Resources

The impact of ageing on the body and its association with skin harm and frailty in relation to multimorbidity, comorbidity and polypharmacy is clearly described in the literature. The ageing population globally brings with it the challenge for healthcare professionals of managing individuals with increasingly complex and inter-related needs. This article considers ageing skin and skin tears within the context of frailty as a syndrome. It discusses what frailty is understood to be, how to recognise and assess for it, and how to consider risk and prevention of harm to the skin of the ageing person with frailty.

Lower limb ulcers are one of the most common chronic wounds in the UK and have a negative impact on health-related quality of life (Phillips et al, 2020). Venous leg ulcers (VLUs) often present with excessive exudate, which may damage the wound bed and
periwound skin; and therefore act as a barrier to wound healing. Cleaning and debridement are key to the management of devitalised tissue and exudate. Although debridement helps promote the healing of both arterial and venous leg ulcers, its use may be restricted by pain levels associated with the procedure (Claeys et al, 2011). Because pain can be a barrier to patients tolerating debridement, this may compromise the healing process (Roberts et al, 2019). A small-scale evaluation was recently completed to investigate the efficacy of wound debridement pads, together with patient perceptions of the treatment. The impact on pain and tolerance of pain during the use of
pads was explored. Spending time explaining the potential benefits of debridement on wound healing and listening to patient concerns appeared to have a positive impact on acceptance of treatment.

The aim of this article is to identify challenges for advanced practitioners within the district nursing services in remote and rural areas and the impact of the new Scottish GP contract. Advanced nurse practitioners (ANPs) working within the community providing care in patients’ homes have a wide skill base to draw upon. However, community care is often not reviewed or studied to identify the impact it makes to patients and the wider community.
This article looks at a review of the qualitative research provided by a search on CINAHL, Medline, PsychINFO and Google scholar between 2019 to 2023. Studies needed to be about advanced practice in remote and rural areas with a focus on district or community
nursing. A separate search was conducted for reviews on the new Scottish GP contract and the impact on services this has had, using the same search engines and between the same dates. Articles that were based on ANPs working in GP practices were excluded.

Lymphoedema is a progressive long-term condition that detrimentally affects many aspects of quality of life — physical, emotional, and social. The introduction of lymphoedema patient-reported outcome measures (PROMs) has supported patients to communicate the psychological impact, raising concerns such as anxiety, fear, low
mood, and poor body image. However, some healthcare professionals report feeling ill-equipped to respond effectively to these needs. This study explored lymphoedema healthcare professionals (LHCP) psychological and emotional education needs. A Google Forms survey was developed based on literature and expert opinion and disseminated via email to all staff (120) within Lymphoedema Wales Clinical Network (LWCN). Data demonstrated statistically significant correlations between levels of perceived  confidence, perceived skills to discuss psychological issues, and level of psychological training received (p <0.001). However, nearly three-quarters of participants reported never receiving psychological training. This study represents the first step in  understanding psychological education needs of LHCP and indicates future  opportunities to potentially improve clinical practice in this area.

Suboptimal management of leg ulcers is a growing burden on NHS nursing and financial resources (Guest et al, 2015; 2017; 2020). Compression therapy plays a crucial role in leg ulcer management by improving outcomes and reducing the burden of disease, however it is not routinely applied in practice and knowledge and confidence between bandage types and application styles often varies greatly (Guest et al, 2017; Hopkins, 2023). This article focuses on the importance of compression therapy in the management of leg ulceration and how to select the appropriate compression therapy based on the patient’s presenting symptoms. It identifies possible barriers to application and offers potential strategies and suggestions to support the use of compression options in the community.

Falls in the elderly come at a high cost, both to the NHS and to the health and confidence of the person who has fallen. Hospital-based trials in 2021 started to explore potential links between caffeine and falls associated with going to the toilet, given caffeine’s diuretic effect. In 2023, following positive trial outcomes, the project spread to social care, where a 35% reduction in falls associated with going to the toilet was seen when decaffeinated products were introduced as standard in eight care homes for the elderly. This article explores the Decaf Project and potential benefits of decaffeination in wider community settings, including for elderly people living in their own homes. It examines ways in which community nurses can support those in their care to understand potential benefits of decaffeination.

Suicide is a stark word that provokes a deluge of emotions in all of us, including community nurses and society at large, both on a personal/community and professional level. Suicide provokes a wide range of questions and has many ramifications that ripple outwards. It can cause consternation on the part of the community practitioner by questioning themselves and their actions and also on the part of the families and friends while coping with grief
and all asking, among other things, should I have acted or spoken differently. Suicide and attempted suicide impacts all of us, our colleagues, our patients and ourselves.

Here, Professor Michelle Howarth, professor in health and social care, associate director CSR (Centre for Social Responsibility), Faculty of Health, Social Care and Medicine, Edge Hill University, Rhian Last, nurse educator, Self-Care Forum self-care champion and Libby Whittaker, Self-Care Forum manager, explore the findings of a project undertaken last year on self-care, highlighting ways that community nurses can support self-care both in their day-to-day role and more strategically across primary care populations.

My first experience of working in a prison was delivering rehabilitation programmes and I left this post to undertake my nurse training. After spending several years working in acute hospitals and community drug and alcohol services, a post for an advanced clinical practitioner came up in a prison. The job description really appealed to me with being able to work across the four pillars of advanced practice, and having worked in a prison environment previously, I thought it would be a good opportunity to expand and  develop my skills further.