The management of incontinence is often a neglected area of community care, even more so when allied to older people, and it is essential that community nurses consider the effect of the ageing process and its impact on continence. Often, this can involve the specific effects of dementia and the management of urinary incontinence can then become complex due to the range of practical approaches required and the need to adjust these for each patient. A large percentage of the community nurse’s time is spent supporting carers; therefore, it is essential to consider their feelings when suggesting any strategies as they may feel that they are already incorporating them in the patient’s daily activities. It is also important to focus on few key elements of advice around incontinence and to listen empathetically to appreciate the challenges experienced by carers, which will help in identifying suitable strategies.
This article details a literature search that aimed to find evidence for best practice in treating heel pressure injury. The article gives some background to the aetiology and presentation of heel injury, as well as detailing some of the evidence and literature that was found in the search. The results show that more good quality studies are necessary to arrive at a definition of best practice in heel pressure ulcer treatment to guide nurses. For example, there should be clear indications about how to treat the different categories of pressure damage, the surgical intervention required to repair wounds without putting patients at risk of major amputation, and more focus on the benefits of a through vascular assessment before stating any debridement.
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.
Candice Pellett OBE, Queen’s Nurse, is a transition project manager at the Queen’s Nursing Institute (QNI) in London. Candice received the OBE in 2014 for Services to Nursing and Healthcare.
Candice talks about her background in community practice.
As the vast majority of you will already know, revalidation has now become a reality. From 1 April, 2016, every nurse and midwife will have to demonstrate their ability to meet the standards of the Nursing and Midwifery Council (NMC) code through the revalidation process.
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.
