British Journal of Community Nursing最新文献

In this month's Policy column, Iwan Dowie explores the significance and role of co-production in patient care.

Colostomy patients have distinct needs that require specialised pathways for optimal care. Recognising that these needs vary, based on the type and configuration of the stoma, is crucial. Specialist nurses play a vital role in providing long-term support and expertise. While many stoma nursing services in the UK offer patient pathways, these often lack specificity for different stoma types. Tailoring pathways to colostomy patients can prevent complications, reduce hospital readmissions and enhance quality of life. Community nurses and other healthcare professionals are essential in supporting colostomy patients through individualised care. Their involvement ensures that patients receive appropriate preparation for life with a stoma and are adequately educated about their specific needs. This multidisciplinary approach fosters a comprehensive care environment, addressing both the physical and emotional aspects of living with a colostomy. By focusing on personalised care and life-long support, healthcare professionals can significantly improve patient outcomes and overall well-being.

The correct storage of vaccines is vital to ensuring that they work effectively and keep patients safe. In this article the author explains how to ensure compliance with regulations without placing an undue burden on community nursing staff.

Ageing is associated with an increased risk of adverse drug reactions. This calls for great care and diligent follow up when prescribing medication to older patients. Yet, this is seldom the case and the proportion of older people taking five or more medications has quadrupled from 12% to 49% in the last 20 years. Certain medications are riskier than others. Those with anticholinergic effects are of particular concern. Adverse effects of anticholinergics include dry mouth, nausea, dizziness, fatigue, vomiting, constipation, abdominal pain, urinary retention, blurred vision, tachycardia and neurologic impairment, such as confusion and agitation. Anticholinergic medication can cause daytime drowsiness and cognitive decline, while increasing the risk of fall and can lead to increased mortality. Although anticholinergic medication should be avoided in older people whenever possible, their use has almost doubled in the last 20 years, and those who are most vulnerable to its adverse effects had the greatest increase in use. This article examines why older people are at increased risk of adverse drug reactions and how medication review can enable older persons to take medications regularly, improve quality of life and minimise medication waste.

The UK has a growing ageing population with increased prevalence of long-term conditions. It has the potential to overwhelm the country's healthcare system. The COVID-19 pandemic and its risk of transmission provided an opportunity for people with long-term conditions to focus on self-care and for district nurses to promote self-management. Self-management strategies, such as digital technology, motivational interviewing, social prescribing and shared decision-making can assist them in planning a whole-population approach towards managing physical and mental wellbeing. For this to become a reality, investment is needed to educate the patients, their carers, district nurses, multidisciplinary teams and to ensure the sustainability of self-care methods for future practice.

Atopic dermatitis is one of the most common conditions managed in the community world-wide. Atopic dermatitis is under intense scrutiny by academic researchers, not to mention drug companies, enabling regular research in the area. Dermatologists have a growing appreciation of the complex causes of this common condition.

Some patients develop breast/chest lymphoedema following breast cancer treatment. Historically this group of patients has been managed in the same way as those with limb lymphoedema, through the application of compression in the form of vests or bras. Some patients reported pain and the feeling of being in a 'strait jacket' and, therefore, abandoned these items for lighter and more comfortable garments without any adverse effects. Reflecting on this insight, the author adapted breast/chest lymphoedema management by suggesting a change to lighter garments to patients who reported improved comfort, with no obvious negative impact on their lymphoedema. Within this article, the author gives a brief explanation of lymphatic mechanisms and factors relating to lymphoedema including signs and symptoms of breast oedema. There will be an exploration of the available treatments for lymphoedema along with treatment plans found to be effective by the author.