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

Rationale and key points: Skin sutures are commonly used to bring together the edges of a wound, assisting it to heal. Depending on the location of the wound, the sutures used may be absorbable or non-absorbable. Non-absorbable sutures will need to be removed once the wound has sufficiently healed. Timely, safe and effective removal of non-absorbable sutures is crucial to avoid complications and ensure optimal cosmetic results. Nurses undertaking suture removal must have the knowledge and skills to undertake the procedure safely and effectively and work within the limits of their competence. • Before suture removal, the wound must be checked for signs of infection and indications of dehiscence. • Removing sutures at the recommended time assists in preventing new skin growth from covering the sutures and in reducing scarring. • Aseptic non-touch technique (ANTT) is recommended for suture removal, but local policy should always be followed. 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 removing non-absorbable sutures. • How you could use this information to educate nursing students or your colleagues about the procedure for removing non-absorbable sutures.

Diabetes mellitus is a highly prevalent chronic metabolic disorder that requires rigorous self-management to prevent complications and maintain health. Managing diabetes can also be psychologically challenging for those living with the condition, significantly affecting their mental health, particularly when diabetes-related stigma manifests as discrimination, social rejection and internalised shame. This article examines how diabetes-related stigma often stems from misconceptions about the condition, but nonetheless can adversely affect the self-care, physical health and quality of life of people living with the condition. The author explains how mitigating this stigma through targeted education, empathic communication and advocacy is essential and explores the pivotal role of nurses in reducing diabetes-related stigma.

Alcohol withdrawal can occur following the abrupt cessation or marked reduction of alcohol use in a person with alcohol dependence. This article provides an overview of the assessment and management of acute unplanned alcohol withdrawal, and discusses the crucial role of nurses in addressing this complex condition. It outlines the pathophysiology, signs and symptoms of alcohol withdrawal and explains the need for a multifaceted approach to its management, often involving a combination of pharmacological treatment and supportive care. The article aims to equip nurses with the knowledge and skills necessary to improve outcomes for people experiencing alcohol withdrawal.

Children's hospices are central to specialist palliative care provision for the increasing number of children and young people with life-limiting conditions and their families. These hospices provide holistic care through a range of services, including ongoing care from the point of diagnosis, at the end of life and into bereavement. This article outlines the services provided by children's hospices, while dispelling misconceptions that they exclusively provide care at the end of life. It also explains how these services have developed and evolved as a result of technological advances. It is useful for nurses to be aware of the role of children's hospices, so that they can support the effective care of children and young people with life-limiting conditions and their families.

Infection prevention and control is crucial to prevent patients and healthcare staff from being harmed by avoidable infections, including healthcare-associated infections. This article outlines the main elements of standard precautions for infection prevention and control, as set out by the World Health Organization. Nurses and other healthcare professionals can use this information to refresh their knowledge of infection prevention and control, understand the appropriate practices that should be adopted to reduce the risk of infection transmission, and increase their awareness of the importance of sustainability and education.

Health inequalities between groups of people are often unjust and avoidable and are influenced by social determinants of health, the non-medical factors that influence health outcomes. Gypsy and Traveller communities experience significant health inequalities, including barriers to accessing healthcare services and suboptimal health outcomes compared with the general population. This article provides an overview of health inequalities in relation to Gypsy and Traveller communities and examines three social determinants of health - discrimination and racism, accommodation and access to healthcare - that influence these inequalities. The authors propose that accurate data collection as well as delivery of culturally competent health services and care may facilitate access to healthcare for Gypsy and Traveller communities and potentially reduce health inequalities.

A thorough, holistic wound assessment is essential to identify the aetiology of a hard-to-heal wound and formulate a diagnosis, which will underpin the treatment plan. This article describes the fundamental elements of assessing a patient with a hard-to-heal wound holistically, including taking a patient history, performing a clinical examination and investigations, and considering the patient's physical, psychological, spiritual and social needs. The author also outlines the aspects of the TIMERS (tissue, infection/inflammation, moisture, edge, regeneration and social factors) wound assessment tool in detail, and explains some of the challenges associated with accurately assessing a wound.

Makaton is a unique multimodal language programme that uses signs, symbols and speech. It offers a flexible communication system that can be used across settings with a wide range of people, including those with learning disabilities or communication difficulties. This article explains what Makaton entails and how it can be used to aid communication with service users. The authors suggest that Makaton should be integrated in preregistration nurse education for all fields of practice, particularly learning disability nursing. Effective communication skills are essential for all nurses and learning Makaton as part of their preregistration education programmes could improve their competence and confidence in engaging in meaningful dialogue with people who find it challenging to communicate verbally.

The prevalence of mental health issues among black women is high, but they are underrepresented among mental health service users. This article details a systematised review of the literature that explored black women's perceptions and experiences of, and barriers to, engaging with mental health services. A total of 16 articles from the UK and North America were included in the review. Four main themes were identified as presenting barriers to black women's engagement with services: mistrust; sociocultural factors; lack of awareness; and practical barriers. The intersection of gender and race was evident in the 'strong black woman' ideal, which may have hindered their recognition and disclosure of mental health conditions, as well as in practical barriers such as costs and caring responsibilities. Historical and cultural perceptions of mental health issues and healthcare services, alongside their previous negative experiences of services, may prevent many black women from accessing essential support. Nurses and other healthcare professionals have an important role in engendering trust, challenging racism and promoting positive mental health.

Dementia usually occurs as a result of brain disease and, while it is usually chronic or progressive in nature, it has not traditionally been conceptualised as a terminal or life-limiting syndrome. However, the median survival time for people with dementia is between 3.5 years and 4.5 years from symptom onset to death, although this varies depending at which stage the dementia is diagnosed and its cause. As such, it has long been recognised that people with dementia and their family carers have palliative care needs equal to those of patients with cancer. However, a palliative approach to dementia care requires both the dementia and palliative care workforces to fully understand the needs of people with dementia and their families towards the end of life. This article describes the development of a 'community of practice' where healthcare professionals from dementia and palliative care services shared their practice and learned from each other in a safe and supportive environment.