Community nurses will often encounter patients with psoriasis in their day-today work, and may be involved in delivering care directly or monitoring the condition. However, psoriasis has various presentations and knowledge of these variations is beneficial for all clinicians working in the community, particularly when it comes to understanding the range of treatments available. This article, the first in a series on psoriasis, will discuss the types of psoriasis that can be encountered, while future articles will examine the different treatment options that are currently available, focusing on the National Institute for Health and Care Excellence’s (NICE, 2016) treatment pathway for managing patients with psoriasis (see Figure 1). The series will focus on each of the steps in the pathway and how they relate to nurses working in the community.
The number of patients in a community setting with percutaneous endoscopic gastrostomy (PEG) tubes is increasing year-on-year. PEGs provide a secure route of delivering artificial nutrition, hydration, and medication in patients who are unable to swallow safely, however, there are complications associated with their insertion and ongoing use. Common problems include infection, leakage, tube blockages, development of granulomas at the insertion site, and so-called ‘buried bumper syndrome’. Community nurses are ideally placed to identify these complications, and this article provides a quick reference guide to troubleshooting and managing these issues.
Donato Tallo is a nurse assessor at the hospital intervention team, Eastbourne District General Hospital, East Sussex Healthcare NHS Trust.
WHAT DOES YOUR CURRENT ROLE INVOLVE?
I work for a large NHS trust that provides integrated hospital and community-based healthcare services. I am a nurse assessor with the hospital intervention team, a multidisciplinary team consisting of nurses, physiotherapists and occupational therapists.
With over a million devices used in the NHS every year, indwelling urinary catheterisation is widely acknowledged as one of the most commonly used invasive healthcare procedures. Despite its widespread use, there is also extensive evidence of the risk of infection, blockage and bypassing associated with indwelling catheters, all of which can adversely affect patients’ health and quality of life, as well as placing a significant burden on the supportive health services that manage the caseloads of catheterised patients in both community and acute settings. This article looks at the reasons for the use of long-term catheters, the complications that can arise and the positive impact the use of a triclosan-based solution can have when instilled into the inflation balloon of the catheter. A selection of case studies highlight the use of Farco-fill® Protect (CliniMed) in complex patients whose only management option for effective bladder drainage is to use an indwelling catheter.
In each issue we investigate a hot topic currently affecting you and your community practice. Here, Jason Beckford-Ball looks at some of the challenges that lie ahead in the coming year.
Every 10 seconds someone in the UK has a potentially life-threatening asthma attack and three people die every day from the condition. Tragically, evidence shows two-thirds of these deaths could be prevented by using some key elements of basic care. Also, many of these deaths occur in people with mild or moderate asthma, the kind that can be managed in primary care and with daily self-management.
Prevarication is a terrible thing. It’s 11.00am and I’ve been sitting at my desk trying to write this piece for two hours. Even though I know what I want to say, I always struggle to start. I’ve completed a number of other (less important) tasks on my ‘to-do list’ as well as some that weren’t on the list but offered a distraction from the blank page in front of me.
Around 2,500 people every year are diagnosed with mesothelioma in the UK, an incurable cancer that affects the mesothelium, the membrane that lines the inner surface of the chest wall (pleura), the abdomen (peritoneum) or testicles. The primary cause is contact with asbestos and symptoms don’t usually appear until 20–50 years after exposure. Men are 4.6 times more likely to develop mesothelioma and with a latency period of approximately 30–40 years, the vast majority of people diagnosed with the condition are over 70 years old.
With many hospitals struggling to meet safe staffing quotas, it is often the support of agency nurses that keep hospital wards and community services open and running. But what of the agencies supplying them? Here the JCN profiles Hallam Medical, one of the UK's premier primary care recruitment agencies.
