British Journal of Community Nursing最新文献

There is a lack of reliable prevalence and cost data regarding leg ulcers, with regional health authorities and commissioning groups not requesting these outcome data, resulting in a lack of understanding of the true magnitude of the problem. Adherence to guidelines or recommendations is rarely assessed or audited, with little record or acknowledgment of poor care provision. This article identifies and discusses clinical audits and service evaluations against leg ulcer guidelines or recommendations within the UK. It concludes that although literature supports the use of guidelines and recommendations to provide up to date and evidence-based practice, there is a paucity of published clinical audits making it difficult to compare data to reveal the effect guidelines have within real-world practice.

Malodour is a potentially distressing complication of chronic wounds, and it is one that is frequently managed within community settings. Malodorous wounds are primarily caused by anaerobic bacterial colonisation and sloughy or necrotic tissue. Malodorous wounds are frequently a challenge to the clinician as well as the patient, their family members and carers. They have a significant impact on overall wellbeing, sleep, social interactions, diet and, potentially, wound healing. Understanding the cause of malodorous wounds, alongside developing assessment and management skills, can improve care for clinical and psychological patients, as well as being clinically cost effective. The author offers a structured approach for assessing and managing malodorous wounds in the community setting. It outlines the importance of holistic assessment, antimicrobial stewardship, psychological support and emerging innovations. The article also highlights the limitations in current assessment tools and the need for validated quality of life measures specific to malodorous wounds.

Embarrassment and concealment of chronic leg wounds can delay presentation, increase complication risk, and perpetuate social isolation. Recognition of psychosocial barriers is essential for timely assessment and dignified care. This case illustrates how embarrassment and self neglect can delay presentation and exacerbate wound severity. Community networks can play a pivotal role in identifying vulnerable individuals. Effective management requires integrated clinical treatment alongside supportive, non-judgemental approaches that preserve dignity and encourage disclosure to enable timely care.

Wound care is estimated to cost £8.3 billion annually and takes up to 50% of community nurse time. Thorough wound assessments followed by selecting the best wound dressing for the patient, taking into consideration wound severity (acute or chronic), depth, location, treatment duration and ease of application will help to improve wound healing rates and patient quality of life while saving on healthcare resources. This article discusses synthetic dressings, which make up most modern dressings, and include moist, absorbent, and non-adherent dressings that are further broken down into different products. This article explores the mode of action of each dressing, their recommended indications, and summarises their strengths and limitations for ease of reference. Healthcare professionals should continue to keep up to date with the current research and guidelines in order to provide care that optimises wound healing.

Social media has the power to enable healthcare professionals to share their research findings, develop their knowledge and skills, and network with colleagues in an inclusive environment. However, this comes with risks and limitations. For community nurses, where the boundaries between their personal and professional lives can be challenged, awareness of policy and regulation is even more imperative. The author explores the benefits of networking on social media platforms in conjunction with regulatory body guidance and cautions to be considered.

Background: Temporary staffing to fill gaps in community nursing is a common practice in the UK. Specific figures for agency nurses working in community nursing remain unknown. However, both evidence-based and anecdotal reports suggest several reasons why nurses choose agency work, including greater flexibility and financial incentives.

Aims: The study explores why community nurses with temporary contracts may join an adult community NHS trust and what would influence their retention.

Methods: This study used a qualitative exploratory approach with semi-structured interviews, analysed using the framework approach.

Findings: A total of four participants were recruited from an urban and coastal NHS trust. Ten themes were identified, which influenced the decision of nurses with temporary contracts to join or leave an NHS organisation.

Conclusions: Community nurses with temporary contracts are vital to the provision of community nursing services, especially because of staffing shortages and deferred visits. Without intervention, community nursing is likely to continue operating under a hybrid staffing model, with permanent and temporary staff, as NHS trusts struggle to fill vacancies.

This article explores the significance of providing compassionate end-of-life care around Christmas. Patients and their families may find this time particularly hard and community nurses have an important role to play in minimising their strain and stress. Sensitive and engaging communication about death and dying can make a difference.

This article discusses the Government's plans to overcome 'hospital by default' care and the lack of sufficient financial and regulatory enablers to turn the policy ambition into reality. The author talks about the evolving family dynamics and their impact on the availability of familial care for older adults and children.