Resources

Sepsis is the body’s over-reaction to an infection or injury, which causes the immune system to attack its own organs and tissues. It affects 245,000 people every year in the UK and kills 48,000 (Rudd et al, 2020) — more than breast, bowel and prostate cancer combined. This ‘hidden killer’ is responsible for one in five deaths worldwide — 11 million a year (Rudd et al, 2020). If not treated quickly as a medical emergency, sepsis can result in organ failure, amputation and death in under 24 hours (Royal College of Nursing [RCN], 2021). However, with early diagnosis, it can often be treated with intravenous (IV) antibiotics and fluids, and the outlook is usually good for the majority of patients who seek urgent medical attention.

Here, Joan Gracie, supervisor, Family Nurse Partnership, NHS Forth Valley and Queen’s Nurse, talks about the importance of addressing blind spots in preconception health and why she wanted to get involved in the Queen’s Nursing Institute Scotland’s (QNIS’) new programme, Healthier Pregnancies, Better Lives, to support women to better prepare for pregnancy.

This JCN clinical skills series looks at dif ferent aspects of continence care in the community, with useful tips on patient care and improving practice.

The third part of the JCN continence clinical skills series identifies what conservative therapies and treatments are available to treat bladder and/or bowel dysfunction. This includes a range of treatment options which can be provided by practitioners/clinicians from a multitude of healthcare professional disciplines. It highlights simple interventions, such as lifestyle changes, i.e. from diet, fluid, smoking and weight loss advice, up to the more complicated treatment options such as pelvic floor rehabilitation, bladder retraining and use of medication.

This article explores wound assessment and management, specifically the management in a challenging group of patients who inject drugs. It describes the development of a service to meet their specific needs and how this service has flexed and adapted over time. A case study is presented to showcase the assessment and subsequent management of a chronic wound, which developed as a result of injecting drugs, with Biatain® Ag Non-Adhesive with 3DFit™ Technology.

It can be a bit daunting when you are faced with a complex, chronic wound that is failing to progress. What makes a chronic wound hardto- heal and where do you start with its management? It can also be challenging for patients because the wound may be affecting their quality of life, often causing a high volume of exudate, increased pain or discomfort and malodour (Atkins et al, 2019). This article describes what can make a wound become hard-to-heal and offers guidance on assessment and management and how the use of a collagen wound dressing, Cutimed® Epiona (Essity), can help promote wound healing.

A recent economic analysis has reported a £8.3 billion cost to the NHS for wound management. This overwhelming cost has meant alternate wound management strategies are needed. One example is a Hospital @ Home (H@H) negative pressure wound therapy (NPWT) service, whereby patients are discharged from hospital with an open wound and traditional NPWT (tNPWT) and/or single-use (sNPWT) is provided in their own home. The aim of the service evaluation presented here, which was conducted from the H@H nurse base within Brighton General Hospital, was to highlight the clinical outcomes of utilising NPWT in a homecare setting, to assess changes in patient quality of life through a validated instrument, and to understand the anticipated cost savings to the NHS. Thirty-one patients, all of whom had received surgical intervention resulting in an open wound requiring NPWT and were receiving H@H NPWT, were included in the evaluation. A statistically significant reduction in wound dimentions and improvement in patient reported general quality of life was found. Overall, the delivery of this H@H NPWT service enables patients to return home, with ongoing wound management which results in wound closure. The service evaluation also enabled a cost saving analysis to be reported, suggesting that this locally implemented H@H service can reduce costs of approximately £5,256 per patient by utilising H@H NPWT compared to hospital inpatient managed NPWT.

The definition of incontinence is acknowledged as any involuntary loss of urine or the inability to control the bowels (International Continence Society [ICS], 2013). It is not a life-threatening condition, but has a significant and distressing effect on the physical, psychological and social quality of life of those affected (Lukacz et al, 2011). Isolation, anxiety, depression and embarrassment are commonly reported by people who have a bladder or bowel issue (Wan and Wang, 2014). Urinary incontinence is more common than breast cancer, heart disease or diabetes among older women (Sexton et al, 2011; Tannenbaum et al, 2013). Incontinence is not gender or age specific, it can affect people of all cultures at any point from childhood to old age and can have devastating implications for the individual and their family. Many people may fail to seek help with incontinence for years due to embarrassment and stigma.

Here, Davina Richardson, children’s specialist nurse, Bladder & Bowel UK, looks at the guidance available for school leaders, proprietors, governors, staff and practitioners to help them better support children and young people with bladder and bowel issues as they return to school.