bluuebunny/crossref_metadata_2025_split huggingface dataset:
Accident prevention and older people
Authors: Morgan Pauline , Carter Yvonne 
Published: May 2014

During 1993, the European Year of Older People and Solidarity between Generations, a national study to examine the accident situation amongst people aged 70 years and over was commissioned by The Royal Society for the Prevention of Accidents (RoSPA) and funded by the Department of Health (DoH). This study consists of two parts: a national postal survey and an interview survey. This paper will concentrate on the second part of the study to examine the accident experience of older people living in the community. The database that was used for the postal survey consisted mainly of people from social classes I, II and III. The authors felt that it would be worthwhile to conduct a further study consisting of structured interviews with 104 older people, residing in the West Midlands and belonging to social classes III, IV and V. This paper describes the retrospective accident experience of these people during a 12 month period. The aim of the study was to determine whether people aged 70 and over were receiving sufficient accident prevention advice to meet their needs.
Older people who fall: why they matter and what you can do
Authors: Oliver David 
Published: May 2014

The population is ageing in all developing nations. As treatments and survival rates improve for conditions affecting younger people, age-related problems linked to frailty, functional impairment and long term conditions will pose an ever larger challenge to health and social care systems. Falls and associated injuries or loss of function are such a problem. Effective falls intervention strategies mean that primary care and community nursing must play a central role, as many patients will never present to hospital services, nor could hospital services cope – for instance one in three people over 65 will fall in a given year and one in two women will sustain a fracture during their lifetime. Fall and fracture prevention has, until the past few years, been a low priority in service delivery, training and research. However, its importance as a public health challenge has been increasingly recognized in government policy and in clinical guidelines, though we are still a long way off delivering evidence-based interventions and assessments to those who would benefit. There is plenty that clinicians can do to reduce the chance of further falls and injuries, to optimize patients’ confidence and ability to cope and to use falls as a ‘case-finding’ trigger to address a host of other, often unrecognized problems. There is plenty community nurses can do in initial assessment, intervention and monitoring. This article sets out the key practice points and in particular the key sources of evidence for practice development.
Equality and anti-discrimination legislation in health care
Authors: Griffith Richard , Tengnah Cassam 
Published: May 2014

The NHS constitution for England (Department of Health, 2009) sets out the rights and responsibilities of patients and staff in relation to the delivery of health care. A key requirement for staff is to ensure that they not to discriminate against patients or staff, and adhere to equal opportunities, equality and human rights legislation. Successive governments have introduced a varied range of anti-discrimination laws that district nurses are required to abide by. These have often developed in isolation to one another, with distinct requirements and rules applying to different forms of equality law. It is essential that nurses working in the community are aware of these rules and that they fulfil their duty under the NHS constitution, the law and their code of conduct.
National minimum standards for community equipment services
Authors: Donnelly Brian 
Published: May 2014

There are approximately 10 million pieces of community equipment delivered to 3.5 million clients every year in England and Wales. The service is key for moving people safely around the whole health and social care system, and is used by almost every clinical professional working in the community. It is an absolute essential part of the early intervention and prevention agenda. Unfortunately, the service currently has no standards in place nor is it regulated or inspected in its own right by any of the regulators. Recently enacted legislation impacts significantly on this service area, which has serious penalties for failure. There are some concerning aspects of service delivery, particularly regarding quality and patient safety issues. Widespread failings in service delivery are resulting in a significant number of unnecessary fatalities and incidents, and avoidable costs being incurred. Undue care in this area is resulting in health and social care organizations not fully realizing their strategic and policy objectives. Unless community equipment is addressed appropriately, these issues are likely to be intensified, especially with recent and proposed changes for community equipment services, such as ‘choice and control’. It is proposed that national minimum standards will reduce risks and improve quality and safety, while saving public funds through a reduction in secondary episodes of care.
Clinical observations 4/6: assessing blood pressure
Authors: Peate Ian , Wild Karen 
Published: May 2014

This is the fourth article in the series of six focusing on clinical observations and here we will consider the assessment of a person's blood pressure. The healthcare assistant (HCA) and assistant practitioner (AP) are often required to carry out this important observation several times a day. This article will address the why, when, how, what and where of blood pressure assessment. An overview of how blood pressure is maintained will be provided, along with the appropriate pathophysiological changes that may impact on a person's blood pressure. The HCA and AP must be aware of how they are to record and report blood pressure findings in line with local policy. Understanding the mechanics of blood pressure and how to perform this task effectively will enable the HCA and AP to provide high-quality, safe and effective care.
Mentorship in action for healthcare assistants
Authors: Hayes Catherine 
Published: May 2014

There is increasing focus in the healthcare sector on mentoring, the process whereby one person gives special attention and support to another. Without care, the mentor-mentee relationship can be fraught and unhelpful. A shared and mutual understanding on behalf of mentor and mentee of what the process of mentorship involves often defines the facilitation of learning and determines the overall time that the professional relationship lasts. Both sides must sign up to a contract that defines the parameters of their work together. This article looks at the elements that make for a good experience for both sides in mentoring. It discusses methods of improving communication and the importance of encouraging reflexivity.
Developing a code of conduct for support workers
Authors: Higgins Claire , Adams John 
Published: May 2014

There has been an increased focus in recent years on the need to ensure high standards of care from all healthcare workers. Codes of conduct represent an important tool in establishing and maintaining high standards, but in the absence of national registration their adoption by support workers has been patchy. This article describes the development of a code of conduct in one English NHS Foundation Trust, Northamptonshire Healthcare NHS Foundation Trust (NHFT). The elements of the NHFT Code are outlined. These include: professional development; respect, empathy and consideration; confidentiality and data protection; equality, diversity and inclusion; professionalism and accountability; you, your team and the organisation; and, finally, behaviours and attitudes.
Shifting The Balance Of Power: managing change
Authors: Dixon Michael 
Published: May 2014

Shifting The Balance Of Power hands the star role in the NHS to Primary Care Trusts (PCTs). This article looks at the following three major aspects: The current plans of the Department of Health outlined in ‘Shifting the Balance - The Next Steps’, and how we might interpret them. Relationships that PCTs will need to make with those around them. The ways in which PCTs will deliver in their various roles.
Nursing management of subarachnoid haemorrhage: A reflective case study
Authors: Lange Fiona 
Published: May 2014

Subarachnoid haemorrhage is a life-threatening event that presents with a number of discrete signs and symptoms making diagnosis problematic. A delay in diagnosis significantly increases morbidity and mortality and therefore places vulnerable patients at risk. Advanced nursing assessment and management is imperative to promote optimum patient outcomes and therefore decrease morbidity and mortality in acutely ill patients. In this article a case study is discussed with reference to relevant literature to explore an evidence-based approach to the nurse's role, care and management of an acutely ill neuroscience patient with subarachnoid haemorrhage. In keeping with the reflective case study approach, Gibbs's reflective cycle (1988) and case study guidelines by Aitken and Marshall (2007) are used to identify areas of effective clinical practices and identify gaps in the literature. On the basis of this evaluation, suggestions for clinical improvements are made. A reflective cycle can identify areas where clinical practice could be improved. It is hoped that this article will help nurses critically reflect on their own practice in the care and management of an acutely ill patient with subarachnoid haemorrhage.
Thromboembolic disorders: treatment and diagnosis
Authors: Allotey Janette C , Louca Onsy 
Published: May 2014

Thromboembolism is the highest cause of maternal mortality during childbirth (Figure 1 and Table 1). Midwives are in a prime position to identify women likely to be at higher than average risk and initiate medical referral. They can also assist with diagnosis of thromboembolic disorders and discuss preventive or curative care with affected women. Maternal mortality rates in the UK have declined from 10.3 per 100 000 (1988-90) to 9.8 per 100 000 maternities between 1991 and 1993 (Department of Health, 1996). Unfortunately, deaths from thrombosis and thromboembolism have remained relatively high over the past 20 years. Some maternal deaths, including those from cerebral thrombosis, occurred following sudden collapse or demise in previously asymptomatic women. However, in a significant number of cases reported in the latest enquiry (Department of Health, 1996), possible symptoms were misdiagnosed by professional carers. With extra mindfulness of who is at risk and by providing appropriate preventive treatment, it may be possible to achieve a reduction in deaths from this cause. This article reviews the risk factors which may be amenable to prophylactic treatment and the signs, symptoms and treatment of thromboembolism.
Management of the nuchal cord: a summary of the evidence
Authors: Melvin Cathie , Downe Soo 
Published: May 2014

A systematic review of management practices, caregivers' views and women's experiences was undertaken to determine the outcomes associated with nuchal cord management practices after the birth of the baby's head and before the delivery of the shoulders for vaginally born, term, healthy neonates. Three hundred and sixty-one initial hits arose from the search strategy. After abstract and full text review, three of these were found to fit the inclusion criteria. They were tabulated thematically. The findings were that midwives' stated beliefs appear to endorse a hands-off policy, although there is some evidence that midwives tend to cut or reduce nuchal cords in practice. There are almost no data on women's experiences of manoeuvres associated with locating and severing a nuchal cord. There is a notable absence of evidence that could be used to support recommendations for cord clamping practices with regard to management of the nuchal cord.
Supervised practice programmes: help or hindrance?
Authors: Capito Clare 
Published: May 2014

The statutory supervision of midwives has been in place since the 1902 Midwives' Act and was viewed as a means of regulating midwives by ensuring that they were appropriately educated. Over the years the supervision of midwives has developed and evolved to being more supportive of midwives by ensuring that they are promoting best practice and that poor practice is dealt with by means of remedial action. This remedial action has developed into the provision of a programme of supervised practice. In 2007 the Nursing and Midwifery Council published the Standards for the supervised practice of midwives with the purpose of ensuring that there was clarity and consistency with the use of supervised practice to address poor practice. As an experienced supervisor of midwives, who has provided a number of supervised practice programmes, the author has written this article to share her knowledge and experience in this field. This article should prove to be of interest not only to supervisors of midwives but to midwifery managers who have to resource supervised practice programmes as well as to midwives so that the process is demystified and understood. The author believes that when a programme of supervised practice is appropriately run, it can be a positive learning experience for all those involved.
A guide to omega-3 DHA intake during pregnancy and breastfeeding
Authors: Parker-Littler Catharine , Klein Kathy 
Published: May 2014

It is well established that good nutrition plays an essential physiological role in a woman's and baby's health during pregnancy and the postpartum period. Midwives have a strategic opportunity to influence and support healthy eating habits and dietary intake but need accurate and evidence-based information including any new knowledge to inform their clinical practice. In recent years systematic reviews of scientific literature and consensus recommendations from international and national experts have emphasized the important benefits of Omega-3 long-chain polyunsaturated fatty acids (LC-PUFA) especially docosahexaenoic acid (DHA) on fetal development and maternal health. This article includes a review of recent literature relating to adequate DHA intake for preconception, pregnancy and breastfeeding. The literature is reviewed with the purpose of providing midwives with a scientific basis from which they will be confident to share their knowledge. Also included is a guide designed to help midwives establish a cohesive practice regarding the communication of Omega-3 DHA information and intake recommendations, including common food sources.
Diagnosing the latent phase of labour: use of the partogram
Authors: McDonald Ginny 
Published: May 2014

Clinically the latent phase of labour is poorly understood and can be hard to define. The concept of the latent phase has significance in understanding normal childbirth because labour is considerably longer when a latent phase is included. This in itself can be detrimental to a woman's opportunity to birth naturally without intervention. This article explores the literature available surrounding the phenomena of the latent phase of labour, how it is diagnosed and how it is measured in the form of a partogram. Discussion finds that there is no reliable evidence to support the use of arbitrary time limits that are placed on women during labour. Exploration is made surrounding the misdiagnosis of labour, the inappropriate use of the partogram and also the consequences of getting it wrong.
Dame Christine Beasley (DBE)
Authors: Lavender Rebecca 
Published: May 2014

Can you give me a brief summary of your career to date? After training as a nurse at the Royal London Hospital and working as a staff nurse and junior sister, I left nursing for 10 years to focus on my children. I returned to nursing as a district nurse. I have held a range of senior nursing and managerial posts, which included chief nurse and general management posts in hospital and community services. I have worked at regional and national level in developing policy and implementing large scale change across England.
ONE-TO-ONE WITH…
Authors: Lavender Rebecca 
Published: May 2014

Can you give me a brief summary of your career to date? I began my midwifery career as a general nurse before qualifying as a midwife in 1983. I spent many happy years working as a midwife across a variety of clinical settings at the Birmingham Women's Hospital. While working in a number of senior posts, I had three children, developed an interest in infant nutrition and gained an MSc in Advanced Midwifery. In 1999, I was appointed as the National Infant Feeding Adviser to the Department of Health in London and had a steep learning curve getting to grips with national policy and civil servants. I joined NICE in 2006 and I have worked in the centre for clinical practice for 3 years, playing a major role in developing clinical guidelines for the NHS.
Critical evaluation and reflection on the role of the supervisor of midwives within the maternity services
Authors: Barnfather Tracey 
Published: May 2014

This paper critically evaluates and reflects upon an aspect of change (introduction of new electronic records) that occurred in contemporary practice, from a supervisor of midwives' (SoM) viewpoint. The statutory framework of supervision is contextualised ( Nursing and Midwifery Council (NMC), 2011a ; 2012 ), followed by a brief discussion as to why records are important. To facilitate critical analysis of the implementation of a new electronic records system, an adaptation of John Kotter's (1996) eight-step process to change by Kotter and Rathgeber (2006) ( Figure 1 ) is utilised. Throughout the paper the SoM's role, in relation to implementing, supporting and evaluating a change in practice, are debated (including actual actions or suggestions of how to facilitate change). Utilising Leamon's Fusion Framework for reflection (2012) ( Figure 2 ), the change to practice is considered and recommendations for future practice shared ( Stewart, 2002 ). Finally, the paper offers a conclusion summarising the key points debated. [Figure: see text] [Figure: see text]
Parkinson's: symptoms, treatments and research
Authors: Heisters Daiga 
Published: May 2014

Parkinson's is a incurable progressive neurological condition caused by a degeneration of dopamine-producing cells. The most common symptoms of the condition include slowness of movement, tremor and muscle stiffness; other symptoms include sleep difficulties, depression and anxiety. Parkinson's is usually controlled by medication but other treatments and therapies, such as occupational therapy, physiotherapy and speech and language therapy, can also be effective in controlling and managing symptoms. The timing of this medication is key to the successful management of Parkinson's. Delays to initiating medication or missed doses can have serious consequences, and it can take some time for symptoms to stabilize. Research into treatments for Parkinson's and, ultimately, finding a cure for the condition, is ongoing. Parkinson's UK researchers are working on projects to identify the causes of cell death and tests to detect the condition at its earliest possible stage. Current treatments can help to ease the symptoms but none can repair the damage in the brain or slow the progress of the condition; now, Parkinson's UK researchers are working to develop new treatments that can.
The binge drinking culture: Fact or fiction?
Authors: Wright Jane , Shaw David , Weatherburn Gwyn , Gandy Joan 
Published: May 2014

Aim: To explore drinking culture in young people and considers the strategies that might be employed to address this public health issue as well as the motives for binge drinking. Method: A mixed-methods research project in southern England employed a countywide survey and qualitative focus groups. Discusion in this article focuses mainly on the qualitative phase of the project, and presents data and ideas from the young people’s perspective. Results were compared with those of a recent national survey, and there was good cross-validation between the two. In this study, survey and focus group data largely complement one another too. Focus group interviews explored young people’s opinions about how interventions would need to change in order to be most effective. Results: The results indicate that most young people have experience of alcohol, typically taking their first full drink around the age of 13 years. Conclusions: Focus groups revealed the type of alcohol consumed by young people, and the sources from which it is obtained. Young people talked about where drinking takes place and some of the untoward consequences. The results show that young people have no difficulty in obtaining alcohol, and that current attempts to dissuade them from drinking are largely ineffective. The implications for health promotion staff, teachers and other stakeholders in the community are explored.
Meningitis part 3: Recovery and after-effects
Authors: Maitland Elizabeth , Cuthbert Judith 
Published: May 2014

This is the third and final article of a series on meningitis. It provides information on the recovery process, and looks at the possible after-effects and complications that may occur as well as the impact these can have on educational achievement and social life in a child. Some after-effects will be immediately apparent, while others may be slow to materialize. It will also offer practical information, which school nurses can give to teachers, school employees and families, on how they can support those affected by meningitis. School nurses are highly skilled health professionals and can provide an essential link between the school, home and community by supporting children who have experienced meningitis through recovery and rehabilitation.
Educational implications of Meares-Irlen syndrome
Authors: Crabtree Elaine 
Published: May 2014

Meares-Irlen syndrome can be defined as the inability to see comfortably due to visual perceptual distortions. The condition is also known as visual stress or scotopic sensitivity syndrome. The condition is difficult to diagnose as the child or young person is often unaware of it. However, it can have serious consequences on educational achievement and it is crucial that educationalists and school nurses are aware of the symptoms.
Acne: The importance of timely intervention
Authors: Lavers Isabel 
Published: May 2014

Acne vulgaris is the most common skin condition worldwide ( Pommerville, 2010 ), mainly affecting adolescents and young adults. Because acne is so common, many refer to it as a normal part of growing up, underestimating the serious effect acne can have on the way a young person performs at school or socially. Acne is treatable and early intervention is crucial to the successful management of acne and to preventing post-inflammatory scarring. School nurses are ideally placed to offer practical advice, promote early access to effective treatment and provide psychological support. The Chief Nursing Officer Review defined the role of the school nurse as providing ‘general information, advice and support about health issues’ ( Department of Health, 2006 ). Using a case study, this article aims to provide school nurses with general information about acne, an overview of current treatment options and practical tips to support compliance.