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

Sam Foster, Executive Director of Professional Practice, Nursing and Midwifery Council, considers the ways in which the NMC aims to promote professional standards and protect the public.

People with an outward peristomal body profile can experience difficulties obtaining a secure seal with a flat baseplate to the peristomal skin. Baseplates with a concave contour have been designed to provide a better fit to curved body profiles and reduce the risk of leakage. In this 4-week product evaluation, 110 individuals with an outward peristomal body profile using flat one-piece pouching systems were enrolled to evaluate the impact of a concave one-piece pouching system on wear time, unplanned changes of pouching systems and use of accessories. The product evaluation consisted of two test periods of 2 weeks each. After the first screening period, study nurses evaluated whether the concave pouching system was suitable for the participants and, together with each participant, decided whether to proceed to the second evaluation period. Use of the concave pouching system did not significantly affect wear time but led to significantly fewer unplanned changes of pouching systems and less use of accessories, which may lead to cost savings for the healthcare system.

Guidance recommends that prescribed opioids for acute pain should not be continued beyond the expected period of healing and may lead to long-term use if a large supply is provided or repeat prescriptions are requested. This project investigated how opioids are used by opioid-naïve trauma patients in the first 6 months following discharge from hospital. The findings indicate that patients are frequently discharged from hospital with an opioid prescription and for some this will continue beyond the recommended maximum duration of 3 months and will include dose escalation. Clinicians should be aware of the potential risks associated with prolonged opioid use, including the increased risk of accidental overdose and potential death, and be able to identify which patients are at most risk. Screening for indicators for long-term use may prove more useful than formal risk stratification tools in an acute pain population.

Urinary incontinence, encompassing stress, urge, and overflow types, significantly impacts patients' physical, psychological, and social wellbeing. This article provides an overview of each type, exploring their pathophysiology, risk factors, and clinical presentations. It emphasises the crucial role of nursing and discusses evidence-based management strategies, including behavioural therapies, pharmacological treatments and patient education. The article also addresses the impact of incontinence on quality of life and future directions for research and practice, advocating a multidisciplinary approach to improve patient outcomes.

The '5 Moments' approach is a time-space framework that delineates when hand hygiene should be performed and provides a resource for educators and auditors. It has become the dominant paradigm for organisations, practice, policy, and research in relation to hand hygiene. It is a concept that adopts the 'precautionary principle' that if the relative risk of a specific care task is unknown, a safe system must be to treat them on an equal level. However, a literal interpretation will frequently result in an extraordinary, implausible number of hand-hygiene opportunities and if this then becomes the standard to audit practice, within a policy document that espouses zero tolerance, it is likely to generate inauthentic data. If used effectively the 5 Moments concept provides an opportunity to enhance practice and reduce healthcare-associated infections but the healthcare provider organisation must embody a 'just culture' and collect the data in a climate of openness, transparency, and learning.

This article focuses on homeostasis and offers a pathophysiological perspective. The dynamic mechanisms responsible for maintaining internal balance and disruptive processes will be analysed through the lens of key systems including the nervous, endocrine and renal systems. The environmental factors and their potential impact on homeostasis have been considered. A clinical case study will contextualise homeostasis in clinical practice.

Background: The insertion of a PIVC is the most commonly performed invasive procedure in healthcare. Despite its frequency in placement in hospitalized patients, PIVCs are generally perceived as being safe; however, the prevalence of failure ranges from 35%-50%. Additionally, complications are common and often deemed 'acceptable' by clinicians. Healthcare provider and clinician foundational knowledge and competency is lacking nationally. Considering the mere volume of PIVCs placed, the failure and complication rates, the human impact is significant.

Methods: The Association for Vascular Access (AVA) has led a collaborative effort with representatives from the Infusion Nurses Society (INS), the American Association of Critical Care Nurses (AACN), ECRI, and content experts representing nursing vascular access, infusion therapy, infection prevention, critical care, pediatrics, healthcare leadership, a physician, and a patient representative. Our aim is to provide concise guidance that will enhance and standardize practices related to PIVC. By consolidating current standards of practice into a comprehensive document, our framework seeks to advance the quality of care and improve patient safety.

Results: This document has undergone meticulous scrutiny to ensure its quality, including incorporation of current standards, methodology for consensus from the expert panel, and input received from public comments.

Conclusions: We anticipate that this work will have a significant impact on healthcare professionals, policymakers, and, most importantly, patients' experiences by the promotion of consistent, high-quality treatment, safety, and comfort for patients receiving a PIVC.