bluuebunny/crossref_metadata_2025 huggingface dataset:
Interprofessional learning: Opportunities for students of nursing within youth services
Authors: Kelsey Janet , Mullen Katherine
Published: May 2014

Collaborative working is central to UK health and social care reforms. It is seen as the most efficient way of delivering high quality services, preventing fragmented care and improving the quality of the client’s journey as well as being responsive to service user needs. The drive for multi-professional and inter-professional education is aimed at nurturing collaboration by engaging in joint educational initiatives. The challenge, however, is how to encourage this greater collaboration and understanding between health-care professionals.The University of Plymouth has taken this opportunity to offer students of nursing clinical placements within the Youth Enquiry Service, with the aim of providing experience working with children and young people in a supportive, multi-agency environment with professionals from a variety of backgrounds. This paper discusses the benefits of this placement.
Early recognition of meningitis and septicaemia: the ‘red flag’ symptoms
Authors: Pariagh Sandra , Glennie Linda
Published: May 2014

Meningitis and septicaemia can be deceptive in the diversity of their presentation in children. Added to this difficulty, most health professionals see few cases in their professional lifetimes. The meningococcus is the leading cause of bacterial meningitis in the UK, and it can kill within 24?hours of symptom onset. Many child survivors just starting out in life face debilitating and sometimes permanent disabilities including neurological damage, sensory deficits, limb amputations, and often damage to tissue, skin and organs. There may be further impact on quality of life even for those who appear to recover well. Group B meningococcus accounts for the great majority of meningococcal cases, however a vaccine that protects against it remains elusive. Consequently, given the severity of the disease, its ability to develop at an alarming rate, and the absence of universally protective vaccines against meningitis and septicaemia, it is crucial to be able to recognize the signs and symptoms.

‘Red flag’ symptoms have been recently identified as early warning symptoms of the disease. They manifest some 5 hours earlier than the well-known ‘classic’ symptoms. Knowledge of these earlier symptoms could speed up diagnosis and treatment thereby reducing morbidity and mortality. The purpose of this paper is to draw attention to this deadly disease and highlight the early ‘red-flag’ symptoms.
Moving and handling the infant in a hip spica cast: a systematic review
Authors: Aylott Marion
Published: May 2014

Historically, patient handling injury-reduction strategies have been based on tradition and personal experience rather than scientific evidence. There is strong evidence that these approaches are not effective in reducing care-giver injury (Nelson et al, 2006). Manual handling of the infant, child or young person in a hip spica cast has been identified as a high-risk moving and handling activity. Evidence-based approaches are most likely to be clinically effective. Therefore peer-reviewed research which shows the efficacy of an approach may warrant integration into practice, and subsequently reduce safety risks and improve clinical effectiveness.

A systematic review was conducted to compare the effectiveness and/or complications of methods used in the practice of moving and handling the infant/child in a ‘wet’ (first 24–48 hours until dry) hip spica cast. Searches were made using text words and subject headings relevant to moving and handling the infant, child or young person in a ‘wet’ hip spica cast. All potentially relevant titles and abstracts identified by the searches were retrieved. The reference lists/bibliographies of each article were reviewed for additional relevant titles, and these were also retrieved.

Primary research using quantitative or qualitative methods and published audit data were sought but no studies were found meeting the criteria for inclusion in this review.

There is no research-based evidence concerning the manual handling of the infant/child in a hip spica cast. The core of evidence-based practice is to integrate expertise derived from practice with research evidence when making clinical decisions, as successful practice cannot occur with one of these factors in isolation (Sackett et al, 1996). When research in a particular area of practice is deemed unfeasible, alternative evidence must be sought, especially if safety is to be a priority issue.
Exploring student nurses educational needs in relation to end-of-life care in children
Authors: Thompson Lucy , Hall Carol
Published: May 2014

Children’s nurses are most likely to have long involvement with the care of dying children in hospital and at home. As students they expect to be taught how to manage the complex technical needs of children, however, the needs of dying children may not receive the same degree of attention. Review of the literature revealed that student nurses may be exposed to the death of a child with little education to help them deal with specific needs of the children and minimal preparation in coping with personal emotional reactions. This study closely examined student nurses’ educational needs in relation to end-of-life care for children. Eight semi-structured interviews were conducted with final-year child-branch students to identify their experiences and perceptions.

Themes identified included: anxieties regarding providing end-of-life care to children; negative aspects of end-of-life education; positive aspects of end-of-life education; and perceptions of how end-of-life education could be improved. Students perceived that education could be improved to fully prepare them to care for children at the end of life. Additionally, students identified some of the strengths of their education including providing practical nursing care to children at the end of life and receiving good support from both university and clinical staff.
Childhood cancer: The need for shared care
Authors: Hughes Mary
Published: May 2014

Childhood cancer is not only a devastating diagnosis for the child, but also for parents and siblings. As treatment protocols develop, influencing the rate of survival from childhood cancer, this paper examines the literature on parents’, children’s and siblings’ perspectives of the cancer experience.

Literature search using CINAHL, PubMed and Science Direct databases including parents’, children’s, sibling’s and health-care professionals’ perspectives on the shared care model of treatment. The review concentrates on the pertinent studies surrounding the shared care model, from an international perspective. Key words used in the search strategy were: childhood cancer; shared care; children; parents; siblings; healthcare professionals.

The management of childhood cancer has changed dramatically in the last 20 years, to provide primary, secondary and tertiary care for children with cancer, their parents and their siblings. Several studies are reviewed to elicit the effectiveness of this new model of care from the perspectives of the service users and providers.

It is clear that the care of children with cancer affects the lives of the children, their parents and siblings profoundly. Further investigation on the shared care model is required in order to discover the perception of the service users and health care professionals involved in the delivery of care.
Why policy is important for disabled children
Authors: Glasper Edward Alan
Published: May 2014

Hewitt–Taylor (2007), in a soon to be published seminal book, explores through a series of poignant vignettes the experiences of children with complex and continuing health needs, their families and the staff who are involved with their care. In doing so she illuminates the lives of these children, stating vehemently that they are, irrespective of their specific medical requirements, first and foremost children with the same rights accorded to all children, able-bodied or not. This gauntlet is picked up in a new review of disabled children’s services, which on behalf of the government, has been undertaken by the Department for Children, Schools and Families (DCSF) and HM Treasury. Aiming High for Disabled Children: Better Support for Families (2007) focuses on three priority areas that are designed to improve the lives of such children, namely better access (to health care) and empowerment, responsive services and timely support and importantly improving both the quality and capacity of services. This new policy has great symmetry with standard 8 of the National Service Framework for Children, Young People and Maternity Services (NSF) (DfES, 2004) in which one of the primary missions is that children and young people who are disabled or who have complex health needs should be supported to participate in family and community activities and facilities. This is important because children with complex health needs have traditionally been poorly served by society. Dickens’ (1859) vivid portrayal of disabled Tiny Tim and his devoted father Bob Cratchet in A Christmas Carol is a poignant legacy of the importance of the societal context of such children and crucially, as finally realized by Ebenezer Scrooge, why they are important.
Theory focused practice: enhancing the evidence base for children’s nursing practice
Authors: Chambers Margaret , Carter Rachel , Doman Maggie , Jeffery Karen , Kelsey Janet , McEwing Gill , Wayne Lesley
Published: May 2014

The importance of providing an evidence-base for practice for all health professionals is not disputed and in recent years this has become a requirement. However there is an on-going dialogue regarding a theory-practice gap in nursing which suggests that many nurses still do not underpin their practice with evidence to support it. Reflective practice has been seen as a panacea for this but it has been suggested that even this process does not completely close the theory-practice gap. Contemporary nursing education focuses on student-led approaches and encourages critical reading and the application of research findings and other evidence to clinical practice. However, it may be argued that student and novice nurses have difficulty in both finding evidence and then applying it to their every day practice. Indeed it has been suggested that these groups are much more likely to look to their more experienced peers for advice than to actively search out evidence for themselves. This paper sets the scene for an innovative teaching method, the aim of which is to encourage students to seek out the evidence for practice and provide them with the skills to challenge poor practice whenever they meet it. The method has its roots in the concepts of experiential learning and problem-based learning and these concepts are explored along with those of evidence-based practice and the theory-practice gap. A small survey of lecturers in children’s nursing across the UK is reported. This suggests that while a theory-practice gap is not conclusively acknowledged there are still some students and novice nurses who do not use evidence to support their practice or may need prompting to do so. Theory focused practice (TFP) is promoted as an innovative teaching method which may help to mitigate these problems.
Needlestick injuries in clinical practice: exploring the European Union legislation
Authors: Fromage Gemma
Published: May 2014

Although needlestick injuries have been described as 'one of the most serious health and safety threats in European workplaces', there is still widespread underreporting across organisations. A new European Union (EU) Directive was bought to action in May 2010 in order to protect all workers from needlestick injuries and subsequent infection from blood-borne pathogens such as hepatitis. The purpose of the Directive is to ensure a safe working environment for workers and to provide comprehensive training, information, awareness raising and monitoring. In line with the Directive, member states, including the UK, have until 11 May 2013 to ensure all protective provisions have been implemented into national legislation. This article intends to bring aesthetic nurses up to date on policies and guidance currently in place.
Treating the lower face and neck with neuromodulators: benefits and complications
Authors: Fletcher Leslie
Published: May 2014

This article is will educate practitioners on the possibilities that botulinum toxin type A can offer their patients, such as effectively tightening and lifting the lower face and neck, using neuromodulators. The author will review ageing factors, discuss anatomy and physiology, explore the mechanism of action of botulinum Toxin type A on the muscles injected, as well as the antagonistic effect on the opposing muscles, and list common complications and how to avoid or manage them. After reading this article, practitioners will understand the mechanism of action for botulinum toxin type A in the lower face and neck and be more comfortable safely offering this service to their patients. Using botulinum toxin type A for re-contouring and re-draping of the face and neck is a novel and effective approach for aesthetic practitioners.
Looking at the psychological vulnerability of patients undergoing breast augmentation
Authors: Bradbury Eileen
Published: May 2014

Breast augmentation is currently the most popular aesthetic procedure in the UK and US; however, there are often complex and underlying factors that motivate women to seek out surgery. In this article, Consultant Psychologist Eileen Bradbury highlights the psychological implications of this aesthetic procedure and briefly explores the impact of 2012's PIP implant scandal
Launch events: are they really worth investing your time and money in?
Authors: Zadah Kate
Published: May 2014

Although many PR companies hold extravagant launches and events for their clients, aesthetic clinics may benefit from smaller gatherings with relevant journalists. In her column, PR Professional Kate Zadah provides aesthetic nurses with her top tips on attracting media attention, keeping budgets in check, getting the guest list right and following up about editorial copy after the event
Key points from the latest Cosmetic Compliance Summit held in London
Authors: Bowes Lorna
Published: May 2014

This year, the European Union cosmetic products regulations changed to Cosmetic Products Regulation 1223/2009. The new regulations apply to all cosmetic products, thereby affecting all aesthetic practitioners who stock products in their clinics. Lorna Bowes outlines the key points raised at this year's Cosmetic Compliance Summit and defines the role of Cosmetics Europe and the National Trading Standards Board
Exploring the psychosocial impact of undergoing botulinum toxin treatment
Authors: Paraskeva Nicole
Published: May 2014

In 2012, the American Society for Plastic Surgeons reported that 13 million minimally invasive treatments, such as botulinum toxin injections and dermal fillers, were performed in the US. As the demand for these procedures continues to rise, it is vital to understand the psychosocial impact for patients who seek them. Nicole Paraskeva evaluates the literature on botulinum toxin treatments
Westminster Briefing on the future of cosmetic interventions regulation
Authors: Taber Sally
Published: May 2014

Aesthetic nurses, cosmetic doctors and plastic surgeons around the UK continue to wait with bated breath for the Department of Health's response to Sir Bruce Keogh's review of cosmetic interventions. Although it was revealed that there will not be a statutory register for practitioners administering cosmetic treatments, there will be tighter control from the professional regulators. Sally Taber gives aesthetic nurses an update
Learning to trust consumer review and comparison sites as a marketing tool
Authors: Brechon Sarah
Published: May 2014

The Financial Conduct Authority recently launched an investigation into consumer review platforms, raising key questions about these websites as marketing tools and examining them for ‘transparency and fairness’. Although there is a risk of false reviews and doctored moderation of content, comparison websites can be a great tool for aesthetic clinics. Sarah Brechon explores the benefits of online reviewing.
The Cosmetic Skin Clinic: from first impressions to undergoing a procedure
Authors: Zadah Kate
Published: May 2014

When providing advice on running a successful clinic, nothing is better than experiencing the patient journey yourself, from the reception to the treatment room. In this new practice management series, PR professional Kate Zadah will travel the UK visiting clinics and reviewing their layouts, customer service, treatment menus and follow-up care. She will also highlight areas for improvement for each one
Spreading the essence of your clinic by working with other industry professionals
Authors: Deakin Barbara
Published: May 2014

Building a database of professional contacts and partnering with other professionals and manufacturers can provide new ways to grow a business. In her monthly column, Clinic Manager Barbara Deakin advises aesthetic nurses on forming complementary relationships with key industry players, raising their profiles and enhancing their reputations among other practitioners
Prescribing oral isotretinoin: understanding the need for caution
Authors: Fromage Gemma
Published: May 2014

Acne is a common inflammatory disorder that can occur in both adolescents and adults. Isotretinoin is used in severe forms of acne which are resistant to adequate courses of therapy with systemic antibacterials and topical solutions. It has a serious side-effect profile and is associated with a number of significant cautions and contraindications. Therefore, isotretinoin should only be prescribed by or under the supervision of physicians with both expertise in the use of systemic retinoids for the treatment of severe acne and a full understanding of the risks of isotretinoin therapy and its monitoring requirements. Isotretinoin is highly teratogenic and is therefore contraindicated in pregnancy. Oral isotretinoin causes increased skin fragility and can result in scarring, and therefore, its summary of product characteristics recommends that wax epilation, laser skin treatment and microdermabrasion should be avoided during and for at least 6 months after treatment. Thorough patient medical history records should be taken and close monitoring is required owing to the effects of isotretinoin on mental function, serum lipid levels and hepatobiliary function.
Managing dermal filler complications part 1: the Tyndall effect phenomenon
Authors: BRACKENBURY JULIE
Published: May 2014

All dermal fillers are associated with the risk of both early and delayed onset complications. Consequently, both aesthetic practitioners and patients need to be aware of all adverse reactions relating to this treatment. This article reviews a fortunately rare complication—the Tyndall effect. Appropriate planning and management before the administration of dermal fillers will be discussed.
Teaching professionalism in the perioperative environment
Authors: Hinton Jean
Published: May 2014

All health-care students learn in complex, multifaceted environments and sometimes it is difficult for them to understand their professional responsibilities and obligations. Teaching professionalism is now considered by most multidisciplinary health educators to be an essential core skill included in their course curricula. However, some would argue that certain aspects of professional behaviour are unteachable. This article examines operating department practice (ODP) curricula and discusses possible teaching methods that can be used to teach and promote professional behaviours among ODP students. An important aspect of teaching professionalism is the incorporation of the many parts into a whole and this article considers how to teach all aspects of professional behaviour in a perioperative environment from student, through to experienced practitioner. The aim of teaching professionalism in a multiprofessional environment, where students learn from real life practice experiences, incorporating the values and behaviours of their mentors and the wider professional team, allows the internalisation, understanding and development of professional values, attitudes and cultures. Therefore, explicitly teaching professionalism may put the public's mind at rest in addition to producing well-rounded professionals, who are not just competent and safe, but have expected professional values and attitudes.
Have your say…
Authors: Wicker Paul
Published: May 2014

The Journal of Operating Department Practitioners' associated LinkedIn group has a variety of members from all over the world. It provides an opportunity for those working in the perioperative environment to come together and discuss topics that are not only important to them, but are pertinent to the wider health care community. A recent comment, by Consultant Editor, Paul Wicker, whetted the appetite of a number of members and generated a lively debate. Paul's initial comment and a selection of subsequent replies are included below:
Health visitors have a key role in reducing tooth decay in children
Authors: Bateman Peter
Published: May 2014

Figures released by Public Health England last month showed that tooth decay affects more than one quarter of England's 5-year-olds. Dental specialist Peter Bateman explains how health visitors can help in the fight to improve children's oral health.
Weaning onto a vegetarian diet: Advising parents on nutrition
Authors: Patience Sara
Published: May 2014

Weaning is a crucial stage in an infant's development, and parents must ensure that their baby receives adequate nutrition as they progress from milk feeds to solid foods. Some parents may wish to raise their child as a vegetarian, either for ethical or religious reasons, or because of perceived health benefits. It is important that health visitors understand how a family's beliefs can affect the way they raise their child, and are equipped with the knowledge to advise parents while remaining sensitive to such beliefs. This article will look at the implications of weaning an infant onto a vegetarian diet, and how health visitors can support parents to ensure the infant gets adequate nutrition.
Exploring health visitors' use of information and communication technologies with vulnerable families
Authors: Schultz Pamela
Published: May 2014

Social media and information and communication technologies (ICTs) are ubiquitous in modern British culture, and influence patterns of communication in every sphere of life. For public health practitioners, this has created an opportunity for novel forms of working, with associated risks and benefits. However, little is known about how certain groups of public health nurses have engaged with this opportunity. This paper will share some of the findings from a small research project to complete a Master of Public Health (MPH). The project involved a qualitative study using a semi-structured email interview, drawing on a variant of grounded theory methodology proposed by Corbin and Strauss (2008) and Charmaz (2006) . The study explored how one group of health visitors used ICTs in their practice, and their perceptions of ICT use. The author concludes with some recommendations and implications for practice based on the study's findings.
A new principle of universality?
Authors: Cowley Dame Sarah
Published: May 2014

For almost 40 years, health visitors have been guided by four principles. Professor Dame Sarah Cowley considers the value of adding ‘universality’ to the list.
Long-term conditions: Is there a role for health visitors?
Authors: Griffiths Jane , Horne Maria
Published: May 2014

Long-term conditions are the leading cause of mortality in the UK and represent a major public health challenge. While such illnesses primarily affect adults, there are various long-term conditions affecting significant numbers of children, such as asthma and diabetes. The health promotion role of health visitors means they are well placed to help prevent the development of long-term conditions in children and the wider community, in collaboration with colleagues in primary care. This paper discusses the existing and potential role of health visitors in preventing, screening for and helping children and families to live well with long-term conditions.
Introduction of a new childhood influenza vaccination programme
Authors: Craig Laura
Published: May 2014

Autumn 2013 sees the introduction of a universal childhood flu vaccine programme across the UK. It extends the previous flu immunisation programme to include all children aged 2 to under 17 years. Vaccinating children will protect not just the children themselves but the wider community. It is estimated that if just 30% of children had the flu vaccine, there could be 2000 fewer deaths and 11 000 fewer hospitalisations each year ( Joint Committee on Vaccination and Immunisation, 2012 ). A live attenuated intranasal spray called Fluenz is the recommended vaccine for the programme. It is important that health visitors understand the benefits and evidence base relating to the use of the vaccine, as they are in a vital position to achieve high uptake of flu vaccination in children through promoting the vaccine to parents and carers.
Understanding the role of peripatetic community practice teachers
Authors: McInnes Elaine
Published: May 2014

Accepted practice for supporting student health visitors in their training has been for each community practice teacher (CPT) to support a single student in the clinical setting. Following the publication of the Call to Action ( Department of Health, 2011 ), there has been a dramatic increase in student health visitor numbers. This has affected the ability to teach in this way, and a system of ‘long-arming’ has been introduced, whereby each CPT provides teaching support to several students facilitated via mentors. This qualitative study using grounded theory sought to evaluate the impact of this change by interviewing six experienced CPTs. Questions were compiled following a comprehensive literature review. Common themes included communication, capacity to undertake the role and support networks. Interviews confirmed that there remained a deep professionalism and dedication to the role. Despite changes in the role, CPTs continue to strive to provide high-calibre support to students and mentors. All participants saw support from management as positive, although some suggested support from higher education institutions was variable. Effective communications and a commitment to building strong working relationships were seen as important. Some interviewees mentioned being overstretched and had experienced burnout and stress. This appeared greatest where CPTs continued to carry a caseload while managing several students and mentors. Further investigation into the outcomes achieved, through examining the confidence and competence of newly qualified health visitors trained through this method, is recommended.
Part 1: Living theory action research and Adlerian psychology: The alongside approach of a health visitor
Authors: Pound Robyn
Published: May 2014

When a mother asked a health visitor to help her get her son to sleep at night, the solution was found in ‘alongsideness’. This article is the first of two reporting the findings of a collaborative enquiry that continued over 4 months to understand and explain their learning. Part 1 focuses on the health visitor, Robyn's account. In part 2, the mother, Ruth, considers the implications of the collaborative enquiry process of helping her son to sleep, for understanding her future parenting. She reflects on her experiences of health visiting and the process of talking about it. In part 1, Robyn explores the influence of living theory research and Adlerian psychology on alongsideness. She finds her ‘alongside’ values for health visiting also appearing in the alongside way of managing baby sleep difficulties they had used. Alongsideness is an approach that suits the aims of the Health Visitor Implementation Plan, and living theory methodology is offered in addition to the Family Partnership Model for promoting practitioners' understanding, as well as improving, evaluating and explaining what they are doing. In this process, intuitive actions and learning, tuned through experience, become conscious explainable and tested practice.
Inspiration and aspiration: How are we nurturing the new generation?
Authors: Bailey Beverley
Published: May 2014

The Health Visitor Implementation Plan has led to an increased number of staff entering the profession. Bev Bailey considers how its aims can be fulfilled in a practice setting.
North West collaborative project developing an e-learning resource: Learning about health visiting
Authors: Hough Lizz , Blake Jo , Chesney Sarah
Published: May 2014

The changing face of health-care training means that higher education institutions need to be able to respond by adopting innovative approaches to health-care education ( Walsh, 2011 ). Increased recruitment to specialist community public health nursing—health visiting programmes is having an impact on the availability for pre-registration placements in this area of specialist practice. NHS North West contacted the University of Cumbria to lead a project involving education providers to develop and enable online delivery of a health visiting learning resource in support of pre-registration programmes. The resource aimed to enable students to work through specific scenarios developed from the Healthy Child Programme ( Department of Health (DH), 2009 ) and the Call to Action ( DH, 2011 ), reflecting the new service delivery model. Through multimedia simulation and narrative pedagogy, focused around the virtual community of Stilwell ( Walsh, 2011 ; Walsh and Crumbie, 2011 ), the resource design made full use of visual imagery of health visiting in action, ensuring formative assessment of students’ knowledge acquisition and reflection on the context of health visiting in current student placements.
Why it is vital to be on Yellow Alert
Authors: Taylor Alison
Published: May 2014

Following publication of an article on prolonged neonatal jaundice in JHV last year, the Children's Liver Disease Foundation saw a surge in health visitors' requests for its resources. Chief Executive Alison Taylor has taken this opportunity to update health visitors on the Yellow Alert campaign to raise awareness of jaundice in newborns.
Communicating evidence to clients: no easy matter
Authors: Condon Louise
Published: May 2014

In this section, a range of brief synopses of recently published articles that may be of interest to health visitors is presented. The aim of this roundup is to provide an overview, rather than a detailed summary, of the research papers selected. Should you wish to look at any of the papers in more detail, a full reference is provided.
Health improvement programme reaps rewards for local authority
Authors: Bell Maureen
Published: May 2014

South Tyneside Council has taken its new public health responsibilities as an opportunity to tackle significant health inequalities, and was recently named as winner of the first Local Government Chronicle Public Health Award.
Recent changes in the role of the donor transplant coordinator
Authors: Rhodes Tracy
Published: May 2014

Tracy Rhodes explains how the role of transplant coordinator was first developed in the UK 30 years ago. In 2008, the Organ Donation Taskforce stated its main aim of increasing organ donation by 50% in the UK by 2013. Their recommendations resulted in changes to the role of donor transplant coordinator (DTC) and the emergence of the new role of specialist nurse-organ donation (SN-OD).
To dialyse at home or not to dialyse at home, that is the question
Authors: Ellis Peter
Published: May 2014

With the inexorable rise in the number of people needing renal replacement therapy for end-stage kidney disease, renal care providers need to begin to explore more and varied ways of providing this. This article takes a brief and critical look at the policy impetus for providing home haemodialysis in the UK and considers some of the recent evidence that might support its adoption.
Choosing automated peritoneal dialysis
Authors: Pratt Christopher
Published: May 2014

Christopher Pratt began his dialysis treatment at the age of 73 years with continuous ambulatory peritoneal dialysis. He found the changing of bags too much of an interruption while working and moved to automated peritoneal dialysis (APD). He has never met anyone else on APD.
Healthy alliances in wound management
Authors: Franks Y.
Published: May 2014

This study identified disciplinary responsibility and referral patterns for patients with chronic wounds in a combined hospital and community NHS trust in south London. Results show that nurses are aware of the benefits of a multidisciplinary approach but that there are significant differences between care settings in access to other professionals and in the autonomy afforded nurses, with implications for patient care.
Clinical evaluation of a new pressure-relieving mattress
Authors: Bale S. , Price P. , Crook H. , Morgan T. , Harding K.G.
Published: May 2014

In introducing a new mattress into practice it is important to evaluate its performance from both the patient's and nurse's perspective. A total of 20 patients admitted to the integrated medical unit were recruited and nursed on a new pressure-relieving mattress offering two modes of pressure relief (Duo). All patients had been recently admitted to hospital and were considered to be ‘at very high risk’ of developing a pressure ulcer, with an initial Waterlow score >20. Data were collected on admission, mid-point (three to four days) and study exit (seven days).

The primary objective was to investigate the condition of patients' skin and the mode of choice for pressure relief. The secondary objective was to investigate reasons for nurses' and patients' choices. Structured interviews were conducted with the patient, ward nurse and research nurse whenever possible.

Nineteen patients maintained or improved their skin condition during the evaluation.
Evaluation of a range of hospital replacement mattresses
Authors: Kernohan W.G. , Witherow A. , Allen-Hamilton S. , O'Hagan M.
Published: May 2014

A combination of physical measurement and clinical testing was used to evaluate a range of pressure-reducing replacement mattresses, which had met tender specifications, in order to reduce the number available for selection in the purchasing process. Factors considered included mattress price and expected life-span. The results presented have supported a purchasing decision to replace mattresses but care should be taken in adopting these findings in a different context from that of a district general hospital. Optimum performance was found in one mattress replacement (Pentaflex).
Wound dressings and the Drug Tariff
Authors: Heenan Andrew
Published: May 2014

An update on the dressings available for wound care in the community
Haemorrhagic cellulitis
Authors: Danielsen L. , Balslev E. , Thomsen H.K.
Published: May 2014

This report describes two cases where haemorrhagic cellulitis was managed with corticosteroids and antibiotic therapy
Assessing practice in preventing pressure damage
Authors: Harding K.G.
Published: May 2014

At a time when we are appropriately encouraged to deliver evidence-based practice to our patients, it is important to recognise that the study design required to produce such evidence may vary considerably. A number of national bodies have set the threshold design for evaluating new treatments at the level of the randomised controlled trial, with a significant difference in outcome (usually healing times) as the gold standard of evidence required to provide sufficient evidence to change practice.
Practice Points
Authors: Cooper R.A. , Harding K.G.
Published: May 2014

When first developed, penicillin was effective in treating Staphylococcus aureus infections by inhibiting bacterial cell wall biosynthesis. However, within 10 years more than 80% of strains of Staphylococcus aureus that were isolated from patients were penicillin-resistant (PRSA). Most of these were able to synthesise an enzyme (called penicillinase or β-lactamase) that conferred resistance by cleavage of the β-lactam ring to inactivate the antibiotic.
Dermatological conditions and HIV disease
Authors: Whelan J.
Published: May 2014

An update on skin conditions which can affect patients with human immunodeficiency virus.
Practice Points
Authors: Lawrence J.C.
Published: May 2014

Experienced clinicians offer top tips to guide practice on specific wound-care issues.
Reviewing the case for debridement
Authors: Flanagan M.
Published: May 2014

The frenetic pace of today's work place allows little time for reflection. This encourages many clinicians to perform ritualistic practices without thinking. Many of the principles of wound management are enshrined in the mists of time, despite the current drive to deliver evidence-based practice for our patients. One such principle, the need for wound debridement, is explored in this issue of Journal of Wound Care by Vowden and Vowden (page 291-294), who raise critical issues specifically relating to sharp techniques in the second part of their update on wound debridement.
Beds and mattresses
Authors: Clark M.
Published: May 2014

Many of the practices undertaken to prevent and treat pressure ulcers are contentious, based on estimates and guesses rather than evidence.1 One of the areas of greatest uncertainty, the role of pressure-redistributing support surfaces, has become a common foundation to pressure ulcer care. Since Hibbs2 described an ideal shopping list of support surfaces for a large combined acute and community care provider, special mattresses have been widely disseminated throughout health care services in the UK and beyond.1 This utilisation has not been inexpensive, with 7-8% of all pressure ulcer costs attributed to the acquisition of mattresses.3,4
The choice of products in wound management
Authors: Vowden K.
Published: May 2014

In the first issue of Journal of Wound Care, Flanagan1 attempted to establish the deciding factors influencing the choice of wound-management products; many subsequent articles have reflected on this decision-making process. To be effective practitioners, nurses must rely on information published in specialist, unbiased, peer-reviewed sources, including information on local and national guidelines for treatment of chronic wounds.
The past and future progress of wound care
Authors: Hofman D.
Published: May 2014

The forthcoming European Wound Management Association (EWMA) meeting in Harrogate (November 9-11) promises debate on a broad range of topics. The progress of wound healing during the past century will be reviewed, with particular emphasis on the radical changes that have emerged during the past 30 years. In this time there has been an upsurge in the availability of wound-care products in developed countries, together with an increasing emphasis on the need for evidence-based medicine.
Communication matters
Authors: Vousden Martin
Published: May 2014

In the past nurses were not very good at sharing information and disseminating good practice. According to Martin Vousden, this may be about to change.
Fads and fancies
Authors: Baxter Helena
Published: May 2014

The selection of wound-care dressings should be based on clinical evidence. In reality, purchasing decisions are too often influenced by company marketing campaigns and current trends, says Helena Baxter
Pressure-ulcer prevention strategies: are the data valid?
Authors: Dealey C.
Published: May 2014

A literature review in the last month's Journal of Wound care showed that the prevalence of pressure ulcers has not changed in the past 20 years. Here, Carol Dealey responds by examining the dactors that reduced the validity of data on the effectiveness of pressure-ulcer prevention strategies used at a hospital over a 10-year period.
Accessing wound-care information on the Internet: the implications for patients
Authors: Bovill E.S. , Hormbrey E. , Gillepsie P.H. , Banwell P.E.
Published: May 2014

The Internet and the World Wide Web have revolutionised communication and provide a unique forum for the exchange of information. It has been proposed that the Internet has given the public more access to medical information resources and improved patient education. This study assessed the impact of the Internet on the availability of information on wound care management.

The search phrases ‘wound care’, ‘wound healing’ and ‘wounds’ were analysed using a powerful Metacrawler search engine ( www.go2net.com ). Web site access was classified according to the target audience (wound-care specialists, other health professionals, patients) and the author (societies, institutions or commercial companies).

The largest proportion of web sites were commercially based (32%). Of the total number, 23% specifically targeted patients, mostly by advertising. Only 20% were aimed at wound specialists. Extensive surfing was required to obtain wound-care information, and objective information sites were under-represented.

Regulated, easily accessible, objective information sites on wound-healing topics are needed for improved patient education and to balance the existing commercial bias.
What next for nurse prescribing?
Authors: Baxter H.
Published: May 2014

The limited prescribing powers given only to community nurses is not enough to meet the needs of both patients and the health serviceservice, argues Helena Baxter
Producing criteria for static mattress tender and purchase
Authors: Schofield T.
Published: May 2014

When selecting mattresses criteria such as health and safety plus clinical and cost-effectiveness should be considered. These can then form the basis of contract tender specifications.
Klippel-Trenaunay syndrome: what are the implications for wound care?
Authors: Patel G.K. , Banerjee D. , Harding K.G.
Published: May 2014

Patients with Klippel-Trenaunay syndrome may present with problems such as allergic contact dermatitis and ulceration. This case study explains how it should be diagnosed and treated.
Pyoderma gangraenosum: exploring the treatment options
Authors: Kelly J.
Published: May 2014

There is no uniform treatment for pyoderma gangraenosum. This case report describes how the use of several types of treatments, including larval therapy and VAC, achieved wound healing
Cultured autologous keratinocyte sheets: use on large area burns
Authors: Shelton J.
Published: May 2014

The treatment of large burn areas can pose major problems if there are insufficient donor sites. In such cases, cultured autologous keratinocyte sheets present a viable alternative.
Questions & answers
Authors: Vowden P. , Vowden K.R.
Published: May 2014

The editor welcomes readers' questions and alternative answers to questions.These should be sent to the Journal of Wound Care, Greater London House, Hampstead Road, London NW1 7EJ. Fax: +44 (0)20-7874 0386. Email: jwc@emap.com
Questions & answers
Authors: Hampton S.
Published: May 2014

The editor welcomes readers' questions and alternative answers to questions and letters.These should be sent to the Journal of Wound Care, Greater London House, Hampstead Road, London NW1 7EJ. Fax: +44 (0)20-7874 0386. Email: jwc@emap.com
From the journals
Authors: Baxter Helena
Published: May 2014

National guidelines aim to provide a framework for practice and improving patient care. However, guidelines do not necessarily mean that best practice is adopted. This project examines community nurses' experience of a clinicaleffectiveness programme for managing leg ulcers in the community, and identifies factors most likely to ensure a change in practice.
From the journals
Authors: Baxter Helena
Published: May 2014

There are many clinical guidelines in the UK, covering local, national and international perspectives. The purpose of this study was to explore current trends in guideline development using a postal questionnaire sent to 1500 members of the Tissue Viability Society.
Sepsis: its causes and effects
Authors: Smith N.
Published: May 2014

Sepsis contracted after malignancy, surgery or trauma is caused by a variety of micro-organisms ranging from viruses and fungi to bacteria. If untreated, it can lead to permanent damage to organs and tissues, or even to the patient's death.
From the journals
Authors: Baxter Helena
Published: May 2014

An audit of current practice was undertaken at North Devon District Hospital, following observations that patients admitted with wounds had them routinely swabbed, seemingly without any rationale.
A non-adhesive foam dressing for exuding venous leg ulcers and pressure ulcers: six case studies
Authors: Charles H. , Corser R. , Varrow S. , Hart J.
Published: May 2014

Inappropriate control of exudate from chronic wounds can lead to significant clinical problems, including peri-wound maceration, resulting in delayed healing and increased pain. Of equal importance are practical problems such as increased odour, leakage of fluid and stained clothes. These can result in reduced mobility and isolation, with a negative impact on quality of life.
The effects of ageing on fibroblast function during proliferation
Authors: Brown J.A.
Published: May 2014

The effects of ageing on cutaneous wound healing are said to be profound, with subsequent acute and chronic wound morbidity resulting in a potentially massive burden on health-service resources. Anecdotal evidence suggests that ageing prolongs the healing process, but there is a dearth of reliable and valid research to substantiate this. Generally, the healing process in older people is relatively unaffected, although fibroblast function is thought to be reduced.
Effect of glucose concentration on the growth of normal human dermal fibroblasts in vitro
Authors: Han J. , Hughes M.A. , Cherry G.W.
Published: May 2014

Objective:

Glucose requirements increase in tissue repair as glucose is an energy source for cell proliferation and the formation of extracellular matrix components. Glucose concentrations in leg ulcer wound fluid are lower than in normal human serum, with a median of 0.7mM (range: 0.3–1.2mM). This study investigated the effect of such low concentrations on the growth of fibroblasts in vitro.

Method:

Fibroblasts from 50-year-old and 87-year-old subjects were used. Growth in medium with various concentrations of glucose was determined by a colorimetric assay and microphotography.

Results:

Up to day 6, there were minimal differences in growth, but after day 6 a clear dose-dependent increase in growth was observed. In the lower dose range (up to 2.3mM), growth was highly dose-dependent (r2=0.981), with an increase of 1.8mM stimulating cell growth by day 10 up to 163% of the controls (p<0.0001). Concentrations of 5.5–25.5mM glucose stimulated cell growth by day 10 to about 210% of the controls (p<0.0001), with little difference between these concentrations.

Conclusion:

These results suggest that glucose enhancement to cells involved in healing might serve as an adjunctive treatment for chronic wounds.

Declaration of interest:

None.
JWC/Tendra (Mölnlycke) Scholarships: a progress report
Authors: Collier Mark , Fraser Dorothy
Published: May 2014

When in the autumn of last year several of my tissue viability colleagues suggested I enter the Journal of Wound Care/ Tendra (Mölnlycke) Scholarship for Experienced Practitioners 2004, I was flattered and a little apprehensive. Having been appointed the first nurse consultant in tissue viability in the UK in 1992, I was more used to judging and then attending award ceremonies to celebrate others’ contributions to the specialty. But then I thought why not, especially as I remembered my words during the interview for my current post: ‘I want to put Lincolnshire on the map for all the right reasons and let people know that everyone has the potential to achieve positive patients outcomes in whatever area of the country they work in’.
Patient repositioning revisited
Authors: Russell L.
Published: May 2014

Patient repositioning, as part of a planned pressure ulcer prevention strategy, relieves pressure on tissue and aids reperfusion of blood supply. Repositioning, though labour-intensive, should be undertaken as often as is tolerable for the patient, particularly if not on a pressure-relieving support system. Benefits include: