Resources

Venous leg ulcers (VLUs) present a huge burden, not just in terms of healthcare costs (Guest et al, 2017), but also in their negative impact on patient quality of life (Marczak et al, 2019). A holistic, multifaceted approach to assessment is needed to ensure that all factors contributing to their development are considered to allow optimal healing to take place. The European Wound Management Association (EWMA, 2016) however, has highlighted a disparity in care between community and specialist settings, with some nurses lacking the necessary skills needed to undertake effective assessment. Since wound assessment is a core component of wound management, impacting directly on therapeutic choices and thus healing (Lázaro-Martínez et al, 2018), it is imperative that general practice nurses (GPNs) are supported in being able to assess wounds accurately. This article discusses and reflects on the value of effectively assessing wounds in primary care using the Triangle of Wound Assessment framework, which focuses not just on the wound bed, but also the periwound skin.

People experiencing long-term physical conditions are predominantly cared for within primary care settings by nurses. These patients are two-to-three times more likely to develop mental health problems as a result of the detrimental impact of their illness on their physical and social functioning. They are also more likely to disclose mental health issues to nurses working in primary care — therefore, general practice nurses (GPNs) need to be able to recognise both mental distress and mental illness to ensure that their patients receive appropriate assessment, care and management. This article discusses the prevalence of mental health problems in patients with long-term physical conditions and how nurses in primary care settings can recognise, assess and support them.

Lipoedema affects 11% of women worldwide (Buck and Herbst, 2016) and has a significant physical and psychosocial impact. It commonly presents as a disproportionate distribution of body fat in the lower extremities — symptoms include tenderness, pain, bruising and large fat nodules. Treatment is often similar to lymphoedema management and includes decongestive therapy, compression garments and skin care. This article presents a patient case study. It looks at the physical and psychological impact of lipoedema on the patient and the significant improvements seen with the use of juxtafit compression garments. The patient’s treatment included the intervention of general practice nursing and tissue viability services, demonstrating the importance of multidisciplinary working.

In each issue of the Journal of General Practice Nursing, we investigate a topic currently affecting our readers. Here, Dr Lesley Holdsworth, Scottish government clinical lead for digital health and care, looks at: Digital working — what have we learned from Covid-19?

The human and economic burden of chronic wounds is increasing (Sen et al, 2009). In the United Kingdom alone, it is estimated that over 2.2 million wounds were treated by the National Health Service in 2012/13, at a cost of between £4.5 and £5.1 billion (Guest et al, 2015). Choice of wound dressing is therefore an important factor, not only in terms of comfort for the patient, but also in optimising clinical efficiency and thereby minimising treatment time and cost.

Sunlight exposure is the primary source of vitamin D in humans (Scientific Advisory Committee on Nutrition [SACN], 2016), but vitamin D deficiency is common worldwide (Bouillon et al, 2019; Mendes et al, 2020). Measures to contain the recent spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and to help prevent the Covid-19 disease caused by the SARS-CoV-2 virus may increase rates of vitamin D deficiency, as selfisolation is likely to prevent people from gaining adequate exposure to sunlight to meet their vitamin D requirement if they do not have a garden or balcony.

General practice’s unique position at the heart of the NHS is why it is so important that general practice nurses (GPNs) have the Freedom to Speak Up.