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

There is a significant interconnection between nutrition, age-related physiological changes and health, so it is important that older people consume a healthy diet to support healthy ageing. However, diet is a complex concept, in that it provides an individual's nutritional requirements but also requires moderation in the presence of common age-related health conditions. Moreover, food is inextricably linked with factors such as personal taste, cultural background and religious requirements, therefore any discussion about an individual's diet requires nurses to take a person-centred approach while demonstrating cultural humility. In this article, the authors provide an overview of nutrition in older adults, including the risk of malnutrition and the importance of hydration. The authors also discuss the role of essential nutrients in supporting healthy ageing and consider how nurses might promote a healthy diet in older people using a person-centred approach.

'Ultra-processed' foods (UPFs) have received increasing attention in recent years, with concerns around the potential link between high intake of UPFs and adverse health outcomes. However, there is a lack of clear evidence supporting this link, and the current narrative around UPFs may lead to confusion about healthy eating. Since nurses are frequently perceived as trusted healthcare professionals and have a role in supporting healthy eating in clinical and community settings, it is important that they have an up-to-date understanding of the guidance on diet and the consumption of UPFs. This article presents an overview of the latest evidence on UPFs and provides nurses with practical approaches they can use to discuss diet and healthy eating with patients, while also reflecting on their own dietary intake.

Rationale and key points: Intravenous (IV) therapy is used in healthcare to administer fluids, medicines or blood products directly into the venous system. IV therapy must be undertaken with the utmost care. This 'How to' article explains how to safely and effectively prime and connect an IV administration set. Nurses undertaking this procedure must ensure that they have the appropriate knowledge and skills and work within the limits of their competence. • When delivering IV therapy, nurses need to understand the action of the fluids, medicines or blood products they are administering and be fully aware of the risks involved. • Infection control is paramount for safe IV administration and nurses need to decontaminate their hands and use aseptic non-touch technique (ANTT). • It is vital that nurses regularly update their knowledge and skills in relation to IV administration and ANTT. 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 priming and connecting an IV administration set. • How you could use this information to educate nursing students or your colleagues on how to safely and effectively prime and connect an IV administration set.

Rationale and key points: The 12-lead electrocardiogram (ECG) is an important tool in the diagnosis of heart disease. An accurate recording is essential because errors in electrode placement or in the attachment of connecting cables can produce ECG changes that mimic heart disease. This 'How to' article describes the procedure for obtaining an accurate ECG recording, and outlines some of the issues that might lead to errors and inaccuracies. • A 12-lead ECG is recorded by placing ten electrodes on the surface of the body: four on the limbs and six across the precordium. • A high-quality ECG recording requires good electrode contact and appropriate skin preparation. • Common issues that might result in errors and inaccuracies during ECG recordings include misplacement of the precordial electrodes, the effect of female breast tissue, and transposition of the connecting cables. 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 recording a 12-lead ECG. • How you could use this information to educate your patients and colleagues on the procedure for accurately recording a 12-lead ECG.

The association between low nurse staffing levels and adverse patient outcomes is well established. There is also a substantial body of evidence demonstrating that low nurse staffing levels can negatively affect the health and well-being of nurses, in terms of increased stress levels, burnout, job dissatisfaction and intention to leave the role or profession. Given the challenges with nurse retention in the UK, there is a need for strategic workforce planning to address these issues. In this article, the author explores the association between safe staffing levels and nurses' health and well-being, with a focus on burnout, job satisfaction and intention to leave. The author also reviews some of the workforce strategies and initiatives that aim to improve nurses' well-being through addressing low staffing levels and issues related to the workplace environment.

Diabetes mellitus is an increasingly common long-term metabolic disease. There are many treatment options available to manage type 2 diabetes and reduce the risk of associated long-term microvascular and macrovascular complications. The management of type 2 diabetes initially focuses on lifestyle changes, such as a healthy diet and increased physical activity levels, with pharmacological intervention used as an adjunct where necessary. Tirzepatide, sold under the brand name Mounjaro, is the latest pharmacological therapy to be developed for this condition. This article discusses the place of tirzepatide therapy as part of the management of type 2 diabetes. It explains the mechanism of action of this medicine, its administration and dosing, the potential side effects, and its cautions and contraindications.

Neurodivergent conditions include autism, attention deficit hyperactivity disorder (ADHD) and dyslexia. An increasing number of people with these conditions are entering higher education. Neurodivergent nursing students may experience increased challenges during their practice placements and require reasonable adjustments to be made. Despite the best intentions of staff, these students' placement experiences and outcomes can be adversely affected, and without appropriate support they may become less likely to engage with some learning opportunities. Additionally, staff may not always have a clear understanding of these students' needs or confidence in meeting them. This article provides an overview of some of the challenges that neurodivergent nursing students may experience during their placements, and outlines some potential strategies that staff supporting them can use.

Rationale and key points: The safe administration of oral medicines is a fundamental aspect of healthcare practice and is essential for optimising patient outcomes and preventing adverse events. This article outlines a step-by-step procedure that nurses can follow to ensure patients receive oral medicines correctly and safely, without causing harm. • Oral medicines include tablets, capsules or liquid preparations. • When administering oral medicines, it is important to consult the patient's prescription chart or medication administration record and to use the '6 Rs' of medicines administration as a guide. • Oral medicines should not be blindly crushed or spilt because this can affect the absorption rate and dose, and may lead to adverse effects such as gastrointestinal irritation. 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 administering oral medicines. • How you could use this information to educate nursing students or enable colleagues to reflect on their own practice in safely administering oral medicines.

Type 2 diabetes has become a significant global public health issue. Its increasing prevalence is closely linked to sedentary lifestyles, suboptimal diets and high obesity levels. This article provides an overview of type 2 diabetes epidemiology, pathophysiology, clinical presentation, diagnostic tests, risk factors, complications and management. It also describes the role of nurses, which involves: advising patients on weight management, diet, physical activity, smoking cessation and alcohol reduction; encouraging adherence to care plans and drug treatment regimens; and providing ongoing support, education and monitoring to prevent or delay the onset of complications.

Rationale and key points: Administration of an enema is a common procedure undertaken in healthcare settings and, if undertaken appropriately, is deemed a relatively low-risk and safe intervention. An enema may be prescribed for therapeutic purposes, to administer medicines or for diagnostic purposes. The most common reason for administration of an enema is to relieve severe acute or chronic constipation. This article details the preparation and procedure required for safe administration of an enema in adults and considers the associated indications, contraindications and potential complications. • An enema involves the introduction of a substance in liquid form into the rectum and is a prescription-only medicine. • There are three main types of enemas commonly used in nursing practice: retention, evacuant and softener enemas. • Administration of an enema is invasive and highly personal, and nurses undertaking this procedure must have the knowledge and skills required to do so safely and work within their level of competence. 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 administering an enema. • How you could use this information to educate nursing students or colleagues about indications for, and the appropriate method for, administering an enema.