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

Mpox, previously known as monkeypox, is a viral disease that has become a significant global health concern following outbreaks beyond its endemic regions in central and west Africa. In 2022, the World Health Organization declared a 'public health emergency of international concern' (PHEIC) due to a rise in mpox cases, predominantly affecting gay and bisexual men. Although the initial surge of cases had diminished by early 2023, a new PHEIC was declared in 2024 due to a more severe strain of the virus circulating in the Democratic Republic of the Congo. Healthcare workers, especially nurses, have a critical role in diagnosing, managing and controlling the spread of mpox. This article sets out the factors nurses should consider when caring for patients who present with a suspected or confirmed diagnosis of mpox.

Person-centred practice offers an approach to healthcare provision that prioritises the personhood of individuals. This means that nurses' ethical and professional values underpin their approaches to care, where each person and their rights, relationships and dignity are respected. For nurses, the primary intention of person-centred practice is to contribute to a positive care experience for the people in their care. This article examines factors and models that influence person-centredness in nursing practice, notably the Person-centred Nursing Framework and the Person-centred Practice Framework. The authors also explore approaches nurses can take, such as values clarification, reflection on practice and engaging and working collaboratively with others, to engage in person-centred practice and create and sustain person-centred cultures.

People who are lesbian, gay, bisexual, transgender and other sexual and gender minorities (LGBT+) can encounter various challenges when seeking healthcare. For example, many LGBT+ individuals experience discrimination and social stigma from healthcare professionals, leading to feelings of mistrust. This might manifest as explicit homophobia or transphobia, inappropriate questioning, or a lack of consideration for the sensitivities around LGBT+ identities. Similarly, healthcare organisations may have policies that lack inclusivity, with administrative forms and procedures that do not consider diverse sexual orientations and gender identities. Nurses are increasingly recognising the importance of providing inclusive care for individuals who identify as LGBT+, which involves being attentive to their specific needs. This article examines the barriers that may be encountered by LGBT+ individuals in healthcare services and offers recommendations for how nurses can deliver culturally sensitive healthcare to the LGBT+ community.

Rationale and key points: A local anaesthetic infusion is a prescribed method of continuous analgesia to manage post-operative pain as part of a multimodal approach, which may also include an analgesic. During the infusion, local anaesthetic is infused into the tissues surrounding the surgical incision or wound via a multi-lumen indwelling wound catheter. The aim is to manage post-operative pain and reduce the use of other analgesia such as opioids. It is essential that nurses understand the indications for this form of pain management, how to care for the patient receiving it and the potential complications. Nurses must have the knowledge and skills required to undertake this intervention safely and must work within their level of competence. • Managing pain effectively after surgery or an injury requires multimodal analgesia, which is usually supplemented by a local anaesthetic either as a single injection or a continuous infusion. • The nurse has an important role in maintaining patient safety by advising the patient to report any changes they experience following local anaesthetic infusion, such as heaviness in the limbs, and by undertaking regular pain assessments using a structured approach. • Early recognition of side effects is important because the local anaesthetics used in the infusion can be both cardiotoxic and neurotoxic, therefore regular assessment and documentation are essential. 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 caring for a patient undergoing a local anaesthetic infusion. • How you could use this information to educate nursing students or colleagues about the appropriate care for a patient requiring a local anaesthetic infusion.

Iron deficiency anaemia develops when there is not enough iron in the body to sustain normal red blood cell production. It is a major cause of morbidity worldwide and is linked to a range of comorbid conditions, including gastrointestinal cancer. In the UK, iron deficiency anaemia is the most common cause of anaemia identified in primary care and is estimated to affect 3% of men and 8% of women. Nurses can support the management of iron deficiency anaemia by identifying possible causes, ordering blood tests, advising on diet and iron supplementation, and referring patients for additional investigations as required. This article provides an overview of the pathophysiology, identification and diagnosis of iron deficiency anaemia, describes sources of dietary iron and factors influencing dietary iron absorption, and discusses patient management.

Rationale and key points: In hospitals and nursing homes, the maintenance of feeding tubes used in enteral nutrition, such as percutaneous endoscopic gastrostomy (PEG) (the placement of a feeding tube directly into the stomach through the abdominal wall), is often a nursing responsibility. Therefore, it is vital nurses understand how to care for this patient group safely and effectively. Incorrect PEG procedures, inadequate infection prevention and control practices, and a lack of appropriate stoma care, can negatively affect patient outcomes. Nurses administering enteral feeding via PEG must have the knowledge and skills required to do so safely and must work within their level of competence. • Enteral nutrition such as PEG aims to meet the nutritional requirements of patients who have an intact gastrointestinal (GI) tract but whose oral intake is inadequate. • Management of the PEG feeding tube and care of the stoma site are vital, and nurses should be able to recognise common complications of PEG feeding. • A non-touch technique should be used when administering enteral feed via PEG to reduce the risk of bacterial contamination. 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 enteral feed via PEG. • How you could use this information to educate nursing students or colleagues about safe enteral feeding with PEG.

Rationale and key points: Peak expiratory flow rate (PEFR) is an important test in the diagnosis and monitoring of respiratory conditions, especially asthma. PEFR measures the speed at which air is forcefully exhaled from full inspiration, expressed in litres per minute (L/min). It involves using a peak flow meter - a simple, affordable, portable and widely available device that can be used in clinic or home settings. Nurses obtaining a patient's PEFR must have the knowledge and skills required to do so safely and effectively and must work within their level of competence. • PEFR is a simple-to-obtain measure that records the maximal flow rate of air that can be achieved in one forceful expiration following a full inspiration. • Where possible, it is advisable that patients and/or carers learn how to perform the test themselves, so that they can self-manage and monitor conditions such as asthma and chronic obstructive pulmonary disease. • The procedure is simple to teach, but it is necessary to use the correct technique to achieve accurate results. 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 obtaining a patient's PEFR. • How you could use this information to educate nursing students or colleagues about the technique for obtaining an accurate PEFR.

Rationale and key points: A 12-lead electrocardiogram (ECG) is a painless procedure commonly undertaken in healthcare practice. An ECG machine uses cables or 'leads' attached with stick-on electrodes to specific parts of the body to create a series of ECG traces, which are then printed onto graph paper. This provides a recording of the cardiac electrical activity measured from different angles or perspectives. • A 12-lead ECG is a valuable diagnostic tool that has proven effective in detecting various cardiac abnormalities or enabling healthcare professionals to rule them out. • It is a cost-effective investigation that can be performed by any appropriately trained healthcare professional. • Careful preparation and correct electrode and lead placement are crucial to ensure accuracy when recording a 12-lead ECG.

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 students or colleagues about the preparation and recording of a 12-lead ECG.

The sharp increase in the cost of living in the UK over the past few years has affected all populations, including higher education students. Many higher education students, including nursing students, are experiencing financial difficulties and concerns, which adversely affect their mental health and can cause them to consider leaving their course. This article reports the findings of an online survey undertaken in one university in Glasgow, Scotland, that aimed to explore the effects of financial stress on second and third-year nursing students. Most respondents had experienced financial worries since starting their preregistration nursing degree programme; many were concerned about the cost of living, and financial worries adversely affected their academic performance and clinical placements. The authors suggest there is a need for a collaborative partnership between universities and practice placement areas to adopt a student-centred approach to identifying solutions to nursing students' financial concerns as well as a review of the available funding for this cohort.

A priority in wound care is preventing wound infection, because this can cause delays in healing and increase the risk of hospital admission. Moreover, the diagnosis of a wound infection is not always straightforward, and the presence of biofilms may mean that an infection is particularly challenging to treat. This article outlines the main aspects of diagnosing, treating and preventing wound infections. It explains that treating wound infection is multifactorial and may include topical antimicrobials, antibiotics and wound bed preparation techniques. The author discusses various preventative measures that can support patients and healthcare organisations, while also contributing towards effective antimicrobial stewardship.