Chronic oedema is a common condition which is increasing in prevalence, yet is still often under-recognised and mismanaged in community settings. Any oedema is a sign that the venous and lymphatic systems are not working properly. Without early identification and intervention, the condition can worsen, resulting in the need for complex care. Using a case history, this article highlights the inappropriate and ineffective use of medicinal management of a patient with lymphorrhoea (i.e. wet, ‘leaky’ legs). As a result of health assessment and a review of management and medication, deprescribing was effectively implemented in this case. The patient was provided with compression hosiery and education, and supported by a Healthy Legs clinic in the South Eastern Health and Social Care Trust, with positive outcomes for the patient, treatment room and GP. The case demonstrates how good practice uses health assessment and symptom analysis to determine diagnosis and appropriate treatment options. It also poses the question: is pharmacology always the answer?
Chronic oedema is a common condition which is increasing in prevalence, yet is still often under-recognised and mismanaged in community settings. Any oedema is a sign that the venous and lymphatic systems are not working properly. Without early identification and intervention, the condition can worsen, resulting in the need for complex care. Using a case history, this article highlights the inappropriate and ineffective use of medicinal management of a patient with lymphorrhoea (i.e. wet, ‘leaky’ legs). As a result of health assessment and a review of management and medication, deprescribing was effectively implemented in this case. The patient was provided with compression hosiery and education, and supported by a Healthy Legs clinic in the South Eastern Health and Social Care Trust, with positive outcomes for the patient, treatment room and GP. The case demonstrates how good practice uses health assessment and symptom analysis to determine diagnosis and appropriate treatment options. It also poses the question: is pharmacology always the answer?
The National Catheter Education Programme is a Health Education England-funded initiative to improve the care of patients with catheters. Part of this initiative is the Secret Life of Catheters programme. This article highlights the need for improvement in catheter care and explains the development of this project, which aims to drive improvements across primary and secondary settings through the large-scale delivery of a multiprofessional educational programme in catheter care. The programme explores key dilemmas that district nurses, community nurses, healthcare assistants and doctors can encounter with catheters, and provides approaches to address them. By standardising the teaching of clinical concepts and practice strategies, it is hoped that variations in practice and pockets of misunderstanding can be eliminated.
Urinary tract infection (UTI) is caused by the presence and multiplication of bacteria in the urinary tract, with associated tissue invasion. It is most common in women but can be more complicated in male and catheterised patients. This article highlights the importance of the correct diagnosis of UTI, which will identify ‘red flags’ to aid community nurses’ choice of management options and avoid the unnecessary prescription of antibiotics. In addition, the author makes recommendations for reducing catheter-associated UTIs (CAUTIs) in the community.
