bluuebunny/crossref_metadata_2025 huggingface dataset:
Palliative care nursing in relation to people with intellectual disabilities
Authors: Read Sue , Thompson-Hill Jane
Published: May 2014

One of the most rewarding tasks a nurse can ever perform is to support someone at the end of their life, and appropriate care and support at this time should be available to all who need this regardless of personal circumstances. However, it is becoming increasingly evident that personal factors (i.e. where you live, poverty, social class, gender, sexuality, age, ethnicity, religion and disability) can all affect the nature and quality of the palliative care received, and certain marginalized populations are likely to be perceived as ‘disadvantaged dying’. People with intellectual disabilities are often regarded as a marginalized group, and never more so as when they are diagnosed with a life-limiting condition and as the end of life draws imminently closer. This article introduces the challenges faced by nurses caring for people with intellectual disabilities diagnosed with a life-limiting condition. The overall aim is to identify the inherent challenges involved so that they can be addressed from a practical perspective.
Improving the accuracy of medication history taking in a diabetic eye clinic
Authors: Tattersall Chris , Hartry Nicola , Ram AR Raghu
Published: May 2014

Aim: To assess whether the use of a pre-visit medication questionnaire combined with clinical interview improves the accuracy of medication history taking when compared with direct questioning only, for new patients attending a diabetic eye clinic.

Method: A service evaluation was undertaken using a retrospective case-control design. Fifty consecutive new patients visiting the clinic before a new pre-visit medication questionnaire was introduced were used as controls (group 1). New patients attending the clinic after the introduction of the questionnaire, who had been sent the questionnaire and completed it (group 2), were then matched to patients in group 1 over a 6-month period. The reported medication histories for both groups were then checked with the patients’ GP.

Results: Forty-two matched pairs were identified. There was no significant difference (P=0.71) between the number of medications prescribed in group 1 (mean=6.2; standard deviation [SD]=3.8) and group 2 (mean=6.5; SD=2.9). However, there was a highly significant difference in the number of errors in the stated medication lists between groups 1 and 2: this favoured group 2, who completed a preclinic questionnaire before attending the clinic.

Conclusion: The use of a pre-clinic questionnaire combined with clinical interview provides a significantly more accurate assessment of a patient’s current medication list than interview alone.
BOOK REVIEW
Authors: Barber Chris
Published: May 2014

If you were to ask a random sample of 100 ‘adult’ or general trained nurses what they know about autism and Asperger’s syndrome possibly about 10% would know enough about this neurological condition for this knowledge to positively benefi t their clinical practice. This means that 90% don’t.
Urinary tract stones: types, nursing care and treatment options
Authors: J Steggall Martin , Omara Maria
Published: May 2014

Stones (calculi) in the urinary tract (urolithiasis) or kidney (nephrolithiasis) occur in 5% of the population. The lifetime risk of passing a stone is 8–10%. Men are twice as likely to develop stones, with the first episode occurring before 30 years of age. Stones are caused by the aggregation of crystalline mineral deposits in the urine. Calcium stones are the most common type of stone. Investigations for stone disease include plain X-ray, X-ray with contrast media, ultrasound imaging, and computed tomographic (CT) scanning. Treatment of stones is dependent on the size and location, e.g. lithotripsy is used to break down stones in the ureter or kidney, whereas litholapaxy is used for stones in the bladder that are too large to be passed urethrally. Alpha-blocker medication (e.g. tamsulosin) can facilitate spontaneous passing of a stone. Nurses have a crucial role in assessment, management and provision of discharge advice for patients. Strategies for preventing stones include increasing the urine output (by giving 2–3 litres of fluid per day) and dietary modification, particularly reduction in animal protein and salt content.
Classifying and managing pretibial lacerations in older people
Authors: Beldon Pauline
Published: May 2014

As the population of older people increases it is likely there will be an associated increase in the numbers of patients presenting with pretibial lacerations to GP surgeries, accident and emergency departments and referred to community nurses. This will be due, in part, to the increasing frailty of the skin of the older person, as well as comorbidities, the number of which are also likely to increase with ageing. It is important that the older person with a pretibial laceration is treated promptly and appropriately to prevent complications and optimize healthcare resources.
Strategies for preventing peripheral intravenous cannula infection
Authors: Morris Wendy , Heong Tay Mooi
Published: May 2014

Peripheral intravenous (IV) cannulation is a procedure that involves breaching the integrity of the skin, exposing patients to the risk of infection. Acquisition of infection has associated costs both for patients and the NHS. The high number of peripheral IV cannulae (PICs) inserted annually has resulted in serious infection and significant morbidity (O’Grady et al, 2002). Risks associated with PIC infection must be addressed to reduce patient morbidity and increased cost of prolonged hospital admission and treatment. This article discusses the sources and routes of infection associated with peripheral IV cannulation, and examines healthcare management strategies for preventing infection when performing peripheral cannulation. These comprise: the Peripheral Venous Cannulation Policy, which empowers practitioners to challenge poor cannulation skills and standardize practice; education, which provides learning opportunities within programmes such as Infection Control Core Competencies Study Days, designed to promote infection prevention strategies directly related to cannula care and aimed at all levels of Trust staff; and the Peripheral Cannula Care Plan, which ensures accurate documentation of cannulation procedures. This last strategy is simple to use and provides a route for improving cannula-related documentation. A high standard of documentation will also assist audit, which is crucial to reducing PIC infection.
HIV among black African communities in the UK
Authors: Peate Ian
Published: May 2014

Nearly half of all black African individuals with HIV in the UK are diagnosed late (Health Protection Agency [HPA], 2008). As a result, this patient group is missing out on the benefits that come from early diagnosis and early commencement of treatment – such as increased life-expectancy and the avoidance of serious consequences for their long-term health.
C. difficile infection – a tool for improving practice and reducing rates
Authors: Aziz Ann-Marie , Murphy Pauline
Published: May 2014

Clostridium difficile infection (CDI) is a recognized health-care-acquired infection (HAI) and as such it is vital that hospitals do more to reduce the rates of infection. Patients, especially older people, become particularly susceptible to CDI after treatment with antibiotics. Mention of CDI on death certificates is increasing and surveillance, especially when accompanied by feedback to clinicians, has long been established as an effective tool to lower HAIs. In February 2008, a Manchester hospital began to pilot the Root Cause Analysis (RCA) tool for all patients confirmed with a CDI. After receiving feedback from clinicians on its appropriateness and suitability, the RCA tool was amended accordingly and then implemented into practice. The RCA tool has significantly improved practice and collaborative working – it has enhanced teamwork and ultimately reduced infection. This article examines how the tool was embedded in the Trust, how the change process has been managed and ultimately, how patient care has benefited as a result.
Mental health outcome measures in the age of recovery-based services
Authors: Dickens Geoff
Published: May 2014

Patient based outcomes tools such as Health of the Nation Outcome Scales can help users and providers to assess whether mental health services promote wellbeing, and can also inform research and clinical audit. With some exceptions, however, completion rates of routine outcomes ratings are poor, and some argue that current tools are not sufficiently service user-oriented. Concurrently, the recovery model as an approach to mental health care, emphasizing concepts such as hope, meaning and sense of self, has come to prominence. The emerging model creates a need to measure whether recovery-led services deliver positive outcomes. To answer this, it is necessary to first ask whether current routine outcomes tools are suitable measures of recovery-related concepts. This article examines the current state of outcomes measurement in UK mental health services in the age of the recovery model and proposes that a twin-track approach is required.
Infection control and IV therapy in patients with Clostridium difficile
Authors: Higginson Ray
Published: May 2014

Clostridium difficileis a spore-forming anaerobe belonging to the family Clostridium, with the bacteria being found in low numbers in approximately 5% of the healthy adult population. Together with meticillin-resistant Staphylococcus aureus, it is a major healthcare-associated infection and is responsible for considerable morbidity and mortality. Antibiotics administered to patients can alter normal gut flora, allowing the proliferation of C. difficileand causing antibiotic-associated diarrhoea and colitis. Such diarrhoea, if severe, can lead to dangerous dehydration and even hypovolaemia, especially in the elderly. To limit the physiological impact of diarrhoea, it is sometimes necessary to administer intravenous therapy. Although good clinical practice demands that infection control should be considered in all clinical situations, specific infection control procedures need to be adhered to when administering intravenous therapy to patients with C. difficile.
Development of an attrition risk prediction tool
Authors: Fowler John , Norrie Peter
Published: May 2014

Aim: To review lecturers’ and students’ perceptions of the factors that may lead to attrition from pre-registration nursing and midwifery programmes and to identify ways to reduce the impact of such factors on the student’s experience. Background: Comparable attrition rates for nursing and midwifery students across various universities are difficult to monitor accurately; however, estimates that there is approximately a 25% national attrition rate are not uncommon. The financial and human implications of this are significant and worthy of investigation. Method: A study was carried out in one medium-sized UK school of nursing and midwifery, aimed at identifying perceived factors associated with attrition and retention. Thirty-five lecturers were interviewed individually; 605 students completed a questionnaire, and of these, 10 were individually interviewed. Attrition data kept by the student service department were reviewed. Data were collected over an 18-month period in 2007–2008. Findings: Regression analysis of the student data identified eight significant predictors. Four of these were ‘positive’ factors in that they aided student retention and four were ‘negative’ in that they were associated with students’ thoughts of resigning. Conclusion: Student attrition and retention is multifactorial, and, as such, needs to be managed holistically. One aspect of this management could be an attrition risk prediction tool.
An exploration of burnout among city mental health nurses
Authors: Sherring Simon , Knight Denise
Published: May 2014

Aim: The aim of this research was to describe burnout among mental health nurses working in a city Trust and to develop an understanding of the variables involved in burnout for mental health nurses. Background: Mental health nursing is stressful and several authors have linked stress to burnout. Burnout results from high levels of occupational stress, and is characterized by: emotional exhaustion, depersonalization, and a perception of lack of personal accomplishment. There is a growing body of research regarding burnout among mental health nurses; however, there appears to be no research that considers UK mental health nurses working in cities. Methods: The study involved a questionnaire survey of all 475 mental health nurses working at a city NHS Trust. Data were collected in 2007. Results: A deeper understanding of burnout within the Trust was developed, with statistically significant relationships showing that nurses experiencing burnout were more likely to take sick leave and to be considering leaving their jobs or the NHS. Levels of burnout experienced were significantly related to academic qualifications, the frequency and adequacy of clinical supervision, feeling supported and valued at work and feeling involved in decision making and changes. Conclusion: The perceived quality and frequency of clinical supervision influences the level of burnout experienced. Nurses who have higher-level academic qualifications and who feel supported and valued at work have lower levels of burnout.
Studying + work = disaster
Authors: Castledine George
Published: May 2014

When Margaret recently took up her place on a nursing degree course at her local university, she calculated she would have to carry on doing some form of job to make ends meet. Margaret’s parents were already supporting her older brother through his degree, and it was not possible for the family to stretch their finances any further. So like many student nurses, Margaret took up a couple of part-time jobs; one as a barmaid in a local pub, the other as a cleaner.
A post-registration solution to the ‘bioscience problem’?
Authors: McVicar Andy
Published: May 2014

The forthcoming review of pre-registration nurse education (Nursing and Midwifery Council (NMC), 2008a) presents an opportunity to address an issue which has been contentious in nurse education for many years – the ‘bioscience problem'.
Barriers to effective pain management in sickle cell disease
Authors: Wright Kerri , Adeosun Omolola
Published: May 2014

Sickle cell disease (SCD) is a long-term condition that would benefit from a long-term conditions approach to its care and management. SCD is growing in prevalence, affecting 10 000–12 000 people in the UK, with SCD sufferers having an increased life expectancy from in the past. The most problematic aspect of managing SCD is management of the pain from vaso-occlusive crises. Vasoocclusive pain is the most common reason for hospital admissions in people with SCD and accounts for large numbers of accident and emergency (A&E) attendances. A literature review was carried out to examine the management of vaso-occlusive pain in SCD. The review identified three main barriers to effective pain management in SCD: the manifestation of vaso-occlusive pain, the sociocultural factors affecting pain assessment, and the concerns regarding addiction and pseudo-addiction. Addressing these barriers will allow people with SCD to have their pain managed more effectively, improve their quality of life and potentially reduce A&E attendances and admissions to hospital.
Introduction to skin cancer nursing
Authors: Godsell Gillian
Published: May 2014

The incidence of skin cancer continues to increase annually and it is the most common cancer in the UK with over 100,000 cases each year. The treatment of skin cancer can involve many different disciplines including dermatology, plastic surgery, oncology, radiotherapy, ENT and maxillofacial and involves both adult and paediatric services in primary and secondary care. This article considers the many duties of a skin cancer clinical nurse specialist, and the increasing pressure such nurses are under. The skin cancer nurse specialist must liaise and work with the many different departments, and will be involved in the care of the patient with skin cancer from diagnosis throughout the pathway to discharge or death.
The ethics of conducting research with mental health service users
Authors: Keogh Brian , Daly Louise
Published: May 2014

There is a growing emphasis on conducting research that represents the voices of mental health service users in relation to their experiences of and desires for health care. However, this type of research may sometimes be complicated, as mental health users are frequently identified as a vulnerable research participant population. The aims of this article are to firstly highlight some of the main ethical issues that researchers encounter when carrying out research with people who use the mental health services and secondly to identify strategies that can be used to address these issues. The authors draw on their personal experiences of conducting this type of research. While of general relevance, this article is particularly designed to provide guidance to researchers conducting qualitative studies.
Informed consent and the rise of autonomy
Authors: Miola José
Published: May 2014

Although the need for informed consent to medical treatment should be familiar to health-care professionals, the detail regarding what needs to be disclosed to the patient is less well known and even unclear. This article describes the legal requirements for informed consent, and briefly charts the development of the law over the past 25 years. It highlights the fact that the law has changed considerably, and demonstrates that this judicial activism has been as a result of an increasing prioritization of the concept of patient autonomy. It also shows that, on occasion, the courts are prepared to modify the law in order to protect what they see as the underlying principles behind it.
The experience of faecal leakage among ileostomists
Authors: Redmond Caroline , Cowin Caroline , Parker Theresa
Published: May 2014

This study is a report identifying actual and potential faecal leakage problems among ileostomists in relation to the use of different types of stoma appliances and accessories. A descriptive survey was conducted among 1035 respondents with an ileostomy. Fieldwork took place between August 2008 and September 2008. A structured questionnaire was mailed and returned by participants. This article offers a report of the findings, exploring the plight of the ileostomist in relation to the incidence and management of faecal leakage.
Alzheimer’s and the NHS
Authors: Hunt Neil
Published: May 2014

Is hospital really the best place for those with dementia? We need to see some big changes says Neil Hunt, Chief Executive of Alzheimer’s Society.
Acne management and patient support – a nursing concern for all
Authors: Van Onselen Julie
Published: May 2014

Acne is one the most common skin diseases in the UK, affecting not only teenagers, but people of all ages. Acne can cause immense psychological distress and greatly affects people’s lives and wellbeing. However, acne is entirely treatable; early effective treatment of mild and moderate acne can often prevent severe acne and scarring, which can be irreversible. Nurses should be concerned and address the needs of patients with acne, providing advice on management, treatment and psychological support. This article outlines the principles of acne management and identifies how nurses can support acne sufferers in their clinical practice.
Improving the experience of deaf students in higher education
Authors: Noble Helen
Published: May 2014

This article identifies and critically analyses the difficulties faced by deaf students studying in higher education settings and the potential support that they require. Deaf students face significant barriers in gaining access to information and learning in the classroom. At the same time, the number of such students attending universities and colleges has increased dramatically over the past 20 years. Little known about the potential solutions to these problems, and there is a dearth of research on the effectiveness of support services made available, including interpreting, note-taking, real-time captioning (a written rendering of the dialogue spoken, in the same language) and tutoring, particularly when attempting to take into account the impact of such support on academic achievement. The role of motivation is discussed alongside barriers and levers to education in this group. The role of the lecturer in supporting these students is explored
The Guild of Nursing: for nurses committed to caring
Authors: Castledine George
Published: May 2014

There is no doubt that, over the years, the education and general welfare of nurses and nursing care delivered to patients has improved as a direct result of various nursing organizations. The BJN has played its part in the past (see the regular history sections in the journal), not only by helping national groups to get started and publicize their aims and objectives, but also by being a voice for the International Council of Nursing (ICN). In continuing that role, the BJN is supporting the development of the ‘Guild of Nursing’, whose aims are outlined below. We think the Guild is a good cause as it is trying to develop a more positive response to some of the difficulties and scandals that have occurred in health care in the UK. It will also help to develop a grater awareness of nursing and the nurse’s role
Intravenous enzyme replacement therapy: hospital vs home
Authors: Parini Rossella , Pozzi Katia , Di Mauro Stefania , Furlan Francesca , Rigoldi Miriam
Published: May 2014

Two surveys were carried out to establish the status of enzyme replacement therapy (ERT) for lysosomal storage diseases in Italy. The first was a national survey covering the regional reference centres (RRCs) for these diseases; replies disclosed that 57.7% of patients are on ERT, administered almost exclusively in hospital settings (local hospital 60.7%, RRC 34.8%, home 2.6%); Italian health service procedures do not support ERT at home. The second survey was a regional survey in Lombardy, involving 48 patients (six of whom were on ERT at home). According to 40% of the patients, hospital?based ERT is disruptive, causing loss of days at school/ work, stress and family issues. The patients on home therapy did not have these problems. However, 93% of patients receiving ERT in hospital perceived the advantages of greater safety, closer monitoring and more support from health professionals and experts. A total of 55% were willing to receive ERT at home, but 33% were against it. This may be the result of a lack of experience with ERT at home in Italy, or because of different opinions between family members and physicians. As international experience shows that ERT at home saves healthcare resources and improves quality of life, the issue should be raised with Italian healthcare policy makers, who should ensure nursing support for home-based ERT
Time to learn: understanding patient-centred care
Authors: Pelzang Rinchen
Published: May 2014

This article is a literature review of the definition, models and methods of implementation of patient-centred care (PCC). Modern healthcare systems are rapidly changing to adopt a more patientcentred approach to care. However, the implementation of PCC can be hampered by the lack of a clear definition and methods of measurement. It is increasingly important for healthcare providers to understand the core elements of PCC. This article examines the literature to carry out a concept analysis of PCC, including definition, concepts and theoretical perspectives
Oil on troubled waters: emollients and eczema
Authors: Voegeli David
Published: May 2014

While most of us will have suffered from episodes of dry skin (xerosis) at some stage in our lives, this is usually confined to the occasional mildly annoying episode. However, for others, particularly those with eczema, this forms part of a chronic, very distressing situation that often has a significant impact on their quality of life. Despite the fact that many children and adults have eczema, it is still often considered to be a minor skin condition that children will ‘grow out of ’. However, an increased research focus towards examining the impact of eczema on the individual has shown that eczema is anything but a minor problem. There is evidence that eczema can decrease overall quality of life by interfering with achievement in school, influencing or limiting career choices, affects social adjustment, and influences friends and choice of partners. A more recent UK study exploring quality of life in children with chronic diseases showed that the chronic skin disorders (atopic eczema and psoriasis) had the greatest impact on quality of life, with only cerebral palsy scoring higher than atopic eczema (Beattie and Lewis-Jones, 2006)
Nursing considerations in patients with vaginitis
Authors: Holloway Debra
Published: May 2014

Vaginitis is defined as an inflammation of the vagina. It can result in symptoms of any or all of the following: discharge, itching and pain, and often irritation or infection of the vulva. There is no specific cause for vaginitis, and many other conditions can cause the symptoms. Vaginitis is a distressing condition that affects many women of reproductive age and beyond, and encompasses candidiasis (also known as thrush), bacterial vaginosis, and trichomoniasis. It can occur in a single episode, or recur throughout a woman’s lifetime. Some women will seek medical help, but many more self-treat with over-the-counter medications, suspecting the reoccurrence of Candida in particular. This article aims to explore the causes, signs and symptoms, and treatments of vaginitis to provide nurses with the necessary background information to feel more confident in dealing with women’s health issues
Vaginal thrush: quality of life and treatments
Authors: Powell Karen
Published: May 2014

Vulvovaginal candidiasis, or vaginal thrush, is a common yeast infection experienced by three out of four women at some point in their lives. Females who experience recurrent symptoms of thrush may resort to buying products over-the-counter and will often fail to seek professional help. The symptoms of thrush can impact greatly on the quality of life of the woman, and can lead to depression and sexual problems with partners.
Home enteral tube feeding in older people: consideration of the issues
Authors: Hitchings Helen , Best Carolyn , Steed Imogen
Published: May 2014

The demand for acute medical services for older people has risen in recent years and increasing numbers of older people are having enteral feeding tubes placed to ensure they receive appropriate levels of nutrition and fluid safely once oral diet becomes unsafe or insufficient. However, their care may be complicated by cognitive or functional deterioration as a result of comorbidities and polypharmacy. Consequently, providing enteral tube feeding in the community, once the patient is discharged from hospital, may not be straightforward. There are a number of benefits to providing enteral feeding at home; however, problems will arise if appropriate training and aftercare are not provided. This article will address some of the issues that arise when patients who require home enteral feeding are discharged from hospital into their own homes, or into a care home, and examines the knowledge that is required to enable the patient and/or carer to safely manage the feeding tube and feeding regimen, and addresses some of the more common problems that may arise.
An examination of the relationship between breakfast, weight and shape
Authors: Ashwell Margaret
Published: May 2014

In recent years, the number of people described as being either overweight and obese has increased dramatically, and especially among children. Breakfast has long been recommended as part of a healthy diet and, for some time, evidence has been accumulating that people who eat breakfast regularly are slimmer than those who skip breakfast. This article examines the supporting evidence for this claim, in both adults and children, and discusses the importance of a healthy diet and plenty of exercise, as well as methods the nurse can use to help patients remain aware of their shape and weight.
A perspective on changing dynamics in nursing over the past 20 years
Authors: Anderson Beverley
Published: May 2014

The quest to provide individuals with good quality health care has been a long-term goal in which the contribution of health professionals, specifically nurses, has been vital. However, over the years ever-increasing demands from both the government and the general public for higher levels of performance, combined with problems associated with the long-standing issue of staff shortages, and the constant drive for cost-effectiveness, has meant achieving this objective has become more difficult
The mental health of men and boys: an overview
Authors: Peate Ian
Published: May 2014

This article provides insight and understanding into important issues of which nurses need to be aware when caring for men and boys with regard to their mental health. Inequalities in health care are discussed, and suggestions made concerning how all nurses can help redress these inequalities. The mental health of men and boys concerns all nurses; not just those working in mental health settings. The article focuses on a recent review published by the Men’s Health Forum (Wilkins, 2010), and considers a number of gender-specific mental health issues that affect the health and wellbeing of men and boys. The role of the nurse is to protect and promote the health of people in their care and this article makes clear that this extends to and includes the mental health of men and boys. Labelling people and categorizing them into homogenous groups is not often helpful or strategically wise; this article does not wish to categorize, but merely attempts to explain
Experience of overseas nurses: the potential for misunderstanding
Authors: Okougha Mercy , Tilki Mary
Published: May 2014

This article describes the findings of a study about the experiences of nurses recruited from Ghana and the Philippines by a London NHS Trust. The findings report on issues that have the potential to affect care as well as relationships with patients, families and clinical colleagues. Not surprisingly, the research reported communication difficulties. It particularly highlights how customs and conventions such as the use of first names or ‘please’ and ‘thank you’ can be misinterpreted. It identifies significant ethnocentricity and judgmental attitudes about family care that could create tension and misunderstanding between nurses and family carers. The article highlights cultural attitudes to death and dying, which are likely to be misinterpreted by overseas and local nurses alike. The authors acknowledge the importance of professional skills and clinical safety and reiterate the need for induction, training and mentorship for overseas nurses. They also argue for a shift of focus from the newcomers and highlight the importance of preparing mentors and colleagues to facilitate effective adaptation through cultural awareness, knowledge and sensitivity.
Glaucoma expert patient programme and ocular hypotensive treatment
Authors: Amro Raed , Cox Carol L , Waddington Kathryn , Siriwardena Dilani
Published: May 2014

Expert patient programmes (EPPs) are becoming an increasingly important aspect of chronic disease management, resulting in improved health outcomes for patients. Patients with chronic open angle glaucoma (COAG) require lifelong therapy. However, to date, no EPPs have been designed specifically for patients with chronic eye conditions like COAG. This article describes the development and implementation of the Glaucoma Expert Patient Programme (GEPP), a glaucoma-specific educational self-management programme which aims to improve glaucoma patients’ knowledge, self-management skills, expectations and adherence to treatment. A review of theoretical frameworks and models which underpin the design, use and conduct of EPPs was undertaken, and the GEPP was designed based on the model by Kate Lorig (2003). The result is an educational programme which offers COAG patients a different perspective on their condition and supports them with knowledge, skills and strategies to better manage their condition on a daily basis
Are international nursing students disadvantaged by UK patients?
Authors: De Diana
Published: May 2014

International students bring billions of pounds annually to the UK through higher education. Although nursing students may not contribute as significantly in monetary terms as traditional graduate and postgraduate learners, they do, however, bring with them other benefits in terms of wealth of experience, diversity and cultural capital, often looking after client groups sometimes marginalized by mainstream society. The reality is that many nursing homes and care homes simply would not function without internationally recruited nurses contributing to our health service and the wellbeing of society. The author of this article is a module manager for a Nursing and Midwifery Council regulated Overseas Nurses Programme, which runs up to four times per year at a large Faculty of Health, Sports and Science in South Wales. Anecdotal evidence from class disclosures by international nursing students provided the rationale for this independent enquiry. Listening to verbal accounts suggested that internationally-recruited nurses were experiencing episodes of ‘unfair treatment’ by patients under their care when undertaking the clinical practice component of the programme.
Caring for peristomal skin: what every nurse should know
Authors: Burch Jennie
Published: May 2014

Stomas are encountered by most nurses. The three types of ostomates (people with a stoma) to be discussed in this article are those with a colostomy, ileostomy and/or urostomy. One of the more common problems associated with ostomates is sore peristomal skin (skin around the stoma). This article will focus on several issues related to sore peristomal skin, including contact irritant dermatitis, parastomal hernias and skin infections. The probable causes and treatment options for the skin problems will be explored. Treatment includes a range of therapies from re-educating ostomates on their stoma care technique to the use of stoma accessories, such as a skin protector, paste or seals.
Transforming higher education and the professional preparation of nurses
Authors: Sturgeon David
Published: May 2014

Since the early 1990s, nurse education in the UK has been directly influenced by Department of Health policy and by the structure and management of higher education. Market forces, consumer values, increasing demand for quality and accountability, and technological advances have influenced the academic landscape and the provision for nurse education within it. Despite the recent Government confirmation that new nurses will all be educated to degree level from 2013, the future direction of nursing, and nurse education, is still far from certain. The Government proposes significant change to the higher educational sector in order to enhance employer engagement. Foundation degrees are an integral component of the Government’s policy for developing the vocational skills and for widening participation in higher education. As a result of this, and other policy initiatives, it is likely that a smaller supply of graduate nurses will provide future leadership and supervision in the delivery of nursing. It is also likely that there will be greater demand for postgraduate-level education for registered nurses.
In sickness and in health: experience of caring for a spouse with MS
Authors: Mutch Kerry
Published: May 2014

Background People are not expected to die from multiple sclerosis although, as the condition progresses over a period of time, some people become increasingly disabled and will require assistance with all activities of daily living. Their partners invariably carry out these tasks. Objective To gain a deeper understanding of the experiences of the partner living with and caring for a spouse disabled by multiple sclerosis. Methodology In a qualitative study, eight partners who live and care for a person with multiple sclerosis were interviewed using a semi-structured questionnaire to explore their experience of their role. Results The interview transcripts were analyzed using a thematic framework approach. Codes, themes and five categories were identified, which were worry, planning, frustrations, commitment to marriage and coping strategies. These categories were examined using quotes from the transcripts as evidence. Conclusion This qualitative study identified that these couples had been married for at least 20 years before disability of the spouse significantly affected their lifestyle. Partners felt obliged to continue in their caring role due to a sense of duty and commitment of marriage. Partners felt a sense of loss as they prioritized the health and needs of their spouse above their own and, finally, partners lost their identity as husband/wife as they were called ‘the carer’. Partners felt out of control due to the unpredictable and progressive nature of MS and because it consumed their life 24 hours every day. Partners often felt guilty at not being satisfied with their life and wanting some independence
The burning issue of injury in Ireland: Part 1
Authors: Kelly Jacinta , Evans Lia
Published: May 2014

Intentional and non intentional injury is a major global public health concern. Traditionally, injuries have been regarded as random, unavoidable ‘accidents’. However, within the last few decades a better understanding of the nature of injuries has changed these old attitudes, and today both unintentional and intentional injuries are viewed as largely preventable events. Burn injuries are of special importance in the field of injury prevention. On average, 82 people die in Ireland each year from fire and burns. However, burn injuries have known causes and can be prevented and controlled. In order to prevent burn injuries it is important to understand the aetiology and epidemiology of burn injuries. The aim of this 3 part series of articles is to provide an overview of burn injury care where this first article focuses on current epidemiology, aetiology and burn injury prevention strategies.
Bowel and bladder care at the end of life
Authors: Kyle Gaye
Published: May 2014

This article discusses the management of end of life continence care under the headings of four end of life core competencies. Management modalities are identified and explored within the context of evidence based practice
The consultant nurse — expert practitioner and so much more
Authors: Mitchell Theresa , Williams Carole Butler , Easton Karen , Ingledew Ian , Parkin Donna , Wade Sharon , Warner Richard
Published: May 2014

The consultant nurse (CN) role is usually described in terms of four domains devised by the Department of Health — clinical practice, education and training, leadership, and research and service development. This study set out to explicate the diversity and complexity of CN roles in a NHS Trust; to describe aspects of extraordinary practice and to identify perceived differences between this role and other advanced practice roles. Accounts were written by six CNs and subjected to concept mapping to facilitate identification of extraordinary practice. Four themes emerged: entrepreneurial activity and innovation; clinical autonomy and role dynamism; influential national and international research conduct; consultancy and education across discipline boundaries. These included descriptions of higher order skills that surpass usual requirements of ‘expert’ or ‘advanced’ practice. Comparisons with other advanced practice roles are drawn from the literature and data collected in this study. Differences between the roles have implications for sustainability.
Volunteers: your health and social services need you
Authors: Glasper Alan
Published: May 2014

Professor Alan Glasper examines the Department of Health’s recent policy to promote volunteering, and raise the profiles of health and social care volunteers - our heroes
Documented adherence to standards and guidelines: an audit
Authors: Bhardwaj Rashmi , Pickard Robert , Rees Jackie
Published: May 2014

The authors conducted a cross-sectional audit within Newcastle-upon-Tyne Hospitals NHS Foundation Trust to determine the prevalence of urethral catheterisation and documented adherence to relevant NHS standards. An on-line audit questionnaire was completed for all 80 inpatient wards within the Trust on a single day during the third week in June 2009. The tool collected data on prevalence and care requirements detailed in the Department of Health’s (DH) Saving Lives High Impact Intervention 6 (2007). Data were analysed using Snap survey software. Overall, 172 of 1187 (14.5%) inpatients were catheterized and all were using a closed drainage system or catheter valve. Evidence of correct continuing catheter care was documented for 168 (98%) patients, while details of catheter insertion were identified in 153 (89%) patient records. Eight (4.5%) patients were being treated for a urinary tract infection. The authors found satisfactory adherence to basic documentation standards with regard to catheter care. This was associated with a low prevalence rate of catheterization and catheter-associated urinary infection within the Trust relative to previously published figures. Details of catheter insertion were missing from 10% of patient records, requiring further development of accessible and transferable documentation tools. Provision of relevant information to patients is also a target for development.
Supporting self and others: from staff nurse to nurse consultant. Part 2: Learning from experience
Authors: Fowler John
Published: May 2014

This series of articles explores various ways of supporting staff who work in the fast-moving and ever-changing health service. In the first article, John Fowler, an experienced nursing lecturer, author and consultant examined the importance of developing a supportive working culture. Here in the second part of the series, he looks at the supportive effects of learning from experience.
Perceptions of a clinical psychology support group for spinal injury
Authors: Fleming Pete , King Lorraine , Royle Jane
Published: May 2014

Background:

A service evaluation was performed exploring nurses' perceptions of a clinical psychology facilitated peer support group in a spinal injury rehabilitation setting.

Aims:

To determine whether staff found the meetings useful while, more broadly, to highlight the need to support and supervise nursing staff in psychological care appropriately.

Method:

A questionnaire was developed and distributed to the 30 members of staff who worked on the ward. Seventeen questionnaires were returned (57%). Data was analysed using thematic analysis.

Results:

The meetings were viewed as a place to discuss issues, and a safe protected space to share stresses. Staff felt the meetings aided team cohesion and helped them share ideas and draw up clinical strategies. Meetings aided stress management and confidence building. Staff considered the meetings to increase their psychological awareness and understanding.

Conclusion:

Staff involved in the acute care and rehabilitation of spinal injured patients are consistently exposed to highly demanding and stressful clinical environments. Support meetings where staff can discuss patient and ward issues are invaluable. Other clinical nursing areas would benefit from similar support systems.
Writing for publication made easy for nurses: an evaluation
Authors: Richardson Annette , Carrick-Sen Debbie
Published: May 2014

Aim:

The purpose of the project was to encourage and support nurses to write papers for publication in a peer-reviewed journal.

Background:

Writing for publication is an important nursing role as it is a means of communicating knowledge, skills and experiences to improve patient outcomes. Despite the importance, nurses have limited confidence and experiences with publishing nursing developments.

Methods:

A comprehensive development programme was designed to provide direction and leadership on how to write for publication. Fifty participants attended the programme and it was led and supported by two experienced facilitators.

Results:

A multi- method approach to evaluation was undertaken including attendance, an evaluation questionnaire, a focus group and a review of writing outcomes. By one year from commencement of programme, 25% had submitted a paper for peer review publication. The programme created and sustained motivation to write and participants valued the taught focused sessions as well as the unstructured group discussion sessions.

Conclusion:

The writing for publication programme for nurses, midwives and allied health professionals was successful.
Travel health: routine, recommended and required vaccines
Authors: Wong Claire , Simons Hilary
Published: May 2014

Vaccines are an important public health measure and may be the prompt for travellers to attend for pre-travel health advice. Nurses involved in the provision of travel health advice require a sound knowledge of available vaccines together with the diseases they prevent and other risk management strategies. Travel vaccines should always be administered following a travel health consultation and risk assessment, taking into account the informed choice of the traveller. This paper discusses vaccine preventable disease in the context of travel health, and the appropriate use of routine, recommended and required pre-travel vaccines, which can be considered following individual risk assessment.
Sexual dysfunction in rheumatoid arthritis: a hot but sensitive issue
Authors: Palmer Deborah , El Miedany Yasser
Published: May 2014

Rheumatoid arthritis (RA) has considerable personal impact for sufferers and their families. Those with RA suffer from pain, restricted joint movements, and fatigue, and can have problems with self-esteem and body image. It is also possible that medication causes sexual problems. Research on the subject is limited, and shows a divergent picture. Assessment for sexual dysfunction in clinical practice might be another hurdle, as patients and health professionals are reluctant to discuss this issue face to face. The aim of the work carried out and described in this article was to study the possibility of implementing sexual dysfunction assessment into standard rheumatology clinical practice. Results revealed that the multidimensional patient-reported outcome measures questionnaire offered the opportunity to assess the disease activity parameters, functional disability, quality of life, sexual dysfunction, and self-helplessness in one format. The patients appeared willing to complete questionnaires and this may be an acceptable tool for assessment. Improving patient education, as well as nurse-patient communication, through discussions about available options may minimize patients' feelings of isolation in addressing the problem and could help compensate for negative effects resulting from the disease.
Nutrition: safe practice in adult enteral tube feeding
Authors: Fletcher Jane
Published: May 2014

The use of enteral feeding tubes, such as nasogastric and gastrostomy tubes, to support a patient's nutritional intake is generally considered to be safe and effective. However, recent alerts and recommendations from the National Patient Safety Agency (NPSA) regarding enteral feeding have led health professionals to review their practice and guidelines. This article explores safe practice in enteral tube feeding in the light of three NPSA alerts: Promoting safer measurement and administration of liquid medicines via oral and other enteral routes (2007), Early detection of complications after gastrostomy (2010) and Reducing the harm caused by misplaced nasogastric tubes in adults and children (2011).