Skin tears are a largely preventable common injury, particularly in the elderly. However, if not managed appropriately, they have the potential to develop into problematic wounds. This article discusses their classification, why they are common in ageing skin, gives advice on correct wound management strategies and how assessing the patient and their environment and simple strategies can be employed to prevent their reoccurrence.
The suboptimal management of leg ulcers has been identified as a UK-wide problem that involves a high financial and personal cost (Guest et al, 2015). One common omission identified in the care of patients with a leg ulcer is a failure to establish the underlying aetiology of the wound. Ideally, an accurate leg ulcer diagnosis should initiate the appropriate therapy, which should, in turn, facilitate healing; however, an inaccurate diagnosis at the outset means that the patient may not be started on an appropriate management pathway. Although vascular disorders are the major cause of leg ulcers, there are other aetiologies that should be considered when the leg ulcer has failed to respond to evidencebased therapy (Rayner et al, 2009). This article outlines some of the atypical leg ulcer types the author has encountered, as well as detailing the signs that were identified within the assessment process and which allowed the author to formulate an accurate diagnosis.
A pressure ulcer is localised damage to the skin and/or underlying tissue, usually over a bony prominence (or related to a medical or other device), resulting from sustained pressure (including pressure associated with shear). The damage can be present as intact skin or an open ulcer and may be painful (NHS Improvement, 2018a). The consequences of pressure ulcers are increased length of hospital stays for the patient, estimated at 4.31 days (National Institute for Health and Care Excellence [NICE], 2005), but also an increase in cost to the NHS, which is identified at around £14-21 billion annually (Nutritional Pressure Ulcer Advisory Panel et al, 2014). Poor nutrition has been recognised as one of the risk factors in the development of pressure ulcers. Improving nutritional intake of patients is thus paramount in reducing patient harm and unnecessary cost. This article looks at the role nutrition plays in the prevention and treatment of pressure ulcers, provides practical advice and signposts readers to the resources produced by the Nutrition and Pressure Ulcer Task and Finish Group.
The National Catheter Education Programme is a Health Education England-funded initiative to improve the care of patients with catheters. Part of this initiative is the Secret Life of Catheters programme. This article highlights the need for improvement in catheter care and explains the development of this project, which aims to drive improvements across primary and secondary settings through the large-scale delivery of a multiprofessional educational programme in catheter care. The programme explores key dilemmas that district nurses, community nurses, healthcare assistants and doctors can encounter with catheters, and provides approaches to address them. By standardising the teaching of clinical concepts and practice strategies, it is hoped that variations in practice and pockets of misunderstanding can be eliminated.
This series has addressed the treatments for psoriasis as advised by
the National Institute for Health and Care Excellence (NICE, 2017). This condition affects between 1.3-2.2% of the population (Parisi et al, 2011). It is recognised that psoriasis can have a significant impact on mood, mental health, poor lifestyle choices (Cohen et al, 2016; Landriscina et al, 2016), reduced activities of daily living, and is linked with other comorbidities, such as diabetes (Armstrong, 2013) and cardiovascular disease (Rutter et al, 2016). NICE developed a treatment pathway, advising bland emollients, topical treatments, phototherapy, systemic medications and systemic non-biological and biologic therapy. In recent years, the latter options have increased dramatically. This article focuses on the more traditional systemic
treatments, as advised by NICE.
In each issue we investigate a hot topic currently affecting you and your community practice. Here, Georgina Ritchie, Ruth Broadhead and Jayne Livesey, all lecturers at the University of Central Lancashire, ask if community nurses have the courage to compress.
Ageing Better in Camden is one of the fourteen Big Lottery Fund Ageing Better programmes across England working together to tackle social isolation and loneliness among older people. It uses an assets-based approach, drawing on existing skills and resources in the local community and supporting community groups to codesign and co-produce programmes with older members.
The Nursing Now campaign states: ‘It’s time to give nurses more recognition, investment and influence’ (Nursing Now, 2018). By strengthening the nursing profession through the campaign, global healthcare challenges of the 21st century can also be impacted. So, what is Nursing Now, and why should you know about it?
In 2019, the Queen’s Nursing Institute (QNI) is working in a whole variety of ways to support nurses to improve care for their patients, and there are many ways in which you can get involved.
