bluuebunny/crossref_metadata_2025 huggingface dataset:
Moving forward through collaboration
Authors: Young Trudie
Published: May 2014

November is now upon us, and with it comes the annual tissue viability exodus to Wounds UK in Harrogate, which will hopefully provide us with a platform upon which to share good practice and a springboard for further development of the specialty.
Does moist wound healing influence the rate of infection?
Authors: Slater Maggie
Published: May 2014

Background: Wound infections account for 9% of all healthcareassociated infection. Traditional wound dressings have been shown to give limited protection against microbes in comparison with modern dressings, yet they remain the main dressings of choice. While modern dressings facilitate a moist wound healing environment, which may increase the rate of healing, there is growing concern that it will increase the rate of infection. Aim: To review the evidence relating to moist wound healing and its influence on infection rates. Method: Fourteen studies were reviewed from 36 studies found. Methodological issues identified included: differences in the measurement of wound infection, small sample groups, inappropriate dressing selection and limited comparability between studies. Conclusion: The rate of wound infection was not increased with the use of modern dressings when compared with traditional dressings. No statistical significance was found to suggest there were fewer infections under the modern dressings. The barrier effect of some dressings cannot be generalized to include all modern dressings.
Review of 2008 and hopes for the future
Authors: Castledine George
Published: May 2014

It is the time of year when we look back in reflection, and look forward at the new year. Inevitably the plight of the economy makes us all nervous, as there is emphasis both on the economics of the health service and the relationship between politics and health care. There may be some noticeable effects on our patients, particularly the old and the poor. With that in mind, the next stage of Lord Darzi’s Review of the health service came out this July (Department of Health [DH], 2008a), placing nursing at the heart of the health service. It included measures to improve access and quality of care, to ensure the improvement of continuing education, and brought in the end of targets – instead focusing on the importance of care. It is to be hoped that such measures will give nurses the time they crave for to nurse their patients. Lack of such time is one of the biggest complaints coming from nurses and relates directly to the quality of care the patient receives.
Evidence-based management of childhood atopic eczema
Authors: Carr Julie D
Published: May 2014

Atopic eczema often develops during infancy and can have a significant impact on patients’ quality of life. However, despite this the condition is often not taken seriously by health-care professionals. Atopic eczema is also a widespread problem, affecting as many as 15–20% of children in Britain. The incidence of atopic eczema has risen over the last few decades and genetic factors are no longer thought to be the only aetiological factor – it is now postulated that environmental may also play a part in the development of the condition. Recent research highlights how a defective skin barrier can be a significant issue for atopic skin. This article looks at how atopic eczema affects the quality of life of patients and details the management techniques that are available.
Creating innovation in lymphoedema nursing through collaboration
Authors: Davies Rhian , Jones June
Published: May 2014

Against a background of fiscal and regulatory pressure to rationalize and justify health-care interventions, there is an underlying political message that greater cooperation and collaboration would improve health-care for all. This article uses the specialism of lymphoedema to illustrate the developments and improvements in care which can be achieved by harnessing the knowledge and skills of the multi-disciplinary team, and those people with vision, who are prepared to innovate to improve patient care. The article argues that it is the experienced specialist who advances care both by innovation and by working to achieve consensus, which can then guide the less experienced generalist. Using specific examples of published research drawn from other specialities – leg ulcer management, varicose vein treatment and dermatology – the article shows how this supports the practice of lymphoedema practitioners.
Nurses need whistleblowing guidance
Authors: Karstadt Lyn
Published: May 2014

The removal of Margaret Haywood from the nursing register has provoked a range of reactions, but few go beyond considering whether the decision was suitable, or too harsh. Lyn Karstadt explains how the decision directly relates to the NMC’s Code of Conduct, and discusses whether the Code must be stringently abided by, or whether exceptions should be made.
Providing an alternative to zero tolerance policies
Authors: Paniagua Hilary , Bond Patricia , Thompson Andy
Published: May 2014

Until recently, workplace violence and aggression in health care had received little attention. Today, however, there are concerns about growing levels of violence towards health-care workers and in particular nurses. The government is now steadfast in tackling workplace violence and helping NHS staff to apply a zero tolerance approach to reduce risk and ensure the welfare of their employees? This article highlights the issues regarding the application of zero tolerance policies and principles to practice. It looks specifically at the consequences of excluding patients from primary care services and in particular at a scheme that has been set up by one general practice to provide an alternative GP service for patients within the Heart of Birmingham Teaching Primary Care Trust. Initial evaluation of this initiative indicates that patients are being successfully rehabilitated back into the community and suggests that further research is urgently needed to draw conclusions about this project, as well as similar health care services that endeavour to prevent and deal with unacceptable and aggressive behaviour in the workplace.
The accurate diagnosis and treatment of lipodermatosclerosis
Authors: Nazarko Linda
Published: May 2014

Patients attending hospital expect to receive effective evidence-based treatment that improves health and minimises the risk of harm. Clinicians working in acute hospitals are often under pressured to treat people quickly and in such circumstances, some conditions can be misdiagnosed and inappropriately treated. This article uses a case study approach to illustrate the important differences in clinical presentation and treatment of acute and chronic lipodermatosclerosis and cellulitis. It also highlights the importance of clinicians receiving ongoing education so that they can improve their knowledge and provide appropriate care for older people. The article also recommends that national guidelines are developed to enable clinicians to differentiate between infective disorders such as cellulitis and venous disorders so that patients receive prompt effective evidence-based treatment.
Negligence and the legal standard of care: what is ‘reasonable’ conduct?
Authors: Miola José
Published: May 2014

Medical negligence has become a big issue for medical practitioners. Fear of the law, and of litigation, has led to claims of defensive medical practice among doctors and nurses. At the heart of this lies the legal definition of the standard of care, where the law seeks to determine when conduct is ‘reasonable’ (and thus not negligent), or ‘unreasonable’ (and thus a breach of the legal duty of care and potentially negligent). In this article the author clarifies what the law means by ‘reasonableness’ with respect to nurses, drawing on both the law and the NMC Code. Furthermore, the article shall demonstrate that the law is not something to be fearful of but, rather, demands a standard no higher than that of the NMC
Six-point plan could help fast track cancer patients
Authors: Thompson Deborah
Published: May 2014

A new report launched in June by the NHS Institute for Innovation and Improvement will provide hospital teams with guidance on how to improve the management of emergency patients with suspected cancer, and provide more consistent, responsive and timely care. The timing of the report is particularly important in the context of the Prime Minister’s renewed commitment this month to improving access to cancer services.
Meeting the challenges of swine flu
Authors: Karstadt Lyn
Published: May 2014

Swine flu presents a variety of challenges to the nursing profession, but may raise particular concerns for nursing students and those involved with teaching. Lyn Karstadt discusses these issues, and considers what would be an appropriate approach to dealing with swine flu in educational establishments.
Covert medication in older adults who lack decision-making capacity
Authors: Tweddle Frances
Published: May 2014

Any mentally competent adult has the right to give or refuse consent to treatment or nursing intervention. The ethical principle underpinning this free choice is respect for autonomy, and the nurse’s professional duty to respect the decision of the patient is enshrined within the NMC’s Code of Conduct (NMC, 2008). Capacity is paramount to consent and problems arise in practice when the patient is deemed to lack capacity. In this instance, the provisions of the code of practice of the Mental Capacity Act apply (2005). The aim of this article is to present the issues that arise when patients lack decision-making capacity, especially in relation to older adults with dementia who lack the capacity to consent to medication, as well as the covert administration of medication. In relation to consent and covert administration, the nurse is required to balance respect for the patient’s autonomy with their desire to act beneficently and in a non-maleficent manner and emphasis will be given to these underlying ethical principles throughout the article.
Preparing new graduate nurses
Authors: Karstadt Lyn
Published: May 2014

As a requirement of pre-registration nurse education, student nurses must spend roughly 50% of their course, around 2300 hours, on clinical practice on hospital wards to become registered nurses. Lyn Karstadt discusses some of the international attitudes towards clinical placement, and asks whether placement time should be decreased in the UK.
Linking education and practice
Authors: Castledine George
Published: May 2014

The best model for educating nurses has always been a close link to practice. How close this link should be and how much time in practice, is still a question on which professional opinion varies. Just over 100 years ago, many nurses were trained without attending any formal lectures or schooling of any type. The number of years in training also varied widely, and all hospitals created and set their own standards of education. In the BJN3 July 1909 issue, it was reported that, ‘Slowly the large training schools are getting into line in regard to the preliminary training of probationers’ (new recruits). The first to establish a preliminary course was the Royal Infirmary, Glasgow, followed by the Leicester Infirmary, Guy’s Hospital, the Royal Infirmary, Bristol, and St Thomas’s Hospital, London.
Student bursary shake-up
Authors: Karstadt Lyn
Published: May 2014

The Department of Health launched its consultation on the future of funding for healthcare students. Lyn Karstadt discusses how the consultation should see an end to the long-running disparity between nursing diploma students, who receive non-means-tested bursaries, and nursing degree students, who are means-tested.
Managing bladder dysfunction using intermittent self-catheterization
Authors: Nazarko Linda
Published: May 2014

When an individual is unable to empty the bladder fully they are at risk of developing long-term bladder and renal damage. Urinary catheterization may be required if other treatments fail to resolve the problem. Urinary catheters can be indwelling or intermittent. Intermittent catheterization (IC) can be performed by healthcare professionals or carers. Intermittent self-catheterization (ISC) is performed by the person with bladder dysfunction and is considered to be the ‘gold standard’ in managing bladder dysfunction. ISC can spare the individual the unpleasantness of an indwelling catheter and drainage bags. It can enable the person to take control of bladder management, improves quality of life, reduces the risk of infection and preserves renal and bladder function. ISC can transform the lives of people who are who have an appropriate bladder capacity, dexterity and are well motivated.
Inward labour mobility in the Irish health- and social-care sector
Authors: Ryan Denis
Published: May 2014

In an effort to understand the factors that impinge on labour mobility in the health- and social-care sector in Ireland, an exploratory study was undertaken. This study involved key organizational stakeholders and individual practitioners in the health- and social-care environment. A qualitative design using purposive sampling was employed, involving face-to-face and telephone, semi-structured interviews. Four interviews were undertaken with representatives from the Irish Nurses’ Organization, the Health Services Executive, the Department of Health and Children, and the Association of Social Workers. Interviews were also undertaken with five health-care professionals who had relocated to Ireland. Notes were taken during all the interviews, and respondents were then sent copies of the transcripts to verify accuracy. Data analysis was guided by Burnard’s (1991) framework. The data were analysed according to emerging categories and subcategories. Data emerged in relation to reasons for work mobility, the factors that support mobility and the factors that inhibit it. The reasons for moving to Ireland were mostly personal, professional or economic. In addition, factors facilitating movement included having established contacts in the country, organizational support and the attractiveness of educational structures. Challenges included the recruitment process itself, organizational support structures, professional recognition, language barriers and social integration. The findings are discussed in terms of health and social policy.
Assessing the impact: the National Chlamydia Screening Programme
Authors: Anthonisz Marie
Published: May 2014

Chlamydia trachomatis is the most common curable sexually transmitted infection in the UK. Incidence has risen steadily since the mid-1990s with young people in the UK disproportionately affected. Chlamydia and its consequences are estimated to cost the UK more than £100 million annually. The National Chlamydia Screening Programme (NCSP) was established in England to control chlamydia through the early detection and treatment of asymptomatic infection. This article critically analyses the NCSP. It focuses on the impact the policy can have on sexual health care in England, barriers to screening and also aims to identify inequalities in health and services. The NCSP has a positive impact on service users; without it, many infected young adults may remain ignorant of chlamydial infection, putting themselves further at risk of poor health. Early diagnosis and treatment of STIs and targeted prevention can significantly reduce the likelihood of complications and also reduce the strain on limited NHS resources. While screening has the potential to improve morbidity and contain risks inherent to chlamydia, it cannot offer a guarantee of protection from chlamydia itself. In order for the NCSP to effectively improve public health, a high uptake of screening needs to be ensured.
Evaluation of a telephone clinic for patients with intermittent claudication
Authors: Al-Dawoud Marwan , Thompson Lynda , Al-Khaffaf Haytham
Published: May 2014

Although the majority of patients with intermittent claudication are stable, those who develop complications can quickly deteriorate and need a rapid response. Because the majority of issues dealt with at a routine follow-up visit are in the form of a discussion, rely on symptoms and do not require an examination, it was considered appropriate to assess if a telephone follow-up service could replace these face-to-face meetings at the authors’ hospital. This article discusses an evaluation, the objective of which was to pilot a nurse-led telephone follow-up system for claudicant patients in terms of feasibility, patient satisfaction and impact on out-patient vascular surgery practice. This system would maintain supervision of vascular patients to enable fast-tracking into the out-patient clinic/hospital if their symptoms deteriorated. The effectiveness of the nurse-led follow up was assessed by a retrospective analysis of the out-patient clinic attendances before and after introduction of the nurse follow-up service. Attendances decreased, leading the authors to conclude that a structured follow-up system using a telephone clinic run by a skilled and specialized vascular nurse provides excellent support and effective surveillance in patients with intermittent claudication.
Male circumcision, HIV and sexually transmitted infections: a review
Authors: Larke Natasha
Published: May 2014

Three randomized controlled trials in sub-Saharan Africa have shown that circumcision reduces the risk of acquiring HIV infection in men by approximately 60%. In this paper, we review the evidence that male circumcision protects against infection with HIV and other sexually transmitted infections (STIs) in men and their female partners. Data from the clinical trials indicate that circumcision may be protective against genital ulcer disease, Herpes simplex type 2, Trichomonas vaginalis and human papillomavirus infection in men. No evidence exists of a protective effect against Chlamydia trachomatisor Neisseria gonorrhea. There is weak evidence that circumcision has a direct protective effect on HIV infection in women, although there is likely to be an indirect benefit, since HIV prevalence is likely to be lower in circumcised male partners. Although there is little evidence from the trials of serious adverse events from the procedure and of behavioural risk compensation among circumcised men, essential operational research is being conducted to evaluate these key issues outside the trial setting as circumcision services are expanded. Following the publication of the clinical trial results in early 2007, the World Health Organization/UNAIDS has advised that promotion of male circumcision should be included as an additional HIV strategy for the prevention of heterosexually acquired HIV infection in men in areas of high HIV prevalence. As circumcision services are expanded in settings where resources are limited, non-physician providers including nurses will play an important role in the provision of services.
A review of research and strategies for burnout among Chinese nurses
Authors: Lei Wang , Dong Wu , Hee Kang Youn
Published: May 2014

Although the concept of burnout has been a significant nursing issue worldwide over the past 30 years, in China the relevant research about nursing burnout only started in the 1990s. In this time, nursing burnout has become increasingly prevalent. This article examines the research carried out both in China and internationally, in order to investigate the causes of stress that lead to burnout among nurses. With the key stressors identified, the article sets out a proposal for a programme to alleviate the stress of hospital nurses and help them to engage with their jobs
Offering patients a choice of urinary catheter drainage system
Authors: Gibney Linda
Published: May 2014

The aim of this article is to promote understanding of the benefits, assessment process and suitability of catheter valves, as a form of urinary drainage for patients. A literature review on the benefits of catheter valves provides the opportunity for an in-depth discussion that compares and contrasts different urinary drainage systems. On the evidence of the literature review, all patients require a holistic assessment which considers a number of factors, and provides the nurse with the essential objective data to ascertain the suitability of the catheter valve. These data can be transferred into an easy step-by-step algorithm to help guide the nurse in making the decision, with the patient, on the most appropriate urinary catheter drainage system
Recognizing the evidence and changing practice on injection sites
Authors: Cocoman Angela , Murray John
Published: May 2014

Evidence-based practice requires the integration of the best available evidence in conjunction with clinical expertise to make decisions about patient care. At times new research and evidence will contradict established or traditional methods and clinical textbooks: this is in the nature of progress, and the challenge lies in disseminating this new evidence throughout the profession as quickly and widely as possible. The nursing literature cites a number of barriers to evidence-based nursing, and notes that the research evidence for clinical practice utilization does not always percolate down to the clinical setting. This article considers the attitudes of nurses to evidence that challenges traditional practice, focusing in particular on conventional and contemporary best practice regarding injection sites. Nurses in clinical practice continue to use and instruct student nurses in the use of the dorsogluteal (the large gluteal muscle in the buttocks) injection site as the site of choice for intramuscular injections, despite abundant evidence regarding the complications associated with using this site. Advancing the use of the ventrogluteal (located in the hip) injection site is a challenge, primarily owing to nurses’ lack of familiarity with its anatomical landmarks and the published evidence on its benefits. The authors of this article present the current evidence on the dorsogluteal and ventrogluteal intramuscular injection sites in an attempt to assist nurse decision-making and guarantee the integration of evidence-based knowledge in order to improve patient care.
Cuts and consequences
Authors: Castledine George
Published: May 2014

Many people who work in the public sector are bracing themselves for the oncoming cuts which are going to affect the country over the next few years. There have always been ups and downs with regard to the availability of funding for services, but the present cuts are probably going to be among the worst in living memory. The Government seems intent on solving the country’s financial deficit as soon as possible, and it is therefore determined to save money wherever it can. In terms of the healthcare service, reassurances have been given that there will be no cuts affecting ‘front-line’ services, but recent reports coming in from many nurses who work in clinical practice indicate that cuts are starting to happen, and patient care services are being affected. For example, nursing services are not being allowed to recruit staff when someone leaves, or more use is been made of bank staff or those who are not full-time employees of the service.
Achieving a culture of equity and excellence for children in the NHS
Authors: Glasper Alan
Published: May 2014

Professor Alan Glasper discusses the obstacles to effective health care for children and young people, and the plans in place for improvements to these services
Writing for professional publication. Part 3: Following journal guidelines
Authors: Fowler John
Published: May 2014

Recognizing your motivation and identifying the content of your potential article are the first two steps in writing for publication. However, you will almost certainly receive a rejection letter if you do not plan and structure your article to meet the style of the specific journal you intend submitting to. In the third part of a series of articles, John Fowler, an experienced nursing lecturer and author, highlights the importance of downloading and reading carefully the author instructions which are found on the websites of nearly all professional journals.
Protection for ‘have-a-go’ nurses
Authors: Castledine George
Published: May 2014

Stopping to help at an accident or giving first aid to someone in an emergency can be a daunting task for a nurse. Doctors have, for many years, been reluctant to volunteer in such situations for fear of being sued. Professional health regulators appear to encourage nurses to stop and help victims, as long as he/she works within his/her competencies. In practice, the situation has been difficult and there have been attempts by the compensation culture to ‘have a go’ at those who try their best to help people in difficulty. For example, there was one case of a child who drowned because when the police arrived at the scene they could not enter the water because they had no water rescue training. Much of the red tape surrounding these events relates to this country’s over-zealous health and safety laws. In fact, David Cameron has said that the ‘fear of transgressing’ UK and EU rules sometimes meant people ‘stand aside when others need help’
Relapse in long-term conditions: learning from mental health methods
Authors: Gillespie Mark
Published: May 2014

Within the UK, health-related policy and legislation have supported a shift towards a more pluralistic provision of health care in order to meet the challenges associated with the shifting demographics in society (Scottish Executive Health Department, 2009). The management of long-term conditions such as diabetes, heart disease and asthma, is recognized as a priority (Department of Health, 2009), with recognition that these long-term disorders share many similarities with serious mental health problems (Loggernberg, 2008), and suggestions that interventions already applied within the mental health setting are transferable across heathcare settings (Fleming et al, 2010). The application of one such intervention is discussed in this article
Making patient safety work: the Health Foundation snapshot
Authors: Tingle John
Published: May 2014

John Tingle discusses two recent publications from The Health Foundation charity which showcases their current patient safety work
NMC launches new standards for undergraduate nurse programmes
Authors: Glasper Alan
Published: May 2014

As the nursing profession moves towards an all-graduate workforce, Professor Alan Glasperdiscusses the recently announced standards and structure of these educational programmes.
Smooth operators: the use of emollients in skin care
Authors: Lay-Flurrie Karen
Published: May 2014

The skin is the largest organ in the body and is made up of two layers: the dermis and the epidermis. Aside from being a sensory organ, the skin provides a protective layer for the delicate organs underneath and acts as a barrier against bacteria, trauma, irritants and ultraviolet light through the production of melanin. The skin also performs a vital role in controlling body temperature, excreting salts and toxins from the body in sweat, and lastly the synthesis of vitamin D (Casey, 2002).
Patients’ views on topical negative pressure: ‘effective but smelly’
Authors: Abbotts Joanne
Published: May 2014

Topical negative pressure (TNP) is increasingly being used in both the UK and internationally, on wounds of acute, chronic and surgical origin. However, little is known about patients’ experiences of this therapy. NHS Quality Improvement Scotland undertook a health technology assessment on TNP in 2009–2010. This assessment considered clinical and cost-effectiveness, patient issues, and organizational issues. This article describes the primary research undertaken for the patient issues section. Qualitative methods were used to attempt to understand patients’ perceptions and experiences of TNP. A focus group and individual interviews were held in Glasgow, recorded, and transcribed verbatim. Data were analysed thematically. The themes which emerged as being important to patients receiving TNP were healing, smell, embarrassment, pain, nurse training, self-care, information provision, getting out of hospital, and returning to normal life. Implications for practice are suggested for manufacturers, service leads and nurses.
Collaboration in wound prevention and treatment
Authors: Clark Michael
Published: May 2014

Wound prevention and treatment is a global issue for health professionals, patients and policy makers alike. The need to avoid duplication of effort and to harness knowledge and experience has led to the recent publication of International Pressure Ulcer Guidelines (European Pressure Ulcer Advisory Panel, 2009), while the fourth World Union of Wound Healing Societies conference is only two years away. These global initiatives show that with goodwill and shared goals, common ground in wound healing can be found across nations and their various healthcare systems. There are many examples of this kind of collaborative working – from the excellent position papers produced by the European Wound Management Association and the World Union of Wound Healing Societies, through to commercially supported initiatives such as the consensus document Pressure ulcer prevention: prevalence and incidence in context. Medical Education Partnership (2008). These provide clear guidance on several of the most challenging issues in wound prevention and healing.
Considerations when caring for a person with a prolapsed stoma
Authors: Dukes Suzie
Published: May 2014

Stomal prolapse is a complication that can occur with all types of stoma. Not only does a prolapse cause issues with pouch management for the ostomist, but can also lead to many psychological problems. Stoma care nurses are often the first point of contact for ostomists when they prolapse, and are therefore in a position to assess, reassure and educate. However, in order to fully support the ostomist, nurses need to have a thorough understanding of the effect, both physical and psychological, that a prolapse can have on the patient and those closest to them.
A stepped approach to vascular access device selection
Authors: Giacomo Michele Di
Published: May 2014

Infusion therapy has evolved dramatically over the past few decades. From being used only in emergencies and for critically-ill patients, intravenous (IV) therapy has become a specialized form of treatment used for almost 90% of hospitalized patients (Corrigan, 1995). Infusion therapy is the parenteral administration of fluids, medications, nutritional support, blood products and the transfusion of blood. Fluids are delivered through a vascular access device, which is inserted into a peripheral or central vein (Royal College of Nursing (RCN), 2003). The venous route is the most predictable and reliable way to administer fluids and drugs when oral administration is not longer achievable or appropriate.
Colostomy, management and quality of life for the patient
Authors: Swan Elaine
Published: May 2014

The aim of this article is to describe the development and use of a new and unique continence control device (CCD). The Vitala™ CCD is a pouchless ostomy device that seals against the stoma and prevents the passage of stool, while allowing the release and deodorization of flatus. This will enable many end-colostomates to control their effluent. It is the first non-invasive product to temporarily meet the colostomate’s need of faecal continence. The reasons why people receive stomas and the different products available for their management will be explored in this article. Issues with regard to quality of life and the patient experience are discussed in the context of results from a Vitala™ CCD phase III 12-hour study. Two short case studies are also presented to illustrate how Vitala™ CCD can be used by ostomates experiencing functional and/or psychological problems to improve quality of life by allowing them to regain continence for up to 12 hours.
Liberating the NHS: a brave new world, or litigation nightmare?
Authors: McHale Jean
Published: May 2014

The coalition Government, in its White Paper Equity and Excellence: Liberating the NHS and in the subsequent paper Liberating the NHS: the new Legislative Framework has advanced its proposals for NHS restructuring. These proposals are intended to provide much enhanced roles for GPs in relation to the commissioning of NHS services in the future. This article explores these proposals and considers whether they can be seen as a return to the 1990s and the approach of the NHS Community Care Act 1990. It also explores the nature of these greater responsibilities and some of the problems that this may give rise to in the future.
The lived experiences of newly qualified children's nurses
Authors: Hollywood Eleanor
Published: May 2014

Aim:

This paper reports a study that explored the lived experiences of newly qualified registered children's nurses (RCN) in their transition from postgraduate student nurse to staff nurse.

Research question:

What are the experiences of newly qualified RCNs in their transition from postgraduate student nurse to staff nurse?

Methods:

A qualitative phenomenological approach was chosen for the study and six newly qualified RCNs were interviewed. Data analysis was based on the work of Coliazzi (1978) who devised a seven-step approach to assist the analysis within phenomenological inquiry.

Results:

Findings indicate that support is the most important aspect of the transition experience for these nurses. Mentorship and preceptorship programmes facilitate support during the transition period and previous experience prescribes the amount of support required by the newly qualified RCN.

Conclusion:

In highlighting the experiences of newly qualified RCNs in their transition from postgraduate student nurse to staff nurse, this study raises awareness among children's nurses, children's nurse educators and children's nursing managers about this unique group of nurses.
Academic skills: using literature to support your discussion
Authors: Wright Kerri , Street Paul , Gousy Mamood
Published: May 2014

A good academic piece of work aims to locate itself within the available body of knowledge on the subject area. Knowledge can come from a range of different sources, each contributing to the body of knowledge on the subject. The final article in this three-part series discusses the importance of appraising and making sense of literature when considering the knowledge relating to a particular subject area. Guidelines and methods are described to help organize, collate and make sense of the knowledge obtained, so that a logical plan can be created to structure academic work. The academic requirements of different levels are then briefly explained to give guidance on how best to use the literature to support and inform discussions.
Stroke Mood Screening on an inpatient stroke unit
Authors: Gurr Birgit
Published: May 2014

Psychological problems, and post-stroke depression in particular, are common following stroke. This article describes the development and evaluation of a mood screening pathway on a hospital-based stroke unit. The pathway is evaluated against the criteria of the national stroke guidelines, particularly the National Stroke Sentinel Audit ( Royal College of Physicians, 2008a ). The outcome reveals that the Stroke Mood Screening pathway meets the target of assessing every patient in 88.9% of cases. This places the performance of this procedure within the top quarter of stroke units in the UK. The Stroke Mood Screening pathway enabled the rehabilitation team to identify mood disturbances very early following patients’ admission to the unit. Good communication pathways between rehabilitation staff and easy referral routes to neuropsychology made rapid and efficient responses to emerging mood problems possible. The outcomes of this evaluation also give useful guidance for service improvements and consequently, could optimize the provision of psychological support for the patients on the unit.
Mainstreaming mental health issues within the NHS
Authors: Alan Gasper
Published: May 2014

Professor Alan Gasper discusses the launch of the Government's new strategy for improving mental health outcomes across all age groups, and outlines the role nurses can play in achieving this goal
Writing for professional publication. Part 8: targeting the right journal
Authors: Fowler John
Published: May 2014

The previous articles in this series of writing for professional publication focussed on the preparation you need to do before starting to write an article, ways to create interest in the reader’s mind, the importance of the abstract, and how the structure of an article differs to that of an academic essay. In this article, John Fowler, an experienced nursing lecturer and author, discusses the importance of submitting your article to the appropriate journal.
Stroke services across England: a mixed and inconsistent picture
Authors: Tingle John
Published: May 2014

This article discusses a recent report by the Care Quality Commission on stroke care in England. The review concludes that provision of stroke services across England varies widely, with some good service provision but other areas where significant improvement could be achieved. The review reveals failings with important implications for patient safety, and recommends areas where improvements could be made to avoid the likelihood of adverse incidents, complaints or even litigation.
Introducing a new skin-are regimen for the incontinent patient
Authors: Geraghty Jemell
Published: May 2014

Maintaining skin integrity and preventing skin breakdown and moisture lesions in the incontinent patient is an everyday challenge for nurses in the acute setting. The management of incontinence is often a socially or culturally prohibited topic Fletcher (2008) ; it is frequently attributed to ill health, the aging process or hospitalization, and often overlooked. The concept of cleansing should be commonplace, but it is complicated by the ritualism that underpins this ordinary yet fundamental aspect of patient care ( Voegeli, 2010 ).

The use of traditional methods of cleansing with soap and water in the management of skin integrity consumes significant amounts of nursing time. However, this procedure conflicts with infection control measures and predisposes the patient to further skin breakdown. This article looks at the use of an evaluation of a skin-cleansing emollient product in an elderly-care setting to provide evidence enabling an innovation that would lead to a change in practice. It highlights the importance of the implementation of a skin-care regimen as part of basic nursing care for the incontinent patient within the acute setting, and challenges ritualistic practice with evidence-based care.
The new EU healthcare rights directive: greater uniformity?
Authors: McHale Jean V
Published: May 2014

On 9th March 2011 the new EU Directive on Patients’ Rights in Cross-border Healthcare was adopted. This article explores its implications for the delivery of health care in the UK. It notes that the final version of the Directive provides much greater discretion to member states to control access to resources than was suggested in early drafts of the Directive. It explores the situations in which care can be subject to prior authorization and suggests that perhaps the greatest long-term impact of the Directive will not be in patient mobility as such but rather in relation to its impact on broader standard setting across the EU.
Students’ perspectives on their skills acquisition and confidence
Authors: Meechan Ronnie , Jones Helen , Valler-Jones Tracey
Published: May 2014

Aim:

To investigate students’ perspectives on their skills acquisition and knowledge during the foundation year of their nursing programme, and whether this improved students’ levels of competence and confidence.

Method:

Two groups of nursing students (n=140) responded to a clinical acquisition skills survey (CASS) to elicit their perceptions of clinical skills acquisition. Additionally, students’ competence levels were examined, drawing comparisons with the students’ objective, structured clinical examination (OSCE) results.

Results/Findings:

Students identified that the curriculum supported the acquisition of clinical skills, and clinical examination results confirmed that 95% of students were competent to pass their OSCE.

Conclusion:

Students’ responses to items that related to perceived confidence and competence levels were positive. This indicates that the introduction of clinical skills teaching and assessment within a university's simulation suites augmented with structured assessment within the clinical environment improved the acquisition of clinical skills.
Writing for professional publication. Part 12: summary of the series
Authors: Fowler John
Published: May 2014

The previous articles in this series have explored the practical issues of writing for professional publication. In this final article, John Fowler, an experienced nursing lecturer and author, summarises the series and presents an overview of the practicalities of writing for publication.
Consent and assessment of capacity to decide or refuse treatment
Authors: Simpson Owena
Published: May 2014

Consent protects the right of patients to decide what happens to them. Before any medical intervention, adults must give valid consent, which must be voluntary, informed and given free of undue influence. When consent is being obtained, patients must be informed about the intervention, why it is being done and its risks; information they are given must be recorded. Every effort should be made to explain the issues in terms that the patient can understand and by providing support and aids to communicate. Consent can be expressed, where patients say they consent or put it in writing, or implied, where a healthcare professional infers from their behaviour that they consent. While different types of consent are valid, some are evidence of stronger proof in court that valid consent has been given. Competent adults have the right to refuse treatment, regardless of the reasons they give for refusal and even if the refusal will result in death; clinicians must respect their decision. In some circumstances—such as when an unconscious person is admitted as an emergency—healthcare professionals can make decisions on behalf of patients, and must do so in patients' best interests.
Cancer-related fatigue: physical assessment is not enough
Authors: Reidy Alison
Published: May 2014

Cancer-related fatigue has been referred to as ‘inevitable, unimportant and untreatable’ ( Stone et al, 2000 ), with patient experiences easily overlooked or even dismissed by health professionals. This article examines literature regarding the prevalence of cancer-related fatigue, its manifestation and assessment. It also aims to encourage fellow health professionals to reflect on their own practice when assessing and managing fatigue, and identifies the need to address the psychosocial dimensions of the experience, as well as the physical.
Matching the skin barrier to the skin type
Authors: Thompson Hyacinth , North Jacqui , Davenport Rebecca , Williams Julia
Published: May 2014

Peristomal skin problems are thought to be common (Herlufsson et al, 2006; Williams et al, 2010 ), and can interfere with the security of stoma products. Stoma patients are reliant on the integrity of their peristomal skin to maintain a normal lifestyle. Bekkers et al (1996) highlighted that, if the peristomal skin becomes damaged, it not only affects the person physically, but also psychologically, ultimately prolonging rehabilitation and adaptation to the stoma. Therefore, it can be concluded that maintaining skin integrity is a basic and essential skill in ensuring good stoma management. This article explores the assessment of four stoma patients, highlighting the importance of matching their skin type with their skin barrier for optimum skin protection. The patients have kindly agreed for their case studies to be published as a means of informing others. All names have been changed in line with Nursing and Midwifery Council (2010) guidelines to maintain patient confidentiality. This article was originally presented at the World Council of Enterostomal Therapists' (WCET) annual conference in 2010, receiving first prize at poster presentations.
First annual Pioneers of Care awards celebrates nurses
Authors: Pabani Aysha
Published: May 2014

The Pioneers of Care awards recognises nurses who have gone above and beyond the call of duty to affect patient care in a positive, efficient and empathetic way, and have helped to tackle problems in frontline care and improve the lives of patients by introducing new techniques or innovations.
Recent developments in enteral feeding for adults: an update
Authors: Medlin Sophie
Published: May 2014

In the 1980s, enteral nutrition became increasingly recognised as a safe, effective and cost-efficient method of providing nutrition to patients with a functional gut ( Silk, 2003 ). With this came the development of feeding-specific nasogastric (NG) tubes ( Rees et al, 1986 ) and the formulation of nutritionally complete, ready-to-hang feeds ( Keohane et al, 1983 ), as well as the creation of gastrostomy tubes for direct access to the stomach by Ponsky and Gauderer (1981 ) followed by jejunostomys 11 years later ( Shike et al, 1991 ). Since then there have been many developments in every aspect of enteral feeding, with over 30 enteral feeds listed in the British National Formulary (BNF) ( Joint Formulary Committee, 2012 ) and companies continually designing new tubes that are smaller or more comfortable and feeding pumps that are quieter and easier to use. This article discusses the developments in enteral feeding over the last 5 years to give the reader an update on current topics and issues in enteral feeding.
Time to repeal the Tattooing of Minors Act 1969
Authors: Griffith Richard
Published: May 2014

The Health Protection Agency has again issued a warning to teenagers about the risks of infection and transmission of bloodborne diseases from using home tattoo kits. The warning came after two children from Sussex needed hospital treatment for infected tattoos. The trend for teenagers to use kits bought online or to have home tattoo parties is becoming a more common way to overcome the legal ban on tattooing minors. Richard Griffith argues that the public health risk to children from the use of unsterile home tattooing equipment can be countered by repealing the law prohibiting the tattooing of minors so that they can be protected, as adults are, by a regulated and licensed tattoo industry.
Identifying defects in the quality of primary and secondary care
Authors: Tingle John
Published: May 2014

John Tingle discusses a recent GMC report, which considers a number of issues relating to medical care and practice including patient complaints.
Pneumonia part 1: pathology, presentation and prevention
Authors: Driver Carolyn
Published: May 2014

Pneumonia is a significant cause of morbidity and mortality and can affect all age groups although it is the very young and the very old who are most at risk. Pneumonia can be caused by many different organisms and can present as a primary condition or as a complication of other diseases or acute health problems. This article will give an overview of the disease, its symptoms and treatment and will focus primarily on community-acquired pneumonia. Two further articles will look at specific causative organisms, i.e. Streptococcus Pneumoniae and influenza, as well as the preventive strategies for these.