bluuebunny/crossref_metadata_2025_split huggingface dataset:
The impact of depression on recovery and rehabilitation following STEMI
Authors: Martin Fiona 
Published: May 2014

The risk of major depression is significantly increased following the diagnosis of coronary heart disease and it remains high. Depression can have a major impact on the rehabilitation and recovery process after a myocardial infarction—a depressed person may not have the motivation to meet the core components of a cardiac rehabiliation programme. This article describes how depression can affect the recovery process, who is at risk of depression, and discusses key features of depression that may prompt referral for further specialist assessment.
Bereavement and the older person: a community nursing perspective
Authors: Faulkner Micheline 
Published: May 2014

The intention of this paper is not to discuss bereavement in general terms, but rather to focus upon the specific needs of older people. In particular, the paper will describe a bereavement support project designed to identify and work with older people who may be at risk of a poor bereavement outcome. Specific attention will be given to those who have been identified as carers of a chronically ill dependant, and those who have been suddenly or unexpectedly bereaved. A description is given of the Good Grief Project which is one of the 1995 Queen’s Nursing Institute Innovation Awards.
The use of strong opioids for cancer pain in the community
Authors: Daniels Lilian , Faull Christina , Blackshaw Carole 
Published: May 2014

District nurses have been identified as catalysts for change in facilitating the improvement of terminal care at home (Jones 1995). Good pain management is one key element of quality terminal care in the community setting. The emphasis on the primary care team as the focus of continuing patient care, and the ever developing technology and pharmaceutical market for pain management, pose increasing pressures on community health care professionals to ensure practice is evidence-based. A large amount of literature and guidelines exist in the field of pain management. Interpretation of this information and its practical application is essential in order to ensure equitable, individualised and quality focused care.
Development of nutritional risk screening in the community
Authors: Gilford Ann , Khun Khun Resham 
Published: May 2014

A district nurse and community dietitian joint initiative has resulted in the development of a community-focused nutritional screening tool. The purpose of the tool is to standardise community nurses’ practice in the patient’s own home when screening for risk of malnutrition. The tool has a matrix format containing eight categories. A score is given in each category which cumulatively relates to low, moderate or high risk. An action plan has been formulated to relate to these scores. A pilot study has been undertaken using a repeated measures method on a total of 27 patients. Two community nurses screened each patient using the tool under development. A dietitian then reassessed patients using a mix of clinical judgement and a pre-validated nutritional risk tool. Statistical analysis of the pilot study data has shown a high degree of correlation between the two nurses, the tool under development and the pre-validated tool. It is recommended that a more extensive study is required to confirm these results. Research is also required to investigate patients’ perception of the suitability of the nutritional action plans.
The role and function of the school nurse
Authors: DeBell Diane , Everett Gil 
Published: May 2014

The findings of an in-depth study of school nurse services in East Norfolk have revealed major challenges for the definition and organisation of school nursing. The multi-perspective research for this study offers a model for research use by school nurse services elsewhere, because it involves detailed external and internal analysis of the service. The Norfolk research, carried out between January and August 1996, was a study of school nursing, not a study of either the school health service or the health needs of school age children. These broader issues are the context in which school nurse services operate. This paper summarises the key issues that school nurses across Britain are confronting. These are the macro issues. The full research report includes a case study of the school nurse services commissioned by Norfolk Health Authority for delivery from two community health NHS Trusts.
Practice: the focus of learning
Authors: Coles Lesley , Wilkins Vivian 
Published: May 2014

The specialist programme for the preparation of Community Health Care Nurses at degree level presents many challenges for educationalists and Community Practice Teachers (CPTs). This article describes the development of a programme designed to support and enable CPTs in their new role. It includes an overview of Situational Analysis (Skilbeck 1975) as a means to provide an analytical framework to encourage the development of enquiry, reflection and critical appraisal of the practice environment. In addition, assessment of practice at degree level is explored through the use of a Theory to Practice Portfolio to encourage and enhance reflective practice.
Chronic pain: the cognitive behavioural approach
Authors: Ralphs Judith , Corcoran Mike 
Published: May 2014

The specialist area of chronic pain has developed in Britain since the 1980’s to respond to the un-met need of those whose distressing intractable pain has not been helped by conventional treatments. Cognitive behavioral therapy is now the treatment of choice to help improve sufferers quality of life despite continuing pain. The paper examines the consequences of this often disabling condition and describes the enabling self management approach undertaken at INPUT at St Thomas’ hospital in London.
Nursing in primary care: lessons from St Petersburg
Authors: Carey Lynda , Jones Ann 
Published: May 2014

The purpose of this paper is to undertake a comparative examination of nursing within the primary care setting in both Russia and Britain. The paper outlines the value to both nurses currently working within primary care, and purchasers of nursing care, by drawing upon the experiences of nurses working in the less economically advanced environments of the former eastern bloc. It is suggested that this more global perspective will contribute to the re-appraisal of the development of British nursing in primary care. The authors will argue that given the opportunities afforded to nursing in the new Primary Care Act (1997), and specifically the explicit recognition of nursing to healthcare provision, British nurses should seize the opportunity to develop their practice.
A district nurses’ guide to disability discrimination law: part 1
Authors: Griffith Richard , Tengnah Cassam 
Published: May 2014

District nurses have a unique role in the continuing care of people with disabilities. Some 20% of people are considered disabled and they now have rights under the Disability Discrimination Act 1995. However, to benefit from these rights people must meet the legal definition of disabled under the Act. It is essential therefore that district nurses are able to interpret and apply this legal definition in relation to their patients in order to better advise them regarding their disability and their rights under the Act. In the first of two articles on disability discrimination, Richard Griffith and Cassam Tengnah discuss the requirements that need to be fulfilled in order to meet the definition of disabled under the Disability Discrimination Act 1995.
Thinking falls - taking action: a guide to action for falls prevention
Authors: Robertson Kate , Logan Philippa , Conroy Simon , Dods Verity , Gordon Adam , Challands Linda , Smith Sue , Humpage Sally , Burn Ann 
Published: May 2014

Clinical guidelines and research papers help clinicians measure and understand the risk of falling in their older clients but very few provide the assessor with recommendations as to which interventions they can use to reduce the risk of a fall. The Guide to Action for Falls Prevention tool (GtA) was developed to help professionals from a broad range of organizations to recognize factors that might increase falls risk and know which actions to take to lessen that risk. Twenty four professionals tested the GtA in a clinical setting and found it quick (15 minutes) and easy to complete. The GtA needs further evaluation to test whether it is a practical way of delivering a falls prevention intervention.
Chronic oedema and lymphoedema of the lower limb
Authors: Hampton Sylvie 
Published: May 2014

There is a very fine line between oedema, chronic oedema, lymph venous oedema and lymphoedema with the names ‘chronic oedema’ and ‘lymphoedema’ often used interchangeably. Therefore, there can be difficulty with diagnosis of which condition is present in the individual patient, particularly when another unrelated condition (lipoedema) can also be mistakenly diagnosed as lymphoedema. The most important thing to remember is that, although there is this fine line between the conditions, each part of the disease development cannot be entirely separated or treated completely in isolation. The key to good outcomes in lymphovenous oedema is to treat it at the earliest stage possible to prevent deterioration, venous ulceration and the almost inevitable cellulitis that is associated with lymphoedema skin changes. This article will aim to promote an understanding of the different conditions and stages, will provide a simple identification of the condition and will discuss how lymphovenous oedema can lead eventually to the very difficult-to-treat chronic lymphoedema with ideas of how to prevent this deterioration.
Managing patients on enteral feeding tubes in the community
Authors: Omorogieva Ojo 
Published: May 2014

Despite the psychological effects of enteral tube placement, the use of an enteral feeding tube is of vital importance in patients having swallowing problems and those with deficits in nutritional status. The differences in enteral feeding tubes, their complications and the varied management approaches by health professionals including review criteria have significant impact on the outcomes of patients receiving home enteral nutrition (HEN). In addition, the HEN team is a multidisciplinary team that work closely with district nurses (DNs) and community nurses who review these patients independently. Thus, there is a need to have a harmonized framework in form of algorithm that health professionals can apply in practice and will be beneficial to patients. AIM: This study was aimed at reviewing the activities of the HEN team and developing an algorithm for the management of patients who are receiving HEN through tube feeding. METHOD: The activities of the HEN team in terms of the clinical management approach were reviewed in relation to the HEN team policy for managing patients on enteral tube feeding, national guidelines and research evidence. Based on the review, an algorithm for the management of enteral tube feeding was developed. CONCLUSION: Although the current HEN team clinical management approach is in line with national guidelines, the development of the algorithm for the management of patients receiving home enteral tube feeding was aimed at streamlining the various management approaches and standardizing practice.
Whistleblowing and the law
Authors: Griffith Richard , Tengnah Cassam 
Published: May 2014

The Government wants to empower nurses to speak out to protect their patients without fear of being victimized or dismissed and are looking to amend the NHS Constitution to strengthen protection for staff who blow the whistle on poor practice. Currently whistleblowers are protected by the provisions of the Employment Rights Act 1996 as amended by the Public Interest Disclosure Act 1998. This allows a whistleblower to appeal to an Employment Tribunal for reinstatement if they are dismissed or victimized as a result of their actions. The protection currently offered under the 1996 Act is not absolute and a nurse who wishes to pass on information about bad practice in the interests of their patients must be sure to follow the requirements of the Employment Rights Act 1996 and their employer's whistleblowing policy before their disclosure qualifies for protection.
The Health Care Academy: a route into employment
Authors: McEwan Robert , Smith Alison , Laing Joan 
Published: May 2014

Scotland is seeing a rise in long-term illnesses among the elderly population and life expectancy is low compared with most Western European countries (The Scottish Government, 2006). With this decline, it is imperative that Scottish people have a strong health service to rely on. Though the NHS is no stranger to problems with functioning effectively, there are training progammes which are helping to build it up and provide a competent, skilled workforce. NHS Tayside Healthcare Academy provides training for people who are unemployed and many of its students have trained to be healthcare assistants, some are even planning to progress into the role of registered nurse. This article gives an overview of the academy and what training is available for those interested in joining the NHS workforce.
Ageing part 2: the musculoskeletal system, the skin and the senses
Authors: Peate Ian 
Published: May 2014

The first article in this series (Peate, 2007) considered the affects ageing has on the nervous and the cardiovascular systems. This article continues with a focus on the musculoskeletal system, the skin and the five senses. The physical ability of older people is often reduced as they age. It is important for healthcare assistants and assistant practitioners to have a good understanding of why these changes are taking place and this article provides an overview of how these different systems of the body are affected. The third and final article in the series will focus on the gastrointestinal, the endocrine, the immune and the genitourinary systems.
Body fluids: Components and disorders of the blood
Authors: Peate Ian 
Published: May 2014

Anatomically and histologically blood is not classified as a fluid, it should more accurately be known as connective tissue. Blood has its origins in the bones and contains potential molecular fibres - fibrinogen and as such is tissue (White et al, 2007). However, for the purpose of this series, it will be included under the category of fluid. Blood is a red, sticky liquid that is vital for life; it is the life-giving fluid of our bodies and is pumped by the heart via the circulatory system (the blood vessels) throughout the body. Blood forms the main transport system of the body. Every cell in the body gets its nutrients from blood, without blood, cells and tissues will die. An understanding of blood can help you in your day to day work.
Parkinson's disease part3: assistive devices
Authors: Swann Julie 
Published: May 2014

This article describes how Parkinsonian symptoms can produce difficulties with activities of daily living. Adaptations and assistive devices are discussed that can help overcome problem areas and improve levels of independence. Healthcare assistants and assistants practitioners have a vital role to play in the identification of problem areas. They can help patients by providing information on the types of items that are available and direct them to sources of further advice and equipment to help maintain a person's maximum level of independence. There is a glossary at the end of the article which provides definitions of words you may not be familiar with.
Going beyond the call of duty
Authors: Powell Sheila 
Published: May 2014

Sheila Powell has been a healthcare assistant for 9 years. Recently, she has worked particularly hard in order to get her NVQ Level 3 in healthcare and is now able to extend her role to include administration of insulin to patients in the community. District Nurse Team Leader Mandy Churms nominated Sheila as a healthcare hero to celebrate her efforts with patients at home and in residential settings. She is particularly well known for promoting self care and encouraging patients to take a lead in their own healthcare. Sheila gives outstanding care to terminally ill patients and the written and verbal feedback supports this all the time. She will take on extra work and the team feels fully supported by her.
Sexually transmitted infections—3/6: testing
Authors: Collins Emma , Peate Ian 
Published: May 2014

Sexually transmitted infections (STIs) are a major public health problem, and are one of the most common causes of ill-health, and even death, in the world today ( Adler, 2007 ). Concern about sexual health and diagnosis of an STI can have a devastating effect on people. The support worker can play an important role in the management of STIs and the promotion of sexual health and wellbeing. The first article in this series considered the epidemiology of sexually transmitted infections (STIs) and how the support worker's role can help patients meet their sexual health needs in a variety of settings by being aware of the important elements of risk assessment (sexual history). The second article focused on gonorrhoea. This, the third in the series, will consider issues relating to testing for STIs. We will consider what infections can be tested for and how, and think about opportunities for testing in different settings and how the support worker role can facilitate this.
A brief history of the registration of nurses
Authors: Lloyd Jones Menna 
Published: May 2014

To work as a nurse or midwife in the United Kingdom today, you must be on the Nursing and Midwifery Council (NMC) register— and over 660 000 nurses and midwives are registered ( Nursing and Midwifery Council, 2011 ). Recently, the Health Secretary Andrew Lansley officially announced plans for a voluntary register, code of conduct, and basic training standards for healthcare assistants (HCAs). With talk of registration of HCAs, it may be interesting to look back at the trials and tribulations that were to eventually lead to the registration of nurses in 1919 ( Baly, 1973 ). The aim of this article is briefly to follow the path that led to the registration of nurses in 1919.
What is polypharmacy? An overview for HCAs
Authors: Hayes Catherine 
Published: May 2014

Many healthcare assistants (HCAs) working within the context of gerontology will encounter patients with lengthy lists of prescribed and non-prescribed medication. While it is not within the scope of practice of an HCA to question the reason for patients to be following what might appear to be a relatively complex drug regimen, it can be useful for the HCA to understand the common implications of what is termed ‘polypharmacy’. This paper discusses the functional decline of the body as a natural part of the human physiology of aging and also the difficulties associated with managing polypharmacy in the elderly. It has also been written with the intention of building interprofessional capacity between the many HCAs associated with caring for elderly patients and for whom the HCA role is fundamental to high-quality healthcare provision. The paper examines those conditions and disease states in which polypharmacy is more common and more importantly reinforces the fact that there is no one disease process which is unique to the elderly; rather, they are more likely to endure co-existing disease processes as their physiological senescence occurs naturally as an integral part of human aging.
Best practice statement (2nd edn): Care of the older person’s skin
Authors: Jones Menna Lloyd 
Published: May 2014

Skin changes occur as a consequence of ageing and those skin changes increase the susceptibility of the skin to damage. With an increasing ageing population, there is a constant challenge to maintain the integrity of the skin. Best practice statements (BPSs) have been developed in an attempt to provide practitioners with evidence-based guidance on the most appropriate delivery of skin care to this vulnerable group. The aim of this article is to briefly review the content of the revised, second edition of the BPS, Care of the Older Person’s Skin, which was launched at the Wounds UK conference in Harrogate in November—and also to highlight its relevance in clinical practice.
Professional integration of APs via critical incident technique
Authors: Jones Colin , Waller Caroline 
Published: May 2014

It is unquestioned that the assistant practitioner (AP) is a valuable member of the healthcare team; however, some APs have reported challenges in being accepted into their roles. Using a critical incident technique, a purposive sample of 5 assistant practitioners took part in a study, which explored their experiences of working within a multidisciplinary team. More specifically, the objectives of the study were to identify examples of good practice and also to uncover those areas that could be improved. Four key themes emerged from the data: Being acknowledged Professional put-downs Role ambiguity Expectation boundaries Despite being small-scale, the study concluded that the integration of the AP role is fraught with challenge. The study also concluded that the critical incident technique (CIT) is a valuable method when undertaking research in this area.
APs in the nursing home: caring for those at the end of life
Authors: Smith Joanne , Brown Trish , Powell Michelle 
Published: May 2014

Palliative and end-of-life care must be a multidisciplinary approach and can be delivered in a range of settings. As the population ages, many older people who need palliative and end-of-life care may receive this care in a nursing home. The place a person spends their last few days varies, with most people wishing to die at home, whether that be living and dying in their own home or in a nursing or residential home ( Age UK, 2010 ; Munday et al, 2007 ). The final article in this series of 4, with the 3 former looking at hospice care, hospice at home and day care ( Brown and Smith, 2012a , b , c ), will explore the role of the assistant practitioner (AP) in this environment. It will look at the way in which services are responsive to an ageing population and the issues of ageing, also the importance of creating a workforce that can meet this need. Furthermore, consideration will be given to the importance of good-quality care at the end of a person's life within a nursing home setting. Legal and ethical issues will also be examined. There will also be examination of the course that has been developed around end-of-life Care, and comments from a student about her experience.
Continence series 5: managing urinary incontinence
Authors: Nazarko Linda 
Published: May 2014

The person with urinary incontinence can feel embarrassed and ashamed. The person can become depressed and feel that life is not worth living (Aguilar-Navarro et al, 2012). Staff caring for people with urinary incontinence should ensure that when urinary incontinence cannot be treated it is managed well. This requires great sensitivity and skill, but the rewards in enabling the person to avoid complications and experience the best possible quality of life are among the reasons many chose to work in healthcare. Providing quality continence care enables the person with continence problems to maintain dignity and avoid complications such as skin damage, leakage and embarrassment. This makes a huge difference to a person's quality of life.