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

Nutrition plays a vital role in wound healing, influencing both the speed and quality of recovery. The wound healing process encompasses haemostasis, inflammation, proliferation, and remodelling, each reliant on specific nutrients. This article summarises the current literature on the role of nutrition in wound healing, focusing on key nutrients: proteins, vitamins (A, C, E, K), and minerals (zinc, iron, copper, manganese), essential for collagen synthesis, immune function, and cellular activity. Nurses are pivotal in assessing nutritional status, implementing dietary interventions, and educating patients and caregivers about the importance of nutrition in wound care. Practical strategies include personalised dietary plans, appropriate use of nutritional supplements, and regular monitoring of nutritional intake and wound healing progress. Although the benefits of nutrition in wound healing are well established, challenges persist, particularly in the limited evidence beyond pressure injuries and the constrained efficacy of supplementation without deficiencies. A multidisciplinary approach is critical to optimise nutritional support and improve patient outcomes in wound healing.

This article explores the role of the professional nurse advocate (PNA) in supporting the nursing workforce through restorative clinical supervision. It outlines the theoretical framework of the A-EQUIP model, which emphasises advocacy, education, quality improvement, and understanding. Initially introduced in midwifery, the PNA role has been expanded to all nursing areas to address issues such as burnout and workforce challenges, particularly those intensified by the COVID-19 pandemic. PNAs provide a safe space for nurses to reflect on their practice, support their wellbeing, and lead quality improvement initiatives. The role is crucial for fostering a positive work environment, enhancing nurse retention, and improving patient care. The training and skills required by PNAs are discussed, along with the benefits and challenges of implementing this role, and its broader impact on the healthcare workforce.

Advanced clinical practice invites curiosity, rationalising the reasoning behind clinical symptoms. Developing one's own style of critical thinking is a journey that is influenced by a variety of factors including stress, risk, time and knowledge. There has been significant scrutiny in practice around making a clinical judgement when a person is entering the terminal phases of life, yet little clarity exists for clinicians regarding what information is required to make this decision. Within the role of advanced clinical practitioner (ACP) in palliative care there is an expectation to offer guidance and support to persons and families as well as junior nursing and medical staff of the changing phases of a person's illness. There is 'one chance to get it right', yet predicting death and dying remains predictably unpredictable.

Surgical wounds and periwound skin require protection to prevent complications, which affect clinical outcomes and patient quality of life. This study surveyed 45 health professionals treating 394 patients to elicit their experiences of the performance, quality, ease of application and usability of the sterile surgical wound dressing Curapor under routine conditions. Most (90%) wounds were acute, including postoperative wounds, lacerations, cuts and abrasions. The average wear time per dressing was 2.08 days; 94% of patients experienced no dressing slippage and 98% experienced no tape blisters. Curapor was rated good at absorbing exudate. All health professionals reported that their patients thought the dressing was soft or very soft and 98% said that patients found its comfort to be good or very good. The results of the study suggest that Curapor meets the performance requirements for a post-surgical dressing.

Background: The impact of the first-year clinical placement on the mental health and wellbeing of nursing students remains under-researched, with limited information on how well students are initially prepared for clinical placement both mentally and emotionally, specifically child field student nurses (CFSN).

Aim: Understand the psychological preparedness of CFSNs for their first-year clinical placements.

Method: Using a phenomenological approach, this study aims to understand the experiences of CFSNs in the context of their psychological preparedness for their first-year clinical placements.

Findings: Psychological preparedness concerning clinical placement is not a singular concept, but comprises feeling both practically and emotionally ready for the opportunities, challenges and overall experiences that clinical areas offer.

Conclusion: Higher education institutions need to better prepare and protect the psychological wellbeing of CFSNs in their first year. This can be achieved through an enhanced curriculum and developing simulated practice sessions that better reflect the clinical environment.

Burnout, a psychological syndrome caused by prolonged exposure to chronic workplace stressors, is a prevalent issue in nursing, characterised by emotional exhaustion, depersonalisation and a diminished sense of accomplishment. This article explores the widespread impact of burnout in nursing, identifying its key indicators and consequences for both nurses and patient care. Furthermore, it evaluates evidence-based management strategies, including organisational interventions, resilience training, and peer support programmes, aimed at mitigating burnout and improving outcomes.

Diabetic foot disease is a severe complication of diabetes, leading to significant morbidity and lower limb amputations. This review explores the pathophysiology of diabetic foot disease, highlighting the roles of peripheral neuropathy, peripheral arterial disease and immunosuppression in the development of foot ulcers and infections. Key intrinsic and extrinsic risk factors, including long-standing diabetes, poor glycaemic control, inappropriate footwear and trauma are discussed. The importance of comprehensive diabetic foot assessments using diagnostic tools such as the Ipswich Touch Test and Doppler studies is emphasised for early detection and management. Challenges such as delays in referral to specialist care, limited access to multidisciplinary foot teams, and staffing shortages are identified as critical barriers to effective care. The review builds upon extant literature by integrating the most recent evidence, including the 2023 guidelines from the International Working Group on the Diabetic Foot. It emphasises practical application, detailed referral pathways and multidisciplinary care strategies, offering updated tools and insights to improve clinical outcomes and address the often overlooked aspects within inpatient services. Future directions encompass advances in imaging, telemedicine and patient education, which may further optimise preventive and therapeutic strategies for diabetic foot disease.

Pressure ulcer risk assessment is an essential part of pressure ulcer prevention. This article explores the Pressure Ulcer Risk Primary Or Secondary Evaluation Tool (PURPOSE-T), the use of which is advocated by the NHS England National Wound Care Strategy Programme. The article aims to increase awareness of the PURPOSE-T risk assessment tool and address the need, expressed by Wound Care Alliance UK members, for an overview of it. Consideration is given to reliability and validity. Further testing of the tool is needed in some healthcare settings. A recommendation is made regarding its implementation, which should be fully supported by guidance, resources and inform the development of an appropriate, patient-focused individualised care plan, wherever possible agreed with the patient.