Resources

12 April 2024
When caring for people with venous leg ulceration, exudate management is commonly seen as one of the main challenges for clinicians. However, unfortunately, the reason for this wound-related symptom is often not identified or fully understood and therefore the clinical interventions necessary to address the problem are not implemented (Tickle, 2016). This results in people living with wounds that are failing to heal and producing a volume of exudate that has a significant impact on their quality of life (Cunha et al, 2017). Commonly, the words ‘leaky legs’ or ‘wet legs’ are documented in patient notes as the presenting problem — this is not a clinical diagnosis; it is a symptom of an underlying condition which more than likely is venous disease. Unless this is recognised and treated correctly, those ‘leaky legs’ will continue to be a problem and potentially could have a devastating impact on the patient. It is therefore important to have a good understanding of venous disease as well as the role that exudate plays in wound healing, from initial wounding, through the stages of healing, and when (and why) it becomes a problem.
12 April 2024
Selection of the most appropriate wound dressing is vital for promoting effective wound healing. With the vast number of options of wound dressings currently available, healthcare professionals may find it confusing to select the most appropriate dressing (World Union of Wound Healing Societies [WUWHS], 2020a). This article discusses the importance of wound assessment, focusing on identifying goals of treatment and the selection of an appropriate dressing to manage any identified barriers to healing. In turn, this will help community nurses provide person-centred care that promotes healing and improves overall patient wellbeing.
Topics:  Wound assessment
12 April 2024
Lymphoedema is a long-term condition which is incurable at the present time. Due to the nature of the condition, being both long-term and manifesting in physical changes (swelling), its impact on the person and their lives can be hard to quantify. Management options need to be considered within a person-centred approach, with the four cornerstones of treatment being skin care, exercise, compression therapy and manual lymphatic drainage (MLD). Evidence for each is varied and practitioners need to determine their therapeutic benefit. Beyond the cornerstones of treatment, future developments are ongoing within the areas of surgery, such as venous anastomosis and pharmacological interventions, which may reduce the effects of continual inflammation. In the future, these developments may become part of the care delivered to those affected by lymphoedema. However currently, skin care, exercise, and compression therapy remain fundamental, with MLD included if therapeutically indicated, as well as educating and empowering those involved in selfmanagement with the support of practitioners.
Topics:  Management
12 April 2024
The almost quarter of a million people living in the UK with a stoma are likely to encounter damage to the skin around their stoma. Community nurses are well placed to assist in skin assessment and planning of interventions to improve skin integrity if damage does occur. As part of that skin assessment process, it is important to understand the terminology used to identify issues being observed as well as the potential causes. Although general wound healing is similar across different areas of the body, wound healing products used on peristomal skin need to be considered in terms of how they might adversely affect adhesion of the stoma appliance. Sometimes simple changes to diet or skin care routine, which community nurses can suggest, is enough to improve the peristomal skin condition.
Topics:  Skin Care
12 April 2024
Each year, 245,000 people in the UK develop sepsis, with most cases arising in primary care (Rudd et al, 2020). Currently, around 20% of people who develop sepsis do not survive (Burki, 2018), and approximately 40% of survivors have cognitive or functional impairment (Prescott and Angus, 2018). In an effort to save lives and improve outcomes, the National Institute for Health and Care Excellence (NICE), in common with other international guidelines, has recommended that sepsis is treated within an hour with broadspectrum antibiotics (Academy of Medical Royal Colleges, 2022). On the 31 January 2024, NICE updated its NG51 guideline for the UK, which was originally published in 2016. The update includes recommendations on recognition and early assessment, initial treatment, escalating care, finding the source of infection, early monitoring, and information and support. This article updates readers on changes to the NICE guidance and how they affect clinical practice.
Topics:  Treatment
12 April 2024
Disordered gambling is a behavioural addiction that causes harms to individuals, their families and wider society. Gambling harms have been recognised as a public health concern, but little attention has been given in health care to enable community nurses to identify and support patients experiencing gambling-related harms. Uptake of gambling support has been low due to the perceived stigma experienced by the person. Community nurses can use the Making Every Contact Count (MECC) approach when interacting with patients by identifying the signs of harmful gambling, discussing this with their patients, and signposting them to appropriate support. This article explores how community nurses can do this.
12 April 2024
Reflection provides nurses with a systematic way to understand experiences to improve professional development through learning to promote best practice (Horton-Deutsch and Sherwood, 2017). Purposeful reflection can lead to a deeper understanding of the situation and through new learning inform future practice and optimise care delivery (Asselin et al, 2012; Caldwell and Grobbel, 2013), and is used in nursing education and clinical practice worldwide (Galutira, 2018).
Topics:  Care homes
02 February 2024
A lthough we are all both constantly and consistently busy all day every day, I am sure you will agree that at this time of year demand on services escalates even further and the challenges we face increase even more. How can this be possible we ask, but each year it is!
Topics:  Editorial
02 February 2024
For the general public, community staff such as district nurses and health visitors are in danger of becoming a fond memory, much like those other pillars of society we didn’t know
we needed until they were gone — neighbourhood policeman say, or a functioning post office.
02 February 2024
ERIC, The Children’s Bowel & Bladder Charity, helps thousands of families struggling with continence issues, including through their free helpline. But, they could not do it without the generosity of volunteer nurses.
Topics:  Viewpoint