Showing papers in "British journal of nursing in 2011"
TL;DR: The fragility of the adult social care market and the pressure on primary care services are now beginning to impact both on the people who rely on these services and on the performance of secondary care, and the evidence suggests the authors may be approaching a tipping point.
Abstract: SUMMARY 2 Foreword This year's State of Care report shows that, despite increasingly challenging circumstances, much good care is being delivered and encouraging levels of improvement are taking place. However, the sustainability of this position is in doubt. We are also beginning to see some evidence of deterioration in quality, and some providers who are struggling to improve their rating beyond 'requires improvement'. The fragility of the adult social care market and the pressure on primary care services are now beginning to impact both on the people who rely on these services and on the performance of secondary care. The evidence suggests we may be approaching a tipping point. The combination of a growing and ageing population, people with more long-term conditions and a challenging economic climate means greater demand on services and more problems for people in accessing care. This is translating to increased A&E attendances, emergency admissions and delays to people leaving hospital, which in turn is affecting the ability of a growing number of trusts to meet their performance and financial targets. While large numbers of care homes and home care agencies are providing good quality care – and three-quarters of those that we had rated as inadequate, and then re-inspected, improved – this still left a quarter of services originally rated inadequate that did not improve enough to change their overall rating on re-inspection. Through our market oversight function in adult social care, we also know that profit margins are reducing – both due to pressures on fees, and cost pressures that include the national living wage. Already we are seeing some providers starting to hand back home care contracts as undeliverable; local authorities predict more to come. Until recently, the growth in demand for care for people with greater care needs had been met by a rise in the number of nursing home beds, but this bed growth has stalled since April 2015. The financial challenges in the NHS have been extensively documented. Despite this, we have found much good and outstanding care – particularly in children's and young people's services and critical care – which we highlight and celebrate. We have given outstanding ratings to five acute trusts and two mental health trusts, and five trusts have exited special measures since April 2015. However, we have also found too much acute care that we rated inadequate – particularly urgent and emergency services and medical …
191 citations
TL;DR: There is a discrepancy between how leading undergraduate nursing programmes prepare students primarily in the transition of education to practice, and the suggestion from a number of nursing publications that leadership in nurses should be fostered throughout their education.
Abstract: This article provides an introduction to the issue of nursing leadership, addressing definitions and theories underpinning leadership, factors that enhance leadership in nursing, and the nature of leadership content taught in undergraduate programmes. Highlighted are differences between leadership and management, and the notion that leadership can be ‘learned’. The authors also point out that there is a discrepancy between how leading undergraduate nursing programmes prepare students primarily in the transition of education to practice, and the suggestion from a number of nursing publications that leadership in nurses should be fostered throughout their education.
162 citations
TL;DR: This article presents how evidence may be introduced into practice using the Iowa model, offering practical advice and explanation of the issues concerning nurses in practice.
Abstract: Evidence-based practice has gained increasing popularity in all healthcare settings. Nurses are urged to use up-to-date research evidence to ensure better patient outcomes and inform decisions, actions and interactions with patients, to deliver the best possible care. Within the practice setting, there is an increasing challenge to provide clearly measurable care of the highest quality, which is evidence-based. In order for nurses to operate from an evidence-based perspective, they need to be aware of how to introduce, develop and evaluate evidence-based practice. This article presents how evidence may be introduced into practice using the Iowa model, offering practical advice and explanation of the issues concerning nurses in practice.
116 citations
TL;DR: Almost half of the sample failed to meet public health recommendations for levels of physical activity, almost two-thirds did not consume five portions of fruit or vegetables daily and almost half ate foods that were high in fat and sugar content on a daily basis.
Abstract: This study examined the health behaviour of nursing staff, comparing registered and pre-registered nurses in terms of their selfreported health and lifestyle behaviour. In total, 325 pre-registered nurses and 551 registered nurses, based at the same university teaching hospital and located within an acute NHS trust, completed a self-administered health and lifestyle questionnaire survey. With the exception of smoking behaviour, registered nurses generally had a healthier lifestyle compared with pre-registered nurses. However, when examining the overall health profile of the sample, the study reveals that there is room for improvement in the health and lifestyle behaviour exhibited by both registered and pre-registered nurses. Almost half of the sample failed to meet public health recommendations for levels of physical activity, almost two-thirds did not consume five portions of fruit or vegetables daily and almost half ate foods that were high in fat and sugar content on a daily basis. These findings are alarming given the current government emphasis on the health of NHS staff and the important role that nurses play in influencing lifestyle choices among their patients. There is an urgent need to target education and support services to improve the diet and exercise habits of nursing professionals.
97 citations
TL;DR: The death of patients does have an impact on nurses, and education around grief theory and support from others are helpful for staff in developing strategies for coping with patient deaths.
Abstract: There were 509 090 deaths recorded in England and Wales for 2008 (Office for National Statistics, 2010); of these, over 56% (260 000) occurred in NHS hospitals. The death of a patient is an event that most, if not all, nursing staff will encounter during their work. This experience can elicit physical, cognitive, behavioural, spiritual and emotional responses (Parkes, 1998). Aim: The aim of this literature review is to explore how the death of patients in a hospital setting impact on nursing staff. Method: A review of the literature was undertaken using the online databases CINAHL, Medline and Psych Info. The search was limited to articles in the English language and those from peer-reviewed journals. Results: Themes arising from the literature review included: the theoretical context; the emotional impact; the culture of the healthcare setting; staff's previous life experiences; and support available for healthcare staff. Conclusions: The death of patients does have an impact on nurses. This can affect t...
94 citations
TL;DR: Until a common language of spirituality is developed, models of spiritual care developed through research involving mainly nursing staff will be difficult for nurses to apply.
Abstract: Spirituality in nursing care has been discussed for many years in the nursing press. There has been no literature review that explores only UK literature, and this article updates a literature review carried out in 2006 (Ross, 2006). Aim: The review was designed to investigate the current nursing evidence underpinning the concept of spirituality and its application. Method: A systematic review of the literature was undertaken and a thematic analysis performed following a search for literature using defined dates, databases and search terms. Results: Four major themes emerged from the literature: concept clarification; spiritual care-giving; religion and spirituality; and nurse education. Conclusion: Definitions of spiritual care vary, and the concept of spirituality in nursing is still under development. However, until a common language of spirituality is developed, models of spiritual care developed through research involving mainly nursing staff will be difficult for nurses to apply.
89 citations
TL;DR: It is concluded that there is enough validation research, and in line with the majority of these studies' recommendations, future research should focus on the utility of DT as part of a structured distress management programme.
Abstract: The Distress Thermometer (DT) is a well validated screening tool, demonstrably sensitive and reasonably specific to the construct of distress in cancer. Its brevity makes it ideal to incorporate into a system of distress management. To ascertain how far this idea has been developed in practice, and to support future research, a literature review was undertaken. Medline, CINAHL, PsycINFO, Embase, ASSIA, British Nursing Index, AMED, CCTR, and HMIC were systematically searched. Forty studies were reviewed that examined the function of the DT alone, together with the problem list (PL), and/or other validated measures. The majority of studies validated the DT against other robust measures of distress in order to establish 'caseness' in these populations, and establish factors associated with distress. Many of the studies recommended that further research should test their findings in clinical practice. A small section of the literature focused on the clinical utility of the DT as a facilitator of consultations, and found it to have potential in this regard. It is concluded that there is enough validation research, and in line with the majority of these studies' recommendations, future research should focus on the utility of DT as part of a structured distress management programme.
87 citations
TL;DR: Results from a qualitative study exploring mentors' reluctance to refer students who did not perform adequately in clinical settings suggest the need for mentors to have greater confidence in their own clinical abilities.
Abstract: This article reports findings from a qualitative study exploring mentors' reluctance to refer students who did not perform adequately in clinical settings. A focus group and individual semi-structured interviews were undertaken with experienced stage two mentors in an NHS trust. Mentors spoke of having to balance objectivity and intuition when dealing with upset or angry students, those who were popular or those who tried hard but did not perform adequately. They describe a number of factors that led them to pass a student who was less than satisfactory. In particular the findings highlight difficulties with measuring and recording attitudes. The data demonstrate the willingness and motivation of mentors to keep up to date and learn from their students. However, findings also suggest the need for mentors to have greater confidence in their own clinical abilities. Recommendations are made for training strategies to address these barriers in order to ensure that only competent, caring nurses are allowed to register.
79 citations
TL;DR: The role and impact of training and education on nursing leadership has been identified as much needed, and can be provided by universities, healthcare organizations or hospitals.
Abstract: This is the second of two articles on developing leadership in nursing; this article explores the role and impact of training and education on nursing leadership. Nursing leadership education has been identified as much needed, and can be provided by universities (at Masters, diploma and certificate levels), healthcare organizations or hospitals. Research demonstrates that where leadership has been effectively taught and integrated into nursing, it has a positive impact on nurses' leadership skills and practice. It is suggested that healthcare organizations continue to develop and support leadership training, while also seeking ways of maintaining and promoting leadership development in practice.
74 citations
TL;DR: An overview of the literature on record-keeping practice is provided and what makes good quality record keeping and the factors that prevent nurses from achieving good documentation standards are examined.
Abstract: Record keeping is an essential part of nursing practice with clinical and legal significance. Good quality record keeping is linked with improvements in patient care, while poor standards of documentation are regarded as contributing to poor quality nursing care. The quality of nursing documentation has consistently been found to be failing to meet recommended standards. This article will provide an overview of the literature on record-keeping practice and examine what makes good quality record keeping and the factors that prevent nurses from achieving good documentation standards. This article will also look at ways that documentation standards can be improved and the impact that accountability has on the record-keeping practices of nurses.
50 citations
TL;DR: This paper reports on a study to determine the incidence of phlebitis related to peripheral cannulae, and its predisposing factors in a general surgery department, which used descriptive, inferential, and correlational analysis.
Abstract: This paper reports on a study conducted to determine the incidence of phlebitis related to peripheral cannulae, and its predisposing factors in a general surgery department. Phlebitis is a serious health problem that affects a large proportion of hospitalized patients receiving intravenous therapy. A data collection tool was developed based on the previous literature and was completed between 15 October and 30 November 2010 in a general surgery department. All patients with peripheral cannulae who fulfilled the inclusion criteria, and who agreed to participate in the study where monitored. This was a quantitative study, which used descriptive, inferential, and correlational analysis. A total of 171 patients and 286 peripheral cannulae were monitored. The average incidence of phlebitis was 61.5%, and factors such as diabetes and tobacco consumption were identified as relevant to the development of phlebitis. Other elements identified as predisposing to the development of phlebitis include administration of potassium chloride, the dwell time of the peripheral cannula, and the anatomical location of the cannula. Phlebitis associated with peripheral cannulae is still a current problem requiring knowledgeable staff who can prevent, recognize and act appropriately in a timely manner to minimize its severity.
TL;DR: The overall aim of the project was to explore the merits of Twitter as a tool to scaffold learning and engage nursing students in reflection and clinical decision making.
Abstract: In 2010, the Joint Information Systems Committee (JISC) funded a project to explore the usefulness of Twitter as a teaching tool. The project, which was based at the Clinical Simulation Centre at the University of Glamorgan, involved the creation of four short, videoed clinical scenarios and used a high-fidelity mannequin-based simulator. A group of twelve learners on a BSc Critical Care course accessed these videos asynchronously and were encouraged to ‘tweet’ very short messages on the evolving condition of the patient in the videos, on key clinical decision points or respond to specific questions posted by the tutors. Another group of learners on a pre-registration nursing course used Twitter in a synchronous, face-to-face classroom environment and also tweeted their responses to the videos. The overall aim of the project was to explore the merits, or otherwise, of Twitter as a tool to scaffold learning and engage nursing students in reflection and clinical decision making.
TL;DR: An introduction to the concept of nutrition is provided, an overview of nutritional guidelines and nutritional screening tools which identify those at risk of malnutrition are provided and challenges and opportunities encountered are debated to help nurses ensure adequate patient nutrition.
Abstract: The nutritional care of patients is one of the primary responsibilities of all registered nurses (Persenius et al, 2008). A poor nutritional status can lead to malnutrition, which can have serious consequences for an individual's quality of life (Field and Smith, 2008). This paper commences with an introduction to the concept of nutrition, provides an overview of nutritional guidelines and nutritional screening tools which identify those at risk of malnutrition. It reviews the literature on nurses' knowledge, attitudes and practices in the provision of nutritional care and debates challenges and opportunities encountered to help nurses ensure adequate patient nutrition.
TL;DR: The role and responsibilities of the mentor in supporting pre-registration nursing students in clinical practice will be provided, including the importance of recognizing and supporting the failing student.
Abstract: Facilitating the learning of student nurses in the workplace is an integral role of the registered nurse. This article aims to provide an overview of the role and responsibilities of the mentor in supporting pre-registration nursing students in clinical practice. The professional obligations for the mentor to meet the Nursing and Midwifery Council (NMC) standards (NMC, 2008a) will be explored, including the ongoing requirements to keep up to date in mentoring practices. Some of the challenges within the role will be identified, including the importance of recognizing and supporting the failing student. Recent changes to the preparation requirements for sign-off mentors will be discussed. The article concludes by presenting the potential benefits to both the individual and the practice placement provider.
TL;DR: The author conducted a systematic review of the literature using qualitative methods and seven research papers were selected for review, in which physiological measures were used in the assessment of neonatal pain.
Abstract: Neonatal pain assessment is not standardized. Clinicians may use various parameters in the measurement of pain which can lead to different interpretations. Currently, there is no validated biological marker for assessing infant pain in any age group. However, in the non-verbal patient, the most feasible way to assess pain may be by evaluation of physiological parameters. The author conducted a systematic review of the literature using qualitative methods and seven research papers were selected for review, in which physiological measures were used in the assessment of neonatal pain. Heart rate was the most frequently used physiological pain measure in these studies. Oxygen saturation, blood pressure and respiratory rate lacked sensitivity and specificity and cannot be used independently. These measures may detect pain but cannot quantify it and are, therefore, not useful assessments of chronic pain. The multidimensional approach to pain assessment may be the most appropriate owing to the correlation between behavioural and physiological indicators of pain in the neonate.
TL;DR: It was concluded that staff nurses in the study site hospitals lack confidence, trust and satisfaction with the current style of leadership, and it is recommended that effective leadership training be instituted for prospective nurse managers before appointments are made into management and administrative positions.
Abstract: The purpose of this study was to explore the nature of leadership styles used by nurse managers, and describe staff nurses' perceptions of leadership styles. Effective leadership among nurse managers has been associated with staff nurse job satisfaction and retention. Twenty staff nurses from two hospitals in Ghana responded to tape-recorded interview questions. Four themes emerged from inductive analysis of the data. Findings suggest that nurse managers employed intimidation and minimal consultation to control their employees. The study further indicated that nurse managers were perceived as 'figure-heads', who are weak and inarticulate at the level of policy planning and implementation. It was therefore concluded that staff nurses in the study site hospitals lack confidence, trust and satisfaction with the current style of leadership. Staff nurses preferred a more proactive, articulate and independent nursing leadership at the top level. It is recommended that effective leadership training be instituted for prospective nurse managers before appointments are made into management and administrative positions.
TL;DR: A study to examine service users' views on an enhanced recovery programme (ERP) for colorectal surgery patients, in order to improve service provision and indicated that the ERP offers clear benefits.
Abstract: This article describes a study carried out to examine service users' views on an enhanced recovery programme (ERP) for colorectal surgery patients, in order to improve service provision. Background: ERPs combine elements to enhance patients' recovery before, during and after surgery, but patient experiences are unknown. Method: 50 patients were invited to attend one of three focus groups in May and June 2009. Findings: Ten users attended the focus groups. All were generally very satisfied with the ERP, primarily because they could leave hospital quickly and felt empowered to take charge of their own recovery. Areas of concern included support after discharge, postoperative diet and achieving optimum analgesia following discontinuation of continuous analgesic infusions. Conclusions: This patient sample indicated that the ERP offers clear benefits. Feedback was turned into realistic action plans, concerns were addressed and the service enhanced. Obtaining feedback is vital for improving the quality of care ...
TL;DR: Not all students respond positively to simulated activity, which should be used to augment clinical practice and not replace it, so the quality of the simulation enables the educational experience to be positive for students.
Abstract: A variety of approaches to teaching and learning are required to encompass the complexity of nursing. Simulated practice involves computer-based simulated environments, human patient simulation and role play, enabling multiple learning objectives to be taught in a realistic clinical environment without harming patients. The Nursing and Midwifery Council recognizes the use of simulated practice and has enabled higher education pre-registration nurse programme providers to incorporate a maximum of 300 hours of simulated practice as part of the 2300-hour practice hours component. However, not all students respond positively to simulated activity, which should be used to augment clinical practice and not replace it. It is important to ensure the quality of the simulation enables the educational experience to be positive for students.
TL;DR: A broad definition of advanced practice should be broadly defined in ways which include and embrace not only clinical practice, but also other domains such as education, management and leadership, to support the view that the risks around AP are minimal.
Abstract: For many years, nurses have sought to define advanced practice (AP). There is now a developing consensus that it should be broadly defined in ways which include and embrace not only clinical practice, but also other domains such as education, management and leadership. This broad definition is congruent with Benner's notion of the novice to expert trajectory and lends support to the view that the risks around AP are minimal, since advanced practitioners by definition have expertise. The broad model of AP, however, ignores one distinct subset of advanced practice nurses who we term nurse practitioners (NPs). NPs are distinct because of their hybrid, quasi-medical practice, which crucially involves autonomous medical diagnosis and treatment. The risks in this area of practice are substantial, and consequently require nothing less than a nationally-regulated set of benchmarks. These must address the training, assessment and registration of NPs for the primary purpose of public protection.
TL;DR: Optimal and equitable patient access to CNS care will require the development of a strong evidence base showing that specialist nurses not only deliver patient-focused care, but that they can also help to meet healthcare managers' objectives of streamlined, cost-effective clinical services.
Abstract: Despite emerging evidence for the clinical and financial efficacy of the clinical nurse specialist (CNS), the provision of this role is patchy across the country. There is also a risk that incumbent CNS' may be redirected to less specialist work in trusts that do not appreciate the full value of the service that these nurses provide. Optimal and equitable patient access to CNS care will require the development of a strong evidence base showing that specialist nurses not only deliver patient-focused care, but that they can also help to meet healthcare managers' objectives of streamlined, cost-effective clinical services.
TL;DR: Findings indicate that support is the most important aspect of the transition experience for these nurses.
Abstract: Aim: This paper reports a study that explored the lived experiences of newly qualified registered children's nurses (RCN) in their transition from postgraduate student nurse to staff nurse. Research question: What are the experiences of newly qualified RCNs in their transition from postgraduate student nurse to staff nurse? Methods: A qualitative phenomenological approach was chosen for the study and six newly qualified RCNs were interviewed. Data analysis was based on the work of Coliazzi (1978) who devised a seven-step approach to assist the analysis within phenomenological inquiry. Results: Findings indicate that support is the most important aspect of the transition experience for these nurses. Mentorship and preceptorship programmes facilitate support during the transition period and previous experience prescribes the amount of support required by the newly qualified RCN. Conclusion: In highlighting the experiences of newly qualified RCNs in their transition from postgraduate student nurse to staff n...
TL;DR: Parkinson's is a incurable progressive neurological condition caused by a degeneration of dopamine-producing cells; the most common symptoms include slowness of movement, tremor and muscle stiffness; other symptoms include sleep difficulties, depression and anxiety.
Abstract: Parkinson's is a incurable progressive neurological condition caused by a degeneration of dopamine-producing cells. The most common symptoms of the condition include slowness of movement, tremor and muscle stiffness; other symptoms include sleep difficulties, depression and anxiety. Parkinson's is usually controlled by medication but other treatments and therapies, such as occupational therapy, physiotherapy and speech and language therapy, can also be effective in controlling and managing symptoms. The timing of this medication is key to the successful management of Parkinson's. Delays to initiating medication or missed doses can have serious consequences, and it can take some time for symptoms to stabilize. Research into treatments for Parkinson's and, ultimately, finding a cure for the condition, is ongoing. Parkinson's UK researchers are working on projects to identify the causes of cell death and tests to detect the condition at its earliest possible stage. Current treatments can help to ease the sym...
TL;DR: The aim of this article is to provide a brief update on recent developments regarding the differentiation between pressure ulcers and IAD and the prevention of IAD.
Abstract: Incontinence-associated dermatitis (IAD) is a common skin disorder in patients with faecal and/or urinary incontinence The past decade has seen a huge growth in publications focusing on the complexity and inconsistency of the clinical observation of IAD and the differentiation between IAD and pressure ulcers IAD and superficial pressure ulcers cause confusion in clinical practice when trying to determine the true nature and underlying pathology of the lesion It is a daily challenge for health professionals in hospitals, nursing homes and community care to maintain a healthy skin in patients with incontinence The aim of this article is to provide a brief update on recent developments regarding the differentiation between pressure ulcers and IAD and the prevention of IAD Recommendations for clinical practice and research are provided
TL;DR: A longitudinal exploratory study explored patients' search for meaning in life across the first 5 years following myocardial infarction, finding meaning appeared to increase patients' awareness of their current holistic state of life, and to provide impetus for making lifestyle changes.
Abstract: Finding meaning in illness appears to give individuals purpose in life, which may motivate them to maintain a healthy lifestyle. Research to date has mainly used cross-sectional designs in the acute phase of recovery. This article describes a longitudinal exploratory study which explored patients' search for meaning in life across the first 5 years following myocardial infarction (MI). Interviews were conducted between 2000 and 2007 on patients with first MI (n=70; mean=61.9 years; SD=12.1). The qualitative data underwent thematic analysis guided by the analysis framework of Burnard (1991). Finding meaning appeared to increase patients' awareness of their current holistic state of life, and to provide impetus for making lifestyle changes. In the immediate aftermath of MI, patients restructured and re-evaluated their attitudes towards self, life, religious beliefs and others. However, from the third year onwards, as time passed patients lapsed in their behaviour, tending to become non-compliant with treatment and less aware or concerned about the risk of another heart attack. Further education on the spiritual dimension in care may guide nurses and health professionals in order to promote patients' rehabilitation process and persevere with a long-term healthy lifestyle. Further longitudinal comparative research with mixed method approach on various groups of patients is recommended to support these findings.
TL;DR: Enhanced recovery is described, aspects of nursing knowledge that can have a positive influence, and practical changes to assist the development of enhanced recovery programmes are outlined, thereby benefiting all patients undergoing elective surgery.
Abstract: Patients undergoing surgery in the UK are seeing a rise in the development of enhanced recovery programmes as a result of increasing medical advances. Enhanced recovery is concerned with helping patients get better sooner after an operation by following a meticulous regime of care. The practical application of these programmes is undertaken largely by nurses, despite encompassing explicit, medically-driven protocols. However, beyond the professional knowledge and skills required to aid the programmes, nursing knowledge has contributed little to this rapidly developing aspect of surgery to date. Nursing has much to offer through future creation of centrally coordinated, surgical nursing units focusing on patients' holistic experience. This article will briefly describe enhanced recovery, identify aspects of nursing knowledge that can have a positive influence, and outline practical changes to assist the development of such programmes, thereby benefiting all patients undergoing elective surgery.
TL;DR: If nurses, doctors and other health professionals are exposed to good quality patient safety education at an early stage in their careers, they will hopefully become positive patient safety advocates and agents of change.
Abstract: It is well known that the best time to influence a person’s behaviour is when they are young As we grow older we become more set in our ways, less amenable to influence, and less able to cope with change This reasoning also applies to the concept of patient safety If nurses, doctors and other health professionals are exposed to good quality patient safety education at an early stage in their careers, they will hopefully become positive patient safety advocates and agents of change This is the reasoning behind the global release of the World Health Organization’s (WHO) multiprofessional Patient Safety Curriculum Guide (the guide), (WHO, 2011), which states:
TL;DR: A podiatrist perspective of the management of diabetic foot problems, from initial assessment to the managementof complex foot disease is offered.
Abstract: Diabetic foot problems are a common complication of diabetes mellitus and can lead to morbidity and mortality. Foot disease is the leading cause of non-traumatic lower-limb amputation in the developed world (National Institute for Health and Clinical Excellence (NICE), 2004). Diabetic foot disease is a result of three main pathologies, which can occur singly or in combination. These are: peripheral neuropathy, peripheral arterial disease and infection. Consequences of these pathologies are ulceration, Charcot foot, painful neuropathy, gangrene and amputation (NICE, 2004). This article offers a podiatrist perspective of the management of diabetic foot problems, from initial assessment to the management of complex foot disease. Patients with a diabetic foot problem must be assessed thoroughly and referred to the local multidisciplinary team, where appropriate (NICE, 2004). Recurrence of ulcers is common, and therefore good foot health education, adequate footwear and regular podiatry, if required, must be a...
TL;DR: The value of SMARs and in particular the advantages of using the single-use Appeel Sterile Sachet are discussed, which provides an adhesive remover suitable for use on broken skin.
Abstract: Silicone Medical Adhesive Removers (SMARs) have proved a valuable addition to formularies. In the absence of SMARs, trauma following removal of adhesive dressings, ostomy products, retention tapes and monitoring equipment can lead to skin stripping or extension of existing wounds. Those at increased risk of skin stripping include groups such as older people, premature infants and neonates and those with skin fragility syndromes. Appeel® Sterile Sachet (CliniMed) is a sterile SMAR in liquid form supplied in a single-use sachet. The addition of this sterile product to the existing Appeel range of wipes and aerosols provides an adhesive remover suitable for use on broken skin. Unlike delivery from an aerosol, Appeel Sterile Sachet does not feel cold on application, a sensation which can be confused with pain. This article discusses the value of SMARs and in particular the advantages of using the single-use Appeel Sterile Sachet.
TL;DR: Students' responses to items that related to perceived confidence and competence levels were positive, indicating that the introduction of clinical skills teaching and assessment within a university's simulation suites augmented with structured assessment within the clinical environment improved the acquisition ofclinical skills.
Abstract: Aim: To investigate students' perspectives on their skills acquisition and knowledge during the foundation year of their nursing programme, and whether this improved students' levels of competence and confidence. Method: Two groups of nursing students (n=140) responded to a clinical acquisition skills survey (CASS) to elicit their perceptions of clinical skills acquisition. Additionally, students' competence levels were examined, drawing comparisons with the students' objective, structured clinical examination (OSCE) results. Results/Findings: Students identified that the curriculum supported the acquisition of clinical skills, and clinical examination results confirmed that 95% of students were competent to pass their OSCE. Conclusion: Students' responses to items that related to perceived confidence and competence levels were positive. This indicates that the introduction of clinical skills teaching and assessment within a university's simulation suites augmented with structured assessment within the clinical environment improved the acquisition of clinical skills.
TL;DR: Nurses are asked to carefully consider the risks posed by online social media with a focus on boundary crossing in an e-society.
Abstract: Nurses, like the rest of the world's population are increasingly participating in online social media. Nurses must be mindful to avoid situations that could ultimately compromise past, present and future patient health and wellbeing, as well as their professional identities and reputations and that of the nursing profession. Unprofessional uses of social networking tools are common. This article aims to inform nurses of the public accessibility to professionally inappropriate online behaviour and activities. It asks nurses to carefully consider the risks posed by online social media with a focus on boundary crossing in an e-society. Forethought is required to ensure that private information stays private and that the nature of the professional relationship between nurse and patient continues to be respected.