Meningococcal disease is a contagious bacterial condition that can result in life-threatening sepsis as well as the development of extensive blistering and lesions. This article presents the topical management regimen for one young patient’s wound care in conjunction with the community and outpatient paediatric teams. Practical tips on how to manage complex wounds in children will be outlined to demonstrate that such cases can be managed effectively by nursing teams in a relaxed home environment and outpatient setting, preventing readmission and supporting the emotional recovery of the child and parents. The success of this case study and the reintegration of the child back into daily life and school was attributed to the joint working and collaboration between parents and child, and tissue viability, paediatric and community nursing teams.
There are a number of mechanisms at play that can delay wound healing. Wounds can become stuck in a prolonged inflammatory stage resulting in high volumes of wound exudate, which contains agents that contribute to delayed healing. Exudate plays an essential role in wound healing but at excessive volumes it can also facilitate biofilm formation, which can further delay healing. Maintaining optimum levels of exudate is vital for healthy wound healing, as is the prevention or disruption of biofilm formation in the wound bed. This article also looks at Sorbion Sachet S® (BSN medical), a triedandtested uperabsorbent dressing, which is now back on the Drug Tariff, but at a lower price. This article discusses the mechanisms used in the reintroduced superabsorbent dressing and how it provides a cost-effective solution to the problem of treating highly exuding chronic wounds where clinical efficacy and budgetary concerns are both top priorities.
The Mitrofanoff technique uses the appendix to create a continent ‘tunnel’ between the skin’s surface and the bladder, which is then drained using a catheter, which is inserted along the tunnel rather than via the urethra. This is a complex procedure that needs the patient to be motivated and committed to living with such lifechanging surgery. Intense preparation and long-term support from a urinary diversion nurse specialist as well as any involved community nurses is vital. Long term follow-up is vital to ensure continued good health and to anticipate any problems such as infection, stone formation or renal damage. Having access to community healthcare professionals who know about the possible dangers and can offer advice and support is also key to ensure any complications are dealt with swiftly and safely.
Many skin conditions, while no longer requiring hospitalisation, still require a level of knowledge and skill from community nurses, particularly with assessment and diagnosis. Atopic eczema is one such skin condition and can cause significant discomfort, particularly when inflamed skin becomes virally infected, leading to to complications such as eczema herpeticum and molluscum contagiosum. Both of these viral infections can increase the discomfort of eczema, leading to a variety of symptoms including blisters, sore skin, itch and rash. It is important that community nurses are able to identify skin conditions of this type and know whether to treat themselves or refer on to dermatological specialist nurses for more specialised management.
The challenge of providing safe and effective care closer to home for patients requiring ,intravenous (IV) therapy but who are not housebound can be achieved by developing community clinics. However, it is imperative that governance procedures are in place to protect the patient and the organisation. It is also recommended that medicine management is effective, infection control processes are reliable, and clinical audit is performed. Community nurses have a wealth of knowledge and experience which can be used to deliver the government's promise of community care, provide patients with a choice of where to receive their care and deliver effective treatment in an ever-changing NHS.
Nina Turner, explains what her background in community practice is and what her typical days is like.
I work as the clinical manager of Rochester Prison within Oxleas NHS Foundation Trust with a fantastic caring team. I am a very proud prison nurse. Prison nursing is challenging and can be a difficult role, however, if you can work past this it is a very rewarding place to be...
In each issue of the Journal of Community Nursing we investigate a hot topic Jason Beckford-Ball looks at the impact or proposed cuts to nursing student funding and asks the question....
Will cutting student bursaries choke the supply of new nurses?
The most significant change to nurses’ regulation in a generation was confirmed at the end of October — England, Scotland and Wales are ready for the implementation of NMC revalidation for nurses and midwives from April, 2016.
Independent Age is a charity that provides an established voice for older people, the greatest users of the NHS. As we continue to live longer, putting more strain on services, we all need to prepare for what might be an uncertain future. As more people live for longer with chronic conditions, they will need support, much of it being required in the home.
