Resources

Working within the community, we are ideally positioned to offer our patients, and everyone we meet, personalised advice in relation to their health and self-management. We can observe them in their home environment and really understand how our patients live on a day-to-day basis. This supports us to empower them to adopt health promotion strategies and make small lifestyles changes. We can empathise with the difficulties they may encounter and support them to adapt their regular routines to really make a difference. This issue’s ‘Community matters’ piece explores making every contact count (MECC) in more detail (pp. 8–12).

We are all aware of how recent lockdowns have led to an increase in reports of domestic violence. As nurses who visit patients in their own homes, we are in a unique position to make that contact count by asking questions to help victims disclose their situation. Do read how Leeds Community Healthcare (LCH) has equipped its staff not only to address issues of domestic abuse and violence with patients, but also to support employees who themselves are in an abusive relationship (pp. 69–71).

Identifying patients who may be malnourished is again something we all need to be on the look out for during routine clinical care, especially as the majority of those affected by malnutrition are living in the community. In this issue, Anne Holdoway and Hilary Franklin (pp. 30–37) take a detailed look at the development of the ‘Managing Malnutrition in the Community’ resources, which can help you to provide the best nutritional care for your patients. We also discuss dysphagia (pp. 38–42), a very real risk factor for malnutrition, with guidance on how to assess and identify those with a swallowing issue so that you can feel confident to help patients have a safe swallow.

As Christmas approaches, and we head towards 2022, we need to congratulate ourselves on all our hard work and achievements during another difficult year. For whatever reasons, this year has seemed more testing than the previous one, so we should be extremely proud of the difference we have made to our patients and the support we have given colleagues. I hope everyone takes some time to reflect and refresh and prepare for the challenges ahead, and please remember, there is a great deal of support available if you need it.

And finally, here at JCN, we would like to wish all our readers a very happy and relaxing Christmas and New Year.

Annette Bades, editor-in-chief, JCN

In each issue of the Journal of Community Nursing, we investigate a topic affecting our readers. Here, Teresa Burdett, principal academic in mental health nursing, Bournemouth University, and Anneyce Knight (recently passed away), senior lecturer in adult nursing, Bournemouth University, look at making every contact count to promote health in the community. 

It’s not news to JCN readers, but when we talk to people about the fact that urinary tract infections (UTIs) are the second most common kind of infection after chest infections, they are amazed.

Of course, one of the reasons for that is that a UTI is not a condition that people tend to talk about...

When the Prime Minister announced his plan to fix social care once and for all in September, the sector hoped that a major second part of this would be revealed at the Spending Review in October. Unfortunately, we were  left disappointed.

The September paper had underlined concerns about the quality of care, lack of choice, and the burden of care costs to the person in need of care and support. But, there was a fundamental resourcing issue which received no attention: sufficiency of funding to ensure that local authorities can meet their basic statutory obligations...

The Paul Sartori Foundation is a charity based across Pembrokeshire in South West Wales, providing care free of charge to patients in the later stages of life limiting illness in their own homes. Its mission is to ‘provide excellent end-of-life care to the people of Pembrokeshire’. I facilitate and co-ordinate the clinical training for staff and some relevant others. This includes statutory training, as well as topics identified as being relevant to the care provided, for example, delirium, how we can support carers, and dementia. The Paul Sartori Foundation is a charity based across Pembrokeshire in South West Wales, providing care free of charge to patients in the later stages of life limiting illness in their own homes. Its mission is to ‘provide excellent end-of-life care to the people of Pembrokeshire’. I facilitate and co-ordinate the clinical training for staff and some relevant others. This includes statutory training, as well as topics identified as being relevant to the care provided, for example, delirium, how we can support carers, and dementia. 

The fourth and final part of the JCN continence clinical skills series identifies how continence problems, which may not have responded to conservative treatment/interventions, can be managed by the appropriate use of equipment/devices and products. The range available is vast and variable and some are more suitable to specific conditions than others. Healthcare professionals need to understand how they work to offer the best solution for individuals and their lifestyle. Products include, for example, commodes, urinals, sheaths, catheters, anal irrigation and pad products. This article specifically looks at equipment/devices and products for urinary retention, e.g. catheters; urinary incontinence, e.g. sheaths, pubic pressure devices; and faecal incontinence, e.g. anal plugs, transanal irrigation (TAI) and pad products. 

In 2006, the National Institute for Health and Care Excellence (NICE) released the landmark guidance on nutrition, ‘Nutrition support in adults: oral nutrition support, enteral tube feeding and parenteral nutrition’ (NICE, 2006). At the heart of NICE guidance and quality standards is the aim to integrate research into practice and reduce gaps between recommended and actual practice. However, successful implementation is dependent on national and local action. To facilitate the implementation of the NICE clinical guidance (CG32), a national multidisciplinary expert panel was convened to explore and develop strategies that would overcome barriers to implementation of the NICE guidance, facilitate access to practical tools, and enhance knowledge to improve the management of disease-related malnutrition in the community. The collaborative work undertaken by the panel, in conjunction with major stakeholders, led to the development of the ‘Managing Adult Malnutrition in the Community’ materials. This article reviews the work of both the initial panel in 2012 and subsequent expert panels, that have delivered and continue to develop resources for nurses and the wider multidisciplinary team to assist in tackling malnutrition, which affects up to three million people in the UK at any time (Elia and Russell, 2009), especially that which arises as a consequence of illness and long-term medical conditions having an impact on appetite and the ability to eat and drink.

There is evidence to suggest that the older adult is at risk of malnutrition. A number of factors are associated with this, including those living in care homes, and people with long-term or progressive neurological conditions. With the growing number of people surviving into older age, these risk factors needs to be considered. An additional risk factor is those who have dysphagia. This may restrict the choice of foods available and reduce the pleasure of eating. Assessment and management of dysphagia can help patients enjoy their food intake safely and in a nutritious manner. This article discusses the complexity of managing an adequate nutritional intake for those with dysphagia.