With an ageing population and an evolving NHS, many services traditionally provided in the hospital setting are moving to the community. This article examines the development of a community nurse-led intravenous (IV) therapy service. The author explains the background to IV therapy, particularly in the field of antibiotic provision, the development of the nurse-led service and how the service transformed the experiences of patients, allowing them to access care closer to home and avoid unnecessary hospital visits. The author also provides a case study, which details the benefits of the nurse-led IV therapy service for an individual patient.
Lower limb cellulitis is a common acute medical condition that results in a large number of hospital admissions (Clinical Resource Efficiency Support Team [CREST], 2005). It is a growing and costly problem. The NHS spends between £172–£254 million a year on inpatient treatment of people with lower leg cellulitis (Curtis, 2011). The clinical presentation of cellulitis is similar to other conditions and diagnostic errors are common and may prolong hospital stay (Nazarko, 2012). Community nurses are involved in caring for people at risk of cellulitis and are often responsible for referring on suspected cases and then continuing treatment upon discharge. It is essential that community nurses are aware of the evidence base for diagnosis, differential diagnosis, treatment and management, as well as the long-term prevention of cellulitis. This paper discusses the evidence base for treatment and prevention of cellulitis and presents a case study.
Urinary tract infections are often seen in community settings and can be debilitating for patients, involving dysuria (painful urination), increased urinary frequency and urgency, suprapubic pain, haematuria (blood in the urine), and polyuria (excessive urine production). This article takes an in-depth look at these symptoms, as well as the diagnosis and management of this common problem, which mostly affects female patients.
Chetan Shah, Senior Lecturer in Pharmacy Practice/Public Health, University of Hertfordshire
Stephen Goundrey-Smith, Consultant Pharmacist, PDC Healthcare Ltd, Leicestershire
