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Nursing Standard

Lisa Younge
Inflammatory bowel disease (IBD) is a term that refers to two main conditions: Crohn's disease and ulcerative colitis. It is a lifelong inflammatory disorder that affects the gastrointestinal tract. Managing IBD requires a multidisciplinary team approach, and specialist IBD nurses have an important role in this, providing education, support and advocacy to patients with IBD. This article provides an overview of the symptoms of Crohn's disease and ulcerative colitis, as well as the medical, nutritional and surgical management strategies that can be used...
December 10, 2018: Nursing Standard
Gary Mitchell, Shauna Rooney, Colin Sheeran, Joanne Strain
Dementia care has evolved over the years, with a rise in person-centred non-pharmacological interventions such as reminiscence therapy, reality orientation and validation therapy. While these non-pharmacological interventions are an important facet of dementia care, nurses also require up-to-date knowledge of the medicines used to manage the symptoms of dementia, including antidepressants, cognitive enhancers and analgesics. Nurses should also understand the effects of behaviour-modifying medicines such as antipsychotics, anxiolytics and hypnotics, which are often overused or inappropriately prescribed in people with dementia...
December 3, 2018: Nursing Standard
Lindsay O'Dell, Sarah Earle, Andy Rixon, Alison Davies
Spinal cord injuries can result in significant physiological and psychological challenges for patients. Nurses have an important role in the rehabilitation of people with a spinal cord injury, as does the provision of peer support by people who are 'living well' after experiencing a spinal cord injury. AIM: To explore peer support and whether it can have an effective role in a multidisciplinary team approach to supporting a patient with a spinal cord injury. METHOD: This was an independent evaluation that used an online survey, a focus group and telephone interviews to elicit the views of respondents about the Spinal Injury Association (SIA) peer support service in England and Wales...
November 27, 2018: Nursing Standard
Ian Appleyard
Nurses practising in almost any area of healthcare may encounter individuals who are considering acupuncture, particularly those caring for people who are experiencing chronic pain. Acupuncture is a complex intervention and in traditional practice is not simply the insertion of needles, as some people believe. This article provides a historical understanding of acupuncture, outlining some of the differences between styles of practice that may be relevant when selecting an acupuncturist. It also examines the issues that should be considered when assessing the evidence base for acupuncture...
November 21, 2018: Nursing Standard
Emma Davies
Chronic pain affects a significant percentage of the population and is defined as pain that lasts beyond the point of healing. People presenting to hospital with acute illness may have underlying chronic pain that can be exacerbated by their presenting condition, even if this chronic pain is not the reason for their admission. While people may tolerate their usual medicine regimen under normal circumstances, small changes in their physical health can rapidly cause issues with their medication such as increased side effects...
November 15, 2018: Nursing Standard
Lauren Elizabeth Palk
Nurses commonly encounter patients with type 1 or type 2 diabetes mellitus in their practice. Management of these conditions requires an in-depth knowledge of blood glucose monitoring. It is essential that nurses are aware of normal blood glucose levels, so that they can respond to complications caused by elevated and reduced blood glucose levels. This article aims to enhance nurses' knowledge of the acute metabolic complications of diabetes, such as diabetic ketoacidosis and hyperosmolar hyperglycaemic state, to assist in their recognition and management in clinical practice...
November 6, 2018: Nursing Standard
Joanna Goodrich, Beverley Fitzsimons
National surveys of NHS patients in the UK have captured patient satisfaction with healthcare services for more than 15 years. Although this data has been valuable in tracking trends over time and for comparison between healthcare services, there have been issues associated with the concept of 'satisfaction' and the lack of clarity regarding the purpose of collecting such data. The shift in focus to capturing patient experience rather than patient satisfaction is regarded as a positive change, particularly for the purpose of improving healthcare services and patient care...
November 1, 2018: Nursing Standard
Janice Logan
Delirium is the most common neuropsychiatric disorder in patients with palliative and end of life care needs; therefore, providing effective care for patients, and their families, is a clinical priority for nurses. Delirium is characterised by a fluctuating state that affects an individual's attention, orientation, thinking, perception, memory, psychomotor behaviour, emotions and sleep-wake cycle. Early recognition, assessment and management of delirium is essential, because this has the potential to relieve distress and improve the quality of life and death for patients...
November 1, 2018: Nursing Standard
Alison Bardsley
While urinary tract infections (UTIs) are uncommon in healthy men aged under 50 years, their prevalence rises in men aged over 65 years. UTIs can be classified as uncomplicated or complicated. UTI in men is considered to be more complicated than in women, because it is often related to abnormalities of the urinary tract, such as prostatic enlargement or a urethral stricture. UTI is associated with a significant disease burden and cost to patients and healthcare organisations. It is one of the most common reasons for prescription of antibiotics in primary care; however, because antibiotic resistance is becoming increasingly widespread, it is essential that these drugs are used prudently...
November 1, 2018: Nursing Standard
David Thomas Evans, Mark Dukes
Acquired immune deficiency syndrome (AIDS) was first labelled as a new illness in 1981; it took two more years to discover a causative virus, which was named human immunodeficiency virus (HIV) in 1985. Nurses who practised during those times may recall the fear, panic, stigma, ethical dilemmas and refusals to care that were associated with the pandemic. Four decades later, HIV can be considered a long-term condition rather than a life-limiting disease, as a result of developments in treatment. However, the UK has the highest number of people living with the virus since the pandemic was first identified, and there remains a need to challenge stigma and prejudice in relation to HIV and AIDS, to ensure that people receive timely access to HIV testing, treatment and preventive measures...
November 1, 2018: Nursing Standard
Paul Whitby
Healthcare professionals continue to debate how to address the issues of suboptimal care, neglect and abuse in healthcare settings. One solution that is likely to achieve improvements in care is the widespread development of leadership skills in front-line nurses. The behaviour of front-line nurses is a major determinant of patients' healthcare experience and their perception of the quality of care they receive. Front-line leaders in healthcare settings such as wards, care homes and clinics are the people with the strongest and most immediate influence on staff behaviour...
November 1, 2018: Nursing Standard
Dean Whitehead
The term health promotion has been used in healthcare for several years. However, the meaning of this term is debated, particularly in nursing. Some nurses might believe that, because they are healthcare practitioners working in healthcare services, that they are 'by default' automatically involved in health promotion activities; however, this is often not the case. Instead, they are more likely to be engaging in health education activities; that is, simply providing individuals with health-related information, rather than seeking to empower individuals, families, groups and communities...
October 30, 2018: Nursing Standard
Brian Power
Nurses have a central role in health education and promotion, particularly with regard to supporting individuals to optimise their nutritional intake and engage in healthy eating behaviours. However, high rates of obesity, unhealthy eating behaviours and low levels of physical activity have been found among nurses. Nursing is a challenging profession, and a high workload, a lack of resources and shift work may affect nurses' ability to adopt healthy lifestyles. Supporting nurses to improve aspects of their eating behaviours, such as the nutritional value, timing and frequency of meals, can have a positive effect on their health which, in turn, may enhance their ability to care for patients...
October 24, 2018: Nursing Standard
Ali Taherkhani
This article details a case study of the immediate post-operative care of an elective adult patient who presented in a postanaesthetic care unit. It outlines the systematic ABCDE (airway, breathing, circulation, disability and exposure) approach that was used to assess the patient and describes the actions that were taken to manage an airway obstruction that occurred. It also discusses the monitoring of patients required post-operatively, including capnography, peripheral oxygen saturations, blood pressure, temperature, heart rate and respiratory rate, which can assist in the identification and management of any issues and support optimal patient outcomes...
October 16, 2018: Nursing Standard
Sinéad Kelly, Carolyn Fowler
In September 2016, a team of nurses from East and North Hertfordshire NHS Trust (ENHT) and the University of Hertfordshire in England travelled to Kerala, India to interview and recruit nurses for the trust's acute hospital. Before undertaking the interviews, the team visited a nursing college and two hospitals. Based on the findings from these visits and from meeting the interview candidates, the team designed a bespoke mentoring programme for Keralan nurses recruited to ENHT to ease the transition into nursing and living in the UK...
October 9, 2018: Nursing Standard
Hardip Malhi
The term malnutrition refers to both undernutrition and overnutrition. In healthcare, it most often refers to undernutrition, in particular disease-related malnutrition, which can be a result or a cause of an illness. The reasons for malnutrition are multifactorial, and its consequences may include an increased risk of pressure ulcers, reduced mobility and psychological effects such as depression. It is essential that nurses prioritise the nutritional care of all patients and identify those at risk of malnutrition using accurate and reliable nutrition screening tools...
October 4, 2018: Nursing Standard
Patricia Davies
The heel is a common site for pressure ulcer development, particularly in people who are supine or semi-recumbent because of immobility. There is little protective subcutaneous tissue and no muscle or fascia within the heel, which means that it is vulnerable to pressure, friction and shear forces. Heel pressure ulceration remains a clinical challenge for nurses and the wider healthcare team, as well as a cause of pain and physical debilitation for the patient. This article examines the risk factors for heel pressure ulceration, and details patient assessment and specific measures that can be undertaken to prevent the development of heel pressure ulcers...
October 1, 2018: Nursing Standard
Emily Carne
Chronic spontaneous urticaria is characterised by the spontaneous appearance of hives or wheals, and/or angioedema, lasting for at least six weeks. The condition may be associated with significant physical and emotional burden for patients. Nurses have an important role in the differential diagnosis of chronic spontaneous urticaria, assessing patients' quality of life, providing advice on non-pharmacological measures, monitoring the patient's response to treatment, and referring the patient for specialist care, where appropriate...
October 1, 2018: Nursing Standard
Caroline Barratt
Discussions about the sustainability of the healthcare workforce have placed considerable emphasis on improving the resilience of healthcare professionals. However, when discussed in relation to individuals, the contextual aspects of resilience are often lost. This means that individuals are burdened with the responsibility of increasing their resilience so that they can better manage the challenges they experience, rather than examining the external and environmental factors that can affect resilience. This article explores the concept of resilience and suggests ways in which resilience can be developed by individuals and in collaboration with others, resulting in resilient healthcare teams and organisations capable of supporting individuals effectively...
October 1, 2018: Nursing Standard
Christopher Stephen Clare
Stroke is a leading cause of death and adult disability in the UK. A stroke can have significant negative effects on the lives of patients and their families and carers. While improved stroke management has contributed to a reduction in mortality and improved outcomes following rehabilitation, the incidence of stroke continues to rise in the UK, partly because of the ageing population. Stroke rehabilitation involves a multidisciplinary approach, with nurses performing a central role. This article describes the risk factors and types of stroke, the main areas of stroke rehabilitation and the role of the nurse...
October 1, 2018: Nursing Standard
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