Resources

After a long wait, and years after updated international guidelines, the National Institute for Health and Care Excellence (NICE) has worked with the British Thoracic Society (BTS) and the Scottish Intercollegiate Guidelines Network (SIGN) to produce a unified guideline on asthma for the UK (NICE et al, 2024).

It comes at a time when seven out of ten people with asthma are not receiving the basic care they need to stay well, often resulting in their condition being uncontrolled and leaving them at risk of lifethreatening asthma attacks. In fact, the number of asthma deaths has actually risen over the past decade (https://ow.ly/zA1750V5ZRy; https:// ow.ly/OycP50V5ZS0; https://ow.ly/ TIe250V5ZSQ).

With a quarter of children now starting school not toilet trained, ERIC, The Children’s Bowel and Bladder Charity is launching an intervention to help reverse the trend, and is inviting families and healthcare professionals to hop aboard the Toilet Train.

Over the last century, the average age that children are being potty trained in the UK has risen from 12–18 months, to an average of around three or even four years today (Blum et al, 2004).

ERIC, The Children’s Bowel & Bladder Charity, carried out research with the Association of Teachers and Lecturers in 2016 and the National Day Nursery Association in 2018. Both surveys showed that parents are toilet training their children later. Furthermore, research by Kindred Squared (2024) showed that one in four children in England and Wales are now starting school still wearing nappies.

Falls can have a significant impact not only on the person who experiences them, but also their key, informal carers too. When waiting for long periods of time for help on hard, often cold floors, the side-effects can be dangerous and compromise health, wellbeing and dignity. Given that most major trauma patients are aged 60 years and over and experience a low mechanism of injury, careful management is required. With the right training and support, care teams can become competent and confident to manage falls. This article explores how proactive falls management strategies can significantly improve quality of life, alleviating societal and economic burden of falls-related complications.

Pulmonary fibrosis (PF) is a long-term chronic condition, which is more common in older adults. It is a progressive disease limited to the lungs and presents with several features which have variable degrees of severity. PF is a highly complex disease with many different types, of which idiopathic pulmonary fibrosis (IPF) is the most common (American Lung Association, 2024). Idiopathic pulmonary fibrosis is one of the most aggressive forms of PF, characterised by chronic, progressive fibrosis associated with inexorable decline in lung function, progressive respiratory failure, and high mortality (Barratt et al, 2018). The prognosis is often poor and the vague symptoms can make diagnosis challenging for clinicians. This article focuses predominantly on IPF to give an insight into this complex condition with the aim of improving confidence in recognition of the disease. With increased knowledge, it is hoped that quality of life can be improved for patients suffering with this unpleasant condition.

Many ostomates experience leaks at some points in their lives. However, some experience frequent leaks, which lead to physical complications such as sore skin, bleeding and pain, as well as having a negative impact on their emotional wellbeing and quality of life. Worrying about leaks can result in reduced sleep, social isolation and low mood — all of which can be emotionally exhausting and stressful. Effective stoma management is essential to prevent leaks and maintain peristomal skin integrity, such as the use of convex base plates. There are five characteristics of convexity which when applied correctly can reduce leaks and improve skin health, namely: depth, compressibility, flexibility, tension location and slope. These characteristics work together to achieve the desired outcome. However, tension location can be used in a different method to flatten large creases and dips. This helps to promote skin integrity and improve patient comfort and confidence in managing their stoma, as this article describes.

Wound malodour is often an unpleasant side-effect experienced by patients with hard-to-heal wounds. The impact on mental and physical wellbeing is profound and can result in embarrassment, social isolation, depression and nausea. This list is not exhaustive and understanding the effect of malodour on an individual should be considered during holistic patient assessment. This article presents the findings of two surveys which aimed to gain a deeper understanding of the impact that malodour has on individuals and also the challenges experienced by healthcare professionals (HCPs) when treating patients with malodorous wounds. The patient survey was completed by 29 people, of which 76% (n=22) experienced wound malodour. The HCPs survey was completed by 789 respondents and challenges highlighted included lack of training and education, limited access to appropriate dressings and managing patient expectations.

Hard-to-heal wounds present a significant challenge in healthcare, requiring a comprehensive understanding of the wound healing process and effective management strategies. A survey was conducted by the Journal of Community Nursing among its registered online members to explore the current opinions and challenges faced by healthcare professionals (HCPs) who are involved in delivering wound care, including opinions on advanced wound therapies. The survey, which consisted of 14 questions, highlighted some interesting findings including several challenges experienced when treating patients with wounds. Results revealed that 69% (n=311) of participants indicated a lack of time and resources as the primary barrier. Patient compliance (67%, n=303), limited access to advanced therapies (47%, n=211), insufficient training (37%), and cost pressures (32%, n=145) were also significant concerns. Despite these challenges, most respondents (63%, n=281) felt ‘somewhat satisfied’ with their ability to manage wounds, but found the process frustrating due to the difficulties that they encountered.

Purple urine bag syndrome (PUBS) is reported to be a rare condition that occurs in people who have catheters, chronic constipation and bacterial urinary tract infection (UTI). While in most cases it is harmless, the purple colour of the urine (a result of the breakdown of tryptophan, an amino acid found in food, in the intestines by gut bacteria) can be alarming. The priority is to address any underlying infection and maintain good catheter hygiene. Much of the literature focuses on symptomatic treatment. This paper, based on a case history, uses a more holistic approach to explain what PUBS is, why it occurs, and how it can be treated.

This article explores the development of mental health first aid (MHFA) training and how the principles of first aid can be applied with a person experiencing mental health distress. MHFA was designed to reduce mental health stigma and improve the public’s awareness, but is suitable for nurses to complete to enhance their first aid response to both physical and mental health situations. This article seeks to encourage nurses to undertake MHFA training.

Parkinson’s disease at the end of life can present unique challenges both for patients and those caring for them. This article offers a guide for community nurses to understand the complexities of Parkinson’s disease and the importance of managing end-of-life care. Parkinson’s disease progresses differently for each individual and, as it advances, symptom control, especially regarding pain, motor difficulties and non-motor symptoms can become increasingly difficult. Nurses play a critical role in managing these challenges, ensuring that patients receive optimal care tailored to their needs. This includes advance care planning, where nurses can facilitate discussions and provide psychosocial support to both patients and their families. Coordinating with an interdisciplinary team of healthcare professionals ensures a holistic approach to care, addressing physical, emotional, and spiritual needs. These key aspects are explored here, highlighting the crucial role that community nurses play in delivering compassionate, effective care at this complex stage of the disease.