Chronic wounds are a complex and challenging health problem for all concerned, but most importantly for patients who have to live with them. Chronic wounds impact negatively on patients’ quality of life, often accompanied by a loss of independence and, in many cases, a sense of hopelessness. The global prevalence of wounds is predicted to rise with an ageing population, and rapidly increasing numbers of people with obesity and diabetes. In an NHS with escalating costs and a shortage of qualified nurses, it is not sustainable for nurses to continue to manage all wounds. By incorporating shared decision-making and involving patients in their own care, it will be possible to improve outcomes for all concerned.
Bronchiectasis, formally known as non-cystic fibrosis bronchiectasis, is the dilation of the small airways resulting in persistent cough, sputum production and recurrent chest infection, and develops as a result of insult and damage to the airways. The disease is more common in women than men and has an increasing incidence and prevalence. Early recognition of the signs and symptoms of bronchiectasis will support prompt investigations and management to reduce disease progression. This article gives an overview of bronchiectasis, its causes, treatment and management. It also discusses the role of general practice nurses (GPNs) in identifying and treating patients with the condition.
Skin tears are a common type of tissue injury, which often go unrecognised and misdiagnosed. Furthermore, classification and documentation of skin is often poor, resulting in chronic wounds with associated adverse patient outcomes. The International Skin Tear Advisory Panel (ISTAP) recently updated the International Best Practice Guidelines and definition of a skin tear based on emerging evidence and expert discussion and consensus. This article presents a discussion of the epidemiology, risk factors and causes of skin tears. In addition, the most recent best practice recommendations for the prevention, assessment, and management of skin tears is summarised.
Acne vulgaris is a common dermatological condition, with most adolescents experiencing ‘spots’ at some point. For most people, these will resolve by the time they are in their 20s. However, approximately 15% of people in the UK will seek treatment for persistent acne that does not resolve with the use of over-the-counter preparations. This equates to over three million visits per year in the UK to primary care clinicians, such as general practice nurses (GPNs), who are well-placed to support patients. This article outlines the types of lesions that patients can present with, provides guidance on effective skin care, and discusses the topical and oral therapies that may be prescribed and their side-effects. The authors also look at the optimal referral of patients for secondary care assessment, as well as signposting nurses to assessment tools that focus on the psychological, as well as the physical, signs of acne. The psychological effect of having a visible, albeit common, skin condition should not be underestimated.
Here, Tamsen Courtenay, writes about the people she met while researching her book
on the realities of homelessness (website: tamsencourtenay.com)
In each issue of the Journal of General Practice Nursing, we investigate a topic currently affecting our readers. Here Toby Capstick, consultant pharmacist, Leeds Teaching Hospital NHS trust, looks at why correct inhaler technique matters.
Why should general practice nurses (GPNs) be concerned about psychological care? It is relevant in two key ways: identifying and addressing mental health in consultations with patients; and identifying and addressing psychological distress (which may be temporary, e.g. coping with stress) in patients.
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