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Nursing Standard

Lauren Elizabeth Palk
Nurses commonly encounter patients with type 1 or type 2 diabetes mellitus in their practice. Management of these conditions requires an in-depth knowledge of blood glucose monitoring. It is essential that nurses are aware of normal blood glucose levels, so that they can respond to complications caused by elevated and reduced blood glucose levels. This article aims to enhance nurses' knowledge of the acute metabolic complications of diabetes, such as diabetic ketoacidosis and hyperosmolar hyperglycaemic state, to assist in their recognition and management in clinical practice...
November 6, 2018: Nursing Standard
Joanna Goodrich, Beverley Fitzsimons
National surveys of NHS patients in the UK have captured patient satisfaction with healthcare services for more than 15 years. Although this data has been valuable in tracking trends over time and for comparison between healthcare services, there have been issues associated with the concept of 'satisfaction' and the lack of clarity regarding the purpose of collecting such data. The shift in focus to capturing patient experience rather than patient satisfaction is regarded as a positive change, particularly for the purpose of improving healthcare services and patient care...
November 1, 2018: Nursing Standard
Dean Whitehead
The term health promotion has been used in healthcare for several years. However, the meaning of this term is debated, particularly in nursing. Some nurses might believe that, because they are healthcare practitioners working in healthcare services, that they are 'by default' automatically involved in health promotion activities; however, this is often not the case. Instead, they are more likely to be engaging in health education activities; that is, simply providing individuals with health-related information, rather than seeking to empower individuals, families, groups and communities...
October 30, 2018: Nursing Standard
Brian Power
Nurses have a central role in health education and promotion, particularly with regard to supporting individuals to optimise their nutritional intake and engage in healthy eating behaviours. However, high rates of obesity, unhealthy eating behaviours and low levels of physical activity have been found among nurses. Nursing is a challenging profession, and a high workload, a lack of resources and shift work may affect nurses' ability to adopt healthy lifestyles. Supporting nurses to improve aspects of their eating behaviours, such as the nutritional value, timing and frequency of meals, can have a positive effect on their health which, in turn, may enhance their ability to care for patients...
October 24, 2018: Nursing Standard
Ali Taherkhani
This article details a case study of the immediate post-operative care of an elective adult patient who presented in a postanaesthetic care unit. It outlines the systematic ABCDE (airway, breathing, circulation, disability and exposure) approach that was used to assess the patient and describes the actions that were taken to manage an airway obstruction that occurred. It also discusses the monitoring of patients required post-operatively, including capnography, peripheral oxygen saturations, blood pressure, temperature, heart rate and respiratory rate, which can assist in the identification and management of any issues and support optimal patient outcomes...
October 16, 2018: Nursing Standard
Sinéad Kelly, Carolyn Fowler
In September 2016, a team of nurses from East and North Hertfordshire NHS Trust (ENHT) and the University of Hertfordshire in England travelled to Kerala, India to interview and recruit nurses for the trust's acute hospital. Before undertaking the interviews, the team visited a nursing college and two hospitals. Based on the findings from these visits and from meeting the interview candidates, the team designed a bespoke mentoring programme for Keralan nurses recruited to ENHT to ease the transition into nursing and living in the UK...
October 9, 2018: Nursing Standard
Hardip Malhi
The term malnutrition refers to both undernutrition and overnutrition. In healthcare, it most often refers to undernutrition, in particular disease-related malnutrition, which can be a result or a cause of an illness. The reasons for malnutrition are multifactorial, and its consequences may include an increased risk of pressure ulcers, reduced mobility and psychological effects such as depression. It is essential that nurses prioritise the nutritional care of all patients and identify those at risk of malnutrition using accurate and reliable nutrition screening tools...
October 4, 2018: Nursing Standard
Samantha Dorney-Smith, Kendra Schneller, Serena Aboim, Maxine Radcliffe, Nicky Tanner, Rosa Ungpakorn, Ruth O'Brien, Amy Hall
People experiencing homelessness have unique healthcare and health promotion needs. This article provides nurses with information on the healthcare challenges that commonly affect people who are experiencing homelessness, and outlines various effective nurse-led interventions that can be implemented. It provides examples of nurse-led health promotion projects, which demonstrate how a collaborative approach can improve the healthcare experiences of this patient group. This article also examines the issue of homelessness and mental capacity, as well as explaining the role of physical health outreach services in caring for people experiencing homelessness...
September 20, 2018: Nursing Standard
Nicholas Woolfe Loftus, Duncan Smith
Deteriorating patients often present with suboptimal vital signs. If these are not recognised by healthcare staff, the patient's condition can deteriorate further, potentially leading to serious complications and even death. Despite efforts to improve ward nurses' recognition of, and responses to, deteriorating patients, this aspect of care has been found to be suboptimal. AIM: To identify factors that influence ward nurses' responses to deteriorating patients. METHOD: A literature review was undertaken, based on the research question 'What factors influence the trigger component of ward-based registered nurses' afferent response to deteriorating patients?' Several electronic databases were searched electronically to identify relevant articles, alongside hand-searching...
September 18, 2018: Nursing Standard
Phil Cotterell
Idiopathic Parkinson's disease (IPD) is a progressive neurodegenerative condition that causes various motor and non-motor symptoms and will often have life-changing effects for those with the condition, as well as for their family and carers. Nurses can make a significant difference to the lives of those affected by Parkinson's disease, whether in the acute setting, community setting or in care homes. This article explores the causes and progressive clinical pathway of IPD using an evidence-based approach. It emphasises the valuable role of the multidisciplinary team and of the nurse, in particular, in monitoring and improving the quality of life of those with the condition and their family and carers...
September 10, 2018: Nursing Standard
Lucy Webb
Nurses require effective communication and interpersonal skills to provide optimal care, and to ensure that patients and their families and carers have a positive experience of receiving care. The new Nursing and Midwifery Council standards of proficiency for registered nurses, and for nurse education and training, published in May 2018, recognise that future nurses will be practising in increasingly complex roles and environments. This article identifies the essential communication skills that will be required by nurses in the future, summarising the characteristics of a modern nurse communicator...
September 7, 2018: Nursing Standard
Alison Pottle
The role of nurse consultant was introduced in the late 1990s to strengthen leadership in nursing, improve patient outcomes and enhance the quality of healthcare services. Nurse consultants have a wide-ranging remit that includes expert practice, professional leadership and consultancy, education, and service development. In this article, the author reflects on her experience of being one of the first nurse consultants, which included setting up nurse-led clinics, maintaining professional relationships with medical colleagues and assuming increasing responsibility for services...
August 30, 2018: Nursing Standard
Cathy Liddle
There has been an increase in the number of patients requiring surgery who also have complex medical needs. Factors such as being overweight, the presence of significant comorbidities and an ageing population increase the risks associated with surgical procedures for these individuals. As a result, nurses involved in assessing patients and providing preoperative care require knowledge and understanding of the latest evidence in this area to optimise patient care and outcomes following surgery. This article suggests that optimal outcomes can be achieved by preparing patients for surgery in a holistic manner...
August 24, 2018: Nursing Standard
Janice Logan
Delirium is the most common neuropsychiatric disorder in patients with palliative and end of life care needs; therefore, providing effective care for patients, and their families, is a clinical priority for nurses. Delirium is characterised by a fluctuating state that affects an individual's attention, orientation, thinking, perception, memory, psychomotor behaviour, emotions and sleep-wake cycle. Early recognition, assessment and management of delirium is essential, because this has the potential to relieve distress and improve the quality of life and death for patients...
November 1, 2018: Nursing Standard
Alison Bardsley
While urinary tract infections (UTIs) are uncommon in healthy men aged under 50 years, their prevalence rises in men aged over 65 years. UTIs can be classified as uncomplicated or complicated. UTI in men is considered to be more complicated than in women, because it is often related to abnormalities of the urinary tract, such as prostatic enlargement or a urethral stricture. UTI is associated with a significant disease burden and cost to patients and healthcare organisations. It is one of the most common reasons for prescription of antibiotics in primary care; however, because antibiotic resistance is becoming increasingly widespread, it is essential that these drugs are used prudently...
November 1, 2018: Nursing Standard
David Thomas Evans, Mark Dukes
Acquired immune deficiency syndrome (AIDS) was first labelled as a new illness in 1981; it took two more years to discover a causative virus, which was named human immunodeficiency virus (HIV) in 1985. Nurses who practised during those times may recall the fear, panic, stigma, ethical dilemmas and refusals to care that were associated with the pandemic. Four decades later, HIV can be considered a long-term condition rather than a life-limiting disease, as a result of developments in treatment. However, the UK has the highest number of people living with the virus since the pandemic was first identified, and there remains a need to challenge stigma and prejudice in relation to HIV and AIDS, to ensure that people receive timely access to HIV testing, treatment and preventive measures...
November 1, 2018: Nursing Standard
Paul Whitby
Healthcare professionals continue to debate how to address the issues of suboptimal care, neglect and abuse in healthcare settings. One solution that is likely to achieve improvements in care is the widespread development of leadership skills in front-line nurses. The behaviour of front-line nurses is a major determinant of patients' healthcare experience and their perception of the quality of care they receive. Front-line leaders in healthcare settings such as wards, care homes and clinics are the people with the strongest and most immediate influence on staff behaviour...
November 1, 2018: Nursing Standard
Patricia Davies
The heel is a common site for pressure ulcer development, particularly in people who are supine or semi-recumbent because of immobility. There is little protective subcutaneous tissue and no muscle or fascia within the heel, which means that it is vulnerable to pressure, friction and shear forces. Heel pressure ulceration remains a clinical challenge for nurses and the wider healthcare team, as well as a cause of pain and physical debilitation for the patient. This article examines the risk factors for heel pressure ulceration, and details patient assessment and specific measures that can be undertaken to prevent the development of heel pressure ulcers...
October 1, 2018: Nursing Standard
Emily Carne
Chronic spontaneous urticaria is characterised by the spontaneous appearance of hives or wheals, and/or angioedema, lasting for at least six weeks. The condition may be associated with significant physical and emotional burden for patients. Nurses have an important role in the differential diagnosis of chronic spontaneous urticaria, assessing patients' quality of life, providing advice on non-pharmacological measures, monitoring the patient's response to treatment, and referring the patient for specialist care, where appropriate...
October 1, 2018: Nursing Standard
Caroline Barratt
Discussions about the sustainability of the healthcare workforce have placed considerable emphasis on improving the resilience of healthcare professionals. However, when discussed in relation to individuals, the contextual aspects of resilience are often lost. This means that individuals are burdened with the responsibility of increasing their resilience so that they can better manage the challenges they experience, rather than examining the external and environmental factors that can affect resilience. This article explores the concept of resilience and suggests ways in which resilience can be developed by individuals and in collaboration with others, resulting in resilient healthcare teams and organisations capable of supporting individuals effectively...
October 1, 2018: Nursing Standard
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