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Nursing Standard

Lorraine Mutrie, Barry Hill
The provision of nutritional support for patients who are critically ill is complex and multifaceted, in part because of the variety and complexity of potential clinical presentations. This article explores the importance of providing nutritional support for patients who are critically ill and explains the pathophysiology of nutrition in altered health states. It discusses nutritional screening and assessment, the various routes of nutrition administration and the nursing considerations involved in providing nutritional support in critical care...
May 21, 2018: Nursing Standard
Kay Elliott
Atrial fibrillation is a common cardiac arrhythmia and is the most frequent arrhythmia experienced by older people. It is caused by chaotic electrical activity in the atria, leading to an irregular and often rapid heart rate. Atrial fibrillation is associated with an increased risk of ischaemic stroke, resulting from the turbulent blood flow in the atria. This article details the presentation of, and risk factors associated with, developing atrial fibrillation, the importance of reducing the risk of adverse events such as stroke, and the treatment options available...
April 26, 2018: Nursing Standard
Mariama Barrie
Faecal incontinence is a condition that can develop as a result of age, injury or long-term conditions, and may be associated with significant stigma for those affected. Symptoms of faecal incontinence include leakage of flatus and faeces, and the condition can affect people of any age, although it is most prevalent in older people. Faecal incontinence is a subject that might not be openly discussed by patients and healthcare professionals; therefore, it is important for nurses to be aware of its signs, symptoms, causes and risk factors, so that they can identify patients at high risk...
April 20, 2018: Nursing Standard
Ellie Stewart
Urinary incontinence is a common and usually hidden issue that can affect women of all ages. It is often ignored by the patient because of their misconception that incontinence is an inevitable consequence of ageing and their low expectations of successful treatment. There are various types of incontinence, with symptoms that can significantly affect patients' quality of life. This article aims to enhance nurses' understanding of the types of urinary incontinence affecting women, associated risk factors and continence assessment, as well as the initial investigations and conservative treatments that can be instigated by general nurses...
April 20, 2018: Nursing Standard
Claire Anderson
There have been several changes to healthcare services in the UK over recent years, with rising NHS costs and increasing demands on healthcare professionals to deliver high-quality care. Simultaneously, public inquiries have identified suboptimal leadership throughout the NHS, which has been linked to a lack of clear leadership across the healthcare professions. In nursing, the role of the advanced nurse practitioner is regarded as a solution to this leadership challenge. This article examines the background to the development of the advanced nurse practitioner role...
April 19, 2018: Nursing Standard
Julian Barratt
Advanced nurse practitioners, and nurses aspiring to this role, are required to understand how to communicate effectively and on a collaborative basis with patients and carers during consultations, with the aim of enhancing patient outcomes such as improved patient satisfaction, ability to self-manage healthcare needs and adherence to care plans. This article explores collaborative communication in consultations and how best to achieve this, using the author's doctoral observational research based on the findings of a mixed methods observational study of communication in advanced clinical practice patient consultations...
March 27, 2018: Nursing Standard
Kathryn Powrie
This article describes the signs and symptoms of drug allergy, and explains the effects that it can have on patient care. It outlines the risk factors for the development of drug allergy, along with the mechanisms by which allergic reactions are mediated. This article also explains the tests used to diagnose drug allergy, and provides recommendations for the management of patients who experience an allergic reaction to a drug. The author uses case studies to emphasise the importance of the role of the nurse in managing, reporting and documenting drug allergies appropriately...
March 27, 2018: Nursing Standard
Jaskirran Breach
Cardiac arrest is a traumatic event, both for patients and their family members. Traditionally, healthcare professionals have often been reluctant to offer family members the opportunity to witness cardiopulmonary resuscitation (CPR) attempts. However, professional bodies globally have begun to recommend the use of family-witnessed resuscitation (FWR) during CPR, identifying a range of potential benefits including supporting the patient, increasing family members' confidence in healthcare professionals and, in some cases, promoting acceptance of the patient's death...
March 27, 2018: Nursing Standard
Emma Menzies-Gow
This article provides a step-wise, practical approach to recording a 12-lead electrocardiogram (ECG) and explores the evidence base that supports the use of this important assessment tool in clinical practice. •A 12-lead ECG is frequently used in a variety of clinical settings, including emergency care, preoperative and post-operative assessment, and primary care. It is used to assess and diagnose patients with suspected arrhythmias, hypertension, coronary heart disease or heart failure.•Correct positioning of the electrodes using anatomical landmarks is essential to ensure an accurate and high-quality ECG recording...
May 2, 2018: Nursing Standard
Beth Hardy
Carers have a vital role in end of life care in all settings. They are essential in enabling people to live at home at the end of their lives. Carers give and receive care, and have a range of support needs related to this complex role. This article explores the context of caring at the end of life and considers the experience of carers, in particular those who have a non-professional and unpaid relationship with someone who is at the end of life, and the support they require.
April 28, 2018: Nursing Standard
Molly Courtenay
In the UK and internationally, the nursing profession is continuing to advance and innovate its roles and functions. One area in which this is particularly notable is nurse prescribing. The UK has the most extended nurse prescribing rights in the world, with significant advances in this field over the past two decades. This article reflects on this development, what has been learned and the challenges that remain in relation to nurse prescribing and meeting healthcare service needs.
April 28, 2018: Nursing Standard
Vicki Cope, Melanie Murray
Nurses are increasingly using professional portfolios as a way to maintain evidence of their learning and reflection, and to demonstrate that they have met their professional requirements. A portfolio can assist nurses to store and manage their revalidation or reregistration documents in one place, so that these can be easily updated and produced when required, for example in performance reviews and job applications. All nurses are required to undertake continuing professional development activities to maintain, update and improve their knowledge and practice, and they can use their portfolio to document these activities...
March 21, 2018: Nursing Standard
Fiona Springall
People with learning disabilities are often marginalised in healthcare, including in hospice settings, and as a result may not receive effective end of life care. Research in hospice settings has identified that many staff lack confidence, skills and knowledge in caring for people with learning disabilities, which can have a negative effect on the care these individuals receive. To address these issues, the author has proposed a service improvement initiative, which she developed as part of her learning disability nursing degree programme...
March 21, 2018: Nursing Standard
Rimen Lim
Sleep disturbance is a significant issue for patients in intensive care units (ICUs), which can affect their health and recovery from illness. Therefore, it is important to consider ways to address sleep disturbance in these settings. One strategy that has been suggested is the use of 'quiet time' interventions, which involve a defined period where there is a reduction in controllable light and sound, and where interruptions at the patient's bedside are minimised. AIM: To determine the effectiveness of quiet time interventions in improving patients' sleep quality in ICUs; to investigate other potential clinical benefits of quiet time interventions; and to consider the effect of incorporating open visitation when implementing quiet time interventions...
March 21, 2018: Nursing Standard
Edwin Tapiwa Chamanga
Chronic wounds are defined as those that have failed to heal after three months. There are various intrinsic and extrinsic factors that may result in the development of chronic wounds, including comorbidities such as diabetes mellitus and venous insufficiency, and lifestyle factors such as obesity, alcohol consumption and smoking. Chronic wounds represent a significant burden on healthcare resources and can have a negative effect on patients' quality of life. This article discusses the assessment and treatment of non-healing chronic wounds...
March 14, 2018: Nursing Standard
Sally Jane Shaw
Venepuncture and obtaining accurate blood samples is an important procedure in healthcare, and can assist in the diagnosis, care and treatment of patients. This article outlines the procedure for undertaking venepuncture and obtaining venous blood samples. It emphasises the importance of undertaking a visual assessment of the patient's skin and palpating the veins to identify a suitable site for venepuncture. REFLECTIVE ACTIVITY: 'How to' articles can help update your practice and ensure it remains evidence-based...
March 14, 2018: Nursing Standard
Clare Akers
Testicular cancer is a highly treatable and curable malignancy. It typically affects men aged 15-35 years and is the most common malignancy in this age group. Nurses have an important role in assisting patients to cope with the diagnosis and understand the treatment options. It is also important for nurses to provide psychological support, because testicular cancer can have a significant effect on a man's fertility, sexuality and body image. This article examines the epidemiology and aetiology of the disease, together with its clinical presentation and treatment options...
March 7, 2018: Nursing Standard
Zoe Joanne Elliot, Stuart Charlton Elliot
This article discusses the history, types and essential components of mechanical ventilation. It addresses the potential complications associated with mechanical ventilation and outlines the nurse's role in the recognition and prevention of such complications. This article provides an overview of some of the advances in mechanical ventilation and emphasises the importance of patient safety through an awareness of the associated risks and limiting or avoiding mechanical ventilation where possible.
March 7, 2018: Nursing Standard
Wendy Ann Webb, Theresa Mitchell, Brian Nyatanga, Paul Snelling
Homelessness is a complex and multidimensional issue often involving a combination of personal vulnerability, the limitations of social housing, and inadequacies in welfare support. Providing palliative and end-of-life care to people experiencing homelessness is challenging, both to individuals receiving care and nurses aiming to meet their complex needs. This article discusses what is understood by the concept of 'homelessness' and examines the barriers to accessing effective healthcare for people who are homeless and have life-limiting conditions...
February 28, 2018: Nursing Standard
Martha Dixon
Patients in acute settings may present with a variety of signs and symptoms; however, the principles of assessment are applicable to all acutely unwell patients. This article details a case study of a patient who presented to the author's medical ward in a catatonic state, and was assessed using the ABCDE (airway, breathing, circulation, disability, exposure) approach. Catatonia is a disturbed mental state in which a patient exhibits abnormal behaviour, such as the inability to speak and non-responsiveness to stimuli, alongside immobility...
February 28, 2018: Nursing Standard
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