bluuebunny/crossref_metadata_2025_split huggingface dataset:
The experiences of young people with primary lymphoedema
Authors: Harding Jane E 
Published: May 2014

This article presents the findings of a study investigating the experiences of seven young people who were diagnosed with primary lymphoedema before the age of 25. A phenomenological approach was taken and data collected using audio-taped conversational interviews, which were transcribed and analysed using a thematic framework. The findings revealed that young people had struggled to secure a diagnosis and find appropriate treatment, which appeared to be caused by a general lack of professional awareness of lymphoedema. Evidence of a desperate need to keep the lymphoedematous limb hidden became apparent which affected all aspects of their lives - fashion, education, relationships with family, friends and peers and physical activities - and caused difficulties with self-esteem and self-image. Children and young people with lymphoedema all differ because of intrinsic (genetic makeup) and extrinsic (family, surrounding environment, life experience) factors. Therefore each must be considered an individual and the experience unique to them.
Understanding hearing and causes of hearing loss
Authors: Swann Julie 
Published: May 2014

Hearing helps us to understand and negotiate the environment and assists in communication with others. Even a mild hearing loss causes problems with identification of everyday sounds such as voices, the doorbell and the telephone ringing. Severe hearing loss profoundly affects a person's ability to communicate effectively and to participate in many leisure activities. Many of the UK's population experience hearing problems, but some may be unaware of the extent unless it is brought to their attention. This article explores the process of hearing and some of the causes of hearing impairments.
Skin assessment: a vital skill for HCAs and APs
Authors: Andrews Hilary 
Published: May 2014

Wherever healthcare assistants (HCAs) and assistant practitioners (APs) work, they will inevitably come across people with existing skin conditions or new skin changes. Patients in their care may also be at risk of developing skin problems and pressure ulcers. This article explores the HCA/AP role in relation to skin assessment and what is involved in a comprehensive skin assessment. The article also explores when and why skin assessment is important, how to describe skin changes and what steps to take after assessing the skin.
Embracing all areas of the work
Authors: Tatiana Rodrigues 
Published: May 2014

Tatiana Rodrigues was nominated by her line manager, Jackie Tardivel, Senior Sister, at Jersey General Hospital: ‘Tatiana has worked in outpatients for three years. During this time she has shown great courage and commitment in her work. The excellent skills and competencies which she had gained through her NVQ award enable her to work within all specialities in Outpatients. ‘Tatiana tirelessly works in the paediatric clinics, where her calm and reassuring presence means she is able to act as a sensitive support to both child and family. In an extreme emergency, Tatiana used her bilingual skills to support a family to make a terrible situation more bearable, for which they are forever indebted.’
Wound cleansing: is it necessary, or just a ritual?
Authors: Jones Menna Lloyd 
Published: May 2014

Wound cleansing is considered to be an integral part of wound care. Nevertheless, it is often said to be a ritualistic procedure that is undertaken with little thought or rationale ( Magson-Roberts, 2006 ). Is wound cleansing therefore a procedure that needs to be performed? The aim of this article is to consider the need for wound cleansing, the solutions used and the preferred method of cleansing wounds.
Clinical observations 2/6: assessing the pulse rate
Authors: Wild Karen , Peate Ian 
Published: May 2014

This is the second article in a series of 6 that focuses upon clinical observations. The healthcare assistant (HCA) and assistant practitioner (AP) must ensure they employ effective practices and have the ability to record and report findings in line with local policy. This article details the why, when, how, what and where of pulse rate measurement. A discussion concerning pulse rate measurement is offered, providing the HCA and AP with an understanding of how the pulse is maintained. Factors that impact on the pulse rate are discussed and a conclusion is offered Measurement of the pulse is an indirect measurement of the heart beat.
Fundamentals of infection prevention and control
Authors: Nazarko Linda 
Published: May 2014

At the beginning of the 21st century, the UK had one of the highest rates of healthcare–associated infection (HCAI) in Europe ( National Audit Office (NAO), 2000 ; 2004 ). Changes in healthcare practice, including an increased emphasis on handwashing, have led to a major decline in healthcare–associated infections, from 9.2% of patients in 1980 to between 6.7–6.4% in 2011 ( Walker et al, 2011:69 ; Health Protection Agency (HPA), 2012 ). Health Protection Agency data (2012) shows the rate of HCAI fell from 8.2% to 6.4% in five years. There has been a 69% reduction in MRSA bacteraemia rates and a 59% reduction in clostridium difficile infections over the past five years (Public Health England, 2013). Although much has been achieved, recent rising levels of antibiotic resistance mean ‘we could be close to reaching a point where we may not be able to prevent or treat everyday infections or diseases’ ( Department of Health (DH), 2013 ). Every healthcare worker has an important part to play in helping to prevent infection and to stem the tide of antibiotic (also known as antimicrobial) resistance. This article, the first in a series, aims to enable readers to understand the fundamentals of infection prevention and control. It explains how the body attempts to defend itself against infection, who is most vulnerable to infection and how infection affects older people and other vulnerable groups. The article explains how to assess and reduce risk and sets the scene for the series.
Ambulation in older people—mobility explained
Authors: Hayes Catherine 
Published: May 2014

The way older adults move is significantly different and progressively changing as part of an overall decline in physiological and mechanical function in the normal ageing process. The aim of the article is to provide an insight into how positioning of the skeleton and the musculoskeletal system contribute to an older person's capacity to remain independent and mobile, two key factors in their overall health and wellbeing. Certain medical conditions can greatly influence the capacity people have to move; and they can become identifiable not as individuals but as the diseases they have been characterised by in their outward physical appearance. Many HCAs will have no previous knowledge of the terminology of human walking and this article offers a basic introduction to how the gait cycle works and how this changes in ageing. Posture and stability are two pivotal elements to successful ambulation and these are considered alongside the overall concept of movement in older people. From a practical perspective, it offers a means of HCAs being compassionate and understanding about the ease of movement older people live with on a day-to-day basis.
Support workers have a vital role to play in play
Authors: Stonehouse David 
Published: May 2014

Within this article, the author will be examining the importance of play for children and young people, especially when they are in hospital. Play will be defined; however, this is a concept which is difficult to grasp, as play means different things to different people. The article will highlight the benefits that play brings for healthy children, before discussing the important role it has for children and young people in hospital. The fact that play is everybody's business and should not just be left to the play specialist alone, will be asserted and demonstrated. Support workers are closest to patient care and are therefore ideally placed to support children and young people to play within the healthcare settings where they are being cared for.
Models of pressure ulcer care: costs and outcomes
Authors: Clark Michael 
Published: May 2014

Pressure ulcer prevention and treatment are expensive with these costs generally believed to be largely avoidable. The consequences for cost-effective treatment are evident. This paper describes the use of a decision model that predicts both the occurrence and cost of pressure ulcer care within UK hospital populations. The data upon which the model was based was drawn from a large multi-centre cohort study and illustrates the translation of research data into a relevant management tool.
Assessment and management of sexual dysfunction in women with multiple sclerosis
Authors: Ward Nicki 
Published: May 2014

Multiple sclerosis (MS) is a complex, incurable and unpredictable disease of the central nervous system diagnosed in young adults. The progression of the disease can result in significant sexual dysfunction for some, and can cause great distress and severely impair quality of life for both the individual and his/her partner(s). Much of the research into sexual dysfunction in MS has studied the male experience, partly because pharmacological treatments have become available to treat erectile dysfunction in men. However, women's sexual difficulties do not respond well to available drug therapies. This paper looks at the definition and categories of sexual dysfunction and at the assessment of sexual dysfunction in women with MS. Practical suggestions are made for the management of the symptoms of sexual dysfunction in women with MS, and it is argued that the specialist nurse has an important role in providing education and support for such women. A nurse sensitively raising the topic of sexual difficulties allows MS patients to relax and discuss this vitally important area; without this, patients may wish to initiate such a discussion but find it too embarrassing to do so.
The importance of early consideration of palliative care in Parkinson's disease
Authors: Rudkins Helen , Aird Thomas 
Published: May 2014

The topic of palliative care is a complex paradigm. However, there is limited literature considering its component in Parkinson's disease and other neurodegenerative conditions. The aim of this paper is not to discuss the nursing care of palliative-stage Parkinson's disease, but rather the wider issues pertaining to palliation and the role played by the nurse specialist. Initially the definition of palliative is discussed and whether the criteria for reaching the palliative stage of Parkinson's disease match the definition. The palliative stage will be considered alongside the other three stages in the ‘pathways paradigm’ as identified by MacMahon and Thomas (1998). The direct impact of the diagnostic stage is discussed alongside the differential diagnosis of Parkinson's disease. How this may affect when the palliative stage begins and how the role of the nurse affects patient outcomes will be outlined. Additional psychosocial issues will be examined, regarding the impact on family members and carers encountered during the palliative stage. Finally, the provision of services in relation to palliative care of patients with neurodegenerative conditions will be discussed, alongside the National Service Framework for Long-Term Conditions and how it impacts on nursing practice.
Optimal medicines use and lifestyle in migraine management and prevention
Authors: Manning Karen , Jansenn Paul , Dowson Andrew 
Published: May 2014

The management of migraine yields the best results when lifestyle adjustments are made in conjunction with the use of acute and/or preventive treatments. Migraine remains a disabling condition. In a survey of 1614 migraineurs conducted by the Migraine Action Association in 2007, about 80% reported an attack at least once a month, and more than half of them reported having an attack every week. A range of options is available to migraineurs: diet and lifestyle adjustments, acute and preventive medication, as well as complementary therapies and other recent developments. The results of the Migraine Action Association's survey highlight how respondents experience current treatment methods, and to what extent they are aware of alternatives. The authors argue that through improved understanding about migraine and other headache types, and a better knowledge of the help and support available, migraine sufferers will be better equipped to manage this chronic and disabling lifelong condition.
The RESCUEicp study of decompressive craniectomy: Implications for practice
Authors: Corteen Elizabeth , Timofeev Ivan , Kirkpatrick Peter , Hutchinson Peter 
Published: May 2014

The Randomized Evaluation of Surgery with Craniectomy for Uncontrollable Elevation of intracranial pressure (RESCUEicp) study was undertaken to determine whether decompressive craniectomy has a role in the management of patients with traumatic brain injury and raised intracranial pressure. The study compares maximal medical management and decompressive craniectomy, the two approaches used when all other interventions have failed to control intracranial hypertension. Neither of these therapies has grade one evidence to support its use, but both are regularly used as a final escalation of treatment in this vulnerable client group. The pilot phase of the study has been completed and the main study is now underway, having recruited over 100 patients to date. Nurses caring for patients enrolled in research studies have a duty to be involved in the research process, as well as to understand the evidence obtained and apply it to practice. In this article, the authors draw on their experience of involvement in the RESCUEicp study to highlight possible areas where nurses can become more involved in the process of research so that research findings can be used to improve the care that their patients receive when they are at their most vulnerable. Such an approach has great potential to shape the development of nursing as a profession.
Exploring the lived experience of palliative care for people with MS 1: A literature review
Authors: Embrey Nikki 
Published: May 2014

This article is the first in a series which explores patients′ experiences of palliative care services for moderate-to-advanced multiple sclerosis (MS). This first article comprises a review of the literature on palliative care services for non-cancer patients. Subsequent articles will present research evidence of patients′ experiences of palliative care services for MS. A phenomenological approach is adopted, a method especially suited to studying and understanding people′s experiences of illness andthe care they receive. Such an approach entails a rational and intuitive process, rather than a rigid and restrictive method. The findings of this literature review highlight that people in the advanced stages of MS have a number of unmet needs. Variations were noted in the care received, and palliative care appears to enhance the patient′s experience. A supportive care pathway may reduce variations, by identifying appropriate patients for high quality holistic care. It is recommended that imaginative and innovative solutions are sought to meet the needs of those with advanced disease.
Assessment of an autoinjection device commonly used by patients with multiple sclerosis
Authors: D’Arcy Caroline , Parkes Laura , Shepherd Gillian 
Published: May 2014

Aim: To determine the level of correct use of an autoinjection device for administering interferon beta-1a subcutaneously among patients with relapsing–remitting multiple sclerosis (MS), and to identify training needs to improve technique. Methods: In this Phase IV observational study at 11 UK sites, patients were assessed on device use via a 10-point checklist. The percentage of patients performing all 10 steps correctly, the three most common incorrect steps, and the association between correct device use and recent training or disease history were evaluated. Results: Of 100 patients, 38% (95% confidence interval: 28.5%, 48.3%) used the autoinjector correctly. The three most common incorrect steps involved device maintenance, identification of injection completion and device priming. There were no associations between correct device use and recent training, relapse rate, injection-site reactions, cognitive impairment and time on treatment (all P>0.05). Conclusions: There is a need for ongoing training of patients regarding correct autoinjection device use.
Health-care workers' perceptions of contributors to quality of life for people with Huntington's disease
Authors: Harding Vincent , Stewart Inga , Knight Caroline 
Published: May 2014

Background: Huntington's disease (HD) is a long-term neurological condition. Owing to its degenerative nature, quality of life (QoL) considerations are important regardless of whether individuals are in the early, middle, or end-of-life stages. Currently there is a shortage of person-centred research looking at non-pharmacological interventions to improve QoL for those with an HD diagnosis. Objective: To assess perceptions of QoL among health-care workers at a specialist HD unit in a UK hospital, as well as their perceptions of how they and others contribute to the QoL of service users. Methodology: Eight participants were recruited using opportunity sampling. They included dietetics, occupational therapy, nursing, physiotherapy, psychology, and speech and language therapy staff. One-to-one, face-to-face, semi-structured interviews were conducted with each participant. The data was analysed using the qualitative methodology grounded theory. Results: Eight main themes arose: QoL; the unit; staff; communication; hopes, fears and behaviour; family involvement; ongoing support; and future directions for enhancement of QoL. Conclusions: It is hoped that the paper will act as a foundation for further exploration of QoL issues and a focus on how individuals with HD and other neurological conditions can be best supported to live with optimal QoL. The paper should raise awareness of HD and be of assistance to health-care workers by highlighting the challenges faced in providing appropriate support, while also making recommendations for future practice.
Care of pregnant women with heart disease: A multidisciplinary approach
Authors: Abdin Sabah 
Published: May 2014

Owing to recent advances in paediatric cardiology and surgery almost 90% of children born with congenital heart disease will now survive to adulthood. Approximately half of these patients are female. In midwifery we are seeing a new population of pregnant women who have complex heart disease. Many of these young women will have had some form of intervention or surgery previously to treat their heart disease and some are left with significant residual haemodynamic problems. However, these women can have a safe pregnancy with good outcomes for both mother and baby if they are given access to specialist care and a multidisciplinary team approach is taken to their management.
Clinical skills: issues affecting the left-handed midwife
Authors: Chapman Vicky 
Published: May 2014

Left-handed people have the advantage in certain sports, are found concentrated in particular careers and are apparently more likely to be creative and artistic. Unfortunately, they are also more likely to suffer from poor memory, are genetically predisposed to schizophrenia, have a greater tendency towards accidents and probably find the placement of the pen on a chain in the post office frustrating. Issues affecting left-handed midwives have yet to be cohesively addressed. This article identifies some of the practical skills left-handed midwives may find awkward or near impossible. For midwifery students the problems of learning new skills with their right hand poses the greatest difficulties. Mentors and tutors need to identify and even place left-handed students with other left-handers for learning left-hand specific techniques such as perineal repair. In addition, mentors need to teach flexibly and allow left-handers to use their left hand if preferred, even if it means they need to stand on the opposite side of the woman, such as when palpating, performing a vaginal examination or delivering a baby.
Involving supervisors of midwives in student education
Authors: Bacon Lisa 
Published: May 2014

As the complexities and challenges of practice and expectations of the midwifery role requirements increase then so will the support that midwives require from supervisors of midwives as part of their professional relationship. It is well documented in the literature that the role of mentor can bring with it a particular series of challenges, one of the most difficult of these being when a midwife is faced with the situation of having to fail a student in practice. The Nursing and Midwifery Council clearly states that robust processes should be in place to ensure that where there are issues of concern with regard to a student's practice, these should be dealt with swiftly. Early and continued involvement of supervisors of midwives can make a significant contribution to these processes and the form these contributions can take merits further discussion. It is suggested that positive role modelling of supervisors of midwives will benefit students by helping them develop a positive concept of accountability. As leaders of the profession it is argued that supervisors of midwives must create opportunities to engage strategically in the development and delivery of midwifery education.
Midwives should perform the routine examination of the newborn
Authors: Baker Karen 
Published: May 2014

Research indicates that midwives are equally effective as senior house officers, if not more so, in performing the routine examination of the newborn. When midwives performed this examination their level of job satisfaction was increased and the mother's satisfaction with the examination was also increased. However, studies have also highlighted that midwives are concerned that they might be pressurized into taking on new roles as well as being worried that they may have no control over their workload. Furthermore, it has also been shown that the majority of maternity units do not have enough staff to cope with the rising birth rate and that midwives already have to deal with an increasing workload, resulting in them struggling to provide a safe, quality service to women and babies without taking on new roles. By delegating some of a midwife's workload to another category of skilled worker may enable midwives to re-evaluate their existing role, and take on new roles that support the midwifery philosophy of care. This philosophy of care views pregnancy, childbirth and the postnatal period as a continuum, with the woman and baby being the primary focus of the midwives' practice, stresses the importance of the midwife working in partnership with the woman and her family. Such a philosophy enables the woman to make informed decisions about her care. The pregnancy continuum is also viewed as a normal life event, which is supported by midwives. If research indicates that midwives are better at performing the examination of the newborn, then why is it that more maternity units do not have midwives who are able to carry out this skill, since midwives in the UK have been able to undertake this examination for more than 10 years? In addition, in units which do have midwives who can perform the examination, why are these midwives not using their skills?