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

Rationale and key points: Addressing performance issues in nursing practice is a crucial but sensitive aspect of the role of nurse leaders and managers. This article explains how they can undertake this process by using a supportive and proactive approach that can foster a positive work environment, improve patient care and empower nurses to thrive in practice. Those involved in addressing a nurse's performance issues must have the knowledge and skills required to do so effectively with sensitivity and care, while working within their level of competence. • Where performance issues have been identified, early intervention is essential to foster constructive dialogue, preserve relationships and maintain a motivated and productive healthcare team. • The focus should be on understanding what aspects of the nurse's performance require improvement, what has been learned from the situation and how this can be applied to the nurse's future practice. • It is useful to work with the nurse to develop a collaborative action plan for improvement that establishes clear goals, timelines and resource allocation. 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: • A time you addressed performance issues with a colleague or team member, or how someone helped you to improve your practice. • How you could use this information to develop your knowledge and skills in addressing performance issues.

Simulation in nursing education enables nursing students to develop and practise their clinical, critical thinking and decision-making skills within the safety of a realistic learning environment. Evidence suggests that this method of learning can enhance nursing students' confidence, enabling them to navigate the current challenges in healthcare and consider new ways of working. This article outlines the benefits and challenges of simulation and discusses the implications of the use of this learning technique in nurse education for future nursing practice.

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.

Rationale and key points: At some point in their careers, nurses may choose or be invited to give a conference presentation, online or in person. For some, this can be an exciting opportunity to share best practice, impart knowledge and receive feedback, for example, on a local service initiative they have been involved in. For others, it can be a stressful experience, especially if they are not confident in presenting. However, giving conference presentations is an important skill in nursing leadership, particularly when sharing a new method of care or innovative service. Although there is no specific evidence base underlying conference presentation, expert recommendations indicate that a well-delivered presentation relies on thorough preparation, an avoidance of excessive on-screen text and the use of images and key messages to ensure the audience gains maximum benefit. • When preparing a presentation, you should consider aspects such as what the conference organisers require, the time allocated for the presentation and how to prepare the appropriate number of clear and well-presented slides. • Consider the key points that you wish to communicate to the audience and use a balanced mix of text and images. • Maintain a focus on the presentation's application to nursing practice, so that audience members can take away key learning points and apply these to their own practice. 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 presentation skills. • How you could use this information to educate nursing students or other colleagues about effective conference presentation.

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.