British journal of nursing (Mark Allen Publishing)最新文献

Wound care in the UK has long been challenging, clinically complex and economically burdensome. Wounds affect millions of patients annually, costing the NHS billions of pounds. Despite the scale of this problem, wound care services have historically been subject to fragmentation, variable clinical practice, delayed interventions, a lack of coordinated policy focus and poor data collection. Between 2015 and 2025, this situation has persisted in the face of increasing pressure on NHS resources, rising patient demand and growing evidence of suboptimal outcomes, particularly for chronic wounds such as diabetic foot ulcers, pressure ulcers and venous leg ulcers. This article critically analyses the literature relating to clinical and financial outcomes of wound care in the UK from 2015 to 2025 published by Professor Julian Guest. Critically analysing Guest's publications on wound care is important for several reasons, especially in relation to clinical and policy-making contexts in the latest NHS plans; it is essential to understand what strategies have worked, what gaps remain and how future services should be designed. There is a pressing need to synthesise the decade of research and policy developments in wound care. This article serves to critically appraise the progress and effectiveness of recent efforts.

Adult female acne is increasingly recognised as a chronic inflammatory skin disorder affecting women well beyond adolescence. Hormonal fluctuation, inflammatory signalling, skin barrier impairment, and microbiome shifts contribute to its development and persistence. Perimenopause and menopause introduce further complexity due to declining oestrogen levels and relative androgen excess. This article provides an evidence-based overview of adult and menopausal acne, integrating epidemiology, underlying mechanisms, clinical presentation, assessment, management, and the crucial role nurses play in patient education, continuity of care, and multidisciplinary referral.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, considers recent reports looking at violence against healthcare staff and the adverse impact of corridor care on NHS employees.

Sam Foster considers the need to create an environment where nurses feel speaking up will lead to change.

Patient safety remains a critical concern in healthcare systems worldwide, particularly in acute settings such as stroke units, where multidisciplinary co-ordination is essential.

Method: This study explores the implementation and impact of a focused clinical daily safety huddle (FCDSH) as a non-technical intervention aimed at enhancing patient safety, reducing hospital-acquired pressure ulcers (HAPUs), and improving interprofessional collaboration. The project employed Kotter's eight-step change model to guide the implementation process and used Plan-Do-Study-Act (PDSA) cycles for iterative development. Stakeholder engagement, coaching leadership methodology, and a robust data collection process, including run charts, supported the intervention.

Results: The results demonstrated a significant increase in the number of days between reported pressure ulcers, with the ward achieving 142 days without an incident post intervention compared with a baseline average of 18.2 days. The findings highlight the effectiveness of FCDSHs in improving communication, fostering teamwork, and reducing preventable patient harm.

Conclusion: This service evaluation contributes to the growing evidence base for human factors approaches and non-technical skills in clinical practice.

Background: Elderly care nursing has problems such as staffing shortages, stress and limited career opportunities, which are prompting nurses to leave.

Aim: The aims of this service evaluation were to explore the factors contributing to high turnover of nurses in elderly care and propose retention strategies.

Design: A qualitative design was used.

Methods: Seven semi-structured interviews were conducted with nurses from six wards within the elderly care division.

Results: Three main themes emerged: staff and patient safety; lack of career progression; and training needs.

Conclusion: Nurses in elderly care face both personal and organisational challenges. Prioritising their development, safety and recognition is crucial for retention. Trusts should acknowledge and support these nurses' hard work and commitment. Recommendations include flexible working patterns, providing adequate skill mix on the wards and opportunities for career progression in elderly care.