Resources

Non-cystic fibrosis (CF) (bronchiectasis) is a common chronic lung condition, which occurs due to damage to the airways leading to persistent cough, sputum production and recurrent chest infections (Hill et al, 2018). This article focuses on the adult patient and describes the pathophysiology, aetiology, investigation, and management of bronchiectasis in the primary care setting. The aim is to raise awareness of this disease, which is increasing in prevalence and to empower community nurses with information to support patients through the bronchiectasis disease trajectory.

Hydration is an essential component of life. Fluid balance monitoring in health and social care has been a routine monitoring tool carried out by nursing staff for many decades. The evidence suggests poor compliance and inaccurate data with lack of time or appropriate staff cited as the reasons for this. Several recent high profile cases have attributed fatalities to a lack of adequate hydration of patients in health/social care environments. Managing someone’s input and output can have a signifcant effect on their health and wellbeing. Accurate monitoring can also assist diagnosis and ultimately guide appropriate treatment choices for people with lower urinary tract symptoms. This article looks at the variety in terminology and practice, discusses the importance of maintaining accurate monitoring, and the essential components of a useful monitoing tool. It also identifies some of the challenges faced in maintaining effective monitoring of fluid balance with suggestions for improving practice.

The development of an integrated children’s bladder and bowel service is a key recommendation from a number of national documents and helps ensure affected children are seen at the right time and place and by the right person. This facilitates potential cost savings in the long term, with resultant reductions in A&E attendance and secondary care referrals. The key reference document is the Children’s Continence Commissioning Guide, which sets out a clear service framework. By working with several services across the UK, a generic service model has been developed which supports appropriate interventions at both tier 1 and tier 2, including the development of care pathways to help reduce unwarranted variation and inequalities in the provision of care. The key to success with this model is also the empowerment of families to help them self-manage the child’s problem, which also fits within the NHS Long Term Plan (NHS England, 2019).

Here, Nihara Krause, consultant clinical psychologist and founder and chief executive officer of stem4, gives an overview of the resources available for children and young people with mental health needs, and recommends changes that are drastically needed to meet demand and improve services. She also explores work currently being done by stem4 to help identify and support children and young people, and discusses early digital interventions which can help with treatment.

In each issue we investigate a hot topic currently affecting you and your community practice. Here, we ask "What will the Year of the Nurse and Midwife mean for the UK’s community staff?"