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).
Oral mucositis is a painful and often under-reported condition, which affects the oral mucosa of individuals undergoing cancer treatment. This article examines the condition, its causes, and how to prevent, manage and treat it. It also explores the condition from the view of a family member, who watched her father undergo cancer therapy and subsequently develop oral mucositis. Looking at oral mucositis from the position of a carer will hopefully highlight the condition from a different angle. The oral cavity is an important part of the human body — sometimes described as the ‘gateway to the body’; a clean and infection-clear mouth is a basic need. The mouth enables us to eat, speak, smile, laugh and sometimes cry, so a painful mouth can impact greatly on an individual’s general health and quality of life. Therefore, understanding and managing oral mucositis can affect a patient’s cancer therapy and subsequent treatment outcomes.
Over 51,000 carers in England are men over the age of 85 — a number which has more than doubled in the last decade (Carers UK and Age UK, 2015). The older male carer story project collaborated with a group of 11 older male carers (all over the age of 85 and living in Dorset) to learn from their experiences.
In each issue we investigate a hot topic currently affecting you and your community practice. Here, we look at the current state of NHS mental health services and ask the question
Stories of GP practices with staff standing around with no patient lists, NHS trusts being unable to access IT systems, blood
records and radiology services, as well as emails and even telephone systems being interrupted, hit the national headlines back in May (‘Global cyber attack is using US spy hacking tools’ — Daily Mail Online, 12 May 2017; ‘Massive ransomware cyber-attack hits nearly 100 countries countries around the world’ — The Guardian 12 May 2017; ‘NHS left reeling cyber-attack: “We are literally unable to do any x-rays”’ — The Guardian, 13 May 2017).
