Venous leg ulcers make up a considerable part of the community nurse’s workload and the gold standard treatment is multilayered compression bandaging applied to cleansed and debrided lower limbs. The author of this piece looks at the background to leg ulcer development; as well as how to assess patients and the principles of prevention. This article also examines the KTwo® bandaging system (Urgo Medical), which has a built-in pressure indicator to ensure that application is both consistent and effective. The make-up of the twolayer system makes it as effective as four-layer systems without the associated bulk, which means that patients find it easier to wear.
Heart failure is a common chronic condition and people living with it can have periods of relative stability as well as episodes where their symptoms worsen and they require hospital admission and treatment (Chun et al, 2012), such as intravenous (IV) diuretics. Traditionally, patients who failed to respond to an increase in oral diuretics have been admitted to hospital for IV diuretics. The British Heart Foundation (BHF) funded a two-year project in 10 NHS organisations across the UK to determine if delivering IV diuretics in the patient’s home or in a community by patients and carers (BHF, 2014).The programme was led by heart failure specialist nurses working within existing community heart failure teams and was built on existing evidence that, when compared to other heart failure patients, heart failure patients times less likely to be hospitalised (BHF, 2008). As IV diuretic services become embedded into existing services, community nurses have an important role to play in working in partnership with heart failure specialist nurses to support patients having challenges of delivering IV diuretics in the home.
Excessive exudate production interferes with wound healing and has a detrimental effect on patients’ quality of life. Exudate management is crucial as wounds need an optimum level of moisture so that they can heal. Superabsorbent dressings can handle extreme levels of exudate, prevent leakage and reduce the frequency of dressing changes, allowing people to live a more normal life unhindered by saturated dressings that constantly need to be changed. Community nurses will often need to treat chronic wounds and may consider using superabsorbent dressings. The article takes a look at Zetuvit® Plus (HARTMANN), a superabsorbent dressing that is used for superficial, heavily exuding acute or chronic wounds with the author examining its potential role as a wound care option in the community.
Sarah-Jayne Lawson is a registered nurse with ID MEDICAL and currently works as a community agency nurse.
Sue Hill was previously a district nurse in the New Forest and is now the community nurse advisor for NHS England.
JCN talks to those working in the community.
Dinah Latham is a retired community nurse from Buckinghamshire and author of Walking Forward, Looking Back a new novel about district nursing.
JCN talks to those working in the community.
Soline Jerram, director of clinical quality and primary care, Brighton and Hove, Clinical Commissioning Group
Every year there are seasonal spikes in infant hospital admissions for bronchiolitis, a common respiratory infection that affects vulnerable infants and usually occurs between November and March. Bronchiolitis is the most common cause of infant hospital admissions during the winter months and since 2004, admissions have increased by more than 50%.
Through events and consultations held by the Queen’s Nursing Institute’s (QNI) homeless health network, community nurses are identifying emerging issues affecting their patients and their workforce.
Earlier this summer, the QNI repeated a study it first carried out last year measuring the number of district nursing specialist
practitioner programmes (SPQ) being offered by UK universities, and the number of district nurses qualifying this summer.
