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

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.

This article provides an overview of the wound healing process, outlining the four distinct phases of the healing cascade: haemostasis, inflammation, proliferation, and maturation. The different types of closure method are described and, specifically, the various types of surgical suture that can be used for wound closure, as well as the strengths and limitations of each. The article explains aspects of patient care that need to be considered such as obtaining informed consent, and the importance of nurses maintaining appropriate clinical skills. It concludes with a step-by-step outline of best practice on how to remove sutures.

The increasing incidence of surgical site infections (SSIs) following caesarean sections highlights the necessity for updated protocols that address risk factors throughout the preoperative, intraoperative, and postoperative stages. Negative Pressure Wound Therapy (NPWT) and hydrocolloid dressings have demonstrated potential for improving wound management and reducing complications, particularly by enhancing dressing integrity. Nevertheless, the application of NPWT requires careful consideration and adherence to local trust guidelines to ensure both its safety and efficacy.

Background: Nurse staffing levels are increasingly challenged while pressures on healthcare systems are rising. There is a clear need to optimise efficiency in healthcare delivery in order to deliver safe, effective and quality health care.

Aim: To understand how nurses working shifts spend their time and explore opportunities to improve efficiency in care delivery.

Method: A time-motion study was conducted on three acute care wards in a district general hospital in West Wales; 13 nurses were observed over 14 shifts, each activity undertaken was recorded in real time.

Findings: In all, 109 hours were observed. Approximately half of nurses' time is spent delivering direct patient care, with medications administration taking the majority of time.

Conclusion: A number of recommendations are made involving processes and workforce modelling with the aim of improving efficiency and safety. Further research would be required to assess the impact of their introduction.