Resources

How fortunate we are to have specialist teams and services that provide wound care across the UK. But, these teams and services are frequently overwhelmed. Even in pre-pandemic times, increasing referrals, rising caseloads, and the complexities of supporting people with multiple morbidities conspire to challenge service delivery (Guest et al, 2020). At the same time, an over reliance on these teams’ skills by the rest of the system gives rise to the de-skilling of some groups, while inhibiting fundamental wound care skills development in others.

When I started as the education delivery lead for the National Wound Care Strategy Programme (NWCSP), it rapidly became clear from research, conversations, and a deep dive into existing wound care education that, for those not working in a specialist wound care service, wound care was often considered the role of the nurse. And within nursing, the role of the tissue viability nurse.

Changing this mindset is not going to be easy, or fixed by any one act. A cultural shift towards lasting improvement in wound care provision requires buy-in from all professions, service providers, regulatory and professional bodies, coupled with supporting policy. And most importantly, this needs to happen collaboratively. This is exactly what we have done in developing the first multi-professional National Wound Care Core Capabilities Framework for England, published on 9 June, 2021.

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The Queen’s Nursing Institute (QNI) and the National Garden Scheme (NGS) have announced the creation of a new scholarship programme for community nurses, the NGS Elsie Wagg Scholarship. The new programme will support five community nurses each year to undertake projects to improve the health and wellbeing of their own community through gardens and gardening initiatives.

The new scholarship was launched at the Queen’s Nurse Annual Meeting on 12th May by the chief executive of the National Garden Scheme, George Plumptre, who said, ‘Elsie Wagg’s name has always been the historic binding of the National Garden Scheme and our founder, the Queen’s Nursing Institute. The scholarship will be a vehicle through which we will together provide tangible evidence of the health benefits of gardens in a series of new projects and I am full of expectation at the exciting projects that I know community nurses are going to come up with.’

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The pandemic has highlighted that speaking up has never been more important, yet some workers who feared for their safety in this challenging time were let down by leaders who were not listening. NHS and key workers, who were applauded as heroes by the public, are now overwhelmed, exhausted, and burnt out.

As general practice nurses (GPNs), you have a key role to play in patient safety, looking after some of the most vulnerable members of society, so you will be well aware of the importance of being able to speak up, whether to raise a concern or with an idea for improvement. Listening and acting upon matters raised means that Freedom to Speak Up helps to deliver on the promise of the NHS as the best place to work.

In the five years since the National Guardian’s Office was set up, much has been achieved. A network of Freedom to Speak Up Guardians has been developed, who are amplifying the voices of those who might otherwise not be heard, breaking down barriers to speaking up, and promoting the use of speaking up as a valuable opportunity to learn and improve. There are now over 700 Freedom to Speak Up Guardians supporting more than 400 organisations.

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Infection prevention and control (IPC) is a fundamental component of all disciplines of health care. It affects the health of both patients and healthcare providers by preventing the occurrence of healthcareassociated infections (HCAIs) (Storr et al, 2017; Cattini and Kiernan, 2020). General practice nurses (GPNs) have a key role in preventing the transmission of infections in their healthcare setting by understanding and adhering to IPC best practice as part of everyday care delivery (Royal College of Nursing [RCN], 2017; Carrico et al, 2018).

In light of the greatest healthcare challenge in recent times, the Covid-19 pandemic, IPC best practice is more important than ever to save lives (Flynn et al, 2020; Peters et al, 2020). A pre-existing challenge for the NHS is HCAIs (Guest et al, 2020). HCAIs are not only confined to hospitals, and while the type and level of risk may be different, GPNs have the same responsibility as those working in hospitals to prevent the occurrence of infections (RCN, 2017).

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Preventing and managing wound infection has sometimes resulted in inappropriate prescribing of antibiotics and overuse of topical antimicrobial wound dressings. This is partly due to the difficulties in identifying the early signs of wound infection and uncertainty as to who is at risk. This article guides the reader through the importance of considering antimicrobial stewardship (AMS), how to identify at-risk patients, how to reduce the risk through wound bed preparation, and how to identify wound infection. When reviewing wound infection management strategies, it particularly focuses on the role of non-medicated wound dressings, which are becoming a viable alternative to traditional antimicrobial dressings such as silver and iodine.

Disorders affecting the brain cover a wide spectrum of conditions and many increase in incidence and prevalence with older age. Their symptoms are variable affecting each individual person differently, with some diseases following a progressive pattern. In these instances, as progression occurs, symptoms may impact on family and friends, as well as having a significant effect on the health and wellbeing of those affected. This article, the second of a two-part series on brain diseases, covers Parkinson’s disease, brain tumours, epilepsy and multiple sclerosis (MS). Signs and symptoms, risk factors, diagnosis, treatment and management and prognosis are explored, with the aim of giving general practice nurses (GPNs) and non-medical prescribers more knowledge and confidence in advising and supporting patients affected by any of the diseases discussed.

Understanding commonly used drugs and their interactions is vital for the safety of patients and the efficacy of these medicines. Non-prescribers and prescribers alike need to be aware when to query and/or stop medications if the patient is unwell and why this needs to be done. Although stopping and restarting a medication may seem daunting and possibly confusing for patients and clinicians alike, there must be awareness around the medications that can cause problems in the very sick patient. There are many resources available for general practice nurses (GPNs) to check. This article gives a brief summary of some of the most common pitfalls and how to avoid these with useful resources at the end.

The influenza immunisation programme in the UK started in the 1960s and has since been extended to offer protection to those groups most vulnerable to the infection. The extension of the programme to children aims to directly protect them and reduce transmission of the virus to those around them. General practice nurses (GPNs) are among those most trusted in informing and reassuring parents about the benefits of immunisation. This article will primarily describe arrangements for the flu immunisation programme 2021–22 in England. The programme is, of course, delivered in Scotland, Northern Ireland and Wales and there may be subtle differences in programme delivery in the devolved nations. Nurses working in countries other than England should ensure that they are following relevant guidance specific to the area in which they practice (Scottish Government, 2021; Public Health Agency Northern Ireland, 2021, and Welsh Government, 2021).

The National Review of Asthma Deaths (NRAD) (Royal College of Physicians [RCP], 2014) identified many shortcomings in the way that asthma care is delivered, citing preventable factors in 90% of asthma deaths. Among deaths in children, poor recognition of risk of adverse outcome was found to be an important avoidable factor in 70% of deaths in primary care, rising to 83% in young people (RCP, 2014). The challenges of the pandemic over the past 18 months have arguably compounded the difficulties in providing good asthma care, with asthma reviews necessarily being managed in different ways, largely undertaken remotely. To further prevent avoidable deaths, it is important that primary care nurses are confident and competent in undertaking remote asthma reviews so that risks of adverse outcome are identified and effectively managed. As highlighted by the NRAD, parents/carers and children should be taught ‘how’, ‘why’ and ‘when’ to use their asthma medication, be able to recognise when asthma is not controlled, and know when to seek emergency help. This article gives a structured approach to undertaking a remote asthma review with children so that good asthma control and better outcomes can be achieved.

Heart failure is an insidious long-term condition. It is defined as a clinical syndrome characterised by symptoms including fighting for breath, fatigue and fluid build-up, often noticeable in the ankles, and as weight gain. It is caused by a structural and/or functional cardiac abnormality and results in reduced cardiac output (Ponikowski et al, 2016). Here, Delyth Rucarean, advanced heart failure nurse practitioner, Swansea Bay University Health Board, talks about her role to improve in-patient treatment to heart failure patients and coordinated transition of care once they are fit to be discharged into the community heart failure specialist team.