Many of you will be familiar with The Queen’s Nursing Institute (QNI) and its work — funding innovative projects; developing a network of Queen’s nurses’; supporting nurses who work with homeless people; influencing policy; and publishing reports.
Anne Pearson is Practice Development Manager at the Queen’s Nursing Institute.
Healthcare news in the UK often appears to be dominated by Westminster politics and the London-based media, so we asked the chief nursing officers (CNOs) of Scotland, Northern Ireland and Wales about how they see the future of community nursing in their respective countries.
Ros Moore, Chief Nursing Officer, Scottish Government.
Charlotte McArdle, Chief Nursing Officer, Northern Ireland.
Dr Jean White, Chief Nursing Officer/Nurse Director, Wales.
In each issue of the Journal of Community Nursing we investigate a hot topic currently affecting our readers. In this, our re-launch issue, we take a look at the changing face of care provision in the UK with the question...Who is today’s community nurse?
Anne Pearson, Practice Developmen,t Manager,QNI
Anne Williams, Lymphoedema Nurse Consultant and Researcher, Blantyre, Scotland
Kate Arkley, Community RGN, Galway, Ireland
Jackie Stephen-Haynes, Professor and Consultant Nurse in Tissue Viability, Birmingham City University and Worcestershire Health and Care NHS Trust Annette Bades District Nursing Specialist Practitioner and Clinical Lead Cardiorespiratory, Lancashire Care NHS Foundation Trust
Over 60% of individuals receive radiotherapy as part of their cancer treatment, either with curative or palliative intent. Radiotherapy is usually provided as an outpatient service, which means that community nurses need to understand the most common radiotherapy-induced side-effect, an acute skin reaction, which can range from mild erythema to confluent moist desquamation. All patients receiving external beam radiotherapy are at potential risk of developing this reaction. This article presents information on the assessment and management of what can be a debilitating side-effect.
Ellen Trueman, Senior Sister, Radiotherapy Review Clinic, St James’s Institute of Oncology, Leeds Teaching Hospitals NHS Trust; Nursing Times 2011 Winner — Cancer Nurse Leader Award
Numerous studies have shown that pain during dressing change is a major issue for patients with both acute and chronic wounds. Despite this evidence, pain is often misunderstood by clinicians and can be poorly managed. Pain can result in patients abandoning dressing regimens and clinicians need to ensure that patients have their pain reduced as much as possible and do not have to face the trauma of repeated painful dressing changes. This article presents some of the causes of pain and outlines some strategies that clinicians can use to prevent or minimise their patients’ pain.
Jacky Edwards, Burns Nurse Consultant, Burn Centre, University Hospital of South Manchester and Lead Nurse, Northern Burn Care Network
In patients with venous and lymphovenous disease, skin changes to the lower limb(s) occur gradually, and become more serious over time if left untreated. The CHRonic Oedema Signs and Symptoms (CHROSS) Checker is a tool kit consisting of an assessment chart and key cards that have been developed to help clinicians easily identify the skin changes that occur as a result of underlying venous and lymphovenous disease, when carrying out holistic patient assessment. It also provides clear guidance on which compression products can be used to manage the disease type and severity of skin change. For clinicians unfamiliar with some or all of the signs and symptoms listed on the CHROSS Checker chart, the key cards contain further information in the form of a photograph, definition and cause of each sign and symptom listed. This article will describe the theory behind the development of the CHROSS Checker tools and explain how to use them in clinical practice.
Janice Bianchi, Independent Medical Education Specialist and Honorary Lecturer, Glasgow University
Ongoing changes to the NHS (Department of Health [DH] 2010a–c) mean that clinicians responsible for the delivery of wound care need to reduce expenditure while meeting the increasing demand for the provision of quality care (DH 2010a–c). The high impact action (HIA), Your SkinmMatters, identified ‘no avoidable pressure ulcers’ in NHS care settings as a vital improvement to the quality of patient experience and cost effectiveness (NHS Institute for Innovation and Improvement, 2010).
Aaron Knowles, Tissue Viability Podiatrist;
Richie Skinner, Senior Tissue Viability Podiatrist, both at Wound Healing Centres, Eastbourne
Steve Young,Managing Director, Cambridge Health Technology;
Sylvie Hampton, Tissue Viability Consultant,Wound Healing Centres, Eastbourne
With government reforms increasingly bringing care into patients’ homes, community nurses will inevitably encounter more and more people who have a stoma. Stomas essentially involve the maintenance of a permanently open breach of the skin, therefore, the site requires expert skin care as it is vulnerable to stripping and break down. This article looks at the use of silicone-based adhesive removers, which improve quality of life and can also reduce healthcare costs as they prevent the escalation of peristomal skin dysfunction. These products also help to prevent costly ongoing treatment for the effects of stripping on sensitive peristomal skin.
Jackie Stephen-Haynes, Professor and Consultant Nurse in Tissue Viability, Birmingham City University and Worcestershire Health and Care NHS Trust
