Throughout the summer, our readers had the opportunity to complete selected e-learning modules from the learning zone section of the JCN website (www.jcn.co.uk/learning-zone/)and be entered into a prize draw to win a brand new iPad or a £50 Amazon voucher.
Clare Mechen, nurse manager and advanced nurse practitioner, The Adam Practice, Poole; clinical development nurse, Lindsay Leg Club Foundation
The provision of end of life care is important core work for community nursing teams. Once end of life has been recognised, a focus on palliation of symptoms and an emphasis upon assisting people to ‘live well until they die‘ becomes paramount. Breathlessness is a common distressing symptom for patients, significantly affecting their quality of life and is sometimes the cause of unnecessary admissions to hospital. This article explores the pathphysiology of breathing and breathlessness and offers some thoughts on history-taking and physical assessment, skills that nurses in advancing practice roles are now undertaking in the community setting to enhance the care they deliver to patients. This article aims to support community nurses to gain knowledge to inform the provision of effective evidence-based care and assist patients and their families to manage breathlessness at end of life.
Compression is the key to management of lymphoedema and multilayer bandaging has been considered the gold standard. This article looks at adjustable Velcro compression devices as an alternative to multilayer bandaging. The author finds that the devices enable patients to maintain the required pressure in between consultations with healthcare professionals. They also allow for changes in limb volume and can help with concordance, as well as cutting down on the time clinicians need to spend with patients as the devices promote self-management.
Improvement of wound outcomes is a priority for the NHS if the cost of wound management is to be reduced. Failure to undertake a full holistic wound assessment can result in inappropriate and ineffective treatment, resulting in delayed healing, which can have a negative effect on patient quality of life and healthcare resources. NHS England has commissioned a CQUIN scheme for 2017–19. This comprises 13 indicators which seek to improve quality and outcomes of care for NHS
patients, while supporting local areas in delivering their sustainability and transformation partnerships (STPs). The tenth national indicator focuses on ‘improving the assessment of wounds’. This article provides a practical guide to systematic wound assessment for community nurses so that CQUIN targets can be met, and also introduces a new tool from BSN medical, an Essity company, to help nurses in this area.
This article examines current guidelines and best practice statements for the treatment and management of chronic venous leg ulcers (VLUs). There is a need for continuous professional development (CPD) for community staff, who are constantly under pressure to maintain evidence-based practice when dealing with the complex, clinical and challenging environment associated with chronic venous leg ulcers. This article highlights the importance of patient assessment, management and treatment options, including the gold standard of compression therapy and new options available
Patients in the community often have a long-term catheter in place and so their management inevitably becomes the responsibility of community nurses. As urinary incontinence can cause patients discomfort and have a negative impact on their day-to-day life, it is important that healthcare professionals understand the reasons for catheterisation and are aware of the different treatment options available, such as urethral and suprapubic, in order to provide patients with the most suitable device according to their needs and lifestyle. This paper explores the issues involved with indwelling catheterisation and looks at one new product range that aims to promote patient comfort and reduce associated risks.
Bowel dysfunction is a common problem for adults and children, and yet many people do not seek help and when they do it is not up to standard. Unmanaged symptoms impact on the health of the patient, both physically and mentally, and add extra cost to the NHS. This article, by a clinical nurse specialist working with people suffering from bladder and bowl dysfunctions, will help healthcare professionals understand the possible causes of anatomical and functional bowel problems, especially constipation, and the conservative treatment interventions. This first article in a two-part series, explains anatomy and physiology of the lower gastrointestinal tract, what constitutes a normal bowel habit, frequency and variation. The second will focus on the causes of constipation, which are often misunderstood and misdiagnosed, and how they can be assessed and managed, as well as treatment options available.
This third article in a seven-part series looking at the identification and treatment of psoriasis, explores the active ingredients and action of the main topical treatments for psoriasis. Community nurses are perfectly placed to help patients take control of their skin condition, particularly in advising them on the benefits of topical treatments, which as they can be applied directly to the skin, allow the area to be targeted, lowering the level of absorption into the bloodstream and reducing side-effects (Psoriasis and Psoriatic Arthritis Alliance (PAPAA, 2017a).
