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

In our continuing series on the experiences of a nursing student, Jade Petchey describes some of the advice she has found most useful so far in her student nurse career.

Background: Diabetes insipidus (DI) is a common complication following pituitary surgery, causing significant health issues if left untreated. As part of the diagnostic process, accurate urinary output monitoring via indwelling urinary catheters (IDUCs) is essential, despite risks such as urinary tract infections and hindered recovery. Research on IDUC removal after pituitary surgery remains scarce.

Aim: To explore health professionals' perspectives on IDUC management following pituitary surgery.

Methods: Employing a qualitative design, semistructured interviews were conducted with 15 professionals in the neurosurgical ward of a Dutch academic hospital.

Findings: Four themes emerged: Concerns about missing identifying DI, patient-nurse dynamics, workload management, and lack of shared decision making.

Conclusion: The findings underscore the need to balance clinical needs with patient care efficiency. There is a need for evidence-based guidelines and a multidisciplinary approach to optimise IDUC management, given the importance of patient-centred care and shared decision-making.

This article reports on a study that evaluated an innovative 6-week summer returners' programme, part of the Health Education England RePAIR project, designed to support nursing students who have interrupted their studies. Held from May to July 2022, the programme addressed diverse needs through academic guidance, mental health and resilience workshops, creative arts, professional identity development, and practical nursing skills training. The programme ran alongside support from the programme team, student engagement services, and ongoing communication via phone and email. Despite non-mandatory sessions leading to varying attendance, the combined efforts facilitated the return of 67 out of 135 interrupted students. Thematic analysis identified four key themes: anticipation and fear, making contact and reaching out, preparing for return, and psychological wellbeing. The programme's effectiveness underscores the necessity of tailored support strategies to enhance retention and wellbeing. This innovative approach highlights the importance of personalised support in aiding nursing students' return to education and addressing nursing workforce shortages.

Advanced clinical practitioners (ACPs) are experienced health professionals educated to master's level. They are accountable for the assessment, diagnosis and treatment of individuals, and are responsible for making complex decisions. The case study presented in this article critically analyses the consultation involving a male patient in his sixties with a 2-day history of abdominal pain, who was referred by his GP to a surgical assessment unit. Analysis was carried out using the Calgary-Cambridge Model. The article discusses history-taking, abdominal examination and differential diagnoses, and presents the process of how the trainee ACP arrived at the diagnosis of appendicitis.

John Tingle, Associate Professor, Birmingham Law School, University of Birmingham, discusses the recent Darzi report on the NHS in England.

Diabetic ketoacidosis (DKA) and hyperosmolar hyperglycaemic state (HHS) are both diabetic emergencies that require immediate identification and intervention. Advanced clinical practitioners (ACPs) play a crucial role in the early detection, management and co-ordination of care for patients with these conditions, although some may feel less confident in handling such complex cases. This clinical review explores the role of ACPs in managing DKA and HHS, focusing on their responsibilities in diagnosis, treatment initiation, and communication within multidisciplinary teams. It also examines the epidemiology, pathogenesis, risk factors, and causes of these conditions, alongside diagnostic criteria and management strategies. In addition, the review highlights the importance of minimising risks and preventing recurrence to ultimately enhance patient outcomes.