Continence is an area that requires many community nurses to prescribe from the Nurse Practitioner’s Formulary to promote good patient care and appropriate service delivery. Recently in West Berkshire, with the full support of GPs, the continence advisory service has taken over the non-medical prescribing of all continence products, with the aim of providing a safe, cost-effective and timely service. This initiative is aimed at changing the way continence prescriptions are issued to patients. This second article of a two-part series, as well as featuring a case report looking at the management of a patient with multiple sclerosis (MS) and bladder dysfunction, looks at the importance of holistic assessment to ensure appropriate catheter provision in line with prescribing principles.
The knowledge needed to diagnose skin conditions in primary and community care can be elusive, daunting and confusing. By using thorough history-taking, excellent physical assessment skills and thinking ‘outside the box’, healthcare professionals can formulate a differential and working diagnosis to improve patient access to appropriate management, including medications, lifestyle changes and referral as needed. Simple history-taking tools, relevant mnemonics and good resources can help patients to be managed quickly and effectively, and thereby improve outcomes and reduce the need for time delay in diagnosis. This article intends to demystify the dermatology conundrum and give healthcare professionals the tools to simplify the treatment of common skin conditions.
This article explores the natural ageing process and the impact it can have on the nutritional status of elderly patients. In the article, the author considers the body’s ageing process and the changes patients can struggle with as a result. Recognition, identification and treatment of malnutrition with this patient group is an essential part of care within the NHS, which, if done appropriately, can improve patient quality of life - in particular, functional status. An appreciation of the physiological changes which are happening as part of the ageing process allows healthcare professionals to offer tailored advice and provide reassurance to patients.
Depression is the ‘common cold’ of elderly mental health. Many older housebound patients suffer from depression. This has often not been recognised and treated. District/community nurses are the healthcare practitioners most likely to be in contact with these clients. Their role in assessing the emotional health of clients and taking action to address mental health issues is crucial. Cognitive behavioural therapy (CBT) has a strong evidence base for treatment of depression. Knowledge of its principles could be integrated into therapeutic conversations that district/community nurses have with clients.
As a podiatrist, I have worked alongside community nurses since I graduated both here and in New Zealand. The two professions frequently attend the same patients in the community. These patients often have complex medical presentations that benefit from a team approach.
While lifestyle-related conditions such as heart disease, obesity and diabetes are on the rise, district nurse numbers are falling. At the same time, traditional methods for providing lifestyle advice on factors such as smoking, alcohol intake and exercise have proven to be ineffective. This article examines how a technique called motivational interviewing, which seeks to build a partnership with the client, can promote positive change by strengthening the person's own motivation to change.
Exudate management in chronic wounds and hard-to-heal wounds is a vital process and community nurses need to be aware of the best practice evidence as well as correct product choice. This is particularly important when attempting to provide the optimum moist healing environment and achieve a balance of moisture in the wound bed. Another important element in chronic wounds is the promotion of autolytic debridement, which helps to ensure that healing is not complicated by any devitalised tissue, which can harbour bacteria and impede new tissue growth. This article investigates best practice in the treatment of chronic wounds, with a focus on the management of moisture in the wound bed. The author also looks at one dressing in particular, Cutimed HydroControl® (BSN medical, an SCA company), which uses an osmotic effect and a high moisture vapour transmission rate (MVTR) to ensure that excessive wound exudate is drawn away from the wound bed, while also ensuring that fresh exudate is produced to promote autolytic debridement and maintain moisture levels in dry wounds. Cutimed HydroControl is able to avoid inappropriate dressing use by facilitating the needs of both exuding and dry wounds, thereby ensuring an optimum moist wound environment
In each issue we investigate a hot topic currently affecting you and your community practice. Here, Jason Beckford-Ball looks at the current state of the NHS Mental Health Services and asks the question...
Though incidents suchasthis highlight the fragilityof life, they also show thestrength of thehuman spirit.With terribletragedy comesselfless acts of kindness,from both members of thepublic and trained clinicians.
