Management Resources

11 February 2020

Non-cystic fibrosis (CF) (bronchiectasis) is a common chronic lung condition, which occurs due to damage to the airways leading to persistent cough, sputum production and recurrent chest infections (Hill et al, 2018). This article focuses on the adult patient and describes the pathophysiology, aetiology, investigation, and management of bronchiectasis in the primary care setting. The aim is to raise awareness of this disease, which is increasing in prevalence and to empower community nurses with information to support patients through the bronchiectasis disease trajectory.

Topics:  Management
30 October 2019

Dehisced surgical wounds are a common occurrence and are seen both in primary and secondary care. The impact of a dehisced wound is far reaching. For the National Health Service, there are increased in-patient costs and additional resources in terms of an extended healing time, such as staffing and dressing materials and therapies. For the patient, a dehisced wound can impact significantly on their wellbeing and quality of life and for patients of working age, the economic impact of not being able to work can be enormous. This article discusses the incidence of wound dehiscence, outlines the types of wounds which are most likely to dehisce, and the most common reason for this, wound infection. Strategies for managing wound infection, including the use of antiseptic and antimicrobial products, together with a frequently used therapy, topical negative pressure therapy (TNPT), are also discussed.

16 April 2019

Pneumonia has a huge impact upon the healthcare system in the UK and is not only associated with higher rates of hospital admissions than any other respiratory disease, but also carries a high risk of mortality. This article offers an overview of community-acquired pneumonia in adult patients, including the pathophysiology, common aetiologies, at-risk groups and pharmacological management. There is also a brief discussion on differential diagnoses and potential strategies to support clinical decision-making in the community.

Topics:  Management
21 December 2018

On primary infection, the varicella zoster virus is responsible for the development of chickenpox, after which the virus becomes dormant. Upon reactivation of the latent virus, shingles results. The incidence and severity of shingles increases with age, and is associated with significant morbidity and mortality. Early intervention with antiviral medications is crucial to help resolve the rash and reduce any potential complications induced by the virus.

23 March 2018

Asthma is a common lung condition affecting many patients in the community. Nurses are pivotal in the diagnosis and management of people with both stable disease and during acute flare-ups. Asthma reviews offer opportunities to build therapeutic relationships and optimise treatment, helping patients to recognise and plan management of an asthma attack. On average, three people die of asthma every day in the UK - a stark statistic which should encourage nurses to be forever watchful of opportunities to regularly review the evidence base and produce patient-centred care. This article focuses on the management of chronic adult asthma, at diagnosis, management, and briefly touches on assessment of the acute exacerbation. They key differences between the asthma guidelines of the British Thoracic Society/Scottish Intercollegiate Guidelines Network (BTS/SIGN, 2016) and the National Institute for Health and Care Excellence (NICE, 2017) guidelines, which are currently in use in the UK, are presented for reader consideration. 

Topics:  Management
21 December 2017

Pilonidal sinuses are a common condition, and are often found in young males. Treatment is mainly by surgery and caring for these wounds is generally undertaken by primary care practitioners. Fistulas are also challenging wounds to care for. This article offers practical advice on the management of these, often problematic, wounds. Issues, such as cleansing, selecting appropriate wound care dressings, measuring and monitoring progression to healing will be discussed; together with advice on when to refer for specialist input.

Topics:  Management
16 December 2014

The first part of this two-part series on breathlessness (JCN 28(5): 83–90) looked at the emotional and physical distress and social isolation caused by the condition for both patients and their families, as well as examining the assessment of the condition. Refractory breathlessness, i.e. that which persists even when measures to optimise the underlying condition have been implemented, is one of the most distressing symptoms experienced by patients with advanced life-limiting illnesses. This, the second part of the series, looks at how community nurses can successfully manage patients, including lifestyle changes, self-management, psychological therapy and pharmacology.

Topics:  Pharmacology