bluuebunny/crossref_metadata_2025 huggingface dataset:
Expert Patient Programme: managing patients with long-term conditions
Authors: Plews Caroline
Published: May 2014

It is estimated that currently there may be as many as 17.5million adults in Great Britain who are living with a long-term condition. Often these conditions will have a huge impact on the quality of life experienced by the person and any carers who might be involved. The impact on health care services is also profound. Long-term conditions potentially pose serious problems for healthcare systems in terms of adequate and appropriate resources to deal with the complexity of care required. Empowerment programmes which develop individuals' ability to self-manage their conditions are one way of helping people to maintain their independence and maximise their well-being. This article outlines one model (the Expert Patient Programme) and describes key issues with developing this approach in one acute Trust.
What happens to used colostomy pouches outside the acute setting
Authors: Berry Jeannette
Published: May 2014

This article looks at the disposal of used colostomy pouches once a patient is discharged from the acute setting. An overview of the guidance given by stoma care nurses to colostomy patients prior to discharge is given as part of a combined study by a patient association. There are approximately 100000 ostomates in the UK, although the exact number is not known (McCahon, 1999). Approximately 50% of these are colostomates. There appears to be very little literature on disposability of used stoma pouches or advice given to the ostomate with a newly formed colostomy.
A pilot data collecting exercise on stress and nursing students
Authors: Por Jitna
Published: May 2014

This article discusses the lessons learned from a small pilot study exploring the link between the working environment and occupational stress among groups of nursing students. A comparative descriptive design was adopted to examine, describe and compare the two variables (sources and frequency) in three groups of nursing students. The sample comprised 90 students from one large inner-city school of nursing in London. The Expanded Nursing Stress Scale questionnaires were used to collect the data. The main findings suggest that the adult, child and mental health branch students were similar with respect to overall frequency of occupational stress. Areas of commonality and variability in the sources of stress perceived by the three groups of students were identified. A pilot study is a crucial element of a good study design. Areas of concern, lessons learned and suggested refinements were identified.
Community nurse who intentionally made fraudulent expense claims
Authors: Castledine George
Published: May 2014

Nurses have to be careful when it comes to claiming expenses for travel to visit patients. Mary was a community district nursing sister who was covering a considerable number of miles in her family car. It was drawn to her attention by her senior manager that she qualified for a lease car. This pleased her because her husband was complaining that the excessive mileage she was putting on the family car was wearing it out.
A nurse-led ear care clinic: sharing knowledge and improving patient care
Authors: Harkin Hilary
Published: May 2014

This article covers the nursing role within an ear care clinic in the hospital setting. The range of conditions managed in the clinic are listed and some of the current issues affecting ear care and ear, nose and throat (ENT) are discussed. The author conveys her enthusiasm for the appropriate management of wax encouraging colleagues to appreciate the negative affect wax impaction can have on patients. Hearing impairment is briefly mentioned and a screening list is provided to assess the hearing of older adults. Patient care is discussed and there are suggestions for the improvement of the provision of ear care within the community. The nurse practitioner discusses how to facilitate the sharing of knowledge with community practitioners. Study seminars, publications, the use of the hospital intranet site, treatment and discharge summaries can all be used to communicate new developments in patient care.
The legal action that can be taken following a person's death
Authors: Dimond Bridgit
Published: May 2014

Diane was a staff nurse working in an accident and emergency department. One Saturday night several drunken men came in with one suffering from a head injury; blood was pouring down his face. Diane asked him to come to a single cubicle, but against her wishes the others insisted on accompanying him. In the jostle, Diane was pushed to the floor and struck her head on the edge of a stainless steel trolley. Staff came to her aid and she was admitted as an inpatient but died shortly afterwards. Her family wishes to pursue her legal rights after her death. What is the law?
The principles of inflammation in the development of rheumatoid arthritis
Authors: Banning Maggi
Published: May 2014

Rheumatoid arthritis (RA) is a chronic inflammatory condition that involves all elements of the immune response. The aetiology of RA is complex and centres on the development of autoantibodies and immune complexes. The pathogenesis is multistage and involves cytokines, angiogenesis and rheumatoid factor. Nurses managing patients who suffer with RA need to be aware of the pathological changes involved in the disease and its contribution to the progression of the condition. The diagnosis of RA involves blood screening for rheumatoid factor, raised erythrocyte sedimentation rate (ESR), use of arthroscopy to provide evidence of histological changes in the synovium, presenting symptoms, and changes on X-ray. Patient assessment will consider both patient-specific and disease-specific variables, including evidence of non-articular manifestations of RA. Long-term care revolves around trying to maintain patient mobility and the protection of unaffected joints, monitoring for the side-effects from medication and progression of the disease or development of non-articular manifestations.
The benefits of Tubifast Garments in the management of atopic eczema
Authors: Page Barbara
Published: May 2014

Atopic eczema is a chronic inflammatory condition affecting mainly children and is one of the most common skin disorders in the Western world. It has a strong genetic component associated with atopic conditions such as asthma, hayfever or urticaria. The onset is usually within the first year of life and it affects mainly the face, after which the pattern often changes to involvement of the flexures. The most prominent characteristic of atopic eczema is pruritus (itch) together with dry skin. An important treatment of atopic eczema is the application of emollients (moisturizers) to rehydrate and restore the barrier function of the skin. Wet wrapping using large quantities of emollients is a well recognized therapy for atopic eczema and other dry skin conditions. The introduction of new Tubifast Garments by Medlock Medical makes this topical therapy easy to apply for parents and carers in the management of children's eczema.
Staff nurse who was drug-dependent and stole from the ward stock
Authors: Castledine George
Published: May 2014

The BJN recently highlighted the problems that can occur when nurses become over tired (Vol 14(3): 183). In the following case we are shown the actions of a senior sister, Beverly, as she tried to deal with a male staff nurse who appeared to be suffering from excessive tiredness while on duty.
Controlling the risk of MRSA infection: screening and isolating patients
Authors: Bissett Linda
Published: May 2014

Methicillin-resistant Staphylococcus aureus (MRSA) continues to be a major cause for concern to health boards and trusts throughout the UK and the rest of the world. A review of literature sourced via Cinahl, Medline and Pubmed examines the discussions for and against screening patients for MRSA and isolating MRSA-positive patients as a means of managing MRSA within the hospital setting. The research evidence available on the ability of MRSA strains to spread within the healthcare setting and how this influences the opposing arguments is explored. Other factors considered when examining the arguments for and against screening and isolation are: the implications both in cost and resources; the effect of MRSA infection on patient morbidity and mortality; and the need for individual risk assessment of MRSA colonized or infected patients to prevent the transmission of MRSA isolates. The arguments raised lead to the conclusion that screening and isolation should be universal to decelerate the rate of transmission of MRSA.
The importance of tradition in modern health care
Authors: Castledine George
Published: May 2014

Nursing has long been associated with the word ‘tradition’. Ever since Florence Nightingale and the early religious carers, nursing has been seen as a noble profession with a long and worthy tradition of caring. Pearce (1950) described nursing as a science, an art and a vocation. She went on to point out that: ‘The vocational aspect is of greatest importance because it begins with the high qualities and ideals of service the student brings to nursing and, rightly guided and well practised, these develop a love of nursing without which no-one can be a good nurse.’
Renal dysfunction in liver cirrhosis
Authors: Sargent Suzanne , Martin Wendy
Published: May 2014

Liver cirrhosis is an escalating health problem attributed to numerous causes, including an increase in alcohol consumption, morbid obesity and chronic viral hepatitis. The circulatory disturbances seen in advanced cirrhosis lead to the development of ascites, which often lead to progressive renal impairment or the development of hepatorenal syndrome. Furthermore, cirrhotic patients commonly experience clinical situations that predispose them to the development of pre-renal failure, such as dehydration, hypovolaemia, septic shock, or exposure to nephrotoxic drugs. This article provides an overview of the main causes of acute renal failure in liver cirrhosis and describes the current medical and nursing management.
Clinical Corner: An observation of Bowen's disease in wound care
Authors: Bentley Jenny
Published: May 2014

Mary was 78 years old and had presented at the leg ulcer clinic with a non-healing wound. The size of the wound had reduced but epithelialization was not occurring and wound healing was static.
Making careful night rounds for patients' safety and wellbeing
Authors: Castledine George
Published: May 2014

Much has been made of the importance of making regular rounds of patients nursed in hospital, to check that they have received the appropriate care and that documentation and other essential nursing care has been carried out.
The current constraints on nursing education
Authors: Castledine George
Published: May 2014

With the tightening economy and the current financial pressures within the NHS, nursing education will be forced to fight for survival over the next few years. Some observers feel that this is a good thing as it may well improve the content of the present programmes and make them more practical and in tune with the reality of what is happening in the health service today. It is no secret that the NMC has been concerned about the practical experience that students receive.
Correspondence
Authors: Williams Nancy K , Smith Richard
Published: May 2014

We applaud Patrick and others (Patrick et al, 2006) for undertaking an evaluation of their case management programme of frail elderly patients to see its effect on hospital admissions and length of stay. Unfortunately, as the authors acknowledge, the evaluation has severe limitations – and ultimately does not allow any confident conclusions.
IV steroids for MS relapse: clinical governance implications
Authors: Harrison Emily , Porter Bernadette
Published: May 2014

The face of the NHS is set to change enormously during the next decade providing more choice, more personalized care and real empowerment of people to improve their health (Department of Health, 2005b). Fundamental to this approach will be the management of patients’ health needs in the community setting. Using a robust clinical governance framework, the MS team at the National Hospital for Neurology and Neurosurgery worked with the voluntary and commercial sector to design a trial to gather evidence for a new approach to the management of acute MS relapse using intravenous steroids within a home environment. The study was completed in advance of recent governmental initiatives/reforms. This paper focuses on the clinical governance implications of cross-boundary working. It is hoped that by sharing the processes put in place, others contemplating the delivery of acute care outside of hospitals or design of collaborative research trials will find the frameworks useful.
Nurses must embrace and support health policies
Authors: Glasper Alan
Published: May 2014

The NHS is increasingly policy driven and not a week goes by without the thud of another weighty tome landing on some beleaguered chief executive's desk. The role of health policy is primarily concerned with the health and welfare of individuals or groups in society, and such policies are generated at local, national and international levels. The production of health policy is often coordinated by a panel of experts who may spend many months consulting the best evidence before committing to paper. Consequently when a policy is published, often in a blaze of media publicity, it represents the very best standards of evidence-based care attainable in contemporary health settings.
Implications of genetic testing for sudden cardiac death syndrome
Authors: Royse Susan D
Published: May 2014

The completion of the Human Genome Project in 2003 is shifting the focus of modern health care from disease management based on clinical signs to genomic-based treatment and prevention. Nurses at all levels of practice are going to increasingly come under pressure to deliver evidence-based, competent care to families undergoing genetic testing for hereditary conditions (Skirton and Barnes, 2005). A new chapter added to the National Service Framework for Coronary Heart Disease in 2005 raised awareness of the genetic basis of up to 400 sudden cardiac deaths that occur every year in the UK (Department of Health, 2005). This article addresses some of the clinical and ethical implications for nurses caring for families who may be at risk of an inherited sudden cardiac death syndrome. Nursing practice implications are discussed, concluding that more research is needed to explore how family members cope with genetic information which will shape the provision of future genetic healthcare.
Prontosan wound irrigation and gel: management of chronic wounds
Authors: Horrocks Ann
Published: May 2014

Chronic wounds present a challenge that is costly in terms of quality of life to the patient and in financial terms for the NHS. Several factors contribute to the development of a chronic wound, in particular the influence of bacteria as a biofilm within the wound environment. Irrigating a wound with normal saline has long been advocated as the most appropriate method of wound irrigation but biofilms are now known to be resistant to this method of cleansing. A small (10 patient) evaluation of the use of Prontosan® in patients whose duration of chronic wounds exceeded 1 year has demonstrated that Prontosan wound irrigation and Prontosan gel are an appropriate alternative for cleaning, moistening and decontaminating encrusted, contaminated and chronic skin wounds, and can have a dramatic influence of the quality of life for such patients. This article discusses the cause of chronicity within a wound and discusses in depth three of the ten patients in the evaluation.
How accurate are RGNs in grading pressure ulcers?
Authors: Briggs Shiu-Ling
Published: May 2014

This study investigated the level of accuracy with which qualified nurses grade pressure ulcers. The sample of the study was 52 registered general nurses (RGNs) who worked at an acute NHS Trust. The study was conducted as a series of workshops in which questionnaires were administered before and after an educational programme on the theory and practice of grading pressure ulcers. The instrument of measure was a set of 20 photographs of various grades of pressure ulcers and incontinence lesions. At the end of the data collection process 52 sets of data were available and included for analysis (n=52). The level of accuracy of the RGNs in grading pressure ulcers was poor in the pre-test. Although it improved markedly at the post-test, the overall performance of the group remained less than satisfactory (between 80-100% correct answers). In the post-test, only 4 out of the 52 (7.7%) RGNs achieved a level of accuracy between 75% to 95%. The limitation of the study means that caution is needed in making inferences of the findings beyond this sample of nurses. However, the study's findings do give some indication of the level of accuracy of pressure ulcer grading within the Trust concerned. A larger scale study is needed if a more reliable picture on the accuracy of pressure ulcer grading by RGNs is to be achieved.
The importance of measuring and recording vital signs correctly
Authors: Castledine George
Published: May 2014

Measuring and recording a patient's vital signs accurately is important as this gives an indication of the patient's physiological state. Vital signs are recorded upon arrival to the emergency department, on admission to a ward, at regular intervals during a patient's stay and also before, during and after a procedure (such as pacemaker implant). Patients undergoing surgery will often have their vital signs recorded on admission to hospital, on the morning of surgery, during surgery, in the recovery room and back on the ward at certain intervals. Some surgical patients will have their vital signs recorded when the attending pre-admission clinic.
Perioperative analgesia: a factor in the development of heel pressure ulcers?
Authors: Edwards Jane L , Pandit Hemant , Popat Mansukh T
Published: May 2014

This article presents the incidence of heel pressure ulcers after an elective hip or a knee replacement. The majority of patients in the authors' institute receive either a neuraxial block (epidural and/or spinal) or peripheral nerve blocks (femoral and sciatic), depending on the anaesthetist's and surgeon's preference, and the patient's physical status. The past few years have seen increasing use of peripheral nerve blocks for knee replacement surgery. Patients with either the central or peripheral nerve blockade are at an increased risk of developing heel pressure ulcers. This article describes the experience at a tertiary referral centre and, in particular, highlights the risk of developing heel ulcers in patients receiving peripheral nerve blocks. Medical and nursing staff looking after these patients should be made aware of this complication and appropriate measures should be taken to prevent this avoidable complication.
Feet first: a guide to diabetic foot services
Authors: Brookes Sally , O'Leary Bill
Published: May 2014

Foot problems may be one of the lesser known complications of diabetes, but they have a major impact on people with the condition. The NHS National Diabetes Support Team has produced a guide to diabetic foot services and this article will look at some of the key areas in diabetic foot care today which are also outlined in the guide. The key areas are: prevention and screening, care pathways, multidisciplinary teams, and workforce and staff skills. Examples of how some of these issues are being tackled in England are featured in the article as case studies.
The role of the nurse in pre-renal transplantation
Authors: Murphy Fiona
Published: May 2014

The following two articles explore the role of the nurse in caring for and educating the patient both pre- and post-renal transplantation. The nurse plays a pivotal role in assisting the patient facing the many challenges that are associated with transplantation. Renal transplantation is considered the optimal treatment of choice for patients with end stage renal failure (ESRF) and who are receiving dialysis. This first article will explore the role that nurses play regarding the care of the patient pre-transplant, including the physical, psychological and educational support required to assist the patient and family members deal with the many challenges associated with transplantation.
Best interest. A review of the legal principles involved: Part 2(a)
Authors: Fullbrook Suzanne
Published: May 2014

The ways in which people are allowed to act on another person’s behalf have been the subject of discussion for a while. In 1993, the case of Tony Bland [1993] focused the minds of the judiciary on the idea of withholding or withdrawing the treatment offered to people who were judged to be in a permanent vegetative state. This topic is vast and for some, confusing. The aim of this two part article is to explore the various threads of the law and the debate, with a view to elucidating on the legal position. An exploration of the responses of the professional regulatory bodies is included to illustrate how important it is that all health providers understand the law and apply it correctly in all circumstances so that patients’ needs are met at all times, and their autonomy and dignity is recognized and respected.
Dermatology conference heralded as a success
Authors: Goad Nina
Published: May 2014

This year’s British Dermatological Nursing Group (BDNG) and British Association of Dermatologists (BAD) annual meeting took place at the International Convention Centre in Birmingham from July 10th to 13th. Attended by 300 nurses and 900 dermatologists from the British Isles and abroad, the conference was heralded as a huge success by its organizers and the attendees. The BDNG had a busy academic programme in parallel with that of BAD, with both organizations joining forces for the joint meeting on improving clinical practice.
Confidentiality. Part 3: Caldicott guardians and the control of data
Authors: Fullbrook Suzanne
Published: May 2014

In the preceding articles on confidentiality, a framework of understanding has been built up by exploring two features of the subject. First, legal obligations that arise from the common law have been reviewed, and second, the scope of understanding has been expanded by rehearsing the requirements placed on professionals by their respective regulatory bodies. The Nursing and Midwifery Council and the General Medical Council have worked extensively to provide guidance on the subject of patient confidentiality. This third and final article will explore the issues raised by the way in which technology has presented public services with concerns as to the acquisition, storage, use and dissemination of data. The position of Caldicott guardians will be described, as their role has been created by Government to ensure that data is held, accessed and used in a manner that facilitates proper access by competent health providers while maintaining the confidentiality of private, personal health records.
Intermediate and long-term regulation of acid-base homeostasis
Authors: Clancy John , McVica Andrew
Published: May 2014

The first part of this two-part article (Clancy and McVicar, 2007) identified acid and alkaline buffers in the body fluids as the body’s short-term homeostatic mechanisms involved in maintaining the ‘acid-base homeostasis’ of body fluids. The second part of this article explores the respiratory and renal systems as the respective intermediate and long-term homeostatic mechanisms involved in maintaining acid-base homeostasis. It also discusses what happens if these mechanisms fail.
Researching the management of constipation in long-term care: Part 1
Authors: Castledine George , Grainger Michelle , Wood Neil , Dilley Carol
Published: May 2014

The management of constipation is a problem in any healthcare setting, for a variety of reasons. These include the lack of a unified definition of constipation, differences in bowel habit between individuals, the lack of literature on assessment of constipation and nursing research into the condition, and the numerous risk factors. A good knowledge and understanding of these factors, which can help not only in dealing with constipation, but also in preventing it and maintaining the individual’s comfort and health, is essential. This two-part article describes a research study carried out in nine care homes, among patients of various ages with a variety of chronic conditions. The aim of the study was to investigate and improve bowel care in long-term care settings. Part 1 presents the background to the study, including the definition, causes, risk assessment and management of constipation, which focuses on the role of health education and the use of laxatives. The main part of the study and implications for practice will be presented in part 2.
Mental capacity and decision aking: definining capacity
Authors: Dimond Bridgit
Published: May 2014

The Mental Capacity Act 2005 came fully into force on 1st October 2007 (some sections came into force on 1 April 2007). This series of articles considers some of the key features of the Act, including the concepts of best interests, the lasting power of attorney, the role of the new Court of Protection, the Office of Public Guardian and the deputies of the Court, to name but a few. This first article looks at the central feature of the Act: how mental capacity is determined.
Literature review: should nursing take aromatherapy more seriously?
Authors: Buckle Jane
Published: May 2014

Aromatherapy is often misunderstood and consequently somewhat marginalized. Because of a basic misinterpretation, the integration of aromatherapy into UK hospitals is not moving forward as quickly as it might. Aromatherapy in UK is primarily aimed at enhancing patient care or improving patient satisfaction, and it is frequently mixed with massage. Little focus is given to the real clinical potential, except for a few pockets such as the Micap/South Manchester University initiative which led to a Phase 1 clinical trial into the effects of aromatherapy on infection carried out in the Burns Unit of Wythenshawe Hospital. This article discusses the expansion of aromatherapy within the US and follows 10 years of developing protocols and policies that led to pilot studies on radiation burns, chemo-induced nausea, slow-healing wounds, Alzheimers and end-of-life agitation. The article poses two questions: should nursing take aromatherapy more seriously and do nurses really need 60 hours of massage to use aromatherapy as part of nursing practice?
Childhood obesity – the 21st century epidemic
Authors: Glasper Professor Alan
Published: May 2014

Levels of obesity among children in the western world are increasing at an alarming rate. Between 1995 and 2003 obesity rates among children in the UK aged 2–10 years, for example, accelerated from 9.9 to 13.7% (Jotangia et al, 2006). The long-term implications on the nation’s health and the burden it will cause to the NHS in years to come if it is not tackled effectively is already a cause of major concern. The British Medical Association (BMA, 2007), for example, estimate that there are already around 1 million obese children under 16 in England. It is believed that if the present trend continues unabated then something like 20% of boys and 33% of girls will be obese by the year 2020. With the NHS currently spending at least £2 billion per year treating illhealth caused by poor diet the economic burden for the future NHS is as predictable as it is inevitable unless action to tackle the root cause of the current epidemic is taken now.
The Mental Capacity Act 2005: lasting power of attorney
Authors: Dimond Bridgit
Published: May 2014

This article continues the series in analysing the implications of the Mental Capacity Act 2005 by looking at how a person (donor) is able to appoint another person (donee) to have the power to act on his or her behalf in relation to care and treatment decisions. Section 9 of the Act explicates that a donee has the authority to make decisions about the donor’s personal welfare or specific matters concerning the donor’s personal welfare, as well as the donor’s property or affairs or specific matters concerning his or her property or affairs. This article examines the details regarding these new provisions as well as the impact this new legislation is likely to have on healthcare professionals.
22 300 deaths: ‘festive’ season for older people
Authors: Bailey Asa
Published: May 2014

Yet another cold, wet, windy morning on my way into work, and getting more so everyday; it must be that time of year again – yes, is Christmas! I’m almost ashamed of myself, I promised myself I wouldn’t write about Christmas, and technically I’m not, more the weather conditions that come with it, the over-eager and often misplaced perceptions of so many people of the warm, family joy of the festive season and the healthcare-associated problems that arise during the winter months.
Finding your voice: key elements to consider when writing for publication
Authors: Wollin Judy Ann , Fairweather Carrie Therese
Published: May 2014

The dissemination of nursing knowledge rests on optimizing the accessibility of such knowledge among nurses and all other healthcare professionals. Nursing publications of all types, including research, case studies, reports, literature reviews, clinical audits, reflections on practice and letters to the editor, are important mechanisms for sharing knowledge and experience. Nurses need to publish their knowledge and experiences to inform and reflect on nursing practice. Barriers to writing for publication include inexperience and lack of know how. This article provides guidance for the novice writer.
The interpretation and implementation of regulatory fitness requirements
Authors: Sin Chih Hoong , Fong Janice
Published: May 2014

The Disability Rights Commission launched a general formal investigation (FI) into the impact of fitness standards on disabled people studying, qualifying, registering and working in three public sector professions, including nursing. The FI’s review of statutory and regulatory frameworks identified a significant amount of primary and secondary legislation and guidance, with an array of fitness requirements of statutory basis. There is, however, scant reference to the Disability Discrimination Act. The FI additionally issued a formal call for evidence targeting key stakeholder organizations, exploring how these interpret and implement regulations and guidances. Responding organizations acknowledge that the potential for, and reality of, discrimination exists and stems from highly variable and subjective interpretations and implementation of the regulatory fitness requirements. There is a widely perceived lack of adequate and clear guidance for practice purposes. Fitness requirements can discourage disabled people from attempting entry into the profession. A risk-averse culture discourages disclosure, and can affect the types and timeliness of support being provided to disabled students and professionals.
Clinical audit documenting insertion date of peripheral intravenous cannulae
Authors: Biswas Juyaly
Published: May 2014

The Royal College Of Nursing (RCN) have evidence-based guidelines with regard to optimal time for changing peripheral intravenous cannulae (PIC) and documentation post-insertion (patient and nursing notes). This clinical audit assesses the compliance with respect to the RCN and Eastbourne District General Hospital guidelines of documenting the date post-insertion of PIC, optimal time for changing cannulae and rates of superficial phlebitis on the surgical wards All PIC, their dressings, sites and intravenous infusions were examined on all inpatients on the surgical wards on three random days. Staff awareness with regard to RCN and local guidelines for optimal time to change peripheral venous cannulae and documentation post-insertion was assessed. The majority of staff nurses correctly stated that the optimal time for changing an uncomplicated PIC was 72 hours, despite this 13.8% had a cannulae which had been inserted for more than 72 hours. Our study has found that despite medical and nursing staff being aware of RCN and local guidelines, there is still poor compliance with regards to documentation, optimal time for changing and thus increased levels of superficial phlebitis post insertion of PIC.
Needlestick injuries: is it time for a new approach?
Authors: Adams Dr Debra , Elliott Prof Tom SJ
Published: May 2014

Hypodermic medical devices, such as hollow-bore needles, peripheral and central vascular catheters and phlebotomy equipment, are widely used in the healthcare setting. However, these devices continue to be associated with a relatively high risk of occupationallyacquired needlestick injury (NSI).
It’s all about change – at BJN and at Congress
Authors: Bailey Asa
Published: May 2014

Change - it’s all around us: our environment, our work life, our future - constantly changing and there’s little we can do about it. Or is there? Some things we can’t control or have even the smallest effect on, but a lot of what we do in our professional capacity we can control. Maybe not entirely, but to a certain extent we can all shape our future.
Effective communication in diagnosing Parkinson’s
Authors: Heisters Daiga
Published: May 2014

Unfortunately, this experience of being told you have Parkinson’s is not unusual among members of the Parkinson’s Disease Society (PDS). Approximately 10 000 people in the UK are diagnosed with Parkinson’s each year, and of these one in 20 will be under the age of 40 (Schrag et al, 2000). At the point of diagnosis many patients will have only limited knowledge of the condition and may imagine the worst-case scenario at diagnosis – dealing with the unknown can be very difficult.
Ten steps to successful poster presentation
Authors: Hardicre Jayne , Devitt Patric , Coad Jane
Published: May 2014

Receiving a letter confirming acceptance for you to present a poster at a conference can evoke mixed emotions. Joy, panic, fear and dread are among the many possible emotions and this is not exclusive to first time presenters. Developing an effective poster presentation is a skill that you can learn and can provide a rewarding way to present your work in a manner less intimidating than oral presentation (Shelledy, 2004). The key to successful poster presentation is meticulous, timely, well informed preparation. This article outlines ten steps to help guide you through the process to maximize your success.
Ten steps to successful conference presentations
Authors: Hardicre Jayne , Coad Jane , Devitt Patric
Published: May 2014

Delivering an oral presentation at a conference can be a demanding yet exhilarating experience. It can create a variety of emotions such as excitement, joy and achievement – but for many the overriding emotions are those of anxiety, fear and dread. A certain amount of nervousness can enhance your performance but how can you avoid pre-presentation nerves developing into full-blown anxiety and fear. The key to successful conference presentation is meticulous preparation and practise. This article guides you through ten steps to help maximize your success and enjoyment.
Innovation, safety and cost effectiveness in IV therapy
Authors: Castledine George
Published: May 2014

It is now estimated that the majority of patients coming into hospital require some form of intravenous (IV) therapy. Such openings into the body are prone to infection and thus care is needed when considering such procedures. Not long ago nurses were not expected to be involved in inserting such lines, but were responsible for maintaining them and preventing complications. Now, judging by the expertise presented at the 7th International conference on IV therapy in March this year, nurses are playing a much more significant role. Not only are nurses assisting in minor surgical procedures but they are also taking over and inserting complex lines.
Don’t give me evidence, give me reality!
Authors: Maylor Miles
Published: May 2014

This week I have been wondering what title I would give to a publication on the current attempt to commit tissue viability to an early grave? You might have heard of the book, The Man Who Mistook his Wife for a Hat (1985), which was written by the famous neuropsychiatrist Oliver Sacks? Some people also assume that a dressing is a hat. This illustrates at least two things: first, that it is no more than a covering. Hence, if you want to treat a wound, all it takes is to put a hat on it! Second, and more importantly, the man Sacks refers to is cognitively impaired, and has at least an organic excuse for his mistaken beliefs. But, decisions are being made by people such as procurement officers, pharmacy managers and medical staff who, in many cases, have no idea what various dressings look like, what their properties are and when they might be clinically appropriate. However, despite the influential position of members of formulary committees, they are predominantly shielded from the reality of trying to cope with a patient’s wound.
Adherence to a 2-layer compression system for chronic venous ulceration
Authors: Mudge Elizabeth , Ivins Nicola , Simmonds Wendy , Price Patricia
Published: May 2014

Adherence to compression therapy is fundamental for healing venous leg ulcers (Moffatt, 2004). The aim of this study was to investigate adherence and comfort associated with using a 2-layer compression system over a 6-week period for the management of chronic venous leg ulceration in patients with a history of non-adherence to other compression systems. Self-report rating scales were completed each week by the patients to record adherence and comfort of the compression system, while condition and ease of use of the system were recorded each week by the nurses involved in their care. The majority of the patients reported wearing the compression system for 75% of the time and were considered by the nurses to be ‘fully adherent’ for 80% of the time. Comfort and ease of use were rated highly by the majority of patients and nurses respectively.
Letter to the Editor
Authors: Oliver John
Published: May 2014

Your editorial, Presumed Common Sense (Br J Nurs 17(7): 411), usefully highlights the debate now taking place about potential changes to the United Kingdom (UK) system of organ donation.
Duty of care and political expectations. Part 5: standards and clinical outcomes
Authors: Fullbrook Suzanne
Published: May 2014

The previous article ended by raising the question of how ‘standards’ are being defined, developed and regulated according to Government expectations as expressed in Department of Health literature. The context of the enquiry is to try and correlate the legal definition and expectations that underpin our understanding of the ‘standards’ of behaviour expected of us in our nursing practice – with the political expectations that the current Government have brought into being. The last article recognized how the literature explored had been produced at the beginning of the Government’s ‘10 year plan’, and that in this respect the language would be rhetorical and aspirational. We are now 8 years on from the promise of a new dynamic ‘patientcentred’ NHS, so maybe it is possible to reflect on ways in which nurses and other health providers have instigated the Government’s directed health delivery programmes, and have been affected by the changes brought about by political command.
Getting back to ‘real nursing’
Authors: Castledine George
Published: May 2014

I have spoken at a number of venues around the country recently and there is no doubt that the unanimous and strong message coming from concerned nurses and the public is
Performing a percutaneous liver biopsy in parenchymal liver diseases
Authors: Karamshi Mina
Published: May 2014

There are many ways of obtaining a liver biopsy sample but the percutaneous method is deemed as one of the simplest and safest methods. Percutaneous liver biopsy (PLB) is a commonly performed procedure carried out for the diagnosis and management of patients with parenchymal liver diseases. It plays a central role in providing histological assessment for either diagnostic or therapeutic purposes. This article describes how PLB is performed at the Royal Free Hospital radiology department, London, under ultrasound guidance, along with indications, contraindications, complications and advantages/disadvantages this method offers. Nursing implications are discussed in terms of assisting, caring and managing for these patients safely. This article aims to raise awareness of PLB and inform the reader how this tissue sample is taken, thus enabling further understanding of this procedure. It is concluded that the percutaneous route of obtaining a liver biopsy enables a good size and quality of sample to be taken in a safe and effective manner, with usually one pass being required with minimal associated complications.
The application of crime science to the prevention of medication errors
Authors: Cox Karen
Published: May 2014

It is now accepted that human error in healthcare is inevitable and that a punitive response does not facilitate patient safety. Reason’s (2000) system approach acknowledges that adverse events, such as medication errors, rarely have a single explanation and advocates the review of systemic factors, such as organizational culture, management and strategy. Rational choice theory has much in common with the system approach but the emphasis is on understanding the decision making process of those who make errors. It could therefore be used in conjunction with the system approach to enhance the ability of healthcare providers to learn from medication errors and other adverse events. The aim of this article is to explore the relationship between rational choice theory and the system approach to error management in nursing.
Portrayal of mental illness and special hospitals in the UK press
Authors: Dickens Geoff
Published: May 2014

The portrayal of mental illness in the media can be negative and stigmatizing. Mental health nurses, therefore, need to be aware of the ways in which the media frame mental illness issues, and should be prepared to challenge inaccuracy. This article examines the changing nature of the UK press’s reporting of mental health issues by focusing on two areas. First, the changing terminology the press uses in their attempt to appear more sensitive, exemplified by recent growth in use of the term ‘suicide watch’. Secondly, the article examines the press’ reporting of the three English high-security special hospitals as an example of how the framing and personalization of stories is used to set the public agenda on mentally disordered offenders.
Top-ups for NHS patients: the welcomed next stage
Authors: Evans Helen
Published: May 2014

As the Government reviews the rules on private top-ups for NHS patients who want to access innovative medicines denied to them by the state, Nurses for Reform (NFR) are delighted that ministers will choose freedom in the coming weeks and in so doing embrace the next level of partnership working with private medicine.
Nutrition through the life-span. Part 1: preconception, pregnancy and infancy
Authors: Shepherd Alison Anne
Published: May 2014

Good nutrition throughout the life-span is fundamental if infants are to grow into healthy adults with subsequent progression through to old age. However, with an alarming increase in both the rates of obesity and malnutrition, it would seem prudent to suggest that infants, children and adults are not achieving an adequate nutritional status. This article is part one of a two-part series which aims to educate nurses by giving some guidelines on how such individuals may achieve a healthy nutritional status right through from preconception, pregnancy, infancy and childhood, through to adulthood and old age. It should always be remembered that although nurses are in a prime position to identify and treat malnutrition, it is not just a nursing responsibility. Safe and effective nutritional care can only be delivered if all those involved in the care of the patient – dieticians, nutritionists, doctors and pharmacists – are working together.
Exploring knowledge and skills on HIV in student nurses and midwives
Authors: Veeramah Ven , Bruneau Ben , McNaught Allan
Published: May 2014

A cross-sectional survey design using a self-administered questionnaire was sent to a sample of 62 final-year student nurses and midwives to describe their knowledge of, skills related to, and attitudes towards, human immunodeficiency virus/acquired immune deficiency syndrome. Out of the 47 respondents who return the questionnaire, only 53% stated that they had received class instruction on the topic and 63.8% claimed to have increased their knowledge mainly from reading professional journals. Although only 32% said that they had cared for a patient or knew of a family member or another person with the disease, 91% indicated that they were willing to care for such patients. Overall, the respondents demonstrated positive attitudes towards this group of patients and a good level of knowledge about the subject, although some gaps were evident. However, a large majority stated that their skills to cater for the physical and psychological needs of this group of patients were deficient and would like further training
Autonomous emergency ophthalmic nursing: a pilot educational module
Authors: Gallagher Mary-Josephine , Mathison Joan , McKnight Margaret
Published: May 2014

Enhanced and extended roles proliferate in nursing today. This is, in part, due to changes in doctors’ working hours and nursing becoming increasingly specialized. Ophthalmology has always had enhanced roles for nurses and the boundaries continue to evolve and widen. Accredited education in emergency ophthalmic nursing practice is essential to enhance safe practice, peer recognition and professional development in keeping with the Nursing and Midwifery Council’s Code of Professional Conduct. Finding no appropriate educational and practice programme available, locally or nationally, the authors decided to devise their own module in conjunction with their ophthalmic department, their hospital’s continuing professional practice development department, and Queen Margaret University. This article describes the authors’ experience and the progression from inception, planning and organization to completion, and, finally, piloting the module themselves.
Classification, aetiology and nursing management of lymphoedema
Authors: Honnor Amanda
Published: May 2014

Lymphoedema is a common problem affecting at least 100 000 people in the United Kingdom. There is a lack of knowledge among healthcare professionals regarding lymphoedema and this has led to the condition often not being recognized early enough or being adequately managed. Lymphoedema is an incurable condition which will progress if it is not appropriately treated. Physical problems associated with lymphoedema may include pain, discomfort, heaviness of the limb and distortion in limb shape and size leading to reduced mobility and function. This has implications for lymphoedema patients who may experience a significant reduction in their quality of life because of this condition. Treatment, if commenced early, is straightforward and patients can be taught to carry out an effective programme of daily self-care. If, on the other hand, the lymphoedema is not recognized early or not properly treated, it can develop into a serious and highly debilitating condition.
The way forward for learning disability nursing
Authors: Camus Heather
Published: May 2014

This article looks at a possible future or direction for learning disability nursing. Taking into account the physical, emotional, spiritual, social, medical, dental and mental health needs of people with learning disabilities, government policies, and reports from Mencap, this article outlines the need for flexibility and innovation from within the nursing profession. One forward-thinking residential home is identified who employ their own learning disability nurse to support the residents in achieving good health and encourage communication skills between staff and residents and to promote individual rights, choice, privacy and dignity.