Urinary tract infections (UTIs) are one of the commonest infections seen in primary and secondary care and consequently are often treated with antibiotics. However, recently there has been an increasing amount of evidence highlighting the problem of bacterial resistance to antibiotics commonly used to treat UTI. This makes diagnosis and treatment even more critical. Diagnosis of a UTI can be difficult, especially in elderly patients, and poses many challenges for nurses, including those working in the community, particularly in nursing and residential homes. This article examines the adoption of a chemical indicator dipstick test. This demonstrated good correlation with urine culture results and was seen as a useful additional tool to assist in the diagnosis of UTI, especially in those patients where urine samples may be more difficult to capture.
This article highlights the normal and abnormal physiology of fluid circulation in the lower limb with particular reference to venous and lymphatic flow. Consideration is given to the assessment and diagnosis of disease and its severity, particularly the impact on the patient including chronic oedema, ulceration, cellulitis and loss of mobility. Options for disease management and prevention such as compression bandaging and hosiery are also discussed, and the gaps between theory and practice are highlighted to provide community nurses with the most up-to-date information and practical solutions.
As community nurses increasingly visit patients in their own homes to perform wound care, continence care or other common community nursing tasks, they may notice various skin conditions in the course of examining or treating patients. In order to provide holistic care, it is important that community nurses have a working knowledge of the variety of infections and infestations that can affect an individual's skin. This article takes a look at some of the more common skin infections/infestations — impetigo, fungal infections, viral warts, and scabies — and provides information on presentation, assessment and treatment.
Interstitial lung disease is a wide-ranging category of respiratory illness that includes many different lung conditions, such as interstitial pneumonia, idiopathic pulmonary fibrosis, non-specific interstitial pneumonitis and hypersensitivity pneumonitis. All interstitial lung diseases affect the interstitium, a delicate network of tissue that extends throughout the lungs and which supports the microscopic air sacs within the lungs (alveoli). Unfortunately, some forms of interstitial lung disease have a very poor prognosis, therefore it is important that community nurses are aware of the signs and symptoms of interstitial lung disease so that prompt referral, assessment and treatment can be started.
This article examines and summarises the role of nutrition and the dietitian in the final stages of palliative care. The recent publication of One chance to get it right (NHS England, 2014), highlighted the need for a change in the approach to food and drink, especially when caring for those patients who are at the end of life. There is a clear need for documentation and formulation of clear, patient-centred and effective care plans, as it is vital that food and drink are offered, as long as it remains safe and is not harmful to the patient.
JCN talks to those working in the community.
Dinah Latham is a retired community nurse from Buckinghamshire and author of Walking Forward, Looking Back a new novel about district nursing.
From watching whales off the Mexican coast to dealing with on-board norovirus outbreaks, the life of a cruise-ship nurse is rarely dull. Here, Gary de Beer explains what it is like to be part of an on-board medical team, which might have access to state-of-the-art equipment, but can be many miles out to sea...
JCN talks to those working in the community.
Soline Jerram, director of clinical quality and primary care, Brighton and Hove, Clinical Commissioning Group
In each issue of the Journal of Community Nursing we investigate a hot topic currently affecting our readers. Here, Jason Beckford-Ball looks at the latest plan for the future of the NHS in England and asks the question...
