The NHS spends the majority of its budget on labour costs and it could be argued that frontline staff such as community nurses are the organisation’s most valuable resource. However, optimal wound care is dependent upon effective patient engagement, the application of clinical expertise and access to wound management products. The tension between increasing demands for services and the number of nurses is already causing problems in care provision as staff cuts and excessive workload inevitably endanger patient care. Enhancing efficiency through the use of innovative products will become essential in the future if nurses are to continue to provide expert care against a backdrop of cost-savings. This article details the appraisal process undertaken within Worcestershire Health and Care NHS Trust to investigate the in-practice clinical performance of a silicone foam dressing (Allevyn™ Life Smith & Nephew, Hull).
Declaration of interest: Richard Searle and Alistair Bielby are employees of Smith & Nephew. This project was supported by an unrestricted grant from Smith & Nephew.
Jackie Stephen-Haynes, Professor and Nurse Consultant, Practice Development Unit, Birmingham City University and Worcestershire, Health and Care Trust
Alistair Bielby, Clinical Team Manager, Smith & Nephew Healthcare Ltd
Richard Searle, Health Economics Manager, Smith & Nephew Medical Ltd
This article outlines a survey that was undertaken in the community to find out how often patients with venous disease who are wearing compression hosiery have their ankle brachial pressure index (ABPI) monitored. It also asked clinical nurse specialists (CNSs) their opinion on the desired frequency of ABPI follow-up, and which patient groups they considered to be most at-risk. The survey findings highlight the lack of consensus and consistency in follow-up care. The majority of CNSs identified potential high-risk patient groups, the majority of which have their ABPI monitored every three months. However, there were inconsistencies in time interval for follow-up in patients with similar risk factors.
Winnie Furlong, Lead Clinical Nurse Specialist, Princess Alexandra Hospital and West Essex Leg Ulcer Service
The health of the population is determined by a range of complex and interconnected influences, many of which, such as poverty, inequality, housing, education, employment, mobility, transport and pollution, fall outside a medical remit. In order for nurses and other healthcare professionals to tackle public health, they not only need to engage with individuals, families and communities, but should also have the ability to influence the design and development of services and understand the new relationships with local authorities and other agencies.
Jane DeVille-Almond, Independent Nurse Consultant/Chair of the British Obesity Society; Senior Lecturer at the University of
Wolverhampton.
In each issue of the Journal of Community Nursing we investigate a hot topic currently affecting our readers. In this issue, after recent reports of poor care, we take a look at services for older people and ask the question...
Since The Queen’s Nursing Institute (QNI) was established in 1887, we have been a charity focused on improving the experience of the patient cared for in the home and community.
One of the many ways in which we can demonstrate that we make a tangible difference to patients, families and carers is through the support we give every year to the successful delivery of our QNI frontline innovation projects.
Crystal Oldman, Chief Executive of The Queen’s Nursing Institute (QNI).
Although community nurses often work in isolation, it’s good know someone at a national level has got your back. Jason Beckford-Ball went to meet Viv Bennett and asked her about her vision for public health nursing in England.
Although many people say they would like to die at home, only 20% actually do, with the majority dying in hospitals, hospices and care homes. As a student nurse, Ilhan Wardhere found reflection helpful in working through clinical challenges. Here she shares her experiences of dealing with end of life care in the community.
Community nurses are frequently involved in the care of patients after they are discharged from hospital, including many who have undergone stoma-forming surgery. There is evidence that it takes some time to adjust to life with a stoma, with much of this adjustment occurring in the first three months following surgery. During this period, nurses can use their skills to resolve any
problems that might occur, helping patients to adapt and improve their quality of life. If community nurses cannot resolve any issues patients may have with their stomas, referral to a specialist such as the local stoma specialist nurse, might be necessary.
Jennie Burch, Enhanced Recovery Nurse, St Marks Hospital, Surgery, Harrow, Middlesex
Irritable bowel syndrome (IBS) is associated with a significant impairment of quality of life. Due to the nature of its symptoms, the role of the nurse is central to the care of patients who may have IBS. The often embarrassing symptom profile means that patients may rely on nurses to provide psychological and physical support in helping them to improve their symptoms. In this article, the author discusses the management of patients with irritable IBS, including the optimal delivery of care for patients and the role of community nurses in dealing with this chronic condition.
Isobel Mason, Nurse Consultant, Gastroenterology, Royal Free London NHS Foundation Trust, London
Eating well in later life is an essential part of enabling older people to live independently at home for longer. However, with increasing funding cuts to community care services in the context of an ageing society, is enough being done to encourage good nutrition in later life? This article discusses the importance of nutrition for older people and explores how community practitioners are ideally placed to spot the early warning signs of malnutrition and encourage patients to take better care of their diet.
Helen Willis, Dietitian, Wiltshire Farm Foods
