bluuebunny/crossref_metadata_2025_split huggingface dataset:
Development of a community cardiac liaison nurse service
Authors: Fisher Sarah 
Published: May 2014

Coronary heart disease (CHD) is the leading cause of death and ill-health in the United Kingdom (UK), accounting for a large proportion of NHS expenditure (Department of Health (DoH) 1993). Reducing mortality from CHD has been identified as a key area in the government's Health of the Nation strategy (DoH 1992). This paper will present an overview of acommunity-based cardiac liaison nurse service and its role in the management of individuals with established CHD. The service is based within a community NHS trust in North London, serving a population of 470000 people, 34 per cent of whom belong to ethnic minority groups and 13 per cent of whom are aged over 65 years.
Innovative solutions to daily challenges
Authors: Derbyshire Adam 
Published: May 2014

Today’s clinicians face the daunting task of finding the best cost-effective and clinically appropriate solutions to ever complex wounds. The right combination of dressings help to maintain a moist environment, successfully manage exudate levels and reduce complications. This article seeks to explore the fundamental issues behind successful dressing choice and the new products that are becoming available for use as tools in the ongoing wound care initiative. In particular, the antimicrobial dressing Cutimed® Sorbact® used in conjunction with the exudate management properties of Cutimed® Siltec® and Cutisorb® Ultra by BSN medical will be examined with the commencement of three clinical evaluations.
Nutritional status of older patients admitted to hospital for surgery
Authors: Stewart James 
Published: May 2014

This article summarizes the nutrition-related findings of an NCEPOD review into the care received by patients aged 80 years and over who died in hospital within 30 days of surgery. Method: Data were collected on 1758 elderly patients (aged >80) who underwent surgery and died during the same hospital admission during April to June 2008. Questionnaires were sent to the surgeon and anaesthetist responsible for the patient and photocopied case note extracts were requested. Cases returned were reviewed by a group of specialists and assessment made of a number of aspects of care provided. The assessment of patient nutrition was one area. Results: From the surgical questionnaire, and where the question was answered (n=967), 93 patients had malnutrition on admission and only 55/93 were given nutritional support. From the case notes (n=902) only 118 patients had height recorded and 212 weight recorded. Formal nutritional assessment was made in only a minority of patients. Conclusion: Nutritional assessment in hospital is poor in an elderly surgical population. However, it must also be recognised that 93 patients were malnourished on admission and this may have been missed in the community.
Tissue viability specialist module: venous leg ulcers
Authors: Trevena Linda 
Published: May 2014

Linda is in her second year of the assistant practitioner foundation course. This article is an adapted version of her assignment for the tissue viability specialist module. It focuses on a patient with a venous leg ulcer. The original paper included appendices but these have been removed for editorial purposes. Linda is awaiting her mark for the assignment and this will be published in the August issue of the Journal along with the marking criteria.
Pharmacology - a systems approach: renal system
Authors: Hennefer Dawn , Lawson Elizabeth 
Published: May 2014

In relation to physiology and pharmacology there are two important considerations to note when administering medicines. Can the drug be effectively metabolized, and can it be effectively excreted? Examination of the individual's liver and renal function, and the presence of any co-existing disease, will determine the answers. Having discussed the liver in the first part of the series, this article will look at the renal system, common disorders and the pharmacological interventions used to treat some of those.
The fundamentals of skin care
Authors: Andrews Hilary 
Published: May 2014

With skin being the largest organ in the body and the skin playing such an enormous role in not only the physical but also the psycho-social health and wellbeing of an individual it is vital that all those who care for individuals are knowledgeable and competent in aspects of skin care. Healthcare assistants (HCAs) and Assistant Practitioners (APs) are often well placed to be able to observe and assess the skin of the people that they care for in whatever setting. This article explores the fundamental aspects of skin care including skin cleansing, maintenance of skin integrity and skin assessment.
A genuine partnership to raise the status of support workers
Authors: Griffin Richard 
Published: May 2014

In response to the Francis Report, the Government commissioned Camilla Cavendish to undertake a wide-ranging review of support worker development. Cavendish recommended a compulsory certificate of fundamental care be obtained by all support workers before they can give care. This article focuses on one question, ‘How do we effectively develop healthcare support workers in a way that improves the quality of care?’ There are 6 critical things to consider: workforce planning, clarity about role boundaries, awareness of support worker roles, good-quality education and training that promotes employee self-efficacy (confidence to learn), team working, more research and, finally, quality assurance.
The impact of living with a chronic skin condition
Authors: Andrews Hilary 
Published: May 2014

The aim of this article is to help create healthcare assistants (HCAs) and assistant practitioners (APs) who work with compassion, recognising that patients with skin disease are often affected in many dimensions of their lives—physically, socially and psychologically. The impact of living with a chronic skin condition is explored, along with the impact on the lives of those who care for them. Complex relationships exist between the skin and the mind and this aspect of dermatological care is discussed. The role that the HCA and AP can play in caring for individuals and their families with a skin condition is described by using a framework based on the 6 Cs - the six core values and behaviours recently described by the NHS Commissioning Board Chief Nursing Officer and Department of Health Chief Nursing Adviser as those that underpin good care ( Hollis, 2012 ).
Northern soul: Manchester's part in creating the AP role
Authors: Mullen Chris 
Published: May 2014

The article provides the reader with an historical overview—by the project director who led the development for the first 10 years—of how, when and where the assistant practitioner (AP) role was first developed, beginning in 2001. The project was called ‘Delivering the Workforce’ and became a long-term workforce modernisation strategy for the North West region. The AP role was the major role that emerged and is still in place today. The key principles that underpinned the development of the AP role are described, alongside some of the resources and processes that were used. The aim of the article is to provide readers with the background to the origins of the AP role and also to help provide an understanding of the context and risks that the original ‘pioneers’ took particularly the first students, the two universities, the ‘practice trainers, and the organisations. A short reflection on the AP role today and the original ‘AP design’ is briefly discussed.
Dispelling myths about ageing for healthcare assistants
Authors: Hayes Catherine 
Published: May 2014

This article provides healthcare assistants with some clear definitions of concepts in ageing that they can consider in their everyday practice. By defining ageing and its obvious link to the process of biological senescence (the normal process of biological ageing, which all living organisms experience from the moment their lives begin), HCAs are introduced to the characteristic signs of functional decline—which often epitomises the view we have of older people—and the normal physical degenerative trajectory towards death. Physical characteristics of the ageing process are discussed in relation to the physiological signs of ageing as a gradual deterioration in function and capacity to respond to environmental stress. This is interlinked with the complex medical histories with which elderly people often present in healthcare practice. Specific considerations of working with older patients such as polypharmacy (the use of multiple medications), and general health problems, are then discussed and the notion of ageism as a discriminatory practice is briefly explored.
Logistics - a catalyst for change in the NHS
Authors: Kidd Paul 
Published: May 2014

Hospital supply chains have traditionally relied heavily on their nursing staff to order and replenish stocks – an activity which, though important is not the most effective use of finite nursing resource. This article looks at how the Central Middlesex Hospital has developed a Public-Private Partnership (P-PP) with a leading logistics company which has not only streamlined the hospital's supply chain, but has also achieved significant cost savings.
Development of a valid and reliable tool for assessment of urinary incontinence in people with neurological problems
Authors: Woodward Sue 
Published: May 2014

The aim of this study was to evaluate a tool for use by non-specialist nurses to assess continence problems in neuroscience patients. Methods: An evaluation study was conducted, to facilitate assessment of validity and reliability of a newly developed tool. A cohort of 84 student nurses was selected to participate and was asked to complete a previously validated knowledge questionnaire on the subject of incontinence, before and after attending a study day on continence promotion. The cohort was also split into two groups and each group was asked to identify types of incontinence in a series of previously validated vignettes. One group performed this task using the Woodward Key to Continence, and the other group without. The validity and reliability of the tool was assessed using multivariate analysis of variance. Results: Both groups of students significantly improved their knowledge of incontinence following teaching (P<0.001) and their ability to identify correctly the type of incontinence represented by the vignettes (P<0.001). There was also a difference between the groups' abilities to correctly assess the vignettes, with the group using the Woodward Key to Continence performing significantly better than those working without the tool (P<0.001). Limitations: The study used vignettes rather than real patients. It is not possible to identify if knowledge gained and the effects produced would be applied in practice. Conclusions: The teaching given was effective in improving students' knowledge of incontinence and ability to correctly identify types of incontinence from vignettes. It was found that the Woodward Key to Continence is a valid and reliable tool.
Infusion line preferences of patients prescribed apomorphine for complex Parkinson's disease
Authors: Parsons Jan 
Published: May 2014

There are over 1000 patients with complex Parkinson's disease in the UK undergoing waking-hours apomorphine (APO-go) infusion therapy. Correct line placement in the subcutaneous fat is critical for optimal drug absorption and helps prevent adverse events at the injection site, such as nodule formation. The majority of patients on apomophine therapy manage their treatment without any nursing involvement, according to the NICE guidelines for Parkinson's disease. Aim: To explore the experiences and preferences of patients with Parkinson's disease using two types of infusion line for apomorphine infusion therapy: the Graseby and Contact/Thalaset lines. Method: A brief five-point questionnaire was sent to 104 patients of two specialist nurses receiving apomorphine infusion therapy for treatment of Parkinson's disease. A total of 69 patients returned completed questionnaires, of whom 51 had used both lines and were able to express a preference. Conclusions: It was demonstrated that the patients preferred an infusion line for apomorphine infusion therapy that had a fine needle design with a 90° insertion technique (the Contact/Thalaset type) beause this was found to be easier to insert than a butterfly line and is associated with fewer adverse effects such as pain, nodules and occasional abscess, at the injection site, which leads to better compliance with the drug regimen.
The Birth Place Choices Project: phase two initiative
Authors: Barber Toni , Rogers Jane , Marsh Sarah 
Published: May 2014

The Birth Place Choices (BPC) Project was 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 that 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 educational, marketing and change management initiatives that were carried out as part of phase two of the BPC Project. These included a marketing campaign for local Midwifery-Led Units, the provision of a maternity service user leaflet on local birthplace choices, and the development of a multi-professional guideline on place of birth. Midwife practice educators were employed to help disseminate the leaflet and guideline as well as implement educational initiatives for local midwives on and around informed choice and place of birth.
Advances in newborn bloodspot screening
Authors: Israel Janet , Parsons Evelyn P , Bradley Don M 
Published: May 2014

This paper looks at the utilisation of tandem mass spectrometry (MS/MS) in newborn bloodspot screening. MS/MS has the ability to analyse a single blood sample for a relatively large number of neonatal disorders, including inborn errors of metabolism. It has therefore the capability to transform the face of newborn screening. In the UK medium chain acyl-coenzyme A dehydrogenase deficiency (MCADD) has been highlighted as a suitable candidate for screening using MS/MS but debates are still taking place about the disease process and the psychosocial implications of screening. Midwives are central to newborn screening and therefore any expansion of bloodspot screening would have implications for their practice in terms of information giving, parental consent and education. To ensure the continued success of newborn bloodspot screening it is important that midwives practice in accordance with professional standards, are aware of current developments and engage in debates prior to new service delivery implementation. The Department of Health and the National Screening Committee have undertaken a two year pilot study (2004–2006) looking at newborn screening for MCADD and their report, due out 2006/2007, has the potential to contribute constructively to current debates.
National training resources for newborn bloodspot screening
Authors: Stewart Ruth , Oliver Sandy , Hargreaves Katrina 
Published: May 2014

Policy decisions to expand newborn screening and support informed choice prompted a review of information for parents and resources to support health professionals. The UK Newborn Screening Programme Centre conducted a needs assessment to identify training needs. We took into account existing reports of training needs as well as conducting our own survey of Midwifery Schools and screening laboratories. Prior evaluations, and our own survey, suggested the need for national resources on newborn bloodspot screening, rather than an additional national training programme. Based on these findings we developed resources that could be used within current training initiatives. These resources are now available to midwifery trainers for use alongside or in place of existing resources, as well as to individual midwives as part of a ‘self-learn’ package.
Improving care for women with epilepsy
Authors: Morley Kim 
Published: May 2014

All women with epilepsy require multi-professional shared care in pregnancy to reduce the risk of maternal death and fetal compromise. This is achievable by the development of shared care pathways between the woman and her neurological and obstetric team. To facilitate this, as part of Epilepsy Action's Mother's in Mind healthy births campaign, a resource pack for obstetricians, midwives, health visitors and community practitioners has been produced by Epilepsy Action in conjunction with a working party of Specialist Epilepsy Nurses and Midwives referencing recommendations from NICE (2004) and CEMACH (2007). This article focuses on women with epilepsy and not those taking antiepileptic drugs for migraine, neuropathic pain and mental illness; the effects of exposure to the foetus and on hormonal methods of contraception are the same therefore, these women of childbearing potential should be counselled accordingly.
Making sense: women's abortion experiences
Authors: Trybulski JoAnn 
Published: May 2014

This study investigated the meaning of women's elective abortion experiences. American women who had ended or were nearing the end of their intended childbearing and had terminated a pregnancy for non-genetic reasons participated in a phenomenological exploration. Sixteen women participated in this interpretive phenomenological study which resulted in nine overall themes. The theme of making sense is detailed in this article. Women make sense of their abortion in varied ways and helping women make sense of their abortions is critical for their wellbeing.
‘A labour of love?’: mothers and emotion work
Authors: John Veronica 
Published: May 2014

The aim of the study was to explore the emotion work involved between mothers and their midwives during birth. Ethnographic observation and in-depth interviews explored the experience from the perspective of mothers and their midwives. This article analyses emotion work during birth from the mothers' perspectives. A key finding of the study was that mothers valued the feelings of calm provided by the midwives' during birth but did not recognize this as a component of midwifery work (John and Parsons, 2006). This was because of the profound range of emotions that mothers' themselves experienced throughout labour. One important finding was that the mothers identified that it was important for midwives to be intuitive and sensitive to their changing needs. The mothers realized that their needs altered during labour as they experienced feelings of fear, relief and changes in consciousness. Thus, mothers used emotional management techniques to stay calm and gave subtle clues to indicate the level of input they needed from their midwives. They also noted the need for different types of emotional care in different situations.
Safety of lavender oil in the treatment of perineal trauma
Authors: Jones Catriona 
Published: May 2014

Essential oil therapy in wound care is gaining increasing popularity. This largely consumer-driven trend is currently being incorporated into the care of postnatal women experiencing perineal discomfort. Anecdotal evidence suggests that some midwives recommend the use of perineal pads pre-spotted with an essential oil blend containing lavender oil. Currently, the topical use of essential oils as a complementary therapy for perineal wound management is not underpinned by empirical evidence. A review of the existing literature on lavender oil in wound care has been conducted in an attempt to explore the safety of current practices. This review highlights that currently there remains limited evidence to support the direct topical use of pure lavender oil as an effective and safe treatment or comfort measure upon the perineum.
Experiences of gay women during their partner's pregnancy and childbirth
Authors: Erlandsson Kerstin , Linder Hanna , Häggström-Nordin Elisabet 
Published: May 2014

Growing numbers of openly gay women choose to have children, but there have been few studies on the topic. The aim of this study was to describe the co-mother's experiences of care provided during their partner's pregnancy, childbirth and the postnatal period. Six co-mothers were interviewed between six weeks and three years after the birth of their child. The open interviews were analysed using content analysis. The overall theme of the findings was ‘like everyone else, but not quite’. The following main categories were identified: need for acknowledgement, need for care designed to suit same-sex couples, and in the hands of nursing staff. Co-mothers felt themselves to be ‘like everyone else but not quite’. In order to support the relationship of same-sex parents in parenthood it is important for midwifery staff to recognize co-mothers as an equal parent of the child.
Birthing outcomes from an Australian HypnoBirthing programme
Authors: Phillips-Moore Julie 
Published: May 2014

Background and aim: HypnoBirthing, which is steadily increasing in popularity both in Australia and overseas, is a set programme consisting of 10–12 hours of instruction for couples approaching the later stages of pregnancy and birth. A survey was carried out to investigate how Australian participants attending the HypnoBirthing programme between 2007 and 2010 compared to other studies where hypnosis was used for childbirth. Results: The average length for both stages of labour was shorter in the HypnoBirthing group compared to general population figures. Caesarean section rates were lower, as was the use of gas and epidurals. Of the 81 participants, 46 (51 %) did not use any pain medication at all and the overall discomfort level for labour and birth was 5.8 out of 10 with 32 % of the participants scoring under 5.8, including two participants who recorded zero discomfort. Conclusion: Women attending the HypnoBirthing programme demonstrated similar results to those found in other research in hypnosis for childbirth. However, the findings also demonstrated some added benefits of HypnoBirthing. The majority of women reported feeling more confident, relaxed, less fearful, focused, and more in control. They also commented on the ease and comfort of labour and birth and the satisfaction of having their partners involved and supportive.