Resources

People who are extroverted tend to seek social stimulation and opportunities to engage with others through social interaction. Yet, whether you have an introvert or extrovert personality, loneliness can strike anyone. Being an extrovert by nature, experiencing enforced lockdown earlier this year was initially extremely daunting and challenging for me. Although well past the ‘flush of youth ‘, I am still in a section of life where my calendar was filled with meetings, attendance at international conference/exhibitions,
networking and travelling, giving me a purpose to manage my professional and home life with positivity.

HARTMANN UKI has launched a new initiative — HOME (acronym for holistic, outline, manage, evaluate/educate) — to help healthcare professionals introduce and manage shared-care solutions for patients at home.

Viscopaste and Ichthopaste bandages have been available in the wound care dressings market since the 1950s and 1930s respectively and are widely used within their clinical indications, primarily in lower limb management to treat leg ulcerations and the skin conditions associated with a leg ulcer. The products are commonly used within dermatology to manage chronic lichenified (thick and leathery) skin conditions, such as atopic eczema and dermatitis. Recently, Viscopaste and Ichthopaste bandages have been utilised in the management of skin conditions related to chronic oedema, for the treatment of patients with a diagnosis of red leg syndrome, which is often misdiagnosed as cellulitis  (Elwell, 2014)

Venous leg ulcers (VLUs) are known to place a significant burden on healthcare services, with unhealed ulcers costing 135% more than their healed counterparts over the course of a year (Guest et al, 2016). This is a consequence of unwarranted variation in care attributed to difficulties experienced by non-specialist clinicians caring for VLU in the community. VLU healing rates are relatively unknown, and national targets for healing do not yet exist, but there is evidence in the literature that specialist VLU services improve healing rates (Moffatt et al, 1992). Healogics is a specialist third party provider of VLU and lymphoedema services to the NHS, that takes a systematic approach to the assessment and management of these co-existing conditions. This paper presents the healing rates of 1015 people with VLU treated by Healogics for the full 65-month duration of an any qualified provider (AQP) contract. Healing rates of 86.14% were obtained in an average of 117 days in line with the published healing rates from other specialist leg ulcer services (Moffatt et al, 1992; Edwards et al, 2005). The healing rates reported in this paper demonstrate that a consistent, specialist approach to VLU management that is underpinned by best practice and national guidelines can help to achieve timely healing in the majority of patients, and can identify more complex patients for whom healing is not possible, enabling them to be placed on a maintenance pathway. The authors suggest that grading of VLUs according to complexity and data collection and analysis of healing rates could help to improve healing outcomes on a national level.

With an ageing population, it is likely that the numbers of leg ulcers requiring intervention will increase proportionately. Given that most leg ulcer care is conducted in the community, this will place an extra burden on primary care staff. Therefore, any cost-effective interventions which improve management are worth considering. The Complex Wound Clinic team (Central and North West London NHS Foundation Trust) undertook a 12-month evaluation of using octenidine-based antimicrobial wash mitts as an alternative to
bucket washing. The aim was to monitor both patient and staff reaction to the use of wash mitts instead of bucket washing, track reported incidents of staff musculoskeletal injuries, and monitor infection rates, including Pseudomonas and wound infections requiring antibiotics.

Urinary incontinence (UI) is a common consequence of radical prostatectomy for which men often feel unprepared despite the provision of information about treatment and management. The aim of this study was to explore from the patient’s perspective the nature of information and support men require to aid adjustment to daily life with UI. In a qualitative study using a convenience sample, recruited men (n=35) were aged over 18 years old and were less than 18 months post radical prostatectomy. Data were collected using interviews and a thematic analysis was performed. The study identified that men need less rather than more information, which should be succinct, and focused on management of incontinence to enable them to cope with daily activities. Effective management strategies rather than an overreliance on treatment methods, which may be ineffective, were also key to enabling successful adjustment. Men need clarity about care pathways, including access to appropriate contact information. Finally, men describe the confusion experienced when choosing containment products and require clear, concise information. 

The term ‘wound’ can cover everything from relatively minor wounds, such as a small surgical scar, to major wounds, such as chronic leg ulcers. Typically, the cause and type of wound determines how quickly and effectively it heals (Thomas and Bishop, 2007). The presence of complications such as infection can dramatically increase the time it takes for a wound to heal. In a 2015 research study, conducted by gathering data from The Health Improvement Network (THIN) database, the cost burden of wound care in the NHS was estimated. After adjusting for comorbidities, the estimated cost to the NHS was between £4.5 billion and £5 billion. Furthermore, the study found that nutritional deficiency and diabetes were independent risk factors for wounds not healing (Guest et al, 2015). Nutritional factors, such as protein-energy malnutrition, dehydration, and deficiency in certain micronutrients, have all been identified as important for some stages in the process of wound healing. Being able to identify those who are malnourished or at risk of becoming so, and those who have micronutrient deficiencies, is key to successful wound healing outcomes.

Claire Campbell, chair of the National Nurses Nutrition Group (NNNG) and nutrition support nurse specialist, Frimley Health NHS Foundation Trust, looks at how community nurses can help to tackle malnutrition and identify those most at risk.

In this article, Maria Hughes discusses her unique nursing role working alongside the North Wales Police.