Resources

Covid-19 has had a severe impact on everyone’s lives, but the past year has been exceptionally challenging for nurses and healthcare workers battling the pandemic on the frontline.

There are striking parallels between the experiences veterans faced in conflict to those which healthcare professionals continue to face in the fight against Covid-19. Any traumatic event — whether a global pandemic or experience of war — takes its emotional toll. Repeated exposure can overwhelm the nervous system and lead to burnout and trauma fatigue.

Hourglass is the only charity in the UK focused on the abuse of older people and safer ageing. The charity rebranded from Action on Elder Abuse in March 2020 and receives around 8,000 calls from those affected by older abuse throughout the year. Currently, Hourglass is calling for amendments to the Domestic Abuse Bill, so it better reflects the challenges and reality faced by older people throughout the UK. The seriousness and level of abuse taking place has been pulled into harsh focus by recent lockdowns. Hourglass wants to ensure that all victims, especially from older groups, receive the legal and

World Continence Week (WCW), taking place from 21–27 June, is an annual health campaign run by the World Federation for Incontinence and Pelvic Problems (WFIPP). The campaign highlights the impact that urinary incontinence can have on people’s lives and encourages sufferers to seek help to improve their quality of life.

When the skin is subjected to prolonged or continuous exposure to moisture the result can be mild, moderate or severe skin damage known as moisture-associated skin damage (MASD) (Parnham et al, 2020). To ensure that the correct preventative or management strategy is implemented, it is vital to perform holistic assessment which should incorporate tools that help alert practitioners to potential damage and categorise existing skin damage (Parnham et al, 2020). One such tool, Skin Moisture Alert Reporting Tool (S.M.A.R.T), has been endorsed by the National Institute for Health and Care Excellence (NICE, 2019). As a result of assessment, different products will be selected depending on whether the skin is intact or there is mild, moderate or severe skin damage.

This product snapshot, the second of two, examines the benefits of Medi Derma-PRO Foam and Spray Incontinence Cleanser and Skin Protectant Ointment (Figure 2) within a structured skin care regimen, in the prevention and management of severe skin damage. The first product snapshot focused on Medi Derma-S Total Barrier Cream and Film in the prevention and management of mild and moderate skin damage.

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.