Resources

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.

The problem of delayed wound healing has been highlighted in several publications which has stimulated debate on variance and the need for updated care pathways. This paper demonstrates how adjunctive therapy can be added to the ‘standard care’ model, described in the National Wound Care Strategy Programme’s recommendations for lower limb wounds, to enhance outcomes for patients with ‘hard-to-heal’ lower limb wounds (NWCSP, 2020). A decision-making pathway based on published literature is described,  which uses wound assessment and observed response to treatment to allow the effective and targeted introduction of adjunctive therapies for ‘hard-to-heal’ wounds. This approach will allow the cost-effective introduction of new and evolving therapies, such as WoundExpress™(Huntleigh Healthcare), which addresses the underlying problems associated with resistant lower limb oedema and compromised venous function. The pathway also indicates how other adjunctive or innovative topical wound-based treatments can be integrated to optimise outcomes while providing cost-effective care.