British Journal of Community Nursing最新文献

Skin ageing is an inevitable process influenced by both intrinsic and extrinsic factors. Intrinsic aging leads to thinner, drier and less elastic skin with fine wrinkles, while extrinsic factors such as sun exposure, smoking and environmental stresses amplify these changes. Photo-ageing, in particular, causes deep wrinkles, uneven pigmentation and increases the risk of skin cancers. Age-related alterations in skin structure and function include thinning of the epidermis, reduced collagen and elastin and changes in fat distribution, all of which compromise the skin's barrier and mechanical properties. These changes not only increase the susceptibility to conditions such as xerosis, fungal infections and atopic dermatitis but also carry psychological implications. Interestingly, atopic dermatitis, often associated with childhood, has a secondary peak in older adults and may be linked to neurodegenerative conditions such as Alzheimer's disease. This article explores the interplay between skin aging, dermatological diseases, and their broader physical and emotional impacts.

The article focuses on assisted dying, its legislation process and why it might be a political priority for UK lawmakers at this time. The author also raises questions about what the implications of this bill for nurses, particularly community nurses. The article mentions places outside the UK where assisted dying is already a feature of healthcare. 'Bill' or 'bills' should be taken to mean the draft legislation at the time of writing this article; these are subject to revision or even rejection in each jurisdiction either in the short or long term. It is important for nurses to think about the issue in general terms now, as it returns to the political agenda every few years. Nurses need to be able to discuss it professionally as professional standards, training and regulation will change. The questions presented give rise to polarised and strongly held views. It is important to examine any bill from a theoretical standpoint, to provide valid reasons for the position that professional nurses take, for or against these concepts in principle. There are questions of conscience and religious faith, which are challenging, but it is vital to look at the issue in an unemotional manner.

Background: Screening of deep vein thrombosis (DVT) is an NHS priority for improving community health service. Effective DVT screening and documentation improve patient outcomes, prevent prolonged hospitalisation and lead to fewer expenses. The lack of evidence of DVT screening in the community requires action. This Quality Improvement Project focuses on improving DVT screening and documentation for housebound patients in the community.

Aim: To improve screening and documentation of DVT in four months by introducing several interventions in collaboration with one care community.

Methods: The authors used a fishbone analysis and driver diagram to form three 'Plan, Do, Study and Act' cycles. The authors also developed a Wells' template, delivered a training session, had a team meeting with community nurses, audited their screening records and collected their feedback.

Findings: There was a 74% increase in staff using the National Institute for Health and Care Excellence guidelines and 100% documentation of DVT assessment, of which 82% used the Wells' score template.

Conclusions: DVT screening and documentation in community services can be optimised and sustained with training and monitoring.

Iwan Dowie explores the critical role of ethics in community nursing, where nurses often make autonomous decisions in the home care of patients. Nurses are tasked with balancing individual patient rights with the broader needs of society, guided by ethical principles such as autonomy, beneficence, nonmaleficence and justice.

The world's population is rapidly ageing, with conditions such as urinary incontinence, which are especially prevalent among older adults, expected to rise in prevalence as a result. Urinary incontinence is particularly common in older women; however, despite its profound impact on every aspect of women's health and wellbeing, it is often minimised by both individual patients and the wider healthcare system. Francesca Ramadan delves into the prevalence of and psychosocial effects and patient-related factors related to urinary incontinence in older women.

Over the past 160 years, the UK has experienced significant winter mortality among older people. A quarter of a million older people have died from cold-related illnesses over the past decade, with one older person dying every seven minutes. Misconceptions about winter deaths must be addressed. Evidence shows that winter deaths are avoidable. These deaths are not because of hypothermia and are unlikely to decline with climate change in the future. Improving indoor heating may only partially reduce winter deaths. An integrated policy is needed to reduce all risks equally, with community nursing playing a crucial role in such policies. This article explores the multifaceted impact of cold weather on older individuals and emphasises the crucial role that community nurses play in mitigating the associated challenges. Grounded in advanced concepts and research methodologies, the analysis encompasses physiological, psychological and social dimensions. The integration of primary sources and academic theories aims to provide a comprehensive understanding of the topic. The article also explores the specific responsibilities of community nurses and the evidence-based interventions required to address the unique needs of older individuals during the colder seasons.