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

A cancer diagnosis is an emotionally and physically overwhelming experience. For patients with stomas, this journey is further complicated by unique challenges that demand specialist care and attention. The presence of a stoma introduces additional layers of complexity, making the role of a specialist stoma nurse indispensable. Their expertise not only helps in preventing severe complications but also ensures timely management of issues, empowering patients to navigate their treatment with confidence and dignity. This article explores common side-effects of systemic anti-cancer therapy and how these complications specifically impact stoma care, with specialist-tailored management strategies for each stoma type.

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers the Court of Protection's guidance on how to adhering to the requirements of the Mental Capacity Act 2005 when assessing capacity.

Continence problems remain widespread across community and secondary care, yet provision in the UK continues to be shaped by inequities, fragmented commissioning, stigma and variation in workforce capability. This article examines the contribution of advanced practitioners (APs) to continence care through the four pillars of practice and considers how their clinical expertise, leadership influence, educational role and engagement with research can strengthen assessment, co-ordination and person-centred support. Evidence from national reports and existing studies demonstrates the need for improved pathways, enhanced staff capability and dignity-focused practice, particularly for populations affected by frailty, cognitive impairment, or cultural and communication barriers. By integrating comprehensive assessment, sensitive communication, culturally responsive engagement and informed use of innovation, APs can advance equitable continence provision and improve the lived experience of individuals with bladder and bowel needs. The article concludes that AP-led practice is essential for progressing continence care within a system that requires greater consistency, stronger evaluation and sustained attention to wellbeing and quality of life.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, discusses several reports relating to patient communication and complaints around patient safety in the NHS.

This article explores the pivotal role of nurses in antimicrobial stewardship (AMS), emphasising their contribution to combatting the global healthcare challenge of antimicrobial resistance (AMR). It begins by outlining the significant clinical and economic burden posed by AMR, underscoring the consequences of inappropriate and excessive antimicrobial use. The discussion then shifts to the evolving role of nurses in AMS, supported by a review of literature and clinical guidelines. Key barriers to nurse engagement in AMS are identified, including educational, systemic and cultural challenges. This article also considers the potential of competency-based education to empower nurses in this domain. Finally, key learning points are summarised, and practical recommendations are proposed to enhance nursing involvement in AMS initiatives.

Highlights: Implementation of the line guard led to a significant decrease in central line-associated bloodstream infection (CLABSI) incidence Since implementing the line guard, the Pediatric Critical Care Unit (PCCU) is CLABSI-free Consistent audits showed CLABSI rates improving over time.

Background: Clinicians strive for a central line-associated bloodstream infection (CLABSI)-free environment. Effective prevention strategies are crucial to reducing the burdens associated with these infections. The purpose of this study was to assess whether a line guard, a transparent line-to-line barrier against gross contamination, was effective in contributing to the reduction of pediatric CLABSIs.

Methods: A line guard was implemented into central venous access device (CVAD) practices for all inpatients at 1 children's hospital. This pre-post intervention study assessed its effectiveness in CLABSI prevention, comparing retrospective surveillance records to postimplementation data.

Results: CLABSI rates throughout the hospital were significantly lower during the study period (P=0.0208), and since implementation of the line guard, the PCCU has been over 1 year CLABSI free (P=0.0189).

Conclusions: With good line guard use compliance and no other practice changes occurring simultaneously, findings suggest a line guard is a promising addition to CLABSI prevention bundles, especially for patients at highest risk of external contamination to their lines.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, discusses several recent patient safety reports and what they show about the development of an effective NHS patient safety culture.