Due to changes in national healthcare policy community staff, including nurses, are being asked to care for ever-larger and more diverse groups of patients. However, the challenge for staff and service providers is how to deliver higher standards of clinical care while ensuring that patient safety remains a priority. One of the answers is to ensure that staff who deliver any clinical skill do so competently, but reports have highlighted technical skills gaps that need to be addressed. No failings should be regarded as acceptable as they can impact on patient safety and there is a responsibility to address any areas for improvement through education and skills training. The study outlined in this article attempted to capture the perceptions and experiences of community staff to gain an insight into the gaps in clinical skills training and make recommendations for improvement.
Kathy French is a freelance nurse. She was formally a nurse advisor at the London sexual health programme and a nurse on the Independent Advisory Group for Sexual Health and HIV.
Economic studies of leg ulcer management strategies have mainly concentrated on different compression, dressing and pharmaceutical products rather than different modes of delivery or systems of care.
Leg ulcer management in the community presents a number of challenges. This paper discusses the challenges and rationale of introducing a new service delivery for leg ulcer management based on patient empowerment, health promotion and education, and its implication for clinical practice. It focuses on an initiative that provides a patient-centred resource for the prevention, treatment and management of leg ulcers and associated conditions.
Ellie Lindsay BSc (Hons) RN, DN, CPT, DipHE, Independent Specialist Practitioner. Visiting Fellow, Queensland University of Technology.
Article accepted for publication: October 2012
‘It is widely known that there are differences between men and women in the incidence and prevalence of most health conditions. Sometimes there are clear biological reasons for these differences – but often there are not.’ (Mens Health Forum – www.menshealthforum.org.uk)
Although men are starting to realise that their health outcomes could be much better with a bit of effort, they continue to die on average, years earlier than women, and for just about every disease common to both sexes, men still come off worse. It’s only in the last few years that we have started to ask ourselves why is this?
Jane DeVille-Almond, SRN, SCM HV BA(Hons) Independent Nurse Consultant/ Chair of the British Obesity Society http://www.obesitysoc.org.uk/, Senior Lecturer at the University of Wolverhampton.
Article accepted for publication: November 2012
Clinicians often find it difficult to devote sufficient time to develop proposals that will investigate issues that enhance the patient experience. Thus, clinicians need to access researchers and academics who can assist in developing research proposals, undertake service evaluation, audit current practice, provide advice on best practice and offer education that maintains clinical knowledge and skills.
The University of Huddersfield recognised the challenges faced by clinicians in undertaking research in the specialist area of skin, and in 2011 formed the Skin Interface Sciences (SIS) Research Group. This article outlines its development and achievements to date.
Karen Ousey, Reader, PhD, RGN, School of Human and Health Sciences, Centre for Health and Social Care Research, University of Huddersfield, West Yorkshire. E-Mail: k.j.ousey@hud.ac.uk
Ross Atkinson, PhD, Spinal Research, Coordinator – Greater Manchester, Neurosciences Centre & Honorary Research Associate – The University of Manchester, Manchester Academic Health Science Centre, Salford Royal NHS Foundation Trust, Salford
Leigh Fleming, PhD, Senior Research Fellow, School of Computing and Engineering, University of Huddersfield, West Yorkshire
Barbara Conway, PhD, Professor, School of Applied Sciences, University of Huddersfield, West Yorkshire
Skin Interface Sciences Research Group, University of Huddersfield: sisgroup@hud.ac.uk
Article accepted for publication: December 2012
Objective: In Slovenia, community nurses usually use tap water as a cleanser for chronic wounds, but is this the best practice? The purpose of this review is to establish if there is any difference in healing and infection rates when wounds are cleaned with tap water instead of sterile saline.
Method: An electronic literature search using the key words chronic wounds, wound cleansing, tap water and saline was undertaken.
Results: Results showed that there was no increase in infection or in wound healing rates between patients whose wounds were cleaned with tap water or sterile saline. Tap water may be as safe and effective as sterile saline but only when the water comes from the properly treated supply and used at body temperature.
Conclusion: Some evidence suggests that the use of tap water of drinkable quality appears to be a safe alternative to sterile saline, and that there are numerous benefits in its use.
Acknowledgements:
This contribution is part of Master’s Degree undertaken at College of Health Care, Izola. The author is grateful for the support and assistance of Professor Dame June Clark, Swansea University.
Andreja Ljubič RN, University of Primorska, Faculty of Health Sciences Izola, Slovenia and Health Center Postojna, Postojna, Slovenia.
Article accepted for publication: January 2012
Throughout history, it has been observed that wounds tended to heal more quickly with fewer complications when larvae found their way onto open wounds. Larval therapy (LT) is used for the debridement of chronic wounds and to create a wound bed conductive to effective healing. The aim of this article is to discuss the effectiveness of larval therapy for the debridement of chronic wounds through a critical analysis of the relevant literature.
Laura Wood, BA (Nursing). Previously Staff Nurse, AMU, Heartlands Hospital, Birmingham
Mark Hughes RGN, DN, HV, BSc (Hons), MSc, PGCE, Lecturer, University of Birmingham
Article accepted for publication: December 2012
