Showing papers in "Nursing times in 2004"

A practical approach to promote reflective practice within nursing.

Abstract: Although reflective practice has been identified as a valuable tool to help nurses recognise their own strengths and weaknesses, many still find it a difficult concept to embrace. This article dispels some of the myths surrounding reflective practice and offers examples of how it can benefit nurses both on a personal and a professional level.

Acute wounds : an overview of the physiological healing process

Abstract: When an injury occurs and the skin is damaged, the process of tissue repair begins immediately, but some wounds can take up to two years or more to heal completely. Healing is usually categorised into stages to aid understanding of the complex physiological processes that are occurring. However, it is a continuous process and different parts of a wound may be at different stages of healing at any one time.

The legal and clinical implications of crushing tablet medication.

Abstract: It has recently been estimated that 75 per cent of all older patients will fail to comply with their medication regimes at some point during their hospital stay (Wright, 2002). Crushing tablets or opening capsules in order to assist a patient with swallowing difficulties appears to be a widespread activity. There may be times when tablets will need to be crushed in order to deliver essential drug therapy; this should only be done as a last resort. Crushing tablets is a practice that has the potential to endanger patient safety and contravene legal and professional requirements.

Up close and personal.

Abstract: An increasing administrative burden can make it difficult to take time away from the lab or office to attend meetings. But personal encounters can be invaluable.

Managing the pain of primary and secondary dysmenorrhoea.

Abstract: Dysmenorrhoea, pain during menstruation, affects 40-95 per cent of menstruating women, and has been reported as the most common causes of regular absenteeism among young women There are two types of dysmenorrhoea: primary and secondary Primary dysmenorrhoea is a painful menstruation with no detectable organic disease and is more common in adolescent women Secondary dysmenorrhoea is painful menstruation that is frequently associated with a pelvic pathology The symptoms that present with dysmenorrhoea, the management and treatment options that are available, and the implications for nursing practice are discussed

Improving the monitoring and assessment of fluid balance.

Abstract: This article reports on a project conducted by final-year students on a preregistration nursing programme. The students explored the potential to improve practice in a clinical area relevant to the trust at which they undertook their clinical placements. It is seen as innovative because it encourages partnership working between the educational institution and the NHS, helps to prepare students for their forthcoming registered nurse status and provides information of real practical value to the trust, enabling it to change and improve an important aspect of care.

Understanding the barriers to multiprofessional collaboration.

Abstract: Multiprofessional collaboration is key to delivering quality patient care. Many developments in health care such as supplementary prescribing or the single assessment process rely on the premise that such collaboration already exists. This article focuses on barriers to interprofessional collaboration and explores whether 'new ways of working' in health care can survive in an environment with a long history of independent disciplines.

Using judgement to improve accuracy in decision-making.

Abstract: Nursing judgements are complex, often involving the need to process a large number of information cues. Key issues include how accurate they are and how we can improve levels of accuracy. Traditional approaches to the study of nursing judgement, characterised by qualitative and descriptive research, have provided valuable insights into the nature of expert nursing practice and the complexity of practice. However, they have largely failed to provide the data needed to address judgement accuracy. Social judgement analysis approaches are one way of overcoming these limitations. This paper argues that as nurses take on more roles requiring accurate judgement, it is time to increase our knowledge of judgement and ways to improve it.

Enabling students to develop confidence in basic clinical skills.

Abstract: An increase in the number of nursing students is making it difficult to guarantee those on the common foundation programme the opportunity to practise basic nursing skills. In order to address this problem a nursing college developed a skills week that enabled students to practise their skills and develop confidence. Simulated clinical situations gave students the opportunity to relate these skills to practice while learning about teamwork and holistic patient care.

Assessing pain at wound dressing-related procedures.

Abstract: This article is an abstract from a new guide, Principles of Best Practice: Minimising Pain at Wound Dressing-Related Procedures. It is an educational initiative of the World Union of Wound Healing Societies (WUWHS). The guide has been inspired by two seminal documents: the European Wound Management Association's position document, Pain at Wound Dressing Changes (EWMA, 2002), and Practical Treatment of Wound Pain and Trauma: A Patient-centred Approach (Reddy et al, 2003). As an international educational initiative, the WUWHS document is aimed at anyone involved in dressing-related procedures anywhere in the world. This article summarises the section on best practice in the assessment of wound pain.

How users and carers view their involvement in nurse education.

Abstract: User and carer participation in health care is central to care planning and delivery. From an educational perspective, their input is beneficial in terms of enhancing the quality of the education process. The study reported in this paper explored the experiences of user and carer participation in nurse education from the perspective of the key stakeholders involved in the process. By pinpointing key issues of concern for participants, the study aims to help inform the ongoing development of practice in this area.

Rheumatoid arthritis: symptoms, diagnosis, and management.

Abstract: Rheumatoid arthritis is the most common inflammatory joint disease and a major cause of disability, morbidity, and mortality It occurs worldwide, affecting approximately one per cent of adults Inflammation of the synovial membrane surrounding a joint leads to swollen, tender, and stiff joints This may be accompanied by fatigue, weight loss, anxiety, and depression Nursing management goals should include the relief of symptoms, preservation of joint function, prevention of joint damage and deformity, maintenance of an acceptable lifestyle, and patient education To achieve these aims the nurse should play a pivotal role within the multidisciplinary team, ensuring the highest quality of care

The physiological effects of smoking on the respiratory system.

Abstract: Knowledge about the harmful effects of smoking on the lungs is high among the general population. This damage can occur to both active and passive smokers. Although scientific understanding in this area is incomplete we do have some knowledge about how individual toxic substances in cigarette smoke act on the lung tissues. There is great variation in smokers' susceptibility to the harmful effects of tobacco dependence. The reasons for this are complex and the role of genetic factors requires more research.

Better preadmission assessment improves learning disability care.

Abstract: Aim This qualitative study explores the experience of hospital admission from the perspective of four different stakeholders: people with a learning disability, their family/carers, hospital staff, and community learning disability nurses. It introduces and evaluates a new preadmission assessment, identifies key factors that influence the process of health care, and compares the results of this study with the current evidence base. Method Process evaluation with multiple stakeholder analysis using semi-structured interviews for data collection. A focus group was used in preparation for the study. Findings Stakeholders were generally positive about their experiences, and the preadmission assessment was well received. Conclusion Preadmission assessment of people with learning disabilities can be helpful to all concerned as it helps the different stakeholders to understand each other and their needs.

Catheter-associated urinary tract infections: primary care guidelines.

Abstract: In primary and community health care settings, long-term (> 28 days) urinary catheterisation (LTC) is most commonly used in managing older people and those with neurological conditions. Studies suggest that in the UK LTC is used in 0.5 per cent of people aged 75 or over (Kohler-Ockmore and Feneley, 1996) and in four per cent of people receiving domiciliary care (Getliffe and Mulhall, 1991). Most health-care associated infections (HAIs) are caused by indwelling urinary catheters (Stamm, 1998). Many of these infections are serious and lead to significant morbidity. In acute care facilities, 20-30 per cent of catheterised patients develop bacteriuria, of whom two to six per cent develop symptoms of urinary tract infections (UTIs) (Stamm, 1998).

Childhood obesity: its incidence, consequences and prevention.

Abstract: In 1998 the World Health Organization declared childhood obesity a 'global epidemic' (WHO, 1998). The Department of Health has identified that prevention must be aimed at children to address its rise in future generations (DoH, 2002). Childhood obesity is recognised as a predictor of adolescent and adult obesity (Smith, 2002; Parsons et al, 1999; Whitaker et al, 1997). Without intervention to prevent the growing trend of childhood obesity there is a risk of increasing economic cost and human suffering in future generations (Laing, 2002).

Assessing the value of the internet in health improvement.

Abstract: The internet is a powerful tool that provides easy access to information Many people access it for health information and bring the material gathered to health appointments However, the information may not always be correct or adequately monitored for quality This could lead to some of it being harmful This article examines whether or not the internet will enable us to lead healthier lives The need for a quality label, how professionals must become adept at using the internet, the possibility of a digital divide exacerbating health inequalities and the dangers of misusing the internet's interactive elements are examined

Barriers to the provision of effective pain management.

Abstract: Despite major advances in the management of pain since the Royal College of Surgeons and the Royal College of Anaesthetists announced in 1990 that postoperative pain management in British hospitals was inadequate, pain continues to be an unacceptable but common sequel to surgery (Wood, 2002). Pain assessment is simple, but unfortunately it is infrequently performed. When clinicians do not obtain pain ratings from patients they are unlikely to underestimate the patients' pain. Improving pain management requires that pain is recognised as a priority and that nurses are encouraged to play an active and pivotal role within the multidisciplinary team to recognise, prevent and treat it.

The use of phosphate enemas in the treatment of constipation.

Abstract: Phosphate enemas are commonly used by community nurses in the treatment of constipation. This article reports on a literature review of evidence relating to their use. No evidence was found to support the use of these enemas conclusively, although a number of articles reported risks, contraindications, and complications. Phosphate enemas should therefore be used with caution and nurses should be aware of the contraindications associated with their use.

Listening to carers talking about the subjects of continence and toileting

Abstract: Toilets and continence play critical roles in the lives of people who care for a relative at home. Issues around toileting are central to the relationship between the carer and the person being cared for, with the bathroom often becoming the most important place in the house.

Factors influencing the selection of appropriate pain assessment tools.

Abstract: Pain is one of the most complex human experiences. Nurses have a moral, ethical, humanitarian and professional responsibility to provide an adequate standard of pain assessment and documentation. In order to obtain an accurate pain assessment from patients, they need to feel that their expression of pain will be listened to, accepted and acted on. It is therefore vital that nurses are educated in the process of pain assessment.

Understanding the experience of training for overseas nurses.

Abstract: AIM To explore the perceptions of overseas nurses during their induction programme. SAMPLE A pilot cohort of 20 overseas nurses. METHOD A qualitative research approach was used. RESULTS The key themes were: communication issues, culture, role definition and feelings of self-worth, which are interrelated and suggest how the experience has influenced each nurse's professional development and ultimate achievement of 'competence' as a registered nurse able to practise in the UK. CONCLUSION These findings confirm there is a need for greater understanding of the 'adjustment process' and integration into the workforce. Recommendations are made that for future projects to succeed, comprehensive support frameworks are required to fully support both the overseas nurse and the organisation as a whole.

Why good communication skills are important for theatre nurses.

Abstract: Excellent communication skills, both verbal and nonverbal, are needed throughout the perioperative experience to educate patients undergoing surgery and so ease their anxiety. In addition, good communication with theatre colleagues, the multidisciplinary team, and other departments is vital to achieve technical excellence and individualised, holistic patient care. This article discusses the importance of effective communication and describes how it can be improved in the perioperative setting.

Using decision trees to aid decision-making in nursing.

Abstract: This article discusses judgement and decision-making in nursing. It outlines an approach to analysing clinical problems known as decision analysis. It suggests decision analysis can be a useful technique for nurses to assist them with decision-making in practice.

How to ... manage stress.

Abstract: • Manage Stress: A Healthy Living Message http://www.prevention.va.gov/Manage_Stress.asp • Manage Stress Workbook http://www.prevention.va.gov/MPT/2013/ManageStr essWorkbook_Dec2013.pdf • Pleasant Activities Tip Sheet http://www.prevention.va.gov/MPT/2013/PleasantAc tivitiesTipSheet_Dec2013.doc • Relaxation Recordings (links to these recordings will be provided at a later date) • Suicide Prevention http://www.prevention.va.gov/MPT/2013/SuicidePre vention_Dec2013.doc • Limit Alcohol: A Healthy Living Message http://www.prevention.va.gov/Limit_Alcohol.asp

Improving pain management for patients in a hospital burns unit.

Abstract: The pain caused by burns can be unpredictable and its management is complex. In order to minimise the discomfort experienced by burns patients, it is important that health care professionals understand the principles of analgesia and the importance of delivering the right drugs at the right time. An audit in a burns unit revealed that nursing and medical staff lacked confidence in prescribing and administering analgesia, and as a result patients were experiencing uncontrolled pain. A new system of pain assessment and management was developed with an accompanying education programme, which resulted in improved pain management.

The management of acute upper gastrointestinal bleeding.

Abstract: Acute upper gastrointestinal (GI) bleeding is one of the most common medical emergencies and most cases require urgent medical assessment. Half of all cases are due to peptic ulcer and this article focuses on non-variceal bleeding. The priority, following emergency hospital admission, is to support the circulation of the shocked patient rather than to identify the source of bleeding. After resuscitation the patient can have an endoscopy procedure. It is important that all nurses are fully aware of the signs, symptoms, and management of acute upper GI bleeding, issues that are all addressed in this article.