bluuebunny/crossref_metadata_2025_split huggingface dataset:
Learning disabilities: a practical approach to helping people grieve
Authors: Elliot David 
Published: May 2014

Reasons why people with learning disabilities do not receive the support they require following a bereavement are explored in the context of a social model of disability. Grief and bereavement issues are also seen as a health promotion issue. A variety of interventions are identified which could meet the needs of people with learning disabilities at this sensitive time in their lives. The outcomes of health promotion interventions are highlighted, and a facilitation model of grief is outlined (based on Heron 1989). This model is designed to help people who have experienced uncomplicated grief reactions and consists of six dimensions of facilitation which are detailed. Finally, ways of moving forward in this sensitive area are suggested.
Study of care management arrangements for dying children
Authors: While Alison , Cornish Jocelyn , Citrone Christina 
Published: May 2014

An interview study of ‘key’ providers of care for children over one year of age with life-limiting, incurable disorders is described. The study was conducted in 12 District Health Authorities (DHAs) across four selected Regional Health Authorities.The data were drawn from 92 semi-structured transcribed interviews with care professionals, such as social workers, community nurses and paediatricians. Not all DHAs had written local strategies to guide care management. A wide diversity of provision, together with care management arrangements, was described for a number of diseases. Several care professionals were found to contribute to the care of these children and their families in a variety of ways. The need for more respite care facilities and bereavement services was highlighted, although most DHAs had plans for the future development of services. Equity of access to treatment and support services to a common standard is a major issue which needs addressing, as is the relative merit of specialist versus generalist service provision.
Looking forward to the new asthma guidelines
Authors: Crockett Anthony 
Published: May 2014

Asthma is a chronic common disease which is mostly managed from within primary care. Modern asthma care aims to abolish and prevent symptoms and to aim for perfection. Care may be delivered by the most appropriate member of the extended primary health care team, but for care to be consistent and of the highest standard there must be good teamwork and communication.Although there is no cure for asthma there are a variety of excellent treatments. Asthma severity varies between individuals and in an individual over time. The treatment of asthma must similarly vary, to meet or anticipate the needs of each patient. Guidelines on how and when to alter treatment have been widely used for many years, and should be shared by all members of the extended primary health care team. There have been recent changes in our knowledge and care of asthma – the guidelines therefore need to be revised and updated to reflect these changes.
Community nurses and self-monitoring of blood glucose
Authors: Abbott Stephen , Burns Jill , Gleadell Anna , Gunnell Caroline 
Published: May 2014

Self-monitoring of blood glucose (SMBG) is commonly recommended to patients with diabetes, although the rationale for this is unclear. This small research project was designed to explore the reasons why nurses working in the community recommend SMBG. Seven interviews were carried out with community nurses caring primarily for housebound patients. Those interviewed believed that a sound evidence-base supported the recommendation that patients test their blood, but not urine, for glucose levels. Though nurses believed in the importance of patient choice and empowerment, the scope for these was limited among housebound patients. There was no evidence that patients understood how to respond to test results, or that comprehensive care planning was normal practice. Although small, this study suggests that nurses working in community settings may need to update their knowledge. It also suggests that a national debate is necessary to disseminate better the evidence about SMBG, and its implications for nursing practice.
Caring for patients with COPD and their families in the community
Authors: McHugh Gretl , Chalmers Karen , Luker Karen 
Published: May 2014

Community matrons have a key role to play in the management of patients with long-term conditions. With the expected increase in prevalence of Chronic Obstructive Pulmonary Disease (COPD), largely due to cigarette smoking, the management and care of patients with COPD is a priority for the NHS. This paper examines the current and future role of community matrons in the management of patients with COPD. Community matrons have a potential role in providing evidence based care and could fill a gap in the implementation of effective interventions to help patients and family members stop smoking. A family focused approach to assessment and case management are important to achieving quality care and management of these patients. Recommendations are made with respect to the improvement of service provision for individuals and families with COPD.
District nursing workforce planning: a review of the methods
Authors: Reid Bernie , Kane Kay , Curran Carol 
Published: May 2014

District nursing services in Northern Ireland face increasing demands and challenges which may be responded to by effective and efficient workforce planning and development. The aim of this paper is to critically analyse district nursing workforce planning and development methods, in an attempt to find a suitable method for Northern Ireland. A systematic analysis of the literature reveals four methods: professional judgement; population-based health needs; caseload analysis and dependency-acuity. Each method has strengths and weaknesses. Professional judgement offers a ‘belt and braces’ approach but lacks sensitivity to fluctuating patient numbers. Population-based health needs methods develop staffing algorithms that reflect deprivation and geographical spread, but are poorly understood by district nurses. Caseload analysis promotes equitable workloads but poorly performing district nursing localities may continue if benchmarking processes only consider local data. Dependency-acuity methods provide a means of equalizing and prioritizing workload but are prone to district nurses overstating factors in patient dependency or understating carers’ capability. In summary a mixed method approach is advocated to evaluate and adjust the size and mix of district nursing teams using empirically determined patient dependency and activity-based variables based on the population’s health needs.
Mental Capacity Act 2005: statutory principles and key concepts
Authors: Griffith Richard , Tengnah Cassam 
Published: May 2014

The Mental Capacity Act 2005 represents the most significant development in the law relating to people who lack decision making capacity since the Mental Health Act 1959 removed the states parens patriae jurisdiction preventing relatives, courts 0and government bodies consenting on behalf of incapable adults (F vs West Berkshire HA [1990]). The Mental Capacity Act 2005 impacts on the care and treatment provided by district nurses and it is essential that you have a sound working knowledge of its provisions and code of practice. In the first article of a series focusing on how the Mental Capacity Act 2005 applies to district nurse practice, Richard Griffith and Cassam Tengnah consider the principles and key concepts underpinning the Act.
Sorbion Sana: a non-adherent, highly absorbent, hypoallergenic dressing
Authors: Beldon Pauline 
Published: May 2014

The management of highly exuding wounds represents a significant clinical challenge. Protection of the surrounding skin from the effects of exudate, while not stimulating a skin sensitivity, can be difficult in venous leg ulcer patients with their higher than usual predisposition for skin allergy/sensitivity. Venous leg ulcer patients can require frequent dressing changes, which are costly in terms of time taken to wash the limb, dress and apply compression bandages, in addition to the actual cost of dressings and compression bandages. This product focus article considers Sorbion Sana®, a dressing that provides a means of absorbing and retaining exudate, so reducing the frequency of dressing changes and the likelihood of skin allergy/sensitivity.
Overview of depression: epidemiology and implications for community nursing practice
Authors: Lazarou Chrystalleni , Kouta Christiana , Kapsou Margarita , Kaite Charis 
Published: May 2014

Depressive disorders are among the most common psychological conditions currently affecting individuals living in the Westernized world. Yet, available data indicate that fewer than one third of adults with depression obtain appropriate professional treatment. This is attributed, among other reasons, to the under-recognition of the problem by health professionals, including district nurses. In order to improve recognition of the problem, it is imperative for nurses and especially those working in community settings, to appreciate the importance of prompt diagnosis which presumes both an understanding and knowledge of basic aspects of the problem and, an understanding of their role in dealing with depression. This overview presents epidemiological data and identifies the potential consequences of depression on daily functioning and other aspects of life among adults in Westernized countries, aiming to raise awareness and sensitize district nurses about the issue The article discusses how the role of district nurses can be enhanced to improve recognition rates.
Research to support evidence-based practice in COPD community nursing
Authors: Kirkpatrick Pamela , Wilson Ethel , Wimpenny Peter 
Published: May 2014

Evidence-based practice (EBP) is a requirement of nurses through the generation of evidence to implementing it, in a bid to to improve clinical practice. However, EBP is difficult to achieve. This paper highlights an approach to generating evidence for enhancing community nursing services for patients with chronic obstructive pulmonary disease (COPD) through a collaborative partnership. A district nurse and two nursing lecturers formed a partnership to devise a systematic review protocol and perform a systematic review to enhance COPD practice. This paper illustrates the Joanna Briggs Institute (JBI) systematic review process, the review outcomes and the practitioner learning. Collaborative partnerships between academics, researchers and clinicians are a potentially useful model to facilitate enhanced outcomes in evidence-based practice and evidence application.
Extending an approach to hospital malnutrition to community care
Authors: Moynihan Paula , Macdonald Alastair , Teal Gemma , Methven Lisa , Heaven Ben , Bamford Claire 
Published: May 2014

This feature investigates the potential relevance to community care of a new food provision and nutritional management system for older hospital patients. A qualitative study identified the core factors contributing to inadequate food intake in older patients in hospital, including: poor mealtime ambience; lack of necessary mealtime assistance; inflexible meal provision; lack of monitoring of nutrient intake and absence of accountability in nutritional care. Many of these factors are also relevant to older people living in the community. To address these issues, we designed a new system for the nutritional care of the older patient: ‘hospitalfoodie’. Hospitalfoodie facilitates: patient nutritional screening; patient-tailored food choice; and information exchange among the healthcare team. The system introduces a more flexible approach to provision of food, including the development of nutrient-dense ‘mini meals’ for older patients. The system facilitates monitoring of patient food intake against their nutrition targets and alerts staff of nutrition shortfalls. The relevance of components of hospitalfoodie to community nutritional care was explored through qualitative interviews and focus groups with a range of care providers.
Maintaining professional boundaries: keep your distance
Authors: Griffith Richard , Tengnah Cassam 
Published: May 2014

Maintaining professional boundaries is essential to an effective nurse-patient relation whose sole focus must be on the care and treatment needs of the patient. Complaints about failures to maintain professional boundaries are increasing, with the Nursing and Midwifery Council reporting some 247 new cases in the year 2011-12. This article outlines the scope of the nurse-patient relationship, what activity is considered to be outside the professional relationship and considers the consequences for community nurses if they are found to have breached a professional boundary.
Improving nutrition and care for people with dementia
Authors: Williams Kathryn , Weatherhead Ian 
Published: May 2014

As the number of people diagnosed with dementia rises, care services are facing a significant increase in people accessing services, be it community, hospital or long-term residential care. Maintaining wellbeing is an essential aspect of quality of life, and appropriate nutrition and hydration are essential to wellbeing. Care staff require knowledge and understanding of dementia, the impact dementia has on the individual and the challenges and issues it presents for formal and informal carers. The National Dementia Strategy and the Prime Minister's Challenge have placed emphasis on improved quality of care and education on dementia for care professionals. Nutrition is a constant need to be met, especially as the illness progresses and the person may require considerable support to meet this need. Physiological changes through the journey of the illness present many challenges and considerations, especially towards end of life. This article aims to raise awareness of dementia, diagnosis and issues faced on meeting the nutritional needs of people with dementia
Acute stroke, dysphagia and nutritional support
Authors: Hutchinson Emma , Wilson Neil 
Published: May 2014

Annually, an estimated 152 000 people in the UK have a stroke, accounting for 11% of all deaths in England and Wales, but for those that survive, nutrition is key to the body's recovery. Consequences of malnutrition can include increased susceptibility to infection, delayed healing, impaired cardiovascular function, decreased muscle strength and depression. Given the complex nature of post-stroke dysphagia, it may not be possible that simple screening tools sufficiently identify those at risk of aspiration. If a patient is deemed unsafe or unable to meet their nutrition and hydration needs orally, guidelines recommend they should be considered for nasogastric feeding within 24 hours and a referral for dietetic/nutrition team input should be made accordingly. Speech and language therapists can predict early in a patient's journey whether or not prolonged dysphagia is likely. In turn, the need for long term artificial feeding can then also be anticipated.
What is multiple sclerosis?
Authors: Swann Julie 
Published: May 2014

This article is the first in a series on multiple sclerosis. It describes how this neurological disease affects a person's level of abilities. Multiple sclerosis (MS) is a progressive neurological disease. MS is generally diagnosed between the ages of 20 and 50years but can appear later and, in rare cases, children can be affected. The Multiple Sclerosis Society (2007) states ‘MS is the most common disabling neurological condition affecting young adults’. Around 85000 people in the UK have MS.
Domestic violence: top tips for support worker practice in Wales
Authors: Shakesby Amy , Wallace Carolyn 
Published: May 2014

This article reports on a placement project carried out in Wales by a graduating Health and Social Care student to identify information for improving key relationship factors when working with women and their children who have been involved in or suffered from domestic violence.The student undertook a review of the literature synthesizing research, policy and guidance to inform health and social care worker practice. Ten key tips were identified, which could be used to improve the relationship between support workers, domestic violence victims and their family members. These key tips helped provide support to them and assisted in an improved response of health and social care agencies.
The therapeutic alliance in healthcare assistant practice
Authors: Hayes Catherine 
Published: May 2014

Patients who have been formally diagnosed with a mental illness are much less likely to access the same healthcare for general health problems as other people. As a direct result of this, patients with mental health problems are statistically much more likely to die earlier of conditions such as cancer and common minor ailments. Clinical symptoms of disease are much more likely to remain uninvestigated, with increasing numbers of mental health patients remaining undiagnosed with type 2 diabetes mellitus, for instance. Ultimately, this leads to a diminished quality of life and a markedly decreased age of death. This article identifies the role of the healthcare assistant (HCA) as one means of engaging with people for whom mental illness may be an issue. The settings in which healthcare assistants work lend themselves to conversations and communication with people which might indicate that a patient with mental illness might need additional support and help. This process can ultimately be termed the ‘therapeutic alliance’. This article highlights key aspects of the need to build capacity within and between all professional healthcare disciplines in order to provide equity of care for all. It uses two theoretical standpoints, along with worked examples, to demonstrate the relevance of basic psychosocial interventions in the context of healthcare practice.The promotion of the concept of recovery is one that has the potential to aid in the removal of stigma for people with mental illness. Healthcare assistants are present during many patient assessment, diagnosis and management pathways and it is here that the concept of the therapeutic alliance could potentially be developed further so that patients with mental health problems might be better supported.
LINCS in Lancs: clinical research at the grass roots
Authors: Loughlin Wendy 
Published: May 2014

In this article, a healthcare assistant reports on her experience of clinical research, as part of a team at her hospital trust. With training and support from the team, and financial backing from the National Institute for Health Research (NIHR), she was able to gain secondment for 2 days a week and play a full part in research into oral hygiene following a stroke. The ‘Lancashire Initiative for Nursing and Caring research in Stroke’ (LINCS) is a partnership between the University of Central Lancashire (UCLan) and the Lancashire Teaching Hospital Trust and the author found that her experience of research at LINCS fed back into better care for her patients. She describes the challenges of her project on oral flora, but says she would definitely recommend that anyone considering taking part in clinical research do so.
Wellbeing, compassion fatigue and burnout in APs
Authors: Durkin Mark , Smith Joanne , Powell Michelle , Howarth Jane , Carson Jerome 
Published: May 2014

It is important that the mental wellbeing of the healthcare workforce is attended to by managers. While many research workers have looked at issues of occupational stress and burnout, fewer have considered the mental wellbeing of staff. In this paper, we report on the findings from a larger survey of mental wellbeing, compassion fatigue and burnout in health and social care professionals. Here we focus on the findings for assistant practitioners (APs). Some 45 APs took part in our questionnaire survey. They were all completing their foundation degree at the University of Bolton. The group were all quite experienced and most worked full-time. The average score on the Warwick Edinburgh Mental Wellbeing Scale for our group was 22.96, which is significantly below the average for the general population in the North West of England of 27.70. Only 3 out of 45 APs had ‘high wellbeing’, while 7 out of 45 had ‘low wellbeing’. Scores for trust were also quite low. Burnout was more of a problem than compassion fatigue for this group of practitioners, with the highest score on the item: ‘I have frequently felt weak, tired or rundown as a result of my work.’ While this was only a small study, and as such needs to be treated with some caution, it does reinforce the need to think about the wellbeing of the workforce and the necessity for managers to provide support for APs in their roles.
Hidden in the home: supporting same-sex partnerships
Authors: Hutchins Thomas 
Published: May 2014

By allowing a situation to continue where lesbian, gay and bisexual (LGB) older people and their partners to remain hidden in health and social care, healthcare professionals risk ignoring their specific needs, which encompass a variety of biological and psychosocial issues. Awareness that 4–10% of residents could be LGB can prepare staff to tackle their care needs with sensitivity, as can practical measures to make sure the environment, human and physical, is welcoming to LGB people.
Across the great divide: discussing the undiscussable
Authors: Bosanquet Nick , Dixon Jennifer , Harvey Trevor , Hunter David , Sang Bob , Pollack Allyson , Wall Andrew , Webster Charles 
Published: May 2014

Recently, the career changes and challenges facing managers have gained almost critical mass. From modernisation to The NHS Plan, from the Learning from Bristol report to Shifting The Balance Of Power, it seems the only constant is change. Change which will make or mar the NHS' future. How well conceived are the new plans? Is there meaningful consultation? What will be the effects on the future career of managers? Is there a forum for dialogue and discussion, when new ideas are felt to be unwise, ill-founded or just plain wrong? Can managers feel free to speak out if they wish? In a desire to see these questions given due attention, British Journal of Health Care Management has asked a range of experienced figures to voice their concerns. A commentary on these views is given by respected US health care academic Professor Ted Marmor (who will give December's Rock-Carling Lecture).