Many of you may have experienced heavy, aching, tired legs when returning home from work. We tend to put this down to a long day and to some extent we are right. However, over time, these symptoms could be a clinical manifestation of a condition known as chronic venous hypertension...
If you are one of the estimated 12 million people with some form of bladder or bowel problem in the UK, you will know that needing the toilet frequently can be an urgent requirement and you will often need to go at just a moment’s notice.
Aa district nurse with a specialist practitioner qualification (DNSPQ), I understand how important this role and the qualification are, not only to patients, but also to delivering the aims of providing care closer to home, as described in the Five year forward view (NHS England, 2014). This has to be led by highly competent, experienced and compassionate district nurses who have the additional training required to ensure the necessary skills and competence.
The National Garden Scheme (NGS) is the largest funder of the Queen’s Nursing Institute (QNI) and, in fact, it is the largest charitable funder of nursing and caring organisations in the UK. We are often asked, how did this relationship originate?
Chronic leg ulceration is an increasing burden in the UK, both financially to the health service and on a human level. This first article in a four-part series, which looks at leg ulcer management and understanding compression therapy, explores the cardiovascular system, the underlying causes of lower limb problems, and the risk factors for leg ulceration. An overview of how compression therapy works and an introduction to the options available for patients and clinicians in this field of practice is also given. Subsequent articles in the series will look at holistic assessment and clinical decision-making in leg ulcer management, understanding compression hosiery and adjustable wraps, as well as compression bandaging and skin care
This article reports on the monitoring of healing rates of fullthickness pressure ulcers at one care provider in the Midlands. This was an agreed measure that was part of the Commissioning for Quality and Innovation (CQUIN) incentive scheme for the CCG. It was an attempt to provide data to support the anecdotal reports that pressure ulcer healing rates had improved after the implementation of a pressure ulcer reduction scheme called the Midlands and East Pressure Ulcer Ambition in 2012. The healing times for full-thickness pressure ulcers were recorded at 40 and 80 days after being reported by the community care provider (a community interest company [CIC], providing NHS funded services). There were 138 patients included in the data collected over a one-year period in 2015. A total of 34% of the patients were healed or healing at 40 days. A total of 55% of patients were healed or healing at 80 days. Of the 138 patients who had a full-thickness pressure ulcer, 56 died (41%), 15% had deteriorating or static wounds at 40 days and 9% at 80 days. This demonstrates that the majority of full-thickness pressure ulcers progress to healing unless the patient is at the end of life. There should be a continued emphasis on preventing as many pressure ulcers as possible to reduce avoidable harm to patients.
This series focuses on the patient treatment pathway in managing psoriasis as laid out by the National Institute for Health and Care Excellence guidelines (NICE, 2016). This disease affects up to 1.8 million people within the UK, necessitating up to 60% of these patients requiring a form of secondary care input (Jackson, 2012). Secondary care is often required to provide further topical treatment advice, but equally this also falls within the remit of all healthcare professionals, such as community nurses, who have face-to-face contact with patients with psoriasis. As these topical treatments may not manage the symptoms of psoriasis alone, referral to dermatology departments where more specialist treatments can be prescribed may be needed. The first option is to offer a course of phototherapy. There are several forms of treatment under this umbrella, with which community nurses should be familiar.
Anxiety disorders are common amongst elderly housebound clients and are undertreated with detrimental effects to this population. Effective treatment for anxiety includes access to a talking therapy. Cognitive behavioural therapy (CBT) for anxiety is proven to be successful and has a low r elapse rate. Elderly housebound clients have poor access to talking therapies which compounds existing health inequalities. District and community nurses could be instrumental in enabling elderly housebound clients to have access to CBT approaches for the treatment of anxiety at an early stage, which could gr eatly improve outcomes.
The number of people with venous and/or lymphatic disorders who require long-term management of their condition with compression garments in a community setting is growing. Here, Professor Jackie Stephen-Haynes, professor and consultant nurse in Tissue Viability, Birmingham City University and Worcestershire Health and Care NHS Trust, outlines the problems that some patients and clinicians encounter as a result of delayed and/or inaccurate dispensing of garments, and asks if this is a problem that affects you in your practice.
