bluuebunny/crossref_metadata_2025 huggingface dataset:
Birthing outcomes from an Australian HypnoBirthing programme
Authors: Phillips-Moore Julie
Published: May 2014

Background and aim:

HypnoBirthing, which is steadily increasing in popularity both in Australia and overseas, is a set programme consisting of 10–12 hours of instruction for couples approaching the later stages of pregnancy and birth. A survey was carried out to investigate how Australian participants attending the HypnoBirthing programme between 2007 and 2010 compared to other studies where hypnosis was used for childbirth.

Results:

The average length for both stages of labour was shorter in the HypnoBirthing group compared to general population figures. Caesarean section rates were lower, as was the use of gas and epidurals. Of the 81 participants, 46 (51 %) did not use any pain medication at all and the overall discomfort level for labour and birth was 5.8 out of 10 with 32 % of the participants scoring under 5.8, including two participants who recorded zero discomfort.

Conclusion:

Women attending the HypnoBirthing programme demonstrated similar results to those found in other research in hypnosis for childbirth. However, the findings also demonstrated some added benefits of HypnoBirthing. The majority of women reported feeling more confident, relaxed, less fearful, focused, and more in control. They also commented on the ease and comfort of labour and birth and the satisfaction of having their partners involved and supportive.
Perinatal domestic abuse: Midwives making a difference through effective public health practice
Authors: Williams Helen , Foster David , Watts Pauline
Published: May 2014

This discussion article addresses the key issues around some of the challenges of perinatal domestic abuse. It provides some guidance on initiatives recently developed as part of the national nursing and midwifery vision and strategy Compassion in Practice; specifically around developments within public health nursing and midwifery. The importance of building effective partnership and wider agency working relationships between midwifery and fellow professionals is explored together with some practical guidance on improving health outcomes for this vulnerable group of women.
Myths and misconceptions: Midwives' perception of the vaginal opening or hymen and virginity
Authors: Christianson Monica , Eriksson Carola
Published: May 2014

Ideas and misconceptions about the vaginal opening, hymen and virginity are widely held in many societies. The aim of this study was to investigate the perceptions of the vaginal opening, the hymen and its connection with bleeding, sexual intercourse, physical activity and virginity verification among an international group of midwives. an online questionnaire about the topic was emailed to midwives who attended the International confederation of Midwives' (ICM) congress in Glasgow. The respondents (n=480) represented five continents with european delegates dominating the attendees. Two thirds (66%) of the respondents believed that girls are born with a covering membrane that breaks during the first vaginal intercourse and 52% thought that the membrane breaks during physical activities. Fifteen percent connected bleeding with the first vaginal intercourse and 21% stated that virginity can be verified by a gynecological examination. Midwives play a significant role in improving the sexual and reproductive health of women, thus in order to challenge long-held biomedical ‘truths’, midwives must become conscious and knowledgeable about how the myths surrounding the hymen contribute to gender inequalities and health disparities in women. a first step is to implement gender perspectives in midwifery education.
Starting my first post as a newly qualified midwife
Authors: Price Cheri
Published: May 2014

Cheri Price, newly qualified midwife, begins her post as a newly qualified midwife. She shares the experiences of her first few weeks back in practice.
Facilitating effective initiation of breastfeeding - a review of the recent evidence base
Authors: Barry Maebh , Tighe Sylvia Murphy
Published: May 2014

Midwives are in a unique position to support mothers in the initiation of breastfeeding. In order to advise and support mothers effectively it is important that midwives have an in-depth understanding of the evidence base underpinning practice. Traditional explanations of breast anatomy have altered ( Geddes, 2007 ) and over the years many of the practices in relation to breastfeeding have changed. It is important that midwives acquire knowledge on interventions that help rather than hinder breastfeeding. This paper explores the latest evidence on the lactating breast, the process of lactation, sucking skills, post-birth practices impacting on the initiation of breastfeeding and supporting the natural process of breastfeeding.
Baby Be Smoke Free: Teenage smoking cessation pilot
Authors: Hill Susie , Young Danielle , Briley Annette , Carter Jenny , Lang Rebecca
Published: May 2014

Smoking is a highly significant modifiable risk factor in pregnancy. Despite its association with an extensive list of adverse outcomes, 35% of pregnant teenagers smoke throughout their pregnancy ( NHS, 2011a ). Although a successful method of quitting, engagement with Stop Smoking Services (SSS) is low among young women ( National Institute for Health and Care Excellence (NICE), 2010 ). Alternative methods of encouraging this group to utilise SSS are needed. In this study, qualitative data were collected from 32 teenage pregnant smokers and 60 specialist teenage midwives, and used to develop an online tool—‘Baby Be Smoke Free’ (BBSF)—to support smoking cessation in young pregnant women. The tool was piloted in the antenatal clinic of an inner city tertiary referral centre with high rates of teenage pregnancies. Thirty six young women were recruited and qualitative feedback was gathered from a further 15 young pregnant women. BBSF increased awareness of the impact of smoking and motivation to quit. Four out of the 36 women requested support from SSS. Broader testing and refining is required, but BBSF could be a useful intervention to engage this hard to reach group of pregnant women.
Student midwives' perceptions of real-time simulation: A qualitative phenomenological study
Authors: Deegan Maura , Terry Louise
Published: May 2014

In recent years there have been several drivers promoting the use of simulation within the learning environment for students undertaking pre-registration midwifery training. Many studies conclude simulation is a viable learning and teaching strategy within health education; however, little is known about ‘real-time’ simulation. This study explores the perceptions of student midwives' experiences of real-time simulation, where their classroom learning within a university setting was interrupted to manage simulated obstetric emergencies in delegated roles. The study utilised a qualitative approach using Heideggerian phenomenology ( Parahoo, 2006 ), and data were collected through focus groups. Analysis and interpretation of the data was achieved using thematic analysis, which revealed that real-time simulation supported student midwives to link theory to practice by ‘doing’. It also revealed that the realism created along with role delegation evoked unexpected emotions and stressful responses from the participants. Midwifery educators need to address these issues when facilitating real-time simulation.
Maternal insertion in electronic fetal monitoring: A case report
Authors: Schwarz Christiane
Published: May 2014

It is important that professionals using electronic fetal monitoring are aware of various aspects regarding interpretation and clinical value of the trace. In practice, there are some typical misunderstandings and mistakes, which can lead to unexpected and sometimes adverse outcomes. One of the most frequent errors is the recording of maternal blood vessel pulsation (maternal insertion), instead of the fetal heart. In this article, a case of maternal insertion is presented and implications for practice are discussed.
Future proofing supervision in Wales: Improving the quality of statutory supervision
Authors: Ness Vinny , Richards Julie
Published: May 2014

The Local Supervising Authority (LSA) in Wales, working closely with Directors of Nursing, Heads of Midwifery, Nursing and Midwifery Council (NMC), Welsh Government and the Royal College of Midwives (RCM) have mapped out a revised model for the delivery of statutory supervision that will be sustainable, cost effective, minimise the current risks facing Health Boards and the LSA, and one that will enable supervision to demonstrate quality and added value whilst meeting its main objective of enhancing public protection.

The overarching purpose of this change is to improve the quality of statutory supervision in Wales through the appointment of supervisors, to work full time as a Supervisor of Midwives (SoM) for a rotational 18 month period. The SoMs will be dedicated to the role of supervision, increasing their visibility and accessibility to midwives and service users. It is considered that this model will enable more efficient and proactive management of investigations, external to employing Health Boards, and ensure timely remedial support for midwives. There will be an all Wales 24-hour on-call rota for regulatory advice and guidance and supervisors will provide supervision through clinics/surgeries for midwives, students and user group forums. Midwives will benefit from a more robust annual supervisory review process through group supervision and sharing of best practice, all of which aims to enhance public protection.

The model will be evaluated with key performance indicators including; regular updates of workforce planning in line with NMC requirements; a focus on the timeliness and quality of the whole investigation process; 100% of students in the clinical area meet a supervisor at least twice a year and collation of the trends and themes from supervisory on-calls to inform service development.
The need to clarify levels of specialist practice
Authors: Murray Cyril
Published: May 2014

The UKCC has released its latest document on standards for specialist practice (UKCC, 1998a), the purpose of which, and the accompanying Registrar's Letter (UKCC, 1998b), is to draw together all previous correspondence on specialist practice.
Clinical supervision for nurse teachers: the pertinent issues
Authors: Rodriguez Patricia , Goorapah David
Published: May 2014

The emergence of clinical supervision in nursing is viewed with both enthusiasm and reservation. Professional growth of the nurse practitioner is envisaged through adopting this support framework, although concerns exist particularly in relation to the role of management in monitoring performance and standards. Most authors have attempted to reassure nurses by stressing the positive elements. Potential benefits include the development of self-learning and clinical skills through reflection using a supervisor. It is anticipated that the supervisee will retain ultimate control of the process. Implementation of clinical supervision in nurse education is being considered. The need for a formal method of support has not been identified by teachers. It is debatable whether a format similar to that for clinical practice would be appropriate when the role of the nurse teacher focuses mainly on academic rather than clinical issues. Supervision In nurse education may be accepted or rejected, but a decision cannot be reached until role and cost issues have been adequately addressed.
Children are not simply miniature adults
Authors: Powell Catherine
Published: May 2014

Children's nurses and policy makers should have had time to reflect on the contents of the reports of the House of Commons Health Committee on Health Services for Children and Young People (1997a,b,c,d) and the Government's initial response (DoH, 1997). One of the central messages of the reports is that: ‘Children are not simply miniature adults.’ There is nothing new about this message.
Pressure area management in an orthopaedic setting
Authors: Young Trudie , Haughton Bill , Williams Clare
Published: May 2014

Pressure area care for patients who have undergone a hip replacement is extremely difficult as patients' mobility tends to be restricted because of fear of dislocation. Orthopaedic surgeons influence the positional changes and techniques utilized by nurses in the postoperative period. This article reviews factors that prevent early rehabilitation and highlights methods of pressure relief for this patient group. Alternating-pressure mattresses are a main source of pressure-relieving equipment. A pilot study using the Nimbus II mattress was carried out to establish the role of alternatingpressure mattresses in the postoperative management of patients undergoing elective/emergency hip replacement surgery. None of the patients in the pilot study suffered prosthetic dislocation and 87% did not develop pressure sores. Three patients did develop a grade 2 pressure sore postoperatively. The results reinforce the use of alternating-pressure mattresses in the postoperative management of patients undergoing hip replacement surgery.
Male catheterization by female nurses: a small-scale survey
Authors: Porter-Jone Gary
Published: May 2014

A small-scale questionnaire survey of nurses in one Welsh district general hospital examined the views of nurses in relation to catheterization of male patients. The findings demonstrate that while most nurses agree that it is acceptable for females to catheterize male patients, most female nurses do not undertake the procedure as they incorrectly believe there are either local or national policies that prevent patients from being catheterized by nurses of the opposite sex. This often results in patients waiting longer than necessary to be catheterized, and nurses (usually male nurses) from other clinical areas being requested to catheterize a patient for whom they are not caring. Such beliefs and practices stifle the development of knowledge on this issue.
Will primary care groups lead to improvements in health care?
Authors: Wilson Jo
Published: May 2014

The author has participated in a series of regional workshops in Wales, Scotland and England where mixed views were expressed by GPs, nurses and primary care professionals regarding the impact of the new White Paper ‘The New NHS: Modern, Dependable’. Many welcome the proposals and the opportunity to influence change. Others, however, expressed widespread concern about the proposed changes, particularly the short timescales, lack of skills, resources and information technology with which to achieve the changes, the lack of start-up funds to get the process going and the lack of incentives to sustain it. The input of community nursing to these workshops was disappointing — many were unclear of their role and involvement, and some were waiting for the GPs to involve them; others, however, were starting to set up their own groups to ensure that their views were heard and included. Primary care groups need active involvement of community nurses at management and operational level and nurse representation at governing body level. It is essential for nurses and nursing to get their act together in relation to the decision-making, configuration and determination of the functionality of primary care groups/trusts.
Reducing NHS waiting lists: a political ploy?
Authors: Scott Helen
Published: May 2014

It has been announced recently that the number of people currently on NHS waiting lists has fallen by over 45 000. Frank Dobson, Health Secretary, has stated that 83 000 more hospital cases were treated from April to June 1998, compared with the same period in 1997. It is also claimed that nobody is having to wait longer than 18 months on a waiting list for hospital treatment.
Clinical governance relies on a change in culture
Authors: Scott Amanda
Published: May 2014

Clinical governance has been heralded by the Government as the way forward for ensuring and improving the quality and standard of NHS clinical services. Introduced in the Government White Paper (DoH, 1997), the proposals have been brought into sharper focus since the publication of A First Class Service — Improving Quality in the NHS (DoH, 1998).
Developing nursing's future role: a challenge for the millennium: 1
Authors: Naughton Maureen , Nolan Mike
Published: May 2014

Over the past decade health care in general and nursing in particular have experienced a period of unprecedented change resulting from a variety of factors including demography, advances in technology and the introduction of differing service delivery systems. For nursing this has created a number of tensions, especially between professional aspirations and the demands of a new managerial culture. Many nurses have found themselves torn between the push towards the ideal of individualized holistic care and the reality of resource constrained environments. The new White Paper ‘The New NHS: Modern, Dependable’ (Secretary of State for Health, 1997) heralds a move away from the ‘short termism’ of the internal market towards a partnership model of integrated care. It also reaffirms the Government's commitment to further develop the role of the nurse. This article, the first of two, considers the challenges nurses face in responding to a managerial agenda while simultaneously maintaining the development of the nursing profession. The opportunities afforded by the recent White Paper are identified and the need to address a number of current tensions are highlighted. Developments at the Northern General Hospital in Sheffield are briefly described, with the results of a major survey being presented in the second article.
Standards of cleanliness and the role of the nurse
Authors: Castledine George
Published: May 2014

We have become too complacement about infection control and cleanliness in nursing. In the past, nursing textbooks and ward sisters used to emphasize the importance of not only the hygiene of the patient but also the hygiene of the area in which the patient was being nursed. Nurses were responsible for the cleanliness of the patient’s environment, bed locker and floor space. However, today, noone is sure whose responsibility this is.
Will higher level practice help the profession?
Authors: Murray Cyril , Wild Karen
Published: May 2014

The UKCC has recently released its consultation document on a higher level of practice (UKCC, 1998). The proposals include setting a UK-wide generic standard for a higher level of practice, a mechanism of marking practitioners who reach this level with a prefix letter after their initial registration, introducing a system of assessment based on current competence and future development plans and the initiation of a charge for the whole process.
A higher level of practice is the way forward
Authors: Scott Helen
Published: May 2014

At last the UKCC has shown that it can provide effective leadership by bringing order to the chaos that surrounded the specialist practice framework. Since this framework was first outlined in the PREP document in 1994 there has been a proliferation of nurse specialist posts. The criteria necessary to qualify for these roles have never been made clear by the UKCC which has led to trusts and the profession interpreting them in various ways.
How do I diagnose and treat wound infection?
Authors: Miller Mick
Published: May 2014

This article is the first in a ‘How do I?’ series, which will examine various aspects of wound management. With best practice continuously the goal, these articles will explore options and provide the nurse with practical advice on how to tackle the issues in question. The first article in the series aims to answer the question: ‘How do I diagnose and treat wound infection?’
Complaints within the NHS
Authors: Rodgers ME
Published: May 2014

On 1 April, 1996, the complaints system within the health service was overhauled and replaced with a single procedure for all types of complaint. The key objectives of this are: ease of access for patients and complainants; a simplified procedure for complaints about any NHS service; separation of complaints and disciplinary procedures; an improvement in quality of services by learning from complaints; fairness to staff and complainants; a rapid, open process; and to resolve the problems (Department of Health (DoH), 1995). It is now a requirement that all health authority boards, trusts and family health service practitioners establish a formal, written complaints procedure and publicize these arrangements, including advice on how to use the complaints procedure.
Clinical negligence and nurses
Authors: Peysner John
Published: May 2014

The number of nurse specialists and nurse practitioners is increasing and all nurses are delivering more invasive medical and therapeutic interventions. As independent professionals acting on their own initiative, it is inevitable that specialist nurses will become more involved in clinical negligence actions. These actions will deal with alleged negligence in the context of obtaining consent and acts and omissions in practice.
Recognizing barriers to disabled people
Authors: Scullion Philip
Published: May 2014

Nurses have long agreed that hospitals should ‘do the sick no harm’, but the principle that they should not cause disabled people any further disability is only now gaining a place on the nursing agenda. Inadvertently, nurses and service providers may be denying many patients, who happen to be disabled, full access to services.
Intensive care units must be more patient-friendly
Authors: Castledine George
Published: May 2014

Why is it that specialist intensive care units (ICUs) give the impression that they are divine, hightech, inhuman, all-powerful sanctuaries? Surely there are ways we can make ICUs more friendly, personable and merciful for all concerned. Unfortunately, many designers of ICUs have difficulty creating an appropriate environment for staff, patients and relatives. For example, it seems that all you need for the average ICU is an open space, with enough power points and room for beds. Numerous units have been designed in this way, either converted from old Nightingale wards or built on the modern warehouse method of maximum space. If one was going to build the ideal ICU then the best people to ask about the design are the staff and those who would use it.
EasiCath: an advanced alternative to indwelling urethral catheters
Authors: Doherty Willie
Published: May 2014

This article looks at EasiCath, the single-use hydrophilic catheter manufactured by Coloplast Ltd. EasiCath is now widely used throughout the UK and Europe. Since the launch of EasiCath, Coloplast has continued to develop its lubricated catheters and with the recent inclusion of the 30 cm EasiCath on the Drug Tariff, Coloplast now provides the most extensive range of lubricated catheters in the UK. In recent trials looking at the cell count on the surface of hydrophilic catheters following catheterisation, EasiCath performed well, indicating that it is a safe choice of lubricated catheter (Biering-Sorensen et al, 1999). This, combined with the benefits of the precoated, polished eyelets and the potential cost saving to the GP (£4.60 per box of 25) over a number of other catheters available, means that EasiCath has become the first choice of hydrophilic catheter for many patients.
Clinical audit systems
Authors: Wilson Jo
Published: May 2014

Clinical audit is a crucial tool for ensuring improvements in the quality of patient care. One of the key components of clinical governance is for all clinicians to participate in clinical audit systems. Clinical audit will provide a comprehensive framework for quality improvement and the monitoring of clinical care using effective information and clinical record systems.
Nursing must be the core of nurse consultants' work
Authors: Castledine George
Published: May 2014

In my last column (Vol 8(13): 902) I emphasized the importance of developing a clinical career structure for nurses. With the launch of the Government's new strategy for nursing Making a Difference (Department of Health, 1999), this could be achieved.
Public and private sectors need the same standards
Authors: Scott Helen
Published: May 2014

The standard of care in the private health industry has always been the subject of much scrutiny and debate. Therefore, the publication of the Government's consultation document looking at the regulation of the independent sector is to be strongly welcomed (Department of Health (DoH), 1999). The document states that current regulatory arrangements in the independent sector are ‘out of date, unsatisfactory and not sufficiently independent… nor do they provide the protection to which the public is entitled’.
Carbon monoxide poisoning and hyperbaric oxygen therapy
Authors: Durmaz Emma , Laurence Stephen , Roden Paul , Carruthers Steve
Published: May 2014

This article describes the treatment of carbon monoxide (CO) poisoning with hyperbaric oxygen therapy (HBO). Carbon monoxide poisoning is the commonest cause of fatal poisoning in the UK. Despite this, HBO is an underused treatment modality. Current criteria for hyperbaric treatment include any patient with neurological deficit and any episode of depressed consciousness, cardiovascular disturbance, patients initially treated with surface oxygen and who developed recurrent symptomatology and minor symptoms unresponsive to oxygen. During a 5-year period 82 patients have been treated from a wide geographical area. Of these patients 57% suffered carbon monoxide poisoning as a result of self-poisoning. Other causes of poisoning were: house fire; faulty gas appliances; industrial furnaces; and petrol generators. Of the 82 patients treated, 13 required mechanical ventilation and full haemodynamic monitoring, while the remainder were able to walk in and a few patients received intravenous sedation. In recent years the trend has been to re-treat patients more than once in the first 24 hours to increase efficacy and hopefully decrease the serious sequelae that can occur following CO poisoning.
The NHS is losing its personal touch with clients
Authors: Castledine George
Published: May 2014

A friend of mine recently remarked that banking was becoming more impersonal. For example, your account can now be managed at home on your own PC and requests are dealt with over the phone by someone whom you have never met before. In addition, the days of talking to your friendly local bank manager are fast disappearing.
Phase 1 studies: the development of new dressing technology
Authors: Bale Sue
Published: May 2014

This article describes the use of phase 1 studies in the research process when developing new dressing technology. A phase 1 study refers to the first time that humans are exposed to a new therapy. In general, participation is open to healthy volunteers only. Phase 1 studies are an essential element in the research process and are used to test the safety of a new product. In this study, volunteers were patch tested on broken skin to assess whether they were sensitive to a new product.
Education report needed to be more prescriptive
Authors: Scott Helen
Published: May 2014

The UKCC's Education Commission has made some commonsense suggestions for improving the fitness of nurses to practise (UKCC, 1999). For example, longer clinical placements with students being more actively involved in patient care (see also Pp. 1126 and 1182). However, the Commission has neatly sidestepped some of the most crucial issues relating to preregistration nurse education, particularly which subjects students should cover on the common foundation programme (CFP), and whether the current branch programmes should be disbanded in favour of a more generalist approach, retained or even extended to reflect the changing healthcare environment.
Government misses the point on residential care
Authors: Hartley Barry L
Published: May 2014

The Government's long-awaited consultation paper on improving standards in residential and nursing homes has now been published (Department of Health, 1999). Unfortunately, it has left many healthcare providers dismayed that an opportunity to recognize quality care practice based on outcomes has been missed. Some of the proposals, rather than enhancing quality standards, are actually threatening the viability of certain establishments. Many healthcare providers, having made heavy financial commitments, will be seeking compensation if the Government's proposals are adopted.
Educational preparation: specialist practice in continence care
Authors: Williams Kate S , Assassa R Phil , Smith Nigel KG , Shaw Christine , Carter Ellen
Published: May 2014

Contributing factors to effective continence service provision include funding, organization, and expert knowledge among the individuals providing care. Expert knowledge can be gained through clinical experience and appropriate ongoing education. It has been widely reported that undergraduate education in this area for nurses, doctors and physiotherapists is limited (Brocklehurst, 1990; Swaffield, 1994; Laycock, 1995). Many nurses providing continence care have accumulated knowledge through experience and trial and error. Little is known about the effectiveness of advanced postgraduate education of ‘experts’ in continence care. This article outlines a continence education module developed to prepare a specialist group of nurses to provide a high standard of continence care that is both safe and effective in a clinical environment. This module was designed and evaluated specifically as part of the Leicestershire Medical Research Council (MRC) Incontinence Study. Changes in continence knowledge, attitudes to research, and acceptability of the module have been explored. When setting up a new nurse-led continence service, it is of great importance to systematically detail the components of the educational preparation of the nurses providing the service. Open discussion of any problems in the design and implementation of this module may inform future modules in this and other areas.
Protecting patients by questioning doctors
Authors: Castledine George
Published: May 2014

The Government's new consultation strategy for quality improvement in the NHS includes new measures to improve doctors' clinical performance (Department of Health, 1999). It has long been felt, particularly by nurses and, more recently, by dissatisfied patients, that doctors have had it their own way for far too long.
Organizing the long-term care of older people
Authors: Kohler Mervyn
Published: May 2014

When the Royal Commission into the long-term care for elderly people reports, the important response will be the one made by Government ministers. It will be interesting to know which parts they accept, where they feel further debate is needed, and how quickly they propose to act. Governments have for too long sheltered behind the Commission's continuing deliberation and left long-term care in a state of suspended animation.
Triage in accident and emergency 2: educational requirements
Authors: Wilkinson Richard Allan
Published: May 2014

The first article in this two-part series on the review of the concept of triage (Vol 8(2): 86–102) examined the areas of waiting times, patient satisfaction and the difficulty of trying to implement universal standards into accident and emergency (A&E) departments because of their varying infrastructures. This article aims to identify the educational requirements needed to become a triage nurse. Indeed, none of the reviewed literature explicitly addresses this issue. Educational literature tends to focus on the scientific aspect of practice rather than acknowledging that art, where interactions between the nurse and patient are essentially social acts that can never be accounted for by science, is also an inherent part of nursing practice. This article also investigates and analyses the use of research methods utilized to investigate triage and suggests that a re-evaluation of these methods is needed if the true effects of triage are to be ascertained.
Review of the statutory bodies: five into one may go
Authors: Castledine George
Published: May 2014

As I have been very closely involved with the UKCC, I thought that I would find it difficult to accept the proposed changes to it. However, on reading JM Consulting Ltd's (1998) report on the future regulation of nurses, midwives and health visitors I feel that the future appears more positive.
Do newly qualified nurses have the clinical skills?
Authors: Glasper Edward A
Published: May 2014

There is increasing concern among clinical members of the profession about the theory/practice gap in nursing. This term, however, has become a euphemism to describe apparent failures by nursing establishments to teach what trained nurses need to know in the real world of clinical nursing practice. In an attempt to throw more light and less heat onto the subject, the UK’s Chief Nursing Officer has commissioned an investigation to help educationalists and senior nurses debate the issue more fully (NHS Executive, 1998).
Health care should be rationed
Authors: Cutcliffe John , Blatt Barry
Published: May 2014

Rationing of health care, in its simplest form, is finite resource allocation within a context of infinite demand. It is a method of determining which services receive funding and which treatments can be afforded.
A guide to the UKCC's professional conduct procedures
Authors: Skyte Stuart
Published: May 2014

The primary purpose of the United Kingdom Central Council for Nursing, Midwifery and Health Visiting is to protect the public. One of the most visible ways it does this is through its professional conduct procedures. This article sets out how these procedures work and acts as an introduction to a new series in the British Journal of Nursing highlighting examples of professional misconduct case studies (please refer to p. 344).
The DIAL-log study 1: profiling the experience of people with dementia
Authors: Keady John , Gilliard Jane , Evers Clive , Milton Steve
Published: May 2014

Between July 1996 and December 1997 telephone helpline staff from the Alzheimer's Disease Society (ADS) in London, and six participating ADS regions in England and one in Northern Ireland, documented calls from people with dementia who contacted the service. Each call was recorded as soon as practicable after its completion on a Dementia Information and Advice Line (DIAL) log form (DIAL-log). Sixty-four calls were recorded in this way and 62 completed DIAL-logs were included in the study findings. Analysis of the data was undertaken via SPSS 6.1 for WindowsTM. This article, the first of two, introduces the background to the study and notes that callers reported memory loss and forgetfulness as the most frequently noticed first signs of dementia. The study aims and limitations are also outlined in this first article. The second article will detail the main findings and the challenges that the DIAL-log study may provide for future dementia care practice and research.
Critical care nurses should work together
Authors: Aylott Marion
Published: May 2014

Neonatal, paediatric and adult intensive care units have been separate entities for some time now, with their own specially trained staff. The divisions, however, are arbitrary and are not necessarily in the interests of the different nursing sub-specialties.
Nurses must not ignore clients’ sexual health needs
Authors: Aylott Jill
Published: May 2014

Sexuality and sexual health is a neglected subject in nursing. However, it is an area that nurses and healthcare professionals need to address with service users for a wide range of reasons. Examples in clinical practice include: exploring ways to teach people with learning disabilities about their sexuality (e.g. to masturbate or ejaculate); working with individuals who are sexually disinhibited in rehabilitation, care of the elderly or mental health settings; or preventing discrimination of service users because of their sexuality (e.g. a gay man on a surgical ward being pressurized by a surgeon to have an HIV test before major surgery).
WEB WATCH
Authors: Mangan Paul
Published: May 2014

Welcome to this regular column of the British Journal of Nursing. The idea behind Web Watch is to bring together in each issue a collection of worldwide Web pages that can be found on the Internet.
Report requests more flexible community care
Authors: Beckford-Ball Jason
Published: May 2014

Community care was originally based on the principle of removing people with mental health problems from large institutions and allowing them to regain a place in their own community. However, it is a policy which has often received a bad press due, in part, to high profile cases such as the murder of Jonathan Zito by Christopher Clunis in 1993 and the perception that people with mental health problems were being forced to live on the streets because of a lack of resources.
Reinforcing the medical stereotype of nursing
Authors: Castledine George
Published: May 2014

The Government's plan for the future of the NHS demonstrates commitment and determination but lacks the sensitivity and depth of understanding in relation to nursing's fundamental role (Department of Health (DoH), 2000). Three core functions always seem to emerge when the nursing role is being discussed: care, cure and coordination.
Long-term care must not be the ugly sister
Authors: Nolan Mike , Davies Sue
Published: May 2014

There is a saying that: ‘If geriatrics is the Cinderella of services then longterm care is the ugly sister’. This sentiment accurately reflects the denigrated status of long-term care within the health and social services. Therefore, anything that seeks to raise the profile of work within such environments and to improve the quality of care given to the frailest and most vulnerable of older people is to be welcomed. This is the purpose of the recent report The Health and Care of Older People in Care Homes (Royal College of Physicians et al, 2000).
Responsibility for controlled drugs in operating departments
Authors: Mitchell Michael , Veitch Bryan
Published: May 2014

The difficulties experienced with the recruitment and retention of registered nurses has made it necessary for NHS trusts to review the traditional role of nurses and to transfer some of their duties to other groups of staff in order to maintain services. For example, in the operating department, operating department assistants and operating department practitioners (ODAs/ODPs) are undertaking some of the duties that were previously the responsibility of nurses. This article presents the findings of a survey to determine the extent to which ODAs/ODPs have access to controlled drugs in operating theatres. The survey was initially undertaken by the author in Welsh hospitals during 1998. The mixed responses generated discussion in the Duthie Review Committee (Committee Chairman, personal communication, Royal Pharmaceutical Society of Great Britain (RPSGB), 1999) and led to a collaborative exercise based on a random selection of NHS trust hospitals in England, Scotland and Northern Ireland to obtain a broader data across the UK. Despite a clear legal position concerning possession, the survey showed that practice varied widely and that some trusts may be contravening the Misuse of Drugs Regulations 1985 in order to keep the service running when registered nurses are not available.
Mixed blessings: is the NHS Plan revolutionary?
Authors: Glasby Jon
Published: May 2014

Following much speculation, the Government's NHS Plan was launched on 27 July 2000. Billed as a revolutionary document to modernize health services for the 21st century, the Plan announced measures to redesign the NHS around the needs of the patient, increase investment, improve efficiency, monitor standards and expand the nursing role. While many of the initiatives received an enthusiastic welcome, there was concern about the implications for the health and social care divide.
Web Watch
Authors: Mangan Paul
Published: May 2014

This edition of Web Watch contains the last of a mini-series on major nursing mailing lists. These are often a good way to ask specific questions, or seek advice from specialist colleagues around the world. The list-serve mechanism is usually used by sending an e-mail to a specific address with the words ‘subscribe me’ in the e-mail title. Once you have become a member of one or more lists you and all other members of the list will be able to receive all mail sent concerning your chosen subject.
The new QUATTRO PLUS™ mattress replacement system
Authors: Gray David
Published: May 2014

Since the early development of alternating pressure air mattresses (APAMs) there have been regular alterations in design. These designs have led to improved reliability and performance. This article outlines the changes made by Talley Medical to the QUATTRO PLUS™ replacement mattress. Improved safety features and design modifications continue the process commenced many years ago which has seen the use of alternating pressure air mattresses become widespread throughout the UK.
Florence Nightingale must remain as nursing's icon
Authors: Hoole Louise
Published: May 2014

There was much debate last year over whether or not Florence Nightingale was an appropriate figure to lead nursing into the new millennium (e.g. Wheeler et al, 1999). A few nobles of nursing history were given cursory attention as possible successors to Nightingales plinth, but Mary Seacole emerged as the only real contender.
Attendance for self-harm in a West Midlands hospital A&E department
Authors: Kinmond Kathryn S , Bent Marie
Published: May 2014

This article focuses on the issue of self-harm. It reviews the literature and details specifically a comparison of data collected in the accident and emergency (A&E) department of a hospital in the West Midlands in 1990 and in 1997. Both the research literature and the data collected at the hospital suggest that there is a rise in the numbers of people self-harming and presenting to A&E departments. Any changes in rates of self-harm or the demographic characteristics of the patient population are likely to have important implications for clinical services. Additionally, the links between self-harm and suicide are well documented (Hawton and Fagg, 1988; Morgan and Williams, 1994) and there is an urgent need to ensure quality service for this high-risk group. An effective assessment of the area is difficult. The limited number of comprehensive studies prohibits definitive epidemiological data. Furthermore, confusion over terminology hinders clear analysis and comparison of that which is collected.
Infection control must be the priority of all nurses
Authors: May Dee
Published: May 2014

Two major reports have been published in recent weeks (Public Health Laboratory Service/London School of Hygiene and Tropical Medicine (PHLS/LSHTM), 1999; National Audit Office (NAO), 2000) which provide comprehensive data on the socioeconomic burden, management and control of hospitalacquired infection (HAI).
Karomed armchairs and cushions in the prevention of pressure ulcers
Authors: Collins Fiona
Published: May 2014

The clinician providing seating for patients who are unwell, who have poor functional ability or who are at risk of pressure sores, is faced with an increasing choice of products. Making the decision as to which product and associated features to choose can be a difficult task. This article describes the importance of suitable seating provision in patients who are at risk and outlines the Karomed range of armchairs.
Applying the principles of infection control to wound care
Authors: Parker Lynn
Published: May 2014

Human skin in healthy adults is inhospitable to pathogenic organisms. A wound may occur from any accidental or deliberate trauma that breaks the surface of the skin. Once this line of defence is broken there is a risk of infection. All soft tissue injuries, whether chronic, traumatic or surgical, involve the same basic biochemical and cellular processes. This article looks at the risk factors associated with healing of such wounds. The principles of asepsis, wound cleansing agents, choice of dressings and the taking of wound swabs are considered.
Nurse prescribing: the sensible way forward?
Authors: Castledine George
Published: May 2014

The Government is intent on bringing in limited prescribing for nurses as part of its drive to improve and develop the NHS. However, do nurses really understand the implications of what they are embarking on? Prescribing should be directed at knowledgeable and experienced clinical nurses who will benefit patients and clients by being able to prescribe. In 1986, Baroness Julia Cumberlege, who chaired a government study into the nursing services provided outside hospital, was convinced that the government should, ‘agree a limited list of items and simple agents which may be prescribed by nurses as part of a nursing care programme and issue guidelines to enable nurses to control drug dosage in well defined circumstances’ (Department of Health and Social Security (DHSS), 1986).
Caring for people with a learning disability who are victims of crime
Authors: McNally Steve
Published: May 2014

This article considers the increased vulnerability of people with a learning disability to crime ranging from verbal abuse to physical or sexual assault. The difficulties faced by people with a learning disability in giving evidence, being treated as credible witnesses and ensuring that the alleged offender has to answer charges are explored. It is suggested that ways of remedying these difficulties must be pursued in order that all citizens have equal rights, including access to the processes of the civil and criminal justice system. Offences committed within service settings should be treated as they would in any other sphere of society and should be recorded, investigated and the appropriate action taken.
Educational leave for lecturers to regain clinical competence: 2
Authors: Gopee Neil
Published: May 2014

The way in which nurse lecturers can use paid educational leave (sabbaticals) to develop their own competence is addressed in this article, the second of two parts. The first part (Vol 9(7): 440–4) used Johns' (1998) model of structured reflection to explain the nature of an actual clinical sabbatical. This second part will address the other elements of the model. It focuses on the factors that influenced the decisions made, alternative strategies and the learning that occurred during the author's 3-month leave.
Pressure area care in infants and children: Nimbus®Paediatric System
Authors: Jones Irene , Tweed Carol , Marron Maggie
Published: May 2014

Survival rates in both critically and chronically ill infants and children have improved dramatically in recent years and new challenges exist in the nursing care given to these patients. Among these is the increased risk of pressure ulcer development. Children in intensive care environments are especially at risk. Prevention and management of pressure ulceration in the paediatric population requires clinical judgment and skill. The use of pressure ulcer risk assessment tools can assist in this process; however, to date, there is a lack of research evidence and further studies are needed. The pressure relief requirements of the paediatric patient are significantly different to those of the adult patient. In children under the age of 36 months, the ears and occiput are the areas most at risk of pressure injury as a result of the fact that this area is proportionately the largest and heaviest bony prominence. Despite the abundance of specialist pressure-redistributing devices for adults, there is little available specifically for the paediatric patient. This article describes a review of the literature on these subject areas and follows with a short report of the evaluation of the new Paediatric Nimbus®System undertaken at The Royal Hospital for Sick Children in Edinburgh.