bluuebunny/crossref_metadata_2025 huggingface dataset:
Polytrauma: a case report
Authors: Hitt Andy
Published: May 2014

In the prehospital setting, the ‘foot of the bed inspection’ becomes an ‘over the ambulance dashboard inspection’. A mangled wreck at the foot of a tree is usually a good indication that someone has been injured and that timely clinical intervention may be required. By considering the mechanisms involved and performing a thorough primary survey, time critical patients can be triaged and treated with efficiency. As paramedics’ assessment skills continue to improve and doctors gain prehospital experience, it is anticipated that a well balanced team will emerge. A team that is aware of their limitations and limit their interventions to the time permitted to intervene. This case study is based on the young male driver of a vehicle that has been involved in a high speed collision with a tree. It aims to identify the probable pathologies, explain the pathophysiology of clinical signs and discuss, with evidence, the treatment options and appropriate destination for the patient.
Australian first responder programmes: a review of the literature
Authors: Howard Stuart , Burgess Stephen , Boyle Malcolm
Published: May 2014

Early access to defibrillation for cardiac arrest patients is highlighted in the seminal paper describing the ‘chain of survival’ concept. The objective of the study was to identify Australian first responder programmes and report their effect on survival rate from out-of-hospital cardiac arrest (OHCA). Methods: a literature search was conducted using medical electronic databases Medline and EMBASE, with the databases searched from their beginning until the end of May 2011. References from retrieved articles were reviewed. Articles were included if they reported on Australian first responder programmes and their outcomes, including survival to discharge from hospital. Articles were excluded if they were not written in English or were hospital-based. Results: there were 674 articles located by the search with seven articles meeting the inclusion criteria. Two articles were subsequently excluded, as they did not report survival outcomes. The survival rates from cardiac arrest ranged from 4% with the Metropolitan Fire and Emergency Services Board first responder programme to 71% with St John Ambulance Australia at large public events. Conclusion: the results of this study suggest the survival from OHCA attended by first responders in Australia is, in some studies, comparable with international studies.
Induced hypothermia in the management of head trauma: A literature review
Authors: Ravenscroft Tristan
Published: May 2014

Mild hypothermia treatment (MHT) involves a controlled decrease of core temperature in order to mitigate the secondary damage to organs that follows post primary injury. In the case of traumatic brain injury (TBI) suggestions that the brain could be conserved by cooling go back as far as the 1940s. The idea was to reduce cerebral metabolism and hypoxic insult by using MHT. However, more recent research suggests that this is a ‘simplistic view’ of brain cooling when there is in fact a much more complex web of effects that need to be understood and accounted. There clearly needs to be a variety of multi-disciplinary team based simultaneous pre-hospital and then in-hospital treatments to ameliorate harm (Nonmaleficence ) and enhance brain healing processes (Beneficence). Examination will take place of the varied probable mechanisms of action and contemporary evidence for and against the use of MHT in TBI. Discussion will range across issues such as target range of MHT, time to achieve this range, duration of cooling, and finally re-warming rates on neurological outcomes following TBI. This in turn, should create a clearer evidence base, for the UK paramedic practitioner who is considering using MHT in the pre-hospital setting in the minutes following TBI and inform decisions around: methods and timing of cooling; shivering prevention using sedation; reliable on-going monitoring of core temperature and team building with hospital services.
Anatomical and physiological mechanisms of heartblock associated with AMI
Authors: Edwards Tim
Published: May 2014

Heart block (HB) is a recognised complication of acute myocardial infarction (AMI) and is often a marker for increased mortality and morbidity. An appreciation of the anatomical and physiological mechanisms associated with the development of HB in AMI is important for the prediction and management of complications when dealing with such cases. Certain forms of HB are classically linked to infarction of specific anatomical territories in AMI. However, variations in pre-morbid state and anatomy of the coronary vessels provide potential for the development of HB in any patient experiencing AMI, regardless of the territory affected.
Single-dose activated charcoal as a pre-hospital treatment for self-poisoning
Authors: Walker Richard
Published: May 2014

This article aims to find and evaluate current available evidence to determine whether the known clinical benefits of orally administered single dose activated charcoal would justify its use in a pre-hospital ambulance setting. A search of medical databases resulted in evaluation of four studies considered to be of sufficient quality to answer the clinical question. The article acknowledges that further research is desirable into the long-term benefits of pre-hospital charcoal and that much current evidence relies on a reasonable extrapolation of benefit from toxin biomarker data in clinical trials. Nevertheless, it recommends that sufficient evidence now exists for ambulance services to consider its use in cases of self-poisoning attended by ambulance paramedics within one hour of toxin ingestion as recommended by NICE (2004) Clinical Practice Guideline Number 16: Self-harm: The short-term physical and psychological management and secondary prevention of self-harm in primary and secondary care. Recent recommendations lowering the threshold of hepatotoxicity requiring hospital admission to 75 mg paracetamol per kg bodyweight ( National Poisons Information Service, 2012 ) will undoubtedly increase the number of overdoses of the drug encountered by crews where charcoal may prove of benefit.
Paramedic treatment—wherever that may be?
Authors: Price James
Published: May 2014

James Price is Chair of the HART National Operations Group and HART Manager for West Midlands Ambulance Service NHS Foundation Trust, explains areas of operation and types of PPE used by the programme, and the challenges in delivering clinical care within the Inner Cordon.
Treating chronic pain: the nurse’s role and the impact of supplementary prescribing
Authors: McGann Karina
Published: May 2014

Chronic pain is one of the most common reasons why people seek medical care, and those who suffer from it use health services up to five times more frequently than the rest of the population (Von Korff, 1993). The total direct cost of back pain is an estimated £1632 million per year in the UK (Maniadakis and Gray, 2000). Nurses are key team members in the total management of these patients. The introduction of extended nurse prescribing will enhance their role and can only benefit patient care. The current proposals for supplementary prescribing, however, will limit the usefulness of this prescribing due to restrictions on unlicensed medications and controlled drugs.This article outlines the different types of chronic pain, the treatments available and discusses how the current proposals are unnecessarily restrictive.
Extended formulary nurse prescribing within contraceptive services
Authors: Feehan June
Published: May 2014

Jenny*, 23 years of age, attended a Young People's Open Access Clinic for a repeat prescription and supply of Microgynon 30, a combined oral contraceptive pill (COC). She had been using this method of contraception effectively since the age of 17 years and had not experienced any problems. On this occasion, Jenny was seeking advice regarding her recent pill taking. Additionally, Jenny informed me that she had just completed her training as an airhostess and would be working as a cabin-crew member on long haul flights to a variety of locations.
Antimuscarinic treatment in overactive bladder syndrome
Authors: Rigby Deborah
Published: May 2014

Overactive bladder (OAB) is a common condition which can significantly a patient's quality of life. Treatment of OAB can vary considerably and largely depends on identifying the cause of the overactivity. While behavioural approaches to treatment play a significant role, antimuscarinic drugs are the most widely used form of treatment for OAB. This article provides background information on the causes of OAB and takes an in-depth look at the types of antimuscarinc drugs currently available.
Ethics in prescribing practice: a review of topical issues
Authors: Amoroso Jasmin , Otway Chris
Published: May 2014

Prescribing is a complex process and many of the complexities are linked to ethical issues. This article discusses the use of ethical decision-making models to aid decision making. Three scenarios are described and analysed using the Seedhouse ethical grid. It is acknowledged that prescribing can be a stressful occupation and the need for clinical supervision should not be overlooked.
Role of the nurse prescriber in managing anal fissure
Authors: Stewart Jenny
Published: May 2014

In December 2005 a team of colorectal clinicians from across Europe met with the aim of developing an evidence-based treatment algorithm for anal fissure, to be used in both primary and secondary care. In this article, Jenny Stewart explores its implications for the management of anal fissure by nurses in primary and secondary care.
Prescribing oxygen therapy in chronic lung disease
Authors: Barnett Margaret
Published: May 2014

Oxygen therapy in primary care is widely used in patients with chronic obstructive pulmonary disease (COPD) to treat hypoxemia, and for relief of breathlessness. However, the prescribing of supplementary oxygen therapy for patients with a diagnosis of COPD is not without risk if administered incorrectly. Apart from the risk element it is also a costly treatment in the management of COPD, which is not always prescribed appropriately. This article outlines the different types of oxygen therapy available for patients with stable COPD, when it should be used and how to prescribe it safely.
Hormone replacement therapy: risks and benefits
Authors: Parke Audrey , Abernethy Kathy
Published: May 2014

For many women, the menopause is accompanied by uncomfortable symptoms, which can be alleviated by the use of hormone replacement therapy (HRT). HRT however, is not suitable for everyone and the benefits must be carefully balanced against the risks. Over the last few years, data has become available to help nurses to educate women about these risks and benefits, enabling us to advise women more comprehensively and evaluate the risks and benefits for an individual. This article summarizes the evidence to date, outlining the current thinking of HRT use in the UK.
Prescribing inhaled therapies in the treatment of COPD
Authors: Bostock-Cox Beverley
Published: May 2014

NICE recently updated its guidelines on the management of chronic obstructive pulmonary disease (COPD). This article focuses on pharmacological options available for the treatment of COPD. Treatment options should be based on the severity of the patient's condition, as assessed by both measurement of lung function and severity of symptoms. Treatment may consist of ‘as required’ short-acting bronchodilators, regular long-acting bronchodilators and/or inhaled steroids prescribed as combination therapy. Inhaled steroids should also be considered in patients with a history of exacerbations. New therapies for COPD are also discussed briefly.
Syphilis: a public health issue
Authors: Keefe Alison
Published: May 2014

There has been a signifi cant improvement in the delivery of care and accessibility of genito-urinary medicine services as a result of the implementation of nurse-led clinics. However, there remains an increasing incidence of sexually transmitted infections (STIs) and HIV in the UK. This article addresses the complex nature of syphilis; an STI which has historical notoriety and remains a public health issue among specific patient groups.
Administration of medicines: safety first?
Authors: Russell Marion
Published: May 2014

Are nurses and midwives sufficiently skilled to administer medicines safely? In this third instalment of the ANP Forum, Marion Russell, Medicines Management Nurse, offers a personal reflection
Over-the-counter medicines: perils and pitfalls
Authors: Rutter Paul M
Published: May 2014

Over the past 15 years UK health policy has placed greater emphasis on patient empowerment and encouraging people to exercise self-care. This has been facilitated by the deregulation of medicines from prescription-only status to non-prescription use, which has swollen the number of medicines available for consumer purchase and allowed a larger number of conditions to be self-managed. This article explores this process of medicine deregulation, how this process affects their sale and supply and the effectiveness of non-prescription medicine.
Prescribing calcium channel blockers
Authors: Sargent Andrew
Published: May 2014

This paper examines the role of calcium channel blockers (CCBs) and the various modes of action of each of the sub-types of CCBs. CCBs can be prescribed in a variety of cardiovascular disorders, and the selectivity of each type of CCB will be discussed.
Overactive bladder management: pharmacological options
Authors: Rigby Deborah
Published: May 2014

Overactive bladder (OAB) is a common condition that can significantly affect a person's quality of life. The treatment of OAB can vary considerably, and largely depends on identifying the cause for the over-activity. While behavioural approaches to treatment play an important role, antimuscarinic drugs are the most widely used form of treatment for OAB. All patients presenting with bladder urgency and incontinence should be offered an initial assessment by a suitably trained individual to ensure appropriate assessment and treatment. This article provides an overview of pharmacological options available and the stepped care approach.
The pharmacology of drugs used in the management of IBS
Authors: Hall Sandra
Published: May 2014

Abstract

The management of inflammatory bowel disease (IBS) is varied and complex. Therefore, this article will concentrate on the pharmacology of the individual drugs that may be used to treat IBS. At present, there is no cure for IBS, and the emphasis is on using a combination of drug therapies and nutritional support to maintain patients in long periods of remission. The main goals of treatment are to induce and maintain remission while limiting the drug toxicity and avoiding complications. Three main groups of drugs are used in the management of IBS: aminosalicylates; corticosteroids; and drugs that affect the immune system, including immunosuppressants and monoclonal antibodies. Other drugs, such as antibiotics and antidiarrhoeals, are also used to manage symptoms but will not be discussed in this article.
The pharmacogenic revolution in drug development
Authors: Greener Mark
Published: May 2014

Clinicians and researchers increasingly use ‘pharmacogenetics’ (also called ‘pharmacogenomics’) to understand variations in drugs’ efficacy and side-effect profiles and to develop targeted treatments. The Human Genome project estimates that Homo sapiens’s genetic code contains 25,000 genes, some of which influence the efficacy and tolerability of commonly used medicines. For example, genetic variations (polymorphisms) in beta-adrenergic receptors and angiotensin converting enzyme influence responses to salbutamol and ACE inhibitors respectively. Around 10% of the population carry a ‘loss of function’ polymorphism that means codeine does not provide adequate pain relief. Another common polymorphism increases the risk of life-threatening bleeding among people taking warfarin. Polymorphisms raise the prospect of being able to analyse a patient’s genetic profile to tailor treatment more accurately. Indeed, genetic testing is already a reality: more than 15 000 genetic tests are performed on solid tumours in the UK each year, which help guide treatment. Researchers also look beyond genes themselves to develop a new generation of ‘epigenetic’ therapies. As this review illustrates, genetic studies offer unprecedented insights into the pathology of numerous diseases and new opportunities to optimise treatment.
Choosing drug therapies for urge urinary incontinence in women
Authors: Rantell Angie
Published: May 2014

The aim of this article is to provide an overview of the current pharmacological treatments used in the management of urge urinary incontinence.
Pharmacological management of premature ejaculation
Authors: Steggall Martin
Published: May 2014

Premature ejaculation is the most common male sexual complaint, affecting approximately 23% of all men. All definitions of premature ejaculation incorporate three main qualifications: a short time interval between penetration and ejaculation, little or no control over ejaculation, and interpersonal or relationship distress. There are two primary pharmacological interventions for premature ejaculation: antidepressants and local anaesthetics, although phosphodiesterase type 5 inhibitors, intracavernosal injections, and opiates have also been used. The selection of treatment is dependent on accurate assessment (to exclude prostate infection), the context of the patient's sexual relationship, and the patient's choice. For many, a combination approach of pharmacology and behavioural intervention will be needed. In this article, treatment choices are considered and recommendations made for the clinical management of premature ejaculation.
Viral infections: A tale of two genomes
Authors: Greener Mark
Published: May 2014

Approximately 200 viruses cause human diseases, from common colds to certain cancers. Viruses cannot replicate outside their host's cells; instead, they subvert the patients' cellular machinery to create new viral particles. While researchers and clinicians, including nurses, have made considerable progress in tackling viral infections, a combination of rapid replication and errors copying the virus's genetic code often produces mutations that are resistant to initially promising vaccines and antivirals. However, recent studies that decipher the viral genome help clinicians optimize treatment efficacy, trace the spread of diseases, and explain why new pandemics emerge. Viruses and their hosts have co-evolved for millions of years, and humans developed several lines of antiviral defences—and these lines continue to evolve as, for example, viruses change to overcome modern treatments. Studies into the interactions between viruses and their host cells helps explain, for example, why some people do not contract HIV despite being at high risk for many years. Scientists also identified numerous variations (polymorphisms) in the genes encoding human antiviral defences that help determine clinical and therapeutic outcomes. Understanding the genetics and lifecycle of viruses helps nurses understand the clinical consequences of viral infections, suggest or prescribe the most effective approaches to management, and identify opportunities to augment infection control. As this feature illustrates, the risk of infection, the severity of the resulting disease, and the effectiveness of treatment may depend on the interplay between two genomes.
Oral contraception for women: a brief overview
Authors: Robinson Gina
Published: May 2014

The most popular contraceptive formulation in the United Kingdom remains the oral contraceptive pill. This article provides a brief overview of the main benefits of the two most popular forms of contraception prescribed: the combined pill and the progesterone only pill. Practitioners are advised to take a medical history of the woman to determine which formulation is the most appropriate, and to refer to the manufacturer's instructions when giving advice on managing missed pills and interactions with other drugs. Nurses are also advised to keep up to date with new formulations.
Rabies: vaccination, symptoms and diagnosis
Authors: Duncan Deborah , Boulton Jacqui
Published: May 2014

Rabies is a disease that most of us have heard of because of the acute unusual symptoms, but few have had to treat. It is also a notifiable disease under the Public Health Act 2008. The rabies virus is a part of the Rhabdovirdae family of viruses. Its specific genus is that of the Lyssavirus and is one of the few that is symptomatic in humans. Rabies is a viral disease that affects mainly warm-blooded animals. Rabies has no cure and its progress mimics several other acute infections, therefore it is important that a clinician seeing a patient with acute symptoms find out, from the patient or a relative, if he/she has travelled to a high risk area, if they have been exposed to animals over the course of their work, and if they have been bitten by any animal. This article provides a brief overview of rabies and its symptoms, its vaccine, and issues to consider when advising a person who is going to travel to remote overseas areas.
Infections increase deep venous thromboembolism
Authors: Greener Mark
Published: May 2014

In brief

▪ Infections increase the likelihood of developing deep venous thromboembolism

▪ Rheumatoid arthritis patients who discontinue statins risk death

▪ Patients are unaware that they can report adverse reactions to drugs through the yellow card system

▪ Selective serotonin reuptake inhibitors do not undermine motor function in patients with Parkinson's disease

▪ People receiving statins are also being prescribed medication which inhibits enxymes that metabolise statins, putting patients at risk

▪ ACE inhibitors can reduce all-cause mortality in people with hypertension
Ten tips for safer prescribing by non-medical prescribers
Authors: Petty Duncan Robert
Published: May 2014

This article explores 10 ideas for improving the safety of prescribing through better ways of working. Personal vigilance and care is required when prescribing to avoid errors resulting from poor prescribing decisions, for example, wrong drug, dose, route, frequency, and/or quantity. However, errors can also occur for other reasons, including poor patient communication, lack of monitoring, and poor interface communication, especially in primary and secondary care. Systems for reviewing and monitoring will help reduce errors, and the non-medical prescriber must work with other prescribers to ensure these systems are in place. These top 10 tips ware not exhaustive, but if practiced will go a long way to improving patient safety.
Managing genital herpes and minimizing the discomfort
Authors: Keefe Alison
Published: May 2014

The incidence of genital herpes has increased over the previous decade and presents in patients in primary care, contraceptive clinics, and sexual health or genitourinary medicine clinics. In this article, ways of minimizing the discomfort and emotional impact of this poorly understood viral infection and the challenges that health professionals face when dealing with such sensitive issues are discussed.
Prescribing for contact eczema (dermatitis)
Authors: Watkins Jean
Published: May 2014

Contact dermatitis is a common problem. Identifying the condition and determining the cause are important in its management, as the condition will only worsen if contact with the offending substance continues. Whether it is due to an allergic reaction or contact with an irritant substance will often be decided based on an accurate history, and sometimes patch testing with specific antigens may be necessary. If needed, topical corticosteroids should settle the reaction, emollients are always useful to aid rehydration of the skin, and, occasionally, in more severe cases, topical immunomodulators and systemic corticosteroids may be required. When concern continues, a specialist opinion should be sought.
Genital warts: diagnosis, management, and prevention
Authors: Keefe Alison
Published: May 2014

The incidence of genital warts has increased over the previous decade in England. In this article, various aspects of the management of genital warts are described. Ways of minimizing the emotional impact of genital warts are explored and preventive measures, including the national human papilloma virus immunization programme, are discussed.
Managing foot disorders in patients with diabetes
Authors: Morris David
Published: May 2014

In this article, issues relating to the management of foot disorders in patients with diabetes are discussed. These include the nature of foot ulceration, foot screening, and the management of peripheral neuropathic pain, neuropathic and ischaemic ulcers, infected foot ulcers, and Charcot foot.
Syphilis and lymphogranuloma venereum: raising awareness
Authors: Keefe Alison
Published: May 2014

There are several diagnoses for patients who present with ulceration in the sexual health clinic or primary care. In this article, syphilis and lymphogranuloma venereum (LGV) are discussed. Syphilis and LGV are sexually transmitted infections that may present in various guises and sometimes present as co-infections. They are both serious infections that occur with a high incidence among men who have sex with men. Providing the patient with an environment in which sexual practice can be discussed with openness and honesty will enable the health professional to diagnose and treat appropriately. The treatment options and management should be discussed, and education and awareness relating to high-risk sexual behaviour will prevent onward transmission and long-term sequelae.
Nursing management of Clostridium difficile infection
Authors: Aziz Ann-Marie
Published: May 2014

Clostridium difficile infection is a severe infection of the colon. Infection with C difficile bacteria, which naturally reside in the body, can be debilitating for patients and can become severe. The Health Act states unambiguously that prevention and control of healthcare-acquired infections (HAIs) should be a high priority for all parts of the National Health Service (NHS) and calls for ‘a high awareness of the possibility of HAI in patients’ ( Department of Health, 2008 ). Nursing practice plays a fundamental part in ensuring patients do not acquire HAIs and that they receive the appropriate nursing care and the correct antibiotics. Three elements are required for management: hand hygiene, contact isolation, and environmental measures. This article provides information on the current guidance for managing C difficile infection and how nursing care can be optimised so patients can be care for in a clean and safe place.
Carrying out asthma reviews in primary care
Authors: Kochhar Suneeta
Published: May 2014

Asthma is a chronic respiratory condition that affects 5.4 million people in the UK. Annual reviews are recommended for asthma patients and this review should include an assessment of current symptoms, in addition to possible triggers, current treatment and its effectiveness, adherence to therapy, lung function measurement and observation of inhaler technique. A patient self-management plan should also be put in place.
Pharmacology of coenzyme Q10: Relevance to cardiovascular and other disorders
Authors: Mantle David
Published: May 2014

Coenzyme Q10 (CoQ10) is a vitamin-like substance that plays a key role in the metabolic process that supplies all cells with energy. Tissues with a high energy requirement, such as the heart, are particularly dependent on maintaining an adequate supply of CoQ10 for normal functioning. Deficiency of CoQ10 has been identified as a risk factor for a variety of disorders, including cardiovascular and neurological diseases. The objective of this article is, therefore, to provide a brief overview of the pharmacology of CoQ10, with particular emphasis on its role in the prevention and treatment of cardiovascular disorders.
A case study on prescribing for an acute ear infection in a child
Authors: Nash Louise
Published: May 2014

In this case study, history taking, clinical examination, and diagnostic skills are described in relation to treating a child with ear infection. The importance of responsible prescribing of antibiotics is discussed.
The physiology and pharmacology of vitamin D
Authors: Hughes Philip J , Brown Geoffrey , Kutner Andrzej
Published: May 2014

Vitamin D was identified nearly a century ago as an important regulator in the absorption and transport of essential minerals (particularly calcium, phosphorus and magnesium), and as such is a key determinant of normal bone development. Vitamin D is now seen as a potentially key hormonal regulator in the cardiovascular, musculoskeletal, renal, nervous, adipose and immune systems. An adequate supply of vitamin D at all stages of life is essential for the maintenance of good health. It has, however, been estimated that upwards of 1 billion people, in both the developed and developing world, can be categorised as being vitamin D deficient. This article discusses some of the key aspects of the biochemistry, physiology and pharmacology of vitamin D.
Nurse prescribing and vicarious liability
Authors: Brack Graham
Published: May 2014

Vicarious liability is the idea that the employer is responsible for errors made by employees for acts that take place as part of their employment. This article discusses the idea of vicarious liability as it applies to nurses. Vicarious liability does not apply in all cases, for instance when undertaking work outside your role, if you are self-employed, or in cases of gross negligence.
An overview of the treatment of psoriasis in adults
Authors: Watkins Jean
Published: May 2014

Psoriasis is a common inflammatory skin condition that is estimated to affect up to 2.2% of the population. Lesions may be persistent or chronic, or undergo periods of exacerbation and remission. Psoriasis may present in a variety of different ways and can have varying severity. Assessment of the severity of psoriasis is important at diagnosis, as well as at each follow-up appointment to determine whether treatment has been successful. In this article we will discuss the different presentations of psoriasis and approaches to the management of adults with each type of psoriasis, as well as indications for referral to specialist treatment services.
Antimicrobial resistance and prescribing behaviour
Authors: Ness Valerie , Price Lesley , Currie Kay , Reilly Jacqui
Published: May 2014

Antimicrobial resistance (AMR) is an urgent public health concern and threatens to reduce the effectiveness of antimicrobials in the treatment of infections ( WHO, 2011 ). High consumption, increased frequency and imprudent use of antimicrobials is believed to accelerate resistance and research suggests that inappropriate prescribing is apparent in practice. With a growing number of nursing staff prescribing antimicrobials, and the significant health impact of inadequate decision making around this prescribing, the practice of nurse prescribers is of particular interest. Since around 80% of antimicrobial prescribing occurs in primary care, where nurse prescribers have a key role, and with a growing number of nursing staff potentially prescribing antimicrobials, the impact of their practice must have an influence on AMR. This article will discuss the problem of AMR and its link with nurse prescribing before offering suggestions for nurse prescribers to improve their own prescribing practice.
Managing urinary incontinence with penile sheaths
Authors: Pomfret Ian
Published: May 2014

Ian Pomfret offers a simple guide for care home staff on how to select the right penile sheath and fixation method, and how to correctly fit it.
Managing change effectively
Authors: Newson Pauline
Published: May 2014

Change happens, it may be planned or unplanned but nevertheless change happens. It is an inescapable fact of life that whoever you are you will experience change.
Making the LINk
Authors: Sims Beccy
Published: May 2014

Beccy Sims reports on government plans to ensure that the public get a better say in the planning, development and delivery of health and social care services.
The role of the care assistant in promoting wound healing
Authors: Nazarko Linda
Published: May 2014

Care assistants can make a valuable contribution to care by working as part of the health care team. Linda Nazarko describes the fundamentals of wound healing, and the important role that the care assistant can play in maintaining residents' wellbeing, wound prevention and healing.
Dignity must come first
Authors: Sims Beccy
Published: May 2014

Beccy Sims reports on the Royal College of Nursing's efforts to ensure that nursing staff are supported to provide patients with top quality care.
The role of skin care in preventing infection
Authors: Bissett Linda
Published: May 2014

Damaging the skin makes staff and patients more vulnerable to infection and contamination. Linda Bissett discusses the role that good hand care can play in preventing infection and offers some advice on skin care.
News Analysis
Authors: Sims Beccy
Published: May 2014

Beccy Sims reports on plans to tackle some of the more common health issues experienced by older people.
The right to request time off for training may be extended
Authors: Graham Alison
Published: May 2014

From April 2011, there is a possibility that employees in organizations with under 250 employees will have the right to request time off for training. The legalities and procedures involved are explained by Alison Graham.
Part 1: Contribute to health and safety
Authors: Weaver Dawn
Published: May 2014

Dawn Weaver explores the legislation around health and safety and how it applies in care settings [Box: see text]
Legal aspects of the recruitment process
Authors: Davies Julie
Published: May 2014

Julie Davies explains care home operators’ obligations under the Health and Social Care Act 2008, which assists operators to optimize the quality of care by employing the right people.
Practical care: how to improve your care plans
Authors: rollin Helen
Published: May 2014

The key to a good person-centred care plan is knowing the person, as nursing home Manager Helen rollin explains. This article discusses how to write an excellent care plan and avoid common mistakes.
Handling information: storing, recording and sharing
Authors: Cox Danielle
Published: May 2014

This mandatory unit is designed to provide health and social care professionals with the knowledge and skills required to correctly store, record and share personal information.
How to effectively manage COPD in care home residents
Authors: Barnett Margaret
Published: May 2014

Chronic obstructive pulmonary disease (COPD) is a common and serious condition. This article explains how the disease can be managed with the help of the multidisciplinary team
Care home funding: what to expect and what to do
Authors: Ursell Frank
Published: May 2014

The increasing emphasis on the personalization of care and forecast drop in local authority funding means financial difficulties for some care homes. Frank Ursell explains how to confront funding cuts.
A framework for the best end of life care planning
Authors: Henry Claire , Sherwen Eleanor
Published: May 2014

The National End of Life Care Programme has published its guide to improving the care of dying people in care homes. Here, we discuss how it can help optimize end of life care in your home.
Introduction to equality and inclusion in social care
Authors: Newson Pauline
Published: May 2014

This, the third of the mandatory units for the new diploma, introduces you to what equality and inclusion means in your practice.
Catheter care and prevention of associated infections
Authors: Fraczyk Linda , Tibbs Jenny , Brennan Mary-Lou , Godfrey Helen
Published: May 2014

How do catheter associated urinary tract infections develop? What role do staff play in catheter care and the decision to catheterize? Here, continence experts explain.
Skin conditions: care as independence decreases
Authors: Burr Sara
Published: May 2014

As a person with a long-term skin condition becomes less independent, what is the impact on the individual and the care that they require for their skin? Sara Burr explains.
Nutritional care for people with heart failure
Authors: Shepherd Alison
Published: May 2014

People with heart failure commonly experience poor nutrition, partly because of the disease but nutrition also affects the progress of it. Alison Shepherd explains what you can do to help.
Psychosocial interventions through memory clinics
Authors: Moniz-Cook Esme
Published: May 2014

Memory Clinics are associated with early diagnosis and treatment of dementia. Esme Moniz-Cook considers how these might support staff in care homes to assist residents to ‘live well with dementia’.
Caring for residents with Parkinson's
Authors: Bains John
Published: May 2014

Most people think they know what Parkinson's is, but there are many things to think about when caring for a resident with the condition. John Bains helps us understand the condition and how to care for those with it.
Introduction to duty of care in health and social care
Authors: Weaver Dawn
Published: May 2014

Dawn Weaver explains how a duty of care contributes to safe practice

[Box: see text]
Preventing falls when pushing people in wheelchairs
Authors: Okunribido Olanrewaju O , Edgar Jean
Published: May 2014

In 2005, a lady fell from her wheelchair during transport by care staff and later died. Two experts discuss how correct wheelchair use may have helped prevent this tragic incident.
Caring for people with vascular dementia
Authors: Stacpole Min , Thompsell Amanda
Published: May 2014

The authors look at how an understanding of vascular dementia helps care home staff anticipate symptoms and control the risk factors for progression of cerebro-vascular disease.
Parkinson's and associated mental health issues
Authors: Heisters Daiga
Published: May 2014

Many healthcare professionals are aware of the physical symptoms of Parkinson's, but less is known about the potential impact on mental health. Daiga Heisters discusses the cognitive symptoms of Parkinson's.
Care Ambassadors help recruit young people into care
Authors: Farrell Zoe
Published: May 2014

Zoe Farrell Reports on how the Care Ambassadors scheme can help to attract people to work in social care.
Why you need to know about scabies infections
Authors: Olley Matthew
Published: May 2014

Scabies is associated with people living in close proximity, such as in care homes, and the spread of the infection can be difficult to contain. How can you identify infections and how are they treated?
Easing agitation in residents with ‘sundowning’ behaviour
Authors: Forbes Rebecca , Gresham M. D.
Published: May 2014

‘Sundowning’ is a term describing the increased agitation some people with dementia display during the late afternoon or early evening. rebecca Forbes helps us to understand and deal with such behaviour
Befriending in care homes—the results of a pilot study
Authors: Downey Judy
Published: May 2014

Judy Downey reports on a pilot study undertaken by the relatives & residents association, that investigated how befriending could be implemented into care homes and advises us how this can guide practice.
Implement person centred approaches
Authors: Cox Danielle
Published: May 2014

This mandatory unit introduces you to key ways of working to ensure clients are able to participate in their own care provision and that their rights are protected [Box: see text]
Practical care: how to enhance mealtime setups
Authors: Swann Julie I
Published: May 2014

Dining experiences can be enhanced by paying attention to the ambiance, the décor and how food is served. This article discusses how to apply these principles and how staff can help residents to manage feeding.
Telecare comes home
Authors: Law Derek
Published: May 2014

Helping care home residents maintain their independence and dignity while also ensuring their care and safety is an ongoing challenge. This article investigates whether telecare can provide some answers
Spoilt for choice: stoma accessories and appliances
Authors: Burch Jennie
Published: May 2014

A basic knowledge of equipment for ostomates may help reduce complications after surgery. Jennie Burch provides a run down of available appliances to assist residents
Seasonal update: promoting vaccination in the home
Authors: Payne Drew
Published: May 2014

People living in care homes are especially at risk from infectious illness but over 65s may have particular reservations about having the latest inoculation. Drew Payne explains why
Nutritional monitoring of residents
Authors: Grantham Christine
Published: May 2014

A good nutritional care plan is key to the effective management of residents at risk of malnutrition. Christine Grantham looks at the care planning and monitoring process
Supporting the QCF assessor
Authors: ashurst Adrian
Published: May 2014

In this article adrian ashurst discusses the importance of supporting the Qualifications and Credit Framework assessors working in a care home.
A review of insulin delivery devices and glucose meters
Authors: Edden Anna , Hawthorne Gillian
Published: May 2014

Anna Edden and Gillian Hawthorne review products that are suitable for residents who wish to remain independent with self-monitoring and self-injecting and outline the correct procedures
Lessons to be learned from Winterbourne View
Authors: Cave Tabitha
Published: May 2014

The serious case review, published by South gloucestershire Council, details that providers, staff, authorities and regulators must work together to prevent abuse from happening. Tabitha Cave explains
Introductory awareness of sensory loss
Authors: Veselinova Claire
Published: May 2014

This unit is designed to provide health and social care workers with the knowledge to understand the causes of sensory loss and to consider issues closely linked with sensory loss support
What to expect at an inquest: attending a coroner's court
Authors: Cave Tabitha
Published: May 2014

Tabitha Cave discusses three inquest-related matters: the impact of new regulations, which have come into force this year; what care homes should expect if they are asked to attend an inquest; and the support available to care providers, staff and residents
Record keeping: an accurate refection of support provided
Authors: Wharvell Tracy , Sheldon Jan
Published: May 2014

Tracy Wharvell and Jan sheldon provide information on how staff should accurately record services in the care home and outline what policies and procedures should be undertaken
Hypoglycaemia and nutrition: common concerns for staff
Authors: Brown Katrina , Heeley-Creed Diane
Published: May 2014

Katrina Brown and Diane Heeley-Creed address the concerns expressed by staff of care homes who work with, and are responsible for, the management of people who have diabetes
Ensuring quality of life for people with severe dementia
Authors: Bate Helen
Published: May 2014

Helen Bate emphasises the importance of addressing basic needs of comfort and freedom from pain, but also the higher need of personal fulfilment and respect in care for people with late-stage dementia
Supporting the older person with oral hygiene
Authors: Johnson Richard , Quinn Barry
Published: May 2014

The wellbeing of older people can be improved and maintained through good oral hygiene and dental care. Richard Johnson and Barry Quinn provide practical advice on the use of supportive aids
Making music: promoting wellbeing for older people
Authors: Heathcote Julie
Published: May 2014

Musical activity is something that residents and staff can enjoy, which can impact on the ethos of the home. Julie Heathcote advises care homes on getting involved with local groups, organisations and projects
Service user safety: developing effective organisational processes
Authors: Dallinger Tim
Published: May 2014

Tim Dallinger explains how to use the Essential Standards to ensure the health and wellbeing of residents is maintained in the following areas: infection control, medication management, safety and suitability of premises, and safety and suitability of equipment
Plans for foundation-level dementia training
Authors: Learner Sue
Published: May 2014

The Government has announced plans to give over 100 000 staff training in dementia. The programme will enable staff to spot the early symptoms of the condition and provide appropriate care
Care and maintenance of gastrostomy site infections
Authors: Edwards-Jones Valerie , Leahy-Gilmartin Anne
Published: May 2014

Valerie Edwards-Jones and Anne Leahy-Gilmartin explain the procedure for percutaneous endoscopic gastrostomy and how nurses in care homes can identify, manage and treat infection
Older people and psoriasis: the use of emollient therapy
Authors: Van Onselen Julie
Published: May 2014

Good skin care will improve dry and scaly skin and enhance residents' comfort. Care staff should support residents with psoriasis by helping them use emollients daily for washing and moisturising where appropriate, as Julie Van Onselen explains
HSC 3048: Support individuals at the end of life—part 2
Authors: Green Danielle
Published: May 2014

This optional unit assesses the health and social care worker’s ability to provide support throughout end-of-life care. Danielle Green continues the second part of the series, highlighting the importance of advance care planning
Health and safety law: a view from the top
Authors: Bennett Andrew
Published: May 2014

Andrew Bennet discusses the wider remit of section 37 of the Health and Safety at Work etc Act 1974 instigated by the Court of Appeal and what implications this has for managers and directors in the care home sector
Water, water, everywhere and not a drop to drink?
Authors: Shepherd Alison Burton
Published: May 2014

Lack of fluid provision for older people can cause unnecessary suffering and loss of life. Alison Burton Shepherd provides guidance that can support care home staff and multidisciplinary teams to prevent, identify and treat dehydration
Facing the future: touchscreen technology for residents
Authors: Rudston Sarah
Published: May 2014

The internet provides a limitless resource of materials that can be called on instantly. Staff can use this technology to provide empowering activity sessions for individuals by enabling them to choose what they would like to see and do
Cultivating a positive relationship with the Care Quality Commission
Authors: Forret Tanya
Published: May 2014

Establishing a good working relationship with the Care Quality Commission (CQC) can make issues that do arise easier to resolve. However, managers should check that their rights are being respected, as Tanya Forret explains
The niqab in care settings—should it be banned?
Authors: Cook Allison
Published: May 2014

The niqab's place in British society is a subject which incites a great deal of public interest and debate. Allison Cook outlines the facts that organisations need to be aware of when forming workplace policies around this controversial issue
Using hormone therapy for the management of prostate cancer
Authors: Malik Sarah
Published: May 2014

Each year an estimated 40 000 men are diagnosed with prostate cancer in the UK. Sarah Malik discusses how many of these men will be treated conservatively with hormone therapy, and how the side effects can be managed to improve quality of life
Don't be afraid to plan ahead for end-of life care delivery
Authors: Sander Ruth
Published: May 2014

Staff must understand the difference between a general advance statement, advance decision to refuse life-saving treatment, and lasting power of attorney. In addition to legal issues, they should recognise how to support family, residents and colleagues
Constipation and the pros and cons of laxatives for older adults
Authors: Day Mary Rose , Wills Teresa , Coffey Alice
Published: May 2014

Constipation is a common problem and includes symptoms of straining, discomfort and difficulty in passing stool. Mary Rose Day, Teresa Wills and Alice Coffey discuss the advantages and disadvantages of laxatives to combat the condition
Understanding types of discrimination in the workplace
Authors: Thornicroft David
Published: May 2014

Equality and diversity is an important concept, but it is often difficult to translate it into practice in a health and social care setting. David Thornicroft offers some useful suggestions in this article