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

Skin problems are common, affecting up to one-third of the population during their lifetime, and they are frequently encountered by advanced clinical practitioners (ACPs) in both primary and secondary care settings. Despite the prevalence of dermatological presentations, ACPs often feel unprepared to conduct a thorough dermatological history and examination. This article aims to provide guidance to trainees and qualified ACPs, whether in acute hospital settings or primary care, to perform dermatological assessments and examinations systematically. This is the first article in a two-part series on dermatological assessment.

Background: Administration of intermittent medication through intravenous infusions is common practice. However, recent literature questions whether current practices deliver full doses of prescribed medications.

Objective: This protocol outlines the methodology intended to profile literature describing management of residual volume in medication administration lines.

Methods: The proposed review will use Joanna Briggs Institute scoping review methodology to scope the literature, following a six-step framework. Searches will be conducted in electronic databases, and websites of societies providing guidelines for intravenous therapy. Three reviewers will use the 'PCC' framework to carry out two levels of screening. Results will be tabulated, described, and discussed in a narrative analysis.

Conclusion: This review will improve understanding of current practices by examining flushing procedures used in the management of residual volume, identifying instances when residual volume is discarded, documenting effects on dosing, examining the impact on patient outcomes, and examining possible environmental harm from waste disposal of undelivered medication.

Introduction: The aim of this observational study was to investigate the risk factors of a failed first attempt at pediatric central venous catheter (CVC) placement and its impact on CVC-related morbidity.

Materials and methods: In this prospective observational study, we included 3-month-to 5-year-old children proposed for infraclavicular subclavian vein catheterization consecutively sing the anatomic landmark technique. Patients were divided into two groups: group 1 included single-attempt catheter placements, and Group 2 included failed first attempts at catheter placement. The management protocol was standardized for all patients. After comparing the two groups, univariable logistic regression was used to investigate the risk factors for a failed first attempt and to show the interest of the single-attempt catheter placement.

Results: Among 150 pediatric CVC placements, the incidence of failed first attempts was 41.3% and its main risk factors were children with comorbidities (OR=3.11; 95%CI: 1.17-8.21), hematology and oncology patients (OR=5.6; 95%CI: 2.75-11.38), children with aplastic anemia (OR=3.05; 95%CI:1.388-6.705), and anesthesia sedation with I-Gel airway ventilation (OR=9.21; 95%CI: 1.080-78.5). On the other hand, a single-attempt catheter placement was a protective factor against catheter-related complications with OR=0.258 [0.12-0.55].

Conclusion: It seems that a single-attempt CVC placement may reduce the incidence of complications. The knowledge of the main risk factors of failed first attempts is mandatory for taking necessary precautions.

Infiltration and extravasation injuries are a common complication of intravenous therapy and vascular access practice. However, there remains a lack of awareness and understanding surrounding these injuries. The first of two articles (Barton, 2024) reported on data from a study showing that the use of ivWatch infusion site surveillance technology can dramatically reduce the number of infiltration and extravasation injures with peripheral intravenous infusions of vesicant preparations, which can improve patient safety and have a positive financial impact. This second of two articles on infiltration and extravasation examines the financial and academic burdens.

Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers what information a person needs to understand, retain, use and weigh to have capacity to execute a lasting power of attorney.

The ever-increasing burden of hard-to-heal wounds requires emphasis placed on early intervention to help heal wounds and improve patient quality of life. A patient's healing potential can be optimised by applying the 'Wound Balance' holistic framework for wound assessment, care planning and quality of life considerations. This holistic management can be facilitated with appropriate dressings, such as dressings containing superabsorbent polyacrylate polymers (SAPs), including RespoSorb^® Silicone Border (Hartmann). SAP-containing dressings can absorb exudate and bind and lock away wound inhibitors, such as proteases and micro-organisms, reversing the factors associated with hard-to-heal wounds to enable a healing environment similar to an acute wound. Three case studies demonstrate the positive benefits of using RespoSorb Silicone Border in clinical practice. The dressings proved easy to use and comfortable, with atraumatic changes and long wear times, providing a costeffective option for patients with both acute and hard-to-heal wounds.

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, discusses the work that is progressing on nursing and midwifery student education, including simulated practice learning.