British Journal of Community Nursing最新文献

Mrs J is a 45-year-old mother of three teenagers who developed a leg ulcer after a minor injury because of underlying venous issues from years of standing as a hairdresser. Despite regular visits to her GP practice nurse, her ulcer worsened over three years. A turning point came when she joined a local Leg Club, where her ulcer healed rapidly. Mrs J later sought specialised treatment and pursued legal action against her GP for inadequate care, highlighting the critical need for proper training and adherence to guidelines in ulcer management.

Many of the approaches for managing lymphoedema are straightforward and easily accessible, allowing individuals to take considerable charge of their care. As a result, nurses can play a vital role in lymphoedema treatment by equipping patients with crucial knowledge and offering practical assistance to foster self-management. Francesca Ramadan elaborates upon the aspects of patient education that the community nurse must promote and support to enable individuals with lymphoedema to take back control.

Pain is highly prevalent among older adults, equally affecting people with dementia and those without cognitive impairments. As dementia progresses, patients often develop difficulties in communication and it may impact their ability to self-report pain. Therefore, it is essential that nurses working with dementia patients understand how to recognise, assess and manage pain in this population. This article explores how pain affects people with dementia, especially those who cannot communicate their discomfort, and discusses how pain may present in these individuals. The article also offers guidance on assessing pain using observational tools. It highlights the importance of knowing the person and the valuable information provided by family caregivers. A hypothetical case study is used to consider some of the common issues in community nursing.

Assessment of pressure ulcer (PU) risk is important in clinical practice and the need to document it in the patient's record is paramount. Despite national and international guidelines highlighting the need to document PU risk, nursing documentation remains variable. The first article in this series discussed the evidence base underpinning the development of clinical guidelines for PUs, alongside the creation of bundle approach for PU prevention. The second article presented the results of a clinical audit exploring compliance against a PU prevention bundle (aSSKINg framework) in an adult community nursing setting in the South East of England. This final article in the series presents the results of a quality improvement project that involved a clinical audit following the implementation of the aSSKINg framework into the electronic patient record (EPR). The aim was to improve nursing documentation for patients with PU risk. The clinical audit was conducted in two parts, with a pilot phase running between 6 February 2023 and 15 April 2023. After the template implementation into the EPR, a follow-up audit was undertaken between 1 November 2023 and 31 January 2024. Overall compliance against the aSSKINg framework improved, especially the completion of the PURPOSE-T on the first visit, full skin assessment and repositioning advice. Following the pilot phase, the aSSKINg template was rolled out in a phased approach to the adult community nursing, enhanced care home matrons and urgent community response teams.

Iwan Dowie talks about the Human Rights Act, a controversial piece of statutory legislation. The article emphasises the critical role of community nurses in upholding human rights within their practice and outlines the historical context of human rights protections in the UK. The article also addresses the legal implications of resource constraints in healthcare decisions.

There is a growing number of non-medical prescribers in the UK. Practitioners working in advanced and specialist roles access university-based non-medical prescribing programmes to enhance their clinical practice. Despite this clinical and cultural shift, there is a paucity of literature and evidence on this issue. Using a mixed-methods approach of a focus group and the Likert survey, this study explored the experiences of specialist practice district nursing students undertaking non-medical prescribing. The findings of the study suggested that while the students felt supported by their teams, university and peers, there were limitations to the supervisors available and supervised prescribing opportunities, with a variance in the experiences of prescribing supervision. Further exploration into the experiences of prescribing supervision is warranted, as is the experience of prescribing students across multiple care settings.