General practice nurses (GPNs) play an important role in prevention and must make every contact count to educate patients. When it comes to melanoma skin cancer, 86% of cases are preventable, but over the last decade, mortality rates have increased by around 14% in the UK (Cancer Research UK melanoma skin cancer statistics).
Wound assessment is a vital skill for general practice nurses (GPNs); however, time pressures can sometimes impede the effective assessment of wounds in primary care. This article aims to provide GPNs with a rapid wound assessment approach that is evidence-based and person-centred. The author details the main points of wound assessment and outlines a holistic approach that considers biological, psychological and social factors, with the aim of improving GPNs’ assessment skills. An approach to wound assessment known as TIMES (tissue, infection, moisture, edge and surrounding skin) will be discussed. This will enable GPNs to understand the key factors that influence wound healing. The investigations used to identify any underlying disease processes that may affect wound healing are also considered. The author aims to assist GPNs to improve their wound assessment skills, which will, in turn, help them to exercise their best clinical judgement at all times.
Wounds impact a patient’s quality of life, but research shows that this is often overlooked. Lifestyle concerns are haphazardly disclosed by patients, and not always recorded and addressed by nurses. Research (Green et al, 2013a; 2013b) led to the development of a leg ulcer consultation template (LUCT), which, in turn, raised the need for a generic tool to produce an overall, self-assessed ‘quality of life’ score for any patient with a wound. The principles of the LUCT were reviewed and a new ‘wound checklist’ developed, supported by an advocacy service, to ensure utility for all patient groups. Images, simplified questions and use of a ‘pain’ and ‘quality of life’ score improved the checklist’s accessibility, and aimed to show which areas of the patient’s life were affected by the wound. Results of an evaluation have been positive, and the new checklist is available as a paper version and is being developed as a digital resource.
Peripheral arterial disease (PAD) occurs when there is a narrowing or occlusion of the peripheral arteries, resulting in reduced blood flow to the leg (National Institute for Health and Care Excellence (NICE), 2015). This can lead to limb ischaemia and thrombosis. Patients with PAD have a reduced quality of life and are at risk of lower limb amputation and even death. This article addresses the need for early diagnosis of PAD to reduce the burden of the condition to patients and the NHS, and to try and reduce the number of lower limb amputations that occur in the UK every day. Promoting healthy arteries will raise awareness of the risk factors associated with PAD and encourage the population in the risk categories to be proactive in receiving ankle-brachial pressure index (ABPI) assessment. Healthcare professionals with improved knowledge of PAD will be better able to identify patients in the early stages of the disease and to advise them about lifestyle changes to improve their prognosis.
Long-term wounds in the UK are increasing at the rate of 12% per year. The rise in these numbers is partly due to the older population, who tend to have slower healing processes. The majority of wound care is provided by nurses, not all of whom will have received wound care education. Although patient outcomes demonstrate improvement when healthcare professionals receive postgraduate training, it has also been identified that collaborative care and a coordinated team approach can benefit patient care in preventing a wound becoming long term, as has been demonstrated by the Tower Hamlets project. This article explores these issues and the effects that a ‘never healing’ wound can have on a person.
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.
There is an unmet need for contraception in the UK. Providing women with up-to-date information on contraceptive choices is essential to reduce unplanned pregnancies. There is a wide choice, including short-, medium- and longterm options. No method is 100% effective, with some relying on the user (e.g. pills) and others working largely independently of the user (e.g. subdermal implant). Many methods have side-effects or pose health risks to certain subpopulations of women. General practice nurses (GPNs) should be allowed to make an informed choice while also undertaking a risk assessment of each individual. This article provides an update on current practice regarding contraceptive choice, including emergency contraception, as well as the efficacy, acceptability, methods of delivery, side-effects and health risks of the different methods available.
Here, Ellen Nicholson, course director/lecturer, School of Health and Social Care, London South Bank University, explores what the plan means for general practice nurses (GPNs) and how this key document will affect their role in general practice.
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