Compression therapy is a key component of venous leg ulcer management. Best practice guidelines recommend that an ankle brachial pressure index (ABPI) is determined before applying full compression to establish if peripheral arterial disease (PAD) is present. However, a recent study by Guest et al (2015) highlighted that 84% of patients with a wound to the foot or leg have no recorded ABPI. The reasons for this are thought to be insufficent time to carry out the assessment (Chamanga et al, 2014), and lack of competency (Worboys, 2006).
Many government and healthcare strategies now advocate supporting self-care in the management of long-term conditions (LTCs). This approach has been driven by the increasing number of poly-morbid, obese and elderly people in the UK, which is putting an immense strain on already stretched health and social care resources. The emphasis on promoting self-care throughout the illness trajectory has been a pivotal aspect of nursing care for more than 50 years and this approach in the management of chronic oedema has always been a key aspect of treatment plans by specialists in this field. Practitioners need to be skilled in assessing the self-care needs of patients and to be ready to adopt this approach and provide appropriate support. This article gives an overview of self-care for people with chronic oedema and focuses on how nurses can encourage and support patients to do this. A case study demonstrates the importance of thorough and accurate assessment to encourage self-care and health behaviour change.
Healthy eating is a topic covered widely in the media, and is particularly relevant to healthcare, with diet and nutrition vital to the management and prevention of many conditions. Wound healing is a complex process that relies on the coordination and internal regulation of activities such as the removal of devitalised tissue and growth of fresh blood vessels. This article examines the phases of wound healing and discusses how nutrients can affect and enhance this process. Understanding the role of nutrients in wound care enables nurses to offer advice to patients whose wounds are not progressing in the expected manner. Nutrition should form part of holistic wound assessment, with any malnourished patient being referred to a dietician. It is a misconception that only underweight individuals can be malnourished and the use of a robust assessment tool will assist nurses in deciding which patients require onward referral. There appears to be a significant link between poor nutrition and delayed wound healing, with a higher risk of complications such as infection identified in malnourished patients
The third in this four-part series about understanding compression explores the use of both compression hosiery and adjustable compression wraps. The case for early intervention, as well as the need to see compression as a lifelong treatment for those diagnosed with venous disease, are also discussed. In addition, the differences and similarities, advantages and limitations of compression hosiery stockings, two-layer compression hosiery kits and adjustable wraps will be deconstructed.
The scientific and clinical focus on honey which has come about in the past 30 years has led to the classification of medical grade honey and the commercial availability of highly regulated products. Medical grade honey has proven antibacterial activity, traceability of source, and lack of contaminants. It is gamma-irradiated to kill bacterial spores that may be present in raw honey (Amaya, 2015; Cooper, 2016). It is available in a wide range of products, including sterile tubes of honey ointment, honey impregnated tulles, alginates, gels and meshes.
Brexit poses seismic challenges for health and social care provision in the United Kingdom concerning the ongoing financial support available to fund health and social care within a post-Brexit economy. Alongside funding issues, there are potential concerns linked to the continued access to medical supplies and equipment which are linked to trading relationships within the European Union (EU). Changes to the context of legal frameworks and funding for research which result from Brexit are also serious concerns. Although many of these areas may have potential detrimental impacts on patient care, there is a particular concern about the loss of migrant health and social care workers, which may exacerbate the recruitment issues currently facing the UK health and social care workforce. Reflections from those who work within health and social care, such as the authors of this paper, can create insider perspectives about what Brexit means to individuals and their families. This can help organisations consider the challenges that their current EU migrant workers experience and explore ways of mitigating these impacts on both the individual and wider organisation to ensure patient care is not diluted, but instead enhanced.
Excess weight can become a particular health hazard with age, triggering cardiovascular disease, diabetes, cancers, joint problems and other inflammatory conditions. This article looks at what can be done to help the elderly population maintain a healthy weight, while avoiding problems such as sarcopenia and bone loss. Weight tends to be carried more around the middle in the older person, which poses more of a risk for metabolic diseases than excess weight elsewhere — why this happens and how it can be avoided is discussed. This paper also looks at appropriate calorie intake and activity and explores weight loss and why it is harder and slower to lose weight with age. Preventing loss of strength and mobility is also important with aging, and, as immune function can decrease with age, how to avoid this declining significantly is also touched upon.
