Community practice Resources

This case report explores the community management of a patient with a medical history of heart failure (HF) and oedema. Gold standard guidelines recommend targeting clinical congestion and oedema with increased loop diuretics alongside multilayer compression bandages for effective limb decongestion, reduction of swelling and limb shape restoration. Without early identification and intervention, oedema can worsen, leading to skin changes such as lymphorrhoea (wet or leaky legs), and having a detrimental physical, functional, and psycho-emotional impact on patients. Yet, HF and oedema continue to be mismanaged because healthcare workers have reservations about the use of compression therapy and concerns about overloading the circulatory system in patients with HF. This case report demonstrates appropriate treatment and management of oedema in patients with HF within a community district team setting, highlighting best guidance on diuretics, compression therapy, exercise, and skin care.

Imagine the scenario. You’ve arranged a special dinner for a group of friends. You’ve bought the food; picked out your ‘good’ cutlery; dressed in your best clothes. You may have even tidied up the bathroom and hidden last week’s washing under the bed. Then, they simply don’t turn up. No phone call or email, they just decide, for whatever reason, not to show. Quite apart from the wasted food and wine and the fact that you’ve spent the afternoon preparing, there’s the knowledge that if you knew they weren’t coming, you could have invited someone else. Annoying doesn’t quite cover it.

Ryan Latto is a nurse intern for the Emergency Medicine Association of Tanzania (EMAT) at Muhimbili National Hospital, Dar es Salaam.

He shares his background in community practice...

Candice Pellett OBE, Queen’s Nurse, is a transition project manager at the Queen’s Nursing Institute (QNI) in London. Candice received the OBE in 2014 for Services to Nursing and Healthcare.

Candice talks about her background in community practice.

Colette Ferguson, Dorothy Whyte and Charles Anderson describe their preliminary findings from a qualitative research study which aimed to discover student nurse experiences of preceptorship during their community placement.

Colette Ferguson MSc, RGN, RMN, RCNT, RNT, at the time of writing was a Lecturer, School of Nursing & Midwifery, Bell College, Hamilton, Scotland.
Dorothy Whyte BA, PhD, RGN, RSCN, HV, RNT is an Honorary Fellow, Dept. of Nursing Studies, University of Edinburgh.
Charles Anderson MA, MEd, PhD is a Lecturer, Dept. of Higher & Further Education, University of Edinburgh.

Article accepted for publication October 1998.