Resources

In each issue we investigate a hot topic currently affecting you and your community practice. Here, we look at the 'Public health risks of air pollution'.

The Covid-19 pandemic has put the UK health and care workforce under unprecedented pressure. For nurses, the pandemic has highlighted and exacerbated many issues that predated the pandemic, including inequalities, inadequate working conditions and chronically excessive workloads. The recent King’s Fund report, The Courage of Compassion: Supporting nurses and midwives to deliver highquality care, investigated the key changes to working environments of nursing and midwifery staff needed to enable them to flourish and thrive at work (West et al, 2020). This piece draws out some of the key findings from the research and asks what needs to be done to better support nursing staff working in the community, now and into the future.

In 2020, the Queen’s Nursing Institute (QNI) was funded by NHS England and NHS Improvement (NHSE/I) to create a resource to support nurses working in the community who are caring for people in recovery after being infected with Covid-19 — Living with Covid-19 (Long Covid) and Beyond (www.qni.org.uk/wp-content/ uploads/2020/12/Living-with-Covid- 19-Community-and-Primary-Care- Nursing-Resource.pdf).

As the number of people over the age of 65 years increases, so will the number of people with age-related neurological conditions, such as dementia. It is predicted that by 2040, this figure will rise to over one and a half million people in the UK (Arvanitakis et al, 2019). In clinical practice, before the dementia strategy was launched, it was not uncommon to see a case presented to a ‘fast track’ continuing healthcare funding panel, an urgent funding request for end-of-life care, of a person in the advanced stages of an undiagnosed dementia. This meant that their needs for care and support, as well as those of their family members, had been unrecognised and unmet throughout their condition. Timely diagnosis of dementia can lead to several benefits, including access to a pathway of care and a network of services.

With the mass Covid-19 vaccination roll-out beginning in earnest, JCN talks to Simon Browes about the challenges facing his vaccination programme team.

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.

Continence is not a life-threatening condition, but does affect patient quality of life. The first part in this new continence clinical skills series explores continence issues and how to improve patient care. It looks at the prevalence of the condition, different types of continence issues, how they can affect quality of life and the complications that can occur when poorly managed.

Lower limb haematomas caused by trauma are debilitating wounds for the elderly who are most at risk. Prompt action needs to be taken to stop the bleeding and reduce the extent of tissue damage and skin loss. Literature on the management of lower leg haematoma is sparse compared to the management of skin tears, and there may be debate regarding surgical versus conservative approach. Many patients are not suitable for surgery due to underlying comorbidities, frailty and anaesthetic risk. Conservative management should support early evacuation of the haematoma and application of compression bandaging, avoiding lengthy hospital stays and enabling patients to be managed in the community setting.