With pressure ulcers remaining a challenge to the healthcare system across all care settings, this 12-week pilot study aimed to evaluate implementation of the SEM Scanner as an adjunct to standard of care (SoC) in pressure ulcer (PU) prevention. Two district nursing bases enrolled 17 palliative care patients, who received SoC and preventive interventions. Patients with Waterlow scores 10–19 who were able to be scanned for three consecutive days were included. Broken skin was not scanned, and visual skin checks were documented after SEM scans. Patients with SEM delta ≥0.6 were considered at high risk and preventive interventions were escalated using a clinical decision matrix aligning with SoC. The study found that implementing the SEM Scanner in an existing PU prevention pathway resulted in a reduction in community-acquired PU (CAPU) incidence by 26.7% from 16.1% to 11.8%; 88% (n=15) of patients remained PU free. Furthermore, clinical judgement informed by SEM deltas resulted in 82% (n=14/17) of nurses reporting that the SEM delta had changed their clinical decision-making.
Chronic oedema is a common condition which is increasing in prevalence, yet is still often under-recognised and mismanaged in community settings. Any oedema is a sign that the venous and lymphatic systems are not working properly. Without early identification and intervention, the condition can worsen, resulting in the need for complex care. Using a case history, this article highlights the inappropriate and ineffective use of medicinal management of a patient with lymphorrhoea (i.e. wet, ‘leaky’ legs). As a result of health assessment and a review of management and medication, deprescribing was effectively implemented in this case. The patient was provided with compression hosiery and education, and supported by a Healthy Legs clinic in the South Eastern Health and Social Care Trust, with positive outcomes for the patient, treatment room and GP. The case demonstrates how good practice uses health assessment and symptom analysis to determine diagnosis and appropriate treatment options. It also poses the question: is pharmacology always the answer?
It is estimated that there are currently over 145,000 people diagnosed with Parkinson’s disease in the UK. This progressive neurological condition affects people in a variety of ways, depending on numerous factors, including the impact and severity of their motor and non-motor symptoms. In relation to the current Covid-19 pandemic, the UK government identified people with Parkinson’s disease as clinically vulnerable, suggesting that they were at higher risk of severe illness if they contracted the Covid-19 virus. The subsequent self-imposed isolation could potentially impact on Parkinson’s symptom control, and also affect wellbeing and quality of life. The Parkinson’s disease nurse specialist has had to rapidly adapt service delivery to ensure that the needs of people with Parkinson’s disease are addressed, predominantly with remote assessment, during the Covid-19 pandemic.
The Managing Adult Malnutrition in the Community team has worked with the British Dietetic Association (BDA) and the British Association for Parenteral and Enteral Nutrition (BAPEN) to develop a range of patient information leaflets to advise those who have Covid-19 illness, or who are recovering after the illness, on eating well to assist in their recovery.
In the UK, it is estimated that more than a million older people, or around 10 percent of the older population, experience some form of abuse in any given year (NatCen, Kings College London, 2013).
