With the ever-expanding role of general practice nurses (GPNs), alongside increased clinical scope and capacity, and increasing pressures of targets, it can be easy to simply ‘tick the boxes’ during an asthma review. However, an asthma review is not only to get an enhanced view of the child or young person’s asthma control in general, but also their individual perceptions, triggers, along with their own agenda or drivers (which may not be the same as the clinicians). By considering social, family or emotional influences, the review can answer crucial questions, such as, ‘Why has this child been to A&E again?’, ‘Why is this child getting through four reliever inhalers each month?’, or, ‘Why have these siblings missed their review again when one was so ill last year?’. This article explores how GPNs are well placed to educate patients and their families about asthma, to discuss inhaler technique, medication use and asthma triggers, as well as to ensure that children and families are aware of the importance of attending their next asthma review. It also discusses the use of tools in assessment and planning.
The terms sexually transmitted diseases and sexually transmitted infections (STIs) are used to cover a number of individual conditions that vary in their presentation, treatment, management and risk, and severity of complications. Statistics indicate that the prevalence of some diseases is rising, while others are falling. Yet, in spite of these findings, in 2017 there were 422,147 new diagnoses of STIs made in England alone (Public Health England [PHE], 2018). Current data shows that young people experience the highest diagnosis rates, thought to be likely due to more frequent rates of partner change among younger adults, with females more likely to be diagnosed than males (PHE, 2018). Early detection and treatment is key if complications and avoidance of spread are to be achieved. Given the incidence of some STIs, it is likely that general practice nurses (GPNs) and GPs will be approached by patients asking for help and advice. This article gives an overview of some of the more common STIs, with the aim of improving knowledge and confidence in this area of clinical practice.
The cost of treating wounds in the UK is comparable to obesity or cancer, and has a considerable impact on healthcare budgets. However, wound care receives surprisingly little attention, with education on this topic overlooked within the wider healthcare sector. Inadequate training can result in varying levels of care, impacting on patient outcomes, quality of life, and time and money spent on care. This article discusses the importance of accessible and flexible education. It looks at the National Wound Care Strategy Progamme, which aims, among other goals, to improve access to education for practitioners, patients and carers. The importance of continued professional development (CPD) and its impact on patient outcomes and quality of service is also addressed. It then goes on to look at the types of education available, and how we can keep up with the rapid developments in wound care science and available treatments.
Yellow fever is a disease that has existed for centuries and continues to have grave health implications in the countries where it is present, with a current, ongoing outbreak in Brazil. It is one of the few diseases that is still bound by the International Health Regulations (World Health Organization [WHO], 2005), and can require an international certificate of vaccination or prophylaxis for entry to certain countries. It remains a serious disease for those living or visiting areas of risk, so a clear understanding of the risks by healthcare professionals is vital. Mosquito bite prevention is key to minimising the risk of exposure, but there is also an effective vaccine. However, this vaccine does have rare but serious potential side-effects. Due to this risk, the vaccine is contraindicated in some travellers, and extreme caution needs to be taken with other groups. In the UK, the vaccine can only be administered in registered centres by staff who have been trained accordingly. All staff advising and administering this vaccine need to be highly trained and understand the nature of the disease, as well as the risk assessment process to ensure that patients receive optimum healthcare advice.
Healthcare settings, including primary care, have been identified as important for the promotion of physical activity (PA) for a number of reasons (Pringle et al, 2010; National Institute for Health and Care Excellence [NICE], 2013; Kime and Pringle, 2018; Kime et al, 2020). Primarily, they provide the opportunity for general practice nurse (GPN) involvement (Harris et al, 2017), which in turn offers a chance to assess a patient’s health profile, needs and motives (Dutton et al, 2016). Repeated contact with patients also facilitates continuity of care (Harris et al, 2017) and the opportunity to follow up patients, coupling PA information with treatment (Fong et al, 2018). Importantly, the nursing profession are respected sources of advice for lifestyle behaviours and are able to reach a large proportion of the population who may benefit from additional PA (McPhail and Schippers, 2012; Kime et al, 2020). This paper puts forward a range of strategies that GPNs can adopt when promoting being physically active.
Quality improvement is a necessary exercise for any developing organisation. With the changes currently taking place in the NHS, particularly the relocation of services from secondary care to primary care, it is vital that general practice nurses (GPNs) are able to review and make improvements to their practice. This article reviews the policies that are changing the landscape of primary care, examines the benefits of quality improvement initiatives and provides an exemplar of an effective quality improvement training programme. The author argues that the NHS cannot meet the healthcare needs of the population without a sustained and comprehensive commitment to effective quality improvement as its principal strategy.
The role of nursing staff within general practice is rapidly growing to encompass the consideration of both physical and mental health, as well as wellbeing. While this encourages holistic care, staff report feeling pushed to their limits in terms of time and capacity. With this in mind, this article aims to provide guidance on collecting information to address root causes of an individual’s distress and disability in time-limited consultations. It considers how biological, psychological and social issues combine and influence an individual’s physical and mental health. It also offers guidance on identifying barriers to wellbeing using a biopsychosocial approach. Strategies on opening and closing sensitive conversations are discussed, including ideas for possible sources of support for identified issues. Meaningful and achievable goal-setting as part of care planning for long-term health conditions is explored. It is hoped that these suggestions will aid general practice nursing staff in achieving more rewarding care planning consultations.
Influenza is an important vaccine preventable infection, which is an annual global health threat. Huge advances have been made in our knowledge of the influenza virus and as a consequence the ability to produce more effective influenza vaccines. In the last few years, the Joint Committee on Vaccination and Immunisation (JCVI) has considered newly licensed influenza vaccines for use in the UK population. The UK now has a differentiated influenza immunisation programme with different vaccines being advised for different risk groups. Currently, the various vaccines are differentiated by age, but in the future may also be differentiated by risk group. General practice nurses (GPNs) need to understand how these various influenza vaccines differ, what are their advantages in terms of the increased protection they offer to patients, and, in turn, be able to explain these advantages to patients.
Nutrition is an important modifiable factor for patients with chronic obstructive pulmonary disease (COPD). Being overweight brings breathing difficulties and being malnourished leads to poorer outcomes. Maintaining a healthy weight and a nutritious diet is a central part of COPD management. This article equips general practice nurses (GPNs) and patients with the tools needed to assess and promote a healthy weight and diet while living with COPD. It explains the reasons for malnutrition and how these can be avoided. Helping people improve their diet as well as the role of oral nutritional supplements (ONS) are explored, and specific issues, such as vitamin D deficiency, are discussed.
The recent rise in measles cases in the UK, Europe and elsewhere in the world, cannot have gone unnoticed by anyone, especially by healthcare professionals.This paper looks at the rise in cases in the UK, Europe and elsewhere in the world, discusses possible reasons for the increase and latterly the role that general practice nurses (GPNs) play in ensuring that their patients, themselves and their colleagues are fully protected from this unpleasant disease, which can lead to serious complications, and even death.The nature of infectious diseases and outbreaks are such that the epidemiological reports are constantly updated, published erratically and often data differs between reports (due to reporting delays or erroneous case reporting). Consequently, this paper relies heavily on online reports of outbreaks and cases.
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