bluuebunny/crossref_metadata_2025 huggingface dataset:
Parent-held shared care records: bridging the communication gaps
Authors: Hooker Louise , Williams Jacqueline
Published: August 2014

Specialist centres provide excellent treatment and expert care, but the best interests of children may not be served if they must always attend a hospital far from home. Systems of shared care have been developed to offer care nearer the family home whenever possible. Parent-held shared care records were introduced at a paediatric haematology/oncology centre in response to issues raised by parents and professionals concerning the management of shared care. These were set up to facilitate communication, teamwork and family involvement. Consultation took place within the multidisciplinary team to ensure that the design of the records met the needs of each group. During a multidisciplinary study day the records were introduced to professionals from shared care hospitals. Before formally incorporating these records into regular clinical practice they were piloted with a group of families. The reccyds have become an accepted part of the service provided for family and professional partners in shared care. Formal evaluation of this innovation is currently taking place.
Individual vs collective activity: a primary nursing paradox
Authors: McMahon Richard
Published: August 2014

Primary nursing has been proclaimed as a way of providing nursing care that benefits both the patient and the nurse. This article supports this view; however, a pragmatic approach is taken to identify some of the paradoxes and contradictions that may be encountered. These include: conflicts of loyalty; planning psychological care; empowerment of patients; empowerment of nurses; and competition. By using examples from practice the issues surrounding these concepts are explored, examining the impact both on practice and on nursing as an occupation. Nurses must address these paradoxes if they are to prevent conflict and frustration. The future goal of fully implementing primary nursing will, however, provide great opportunity and potential for improving patient care.
All a matter of common sense? An introduction to psychology
Authors: Wilkinson John A
Published: August 2014

It is sometimes the case that a care plan will make a reference to some notion of what is termed ‘psychological care’ with little explanation of what this means or how it might be achieved beyond some common sense comments about communication. Although psychology yields a body of knowledge which is of use to nursing practice, it is generally only in recent years that the subject has been made formally available to many nurses. As with all theoretical concepts, it is important to explore the application of theory to practice. This article, the first of a six-part series, presents an introduction to psychology by comparing and contrasting its contribution to nursing with common sense approaches. The points raised are illustrated with examples from a range of nursing specialties.
Caring for the adolescent diabetic
Authors: Bradbury Martyn , jenkinson Tim
Published: August 2014

The management of insulin-dependent diabetes mellitus is a challenge for the adolescent patient, his/her family and the health-care team supporting them. If treatment is to be successful and the longer-term complications of diabetes averted or delayed, nurses need to understand the various psychological and physiological factors that contribute to the difficulties in maintaining glycaemic control during this life stage. This article examines some of these factors with a view to encouraging nurses to adopt strategies that will improve patient confidence and coping skills in diabetic care.
Psychology 2: message received and understood?
Authors: Wilkinson John A
Published: August 2014

Human beings judge and make sense of their surroundings in two ways. Sensory organs supply information to the brain where it is processed and interpreted according to the idiosyncrasies of that individual's personality and experiences. Perception is the active process which integrates and coordinates these activities. Hence, any sensory message can be received and/or understood quite differently depending on the individual concerned. This article outlines how a knowledge of psychology can assist in the understanding of human perception, and how this can be applied to a wide range of nursing care settings and applications. The psychology of perception is of particular relevance to areas such as patient/client assessment, skilled communication, teaching and the provision of health education.
Nurses' knowledge of pressure ulcer management
Authors: Wilkes Lesley M , Bostock Erica , Lovitt Lorraine , Dennis Gillian
Published: August 2014

The nursing management of pressure ulcers has not been extensively reported in the Hong Kong context. This article reports the results of a survey of 34 Hong Kong registered nurses to determine their knowledge and practices in preventing and treating pressure ulcers in the elderly. The findings indicate that, overall, the nurses had a sound knowledge of the prevention and treatment of pressure ulcers, but that there were inconsistencies in their practices. This situation could be improved if standardized systems for assessiiiy patients at risk of developing pressure ulcers and for grading (staging) these pressure ulcers were used.
Validation therapy: a review of its contribution to dementia care
Authors: Bleathman Christine , Morton Ian
Published: August 2014

There has been a great deal of interest in validation therapy (VT), an interactive technique and group therapy for people who are disoriented. This article reviews the strengths and development of VT and acknowledges Naomi Feil's contribution to the care of those with dementia. Techniques for communicating with people who are dysphasic are described, as are therapeutic interventions which address the devastating effects of memory loss on the sufferers' sense of self and identity.
The biological basis of cancer
Authors: Cunningham Sheila
Published: August 2014

People with cancer require sensitive nursing. They need information, explanations, encouragement, support and guidance through investigation, diagnosis and treatment options. One person in three may have a diagnosis of cancer sometime in his/her life, thus the nurse is faced with an increased probability of caring for a cancer patient during his/her career. In general, both the public and nurses have a negative view of cancer because of lack of knowledge about cancer. Knowledge of the fundamental pathophysiological aspects of cancer can increase understanding about the causes of cancer, its development and the rationale for treatment approaches. Ultimately, knowledge assists nurses in supporting and empowering their patients.
Nursing's image: it is how you use your stethoscope that counts!
Authors: Castledine George
Published: August 2014

Uniforms have always been an issue in nursing. However, it is not just the style and type of uniform that is important as the trappings that go with it, e.g. hats, badges, belts and buckles, can be used to display status and trend. Today, the stethoscope, once the symbol of medical functions, is also used to signify status as it is no longer the sole preserve of the doctor. It is used by paramedics, physiotherapists and, of course, nursès of all grades
The role of the surgical nurse as a health promoter
Authors: Maidwell Anna
Published: August 2014

This study investigated the role of the hospital nurse as a health promoter, with special reference to surgery. It was hoped to determine whether registered nurses in surgical settings perceived health promotion as part of their role. The findings rejected the null hypothesis and accepted that a role in promoting health exists in surgical settings. After establishing that promoting health is part of every nurse's role and, in particular, that of surgical nurses, the study further investigated whether the role of promoting health was carried out effectively and efficiently while caring for surgical patients. The findings were both positive and encouraging. Although problems and barriers to health promotion exist, the positive attitudes of registered nurses in this survey appear hopeful for the future. The tstudy considers the wider professional context and examines the possibility and feasibility of surgical nurses expanding their role in order to promote health. There is a growing awareness that patients should play a more active role in their treatment and after care. The growing trend towards day surgery usually allows patients to return home within 24 hours. However, in reality, many are kept in hospital for either the morning or the afternoon which means considerably reduced contact time with hospital nurses.
Are nurses being abused by the media?
Authors: Castledine George
Published: August 2014

The recent appearance of a nurse in uniform being pressed for a response to the recent high pay rises for MPs made me wonder just how well nurses are treated by the media. Over the years, the media headlines have portrayed nurses as anything from ‘angels of mercy’ to ‘killers in uniforms’.
Continuous quality improvement in pressure sore prevention
Authors: Dealey Carol
Published: August 2014

The final article in this series examining the draft national clinical guidelines for pressure sore prevention and management considers continuous quality improvement Different professions use different terminologies to describe quality assurance: nurses link it to ‘standard setting’ whereas the medical profession uses the term ‘medical audit’. This article discusses the concepts of quality and audit in relation to pressure sores and their prevention. In particular, it addresses the importance of scientific rigour and multidisciplinary team working and management involvement.
A new professional practice model for nursing
Authors: Castledine George
Published: August 2014

I have recently become very disillusioned with the way that nursing is developing. In fact, some developments have shocked me so much that I am concerned for nursing's future. It seems that our ambition to develop expert clinical nurses and a clinical career structure has made us forget the key principles upon which nursing care is based.
Writing an academic essay: a practical guide for nurses
Authors: Booth Yannette
Published: August 2014

Writing academic essays can be a major hurdle and source of anxiety for many students. Fears and misconceptions relating to this kind of writing can be dispelled if the task is approached in a logical and systematic manner: This article outlines the key steps involved in successfully completing an essay and provides some practical tips to facilitate critical and analytical writing. These steps are: analysing the task; exploring the subject; planning the essay; writing the account; and revising the drafts. Although this process is challenging; academic writing is a means of developing both personally and professionally.
Is nursing becoming a disembodied profession?
Authors: Nolan Mike
Published: August 2014

The first paper I ever presented was entitled ‘Is nursing throwing the patient out with the bath water?’. In it I voiced my concern at the way nursing was distancing itself from the physical aspects of caring in favour of the psychosocial. I argued that this was a retrograde step as the physical components of the nursing role provide the vehicle for delivering holistic care. I used the example of bathing to illustrate how a ‘simple’ activity is, in fact, a multifaceted and highly skilled undertaking that serves both cleaning and social and therapeutic functions. Moreover, as a result of the intimate nature of the task, bathing affords a legitimate opportunity not only to discuss patients' concerns and fears but also to assess their physical condition.
Postoperative nausea and vomiting 2: management and treatment
Authors: Tate Sylvina , Cook Hannah
Published: August 2014

The management and nursing care of patients experiencing postoperative nausea and vomiting (PONV) are discussed, together with the various types of pharmacological and complementary approaches to treatment. These treatments are examined in relation to the causes of PONV and a scientific approach to the use of antiemetics which links causation and treatment is suggested. It is argued that by adopting this approach PONV could be minimized, drug bills reduced, patient choice encouraged and postoperative recovery enhanced.
Exploring the concept of acting In the patient's best interests'
Authors: Ellis Peter
Published: August 2014

Health-care professionals often use the term ‘In his/her best Interests’ to Justify their actions. However, few people can provide a satisfactory explanation as to what is meant by ‘Interests’. This article explores the concept of Interest and Identifies two key Interpretations. The first is easily Identifiable as being part of sentience, as It Is concerned with the capacity to feel pain or pleasure. The second is more difficult to grasp as it has more to do with the Intrinsic value of personhood — It Is a matter of Judgment Both types of Interest warrant our moral concern and as healthcare professionals we should all have some knowledge of what It means to have Interests.
Is nursing in the UK too inward looking?
Authors: Castledine George
Published: August 2014

British nursing is well respected throughout the world. However, we cannot afford to be complacent as there are new internal and external threats to the quality and future of nursing.
Prepacked take-home analgesia for day case surgery
Authors: Marquardt Helen M , Razis Platon A
Published: August 2014

Postoperative pain is one of the main barriers to increasing the range of procedures suitable for day case surgery. Effective strategies for treating postoperative pain must be developed and tested if this range is to be extended. This article examines the effectivesness of prepacked take-home analgesia in providing pain relief for patients following day case surgery. The composition of the analgesia pack was varied according to the type of operation undertaken.
Pressure sore management in the independent sector: 1
Authors: Fagan Rose , Closs S José
Published: August 2014

Little is known about pressure sore prevention and treatment in the independent sector. With a rapidly increasing number of care settings taking over responsibility for continuing care, particularly for elderly people, it is important that essential nursing care is provided at nationally agreed standards. This is the first of two articles which explore current practice in the independent sector of a large northern city. Background information on the study; details of data collection and analysis and baseline data on current practice are presented. This study investigates the extent of evidence-based practice, equipment use, educational needs, patient and informal carer involvement and maintenance of quality of care. Initial conclusions indicate that pressure sore management in the independent sector is evidence based. However; in many areas of practice, personal observations and experience continue to take precedence over research evidence.
The value of the generalist nursing domain
Authors: Castledine George
Published: August 2014

There are four domains of nursing: general, specialist, advanced and paramedical. There is no hierarchical order attached to these and it is not true that the general domain forms the basis of the other three because many students enter nursing directly into specialist domains such as mental health.
Does nicotine have beneficial effects in the treatment of certain diseases?
Authors: Birtwistle Jon , Hall Kate
Published: August 2014

Although tobacco smoking has long been associated with diseases of the lungs and cardiovascular system, numerous studies have demonstrated a negative association between tobacco smoking and ulcerative colitis, and the neurodegenerative diseases, Alzheimer's disease (AD) and Parkinson's disease (PD). The evidence suggests that nicotine — the main pharmacologically active ingredient of tobacco — appears to be responsible for this effect Pure nicotine has no known carcinogenic properties and can be administered in numerous ways including transdermal patches and tablets. As a therapeutic agent, its association with tobacco can be likened to morphine and opium smoking. There is ample clinical evidence to suggest that nicotine could be beneficial in the treatment of some patients with diseases. Pharmacologically, nicotine acts on cholinergic (nicotinic-specific) receptors which are depleted in AD and PD. Nicotinic receptors also interact closely with several neurotransmitters including dopamine, which is implicated in both PD and Gilles de la Tourettes's syndrome. There is no doubt that tobacco smoking can be harmful and no-one should be encouraged to smoke. However, although nicotine has many harmful side-effects, it may have therapeutic value or at the very least be a useful tool for future drug development.
The elective experience: student choice in nurse education
Authors: McDougall Tim
Published: August 2014

This article highlights the importance of choice in nurse education. It is suggested that for too long nurse education has ignored specialties such as forensic or child and adolescent mental health, and points to the elective placement as an invaluable, rich and rewarding learning experience. Through a process of negotiation involving the learner; the tutor and clinical staff, student nurses are empowered to take responsibility for their education and make choices for them selves. The elective placement is a time to consolidate knowledge, develop practice and reflect personal agendas within the nursing curriculum. Since nursing requires practitioners to be able to make decisions, solve problems and act autonomously, choice in education is crucial. This is in keeping with what nursing strives for; i.e. empowering others to take responsibility and make choices for themselves.
Effects of the purchaser/provider split on research implementation
Authors: Balcombe Kathleen P
Published: August 2014

The issues surrounding the use of research to inform practice and the potential problems involved in this process have been the subject of debate within nursing for many years. The purchaser/provider relationship has led to an increase in the number of challenges nursing encounters regarding the implementation of research. These challenges and relationships, which will either promote or prevent the implementation of research in nursing practice, are explored using Nolan and Grant's (1993) framework. The analysis concludes that implementation of nursing research needs to be part of the contracting process involving shared dialogue between purchasers and providers. Discussions on clinical effectiveness need to include nursing evidence as part of the health-care contracting process. Professionals involved in contracting require equal knowledge about research and joint professional values in order to support its implementation within contracting appropriately.
UKCC launches professional conduct complaints report
Authors: Castledine George
Published: August 2014

On 5 November, the UKCC is to launch a document on professional conduct complaints. For the first time since it took over responsibility for investigating complaints of misconduct from the National Boards in 1993, the Council is to publish information on the type of allegations that are made against nurses. The report is based on cases dealt with by the Preliminary Proceedings Committee (PCC) and although it does not give a statistical analysis it does provide a summary of the important factors that have emerged.
Pressure sore management in the independent sector: 2
Authors: Fagan Rose , Closs S José
Published: August 2014

This is the second of two articles looking at pressure sore prevention and treatment in the independent sector of a large northern city. Part one presented background information, details of data collection and analysis, baseline data on current practice and initial conclusions which included an assessment of the extent of evidence-based practice, equipment use, educational needs, patient and informal carer involvement and quality of care maintenance. Part two considers these findings in greater depth. Both positive and negative aspects of pressure sore management in the independent sector are explored. Factors such as the number and types of pressure-relieving equipment used and the lack of independent evidence regarding product efficacy are considered. The survey highlights gaps In educational provision, and the lack of research evidence on certain aspects of care. The article concludes with a detailed series of recommendations with regard to practice, education and research.
Port wine stains: laser treatment and nursing management
Authors: Walker Pauline S
Published: August 2014

In 1960, an American physicist Theodore Maiman observed the first laser in action. Since then laser technology has progressed at an extraordinary rate. This article shows how one type of laser has touched the lives of thousands of people. The Candela tunable dye laser has given hope to people with port wine stain birthmarks. It also shows the duties and responsibilities of the nurse working with lasers and the possibility of the extended role of the nurse in the field of skin laser therapy.
Ageing and quality of life 1: towards a better understanding
Authors: Lundb Ulla , Nolan Mike
Published: August 2014

This article, the first in a two-part series, considers a number of factors that influence quality of life in older age. It highlights the tensions between objective and subjective dimensions regarding the quality of life. It emphasizes the differences between those definitions used by professionals and those employed by older people themselves. The authors argue that there is a need to gain a broader understanding of how people adjust to and interpret their own ageing before the appropriate services can be designed. Assimilation, accommodation and immunization are presented as useful concepts to improve understanding in this important area.
The causes and nursing management of constipation
Authors: Norton Christine
Published: August 2014

Constipation is a common symptom in the Western world with up to 10% of the population experiencing some difficulty with bowel evacuation. The consequences are seldom serious or life-threatening, but constipation is undoubtedly the cause of much chronic discomfort and misery. Most nurses will encounter constipated patients on a regular basis. It is therefore important for nurses to understand the causes of constipation so that an appropriate history can be taken and further investigations suggested if necessary.
Alternating pressure mattresses: comfort and quality of sleep
Authors: Grindley Adri , Acres Jenni
Published: August 2014

Comfort is particularly important for patients with terminal illness where the priority is to maximize quality of life. Equally important is effective pressure area care, as such patients are at high risk of developing pressure sores because of their poor general condition (Bale and Regnard, 1995). The present randomized controlled study set in a hospice focused on the development of methodology for assessing patient comfort and quality of sleep and used this to compare two widely used, alternating air pressure mattresses (the Nimbus II and the Pegasus Airwave). The Nimbus II mattress performed consistently better than the Pegasus Airwave in terms of patient comfort and quality of sleep. Features of the Nimbus II that may explain its better performance include less extreme changes in pressure, lower peak inflation pressures and the ability to automatically vary the pressure to suit the patient's position and weight.
Consultant nurse: an appropriate title for the advanced nurse practitioner?
Authors: Elcock Karen
Published: August 2014

The term ‘consultant nurse’ has been offered as an appropriate title for the ‘advanced nurse practitioner’. Although both share similar roles and functions the way that each will perform within these roles will differ. Many of the principles and processes involved in consultancy may be viewed by nurses as incongruent with nursing practice, including the relationship between the consultant and the consultee and the view that the consultant nurse should not have a direct care role. The title itself has medical connotations and therefore is viewed negatively by many nurses as it conjures up a view of an aloof, elitist practitioner. Nursing is unique, and although many of the processes involved in consultancy are appropriate to nursing they should only be used in a way that keeps the patient at the centre of care. The title is therefore seen as inappropriate for the advanced nurse practitioner.
Role definition: nurse practitioners or clinicians' assistants?
Authors: Cahill Heather
Published: August 2014

This article discusses two different types of nursing role currently being developed and highlights their impact on professional practice. One role type is concerned with meeting trusts' needs to reduce junior doctors' hours and costs, and includes specific aspects of medical practice. The second seeks to advance nursing practice and patient care. Both however; lack organization and clarity of definition. Developing the first type will not achieve the objectives of the second, even if the title of nurse practitioner is attached to the role. The nurse surgical assistant provides a lucid example of a role that is being medically defined, driven and supervised. Although individual nurses are clearly enjoying their new roles, the unique and valued characteristics of nursing are being threatened. This retrograde step should be viewed as unacceptable to the profession.
A practical framework for wound assessment 1: physiology
Authors: Flanagan Madeleine
Published: August 2014

Wound assessment offers practitioners a framework upon which to base clinical decisions aimed at maximizing healing potential. It relies heavily on basic observational skills to detect often subtle differences between a healing and non-healing wound and focuses on the difficulties in identifying clinical signs of wound infection. Part one of this paper relates the physiological process of healing to the practical skill of wound assessment so that appropriate management objectives can be implemented and evaluated. In the second part, wound classification models are reviewedtogether with practical methods of wound measurement and suggestions for improving the quality of wound management documentation.
Encouraging team collaboration in healthcare
Authors: Castledine George
Published: August 2014

Healthcare providers often fail to com municate effectively. One of the problems is that members of the healthcare team interact separately with the patient but ask similar questions. There is bound to be some overlap but at times this becomes tedious and unnecessarily repetitive, especially for the patient.
A new model for Project 2000 students in theatres
Authors: Crofts Linda , Taylor Marion
Published: August 2014

Changes in nurse education have brought into focus the status of the student nurse in the operating department. This article outlines some of the historical perspectives of the role of student nurses undertaking their operating department experience and describes a new model for preparing students for this part of their preregistration education as piloted by one college of health studies after the implementation of Project 2000.
How much should patients be told about their medication?
Authors: Bowles Lindsay
Published: August 2014

Much has been written on the education of patients about their medication, and yet what patients need to know has not been identified and agreed upon by professionals. This study sought to design a tool for this purpose using a series of interviews with experts to identify categories of information. Many core categories were identified and ambiguous sections such as ‘sideeffects’ were clarified. A test-re-test strategy was used to identify the reliability of the resulting questionnaire. A high level of inconsistencies and a low response rate were, in part, attributable to poor design and distribution of the questionnaire. Other contributory factors and the reluctance/inability of respondents to identify what they felt patients should know about their medication are discussed. Some deficits are identified, in addition to an agreement that current systems for educating patients are inadequate. Areas for future research are also identified.
The biology of Alzheimer's disease: 1
Authors: Delieu John , Keady John
Published: August 2014

This article, the first of two parts, attempts to take dementia care back to its foundations by informing nursing practice of the biology and degenerative effects on the brain of Alzheimer's disease, the most prevalent form of dementia. This biological understanding will then be used to illustrate the effect on the emotional, perceptual, behavioural and social world of the individual sufferer and will be selectively applied to inform nursing practice. Studying the biological process of AD is not easy, but an understanding is essential if a comprehensive and holistic stance is to be adopted by clinical nurse practitioners. These articles will also address the medical definitions of dementia, the onset and spread of neuritic plaques and neurofibrillary tangles, and the genetic and aluminium components, and will compare the impact of AD on brain structure and function with that of the normal ageing brain. At the conclusion of the second article, future prospects and the nursing response will be considered.
Genital warts: a study of patient anxiety and information needs
Authors: Chandler Maria G
Published: August 2014

Infection with genital warts is one of the most commonly seen infections in genitourinary medicine (GUM) clinics. A study of 50 women with a first-time diagnosis of genital warts was undertaken to determine the patients' levels of knowledge and anxiety in relation to their diagnosis. The findings revealed that 42 (84%) of these women were aware of their possible diagnosis before attending the clinic. Just over a half of them received this information from their GPs. Eight (35%) patients lacked any fundamental knowledge about the mode of transmission of genital warts and the need for prophylactic use of condoms. Seventeen (74%) of the women did not know or were unsure about the methods of treatment. High levels of anxiety were reported by the patients on their first clinic attendance. To increase knowledge and lessen anxiety in this client group, the author recommend| reciprocal liaison between GPs, their practice nurses and GUM clinics.
Pressure sore guidelines: patient/carer involvement and education
Authors: Benbow Maureen
Published: August 2014

The important issue of patient/carer involvement in relation to pressure sore prevention and management is referred to in the NHS Executive's (1994) draft document on the prevention and management of pressure sores, commonly known as the ‘Pressure sore consensus guidelines’. It states that: ‘A multidisciplinary plan of care should be negotiated with individual patients and/or carers taking into consideration their knowledge and experience.’ This article explores some of the specific aspects of patient/carer involvement in various settings. Key factors identified during the course of the consensus guidelines development in relation to patient/carer involvement are the assessment of risk, the educational strategy adopted, what information should be included and individual freedom of choice to accept or refuse advice or care.
Granugel: hydrocolloid gel
Authors: Williams Clare
Published: August 2014

Hydrogels have been used for some time in wound management to maintain a moist wound interface and to aid the debridement of slough and necrotic tissue. Granugel (ConvaTec) is a combination of both hydrogel and hydrocolloid, which has been shown to be a safe and effective dressing that is also cost-effective.
Treatment of venous leg ulcers: 1
Authors: Williams Clare
Published: August 2014

The management of venous leg ulcers is an important issue for many health-care professionals. If treatment is to be successful, it is vital that clinicians understand the physiology and disease processes of the venous system in general, and of venous ulceration in particular. Part one of this two-part article presents an outline of the normal physiology of the venous system in the lower limb followed by a brief history of venous leg ulcers and an in-depth analysis of the way in which venous disease can lead to ulceration. The analysis compares traditional theories of leg ulcer development with current hypotheses. Part two will look at the treatment of venous ulcers and associated nursing implications.
Comment:Brighter futures: focusing on sheltered housing and tenants with dementia
Authors: Keady John
Published: August 2014

Last December, a report entitled Brighter Futures (ANchor Association, 1995), which had been jointly commissioned by the Anchor Housing Association and Methodist Homes for the Aged, was launched at the Policy Services institute in London. It presented the results of research on health and social care provision for people with dementia living in residential homes, nursing homes and sheltered housing. The report's authors — Tom Kitwood, Sean Buckland and Tracy Petre — were from the bradford Dementia Group, a group which is becoming increasingly recognized for its innovative approaches to dementia care practice (Kitwood and Bredin, 1992; Kitwood and Benson, 1995). Indeed, the group's philosophical emphasis on personhood and individual wellbeing for people with dementia permeate the substance of this report, and give it a context wherein people with dementia are seen as being of value and integral to the fabric of local communities.
Nurses' responses to patient behaviours that threaten health
Authors: Gray Richard , Thomas Ben
Published: August 2014

The articles in this supplement highlight the need for nurses to develop interventions to tackle behaviours that affect people's physical and mental health.
Setting new ethical standards for practice is a collaborative process
Authors: Castledine George
Published: August 2014

The UKCC (1996) is producing a document on ethical guidelines for practice with the aim of making nurses think about the way in which they carry out their responsibilities. It will replace and update the information provided in three previous documents (UKCC, 1985, 1987, 1989).
Nursing management of patients receiving gastrostomy feeding
Authors: Arrowsmith Helen
Published: August 2014

A feeding gastrostomy should be considered for patients who require enteral tube feeding for more than 2 weeks. This article describes three types of gastrostomy: percutaneous endoscopic gastrostomy; replacement/surgically placed gastrostomy; and skin-level/button gastrostomy. The choice of tube and method of insertion are governed by the patient's clinical condition and lifestyle. General guidelines on the decision to initiate gastrostomy feeding are given, together with indications, insertion and nursing management for each tube.
Self-administration of drugs on an oncology ward
Authors: Peett Alison , Cox Karen
Published: August 2014

This article focuses on the development of a programme of self-administration of medicines within an oncology setting. Previous studies which have developed this concept demonstrate that such a programme has a positive impact on a patient's knowledge of his/her illness and treatment. Compliance with drug regimens increases and patients are given back control over one aspect of their lives while in hospital. The development of an individualized drug administration programme within an oncology unit and how it will be evaluated in the future are described.
Infection control in GP surgeries: safe practices?
Authors: Finn Lesly , McCulloch Janet
Published: August 2014

Any increase in the use of invasive procedures carries with it an increased risk of cross-infection. The spread of the human immunodeficiency virus, together with increasing awareness of hepatitis B virus, cytomegalovirus and human papillomavirus, have focused attention on the nature and adequacy of procedures to prevent cross-infection in general practice (Farrow et al, 1988; Hoffman et al, 1988; Foy et al, 1990; Morgan et al, 1990).
Implementation of an aspect of self-care
Authors: Mason Sue , Furlong Sarah
Published: August 2014

This article describes how a nursing development unit (NDU), through the evolution of a self-care philosophy, responded to the changing needs and demands of patients. Patients in the NDU appeared to want to be more informed and involved in their health care. In addition, decreased length of stay as a result of increased sophistication of medical techniques and the need to have a faster throughput of patients has meant that a philosophy is required which is focused around empowering patients to take ownership for their own health care. The application of this philosophy is demonstrated through a case study which describes the experience of a gentleman who was cared for within the NDU.
Understanding stress in the ICU setting
Authors: Sharp Sue
Published: August 2014

This article discusses the physiological effects of stress on patients, relatives and staff in the intensive care unit (ICU). It examines the short- and long-term effects of cortisol on various systems in the body. The information contained in this article encompasses the recognition and understanding of the general adaptation syndrome as described by Seyle (1975). Many nurses working in ICU may identify with the symptoms and subsequent physiological and psychological responses to stress and thus enable informed discussion when planning the care of their patients or support of the relatives, colleagues and themselves.
How nurses make decisions regarding patient medication
Authors: Peate Ian
Published: August 2014

This study seeks to identify the cues used by nurses which enable them to make decisions regarding the administration of medication. The knowledge base which underpins practice is explored and the relationship between knowledge and practice is considered. The rationale for this study was provoked by the possibility that nurses may be given limited prescribing powers. If this becomes a reality, the nurse's role will involve high level decision making (Morris, 1994). It could be that, in the future, changes in the law on drug administration will affect all nurses on the professional register.
Children's understanding of their internal body parts
Authors: McEwing Gillian
Published: August 2014

The aim of this study was to gain some understanding of children's knowledge of the human body and thus help health professionals to communicate at an appropriate level with children when they require medical intervention or health promotion. The relevant data were obtained by the use of a semi-structured interview. The children were asked a series of questions to elicit information about 11 major body parts. The results demonstrated that children's knowledge of their bodies increases as their age increases. Children between 4.5 years and 8.5 years of age could spontaneously recall approximately two to four body parts. They were most aware of the existence of the bones, heart and brain. Young children appeared to hold some common misconceptions about the content of their body. When health professionals are required to give information to sick or healthy children, it is important that they are aware of the child's level of knowledge of the human body to ensure a common level of discourse.
Nurses’ and parents’ perceptions of participation and partnership in caring for a hospitalized child
Authors: Kawik Lynn
Published: August 2014

A descriptive study was undertaken to determine whether parents were able to participate in the care of their hospitalized child and work in partnership with the nurses. The study utilized method triangulation and was conducted in two phases. In phase one a postal survey of 65 nurses was undertaken in three children's wards within an NHS trust hospital, while in the second phase, 12 in-depth interviews were completed with parents in their own homes following their child's discharge from hospital. The quantitative data were analysed using descriptive statistics and the qualitative data were subjected to content analysis. The data suggested that parents were willing to be involved in caring for their hospitalized child yet experienced difficulties as a result of inadequate information and the nurses’ reluctance to relinquish control of the nursing care. These findings demonstrated that nurses and parents had different perceptions of their individual roles. Consequently, the nurse/parent relationship was not always conducive to a partnership approach, which has implications for both nurse education and clinical practice.
Classification of pressure sores: 1
Authors: Young Trudie
Published: August 2014

It is anticipated that the forthcoming national clinical guidelines for the prevention and management of pressure sores will attempt to clarify pressure sore classification. There are many classification systems available, but to date not one has emerged as all-encompassing. A classification system has to be sufficiently detailed to allow accurate assessment of pressure sores. So far this has been difficult to achieve, particularly for pressure sores that do not involve a break in the skin. The assessment forms the basis upon which the patient's care will be planned. There are ethical, legal and financial implications if the assessment is unable to reflect accurately the true nature of the patient's pressure sore. Nurses have attempted to integrate pressure sore classification into the holistic patient assessment process. Their attempts are often thwarted by the limitations of the classification systems currently available. As a result a patient's pressure sore is allocated a classification in which the criteria chosen are nearest to the visual description of the sore, but do not accurately represent the true extent of tissue damage. This article, the first of two parts, highlights the problems of patient assessment and the limitations of current classification systems.
Implications of transplantation surgery for theatre nurses: 2
Authors: Clay Jane , Crookes Patrick A
Published: August 2014

In the first part of this article (Vol 5(7): 400-3), potential difficulties for theatre staff in relation to organ retrieval for transplantation were explored. This second part examines how the death of patients can be a major cause of stress for nurses. It focuses on work which suggests that lack of peer support among nurses and the perception that nurses should always appear to be ‘coping’ are common features which can prevent nurses from asking for, and receiving, support. Possible mechanisms are explored for ameliorating some of the stress that staff experience in association with this work. These include the role of managers and transplant coordinators in supporting nurses involved in transplantation work, reiterating (to staff) the benefits of transplantation surgery for recipients, and the possibility of debriefing staff after surgery. It recommends that more thought should be put into preparing and supporting theatre staff involved in transplant work.
Care study: Palliative nursing care of a man with terminal cancer
Authors: Hanson Elizabeth J , Cullihall Katherine
Published: August 2014

Care study

Harry, a 60-year-old man, was diagnosed with a left parotid carcinoma and bone metastases. He had a left parotidectomy and node dissection, and a course of radiotherapy to his spine. He was admitted to the palliative care unit 2 months later with nausea and vomiting and lower back pain. He lived with his wife, Shannon, and his son, David (22 years of age), who was a source of emotional and financial stress for both of his parents. Harry also had a daughter, Linda (26 years of age), who worked as a nurse in Texas and with whom he enjoyed a close, loving relationship.

On learning that the illness was terminal, Harry and his family were extremely anxious and upset by the relatively rapid progression of the disease. Consequently, primary nursing was employed to ensure continuity in nursing care throughout Harry's stay. His nursing care was organized using the model derived by Roper et al (1980) as this allowed Shannon to help to care for him while ensuring that the primary nurse regularly monitored his progress. In addition, care centred around Harry's usual daily routine, which helped to ease the family's distress. Harry's initial aim was to die at home surrounded by his family and close friends.

The second-named author was the primary nurse for Harry and his family during his stay on the palliative care unit.^arry's family granted permission for the publication of this care study which was written to help nursing students and registered nurses with little background in palliative care to learn more about the nature of nursing care provided by an experienced palliative care nurse to a person with terminal cancer and his family.
Dysmenorrhoea, menstrual attitude and GP consultation
Authors: Hewison Ann , van den Akker Olga BA
Published: August 2014

This study examined the prevalence, source and type of treatment for dysmenorrhoea, and menstrual attitudes. It was expected that negative menstrual attitudes would be related to GP consultation in dysmenorrhoeic subjects. Seventy undergraduate nursing students completed the study. The prevalence of dysmenorrhoea was high, but was not associated with sociodemographic, menstrual cycle and health-related variables. The prevailing menstrual attitude was ‘bothersome’ and ‘anticipation and prediction’, but this was not related to GP consultation. Treatment for dysmenorrhoea was predominantly self or ‘lay’, for which a high rate of satisfaction was observed. Less than one-third of dysmenorrhoeic subjects consulted their GP for treatment, and two-thirds of those who did were dissatisfied with the treatment offered.
Community learning disability teams
Authors: Aylott Jill , Toocaram Jill
Published: August 2014

In the past, community learning disability teams (CLDTs) have not been particularly effective in obtaining the views of their users and perhaps even less effective in adapting the service in line with changing needs. The Halstead Learning Disability Team in Essex carried out two surveys in 1992 and 1994. The findings show that clients and carers have very different needs and expectations which present a challenge to CLDTs to identify and redefine their services.
A hospital-wide quality assurance programme: the Wilson model
Authors: Davies Paul D , O'Gorman Steve P
Published: August 2014

This article examines the Wilson (1987) model and describes how it offers a more realistic framework for quality assurance (QA) in health care and how it can benefit both staff and patients. The model complements total quality management (TQM) and can incorporate audit mechanisms such as the Dynamic Standard Setting System (Dysssy; Royal College of Nursing, 1990). The importance of introducing such a concept before any organization-wide implementation can take place is emphasized. In addition, the need for user-friendly QA across all services in order to strengthen the principles of TQM is stressed.
Intraperitoneal chemotherapy: a prolonged infusion of 5-fluorouracil using a novel carrier solution
Authors: Young Annie , Sherman Margaret , Budden Joanna , Chatwin Diane , Gilbert Jenny
Published: August 2014

A novel carrier solution, icodextrin 20 (7.5%) has allowed exploration of prolonged intraperitoneal (IP) infusion of the cytotoxic drug, 5-fluorouracil. Eighteen patients with intraperitoneal carcinomatosis were entered into a feasibility and pharmacokinetic study of prolonged regional (IP) chemotherapy.. Specialist nurses trained the patients to self-administer their own treatment via a permanent IP catheter. A twin bag delivery system was used to perform one exchange daily. It proved possible to deliver continuous (5 days per week) IP 5-fluorouracil at doses of 200 mg/m2and 300 mg/m2 for up to 12 weeks. The toxicities seen were infective peritonitis, nausea and vomiting, lethargy and anorexia. This was a nurse-led study and the home-based therapy holds promise for patients with malignant peritoneal disease.