In the community setting, leg ulcer management involves both care of the wound itself and the skin of the lower limb. Cleansing is vital to enure that infection does not develop in the wound itself and that the integrity of the periwound skin is maintained. Maintaining the skin’s barrier function is also vital, as, without this, fluid loss, inflammation, dryness and infection can develop. Wound exudate can also act as an irritant to healthy skin, particularly when permitted to accumulate under wound dressings. Keeping the skin clean and free of debris, alongside more frequent dressing changes can help in the treatment of irritated skin. This article highlights the use of an innovative cleansing product (UCS; medi UK), which is designed as a premoistened cloth that safely and effciently cleanses the wound of slough and debris, while rehydrating periwound skin.
There are around 900,000 young people under the age of 19 in the UK with bowel and bladder problems, equating to one in 12 of this age group (National Institute for Health and Care Excellence [NICE], 2010). These problems, which include daytime wetting, nighttime wetting, constipation and soiling, can have significant impacts on the emotional wellbeing of sufferers, with those affected — both young people and their parents or carers — reporting feelings of shame, embarrassment and fear of being found out’. This in turn can lead to low self-esteem, isolation, anxiety, and in some cases depression.
Skills for Health and the National Skills Academy for Health have launched #OurHealthHeroes to mark the contributions of those who play a vital role in delivering patient care. The campaign celebrates the 798,600 people across the sector who work as healthcare assistants, assistant practitioners, porters, cleaners, caterers, maintenance staff and administrative staff. By encouraging people who have benefitted from support to share their stories and thanks, it is hoped that these staff will feel valued and appreciated as part of the healthcare system.
Anew survey has highlighted concern among multiple sclerosis (MS) specialists — including nurses — that some patients with MS are not engaging with specialist services. The research — Multiple Sclerosis Clinician Survey of 100 Specialist MS Nurses and Neurologists — found that 93% of healthcare professionals with expertise in MS believe that there are people with the condition who are missing out on access to new medicines, symptom control and holistic services, all of which can be offered by the MS team.
Wound fluid, or exudate, is a normal consequence of healing but physiological circumstances within the individual or their wound can arise, which lead to excessive wound fluid production. There is a risk of maceration and excoriation of surrounding skin, which can cause distress and impact on quality of life. Therefore robust assessment and nursing intervention can successfully manage exudate and facilitate improved wound healing.
Vulval health disorders can be painful and chronic conditions. The link between long-term painful illness and the mental wellbeing of patients is firmly established. Taking into account the nature of vulval health conditions, it is important to gain an understanding into the impact they can have upon a patient’s quality of life. As part of an initiative aimed at expanding insight into the realities of living with this type of problem, the British Association of Dermatologists surveyed 325 British women who had suffered, or were currently suffering, from a vulval health disorder.
The study took the form of an online survey, collecting mostly quantitative data, with some qualitative insights. Responses were gathered under the categories of demographics; vulval condition; treatment; physical impact; impact upon career and social life; impact upon romantic and/or sexual relationships, and effect on emotional and mental wellbeing. Eighty-nine percent of survey respondents reported that their vulval health disorder had negatively affected their emotional and mental wellbeing. Patients suffering with a vulval health disorder were twice as likely to have suffered with depression and 22% reported having contemplated self-harm or suicide as a result of their condition. Overall, vulval health conditions were found to have a significant impact on quality of life for patients, affecting every aspect to some extent.
It is widely recognised that the NHS is facing unprecedented challenges in trying to improve the quality of services provided, while managing the most severe and protracted period of resource constraint in its history (NHS Confederation, 2014; Today’s NHS, 2015). The hour-a-day project was specifically designed by the author’s trust as an efficiency initiative, with the aim of saving an hour a day for each team member, releasing half that time as cashable savings, with the other half retained for the benefit of patient care. Saving time across 4,175 trust employees offered considerable scope for achieving efficiencies and reducing costs.
In addition to achieving savings where possible, many services report that they now make better and smarter use of their time and resources (Berkshire Healthcare NHS Foundation Trust, 2015). The hour-a-day initiative was in place from autumn 2013 and drew to a close at the end of February 2015. A total of 92 services completed the process and delivered a combined saving of £1.9 million. Berkshire Healthcare NHS Foundation Trust (2015) demonstrated that the project was not overly complicated and simply offered an opportunity for busy staff members to take a reflective but introspective look at the way they work. For the majority, the hour-a-day initiative acted as a springboard for staff and managers alike to address and solve problems together.
Allergic rhinitis (AR) is a common disorder which has a major impact on the lives of sufferers and families. Although currently there is no cure for this disease, a variety of therapeutic interventions can alleviate the symptoms. It is important that nurses are able to differentiate allergic and non-allergic rhinitis (NAR) from viral upper respiratory tract infections (URTIs) in order to best manage their patients. It is also necessary to ask appropriate questions of those patients attending for asthma review, as
they may have unrecognised and untreated disease. Familiarity with the range of medications and their administration is advocated. Patients with troublesome, non-responding symptoms need to be referred, as do those with red flag signs.
Welcome to JCN’s learning zone. By reading the article in each issue, you can learn all about the key principles of subjects that are vital to your role as a community nurse. Once you have read the article, visit the learning-zone to evaluate your knowledge on this topic by answering the 10 questions in the e-learning unit; all answers can be found in the article. If you answer the questions correctly, you can download your certificate, which can be used in your continuing professional development (CPD) portfolio as evidence of your continued learning.
