Resources

International Nurse’s Day, 12th May, is the day when the life of Florence Nightingale, considered by some to be the founder of modern-day nursing, is recognised and celebrated. It is also the day when the world unites in their support and respect of nurses, while acknowledging and celebrating the unique contribution that nurses make, not only in supporting the health of all nations, but in helping to maintain and improve global economic growth. After all, when populations are healthy, they are better able to contribute to society, undertake active work, and care for their families.

Intermittent catheterisation is considered the gold standard for urine drainage (Holroyd, 2018). It can be used as treatment for voiding problems due to disturbances or injuries to the nervous system, non-neurogenic bladder dysfunction, or intravesical obstruction with incomplete bladder emptying (Royal College of Nursing [RCN], 2018). Irrespective of the underlying cause, patients with voiding problems frequently find themselves having to make use of a catheter to drain their bladder when it fills and thereby undertake regular intermittent self-catheterisation (ISC). Intermittent catheterisation involves the introduction of a catheter into the bladder and its immediate removal when drainage stops, a process which needs to be repeated four to six times a day (Holroyd, 2018). The experience of performing ISC, while straightforward for some, can be both difficult and painful for others (Guinet-Lacoste et al, 2016; Rognoni and Tarricone, 2017)

Increasing pressures on healthcare resources require constant evaluation of the efficiency and effectiveness of provision, particularly for the rising number of vulnerable, elderly and obese patients. Practices regarding compression are arguably often ingrained due to its historical usage, with evidence from managing chronic venous insufficiency (CVI) underpinning its effectiveness. This evaluation explores the clinical benefit, impact, outcomes and cost-efficiencies of using an adjustable compression wrap system instead of previous care. ‘Before-after design’ observation of 50 patients captured baseline resource use, costs and outcomes (clinical and patient) at the time of assessment and again at a maximum of six-month follow-up. Data after using the adjustable compression wrap showed significantly improved clinician-reported outcomes: presence of wounds/leg ulceration (from 56% to 21%), incidence of cellulitis (halved), and reduced complexity/severity of lymphoedema. Additionally, patient- reported outcomes, visual analogue scale (VAS) health score and LYMPROM© scores for pain, heaviness, shopping for shoes and clothes, and body image significantly improved. The mean number of community nurse visits per patient reduced from 11.6. to 9.1, but was not statistically significant (p-value 0.09). However, this evaluation found that over six months there was a mean cost reduction of over £383.70 per patient, which included the purchase price of the adjustable compression wrap system.

This article explores the research behind diverticular disease and its dietary management, with a focus on dietary fibre. Diverticula, sac- like protrusions in the colonic wall, are extremely prevalent in older people living in Western countries and range from asymptomatic (diverticulosis) to moderately symptomatic (diverticular disease) to severely symptomatic (diverticulitis). Diet and lifestyle are implicated in the development of these conditions, as demonstrated by the vast increase in prevalence as countries become more industrialised and follow a Western dietary pattern. Dietary fibre is a particular nutrient of interest. Contrary to prior dogma, research suggests that individuals with diverticular disease should actually strive for a high fibre diet to reduce the risk of developing further diverticula and prevent progression to diverticulitis. The dietary management of the symptoms of diverticular disease is not well understood. Vigorous physical activity may reduce the risk of diverticulitis. Community nurses can help their patients to avoid harmful and unnecessary dietary restrictions by using the information in this article.

The risk of developing type 2 diabetes increases with age and can lead to poorer outcomes for individuals and create greater demands on healthcare services. The NHS Long Term Plan (2019a) highlighted the need for more complex care to be provided in patients’ homes and, with recognition of a decreasing community workforce, new ways of working and upskilling the workforce are required to provide integrated, person-centred care. Blended roles programmes focus on a commitment to develop education and competencies to build effective relationships and collaboration between independent care workers to provide individualised person-centred care.

Over 124,000 people in the UK have long-term indwelling catheters (Gage et, al, 2017; Nazarko, 2017). Indwelling urinary catheters increase the risks of infection and ill health (Feneley et al, 2015; Public Health England [PHE], 2016). They can leak, block and management can be burdensome for the person with the catheter, caregivers and health service (Cottenden et al, 2013). This article updates readers on how to reduce the risks of infection, leakage and catheter blockage, and how to manage these problems when they occur.

Community nurses are well placed to provide information about travel to people living with a stoma. Although much of the advice seems like common sense, learning to live with a stoma and adapt the stoma into lifestyles can be difficult. Patients often want advice and reassurance that they can travel — be this on foot, by car, boat or aeroplane. There is a great deal of information on the internet from support groups, which is often reviewed by healthcare professionals and people living with a stoma to ensure accuracy. There is also information available from stoma appliance manufacturers and dispensers on their websites. Healthcare professionals need to advocate caution in using other sites that may be the opinion of just one person and may not offer a balanced view. However, in general, community nurses can encourage travelling as a safe and enjoyable way to live after stoma forming surgery.

Here, Georgina Ritchie, director of education, Accelerate CIC, explains why she and colleagues decided to write a book on lower limb and leg ulcer management using a Q&A approach in order to tease out and explore the most relevant themes in this area of practice. The individual authors for each chapter are all experts in their field, ensuring comprehensive coverage of the topics. This article gives an overview of each chapter and offers JCN readers a special 30% discount code to buy a copy.