As many of you will know, especially those working at an advanced level, the future of advanced practice is changing. I believe this is for the better.
The role of the advanced nurse practitioner has been recognised for many years and there have been many requests to register the title with the Nursing and Midwifery Council (NMC).
Myeloma UK is the only organisation in the UK focused solely on myeloma, a rare and incurable cancer arising from plasma cells, which are made in the bone marrow. There are currently 17,500 people living with myeloma in the UK, and Myeloma UK is helping patients to live longer and with a better quality of life.
While nutrition is important throughout life, it is particularly vital that infants get off to a good start. Here, JCN looks at the knowledge community nurses need to provide best practice...
With all the things community nurses need to think about when visiting patients — continence status; support from friends and family; wound care; smoking cessation, to name but a few — it is easy to see how nutritional status might come some way down the list. After all, it’s pretty easy to tell if a patient is dangerously underweight or drifting into obesity isn’t it? All you have to do is look at them...
When trying to prevent the recurrence of leg ulcers, many community nurses find it hard to get patients to concord with compression devices and techniques, particulary over the long term.
This article looks at a new adjustable Velcro compression device, juxtalite (part of the juxta® range; medi UK), which is designed to be simple to apply. It has built-in pressure system (BPSTM) that allows the nurse to accurately monitor the level of compression being applied to the limb, ensuring a therapeutic level of compression is maintained. Here, the author relates her own expreience of using the juxta system (in particular the juxalite version) through a series of case studies that show how the system aids patient concordance with treatment over an extended period of time.
Pressure ulcers result in pain and poor quality of life for patients as well as being regarded as an indicator of poor practice for nurses and healthcare organisations. Similarly, prevention of pressure ulcers is preferable to treatment, which can be expensive. This article considers the latest guidance on the prevention of pressure ulcers and looks at some of the innovations such as pressure relieving devices and the use of dressing products, which nurses can use to provide holistic care. Finally, the author reiterates that despite the use of guidelines and innovative products, the nurse must also rely on their clinical judgement.
Nutritional intake can have an effect on many areas of a patient’s health, while malnutrition specifically has a recognised role in pressure ulcer development. In this article, the author looks at whether there is any high quality evidence to recommend specific nutritional measures when trying to prevent pressure ulcers, as well as looking at overall recommendations for malnourished patients. Nutritional screening remains essential to help identify those patients most at risk of malnutrition and allows community nurses to prepare nutritional care plans and begin to correct any nutritional deficiencies. The author recommends that community nurses perform nutritional screening at any patient contact, be that in hospital, nursing home or in the patient’s
own home. Recording the outcome of screening at regular intervals also helps to identify trends in a patient’s nutritional state and means that any reduction will be picked up quickly.
Incontinence is associated with other medical conditions and has a variety of social and physiological consequences — from the person who has had a stroke and who needs to urgently empty their bladder; to someone with dementia who has lost the ’skills’ of continence. Community nurses who are able to manage people’s continence needs can help to restore patient’s dignity and improve quality of life, as well as preventing wastage and saving limited NHS resources (All Party Parliamentary Group for Continence Care [APPG], 2011). Knowing what constitutes ‘good’ continence services will also help patients and carers understand the services on offer, as well as making it easier for nurses to deliver standard outcomes. This article looks at recent guidelines that outline measurable continence services for adults, children and young people (APPG, 2011).
hronic obstructive pulmonary disease (COPD) is a progressive, life-limiting respiratory condition that primarily features symptoms of breathlessness, chronic cough, fatigue and reduced mobility (Collins et al, 2012).
Currently, the prevalence of COPD in the UK is over one million people (Health and Safety Executive [HSE], 2012), and it is the fourth leading cause of death worldwide (Halbert et al, 2003).
Ryan Latto is a nurse intern for the Emergency Medicine Association of Tanzania (EMAT) at Muhimbili National Hospital, Dar es Salaam.
He shares his background in community practice...
Community nurses often work in isolation and are not always able to attend best practice updates in venous leg ulcer treatment. As a result, they do not always possess the up-to-date knowledge and skills to manage these patients. This project reached out to local ways of delivering compression therapy; in this case an adjustable Velcro compression device, juxtacures (juxtacures®; medi UK). The juxtacures range is designed to be simple to apply with a built-in pressure system that allows the nurse to accurately monitor the level of compression being applied to the limb. This ensures a therapeutic level of compression is maintained. The authors felt and skill level in compression bandaging. The aims of the project were to reduce the amount and duration of community nursing visits to patients with venous leg ulcers while ensuring that safe, visits to patients with lower limb problems, with some patients successfully discharged to self-manage their lower limbs.
