Resources

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.
 

With all nurses being required to keep up to date with their continued professional development (CPD) and to revalidate every three years, it is important to think about different learning styles and what works best for you to help you learn effectively. In addition, it is essential to recognise how others learn. Consideration of this will facilitate us to adapt our approach when supervising student nurses and to provide individualised, effective learning environments for them. Recently, I have experienced difficulties recruiting registered nurses and know this is not an isolated issue. To build and support our future workforce, it is vital that we focus time and energy to share our wealth of knowledge and encourage pro-active learners. By adapting teaching to cater for different learning styles, we can assist student nurses to optimise the learning opportunities available to them and support them to feel comfortable in recognising their own development needs and becoming competent nurses. Do take a look at this issue’s ‘community matters’ piece (pp. 10–16), which looks at different learning styles and introduces Microworld, a new animated and accessible way to learn about wound care (www.mymicroworld.online).

And, while on the subject of wound care education, the National Wound Care Strategy Programme (NWCSP) has also identified how crucial this is for all nurses with its recently published National Wound Care Core Capabilities Framework for England, which sets out the skills and knowledge needed to care for a person with a wound in whatever setting (pp. 18–19). The capabilities in this resource come in three tiers to accommodate your level of knowledge and skills and help you develop a person-centre approach to care.

I was especially pleased to read Sarah Hamilton-Fairley’s editorial on the work of the UK Sepsis Trust and their campaign for everyone, both public and healthcare professionals, to be ‘sepsis savvy’ (p. 31), as this is a condition we should all be continually on the look out for. Other editorials also flag up initiatives which might be useful for you and your patients, such as Urology Awareness Month (pp. 24–25), the new Leg Club^® exercise classes with Mr Motivator (p. 26), as well as the Primary Care Respiratory Society’s (PCRS) new pathway to help us think about the environmental impact of respiratory healthcare (pp. 28–29).

Such pieces, together with the clinical articles in this issue, brought home to me yet again the sheer diversity of community nursing and myriad of skill sets needed to work with individuals, families, children, and carers. So, I hope you find the articles helpful — and remember, your students are our future.

Annette Bades, editor-in-chief, JCN

In each issue we investigate a topic affecting you and your community practice. Here, we look at 'Teaching and learning styles and why they matter'

How fortunate we are to have specialist teams and services that provide wound care across the UK. But, these teams and services are frequently overwhelmed. Even in pre-pandemic times, increasing referrals, rising caseloads, and the complexities of supporting people with multiple morbidities conspire to challenge service delivery (Guest et al, 2020). At the same time, an over reliance on these teams’ skills by the rest of the system gives rise to the de-skilling of some groups, while inhibiting fundamental wound care skills development in others.

If I were a stick of rock, you would find the word ‘NURSE’ right through me (or maybe ‘community tissue viability nurse’ if there was enough room for all those letters!) So, in 2018, when I came into post as director of the National Wound Care Strategy programme (NWCSP), I saw the issue primarily through a clinical lens. I was not so cloistered that I thought wound care was just a nursing issue, but I did think that it was primarily a clinical challenge. If we could just get the clinical pathways sorted and get everyone who saw people with wounds (GPs, paramedics, podiatrists, surgeons and so on) to work in a more collaborative and coordinated way, we would solve the problem.

Reading the story of Anne’s journey with chronic oedema in a recent issue of JCN was quite disturbing (Rubio, 2021). That someone could have needlessly suffered for so long offers a wake-up call to us all, especially as it is, sadly, a fairly common story. Chronic oedema and lymphoedema are not well understood among many healthcare professionals, so the conditions often go untreated until a patient develops serious complications.