Surgical site infections (SSIs) are the most common type of nosocomial infection, accounting for up to 20% of all hospitalacquired infections in Europe (European Centre for Disease Prevention and Control [ECDPC], 2013). There are varying SSI rates reported across the UK. In 2016, Public Health Wales reported an overall 14-day SSI rate for women undergoing caesarean section of 4.35% — 83% of which were superficial infections and 92.5% were detected after discharge (PHW, 2016). From 2015–2016, Aneurin Bevan University Health Board (ABUHB) services experienced an increase in the SSI rate for women birthing by caesarean section from 3.07% to 5.86% respectively. Therefore, a multifaceted approach to quality improvement (ABUHB organisational method) was adopted throughout the duration of 2017, with a view to implement by 2018. The aim was to reduce SSIs for women birthing by caesarean section in ABUHB. Interventions included the use of evidence-based practice and guidelines, education and engagement among clinicians, patients and staff, and the gradual implementation of Leukomed® Sorbact® (Essity) post-operative dressings.
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.
There are a variety of reasons as to why a patient may require an indwelling catheter, however, these are seldom documented or communicated across healthcare services (Codd, 2013). Thus, short term catheters are at risk of becoming long-term catheters in the absence of clear documentation and forward planning. The risk of infection increases the longer a urinary catheter remains in situ. This article explores the guidance available to support appropriate urinary catheter use, catheter management, documentation, forward planning and patient education for effective catheter care. How this can be implemented to support appropriate removal of urinary catheters or ongoing care for long-term urinary catheter use for patients across the primary and secondary care services is also discussed.
Aa district nurse with a specialist practitioner qualification (DNSPQ), I understand how important this role and the qualification are, not only to patients, but also to delivering the aims of providing care closer to home, as described in the Five year forward view (NHS England, 2014). This has to be led by highly competent, experienced and compassionate district nurses who have the additional training required to ensure the necessary skills and competence.
Patients in the community often have a long-term catheter in place and so their management inevitably becomes the responsibility of community nurses. As urinary incontinence can cause patients discomfort and have a negative impact on their day-to-day life, it is important that healthcare professionals understand the reasons for catheterisation and are aware of the different treatment options available, such as urethral and suprapubic, in order to provide patients with the most suitable device according to their needs and lifestyle. This paper explores the issues involved with indwelling catheterisation and looks at one new product range that aims to promote patient comfort and reduce associated risks.
In each issue we investigate a hot topic currently affecting you and your community practice. Here, Jason Beckford-Ball looks at some of the challenges that lie ahead in the coming year.
Keeping up with your CPD requirements often means attending dull study days in uninspiring classroom blocks. But, it doesn’t have to be that way. Jason Beckford-Ball took a look at a different type of education, where first-class clinical expertise is shared in luxury surroundings, free of charge.