The phasing out of the Liverpool Care Pathway and the introduction of the Leadership Alliance for the Care of Dying People’s (LACDP’s) five priorities of care has enabled clinicians working in end-of-life care to step back and re-evaluate their practice (LACDP, 2014). The review of end-of-life care services, More Care, Less Pathway (Neuberger, 2013) highlighted areas that needed urgent improvement. These included recognising when a person is dying but understanding the need for ongoing assessment; having a senior named clinician for all patients; and improving the communication skills of all clinicians involved in end-of-life care through the development of educational programmes. Non-malignant diseases are particularly challenging and in these cases it can be hard to recognise when a person is nearing the end of his or her life. Community matrons have their own unique relationship with the people on their caseload and can often provide untapped expertise and support as their condition deteriorates.
Chronic obstructive pulmonary disease (COPD) is a condition commonly seen in the community, with symptoms including breathlessness, chronic cough and wheezing. There is much that community nurses can do to support COPD patients through an acute exacerbation (AECOPD) and to optimise their care when stable. Community nurses can take an active role in providing advocacy for the patient and ensuring that their professional knowledge is updated to provide admission and a key area for COPD is a leading cause of hospital admission and a key area for service development in the community. Investment in education and clinical leadership in community nursing is vital to prepare the workforce to deal with the needs of people with COPD in the future.
The number of NHS patients requiring containment products such as pads is increasing year on year due to an ageing population. Patients with long-term conditions are increasingly being cared for at home, and although incontinence is not a disease it is often a symptom associated with other health issues. Community nurses are seeing patients with more complex needs, but incontinence is often not the primary reason for their visit. Containment products can be seen — both by patients and their carers — as the most effective way to manage incontinence and nurses are often put under pressure to prescribe pads, while continence services are being challenged to review the way care is delivered through innovation and the effective use of technology. This article will look at the redesign of a continence service that has involved the development of a community continence team (CCT), along with a summary of the initially encouraging performance indicators. The CCT aims to provide a comprehensive continence assessment with a focus on rehabilitation. The principles underpinning this service redesign could be applied to any community nursing team.
Among the challenges facing community nurses in their day-to-day practice is one that impacts greatly on patients, relatives and healthcare providers — the management of exudating skin conditions and wounds. This article looks at eosin solution, a popular treatment option for exudative dermatoses on mainland Europe, to the extent of being commercially available to the general public, but one which has dwindled in popularity in the UK. This article provides an introduction to this versatile nontoxic dye and outlines its potential application in the community setting by comparing it with the much more widely used alternative potassium permanganate.
Sarah-Jayne Lawson is a registered nurse with ID MEDICAL and currently works as a community agency nurse.
The use of compression hosiery is commonplace in the community. Traditionally, compression hosiery has been used to prevent leg ulceration, including prevention of the recurrence of leg ulcers and skin breakdown after ulcers have healed (Nelson and Bell-Syer, 2012).
The Queen’s Nursing Institute is holding its next annual conference at the Royal College of General Practitioners in London on Monday 28 September. The programme will be announced shortly and we will be bringing together a range of key speakers from national and local healthcare organisations, to speak about the most urgent issues facing community nursing and primary health care today.
Reading between the lines and ignoring all the political showboating that will inevitably precede the general election on 7 May, what are the key differences between the major parties? And what effect will this have on funding, jobs, nurses and, most importantly, quality of service?
The Cavell Nurses’ Trust has been in existence for close to 100 years, but as it’s not yet a well-known charity I’ll start by telling you a bit about its work.
