The effect of drugs on mental and physical health are well documented. However, these consequences do not necessarily prevent people using them either recreationally or more regularly, with some becoming addicted to their drug or drugs of choice. It is estimated that in 2016/17, around one in 12 (8.5%) adults aged 16 to 59 in England and Wales had taken an illicit drug in the last year (NHS Digital, 2018). Ketamine has become increasingly popular, especially among younger users, as it is cheap and mistakenly seen as a ‘safe’, non-addictive drug. However, the reality is that even recreational use may have serious consequences. The effect on the urinary system can be devastating, with users experiencing anything from frequency and cystitis-like symptoms, to extreme debilitating pain from the inflamed and shrunken bladder, resulting in cystectomy and urinary diversion, and, if the kidneys are affected, renal failure and dialysis.
With an ageing population and an evolving NHS, many services traditionally provided in the hospital setting are moving to the community. This article examines the development of a community nurse-led intravenous (IV) therapy service. The author explains the background to IV therapy, particularly in the field of antibiotic provision, the development of the nurse-led service and how the service transformed the experiences of patients, allowing them to access care closer to home and avoid unnecessary hospital visits. The author also provides a case study, which details the benefits of the nurse-led IV therapy service for an individual patient.
Here, Ellie Lindsay OBE, independent specialist practitioner, associate lecturer, CRICP, London and visiting fellow, Queensland University of Technology, and Laura Talbot, clinical audit consultant for the Lindsay Leg Club Foundation, discuss why effective communication is important in clinical practice to help improve the quality of life for individuals living with a PICC line in situ. This feature also recounts Ellie Lindsay’s own personal experience of watching her husband undergo a period of intense cancer treatment, and the difference made by the communication skills and teamwork of healthcare professionals involved once in the correct haematology unit.
Here, a focus group of tissue viability specialists (Box 1) look at the GIRFT programme and how by working together, clinicians and industry can help to prevent variations in wound care.
Indwelling urinary catheterisation is a common procedure especially within a community setting. However, healthcare professionals are sometimes unaware of what is current best evidenced-based practice. This article outlines the clinical indicators for insertion of a urinary catheter, rationale for catheter selection, including Charrière (Ch) or French gauge (Fg), length, balloon size and material of choice including any coating. Catheter insertion requirements are outlined and drainage and supporting/securing devices discussed. Complications of indwelling catheters, such as catheter-associated infections and encrustation are also discussed with recommendations for treating, and, finally, new innovations which may benefit in future care are identified — all with reference to current national guidance and best clinical evidence-based practice.
Thanks to everyone who entered the JCN/GPN Outstanding Practice in Wound Care Award 2018. We received a huge number of entries that demonstrated all the excellent wound care being delivered in the community around the UK. Read more about the winning team here.
