British Journal of Community Nursing最新文献

Community nurses spend a significant amount of time providing wound care, yet despite their efforts significant numbers of wounds fail to heal after a year. Hard-to-heal wounds can be painful, lead to reduced mobility and impair the individual's quality of life. These wounds also place a considerable burden on healthcare resources, increasing costs and demand on services. Addressing this issue requires both clinical insight and practical strategies tailored to complex healing needs. This article examines why some wounds are hard to heal and explores ways to enable community nurses to facilitate wound healing.

To effectively support patients with wounds in the community, healthcare teams must adopt diverse and tailored approaches to care. Patients with pressure ulcers require a detailed assessment of all the factors which may cause pressure ulcers or delay healing. This assessment should be performed by specialists as evidence-based guidelines recommend this approach to achieve the best outcomes. This service evaluation explores some of the complexities of achieving this for a rural community nursing trust. A case study has been used for a patient with multi-morbidities and spina bifida within a rural community nursing Trust. Challenges in delivering effective communication are common across teams, and there are often insufficient pathways for collaborative work. Achieving this would require a significant cultural shift towards interdisciplinary team working. Successful implementation would enhance collaborative practice, improving both patient outcomes and staff satisfaction. However, workforce challenges, particularly staff retention issues, currently hinder teams' ability to transform their working practices.

Artificial intelligence (AI) has revolutionised the world and it is increasingly being used in healthcare settings. Wound care is one such area where the use of AI can be a game changer. From checking in on patients to monitoring the condition of wounds, AI can help community nurses with their workload and allow them to dedicate their time to where it is most needed. This interview features insights from Karen O'Rourke, lead wound care nurse at Home Wound Care. Her team has been part of the pilot AI technology clinic incorporating a variety of AI tools in the treatment of chronic and hard-to-heal wounds.

The 'practising effectively' section of the Nursing and Midwifery code is applicable to all areas of nursing practice, but the nuances of community nursing mean there are particular challenges. The author addresses issues such as the complexities of documentation platforms and the barriers to contemporaneous record keeping. The article also examines the implications of involving family members as interpreters, highlighting the concerns with balancing cultural sensitivity with safe practice. The key drivers that shape decisions around delegation are also explored with a focus on competence, safety and supervision.

Background: Falls are a major public health concern among older adults and are often associated with increased frailty and mental health issues such as depression.

Aims: This study (1) examined the characteristics of falls among older adults admitted to hospital following community-based falls; (2) explored the relationship between frailty and depression in this population.

Methods: A descriptive and relational study design was used with a purposive sample of 400 adults aged 65 years and over, who were hospitalised in an orthopaedic clinic after experiencing a fall. Data were collected using a sociodemographic information form, the Tilburg Frailty Indicator, and the Yesavage Geriatric Depression Scale-15. Data were analysed using descriptive statistics, chi-square tests, t-tests, analysis of variance, logistic regression and Pearson correlation.

Results: Older adults who were aged 75 years and over, female, single, with lower income, chronic medication use and a history of previous hospitalisations were unlikely to have experienced multiple falls. While the number of falls was not significantly associated with depression levels, increased depression scores were positively correlated with physical and psychological frailty. Frailty accounted for 10% of the variance in depression scores.

Conclusions: Although depression levels were not directly influenced by the number of falls, frailty was significantly associated with both fall frequency and depression.

Implications for practice: The findings emphasise the need for a holistic, multidisciplinary approach in the assessment and care of older adults who experience falls.

Dermatophytes (ringworms) are possibly the most prevalent causes of human infection globally. At least 40 dermatophyte species infect humans. For example, onychomycosis, which is responsible for about half of abnormal nails, may: produce ridging, ingrown nails, bleeding and nail loss; make walking painful; and facilitate secondary bacterial infections. Several diseases increase the risk of onychomycosis caused by dermatophytes, including knee osteoarthritis and poorly controlled diabetes. This article focuses on nursing approaches to managing skin and nail dermatophyte infections. Topical antifungals are generally the first-line treatment for tinea corporis, cruris and pedis. Oral antifungals may be appropriate for tinea capitis, onychomycosis, extensive skin infections or if topical treatment does not resolve the infection. Antifungal resistance is becoming more common. However, community nurses should address poor adherence and other possible causes of treatment failure before assuming antifungal resistance. Community nurses should also ensure that patients are diagnosed and treated rapidly, and suggest lifestyle changes that reduce the risk of antifungal failure, infection and relapse.