British Journal of Community Nursing最新文献

Student nurses must be included in workforce planning to support preventative and proactive care, and to replenish an ageing workforce in the community setting. To do this, student nurses must view community nursing as a desirable career pathway when they graduate as a newly qualified nurse. This study explored the perceptions of community nurses from the viewpoint of year 2 undergraduate student nurses (n=9) via a face-to-face focus group. The key themes identified were intimate relationships, cultures, perceptions, skills and learning. The study found that students felt part of the team in the community setting and that there was a willingness to support and teach student nurses during clinical placement, particularly in relation to clinical skills and proficiencies. Close working relationships between nursing students and qualified staff presented opportunities to discuss, reflect on and consolidate their knowledge and apply it to patient care.

Lymphoedema is a condition often seen in palliative patients, characterised by impaired lymphatic drainage, which leads to swelling in affected areas. In the context of end-of-life care, managing lymphoedema and its associated complications, such as lymphorrhoea and infections, is crucial for enhancing patient comfort and quality of life. This article discusses the various management strategies for lymphoedema in palliative care, including compression therapy, manual lymphatic drainage, skin care and gentle exercise. Attention is given to complications such as cellulitis and lymphorrhoea, emphasising early intervention and holistic care to prevent deterioration. Additionally, the importance of mobility support, tailored care plans, and collaboration with healthcare specialists are explored. The article also highlights recent studies, including those on subcutaneous needle drainage and the limitations of current treatment options. Ultimately, effective management of lymphoedema in end-of-life care requires a comprehensive approach that prioritises comfort, symptom relief and the dignity of the patient.

Over 14 million people in the UK experience some degree of urinary incontinence. Therefore, it is inevitable that patients who may be struggling with the psychological or physiological impact of this condition comprise a significant portion of the community nurse's caseload. However, despite the prevalence of urinary incontinence, systemic barriers to high-quality care provision lead to suboptimal outcomes, including an overreliance on incontinence products, particularly in the community setting. Francesca Ramadan explores a more holistic approach to urinary incontinence management.

Over 4 million people in the UK are living with diabetes; the majority have type 2 diabetes and over two-thirds also have hypertension. Diabetes and hypertension increase the risk of complications such as stroke, myocardial infarction and premature death, and they also elevate mortality rates. This article uses a case history approach to illustrate the difficulty and methods for managing diabetes and hypertension in a reluctant patient. Drawing on practical clinical experience, it underscores the complex barriers to effective patient engagement and sustained adherence. The article also explores evidence-based strategies that can improve outcomes despite patient resistance.

Dementia care embraces biological, psychological, spiritual and social components, commonly referred to as a biopsychosocial model. From a biological standpoint, dementia is caused by different diseases, each resulting in damage to nerve cells and transmitter pathways. Most people with dementia reside in a community setting, such as care homes or in their own homes, whether living alone or with family carers and supporters. This article considers the place of medications of the biopsychosocial model and discusses common medications used for: (i) for cognitive symptoms; (ii) non-cognitive symptoms; (iii) other medical conditions that occur alongside dementia. Nurses are in a prime position to support safe and effective care in medications management. The article also examines the implications and effects of polypharmacy on people with dementia, as well as some of the challenges involved in administration, such as covert administration of medicines, polypharmacy and a person's non-adherence.

The 'prioritising people' section of the Nursing and Midwifery Council's code is relevant to nurses working in all settings and ensures that the needs of the patients in their care are adequately met. For those working in community teams, therapeutic relationships can be fostered more effectively in the patient's familiar surroundings. However, there are often challenges in achieving this target. The author addresses the nuances of maintaining professional boundaries while caring for patients in their homes and the additional factors that need to be considered when delivering effective care with dignity and compassion.

This article highlights the crucial role of community nurses in promoting and maintaining oral health in patients, which is integral to their overall wellbeing. Oral health is directly linked to various systemic health conditions such as cardiovascular disease, diabetes and respiratory infections, and poor oral hygiene can exacerbate these risks. Community nurses are ideally positioned to identify early signs of oral health issues, educate individuals on proper oral care and refer patients to dental professionals when needed, especially for vulnerable populations, including the elderly and those with disabilities. The global burden of oral diseases, such as tooth decay and gum disease, is increased by modifiable risk factors, limited access to care and socioeconomic inequalities, particularly in low- and middle-income countries. Additionally, older adults face barriers to accessing dental care, including physical accessibility and negative perceptions of the dental profession. The study further addresses common oral health issues, such as dry mouth and ulcers, in terminally ill patients who require specialised care and symptom management. Community nurses play a pivotal role in addressing these challenges through education, early intervention and collaboration with other healthcare providers, ultimately improving patient outcomes and quality of life.