Resources

The ‘Managing Adult Malnutrition in the Community’ multidisciplinary panel is celebrating the 10th anniversary of the launch of the guidance. The guidance document was developed to assist non-nutrition experts in the identification, treatment and
prevention of disease-related malnutrition in the community.

Dermatological conditions are notoriously difficult to spell! Psoriasis with its silent ‘P’ and eczema without an ‘X’. But how about hidradenitis suppurativa (HS)? Hard to spell, hard to pronounce but, more importantly, really hard to be a patient with the condition.

Seven percent of the population in Britain — around 3.8 million people — currently rely on wound care services (Guest et al, 2020); a staggering, and surprising number. Wound care is often an unrecognised service, hidden away as part of the treatment for other conditions, such as diabetes. This lack of awareness led to a situation where variation in standards meant that patients were having mixed experiences of care across the country (Patients Association, 2021).

Melanoma awareness month, held annually in May, aims to promote sun safety and education on checking skin for signs and symptoms of melanoma. Earlier this year, Melanoma Focus surveyed over 1,000 people in the UK to assess public knowledge and attitudes on melanoma prevention and detection.

Encouraging care closer to home has long been a priority for the government and NHS (Department of Health [DH], 2019). The workforce needs to be trained and equipped to deliver this health care in a variety of community settings (Queen’s Nursing Institute [QNI], 2021). The Nursing and Midwifery Council (NMC) have consulted and responded to these societal changes, i.e. care closer to home, within their review of professional standards which will shape community nursing roles for years ahead (NMC, 2022). The specialist practice qualification (SPQ) provides the education and training to prepare community nurses for their future professional careers as clinicians and leaders and will be at the forefront of implementing these standards.

This article describes the wound infection continuum in surgical, acute and chronic wounds. The phases are: contamination, colonisation, local infection and finally spreading and systemic infection. Clinicians need to be familiar with the signs and symptoms of local infection in order to put strategies in place to prevent a ‘full blown’ wound infection and to recognise how the signs and symptoms differ by wound type. The article looks at the
most recent guidance on wound infection management strategies, together with the identification and treatment of suspected biofilms and the two-week challenge, used in clinical practice to disrupt biofilms. Wound cleansing and the use of antimicrobial dressings
and topical antiseptics are also discussed.

A leg ulcer can be defined as a break in a person’s skin which becomes chronic in nature and takes longer than two weeks to heal (NHS UK, 2019). Evidence outlined by The National Institute for Health and Care Excellence (NICE) states that the prevalence of leg ulcers in the United Kingdom is around one percent over a lifetime, which still describes a large number of people (NICE 2022; Lim et al, 2018). The prevalence of leg ulcers continues to rise and a shift in lifestyle factors, including smoking and obesity, have contributed to this (Agale, 2013). Further risk factors for developing leg ulcers include immobility, advancing age, a history of varicose veins or deep vein thrombosis (DVT) and having a sedentary lifestyle (Scottish Intercollegiate Guidelines Network [SIGN], 2010; Lim et al, 2018). The challenge of caring for these chronic wounds often falls to staff in primary care. Therefore, they should have a good understanding of leg ulcers and how best to treat them. In the author’s opinion, Leg Clubs® provide an ideal opportunity to manage lower limb wounds, while also tackling the wider holistic issues of leg ulcers, such as social isolation and loneliness.

Prescribing by a variety of professionals continues its progression in response to the growing demands for health care. Prescribing by nurses was initiated in the 1990s and supported by the National Prescribing Centre’s ‘prescribing pyramid’ or seven steps or
principles for good prescribing (NPC, 1999). This article explores a new prescribing consultation model (RAPID-CASE), which is composed of elements from the prescribing pyramid and the Competency Framework for all prescribers (Royal Pharmaceutical
Society [RPS], 2021). The RAPID-CASE consultation model is applied to a clinical scenario to illustrate how it can guide a systematic approach to decision-making, using the example of a lower limb skin tear injury.

Respiratory syncytial virus (RSV) is an acute respiratory viral infection and is the main cause of acute lower respiratory tract infection during the first year of life (Lozano et al, 2012; Nasreen et al, 2014). It usually causes a mild, self-limiting respiratory infection in adults and children, but it can be severe and cause bronchiolitis in infants. There was a reduction in RSV during the Covid-19 pandemic, but figures appear to be rising again (Agha and Avner, 2021; van Summerten et al, 2021). This literature review considers assessment, diagnosis and treatment options for RSV.

Breathing is a normal vital function which is spontaneous, regular, self-regulating, quiet and effortless and reflects the way the respiratory system functions. The function of the respiratory system is to maintain the exchange of oxygen and carbon dioxide in the
lungs and tissues and regulate the acid-base balance. Any changes in this system will affect, and may present in the form of symptoms or signs in, other body systems. Breathlessness is a common symptom in people with cardiac diseases, respiratory diseases, neuromuscular disease, anaemia, significant gastro-oesophageal
reflux and can also be caused by pain, anxiety, emotion, deconditioning and obesity. Thorough, careful and systematic history-taking and assessment may help to identify the potential cause(s), with key question to identify whether the breathlessness is
acute (sudden onset) or chronic (long-standing).