British Journal of Nursing最新文献

Clinically assisted nutrition and hydration (CANH) decision-making in adult patients presents complex ethical dilemmas that require careful consideration and navigation. This clinical review addresses the multifaceted aspects of CANH, emphasising the importance of ethical frameworks and the role of advanced clinical practitioners (ACPs) in guiding decision-making processes. The pivotal role of ACPs is highlighted, from their responsibilities and challenges in decision-making to the collaborative approach they facilitate involving patients, families and multidisciplinary teams. The article also explores ethical principles such as autonomy, beneficence, non-maleficence, and justice, elucidating their application in CANH decision-making. Legal and ethical frameworks covering CANH are examined, alongside case studies illustrating ethical dilemmas and resolutions. Patient-centred approaches to CANH decision-making are discussed, emphasising effective communication and consideration of cultural and religious beliefs. End-of-life considerations and palliative care in CANH are also examined, including the transition to palliative care and ethical considerations in withdrawal or withholding of CANH. Future directions for research and implications for clinical practice are outlined, highlighting the need for ongoing ethical reflection and the integration of ACPs in CANH decision-making.

Background: The pre-registration BSc Nursing course in the UK is renowned for being challenging due to its requirement for 2300 hours each for theoretical and practice-based learning. It is therefore inevitable that some students may need to interrupt their study at some point during the course. In many cases, these students do not return and leave the course, which has an impact on the future nursing workforce.

Aims: To examine the reasons why pre-registration student nurses interrupt their studies and consider ways to enable them to return successfully and complete the course.

Methods: The research project was based in one higher education institution (HEI) in the North West region of England. Interrupted students due to return to study in semester 1 of the 2022/23 academic year (n=95) were invited to participate in semi-structured interviews.

Findings: Health, including mental health was the dominant factor leading to the interruption of study for the students.

Conclusion: This research has led the HEI to introduce an improved support package for students. Alongside other recommendations it is hoped the changes will reduce attrition and lead to an improved interruption/return-to-study experience.

The practice of administering blended food via enteral feeding tubes has been growing in popularity in recent years. Concerns have been raised as this practice was perceived to increase risk of gastrointestinal intolerance, allergic reactions, nutritional insufficiency, tube blockages, and infection compared with using commercial enteral feed (CEF), the gold standard, as well as risk of litigation against the professional due to their support of practice that is not evidence-based. However, research has shown that the physical, social and emotional benefits from receiving blended diet may outweigh the previously suggested risks. Guidance has been updated to encourage discussions around blended diet while informing the tube-fed individuals, families and carers of potential risks, potential benefits, barriers, considerations for training, safety and contraindications.

Richard Griffith, Senior Lecturer in Health Law at Swansea University, discusses the importance of consent in nursing and outlines the key elements for ensuring the patient has given valid consent before providing treatment.

John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses what stakeholders in health and patient safety want the next government to deliver.