Resources

In each issue we investigate a hot topic currently affecting you and your community practice.

The number of people living with complex, multiple health conditions is increasing. It is estimated that almost three million people in the UK have three or more long-term conditions, whether these are physical or mental, psychological or cognitive (King’s Fund, 2020). In addition, people living in more socially deprived areas are at greater risk of developing such conditions. Nurses working in the community have a hugely important role to play in supporting people affected to live the healthiest lives possible — working with carers and families.

When things go wrong, we need to make sure that lessons are learnt and improvements made. If we think something might go wrong, it’s important that we all feel able to speak up so that potential harm is prevented. Even when things are good, but could be even better, we should feel able to say something and should expect that our suggestion is listened to and used as an opportunity for improvement.

Urinary incontinence (UI) is among the most common paediatric problems and it is commonly assumed to resolve with age. Consequently, parents and clinicians often adopt a ‘wait and see’ approach to childhood UI (Berry, 2006). A significant proportion of children, however, continue to suffer from persistent UI into adolescence (Swithinbank et al, 1998; Hellstrom et al, 1995; Yeung et al, 2006; Heron et al, 2017). For example, the authors’ research using data from a large birth cohort (Avon Longitudinal Study of Parents and Children — www.bristol.ac.uk/alspac/) found that 4.2% of females and 1.3% of males experienced UI at the age of 14 years (Heron et al, 2017).

During Self Care Week (16–22 November), which is the national awareness week to promote the benefits of self care, I want to remind colleagues in the nursing profession to ‘live self care for life’. This year it is more important than ever, with all health and care workers managing the extreme pressures brought about by the Covid-19 pandemic. It is essential that we look after our own health and wellbeing.

Due to the Covid-19 pandemic, community nursing services have had to adapt rapidly to the regulations and clinical requirements. To learn how nurses have changed their services, with colleagues and new technology, the Queen’s Nursing Institute (QNI) has been gathering examples of new practice in community and integrated healthcare services. Here, we share some of the stories to help promote learning and to drive improvements across the health and social care sector.

The JCN clinical skills series looks at different aspects of wound management in the community, with useful tips on patient care and improving practice. The fourth and final part focuses on dressing selection.

The last part of our clinical skills series looks at dressing selection. Wound dressings should create an environment that supports the wound healing process. However, with an ever-increasing array of dressings available, selecting the correct product can seem daunting. Holistic patient assessment, including assessment of the wound environment, needs to be undertaken before choosing a dressing and will help in the decision-making process. This article explores the principles of appropriate dressing selection and how they can be applied in clinical practice.

Recently, the national wound care agenda has centred around the cost of wounds to the NHS, inadequate holistic wound assessment, reducing unnecessary variations in care and increasing supported shared care. This article demonstrates how one organisation, by transforming the delivery of wound care services into one, addressed those factors while also freeing up valuable community nurse time. It also describes how working in partnership with industry can not only assist in improving the care journey for patients, but also liberate and empower clinical staff.