bluuebunny/crossref_metadata_2025_split huggingface dataset:
Key-worker clinics: the maintenance phase of lymphoedema therapy
Authors: Green Tracy 
Published: May 2014

This article describes the development of services for patients with mild and uncomplicated lymphoedema through a network of community-based staff nurses specially trained in the management of mild and uncomplicated lymphoedema in order to deliver an integrated service across the acute foundation and primary care trusts. Government policies, increasing referral rates and patients with complex co-morbidity requiring intensive treatments had prompted a review of the service provision to examine ways to deliver an efficient and cost-effective service across the local health economy. Patients with mild and uncomplicated lymphoedema do not necessarily require specialist care but can be managed effectively by key workers with appropriate training and skills (British Lymphology Society, 2001a; b; Lymphoedema Framework, 2006). This development demonstrates the benefit of training existing community staff, using their existing skills. Providing access to clinics within the primary care setting helps to provide a cost-effective, structured and co-ordinated care pathway at all levels of intervention, ultimately improving treatment outcomes and patient satisfaction. A cohort of community staff nurses were identified and trained in the provision of lymphoedema management to key worker level, providing the opportunity to develop a lymphoedema service based upon health-care need and not disease site as has occurred with other national developments. These clinics offer the same advice, support and monitoring of the patients condition alongside education and information in a more locally accessible setting, avoiding the need for hospital visits.
Caseload management: an approach to making community needs visible
Authors: McDonald Anne , Frazer Kate , Cowley Dame Sarah 
Published: May 2014

Aim: To explore the process employed in the development of a population health framework and documentation for managing community nursing caseloads. Background: No formal structure exists to validate and link local health information collected by Irish public health nurses to a wider epidemiological framework. Neglect of this bottom up information forfeits opportunities to resource and manage public health nursing services. Design: Action research methods guided the development of the framework in one geographic area in Dublin and 34 participants engaged in Stringer's (1996) Look, Think and Act cycle. Results: The framework identified four patient registers: family health, chronic sick/disability, older adults and acute care, which identify public health outcomes for discussion within the caseload analysis process and can predict risk factors in local populations. Conclusions: The use of the developed documentation identified a framework that describes caseloads in primary care and provides nurse managers with an evidence base to allocate resources, match skill mix to need, and estimate future workforce requirements.
Care of the feet: common problems and how to treat them
Authors: Nazarko Linda 
Published: May 2014

Foot care can be a neglected area of care and health professionals do not always appreciate the importance of helping patients to care for their feet. Patients most likely to need this attention are the over 65s with an estimated 6.5 million older people requiring help to care for their feet (Ellis, 2006). Age related changes and chronic disease can affect the nail beds, nails can become thickened and difficult to cut. Bunions can develop because of ill-fitting footwear. Arthritis, gout and other long-standing diseases can also affect feet. Neurological diseases such as stroke and Parkinson's disease can alter gait and lead to calluses and the development of foot problems (Nazarko, 2006). This article aims to provide guidance for healthcare assistants and assistant practitioners in the care of the feet.
Body fluids: components and disorders of lymph
Authors: Peate Ian 
Published: May 2014

The lymphatic system is a complex network of lymphoid organs that produce and transport lymph fluid from tissues to the circulatory system. The lymphatic system runs throughout the body and carries a colourless liquid called lymph. The lymphatic system plays a major part in the immune system; lymph carries a large number of lymphocytes (white blood cells). The lymphatic system drains fluid into the blood stream, lymph nodes filter lymph as it passes through, if cancer cells, for example, break off from a tumour they can become stuck in the nearest lymph node. Swollen lymph nodes can indicate infection. Lymphoedema occurs when there is swelling of a part of the body, for example, in the arm following surgery for breast cancer where the lymph nodes in the axilla (arm pit) are removed. The swelling occurs because of the obstruction to the flow of lymph. It is important that the healthcare assistant (HCA) or assistant practitioner (AP) understands the function and flow of lymph as this can help to identify in patients potential or actual health problems. Understanding can provide the carer with information that will enable them to offer patients support. HCAs and APs have an important role to pay in assisting those who experience diseases associated with the lymphatic system.
Hyper-acute stroke treatment: the first 48 hours
Authors: Nazarko Linda 
Published: May 2014

Every year, 150000 people in the UK suffer a stroke. This works out at one every five minutes ( Townsend et al, 2012 ). Stroke is the single largest cause of disability and the third largest cause of deaths in England. Stroke costs the NHS over £2.8 billion and can lead to death or severe disability ( Mant et al, 2004 ). The National Stroke Strategy launched in 2007 outlined a 10-point strategy to develop stroke services, reduce death and disability and to improve care ( Department of Health (DH), 2007 ; 2008 ). One of the most important aspects of stroke care is ensuring that stroke is recognised and that everyone acts quickly to preserve brain function and minimise disability. Healthcare professionals and the public need to be able to recognise stroke and to act appropriately when stroke occurs. This article aims to enable readers to recognise acute stroke and to act quickly and appropriately when stroke occurs
Clinical governance: it's all about quality
Authors: Stonehouse David 
Published: May 2014

Within this article the author will examine what clinical governance is. It will discuss some of the many different, but interlinked, components, which, when all working together, help to ensure the quality of care that individual support workers deliver, as well as the organisation as a whole. It will use as a base for its discussion 7 of the components that make up ‘The Temple Model of Clinical Governance’ devised by the Clinical Governance Support Team. Clinical governance is a mechanism that enables quality to be placed at the heart of everything that we do as support workers. Every patient has the right to know that the care they are receiving is of the highest possible standard and quality. It is therefore every member of staff's responsibility to work towards ensuring that quality care is being delivered.
Cushing's syndrome: a problem of excess cortisol
Authors: Peate Ian , Holmes Edward 
Published: May 2014

This article provides the healthcare assistant (HCA) and assistant practitioner (AP) with information about and understanding of Cushing's syndrome, which results from prolonged exposure to inappropriately high levels of the hormone cortisol and may bring with it significant morbidity and mortality. An overview of the endocrine system and the various endocrine and exocrine glands is provided, along with a discussion of the role and function of the adrenal glands. The signs and symptoms of Cushing's syndrome, the investigations required to make a diagnosis, the surgical and/or drug-related treatment options, and the care and management of the person with the condition are described. Excessive levels of the hormone cortisol (glucocorticoid) in the body cause Cushing's syndrome and there are a number of reasons why this may occur. A variety of tests and investigations will be required to establish the root cause of the excessive production of this hormone. The HCA and AP can help to support people with the condition in a safe and effective way if they have insight and understanding of the key issues. A glossary of terms is provided.
Making mental health as important as physical health
Authors: Peate Ian 
Published: May 2014

In its January 2014 strategy, Closing the Gap: Priorities for Essential Change in Mental Health, the Government has given a commitment to make mental health as important as physical health. This article considers the many problems associated with poor mental health, including disability and premature death. Although there are some areas of good practice in the health and social care sectors, many people with a mental illness are being let down by these services with respect to their physical health. A holistic approach, that includes physical and mental health, is necessary. It helps if the HCA or AP is able to demonstrate an awareness of the issues that people with mental ill health face and the fact that their physical needs are being neglected. The ambition is to improve the lives of those people with mental health problems and to promote wider mental wellbeing and this concerns all of us: mental health is everyone's business.
Subarachnoid haemorrhage has long-term effects on social life
Authors: Berggren Elisabeth , Sidenvall Birgitta , Larsson Dennis 
Published: May 2014

Aim: The aim of this study was to describe activities of living after a subarachnoid haemorrhage (SAH) from the perspective of relatives and patients in two cohorts and to evaluate the application of relatives’ statements, as a tool in nursing care, in order to support the patient. Background: Memory problems after SAH are common according to patients’ and relatives’ statements and memory test results. This may influence the adjustment to daily life. Supporting patients and relatives requires knowledge concerning the activities of daily living from the perspective of both patients and relatives. Method: Eleven relatives and 11 patients (cohort 1), 11 years after the onset of an SAH and 15 relatives and 15 patients (cohort 2) 6 years after the onset of an SAH participated in the study. Interview questions and memory tests were used to collect data. Findings: Problems with activities of daily living were common and patients had more problems with social life than with personal and instrumental activites. The change in social company habits were due to emotional problems. Patients’ statements about problems with activities of living corresponded to results from patients’ memory tests and patients’ statements. Conclusions: Relatives’ and patients’ statements are useful as tools in nursing care. Introducing fromalized dialogues and memory tests would improve the after care for this group of patients and improve their future family relationships.
Exercise intervention soon after stroke onset to prevent muscle atrophy
Authors: Tamura Ayako , Ichihara Takako , Minagawa Takako , Kuwamura Yumi , Kondo Hiroko , Takata Shinjiro , Yasui Natuo , Nagahirois Shinji 
Published: May 2014

Objective: To investigate the effects of nurse-led exercise interventions, in addition to standard rehabilitation, on patients suffering from hemiplegia soon after stroke onset. Methods: Interventions involved a series of hip bridges. Efficacy was evaluated by monitoring leg muscle mass. Participants were divided into control, intervention and terminated intervention groups. In addition to standard rehabilitation, the intervention group performed a series of hip bridges once a day. Leg muscle mass was evaluated using dual-energy X-ray absorptiometry (DXA). Measurements were taken 3–5 days after stroke onset, then again 7 days after initial measurement. Results: During the first week, the mean decrease in leg muscle mass on the paralyzed side was 417 g (7%) for the control group, 304 g (6%) for the terminated intervention group and 108 g (2%) for the intervention group. Only the difference between control and intervention groups was significant (P=0.008). Conclusions: Exercise interventions comprising a series of hip bridges soon after stroke onset, in addition to standard rehabilitation, can reduce leg muscle atrophy on the paralyzed side in stroke patients.
Development and evaluation of an interdisciplinary training programme for stroke
Authors: Catangui Elmer Javier , Slark Julia 
Published: May 2014

Introduction: The coordinated, specialized care given in stroke units has been shown repeatedly to improve outcomes for patients ( Royal College of Physicians, 2010 ). Collaborative working within the multidisciplinary team is integral to the good results achieved by such units. Healthcare for London has reorganized stroke care in London to include 8 fully functioning hyperacute units and 24 subacute units providing care for stroke patients. Imperial College Healthcare NHS Trust has been designated a hyperacute unit for northwest London and the staff received specialist training to provide the highest possible care for this patient population.Methods: A team of professionals with expertize in stroke care developed a training programme aimed at all health professionals. The goal is for specialists from all members of the stroke team to teach each professional involved in stroke patient care using a framework of interprofessional education (IPE). The 3-day course includes all aspects of stroke patient care from acute physiological monitoring to continence, physical rehabilitation and end-of-life care.Results: To date, seven courses have been run with excellent feedback from all multi-professional members attending. The teaching team meet after each course to evaluate the feedback forms and amend the course as appropriate. The evaluation allows the attendee to rate the session as excellent, good, fair or poor.Conclusions: Collaborative interdisciplinary working is essential to excellent stroke care provision. The stroke training course at Imperial College Healthcare Trust is attempting to ensure collaborative working starts with collaborative training and hope that those who learn together can grow together and become the best possible team, to ensure the best outcomes for stroke patients.
Quality of life among carers of people with Huntington’s disease
Authors: Cox Marie 
Published: May 2014

Background: Long-term care of people with Huntington’s disease (HD) rests mainly with family or partner carers, and HD care presents burdens not seen in other disorders. Identifying factors that affect HD carer QoL may provide insights into easing carer burden. Aim: To describe the quality of life (QoL) of carers of people with HD. Methods: Thirty one HD carers completed the 34-item Huntington’s Disease Quality of Life Battery for Carers (HDQOL-C) questionnaire. Results: Fifty five per cent of the participants indicated a mid-level QoL. The number of hours spent caring inversely correlated with QoL. The number of times a carer socialised per month was positively related to QoL. Participants reported that access to affordable care programmes for the HD-affected person, more time for themselves, and social support would improve their QoL. Conclusions: Providing respite may improve HD carer QoL. Research on interventions to improve HD carer QoL is warranted.
Providing informational support to the families of TBI patients: a survey of nursing staff in Finland
Authors: Coco Kirsi , Tossavainen Kerttu , Jääskeläinen Juha , Turunen Hannele 
Published: May 2014

Background: People with a traumatic brain injury (TBI) constitute a significant patient care population: every year almost 8 million brain injuries are diagnosed worldwide. Social support (informational, emotional and practical) has been identified as one of the essential factors that help TBI patients' families to cope with the severe situation. Aims: This paper reports on a study of how often nursing staff provide interventions of informational support and the level of competence needed by nursing staff working in all neurosurgical wards to support the families of TBI patients. Methods: The target group included all nursing staff (n=172) in all neurosurgical wards in Finland. Data was collected via a self-completion questionnaire in 2010. The participants were nurses (n=115; response rate 67%) working in the neurosurgical wards of all five Finnish university hospitals. The data were statistically analysed using SPSS version 19. Descriptive statistics, the Kolmogorov-Smirnov test, one-way ANOVA, two-way ANOVA, MANOVA and linear regression were used. Results: Overall, the nurses often provided informational support to TBI patients' families. They often told them about treatment and about their own responsibilities to family members; by contrast, they seldom informed family members about prevention of secondary injuries. There was a connection between the age and work experience of the nursing staff and the provision of information about secondary injuries. Conclusions: Nurses with less work experience may have limited competence in delivering information to family members. This should be taken into consideration when planning the staffing of shifts, ensuring that there are always enough experienced nurses on duty.
Increasing out-of-hospital births: what needs to change?
Authors: Barber Toni , Rogers Jane , Marsh Sarah 
Published: May 2014

This is the third of three articles describing the work of the Birth Place Choices (BPC) Project, a Department of Health funded project carried out between May 2003 and May 2005 as a collaboration between Southampton University Hospitals NHS Trust and Portsmouth Hospitals NHS Trust. The BPC Project had three aims: 1. To identify factors which influence women's decisions about where to give birth. 2. To determine whether the introduction of specially designed information and educational initiatives increase women's knowledge of choices for place of birth. 3. To determine whether implementation of these initiatives was associated with an increase in the number of women choosing to give birth outside main consultant-led maternity units. This article describes the evaluation process carried out during phase two of the BPC Project, as well as the key successes of the BPC Project and the barriers which limited its effectiveness.
Self-administered homeopathy part two: a follow-up study
Authors: Steen Mary , Calvert Jan 
Published: May 2014

Self-administered homeopathic remedies may be acceptable and effective for women and their partners during pregnancy, birth and after birth. They may also reduce the use of pharmacological pain relief methods and promote less intervention during childbirth. However, there has been very little research in this area to date. This second paper discusses a follow-up study that used a semi-structured interview technique to explore further the experiences of women and their partners following the use of a specifically chosen homeopathic kit that included ten remedies for self-administration. Interviews were undertaken in the homes of 18 women who reside in the South Leeds area, West Yorkshire during a six month period (September 2005 to February 2006). Four themes were generated from the data, namely how remedies were used, empowerment, emotional needs, fathers and birth partners. The final core theme was a positive birth experience. The interviews demonstrated that women and several birth partners experienced positive emotional, psychological and physical benefits from using the kit of homeopathic remedies. Self-administered homeopathy has the potential to promote a women-led approach to childbirth and an active supportive role for the birth partner. The findings will form the foundations to undertake further research in this field.
Diagnosis of preterm labour: introducing the fetal fibronectin test
Authors: Ponting Jennie , Tomlin Maggie 
Published: May 2014

This article reports on an innovation within a maternity unit to introduce a fetal fibronectin, point of care test, which will aid the clinician in correctly diagnosing preterm labour. In turn, this will assist in developing an individual plan of care for each woman with suspected preterm labour, rather than treating each case with the same interventions regardless of subsequent outcomes.Fetal fibronectin (FFN) is a complex adhesive glycoprotein which can be detected in the cervico-vaginal secretions of women during pregnancy. Its concentration varies throughout pregnancy. Detectable before 24 weeks of pregnancy the concentration then dips below the minimum detectable level up to 34 weeks of pregnancy, unless the woman is in preterm labour.The FFN test was successfully introduced into clinical practice. It demonstrates that, when used appropriately on women with symptomatic suspected preterm labour, FFN testing can aid in accurate diagnosis and avoid unnecessary, costly interventions.
Managing the psychosocial aspects of heart failure: a case study
Authors: Sykes Catherine , Simpson Susan 
Published: May 2014

Background: Depression is common in patients who have heart failure. This article presents a brief psychological intervention that could be useful for heart failure patients with depression that is likely to be precipitated by heart failure. Method: A brief intervention was designed to help heart failure patients. It was delivered in an outpatient setting as an adjunct to a nurse consultant‐led clinic. A case study of ‘Albert’, who completed measures at 1 month on the waiting list before the intervention, and at 6 months after completion of the intervention is presented. Results: The impact of the intervention was limited but it did show that the patient's scores on the emotional items of the Minnesota Living with Heart Failure Questionnaire had improved. The patient also used more active coping skills after the intervention. The patient self‐reported an improvement in his loneliness, depression and sleep problems. The nurse consultant involved in his care reported an improvement in his anxiety about his condition. Conclusions: This brief intervention showed some benefits for Albert. Ideally, more follow‐up sessions should be provided. However, the patient stated that he felt that the intervention had helped him to start managing his heart failure.
GuardlVa: a novel antimicrobial haemostatic IV dressing: Part 1
Authors: Donnellan Peter D , Real Keith , Beilliú Máire Ní 
Published: May 2014

HemCon GuardlVa® is a hydrophilic polyurethane sponge dressing impregnated with the broad spectrum antimicrobial agent chlorhexidine gluconate (CHG) and a proprietary formulation of the haemostatic agent oxidized cellulose. The intended use of the dressing is to absorb exudate, cover and protect catheter sites. Some common applications include intravenous (IV) catheters, other intravenous catheters and percutaneous devices. GuardlVa is also the only IV site dressing indicated to control surface bleeding from percutaneous access sites. A clinical study in healthy human volunteers has demonstrated the ability of the GuardlVa dressing to significantly suppress skin flora re-growth. The antimicrobial and haemostatic efficacy of the GuardIVa dressing and its effects on wound healing have also been demonstrated by independent laboratories in a number of in-vitro and in-vivo tests. These data suggest that GuardIVa would be an effective component as part of a catheter site regimen to help reduce skin microbial colonization, provide sustained antimicrobial protection against the major organisms responsible for catheter-related blood stream infections (CR-BSIs) and prevent the risk of CR-BSIs.