29 March 2023
Tracheomalacia, bronchomalacia and laryngomalacia are conditions where there is a deficiency in the functioning of the cartilage in the airway walls, which causes them to be weaker or even absent in places. This leads to an exaggerated luminal narrowing within the affected airway during expiration. The malacia may be localised or generalised. There is limited literature and published research in this area. These three conditions are seen in both children and adults. However, because of the size of the airways in small children and the more marked clinical response to any narrowing of the airway, these malacias are usually diagnosed at an earlier stage than when the conditions occur in adults. In the fully mature airway, the symptoms may be less obvious, leading to the conditions
being under-recognised and under-diagnosed in adults. It is also important to understand that in the adult population malacia may coexist with more common conditions such as asthma or chronic obstructive pulmonary disease (COPD), where breathlessness, cough, dyspnoea and other symptoms may be misattributed to these more common diseases.
This article raises awareness of these three malacia conditions.
29 March 2023
Type 1 diabetes mellitus (T1DM) can affect individuals at any age, yet often develops in the younger population, accounting for approximately 8% of diabetes diagnoses in the UK. Although there has been extensive research into the physiology of diabetes, less work has addressed the psychosocial demands and consequent effects on management and quality of life. This article is a critical synthesis of the literature, adopting the Health Stigma and Discrimination Framework (Stangl et al, 2019) as a theoretical lens through which the multifactorial impact of stigma for individuals living with T1DM is unpacked.
Having this understanding can help general practice nurses (GPNs) recognise how stigma within T1DM can permeate throughout the five layers of society: individual, interpersonal, community, organisational, and policy. A case study is provided to highlight how nurses working within primary and community care are well positioned to help understand the
causes of stigma for individuals living with T1DM.
29 March 2023
Pneumonia continues to cause mortality around the world, despite advances in treatment and prevention. The disease can affect any age and can present with variable degrees of severity ranging from mild to severe, with the worst cases resulting in admission to hospital. While vaccination in the UK has impacted on the severity and death rate of this potentially devastating disease, the condition continues to be the largest cause of mortality in children with the highest death rates seen in under developed countries. This article gives an overview of treatment, management and prevention, as well as a brief insight into the possible long-term effects following recovery from pneumonia in babies and children.
29 March 2023
Increasing cancer survival rates and evolving models of care require primary care teams to adapt their practice to meet the needs of people after a cancer diagnosis and completion of treatment. The needs of people after a cancer diagnosis are often complex and require a person-centred, holistic model of care. The ‘NHS Long Term Plan’ sets out the ethos of
personalised care for those living with long-term conditions (LTCs), including cancer. Interventions to support personalised care include cancer care reviews (CCR) in primary care. Recent Quality Outcome Framework guidance for CCR has aimed to personalise the intervention to improve patient experience. General practice nurses (GPNs) are well placed to deliver CCR but need access to education to feel confident and develop competence in this area. There are several resources that have been developed to support CCR as a personalised care intervention. These interventions need further evaluation to assess their impact on patient experience and outcomes.
29 March 2023
The national care bundle for children with asthma is the first phase of a national plan to improve asthma care, focusing on integration of systems and effective communication. It follows several high-profile reports, national and global guidelines, with the aim of training clinicians to consistent standards, keeping children and young people (CYP) with asthma well, improving diagnosis, patient pathways and encouraging self-management. This article, the second in a two-part series, explores practical ways to implement the bundle in clinical practice and how to meet its requirements.
29 March 2023
Here, Callum Metcalfe-O’Shea, advanced nurse practitioner diabetes specialist and co-chair for the Practice Nurse Diabetes Forum for Norfolk, provides the first in a series of articles with direct insight into the changing practice of diabetes in primary care and how general practice nurses (GPNs) can keep up to date with new evidence. This article looks at new guidance from the National Institute for Health and Care Excellence (NICE) for type 2 diabetes, identifying how the implementation of sodiumglucose co-transporter-2 inhibitors (SGLT-2i) as second-line therapy now takes place and how you can use these guidelines to advance practice. Consideration will be given to SGLT-2i use in practice, while recognising the importance of patient preference and individualised care at all stages.
05 December 2022
I had a eureka moment reading the ‘Practice matters’ piece, ‘What do GPNs need to know about GDPR’ and a sensation of various burdens lifting off my shoulders. Now I had found a reason to have a different approach to writing up my consultations and this would be better for patients
05 December 2022
As a general practice nurse (GPN), how much information should you know about a patient? You might say it’s important to know the condition they have and their medical history. It might be reasonable to enquire if they are on any medication, or even ask for some details
about their lifestyle, such as their smoking habits or alcohol consumption, or how many sugars they take in their tea.
05 December 2022
Home mechanical ventilation (HMV) is a treatment, often referred to as non-invasive ventilation (NIV), which provides breathing support for patients with respiratory insufficiency outside of the traditional hospital setting. This type of treatment was first used to treat those affected during the Polio pandemic in the mid-20th century, and has been used in the community setting since the 1980s.
05 December 2022
Prostate cancer is the most common cancer in men. Across the UK over 47,500 men are diagnosed each year with a 10-year survivorship of approximately 80% (Prostate Cancer
UK, 2022). It is estimated that more than 400,000 men in the UK are living with and beyond prostate cancer (Prostate Cancer UK, 2022).
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