Peripheral arterial disease (PAD) occurs when there is a narrowing or occlusion of the peripheral arteries, resulting in reduced blood flow to the leg (National Institute for Health and Care Excellence (NICE), 2015). This can lead to limb ischaemia and thrombosis. Patients with PAD have a reduced quality of life and are at risk of lower limb amputation and even death. This article addresses the need for early diagnosis of PAD to reduce the burden of the condition to patients and the NHS, and to try and reduce the number of lower limb amputations that occur in the UK every day. Promoting healthy arteries will raise awareness of the risk factors associated with PAD and encourage the population in the risk categories to be proactive in receiving ankle-brachial pressure index (ABPI) assessment. Healthcare professionals with improved knowledge of PAD will be better able to identify patients in the early stages of the disease and to advise them about lifestyle changes to improve their prognosis.
Skin tears are a common type of tissue injury, which often go unrecognised and misdiagnosed. Furthermore, classification and documentation of skin is often poor, resulting in chronic wounds with associated adverse patient outcomes. The International Skin Tear Advisory Panel (ISTAP) recently updated the International Best Practice Guidelines and definition of a skin tear based on emerging evidence and expert discussion and consensus. This article presents a discussion of the epidemiology, risk factors and causes of skin tears. In addition, the most recent best practice recommendations for the prevention, assessment, and management of skin tears is summarised.
Patient experiences with wound care treatment are being recognised as central to prudent care. Leg Clubs provide community-based treatment, education and ongoing health promotion and care for people with leg-related problems. This article considers the growing evidence of patients’ experiences of being treated in a Leg Club setting. Six participants from a Leg Club setting were interviewed via a semi-structured interview, and interviews were transcribed verbatim and investigated for themes using interpretative phenomenological analysis in accordance to Smith et al (2009). An overarching theme, the holistic approach to treatment, was identified, with two subthemes: Leg Club education and a sense of autonomy and trust in Leg Club staff. This study revealed the importance of a holistic approach to treatment within a Leg Club setting, and adds to, and complements, the body of evidence.
There are a number of clinical conditions that result in dysphagia (difficulties swallowing food and drink). Sometimes dysphagia can resolve, however, for many it can be long term and also continue to deteriorate over time as the disease progresses. Successful management of dysphagia requires provision of differing levels of texture modification to an individual’s food and fluid consistency. It is important that this is assessed correctly so that the individual receives the appropriate consistency to swallow safely. If an inappropriate consistency is given, this can result in aspiration pneumonia, which can have fatal consequences. If individuals are given a consistency which has been over modified so that it is softer or thicker than required, their pleasure in food and drinks can be reduced unnecessarily, risking malnutrition and dehydration. This article introduces the differing consistencies which are recommended and the consequences that can result from incorrect consistencies being given. It also discusses suitable foods and fluids to meet both the requirements of the differing texture modifications and nutritional components of these consistencies.
Pneumonia has a huge impact upon the healthcare system in the UK and is not only associated with higher rates of hospital admissions than any other respiratory disease, but also carries a high risk of mortality. This article offers an overview of community-acquired pneumonia in adult patients, including the pathophysiology, common aetiologies, at-risk groups and pharmacological management. There is also a brief discussion on differential diagnoses and potential strategies to support clinical decision-making in the community.
Nocturia is a common lower urinary tract symptom that mainly affects older people. Nocturia causes excess urination at night and, because of associated night-time rising, can also result in falls and fractures. Nocturia has a range of presentations, therefore it is vital that nurses understand how to assess the condition accurately to provide appropriate treatment. This article examines the effective assessment of nocturia, as well as detailing the various lifestyle treatment options that can be used, such as a targeted reduction of fluid intake, weight loss and altered medication profiles. Medication and surgical options should only be used following a trial of lifestyle interventions.
