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

The '5 Moments' approach is a time-space framework that delineates when hand hygiene should be performed and provides a resource for educators and auditors. It has become the dominant paradigm for organisations, practice, policy, and research in relation to hand hygiene. It is a concept that adopts the 'precautionary principle' that if the relative risk of a specific care task is unknown, a safe system must be to treat them on an equal level. However, a literal interpretation will frequently result in an extraordinary, implausible number of hand-hygiene opportunities and if this then becomes the standard to audit practice, within a policy document that espouses zero tolerance, it is likely to generate inauthentic data. If used effectively the 5 Moments concept provides an opportunity to enhance practice and reduce healthcare-associated infections but the healthcare provider organisation must embody a 'just culture' and collect the data in a climate of openness, transparency, and learning.

This article focuses on homeostasis and offers a pathophysiological perspective. The dynamic mechanisms responsible for maintaining internal balance and disruptive processes will be analysed through the lens of key systems including the nervous, endocrine and renal systems. The environmental factors and their potential impact on homeostasis have been considered. A clinical case study will contextualise homeostasis in clinical practice.

Background: The insertion of a PIVC is the most commonly performed invasive procedure in healthcare. Despite its frequency in placement in hospitalized patients, PIVCs are generally perceived as being safe; however, the prevalence of failure ranges from 35%-50%. Additionally, complications are common and often deemed 'acceptable' by clinicians. Healthcare provider and clinician foundational knowledge and competency is lacking nationally. Considering the mere volume of PIVCs placed, the failure and complication rates, the human impact is significant.

Methods: The Association for Vascular Access (AVA) has led a collaborative effort with representatives from the Infusion Nurses Society (INS), the American Association of Critical Care Nurses (AACN), ECRI, and content experts representing nursing vascular access, infusion therapy, infection prevention, critical care, pediatrics, healthcare leadership, a physician, and a patient representative. Our aim is to provide concise guidance that will enhance and standardize practices related to PIVC. By consolidating current standards of practice into a comprehensive document, our framework seeks to advance the quality of care and improve patient safety.

Results: This document has undergone meticulous scrutiny to ensure its quality, including incorporation of current standards, methodology for consensus from the expert panel, and input received from public comments.

Conclusions: We anticipate that this work will have a significant impact on healthcare professionals, policymakers, and, most importantly, patients' experiences by the promotion of consistent, high-quality treatment, safety, and comfort for patients receiving a PIVC.

In our continuing series on the experiences of a nursing student, Jade Petchey provides some suggestions for keeping your mental and physical health on track.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, discusses several recently published patient safety reports.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, reports on research that explored the views and experiences of overseas nurses with advanced practice qualifications working in the UK.

Health literacy is defined as an individual's ability to access, understand and use information to make informed decisions. This study aimed to assess health literacy levels and explore the relationship between health literacy and chronic obstructive pulmonary disease (COPD) severity. A cross-sectional study of health literacy in patients with COPD used the Health Literacy Questionnaire (HLQ) and the Medical Research Council Breathlessness Scale to assess COPD severity. HLQ domains of 'having sufficient information to manage my health', 'actively managing health', and 'understanding health information' scored most highly. Patients with the greatest COPD severity had lower scores in the domain 'having sufficient information to manage my health', but indicated an improved ability to appraise health information. Patients with increased COPD severity have greater self-reported skills in appraising health information, but they report reduced confidence in having sufficient information to manage their health. This study highlights the importance of considering health literacy levels, as this could be a barrier to successful self-management.