Resources

Welcome to our first issue of the Journal of Community Nursing for 2022. Over the coming year we will, as always, strive to support you and your practice and keep you updated on current topics. This issue highlights the vital role that all community-based professionals undertake on a daily basis and the importance of being an advocate for everyone that we make contact with. The support we can offer, both from ourselves and the wide range of services from other health and social care professionals, is invaluable and will always make a difference to the lives of individuals we meet.

With an ageing population and more people living with dementia, inevitably comes an increased need for carers. As community nurses, we are in an ideal position to identify, support and value such unpaid carers, which the sixth part in our dementia series explores (pp. 47–51). Indeed, as Karen Harrison Dening rightly points out in her editorial (pp. 12–13), dementia is ‘everybody’s business’. I urge you to read this piece and think about challenging cases and concerns you have encountered and then take part in the survey mentioned, which seeks to capture and understand real-time issues when working with a person with dementia and/or their families. These will then inform a text providing advice and information from an Admiral Nurse.

This first issue of 2022 is packed full of clinical articles relevant to your dayto- day practice. For example, with more people choosing to die at home, it is vital that clinicians have the training and confidence to help provide a dignified and comfortable death. The article on using syringe drivers at the end of life looks at the conditions they aim to treat, detailing the author’s own experience of caring for a patient at life’s end and developing a rapport with her family at this time (pp. 35–39). Safeguarding is another area that is ‘everyone’s concern’, which community nurses need to know how to recognise and report. Darren Butler, named nurse adult safeguarding, Cambridgeshire and Peterborough NHS Foundation Trust, provides a detailed account of the different types of abuse and how to document your concerns (pp.60–65).

As always, I hope you enjoy reading the journal. If you have any ideas for articles, please get in touch, as it is always great to hear from our readers. And finally, don’t forget to check when the JCN exhibition and study days are coming to your area — www.jcn.co.uk/events/series/roadshow-study-day.

Annette Bades, editor-in-chief, JCN

Malnutrition affects at least three million people in the UK, with 93% of these living in the community (BAPEN, 2018). Conversely, managing malnutrition can result in improvements in patients’ physical function, such as strength, quality of life and clinical outcomes, and reductions in healthcare use (such as hospital stays and admissions) (Stratton et al, 2018). Identifying and managing malnutrition can therefore improve lives and save money (Stratton et al, 2018).

There are estimated to be 900,000 people with dementia in the UK and indications are that this will increase to one million people by 2025 and two million by 2051 (Wittenberg et al, 2019). The majority of people diagnosed with dementia live in a community setting, whether that is in their own home, sheltered accommodation, hospice or a care home; indeed, there are few health and social care services where people with dementia are not to be found, and, as such, dementia is everybody’s business.

Now more than ever, those with an interest or specialism in continence care need to be able to access professional development, as well as share knowledge and experiences with colleagues. Covid-19 has rapidly altered service provision and specialist professionals working across different geographical areas have not yet had sufficient opportunity to come together in person and process what these changes mean for their practice and patients. This upheaval has, of course, affected everyone whose work touches on bladder and bowel issues.

Although it may not attract as much attention as other medical areas, the pandemic has had a huge impact on wound care services with many traditional routes of practice compromised during life in lockdown. But, while this continues to add pressure on the nursing community, it also offers an opportunity to retain the recent step change in innovation to tackle backlogs and build back stronger.

Domestic violence and abuse (DVA) is a real issue for many people. It is also sadly in places in our communities and life spaces. During the pandemic, the evidence seems to say things have got worse (https://commonslibrary. parliament.uk/domestic-abuseand-covid-19-a-year-into-thepandemic/). Indeed, victims were suddenly trapped at home with their abuser, with no options of respite or relief (Chambers et al, 2021).

This clinical series aims to demystify and simplify approaches to assessment and management of chronic oedema in the community, including the promotion of self-care, with the aim of improving efficiency and delivering the best evidence-based care for patients with chronic oedema. Part 1 explains what chronic oedema is, its prevalence, causes and appearance.

Moisture can affect the normal function and permeability of the skin, leaving our bodies susceptible to infection. The damaging effects of moisture-associated skin damage (MASD) impact a wide range of patient groups, however, wounds caused by moisture are often mistaken for and treated as if they are pressure ulcers. Moisture can come into contact with the skin from a number of sources, but damage can be treated in the same way, despite its cause. In the authors’ clinical opinion, if nursing staff are able to identify and treat skin damage correctly according to its aetiology, faster rates of healing, improved quality of life, and fewer resources used on wound care would be seen. This article looks at the identification of seven aetiologies of MASD following an audit, and the subsequent development and implementation of a protocol to improve and standardise skin care in the authors’ trust, which it was hoped would provide a dynamic and unified approach to the management and education of MASD.