflect changes in the patient's needs. Glycaemic targets need to be agreed with the patient and those at risk of hypoglycaemia identified. Strategies should be put in place for minimising risk and a clear treatment plan implemented. In cases where the risk of malnutrition is resolved, the patient and family may need support returning to previous dietary recommendations.
Clinical challenges and ongoing role changes for primary health-care nurses
Authors: Boström Eva , Hörnsten Åsa , Persson Chatrin , Rising Inger , Fischer Regina Santamäki
Published: May 2014

Objective:

To investigate the perceptions of primary health-care nurses (PHNs) about clinical demands and future challenges.

Method:

Qualitative content-analysis of open questions from a questionnaire. A total of 121 PHNs from health-care districts in northern Sweden filled in a questionnaire during a mandatory educational day.

Results:

Key issues that were raised included: defending the specific professional role of the PHNs; strengthening their self-governance and authority; and ensuring adequate care in the future through education that focuses more on nursing practice than on academic work.

Conclusion:

To ensure that the role of the PHN continues to develop, it is necessary to enable them to articulate, discuss, and evaluate their profession and to learn, in concrete forms, how to implement science in clinical practice.
Assessing children’s competence to consent to treatment
Authors: Griffith Richard , Tengnah Cassam
Published: May 2014

Although district nurses provide care and treatment to adults, they also have children on their caseloads from time-to-time. Obtaining consent for the examination and treatment of children is a complex process, where parental responsibility and the developmental concept of Gillick competence become increasingly intertwined as the child matures to adulthood. In this article, the authors consider the requirements for Gillick competence, and highlight the factors district nurses must consider when determining whether a child is competent to give consent to treatment.
Subcutaneous injections: preventing needlestick injuries in the community
Authors: Aziz Ann-Marie
Published: May 2014

Community nurses provide care to patients in a variety of settings, for example health centres, community hospitals, patients’ homes, residential and nursing homes. Administering subcutaneous injections to patients in the community is an everyday activity for many nurses in clinical practice. Many problems related to being ‘sharps safe’ are common to both community nurses and hospital staff. The majority of subcutaneous injections administered in the community are for patients with diabetes. Reducing needlestick injuries after the administration of subcutaneous injections in the community remains paramount to all NHS staff. This article provides information on what national standards to employ when administrating subcutaneous injections and what safety practices should be undertaken for good sharps management. Staff administering subcutaneous injections in the community need to ensure that they are updated on the latest developments in safety needle devices in order to prevent needlestick injuries and provide safe, effective and individualised care for their patients.
Medicines law overhaul with
Authors: Griffith Richard
Published: May 2014

The Human Medicines Regulations 2012 are a major consolidation of medicines law. They largely replace the Medicines Act 1968 and some 200 further pieces of secondary legislation, including the Prescription Only Medicines (Human Use) Order 1997 that defined and set out the authority of non-medical prescribers.

Although the 2012 regulations mainly consolidate medicines law into one piece of secondary legislation it does introduce some policy changes that will influence district nurse practice by allowing non-medical prescribers to issue patient-specific directions in primary care settings and allowing community pharmacists to make changes to a prescription without the need to contact the prescriber beforehand.
Managing disease-related malnutrition in the community
Authors: Holdoway Anne
Published: May 2014

Community nurses and colleagues have an important role to play in the identification of nutritionally vulnerable individuals, screening for risk of malnutrition and ensuring that timely interventions take into account an individual's nutritional, psychological, physical and emotional needs. They must also be aware of the oral nutrition strategies available, including practical guidance and information on oral nutritional supplements (ONS) as an adjunct to treatment. This article provides an overview of managing adult malnutrition in the community including advice on the use of ONS.
The psychosocial impact on patients with altered body image from burns
Authors: McRobert John
Published: May 2014

Advances in plastic surgery techniques using autologous skin grafts and bioengineered skin substitutes, combined with a greater understanding of fluid management and intensive care treatment, have increased the chances of survival in patients with major burn injuries. Today, patients are being discharged home from hospital after sustaining burn injuries that 20 years ago would have been considered unsurvivable. This has in turn increased the number of patients who have to cope and adjust to life with larger wounds and disfiguring scars.

The body image care model ( Price, 1990 ) comprises three related key components: body reality, body ideal and body presentation. Our body reality only rarely meets our body ideal, and thus body presentation is used in an attempt to balance the ideal and reality. The fear avoidance model ( Newell, 1999 ) attempts to distinguish between patients who adapt to disfigurement and reintegrate into society and those who do not.

This article questions if both models consider body image as a dynamic, continually changing concept, and if these care models give community nurses a strong basis to provide holistic, patient-centred care. The author also explores whether nurses using psychosocial models alongside biomedical models can successfully provide effective psychological assessment and care for patients with large wounds and disfiguring scars.
Negative pressure wound therapy: a study on patient perspectives
Authors: Bolas Niamh , Holloway Samantha
Published: May 2014

Aim:

to explore patients' lived experience of using negative pressure wound therapy (NPWT).

Method:

A phenomenological approach based on Heideggerian philosophy was undertaken. The study population consisted of 6 participants who had used NPWT for a minimum of 4 weeks. Semi-structured interviews were transcribed verbatim and investigated for themes using interpretative phenomenological analysis.

Results:

Three superordinate themes were identified: altered sense of self, new culture of technology and leading a restricted life. Themes associated with an altered sense of self and leading a restricted life were in keeping with other wound care studies. Identification of barriers such as managing technical difficulties, practicalities of daily living, and improved understandingof NPWT for both patient and practitioner, can foster hope and reduce anxiety.

Conclusions:

Recommendations include holistic assessment of patient suitability for NPWT, education for patients and health professionals on NPWT, use of lighter, quieter devices, and the inclusion of a technology domain in future health-related quality of life studies on NPWT.
Urinary incontinence: providing respectful, dignified care
Authors: Nazarko Linda
Published: May 2014

People are living longer than ever before and ageing and illness associated with ageing can affect a person's ability to remain continent. In many cases, the older person can benefit from rehabilitation and continence promotion. In some cases, this is not possible and the nurse's role is to work with the older person to help the person manage continence problems. It is vital that nurses work with individuals to provide person-centred continence care. This paper examines some of the difficulties older people can experience and how the nurse can enable the individual to have the best possible quality of life.
Good handwriting: a vital element of a district nurse's duty of care
Authors: Griffith Richard
Published: May 2014

Written records and prescriptions continue to be common in district nursing and will continue to be until the Government achieves its goal of a fully digital NHS by 2018. The main issue with written records and prescriptions is the risk to patient safety caused by poor handwriting, resulting in illegible instructions and prescriptions. In this article the author considers the duty of district nurses to write clearly and highlights the financial and human cost of poor handwriting.
Caring for older lesbian, gay and bisexual people
Authors: Peate Ian
Published: May 2014

Ageing brings about a number of challenges for heterosexual, lesbian, gay and bisexual people. It can be a time of anxiety and concern. The expectations that many lesbian, gay and bisexual people have of how they would like to be cared for if they were to enter sheltered housing or other forms of residential care can be very different from the expectations of heterosexual people. This article considers issues that older lesbian, gay and bisexual people may encounter with regard to their health-care needs.
District nursing: the hidden giant of the NHS?
Authors: Heaslip Vanessa
Published: May 2014

The recent 65th birthday of the NHS is a reminder of the purpose of the NHS: to provide a service that puts people that need it at the heart of care. However, recent negative reports have questioned nurses’ ability to provide this care, which led to the development of the 6Cs. This article examines each of these values from the viewpoint of the district nursing service, in particular from a district nurse's perspective, as well as providing a critical commentary regarding the future of the service.
Wound infection: a clinician's guide to assessment and management
Authors: Tickle Joy
Published: May 2014

Wound infection significantly increases the cost of wound care and has significant detrimental effects on patients' quality of life. It is imperative that all health-care professionals are able to promptly recognise and assess for wound infection and initiate effective management. Clinicians must be able to recognise the different levels of bacterial bioburden and to act accordingly. This article provides clear guidance for recognising an infected wound, understanding the different levels of wound bioburden and practical guidance on different forms and appropriateness of antimicrobial agents.
Supporting behaviour change in older people with type 2 diabetes
Authors: Tomlin Ali , Asimakopoulou Koula
Published: May 2014

This article examines current research on behaviour change in relation to supporting older adults with type 2 diabetes in the community. It outlines the different areas of self-care that older adults with diabetes engage in, argues for the need for behaviour change intervention in adults with the illness and discusses the complexities of diabetes self-care regimens, with particular focus on older adults. A review of current scientific thinking about eliciting behaviour change in areas such as diet, physical activity and medication taking is undertaken. The article concludes with a set of practical recommendations for community health professionals.
End-of-life training for paid carers working with people with learning disabilities
Authors: Codling Mary , Knowles Jane , Vevers Ann
Published: May 2014

People with learning disabilities are living longer lives. Over the past few years, research has explored the needs of people with learning disabilities, their families and learning disability professionals in relation to end-of-life care and death. However, little is known about the needs of paid carers and their experience of end-of-life care. This article discusses the development, implementation and evaluation of a study day about end-of-life care that was delivered to paid carers on two separate occasions in Berkshire Healthcare NHS Foundation Trust. A total of 43 paid carers attended and the days were well evaluated. The need for further training for paid carers who work with people with learning disabilities at the end of life was highlighted.
Falls prevention and assessment
Authors: Anthony Loretta
Published: May 2014

This article outlines risk factors for falls and provides detailed information regarding the multi-disciplinary assessment of older people who fall. Comprehensive strategies for the prevention of falls both within the acute hospital setting and the community will also be discussed. There is much that can be done to reduce the incidence of falls and healthcare assistants and assistant practitioners working in all locations are in an ideal position to identify high-risk individuals and also to implement effective falls prevention strategies.
The secret administration of medicines: is it allowed?
Authors: Fullbrook Suzanne
Published: May 2014

Secretly, or covertly giving medicine, e.g. by mixing it with food or drink, can result in a person feeling that their right to choose has been compromised, and that the member of staff who administered the medicine or care has compromised their duty of care. This article will consider the legal implications of covertly administering medicine to patients and offer advice to healthcare assistants (HCAs) and assistant practitioners (APs) who may find themselves in this situation.
Care of the person with a percutaneous gastrostomy
Authors: Nazarko Linda
Published: May 2014

Healthcare assistants, especially those working with people who have swallowing difficulties, may provide care to people who have percutaneous gastrostomy (PEG) tubes. This article aims to enable you to understand why PEG tubes are used and how to care for the person with one.
A stoma support worker
Authors: Brown Maria
Published: May 2014

After working on a busy surgical ward in the Northwest for ten months I saw a position advertised for a stoma support worker. This was a new post and only for six-month secondment, pending the possibility of being made permanent. I was interested in the position immediately. My interest was aroused partly because I had attended a stoma competency day the previous month which I found fascinating and partly because of my own enthusiasm for new challenges. I applied for the job and was successful and started in the position in September 2004. After six months the job was made permanent and again I applied for it and thankfully have been in post for two and a half years.
Morals or ethics: which should you rely on?
Authors: Rennie Iain , Nichol Harry , Carmichael John
Published: May 2014

Healthcare assistants are increasingly being made aware of the responsibility and accountability which they hold when dealing with patients and family. During interactions with patients and family it is vital that decisions made and actions taken are based on sound decision making and not on ritualism. The application of ethical principles which assist in decisions making when caring for patients is broken down in this article to allow real application of ethics in everyday practice. Knowledge of the effect of morals on everyday decisions made within interactions with patients and clients is essential in order to deliver the best patient-centred care possible.
An HCA in a GP surgery
Authors: Davison Caroline
Published: May 2014

I have been a healthcare assistant (HCA) for over 3 years now and am based at the Birdhurst Medical Practice in South Croydon, Surrey. The practice is a very busy one with a patient population of about 6000, and is made up of four doctors, three practice nurses and myself. All my colleagues are extremely approachable and we all pride ourselves on the provision of high-quality care. Indeed, the practice is proud to have gained an Investor In People award.
Work-based learning: a different approach
Authors: Neville Lilian , Owens Denise , Rutherford June , Rosen Lyn
Published: May 2014

This article outlines a range of work-based learning opportunities which are suitable for healthcare assistants, healthcare support workers and assistant practitioners.

Innovation and imagination, plus a sound evidence base, are the foundations for work-based learning opportunities based in the School of Nursing at the University of Salford. Student choice and flexibility combined with a rigorous learning experience are the guiding principles.

The process of learning focuses on ‘real life’ work-related issues that make a difference to clients and service provision. This is achieved through partnership and negotiation between the student, their employer and the university and acts as the medium for the valuing and changing of practice. As one student on the course suggested ‘it's good to able to concentrate on what I'm actually doing... I can make what I am doing meaningful within my work’ (student comment, module evaluation, 2006).
Caring for the person with asthma
Authors: Peate Ian
Published: May 2014

Asthma is a serious health problem both nationally and globally. People of all ages are affected by this chronic airway disorder that can, when uncontrolled, place severe limits on a person's ability to carry out their activities of living. Asthma is a chronic cause of disability and can sometimes be fatal. It can place a burden on an individual's life as well as healthcare costs, lost productivity and reduced participation in family and social activities. Fatalities associated with asthma can be avoided through better routine and emergency care, avoiding delay in getting help or by taking the prescribed medications. Despite the numbers of people living with asthma, the causes are not fully understood. More research is needed to ensure that the health and wellbeing of people with asthma is improved. Healthcare workers working in partnership with people with asthma can ensure that care is person centered.
Caring for the person with psoriasis
Authors: Peate Ian
Published: May 2014

Psoriasis is a common, chronic recurring skin condition. The condition is characterized by an eruption of sharply demarcated red papules and plaques that have overlying silvery scales and it affects men and women equally and can occur at any age.
Infection control
Authors: Wheldon Darren
Published: May 2014

The infection prevention control team I work in consists of four full-time infection control nurses, two part time infection control nurses an audit and surveillance nurse an administration assistant and a data analyst. A Modern matron for infection prevention and control oversees the work of the team. I have been working in this role for one year and have worked for the Trust for 11 years in total.
Walking in their shoes: the importance of empathy
Authors: Baudains Michele
Published: May 2014

Have you ever experienced a feeling so great you just want to share it with as many people as possible? Well, Alice and I have been given this opportunity.
Understanding our patients
Authors: Grainger Angela
Published: May 2014

There are many reasons why I enjoy working alongside healthcare assistants (HCAs) and assistant practitioners (APs), and key to this is that in focusing on meeting the fundamental needs of patients and clients we are placed in the privileged position of being allowed to see things from their perspective. Being grounded in the clinical, and sometimes emotional, reality of what our patients and clients are facing helps us to achieve appropriate and empathetic responses to their needs.
Your role in urinary catheter management
Authors: Foxley Sue , Addison Ray
Published: May 2014

Caring for patients who have an indwelling urinary catheter is a common feature of clinical nursing practice which for some patients is essential to their medical management. However, evidence suggests that in many cases catheterization may be unjustified exposing the patient to a significant risk of acquiring a urinary tract infection which can be life-threatening, which extends length of stay for a patient that may be hospitalized. Improving the care for these patients depends on good education, implementation of best-practice, adequate resources, treatment and competent staff.
End of life care: what options are available to patients?
Authors: Storey Les
Published: May 2014

This article addresses the difficult topic of end of life care. That is care provided for someone with a life threatening condition that will result in ultimate death. The topic is relevant to all health and social care staff particularly care assistants working in care homes and the community who work with older people or people with long-term conditions. This article looks at the work being done to improve quality of care and provide choices for individuals at the end of their lives
Regulation: why it should be introduced
Authors: Hopkins Susan
Published: May 2014

The importance of the role of healthcare support worker (HCSW) is now being recognized in terms of workforce planning. However, as roles emerge and responsibility increases, patient safety and care is paramount and must not be compromised. Regulation would bring with it standards for HCSWs, protection for patients and staff, and some value to this vital role for the future of healthcare in the UK. It is important to keep up to date with this issue as it will move on quickly in the near future.

The next issue of the Journal will include an article on the argument against regulation.
Basic life support - a revision of the current guidelines
Authors: Hand Tanis
Published: May 2014

The ability to respond in an emergency situation is useful in any environment, but especially so for those working in the health setting. This article outlines the current UK guidelines and also the healthcare assistant's role in adult basic life support and the use of the automated external defibrillator, with particular reference to the primary care setting.
Thinking differently!
Authors: Vaughan Paul
Published: May 2014

Recently I attended an NHS Live event ‘Thinking Differently’ workshop. I have read the work of Paul Plsek so was delighted to have an opportunity to attend a workshop that he was co-facilitating. I was not disappointed and the workshop provided me with plenty of practical tools for being creative and stretch my thinking.
Regulation: why it should not be introduced
Authors: Youg Lynn
Published: May 2014

This article follows on from Susan Hopkins’ ‘Regulation: Why it should be introduced’ published in the April issue of BJHCA (Hopkins, 2008).
Bridging the gap: cognitive behaviour therapy
Authors: Chan Lai K , Keenan Paul
Published: May 2014

This discussion paper describes the inception, development and evaluation of a cognitive behavioural certificate programme for mental health support workers, critically examining its content, assessment strategies and effectiveness in terms of theory and practice. Data was gathered via the written evaluation reports from the participants and the personal reflections of the programme leaders. Finally, the paper will reflect on the future direction of this and other cognitive behavioural therapy programmes for mental health support staff.
Strength in opinion!
Authors: Vaughan Paul
Published: May 2014

As you will be aware, I have been working with the Working in Partnership Programme (WiPP) for the past 3years on the healthcare assistant (HCA) Initiative. WiPP completes its work in June 2008. I am delighted to tell you that WiPP have secured a new home for all the HCA resources we have developed; they will be going to the Royal College of Nursing (RCN) where they will continue to build upon the work and offer support to HCAs and assistant practitioners (APs) in the future.
You are the champions!
Authors: Vaughan Paul
Published: May 2014

What a show: This year's Eurovision Song Contest (ESC)! Spread over 3nights because there are so many countries that wish to be part of this exciting and entertaining annual event, it was a real triumph for the hosts Serbia. With over 10000 people in the arena to witness the show live and another 100million watching on the television, you certainly need your nerve to perform. And that was not all, as a performer, you need your nerve to be able to deal with Terry Wogan's caustic remarks as he sends up some of the artists and the event as a whole. Well, for those of you who watched the semi-final, you may have noticed that my home country, Ireland, were represented by a turkey (don’t ask!). But one thing can be said, the WiPP/BJHCA annual HCA conference in association with the Royal College of Nursing (RCN) held on the 16May was no turkey! With over 300delegates present, the event was a real success.
Stroke: caring for the carer
Authors: Welch Rachel
Published: May 2014

The majority of stroke survivors are cared for at home by spouses, the onset of stroke causes disruption of family roles as care giving tasks are assumed. This article will review the effects on the care giver while caring for a stroke survivors.
Care assistants in The Gambia
Authors: Stephenson Nina
Published: May 2014

In February 2008 I was involved in an educational fact-finding trip to The Gambia, in and around Banjul the capital of The Gambia. The visit was funded by the University of Hertfordshire. Prior to my visit I met with my colleagues and it was decided because of our various expertise that I would be responsible for investigating the role and education of support workers across all nursing sectors, in addition to making humanitarian links (commercial or non-commercial)
HCA Open University Diploma Awards Ceremony 2008
Authors: Machan Christina
Published: May 2014

Thirty-eight healthcare assistants, from both community and general practice, graduated on June the 26th this year with The Open University Diploma for Health Care Assistants. The ceremony was opened up to others from across the UK who had taken the award; the majority (34) came from Buckinghamshire. They were joined by their mentors who had supported them throughout the qualification, offering them guidance and opportunities to develop their experience.
The current and future role of HCAs in general practice
Authors: Wilkinson Carol A , Smith Judy , Siriwardena A Niroshan
Published: May 2014

This study was undertaken to determine the role of healthcare assistants (HCAs) working within the general practice setting as there are a dearth of studies which specifically focused on this area of work in Britain. A series of semi-structured interviews revealed that the role is one that is developing, but also presents opportunities for further education and training strategies. The study highlights the desires of HCAs to gain professionalized status which in turn covers the important issue of regulation.
Lymphoedema: diagnosis and treatment
Authors: Nazarko Linda
Published: May 2014

Lymphoedema affects around 100000 people in the UK. This incurable disease can be managed well and complications avoided if diagnosed early. Unfortunately, many healthcare professionals do not fully understand this disease or its treatment and it is often poorly managed. This article uses a case study to explore the diagnosis, treatment and management of lymphoedema.
The many examples of good care
Authors: Vaughan Paul
Published: May 2014

Thank you to all those who got in touch to congratulate me on my new role. I really appreciated your messages of support and your positive feedback on the work I have done over a number of years to promote the role of the healthcare assistant (HCA) and assistant practitioner (AP). Some of you were concerned that now that I have taken up my new post I will no longer be a champion for HCAs and APs. Well, I would just like to re-affirm my commitment to promoting both roles and I will continue to campaign within the West Midlands and nationally on behalf of HCAs and APs. In fact, some colleagues, some HCAs and I are just about to plan HCA Day for RCN Congress 2010. It will take place in Bournemouth next year and if there is something you want to see on the programme, get in touch soon and I will see what I can do about getting your issue or area of interest on the programme.
Causes and consequences of diabetes
Authors: Nazarko Linda
Published: May 2014

The incidence of diabetes in the UK has reached epidemic proportions. Healthcare assistants (HCAs) and assistant practitioners (APs) will regularly encounter people who have been diagnosed with diabetes, and those who have the symptoms of diabetes but who have not been formally diagnosed. This series aims to enable HCAs and APs to improve their knowledge and understanding of diabetes.
Book reviews
Authors: Lloyd Jones Menna
Published: May 2014

This is another book in the 'made incredibly easy' series and has a similar layout to the other books. This one focuses on wound care and I would consider it to be a good starting point for any healthcare professional involved with wound care and very appropriate for healthcare assistants, assistant practitioners or student nurses who are involved with or have an interest in wound care. It is written in a format that is easy to read and explains terminology in a practical and fun manner.
HCA in the community
Authors: O'Connor Julie
Published: May 2014

I work on the Island of Anglesey, and have been an employee of the North West Wales (NWW) NHS Trust since 1 April 1991. I will always remember my first day; it was April Fools’ Day!
Study skills: case scenarios
Authors: Powell Sarra Saffron
Published: May 2014

This article will help students understand and respond effectively to case scenarios in medical and healthcare contexts. It will explain exactly what case scenarios are, how they foster learning, and offer strategies through which to engage with case scenarios appropriately.
Dignity and respect matter
Authors: Allen Judith , Dennis Monica
Published: May 2014

This article examines the notions of dignity and respect in the care of older people in hospitals. It considers the legal implications of the Human Rights Act, and show how basic human rights are routinely denied because of undignified and disrespectful care. The reader is challenged to reflect on these examples, and encouraged to examine their own conscience and practice in relation to the care they provide, considering the role that healthcare support workers can have in dignified care.
Caring for the person with biliary disorders: gallstones
Authors: Peate Ian
Published: May 2014

Gallstones is an incredibly common abdominal disorder which many healthcare assistants and assistant practitioners will see at some point in their careers. It is therefore important to have a good understanding of the condition so that the information can be used to report back to healthcare professionals and explain symptoms to patients.
Falls part 6: risk management
Authors: Nazarko Linda
Published: May 2014

Sometimes it is not possible to eliminate or significantly reduce a person’s risk of falling. In such circumstances the best we can do is minimize the risks of harm when falls occur. This article, the last in the series, discusses how to reduce the risks of injury when a person remains at risk of falls.
Employment rights for informal carers
Authors: Barber Chris
Published: May 2014

As you may have heard, the Queen’s Speech, which opened the 2008-2009 parliamentary year, included reference to the importance of rights for informal carers (House of Commons, 2008). I am no stranger to the world of informal caring as many of you may know. Indeed, I have made it no secret and frequently mention it at the annual Royal College of Nursing Congress and have done so since 2001. For those of you who may not be aware of the term ‘informal carer’, an informal carer is a person who looks after another, be it a friend, neighbour or relative, without pay, regulation, formal recognition or training. This is in contrast to ‘formal carers’ who are employed, paid, recognized, trained and in the case of many care professionals such as nurses and doctors, are regulated. Many, myself included, do both!
Disability Discrimination Acts 1995, 2005
Authors: Hughes Rhidian
Published: May 2014

‘By 2025, disabled people in Britain should have full opportunities and choices to improve their quality of life and will be respected and included as equal members of society’ (Prime Minister’s Strategy Unit, 2005: 53).
Live well
Authors: Kemp Philip
Published: May 2014

You cannot have failed to notice that in the past few months healthy lifestyles, or the lack of them, are receiving a great deal of attention in the media. Reality television and the print media abound with titles extolling us to repent, repair or re-invent. Most are evangelical about the need to turn from our bad ways and find the better, healthier, new-improved you.
In painful denial - a coping strategy: ankylosing spondylitis
Authors: James Terry
Published: May 2014

This is the most difficult thing I have ever written. Not because I find writing particularly difficult; I have spent nearly 40years making my living as a writer and communicator; but because it means I am finally acknowledging in writing that I have a chronic disease.
Huntington's disease part 1: what is it?
Authors: Baker Mark , Blumlein Daniela
Published: May 2014

This is the first in a two-part series on Huntington's disease (HD). Part one describes what the neurological disease is and how it affects sufferers. HD is a progressive genetic neurological disease which affects approximately 6.2 in 100000 adults within the UK (Orphanet, 2008). HD is a hereditary disorder of the central nervous system. It used to be known as Huntington's chorea. Huntington's disease usually develops in adulthood and can cause a very wide range of symptoms (Huntingdon's Disease Association, 2008).
Ankylosing spondylitis: living with the condition
Authors: Swann Julie
Published: May 2014

Ankylosing spondylitis (AS) can cause pain, fatigue and limitation of joint mobility, particularly within the spinal column. These symptoms can affect a person's ability to cope with many activities of daily life. By the adoption of alternative techniques, many tasks can be made easier to manage. However, sometimes it may be necessary to consider the provision of assistive devices and adaptation of property or the alteration of a work environment.

This article explores the impact of AS on a person's daily life and outlines ways to help to make activities easier to manage. It suggests ways that healthcare assistants and assistant practitioners can facilitate this process.
Myalgic encephalomyelitis: why HCAs are so important
Authors: Spencer Sir Peter
Published: May 2014

Myalgic encephalomyelitis/encephalopathy (ME) is a chronic, fluctuating illness. It is also known as chronic fatigue syndrome (CFS). Sometimes it is diagnosed as post viral fatigue syndrome (PVFS).
Understanding vision part 1: structure and mechanics
Authors: Swann Julie
Published: May 2014

Our vision enables us to gain considerable information about our environment. Most people with a visual impairment have a substantial reduction of vision, but are not totally blind. This article describes the visual system and some of the causes of visual problems. It also outlines the vital role of healthcare assistants and assistant practitioners in the early detection of visual problems.
Maternity support workers
Authors: Sneddon Emily , Janda Inderjett
Published: May 2014

In 2008 Kings College Hospital decided to employ maternity support workers to help the community teams. This was a new and exciting project. All the community teams work slightly differently so they were able to adapt the work of their individual support worker to meet their team needs. Kings had only had maternity support workers in the hospital before.
A New Year's resolution
Authors: Green Barrie
Published: May 2014

Language and communication are crucial to our lives. How would we demonstrate our wants, needs and desires without being able to speak and understand each other? It's like ordering food when you're on holiday. How many ridiculous chicken impressions do foreign waiters endure before randomly selecting a meal to satisfy the hunger of the single-language British tourists? No matter how loud or slow we speak, the difficulties of international relations are extremely complicated. The British can normally take the universality of the English language for granted - but for how long?
Breast screening: an interview
Authors: Andrews Sarah , Curtis Judi
Published: May 2014

JC: Sarah, can you tell me a bit about your background and how you came into this area of practice?
APs and foundation degrees: the story so far
Authors: Mullen MBE Chris
Published: May 2014

This article provides the reader with information about Foundation degrees (FDs) in relation to health and in particular the role of the assistant practitioner. It describes what FDs are, what the core FD usually contains, information on the different models used to deliver a FD, what they provide in terms of level of education and progression routes as well as what the advantages are for individuals who decide to undertake it.
Health workers around the world: The Congo
Authors: Nyamutera Kabou
Published: May 2014

Kabuo Nyamutera, is a Community Health Worker in the Democratic Republic of the Congo (DRC). With only 0.6 health workers per 1000 people in DRC-far below the World Health Organisation's advised minimum of 2.5 per 1000-the medical assistance given by people like Kabuo is vital to the country's health services.
Reach for the stars: realizing your potential in the workplace
Authors: Clark Liz
Published: May 2014

With demographic changes and an increasingly ageing population, changes in lifestyle and rapid technological developments, the health needs and expectations of patients and clients have changed over the past decade. In response, healthcare roles and responsibilities are changing in order to keep abreast of these developments, continually improve standards of care and help to create healthier communities. This article looks at how to keep up to date in your area of practice.
End-of-life care: no second chance
Authors: Hughes Rhidian
Published: May 2014

A ten-year end-of-life care strategy was published in 2008. It was the first comprehensive strategy to promote high quality care across the country for all adults approaching the end of life (Department of Health (DH), 2008). The aim is to provide everyone at the end of life with choices about where they would like to live and die.
Manual blood pressure knowledge
Authors: Alexis Obrey
Published: May 2014

This article explores manual blood pressure and the importance of healthcare assistants developing their knowledge base in this area. The author looks at a number of pertinent areas, such as the meaning of blood pressure, systolic and diastolic, some factors that may influence the accuracy of measuring a patient's blood pressure, and guidelines of how a blood pressure should be taken.
Catherine's diary
Authors: Himsworth Catherine
Published: May 2014

My name is Catherine and I work in Health E1 Homeless Medical Centre. My daily role is much the same as other healthcare assistants (HCA) in general practice. It is the patients that we treat here that make my job a little more unusual. Our patients are all homeless, or temporarily-housed. The service we provide for them reflects the requirements of this population.
TOP education for HCAs: improving 'patchy' knowledge
Authors: James Gwennan , Roberts Anna
Published: May 2014

A transdermal opioid patch (TOP) delivers medication that is absorbed through the skin to alleviate pain. The increasing number of patients in the community and in residential homes who are unable to self-manage their patches was in turn increasing the district nursing service's workload. We decided that registered community nurses could delegate this task to community-based healthcare assistants (HCAs) who had undertaken appropriate training and supervised practice to attain clinical competence in TOP management. This article describes the development of a programme to implement training.
A vision for mental health care
Authors: Hughes Rhidian
Published: May 2014

Mental health problems are a ubiquitous feature of our society, yet people with mental health needs can experience stigma and prejudice, which can hinder their recovery or exclude them from being full participants in society.