Close attention is being paid to the role the clinical nurse specialist (CNS) plays in facilitating patient adjustment and adaptation to life in the weeks, months and years after treatment for a colorectal cancer and stoma formation. Much of the CNS work is performed in the outpatient setting, in the community or on the telephone, placing the colorectal CNS in a prime position to co-ordinate the complex care needs of individuals who have undergone surgery and formation of a faecal stoma. In this article, the author examines the combined role of the colorectal/stoma CNS in co-ordinating the complex care needs of the ostomy patient with a colorectal cancer diagnosis by exploring the repertoire of skills and expertise that comes into play in the follow up care of ostomy cancer patients.
Kathryn Foskett RN BSc (Hons) GI Nursing. Senior Colorectal Clinical Nurse Specialist. The Hillingdon Hospital NHS Foundation Trust.
Article accepted for publication: August 2012
Pressure ulcer prevention is a challenge both in acute care and in community care, although prevalence is hard to determine due to differing ways of assessing and reporting both ulcers and risk of ulceration. Those who are acutely ill or have compromised mobility, or are older, or who have multiple co-morbidities are at greater risk of pressure ulcer development.
Acknowledgements:
All District Nursing Staff, Greater Glasgow & Clyde
Lynne Watret, MN, PGCertTLHE, MA, RGN, CNS Tissue Viability
Fiona Middler, BA, Master in Primary Care, Clinical Effectiveness Coordinator, Primary Care, Greater Glasgow & Clyde
Article accepted for publication: August 2012
Wound debridement plays an essential role in preparing the wound to heal and can be achieved in several ways. Most wound debridement requires the skills of specialist practitioners which can be both time consuming and expensive. This observational study looks at a new mechanical debridement system with a monofilament fibre pad that can be used in any healthcare setting with minimal training. In twenty patients with wounds and/or skin that required debridement, the new system was found to be a fast and effective method of debridement causing minimal pain to the patients. This new approach to wound debridement could potentially have far reaching benefits to the patient, the nurse and the organisation.
Susan Johnson, RN, MA, ANP, NMP. Lead Nurse Wound Care, Doncaster Royal Infirmary,
Agnes Collarte, BSN, RN. Tissue Viability Nurse, Central London Community Healthcare NHS
Loty Lara, BSN, RN. Tissue Viability Nurse, Central London Community Healthcare NHS
Andreia Alberto, MSc. Tissue Viability Nurse, Central London Community Healthcare NHS
Article accepted for publication: July 2012
Chronic obstructive pulmonary disease (COPD) is the term given to progressive airflow obstructive conditions, namely emphysema and chronic bronchitis. The disease is not reversible, but its progression can be slowed with the correct treatment and management. Within our organisation, we realised that if district nursing teams worked inter-professionally, exacerbations of COPD could be reduced simply by assessment of inhaler technique whilst making home visits. This article, a previous entry to the JCN Writing Awards, presents the a review of the literature undertaken prior to changing practice.
Annette Bades, BSc (Hons) Adult Nursing, District Nursing Sister, Lancashire Care NHS Trust
Despite many advances in the treatment and management of bladder dysfunction, there are still some patients who require an indwelling urethral or supra-pubic catheter, or intermittent catheterisation to help maintain urinary continence. This article builds upon the principles of catheterisation presented by Booth and Clarke in the May/June 2012 issue of JCN, outlining fundamentals such as privacy, dignity, harm minimisation and the use of care bundles.
Ann Winder, RGN Independent Continence Clinical Nurse Specialist, Director ARC Healthcare Ltd., Chairperson, Continence Clinical Supervision Group England
Article accepted for publication: July 2012
