Resources

F or those living with swallowing difficulties — otherwise known as dysphagia — it is not just the physical side-effects of the condition that can be debilitating. Eating homeblended texture-modified food that one is not accustomed to can, despite best efforts, often be unappealing and have a negative impact on a person’s quality of life.
Josephine Bailey has dysphagia as a result of oesophageal cancer and did not enjoy the experience of homeblending once discharged from hospital three years ago:

I’d lost a massive amount of weight and didn’t want to be tube fed anymore. Mealtimes were becoming really stressful. I didn’t know what to eat, I was pureeing everything with my hand-held blender, which wasn’t working very well, and everything resembled mush.

The Queen’s Nursing Institute (QNI) has recently launched a new project to support recruitment of internationally trained registered nurses to community service providers in England, in line with the the overall national strategy to fill nursing vacancies and secure a sustainable workforce (www.england.nhs.uk/wp-content/uploads/2020/07/We-Are-The-NHS-Action-For-All-Of- Us-FINAL-March-21.pdf).
This work is supported by NHS England and Improvement and dovetails with the work they are undertaking to support six pilot sites around the country with their international recruitment to the community efforts (www.england.nhs.uk/nursingmidwifery/international-recruitment/). The QNI project is not limited to the pilot sites and may be of relevance to any organisation that employs registered nurses in the community. 
While the QNI does not employ nurses in a clinical capacity and is not in a position to support individual nurses who are applying from overseas, we hope that the information and learning from this project will make the process of coming to work in England smoother for employers, managers and overseas applicants alike.

Here, Fabio Trovato Monastra, who after graduating with distinction from University La Sapienza, Rome, initially began his nursing career in Italy and now has five years’ experience as deputy theatre manager and nurse at Highgate Private Hospital and for the NHS, talks about the ups and downs of being an international nurse in the UK.
Being an international nurse was one of the best choices I ever made. If you are considering an experience abroad, I would strongly recommend it. However, you may want to consider a few points before embarking on this undertaking to ensure it is the right choice for you.

Like many organisations and charities, the Covid-19 pandemic hastened a rapid period of adaptation and diversification at ERIC, The Children’s Bowel and Bladder Charity. Here, Alina Lynden, ERIC’s communications manager explains how the charity has risen to the challenge.
The beginning of lockdown back in March 2020 meant we experienced a drastic drop in income from our shop and training programme. Most of the ERIC team were furloughed. But, with the help of generous donations from our service users, supporters and emergency funding from the Charities Aid Fund, we managed to keep our helpline open so that families could continue to access one-to-one support.

Cow’s milk allergy (CMA) symptoms present in 2–3% of all infants versus 0.5% of breastfed infants in the first year of life and can impact on growth and quality of life of the child (Venter et al, 2017; National Institute for Health and Care Excellence [NICE], 2021). Once CMA is diagnosed, hypoallergenic formulas are recommended if exclusive breastfeeding is not possible or the mother chooses a mixed feeding approach (Venter et al, 2017; Fox et al, 2019; NICE, 2021). This product snapshot reviews the diagnosis and management of CMA and focuses on Alimentum® and EleCare®, hypoallergenic infant formulas that are clinically effective at the best value price (price per 100ml) (Sicherer et al, 2001; Data on File, 2020; MIMS, 2021).
Many standard infant formulas are based on cow’s milk and so babies have exposure to these proteins from an early age, when breastfeeding is not possible or parents opt for mixed feeding.

There has recently been an increased focus on the use of patient information leaflets as a means of communicating key information and engaging patients in preventative measures. The prevention and management of pressure ulcers depends on proactive and effective communication between nurses and other healthcare professionals and the patients themselves. This is particularly important in community settings, with the increasing responsibility placed on patients to self-manage their conditions. However, despite the use of patient information leaflets as part of the nursing process, there is little research evidence to support their use with regards to pressure ulcer prevention and, in particular, whether patients themselves engage with and understand the information. This article discusses the existing literature and knowledge around patient information leaflets, looking at it in light of a recent study around pressure ulcer prevention in Birmingham Community Healthcare NHS Trust.

Incontinence-associated dermatitis (IAD) relates to skin breakdown from exposure to urine or faeces, and its management involves implementation of structured skin care regimens incorporating appropriate use of skin barrier products to protect the skin from exposure to moisture and irritants. Medi Derma-PRO Skin Protectant Ointment and Medi Derma-PRO Foam & Spray Incontinence Cleanser are part of the Total Barrier Protection™ (Medicareplus International) range indicated for management of moderate-to-severe IAD and other moisture-associated skin damage (MASD). This article summarises the findings of multi-centred patient evaluations of Medi Derma-PRO Skin Protectant Ointment and Medi Derma-PRO Foam & Spray Incontinence Cleanser, and aims to demonstrate the clinical and cost benefits of using these products for the prevention and management of MASD.

Indwelling urinary catheters remain one of the most used clinically invasive devices in the UK, with approximately 90,000 people living in community settings in England currently using long-term urinary catheters. There has been a plethora of clinical evidence published demonstrating the risks of prolonged use of indwelling urinary catheters and the increased risk of significant infection, sepsis, and, in some cases, fatality. While the use of an indwelling urinary catheter is in some cases wholly justified and unavoidable, it is the responsibility of healthcare professionals to ensure that risks are mitigated/reduced wherever possible. Use of a catheter valve system may improve the chance of normal bladder function resuming following the removal of the catheter. It is a relatively simple intervention that can be managed by many patients and offers more discretion and dignity. Use of catheter valves should always reflect latest national guidance on best practice and be incorporated into local policy. This article explores some of the clinical evidence supporting the use of catheter valves and advice on best practice.

Anecdotally, clinicians have reported difficulties with obtaining the correct compression garments for patients, with dispensing inaccuracies and delays raising concerns of patient safety, clinical inefficiency, unwarranted variation in care and wasted resources. However, limited published evidence exists to support this. JCN therefore carried out two surveys in 2018/19 and 2021 to determine if these issues are experienced widely. Results confirmed these problems were encountered at both points in time and that improvements in dispensing could be made to benefit both health services and patients. The ongoing Coronavirus pandemic has led to a change in preference for product dispensing and delivery, with an emphasis placed on home and self care.