bluuebunny/crossref_metadata_2025_split huggingface dataset:
Assessing capacity to consent to sexual relations: a guide for nurses
Authors: Griffith Richard , Tengnah Cassam 
Published: May 2014

The right to marry and found a family is a fundamental freedom bestowed on adults under the European Convention of Human Rights ( Council of Europe 1950 ). Engaging in sexual activity is an essential component of that right and should be free from state interference. Community nurses, however, often express concern over the possibility that adults with learning disabilities or other impairments of the mind cannot give a real consent to participate in sexual relations and so should be prevented from doing so in their own best interests. In this article Richard Griffith and Cassam Tengnah review the case law in relation to the capacity to consent to sexual activity. They set out how a community nurse should approach an assessment of decision making capacity in relation to engaging in sexual relations and what steps can be taken to protect a person who lacks capacity to participate.
Differences between heart failure clinics and primary health care
Authors: Andersson Lena , Erikson Henrik , Nordgren Lena 
Published: May 2014

There is a paucity of knowledge concerning how people with heart failure experience differences between specialised heart failure clinics and primary healthcare in Sweden. This study aimed to describe differences regarding information and follow-up in heart failure clinics and primary healthcare. The study was conducted in Sweden in 2011. Four people (three men, one woman; aged 60 to 84) with heart failure (NYHA II) were interviewed. The interviews were analysed with qualitative content analysis. The findings revealed after referral from the heart failure clinic to primary healthcare, follow-ups were omitted. Still, the patients needed care, support and information. The findings are illuminated in four themes. The patients' varying and individual needs can be difficult to recognise and manage unless they are followed-up from either HFC or PHC on a regular basis.
Evaluating the use of a reflective diary for assistant practitioners
Authors: Mackey Hazel , Whitfield Louisa 
Published: May 2014

This article examines the use of a reflective diary approach to the supervision of assistant practitioners (APs). A qualitative methodology was used to understand the experiences and insight of APs and their supervising therapists. The evaluation took place in a single health-care trust and involved focus groups with two groups of stake holders: APs and their supervising therapists. The findings came from a study which demonstrates that the reflective diary has the potential to be a valuable tool in the supervision of APs who are attempting to learn new skills, and balance expectations and performance as they define and clarify new working practices. Findings indicate that a reflective diary approach to supervision is useful to APs in developing clinical decision making skills and confidence. It is also a useful tool for supervising therapists to use, explore and reflect on competence and delegation issues.
Chaperoning guidelines
Authors: Peate Ian 
Published: May 2014

All patients, regardless of their age, gender, ethnic heritage, culture, sexual orientation or mental status have the right, if they so wish, to have a chaperone present during care interventions; this is irrespective of organizational constraints or setting. Healthcare assistants (HCAs) and assistant practitioners (APs) who are requested to act as a chaperone should have the competence to carry out the role effectively. The chaperone can be a formal, informal or virtual. The HCA or AP who has undergone training can provide patients with support during examinations and procedures, offering them comfort, reassurance and safeguarding against any unnecessary discomfort, pain, humiliation or intimidation. In general, the role of the chaperone is to ensure that the patient's privacy, dignity and wellbeing are protected at all times. This guidance is offered for the protection of patients and staff.
Ageing part 3: the digestive, endocrine, genitourinary and immune systems
Authors: Peate Ian 
Published: May 2014

This third and final article in the series looks at how the gastrointestinal, endocrine, immune and genitourinary systems are affected by ageing. Ageing is a normal process that is accompanied by pathophysiological changes. Gastrointestinal problems experienced by the older person are common; age-related changes associated with some of these problems are caused by muscle weakness. The problems experienced by the older person can impinge on their ability to ingest, digest and excrete waste products. Age-related changes, for example, in those associated with the pancreas can cause a decrease in glucose tolerance and there can be an ineffective release of insulin from the pancreas. When a person ages there is a known general decline in immunocompetence, which could result in the older person developing chronic diseases and disorders. By the time a person reaches the age of 85 years of age renal function has reduced by half, this has implication for the person's health and wellbeing. There is an ageing population and healthcare assistants and assistant practitioners are likely to care for older people in a variety of health and social care settings. Understanding more about the ageing population can help the carer help the older person in a number of ways; the outcome can have a significant effect on an individual's quality of life.
Unlocking and realizing potential
Authors: Smith Brenda 
Published: May 2014

Every day in wards and departments in the acute healthcare setting we work as a team delivering quality evidence-based care to the best of our ability. But do you ever look at your colleagues and recognize potential? When we do recognize it, what can we do to help them unlock and realize this potential? What are the barriers? And how can they be overcome? This paper tells the story of this very process, - how a small number of healthcare assistants aspired to be scrub practitioners in an obstetric theatre, and achieved it.
Caring for the person with a pulmonary embolism
Authors: Peate Ian 
Published: May 2014

Pulmonary embolism can be very dangerous and must be treated as soon as possible once diagnosed. If it is treated quickly there is a high chance of survival, however, if diagnosis is delayed or there is another underlying illness, likelihood of survival is reduced. There is a glossary at the end of the article which provides definitions of words you may not be familiar with.
Dual sensory impairment: causes and diagnosis
Authors: Swann Julie 
Published: May 2014

The two senses of sight and hearing provide the majority of information that people gain from their environment but problems can arise at birth or during childhood and adult life. There are many causes of impairments of sight and vision that result in deafblindness, also called dual sensory loss. Patients who have dual sensory loss will have problems managing within a clinical setting and coping with everyday life. Previous articles in this series have concentrated on vision and hearing as two separate entities. This article explains the reasons for dual sensory loss and outlines ways that HCAs and APs can ensure that patients are helped, particularly within a clinical setting.
Privacy please...Taking a sexual health history
Authors: Peate Ian 
Published: May 2014

Sexuality is an integral aspect of our health and wellbeing, and needs to be addressed competently and confidently. This article outlines the principle elements of taking of a sexual health history. We all have a right to enjoy sex and to access good sexual health services. Healthcare assistants (HCA) and assistant practitioners (AP) have a responsibility to care for people from a holistic perspective, providing individual and responsive sexual health care where appropriate.
Caring for the person with chronic obstructive pulmonary disease (part 1)
Authors: Peate Ian 
Published: May 2014

This is the first part of an article which aims to provide an understanding of a common respiratory condition: chronic obstructive pulmonary disease (COPD). Although the condition can affect people of any age, this article will focus on older people. Respiratory disease can have a negative impact on a person's health and wellbeing. It may also impinge on an individual's body image and their ability to perform day-to-day activities, ensuring they need assistance. An overview of the anatomy and physiology of the respiratory tract is presented. The pathophysiology underpinning the COPD is discussed. The role of the healthcare assistant (HCA) and associated practitioner (AP) is outlined, and care considerations are explored.
The AP in the hospice setting: work-based learning
Authors: Brown Trish , Smith Joanne 
Published: May 2014

This is the second in a series of 4 articles looking at end-of-life and palliative care, examining the introduction of assistant practitioners (APs) across a range of services through a foundation degree at the University of Bolton. The hospice development will be examined. Changes in attitude to care of the dying will be explored, in terms of the way in which the hospices challenged the notion that death was an inevitable failure; rather, dying is seen as a time when good quality care and support was more important than ever, enabling a good death. The AP's role within the hospice setting will be explored, in terms of the skills they have developed and now utilise and where they fit into the teams they have become part of. The new role is providing important continuity of care; some of the successes and challenges in this new setting are examined.
Looking forward to the next steps on your learning journey
Authors: Clark Liz 
Published: May 2014

All frontline staff need to update their knowledge and skills on a regular basis in order to maintain their competence and make an effective contribution to the multidisciplinary healthcare team and the delivery of high-quality, compassionate and person-centred care. This article encourages readers to recognise all the different ways in which they learn, including the more invisible informal learning in the workplace, and to review their learning during the previous year and the impact it has had on patient experience and service delivery. It ends with a call to action to plan for and take control of their learning to achieve their aspirations, rather than just hoping that it will happen.
Reflections of an HCSW in a specialist palliative care team
Authors: Salvatore Susan 
Published: May 2014

This article will explore the role of the healthcare support worker (HCSW) within a hospital palliative care team (HPCT). The aim is to reflect on an intervention with one patient from my practice and also to reflect on the role of the HCSW on the HPCT. I reflected on a 65-year-old patient with end stage endometrial cancer. This reflective writing enabled me to identify how I contributed to her palliative care. Three themes emerged from this reflection: the importance of empathy, advocacy and communication skills. Empathy is a good basis to develop as a supportive relationship with a patient. Working as an advocate, the HCSW can help the patient make their own views or wishes heard. Both empathy and advocacy rely on the HCSW having good communication skills and the time to spend with the patient.
Clinical skills series/2: enemas and suppositories
Authors: Peate Ian , Gault Christine 
Published: May 2014

The varied role and function of the healthcare assistant and assistant practitioner (HCA and AP) mean that they may have to care for people who require suppositories or enemas. The administration of enemas and suppositories is seen as an intimate care activity. Suppositories and enemas are used for a variety of reasons and the technique for each is slightly different. This article provides an outline of how to care for a person pre-, peri- and post- procedure; it also outlines how to safely and effectively administer suppositories and enemas. In order to do this correctly, the HCA and AP must have an understanding of the lower gastrointestinal tract. The article provides an overview of the lower gastrointestinal tract in order to promote insight and understanding.
A healthcare support worker in interventional radiology …
Authors: Glassby Angela , Roberts Martyn 
Published: May 2014

At the 2012 HCA Conference in Birmingham, at the end of the day, conference chair Tanis Hand asked if of the HCAs or APs present worked in unusual sectors. Angela Glassby of Portsmouth Hospital Trust recounted how for the past 7 years she has been working as a Band 3 in the radiology day case unit, scrubbing up and working closely with the consultants on many procedures. Angela agreed to be interviewed and to talk about her life in healthcare in general, as well as the details of her work in interventional radiology (IR)—one example of the huge range of work undertaken by HCAs and APs in modern healthcare.
... and justice for all? Clinical negligence claims
Authors: Golten David 
Published: May 2014

The Civil Procedure Rules, the Pre-Action Protocol for the Resolution of Clinical Disputes, and Clinical Governance, aim fundamentally to change the way in which health care providers respond to clinical negligence claims and thus to reduce the cost of this type of litigation to the NHS. We examine how these developments will affect the provision and cost of justice to doctors and patients.
Winter referrals: emergency admission patterns
Authors: Loudon Michael , Ward Helen 
Published: May 2014

Every winter, hospital managers hope that patient admission rates are not exceptional. When admission rates rise, some managers ask GPs to request fewer admissions to ease the secondary care load. Is this feasible? Are admissions by GPs avoidable and / or unnecessary? For an ill patient, is nursing home admission an alternative to hospital? This study assesses such issues on the basis of one locality's experience, and offers opinions and provisional lessons from the findings.
Redefining rehabilitation from spinal cord injury: A process–outcome model
Authors: Pellatt Glynis Collis 
Published: May 2014

Rehabilitation is a key component of the National Service Framework for Long-Term Conditions, yet rehabilitation is a concept that is difficult to define. The aim of this study was to identify patients and professionals′ definitions of spinal cord injury rehabilitation. A qualitative approach was adopted using ethnographic techniques. Purposive sampling was used to select informants in a spinal cord injury unit in England. The sample comprised 30 professionals (14 nurses, 5 doctors, 3 occupational therapists, 5 physiotherapists, 1 discharge planning coordinator, 2 clinical psychologists) and 20 patients (8 who had been injured for between 16 and 44 years and 12 who had been recently injured). Data were collected using semi-structured interviews. Analysis was iterative, involving identification of themes according to a variant of the constant comparison method. It was found that participants defined rehabilitation in three ways: ‘toolbox’ (where physical and psychosocial skills are provided); ‘picking up ones life again’ and ‘empowerment’. It is proposed that these three definitions form a process-outcome model that is neither static nor hierarchical, enabling patients to move back and forth in the model throughout their lives as their situation changes. An understanding of this rehabilitation model may help professionals provide rehabilitation that meets individuals′ needs and goals.
Effect of sleep-wake rhythm on consciousness disturbance in cerebrovascular patients
Authors: Yamauchi Noriko , Ito Keiichi , Imajo Kaoru , Fujita Yoshiyuki , Mogi Junichi , Iseki Hiroshi 
Published: May 2014

Objective : The purpose of this study was to examine the effect of sleep-wake rhythm on improvements in level of consciousness disturbance for patients with cerebrovascular disease who received sensory stimulation care. Methods : The sample comprised four patients (3 men, 1 woman) with cerebrovascular disease who were hospitalized. Using sleep-stage analysis by means of 24-hour continuous electroencephalography by polysomnogram, the relationship between the establishment of sleep-wake rhythm and change in level of consciousness disturbance was examined. Results : Some measurements indicated that the establishment of the sleep-wake rhythm may be effective for improving the level of consciousness of patients who are receiving the sensory stimulation. However, it was difficult to verify this hypothesis because it was impossible to control the effects of other variables considered to contribute to the regulation of consciousness Conclusions : These findings provide a useful basis for future research using a more precise method.
Returning to normal: The role of eating in recovery from a critical illness
Authors: Segaran Ella 
Published: May 2014

Much emphasis is placed on proactive early establishment of nutrition support during critical illness. Eating on an intensive care unit (ICU), on the other hand, is a more infrequent occurrence and is often overlooked, as is the social aspect of eating or the inability to eat. Currently there is a dearth of published work investigating any aspect of eating during the critical care phase; patients' experiences of eating at this time and the importance they place on it is not known. This qualitative study aims to explore and accurately describe patients' experiences of eating in a critical care environment. It is intended to seek out the essence of what eating and drinking following a critical illness signifies to those who have experienced it. Eight participants were recruited from the neuro-critical care unit at the National Hospital for Neurology and Neurosurgery, and engaged in tape- recorded in-depth interviews. Sampling was undertaken using purposive sampling and findings were analysed to create themes using Colazzi's phenomenological (1978) approach to qualitative analysis. All interviews were conducted, transcribed and analysed by the researcher. Following data analysis, examination of the phenomena revealed commonalities in experiences, which were organized into four key themes: perceptions of eating, returning to normality, eating with a tracheostomy, eating in critical care. This study suggests that eating and drinking played a fundamental role in the psychological wellbeing of the participants by helping provide a positive milestone to identify that recovery is possible. The overwhelming emotions expressed by patients were derived from their desire to return to normality. The critical care environment also influenced the ability to eat and drink, with most participants depicting a period of adaptation to the environment. After this period of adjustment, patients felt that the environment no longer mattered and that other emotions took precedence.
The effects of ageing and decline after spinal cord injury
Authors: Williams Sue 
Published: May 2014

The NHS Improvement Plan and the NHS and Social Care Model for supporting people with long-term conditions (2005) require health service providers to develop a systematic, collaborative approach to improving the care of people with long-term conditions. Twenty years ago a spinal cord injury would not have been considered a long-term condition, but, as a result of advances in both acute and rehabilitative care, it is possible that the longevity of a person with a spinal cord injury can be equal to that of his/her fellow citizens. Studies into ageing with spinal cord injuries are beginning to accumulate (Gerhart et al, 1997; Go et al, 1995; Thompson, 1999; Kemp and Thompson, 2002). These authors provide greater insight into the problems and complications that people with a spinal cord injury may acquire as they age. The Department of Health (2005) has called for case management training for all health professionals to improve understanding of neurological conditions among generalist staff. The aim of this paper is to raise awareness of the issues related to ageing with a spinal cord injury, by exploring how ageing impacts on the individual with spinal cord injury. It is hoped that this investigation will guide nurses in addressing some of the issues and help them prevent or minimize the extent of the problems through earlier interventions and improved educational strategies.
Quantifying the role of nurse specialists in epilepsy: Data from diaries and interviews
Authors: Higgins Sue , Lanfear Judith , Lewis Shelia , Goodwin Melesina 
Published: May 2014

Aim: Previous research has identified that a clinical nurse specialist in epilepsy (CNSE) plays a key role in the management of people with epilepsy (Goodwin et al, 2004). However, there remains a lack of research that focuses on the clinical knowledge and skill base of an individual CNSE working at an advanced level of practice. The aim of this research study is to meet that void. Methods: Nine CNSEs participated in this study. Prospective data on their daily clinical and non-clinical activity over a period of 20 days using a self-completion diary was collected. Following quantitative collation of the data, the researchers obtained qualitative data from the nine respondents using structured interviews to clarify the initial data. Results: Respondents were highly autonomous in nurse-led clinics, and 40% of their time was spent on the clinical aspects of care, which included epilepsy assessment, ordering investigations and drug management. Time spent on non-clinical activities included teaching, education and research was 60%. Conclusion: This study demonstrates the advanced level of practice of the CNSE. As advanced nurse practitioners, the nine participants demonstrated an ability to make independent and complex decisions about patient care using clinical judgment and their unique and expert knowledge base.
The management of neuromuscular respiratory failure: A review
Authors: Garner Anne , Amin Yogen 
Published: May 2014

Respiratory failure remains a common cause of morbidity and mortality among patients with neuromuscular disorders. Medical optimization of neuromuscular conditions and detection of early respiratory impairment is of primary importance in the prevention of the disease and respiratory deterioration. A multidisciplinary approach should be taken; these patients need regular physiotherapy, optimal nutrition and vigilance for the early signs of new infections. Non-invasive and invasive ventilation both have defined roles in the management of acute and chronic respiratory failure. The management of chronic progressive neuromuscular disorders often involves difficult decisions to implement, withhold or withdraw life-sustaining interventions. The use of advance directives has become accepted practice in recent years, although assisted death at present remains illegal in the UK. With appropriate care and attention this difficult patient group can show significant improvements in quality of life.
Does underpinning evidence influence the frequency of neurological observations?
Authors: Mavin Claire 
Published: May 2014

To date the evidence that has underpinned the practice of neurological observations of patients with traumatic head injury in the UK has been anecdotal. Although national guidance from the Scottish Intercollegiate Guidelines Network (SIGN) and the National Institute for Health and Clinical Excellence (NICE) exist in the UK to direct practice in the care of patients in the first 72 hours following a head injury, guidelines on the frequency of neurological observations are not research based.A number of studies have been undertaken to review the frequency of conducting vital signs observations, particularly in the postoperative period. Many of these indicate that the frequency of observing vital signs is based on tradition and expert opinion, rather than on research evidence. It is possible that this is also the case for neurological observations.