Lipoedema is a challenging condition for patients, health and social care professionals. Lack of understanding about the condition leads to delayed diagnosis and poor support with self-management. This paper draws on key evidence, best practice guidelines for the management of lipoedema, and a patient story, to provide insights into the presentation, diagnosis, impact and management of the condition. It also identifies key points for practice for community nurses.
Here, Sharon Holroyd, lead CNS, Calderdale Bladder and Bowel Service; chairperson, Yorkshire ACA, defines stress urinary incontinence and the treatment options available, and reviews the evidence to support pelvic floor exercises as an effective rehabilitation for patients with symptoms of stress urinary incontinence.
In each issue we investigate a hot topic currently affecting you and your community practice. Here, we ask Can Community nurses take on obesity?
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.
