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. As well as examining the problems of bladder dysfunction in people with multiple sclerosis (MS), this first article of a two-part series, looks at the background to MS and bladder problems, as well as focusing on treatments such as clean intermittent self-catheterisation (CISC). The second part of the series will feature a case study looking at the management of a patient with MS and bladder dysfunction.
This comment piece is based upon a theoretical review of the medical, mass gathering and social science literature relating to music festivals, as background to the author’s PhD study exploring voluntary risk and health in a music festival context
Jacqui Ciotkowski is a part-time bank community nurse for South Warwickshire NHS Trust and a part-time teaching assistant
This article focuses on the work of a team of community nurses running a primary care drop-in centre. As well as a full range of clinic services, the team sees a lot of leg ulcer patients for compression bandaging. A common problem with traditional compression bandaging is the amount of time that community nurses have to spend on the procedure, as well as the dangers of maintaining pressure and bandage slippage between dressing appointments, which can result in discomfort for patients and even skin damage in some cases. This also has implications for patient concordance. This article looks at a review by the team of a new compression system (juxtacures®; medi UK), which offers measurable and adjustable compression and a greater involvement by patients in their own care, which in turn can minimise the time nurses need to spend on dressing changes.
Sometimes in life, one group of professionals are disproportionately blamed for everything that is wrong with society — thus every banker was painted as a reckless gambler after the financial crash of 2008; journalists were collectively pilloried for the phone-hacking scandal; and estate agents ...well, they get blamed for pretty much everything else.
When it comes to healthcare, one group seems more routinely maligned than any other, whether for ballooning budgets or poor continuity of care. Despite plugging gaps in services, providing much needed holiday and sickness relief, and generally propping up creaking wards and community units, agency nurses often attract lurid headlines such as ‘How nursing agencies making billions are bleeding the NHS dry’ and ‘Trust pays an agency nurse £2,200 a day’. But behind the headlines, what is the truth about agency nurses? Are they really money-grabbing opportunists, or is there more to the role than meets the eye? I spoke to one agency nurse, Maggie Scott, to find out what motivates her to put flexibility above a full-time position.
The management of exudate in acute and chronic wounds is a common issue for community nurses, with too much exudate resulting in issues with infection and the breakdown of periwound skin; while too little moisture risks the wound bed becoming too dry. Nurses need to find the most cost-effective and clinically proven treatment regimen when treating wounds that produce different levels of exudate, minimising dressing changes and patient discomfort. While it can be difficult to make a choice about which dressing to use because of the vast array on offer, it is important to match the dressing to the wound and use the most appropriate dressing for the levels of exudate being produced. Similarly, using a more responsive approach to wound management — adapting treatment as the wound changes — will result in a more cost-effective approach. Advancis Medical have a range of wound management dressings that are suitable for different wound types and can handle varying levels of exudate. This allows nurses to use a step-up, step-down approach to the management of exudate as the most cost-effective dressing regimen.
There are currently approximately 2.5 million people in the UK living with, or recovering from, cancer and it is further estimated that 1.8 million of these people will have at least one other longterm health condition. Community nurses have a responsibility to promote health at every opportunity when supporting those living with, and recovering from, cancer. The cancer care review is one aspect of the patient’s recovery package, which aims to help them recover from cancer and its treatment and identifies their individual concerns and support needs. The benefit of the recovery package is that it enables patients completing cancer treatment to take more control of their own care. In trying to help patients to improve their own health they will need support to think about devising an action plan should new concerns or symptoms arise. This article examines how a recovery package can, through assessment and monitoring, help to identify potential problems as well as offering preemptive support for those adapting to the diverse life changes associated with cancer.
In each issue we investigate a hot topic currently affecting you and your community practice. Here, Jason Beckford-Ball looks at some of the challenges that lie ahead in the coming year.
The response of community staff to a person experiencing cardiac arrest can be critical to saving that individual’s life. UK ambulance services respond to approximately 60,000 cases of suspected cardiac arrest each year and resuscitation is performed during approximately 28,000 of these calls; unfortunately, less than one-in-ten people actually survive long enough to be discharged from hospital (British Resuscitation Council, 2015).
Current British Resuscitation Council (2015) guidelines recommended that basic life support consists of two elements: mouth-to-mouth resuscitation and chest compressions. The aim of this article is to challenge the need for so-called ‘rescue breaths’ within cardiopulmonary resuscitation (CPR).
