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

Inequalities in people's health due to economic or social circumstances remain a persistent challenge in the UK, with people from disadvantaged communities disproportionately likely to die earlier and experience more health issues than the general population. Health promotion has a vital role in reversing health inequalities and requires a focus on structural and political-level determinants of health, rather than individuals' lifestyle choices. However, while health promotion is a significant aspect of nurse education curricula, individual nurses may experience role confusion regarding the application of health promotion in their practice. Therefore, a shift is required in nurse education and training on health promotion, as well as its practical implementation. This article suggests some approaches that could be taken to reconfigure the role of nurses in health promotion.

Peripheral neuropathic pain is a complex condition that can adversely affect people's quality of life. Alongside pharmacological interventions, nurses can support patients to self-manage their pain using non-pharmacological interventions such as lifestyle changes and exercise. To do this effectively, nurses should be able to recognise the signs and symptoms of peripheral neuropathic pain and be able to educate patients on appropriate self-management approaches. It is important that nurses provide education, advice and information in a way that patients can understand and check this understanding. This article provides an overview of how nurses can support patients to self-manage peripheral neuropathic pain by using various non-pharmacological interventions.

The Royal College of Nursing (RCN) competency framework for rheumatology nurses was developed in 2020. As part of the framework proposal, a service evaluation was planned following the framework's roll-out to determine its usefulness and acceptability. The aim of this evaluation was to explore rheumatology nurse specialists' answers to the research question: 'What was your experience of using the RCN's rheumatology competency framework?' A total of 14 rheumatology nurse specialists were interviewed and shared their opinions regarding the competency framework. Five themes were identified: personal usage; benefits to managers; inequalities and inequity in nursing; ideas for improvement; and general properties. The findings of this evaluation demonstrated the value of the framework, which enabled rheumatology nurse specialists to document the competency level they were working at and to identify their future training needs.

Arterial blood gas (ABG) analysis is a fundamental skill in healthcare practice, particularly when caring for acutely unwell or deteriorating patients. It can be useful in the assessment of patients' acid-base balance and gas exchange, thereby informing appropriate care and management. However, many nurses find interpreting ABG results challenging. This article outlines a simplified approach to ABG analysis using three main values - pH, partial pressure of carbon dioxide and bicarbonate - and applying the RoMe ('Respiratory opposite, Metabolic equal') technique. It also provides brief descriptions of selected acid-base imbalances and explains how to identify whether these are uncompensated, partially compensated or fully compensated.

Cellulitis is an acute bacterial infection that affects the deep dermis and surrounding subcutaneous tissue. Although it is a common condition, it is often misdiagnosed because it can mimic a range of conditions that also cause inflamed, red, irritated and painful skin. Such misdiagnoses may lead to unnecessary hospital admissions and antibiotic overuse, with most alternative diagnoses being non-infectious. Undertaking a holistic patient assessment, skin assessment and thorough clinical history is important in the diagnosis of cellulitis, and it is vital to use a collaborative multidisciplinary approach in its acute management and to prevent recurrence. This article defines the term cellulitis and explores its presenting features. The author also discusses the associated risk factors, clinical assessment techniques and effective management strategies, as well as outlining the actions that nurses can take to prevent recurrence.

Communication is a process of sharing information and developing relationships through interaction. It is essential for nursing care, providing a basis for nurses to establish therapeutic relationships and trust with patients and their families. It is often assumed that nurses can intuitively communicate well; as a result, traditionally there has been a lack of formal training in this area. However, communication is a skill that can be developed and enhanced. This article explains the elements of communication and discusses the skills required by nurses to communicate effectively and provide compassionate, person-centred care. The author outlines two communication models to demonstrate how nurses can use these skills to deliver bad news and support people in distress.

Skin tears, defined as traumatic wounds caused by mechanical forces, can be debilitating for individuals, causing pain and reduced mobility. Although skin tears can develop throughout the lifespan, older age can make the skin increasingly susceptible to this type of injury. Studies have found wide variation in the incidence and prevalence of skin tears, in part because of suboptimal recognition and reporting practices among healthcare professionals. Effective prevention of skin tears requires a standardised approach to risk assessment, prevention, recognition and classification, such as that offered by the International Skin Tear Advisory Panel (ISTAP) best practice recommendations. This article examines the literature on the incidence, prevalence, prevention and recognition of skin tears, and outlines some of the ISTAP best practice recommendations on risk assessment, prevention and recognition. The authors also consider the need for patient and healthcare professional education to optimise the prevention of skin tears.

Socially constructed gender norms influence people's access to, and experience of, healthcare. Gender norms can negatively affect the health of women, men and people with other gender identities, such as transgender or non-binary individuals. Person-centred care and shared decision-making, which are widely recognised as essential aspects of healthcare, could be effective approaches for enhancing gender equality in healthcare for women. However, many women appear to receive suboptimal person-centred care. Additionally, there is a lack of representation of diverse gender identities in research, as well as a lack of awareness of diverse gender identities among nurses and other healthcare professionals. To enhance gender equality in healthcare for women, nurses and nursing students should be encouraged to reflect on their unconscious biases and adopt a stance of cultural curiosity, while organisations need to improve preregistration and post-registration training on equality and diversity.

Autism is a neurodevelopmental condition that is characterised by features such as persistent differences in social interaction and communication, specialised interests and sensory processing issues. It has been identified that autistic people are increasingly likely to experience various mental health issues, and often encounter challenges in accessing appropriate healthcare and a lack of understanding from healthcare professionals. This article explores the co-occurrence of autism and mental health issues in adults, and explains the role of nurses in providing care and support for this population.

Neurological observations are an essential aspect of assessment in patients with altered mental status and require the nurse to collect and analyse information using a validated assessment tool. Assessing a patient's pupil size and response is also an important element of a neurological assessment. This article summarises the pathophysiology of raised intracranial pressure and lists some of the conditions that may contribute to an alteration in a patient's mental status. The article details the use of two commonly used neurological assessment tools and the assessment of a patient's pupil size and response. The author also considers the challenges related to accurate recording of neurological observations.