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.
Carers play a huge role in supporting people to live at home. In some cases, they provide around-the-clock care for people who would otherwise need to be admitted to hospital or transferred to a nursing home. Carers are crucial to home and community care and yet there is little awareness of, and support for, the important role that they play.
Alex Munro is a registered nurse, with a background in unscheduled care as a nurse practitioner. He has previously been a director of a private healthcare provider delivering a community admission avoidance service and is the co-founder and clinical director of Hallam Medical, the primary care recruitment specialist.
Atopic eczema is a frustrating and complex skin condition that has no cure. However, with good support, education and the correct application of topical treatments it can be well-controlled. Community nurses can provide patients with information about their condition, how to apply their topical treatment effectively and how to manage flares and maintain a routine that will improve the eczema and the patient’s quality of life. Any information provided should be reinforced with written information and a treatment plan, with follow-up support offered as needed.
This article aims to explore the perception that treatment of sacral pressure ulcers is costly and time-consuming, especially when faced with faecally incontinent patients with loose stool. The authors’ tissue viability service used a faecal management system to prevent faeces from coming into contact with the wound bed for 12 weeks, while simultaneously allowing a conventional dressing to perform to its maximum ability. A total cost and wound-healing comparison was carried out in two community patients who were faecally incontinent and bed-bound. One patient was managed with a faecal management system and the other with incontinence pads. The authors found that although the purchase of the faecal management system was initially costly, the frequency of dressing change was reduced, the patient felt more comfortable and fewer visits from the community nurses were necessary. Also, faster healing rates were demonstrated by reductions in wound size. This technique requires further studies with a larger sample size to ascertain its true benefits, particularly around wound healing.
This article examines malnutrition, a complex issue that has wideranging implications in terms of patient experience and resources - evidence suggests that malnourished people are repeat attendees at GP surgeries, incur higher prescription costs and experience twice as many hospital admissions than well-nourished people. While there have been many hospital initiatives targeted at reducing the risks of malnutrition, in the community the solution remains challenging. Recommendations include arranging services so that health and social care professionals can work together to overcome nutrition issues, making extra resources available to combat malnutrition and improving the monitoring of patients' nutritional state. As healthcare shifts to a more community-based model, there needs to be a reallocation of resources from hospitals to community to ensure that efforts to tackle malnutrition have a more realistic chance of success.
For community nurses faced with expanding case-loads and patients who are now being discharged earlier into the community, the sheer range of conditions they come across means that cost-effective and practical, clinically-effective solutions are at a premium. This is particularly true in wound care, where nurses in the community need products that can be used on a variety of wound types that are also cost-effective. This article looks at the range of wound care knowledge needed by generalist nurses, before focusing on one dressing in particular, Silflex® (Advancis Medical, Nottinghamshire). With its all-round versatility, Silflex provides a balance of usability and cost-effectiveness.
Chronic wounds have many psychosocial consequences, including stress, negative mood, pain, and social isolation. In addition to these, frequent dressing changes can cause the individual anxiety and stress. This article explores how wound management can influence both psychological outcomes and, potentially, the rate of healing. Implications for practice are identified, which need to be successfully employed to ensure that patient health is maximised and that the stress and pain associated with wound care are minimised in order that wound healing is improved.
In chronic wound management the potential for healing increases following effective debridement. Indeed, it has been suggested that debridement’s effect on chronic wound healing is similar in impact to the relief of pressure in preventing pressure ulceration. Debridement can be performed using a number of methods, but larval debridement has recognised benefits, including the breakdown of necrotic tissue; removal of microbes; wound cleansing; and breakdown of biofilm. The reduction of malodour in the wound can also help increase patients’ self-esteem and overall wellbeing. This article looks at the use of larval therapy in a community setting, which can be particularly cost-effective as rapid debridement swiftly reduces the bacterial load, helping to lessen the potential for hospital admission.
It has been estimated that around 4% of patients on community caseloads have long-term indwelling catheters (Pomfret, 2000). Healthcare professionals have a responsibility to be aware of the different closed drainage systems available, so that they can offer patients choices to suit their lifestyle and preferences. Leg bags are one option, which can be customised to maximise patient comfort and dignity. This paper discusses the impact that urinary incontinence can have on patient quality of life, and one range of leg bags that has been developed to meet patients’ specific needs.
