Resources

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.

It is estimated that 1.5% of the adult population in the UK is currently living with a leg ulcer (Guest et al, 2015). There is substantial evidence to suggest that venous leg ulcers are being poorly managed with delays in assessment, poor primary dressing choice and suboptimal levels of compression contributing to the delay in wound healing (Gray et al, 2018). The bulk of leg ulcer care takes place within primary care (Guest, 2015). Despite there being considerable evidence to support the use of compression therapy and undertaking accurate leg ulcer assessment, this does not appear to always happen in practice. This paper looks at how one clinic improved healing outcomes and patient quality of life through holistic assessment, patient education, supported self-care and introducing compression wraps into the treatment regimen.

Historically, wounds have been treated within the medical model with a paternalistic approach where healthcare professionals assess the aetiology and condition of the wound bed, identify any modifiable patient risk factors which may impact on healing, and then implement evidence-based treatments to promote healing (Lusher, 2020). This article discusses the challenges in implementing both shared decision-making and self-care and reviews some of the innovative initiatives which have been developed to encourage patient self-care for wounds. The theories underpinning self-care and the advantages and disadvantages of self-care and shared decisionmaking are also discussed from both healthcare professionals and patients/carers’ perspectives.

Urinary incontinence is prevalent in men, with 61% of the general population of men experiencing lower urinary tract symptoms (LUTS) (NHS England, 2018). These symptoms present as problems with voiding, storage or post-micturition of urine (National Institute for Health and Care Excellence [NICE], 2017). Even after assessment and treatment, some men are still left with urinary incontinence, which is normally managed or contained by either pad products or urinary catheters (if clinically indicated). However, there is a vast range of alternative devices for containment. This article reviews some of the alternative devices that are available, namely sheaths, body worn urinals and penile compression clamps. It discusses the merits and disadvantages of each device and advises when they should or should not be used.

The impact of the coronavirus pandemic has challenged everyone’s day-to-day lives. The social distancing measures imposed by the government back in March required people in certain risk categories, such as the over 70s, to self-isolate for weeks. This inevitably has had a huge effect on many, as social relationships are vital for their wellbeing and quality of life. Here, Dr Anna Galazka, postdoctoral research consultant, Welsh Wound Innovation Centre in collaboration with Cardiff Business School, Carole Brooke, chair of Nailsea District Leg Club, retired practice manager and Demelza Spencer-Veale, lead nurse, Weymouth Leg Clubs, Two Harbours Healthcare, look at how some Leg Clubs have helped to maintain a community spirit and enable their members to continue to interact.