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

The delivery of oral health care has been identified as an important part of holistic patient care. Many patients may neglect their own oral health, oral hygiene and self-care when they are hospitalised due to feeling unwell. The Royal Wolverhampton NHS Trust nursing quality team endeavoured to change their Trust's culture relating to oral health management for all adult inpatients. To facilitate ongoing action relating to oral hygiene and health education and training, a bespoke, mandatory digital learning package was designed, developed and delivered to relevant clinical staff at the Trust.

Poisoning and overdose are significant public health concerns in the UK, with poisoning accounting for more than 115000 hospital presentations in England in 2021-2022. Nurses are crucial in managing patients from triage to discharge. Nurses' role in treating poisoning and overdose cases involves recognising toxidromes, initial stabilisation and symptom management. Commonly ingested substances include paracetamol, ibuprofen and illicit drugs; pharmacological interventions available include antidotes such as acetylcysteine and naloxone. Patients require a multidisciplinary approach, and collaborative care may involve clinical toxicologists, mental health professionals and social services to ensure comprehensive recovery. Ethical considerations of poisoning treatment include patient consent and the complexities of intentional overdoses. By understanding the nuances of poisoning and overdose treatment, health professionals can offer compassionate, evidence-based care.

This article examines several factors that can affect how raising of concerns can be supported. Nurse leaders play a vital role in this process to maintain patient safety and act accordingly within the Nursing and Midwifery Council Code. Considerations are provided to explore how the nurse leader can facilitate communication with all team members to influence organisational culture, where colleagues feel confident in voicing concerns. Professional responsibilities pertinent to this process are highlighted, including the nurse leader as an advocate and supporting constructive challenge.

Lipodermatosclerosis (LDS), also known as sclerosing panniculitis, is a chronic inflammatory condition of the skin and subcutaneous tissue caused by longstanding venous insufficiency. Often misdiagnosed as cellulitis due to overlapping clinical features, it requires accurate diagnosis and a multifaceted management approach. This clinical review explores the epidemiology, pathophysiology, clinical presentation, diagnostic challenges and management strategies for LDS. Acute LDS manifests with erythema and induration similar to cellulitis, while chronic LDS is characterised by fibrosis and skin tightening. Key management strategies include compression therapy, lifestyle modifications and interventions targeting venous insufficiency. Challenges such as delayed diagnosis, poor adherence to therapy and limited evidence for systemic treatments may compromise the quality of patient care. Future directions emphasise novel therapeutic approaches, evaluation of current treatments and the integration of artificial intelligence to enhance diagnostic decisions. Increased clinician awareness and research into the epidemiology, pathogenesis and treatment of LDS remain essential to improve patient outcomes.

Background/aim: Addressing the critical global shortage of nurses requires an understanding of how a global pandemic reshaped nurses' motivations and intentions toward education. This study aimed to describe COVID-19's impact on nurses' intent to pursue additional education.

Method: This descriptive study, based in North Carolina in the USA, used content analysis with an inductive approach to examine the responses of nurses to one open-ended question in a large quantitative workforce survey: how has COVID-19 influenced your plans for future education? Responses were coded with counts and organised into themes and subthemes.

Findings: Primary themes identified from the data included: stressors, appraisals and coping. There were 10 subthemes, which supported primary themes with direct quotes from nurses. The implications of the themes aligns with concepts from the self-determination theory: autonomy, competence and relatedness.

Conclusion: Nurse responses to the pandemic can guide organisations and academic institutions in supporting nurses in times of stress and design programmes that align with their goals. Nursing leaders and educators must support nurses' autonomy, competence and relatedness, addressing issues such as burnout, financial strain, work-life balance and evolving professional demands. Academic institutions should adopt flexible, resilience-focused curricula and invest in skilled nurse educators to support the growing need for advanced education and online learning.

Highlights: PIVCs often cause pain, irritation, or infection. Regular and careful catheter checks can decrease complications and improve patient outcomes. Implementation of the I-DECIDED® tool led to fewer idle catheters and complications. We present ideas for implementing the tool and how to overcome some common barriers.

Introduction: Peripheral intravenous catheter (PIVC) assessment and decision making should be evidence based to minimize risks and enhance patient care. Exploring implementation strategies from successful outcome studies can raise health care professionals' awareness, boost adherence to evidence-based protocols, and elevate PIVC care standards.

Aim: To describe the implementation of the I-DECIDED® device assessment and decision tool for PIVC management in the Australian and Brazilian contexts.

Methods: The Promoting Action on Research Implementation in Health Services (PARIHS) framework (evidence, context, facilitation) was used to prospectively plan the implementation of the tool in adult inpatient units in Australia and to retrospectively analyze the implementation of the tool in a pediatric inpatient unit in Brazil. Similarities and differences in the implementation studies were explored.

Results: Implementation of the tool in Australia and Brazil demonstrated that prevention and early detection of PIVC complications is achievable with standardized assessment and decision prompts. Both contexts witnessed a reduction in idle PIVCs, decreased insertion site complications, improved dressing quality, and significant improvements in documentation following implementation. Common implementation strategies included champions, education, badge cards, and posters. Enabling flexibility and context-specific education strategies was essential.

Conclusion: Standardization of PIVC assessment and decision making using the I-DECIDED® tool reduced the prevalence of idle catheters and complications in Australia and Brazil. Implementation of the tool in different contexts confirms its utility and relevance for PIVC management in diverse health care settings. Promotion and adoption of the tool as a PIVC management bundle could increase patient safety and reduce health care costs.

The aim of nursing programmes is to produce employees who are occupationally ready. One method to assess occupational readiness is a verbal examination of subject area knowledge and understanding. This assessment type is used at a higher education institution in the north of England deemed outstanding by Ofsted. The verbal assessment (a professional conversation) requires student nursing associate apprentice learners to demonstrate clinical and professional knowledge and understanding gained and applied throughout a 2-year foundation degree to prepare for registration with the Nursing and Midwifery Council as a nursing associate. Preparation for this assessment consolidates prior learning; the assessment method is authentic and has been found to be an effective means through which learners are able to articulate and showcase their knowledge, with many gaining high marks.

In our continuing series on the experiences of a nursing student, Jade Petchey discusses the importance of acknowledging the work of everyone who helps keep a hospital running.

Background: The burden of hospital-acquired infections (HAIs) equates to 3.5 million cases, resulting in more than 90 000 deaths and 2.5 million disability-adjusted life years (DALYs) across Europe. Biological spills pose infection and safety risks for both patients and staff, so spill management is of strategic importance for containment. There is limited evidence as to the efficacy of spill kits currently in use with regard to infection control management.

Aim: To understand the perceptions of health professionals when using different spill kit systems. Data collection involved videos and interviews with simulated patients and health professionals (n=24). Simulated spills/scenarios were used to compare the use of both two standard (incumbent) and BIOPERL+ spill kit interventions. Data analysis was iterative and informed by the Framework Method of Analysis.

Findings: The BIOPERL+ kit facilitates rapid identification of the appropriate spill kit to use; locating and understanding instructions in both kit types highlight how individuals learn and absorb information; there were positive views on the efficacy of the granules to absorb blood, urine, faeces and vomit of both kit types; the larger scoop of the BIOPERL+ kit was seen as a benefit, facilitating ease of use; concerns were raised over potential cross-contamination and the environmental impact of plastic components used in the kits.

Conclusion: The 'one size fits all' of the BIOPERL+ kit identified it as the spill kit to use for all biological spills, whereas choice of the two incumbent kits depended on spill type. Locating and understanding instructions in both kit types highlighted how individuals learn and absorb information differently, which may have implications for clinical practice. Participants perceived that all kits had minimal to strong odour, yet the incumbent kits emitted a chlorine-type odour, potentially posing a health risk. The BIOPERL+ large scoop size was seen as more efficacious for spillage containment compared with the smaller plastic scoop of the incumbent kits. Participants also perceived that the incumbent kits could be a source of potential cross-contamination when reusing component parts. The cardboard materials used in the BIOPERL+ kit were perceived as a benefit, potentially having less of an impact on the environment. The study identified that the BIOPERL+ kit is an effective, safe novel intervention that is both appropriate for managing human spills and environmentally friendly.