Malnutrition is common in patients with chronic obstructive pulmonary disease (COPD), particularly as the disease progresses. This article looks at the nutritional issues facing patients with COPD, including the effects of medication, social and psychological issues. It outlines the role that general practice nurses (GPNs) can play by implementing the newly updated ‘Managing Malnutrition in COPD’ guidance. The guidance encourages incorporation of nutritional screening into COPD care pathways and the optimisation of nutritional intake for those at medium and high risk of malnutrition via dietary advice and oral nutritional supplementation, where appropriate. It also provides practical tips for patients with COPD to help manage common barriers to eating, such as shortness of breath, dry mouth and taste changes.
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.
In 2019, an indemnity scheme was introduced in England, covering all staff working in general practice. Although the scheme covers work delivered under an NHS contract, there are certain exceptions, including private vaccinations. Here, Helene Irvine, nurse adviser, and Michelle Lombardi, primary care director, both at Wessex Local Medical Committees, look at the scheme and aim to clarify the finer details on who and what is covered, and what, if any, extra indemnity nurses and healthcare assistants (HCAs) must obtain to ensure that their work is fully covered.
Welcome to this latest issue of GPN. We are delighted to share the latest news in the world of Education for Health, including our move to new premises, and present opportunities for you to get involved with us as a student or partner. As always, we hope that you enjoy this issue of the journal and our news update.
In each issue of the Journal of General Practice Nursing, we investigate a topic currently affecting our readers. With more and more patients being seen with complex wounds in primary care, here we consider Are we asking GPNs to become wound care experts?
Chronic oedema is a perennial challenge for nurses in primary care, consuming a large proportion of time, energy and resources. Ironically, chronic oedema is both a contributory factor and a consequence of impaired mobility, infection, or wounds and delayed healing. With growing numbers of older people with multiple and complex conditions that limit their mobility, and obesity on the increase, the prevalence of chronic oedema is predicted to rise. With reports of a current prevalence of 6:1000 (National Lymphoedema Partnership [NLP], 2019), this is a depressing prediction.
Success!