Resources

Wound dressing selection should reflect wound management objectives and be integrated into the overall management plan. Volume of exudate will impact greatly on that decision-making process. This article focuses on what causes excess exudate, assessing exudate and its subsequent management. It concludes by introducing Biatain  Fiber with HexaLock  Technology, a dressing which is used to address clinical challenges of managing wounds which are producing a moderate-to-high volume of exudate.

Ulceration of the lower limbs can be a painful, debilitating condition which may have a profound effect on the patient physically, psychologically, and socially. With an ageing population, it is likely that we will see greater numbers of patients suffering with chronic wounds and associated skin conditions in the coming years. Where there are variations in care, and sub-optimal treatment regimens, delayed healing may be both common and costly to the NHS. National programmes have been put in place to address these inequities, however all clinicians are integral in the management of patients with wounds to ensure that accurate assessment takes place, both on initial contact and opportunistically throughout the care period. Following assessment, appropriate treatment plans should be implemented, preventing further skin breakdown, and improving outcomes for the patient and healthcare system.

Erosive pustular dermatosis (EPD) of the leg is a rare condition that is challenging and complex to diagnose and treat. This cutaneous inflammatory disease is associated with trophic changes of the lower limb, and while its incidence is unknown, it is believed to be more common than previously thought. Care of leg ulcers poses a considerable burden to the health service, although it is estimated that only half of patients receive the appropriate treatment. This article reflects on the case of a patient with chronic ulcerated and swollen legs who was referred to a wound advisory clinic by his GP. It critically assesses the data from the patient history, physical examination and treatment decisions. It is hoped that describing this case — patient history, findings from physical examination and treatment plan — will help further community nurses’ understanding of the condition.

Dementia is an increasingly common condition among the older population. In addition to cognitive impairment, many people diagnosed with dementia will also experience neuropsychiatric symptoms during the life course of their illness. These are referred to as the behavioural and psychological symptoms of dementia (BPSD). The presence of BPSD can be distressing for the person with dementia, their families and carers, and significantly increase carer burden. It is important that staff working in primary, community and social care have an awareness and understanding of the meanings that underlie such behaviours in order to support assessment and subsequent actions, including referral to specialist services where appropriate. This is the third paper in a series that follows two fictional families through case studies to illustrate aspects of dementia care.

Cancer survival rates are increasing, resulting in more people living with treatment or disease-related side-effects. Cancer is now considered to be a long-term condition and patients can present with a wide range of physical, psychological and social needs. Community nurses often see people living with or after cancer, but are not always recognised as part of the cancer workforce. This article outlines a pilot of a ‘cancer in the community’ four-day teaching module for community nurses in South West London. The conclusion and recommendations make the case for community nurses to receive education on cancer as a long-term condition and highlight key learning points from the pilot.

There are currently 15 million people in England who have a longterm condition, which is defined as one which currently has no cure other than drugs and symptomatic management (Bennett et al, 2012). At present, the UK population is affected by the Covid-19 pandemic, and those with a long-term condition have been advised to selfisolate to prevent being infected by the virus (Department of Health [DH], 2020). This paper explores some of the effects of stress and anxiety with reference to Covid-19, as well as how the pandemic has affected the community nurse’s role.

During my 20-year career as a registered nurse, I have worked in a variety of settings, including district nursing, hospice and secondary care. I have always loved being able to care for patients at the end of life and personally, I have experienced several bereavements of close family members. My own experiences have made me passionate about ensuring we deliver the best care possible for our patients and families in the last year of life and into bereavement.