Nursing standard (Royal College of Nursing (Great Britain) : 1987)最新文献

Hypoglycaemia, or low blood glucose, is a common and potentially dangerous health condition. It is primarily associated with diabetes mellitus but can also occur in individuals without diabetes due to other health conditions or lifestyle factors. Prompt recognition and treatment of hypoglycaemia are crucial to managing the symptoms and preventing complications. Prevention of further hypoglycaemic episodes in individuals with diabetes requires identifying the underlying causes and risk factors, providing patient education, and careful monitoring of blood glucose levels - in some cases using digital technologies. This article discusses blood glucose regulation and the causes, symptoms and complications of hypoglycaemia. It also explains how nurses can support people to self-manage their diabetes to reduce the risk of further hypoglycaemic episodes. Education, individualised management and effective communication between the patient and healthcare professionals are essential for the provision of optimal care and prevention of adverse outcomes.

Infective endocarditis is a serious and potentially life-threatening cardiac infection which affects the endocardial (inner) layer of the heart and primarily involves the heart valves. It is most often caused by a bacterial infection, with Gram-positive streptococci, staphylococci and enterococci being the most common pathogens. Where the condition is known to have been caused by bacteria, it is referred to as bacterial endocarditis. While it is still a relatively rare condition, the numbers of infective endocarditis cases and associated mortality have increased over the past 30 years, making it a global public health concern. This article provides an overview of the anatomy and pathophysiology, epidemiology, aetiology, diagnostic criteria, clinical presentation, treatment and management of bacterial endocarditis. The article focuses on bacterial endocarditis but uses the term infective endocarditis when discussing the condition in general.

The management of chronic conditions requires a careful approach to optimise patients' health outcomes. Exacerbations of chronic obstructive pulmonary disease (COPD) can have debilitating physical effects on patients, negatively affecting their quality of life and causing or worsening psychological distress. Many risk factors that lead to COPD exacerbations are modifiable, and proactive management can prevent their recurrence. Informed by research and clinical guidelines, this article explains how to optimise patients' long-term health outcomes, enhance symptom management and reduce hospital readmissions. It also discusses the importance of a comprehensive nursing assessment, multidisciplinary team input, self-management strategies and patient education. The article uses a case study to explore the hospital-based management of a patient experiencing a COPD exacerbation.

This article explores how nursing ethics can be informed by the experiences and perspectives of lesbian, gay, bisexual, transgender and queer or questioning plus (LGBTQ+) people. It discusses research on cancer disparities for LGBTQ+ patients, demonstrating the need for culturally tailored interventions. Research in this area often has a narrow focus on improving care for marginalised groups, rather than considering what dominant healthcare approaches could learn from these groups. Through examining queer theory and areas such as human immunodeficiency viruses (HIV) and acquired immunodeficiency syndrome (AIDS) activism, the author advocates for a 'queer ethics of care' that challenges the way traditional healthcare hierarchies manage events such as the recent mpox (formerly known as monkeypox) outbreak.

Bleeding disorders are rare congenital conditions where a person's blood does not clot correctly. The most common of these disorders is von Willebrand disease and the most well-known is haemophilia. However, less is known about rare bleeding disorders (RBDs), which collectively comprise a significant proportion of all bleeding disorders. Nurses across all fields and specialties may encounter and care for patients with RBDs. This article provides an overview of these disorders including the different types, diagnosis and treatment. It also discusses the psychosocial challenges and treatment obstacles that individuals with these conditions and their families may experience.

Advance care planning supports decision-making autonomy for patients at the end of life. However, research has shown that the uptake of advance care planning is often low among people from minority ethnic backgrounds. This article explores the systemic and intracultural barriers experienced by people from minority ethnic backgrounds when planning care at the end of life. The author also offers a conceptual framework to support greater equity and access to advance care planning in these populations.

There has been a significant transformation in the way that obesity is conceptualised, moving away from notions of individual responsibility and moral failure towards acceptance that it is a complex, progressive and relapsing chronic disease. The way in which obesity is defined or understood has significant implications for clinical practice and patient care. Therefore, it is essential that nurses continue to develop their knowledge of obesity-related theory, practice and clinical guidelines to enable them to provide compassionate, person-centred and evidence-based care and support to patients. This article provides an overview of contemporary concepts of overweight and obesity and the associated influencing factors. The authors also discuss concepts of weight bias and weight stigma and provide practical guidance for nurses on the delivery of person-centred care of individuals with overweight or obesity.

Nurses' well-being is essential for delivering high-quality patient care. The workplace environment significantly influences nurses' physical and mental health and well-being, with consequences in terms of job satisfaction and staff retention. This article explores the characteristics of a healthy workplace for nurses, examines barriers such as bullying and cultural norms, and outlines evidence-based strategies to foster an inclusive professional environment. The author also discusses how to support newly registered nurses and adopt positive leadership behaviours to enhance colleagues' well-being and promote positive workplace cultures.

Rationale and key points: Pressure ulcers are considered a preventable harm, therefore all patients receiving care from a healthcare professional should be screened for risk of pressure ulcers. This includes undertaking a skin inspection to identify areas at risk of, or with existing, pressure ulcers. This 'How to' article explains how to identify and categorise a pressure ulcer using a validated classification system. Nurses undertaking this procedure must ensure they have the knowledge and skills to do so effectively and work within the limits of their competence. • Pressure ulcers can have significant adverse effects on patients' quality of life, potentially resulting in hospital admission, increased length of hospital stay and increased risk of mortality and are costly for healthcare services. • Undertaking an effective skin inspection requires the nurse to be able to distinguish between a potential pressure ulcer and a different type of skin injury, and to be able to recognise and subsequently categorise a pressure ulcer. • Where a pressure ulcer is identified, accurate categorisation using a validated classification tool is essential to assess the severity of the injury and to inform appropriate prevention and management strategies. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when identifying and categorising a pressure ulcer. • How you could use this information to educate nursing students or enable colleagues to reflect on the appropriate procedure for identifying and categorising a pressure ulcer.

Rationale and key points: Venepuncture in adults is one of the most common procedures performed in nursing care. It enables a blood sample to be obtained for laboratory analysis, thereby facilitating crucial diagnostic and treatment processes. It is essential that venepuncture is undertaken correctly to prevent any misleading blood test results and support the provision of high-quality patient care. • Knowledge of vein anatomy and of the risks and benefits of venepuncture supports safe practice. • The needle should be inserted smoothly into the selected vein at an angle of approximately 15-30 degrees. • Blood sample collection tubes appropriate for the blood tests required must be used and patient details must be checked to avoid incorrect tube labelling and patient misidentification. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when undertaking venepuncture. • How you could use this information to educate nursing students or colleagues about the correct technique when undertaking venepuncture.