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

Kandace Chimbiri, based in London, is the author of several Black history books for children.

Enteral tube feeding is commonly used for children and young people with complex health and care needs. Blended diets are becoming more widely used and there is increasing evidence to show the benefits of a blended diet for children, young people and their families. This article aims to collate recent evidence on blended diets and describe the implications for nursing practice. Studies exploring blended diets have identified benefits such as improved gastrointestinal symptoms, positive engagement with families around food and mealtimes and the normalisation of enteral tube feeding. Research has also explored the nutritional and microbial content of food blends as well as the viscosity and risk of tube blockage. These are key considerations when supporting families to make informed decisions and use blended diets safely. Nurses play an important role in supporting the safe and effective use of blended diets as part of a wider multidisciplinary team. It is necessary that they have an understanding of the evidence underpinning nursing practice in this area.

During the disease trajectory, patients with advanced heart failure are often hospitalised with a high probability of admission to the intensive care setting. Using a case study, this article explores the care given to a patient with decompensated heart failure in an intensive care unit (ICU). It will discuss the significance of holistic assessment and effective symptom management, in particular the research related to breathlessness management. The importance of effective communication within the ICU multidisciplinary team, including with the patient/family will be explored, as the ICU environment can often lead to communication breakdown, patients being unable to voice their wishes and over-medicalisation. The effectiveness of early involvement of the palliative care team in ICU will be examined, including the use of tools such advance care planning and a treatment escalation plan and whether use of these can enable a better patient and family experience at the end of life. The role of palliative care champions will be discussed.

Background: Virtual reality (VR) simulation technology was rapidly integrated into pre-registration adult nursing programmes in response to the pandemic and a reduction in clinical placements. The UK's regulatory body for nursing has recognised its value in nursing education by increasing the possible number of simulated practice hours that can replace clinical placements to 600 hours. This article reports on an evaluation study of a novel approach using screen-based VR simulations for groups of students in a classroom setting.

Objectives: This study aims to evaluate student and lecturer experiences of screen-based VR with the aim of informing and sharing insights from this approach.

Design: Students and lecturers responded to an evaluation survey comprising both closed- and open-ended questions.

Setting: A large approved education institute in the East of England.

Participants: Pre-registration adult nursing master's students and adult nursing lecturers who had experience of screen-based VR with groups.

Methods: Quantitative data were analysed using descriptive methods, and qualitative data using thematic analysis.

Results: Student and lecturer experiences of screen-based VR were overwhelmingly positive, overcoming many challenges of simulation documented in the literature. The group-working approach promoted development of non-technical or essential 'soft' skills such as communication, decision-making and teamwork.

Conclusions: Screen-based VR for classroombased learning offers an effective, engaging and cost-effective method of incorporating VR simulation scenarios in adult nursing education. Thoughtful consideration of pedagogical aspects are key to its successful and effective integration into the pre-registration adult nursing curriculum.

Nurses and other health professionals may be at an increased risk of experiencing emotional disturbance associated with caring for people who are experiencing distress, illness or disease or who are at the end stage of their life. This was a particular problem during the COVID-19 pandemic. This article seeks to explore how working closely with individuals who are experiencing ill health may impact negatively on the nurse as a care provider. This exposure to trauma, illness and death can result in a vicarious experience of trauma that may result in a sense of shared experience with the patient. The emotional burden this places on the nurse can lead to increased anxiety, stress and a need to detach from the patient. This can have a detrimental effect on patient care and nurses must remain vigilant to their susceptibility to, and experience of, mutual suffering through secondary trauma. Although nursing offers many positive experiences, this article is focused on highlighting the negative impacts of secondary traumatic stress. This article briefly outlines the literature relating to secondary traumatic stress and mutual suffering in the acute hospital setting and does not consider mental health settings or patients. The aim of the article is to close the theory-practice gap while also encouraging personal reflection on nurses' experiences of mutual suffering in practice. The author recognises the loaded nature of the term 'mutual suffering'; however, this is an established phrase used to explain the phenomena of interest. Although the term 'suffering' may imply a passive sick role for nurses, in this context the term should be seen as a shared sense of the experience of the patients and health staff.

In the first of a series of articles on decision-makers under the Mental Capacity Act 2005,Richard Griffith, Senior Lecturer in Health Law at Swansea University, considers lasting power of attorney and its impact.

Background: Intensive global food production causes soil, water and air pollution, which has a negative impact on our health and future ability to produce sufficient nutritious food. Plant-based diets have the potential to reduce the environmental damage associated with the global food chain.

Aims: The project sought to understand drivers of food waste and to improve food sustainability in a busy, tertiary referral hospital in England.

Methods: Ward-level food waste was quantified. Qualitative data were collected using informal interviews with staff and additional data utilised the patient feedback survey. Ward-level food packaging waste and patient food choices were quantified using data on patient menu choices. The carbon footprint of patient food choices was calculated.

Findings: Beef was the most popular menu choice, and was the main contributing factor to the high environmental impact of the hospital food chain. Increasing the visibility of vegetarian options on the menu led to a four-fold rise in these meals being chosen, which reduced the carbon footprint of the patient meal service. Recycling food packaging was also started, but there are challenges to widespread implementation.

Conclusion: The project was successful, but it remains a starting point from which to increase food sustainability across the NHS and care sector catering provision.