Resources

Asthma is the most common longterm condition in children and young people (CYP),  affecting one in 11 five to 18 year olds (Asthma + Lung UK, 2024a). That is around three in every classroom. Most cases are mild to moderate and, in most children, a few  simple interventions can vastly reduce asthma symptoms and risk of attack (Bush and  Fleming, 2015; British Thoracic Society/Scottish Intercollegiate Guidelines network  [BTS/SIGN], 2019; Levy, 2020; National Institute for Health and Care Excellence  NICE], 2021). The awareness campaign, #AskAboutAsthma, was established to encourage  everyone seeing CYP with asthma to have these interventions front and centre of their minds.

Compression bandaging can present a challenge to healthcare professionals. Some clinicians may not have the necessary skills and training to safely and competently apply it, while others may be using it but not in accordance with the evidence base. As clinicians, it is
our responsibility to make sure that our knowledge and skills are up to date so that we can deliver evidence-based care to patients and do no harm (Abu-Baker et al, 2021). The NHS Long Term Plan emphasised the importance of placing the patient at the heart of their care with their experiences, needs and preferences considered when developing a care plan
with them (NHS England, 2019).

Sjögren’s syndrome. Never heard of it? No, neither had I. In fact, a nurse I spoke to only a few weeks ago hadn’t either.

Sjögren’s syndrome (hereafter known as Sjögren’s) is a chronic autoimmune disorder of unknown origin (Carsons and Patel, 2023), which attacks the secretory glands that produce fluid for the eyes, mouth, skin, gastrointestinal and genital tract resulting in decreased 
fluid production (Lackner et al, 2017). Essentially however, the condition has the potential to affect virtually any organ system leading to extreme clinical symptoms (Negrini et al, 2022), the impact of which can be severely debilitating.

In the final part of our Monitoring matters series, Callum Metcalfe-O’Shea, advanced nurse practitioner and UK professional lead for long-term conditions with the Royal College of Nursing (RCN), discusses lipid management. Again, the term long-term conditions covers type 2 diabetes, asthma/chronic obstructive pulmonary disease (COPD), autoimmune rheumatic diseases and inflammatory bowel diseases  (Crohn’s/colitis). Lipid management is ever evolving with new and emerging treatments available, and many both positive and difficult conversations often occur between general practice nurses (GPNs) and patients around this clinical issue. This article defines lipid management in the context of long-term conditions, highlighting assessment tools alongside treatments to help GPNs identify the
evidence needed to have discussions with patients around lipid management. Treatment options will be considered, but application to local formulary and policy is required.

Although most healthcare professionals agree that medication is the only real treatment for gout, addressing diet can help to prevent its development and possibly help ease symptoms, especially when it comes to weight issues and avoidance of alcohol. Observational data shows some dietary treatment to be effective, in particular healthy diets such as DASH and the Mediterranean diet. Gout usually presents with other comorbidities which benefit from a healthy diet. The author recommends that all gout patients should have a dietary assessment and then guidance on how diet can be improved.

Asthma is one of the most prevalent lung conditions in the UK. Around eight in 100 people are diagnosed with it (Asthma + Lung UK, 2024). However, according to the British Thoracic Society (BTS, 2024), asthma affects around 12% of the UK population, with 160,000 people being newly diagnosed each year. This article focuses on the importance of finding the right inhaler to meet patient needs and lifestyle, while exploring the concepts of shared decision-making within respiratory reviews.

Urinary tract infection (UTI) is a term that describes an infection anywhere within the urinary system where the commonest cause is Escherichia coli, which accounts for 80% of infections and is usually found in the urinary tract (Vasudevan, 2014). Women are more susceptible to UTIs than men as their urethra is shorter, which means that infection can easily ascend the tract (Vasudevan, 2014; John et al, 2016). However, as men age, the risk becomes equal to women (Harrington and Hooton, 2000; Rowe et al, 2014) and accurate diagnosis and management of UTIs in men using guidelines is poor (Isberg et al, 2024). This article considers the risk factors for UTI in men, how they present, and how UTI can be managed in primary care.

Patient safety can be considered similarly to safeguarding, something which is everybody’s responsibility. Indeed, the Nursing and Midwifery Council (NMC) ‘Code of Conduct’ states that risk and escalating concerns form a key part of the nurse’s role to preserve safety (NMC, 2018). Nurses have the most regular contact with patients and therefore play an important role in the identification, recognition and reporting of risk and incidents, the response and escalation of potential harm, and the ongoing patient support throughout and post incident. This article discusses the importance of being familiar with the ‘NHS Patient Safety Strategy’ and how it incorporates risk, incidents and education. And essentially, how it relates to nursing and the need for all nursing interactions to be considered from a patient safety perspective. The topics covered include incident reporting, risk management,  learning from harm, quality improvement, and information sharing. The piece also highlights the significance of record-keeping.

Bullous pemphigoid (BP) is a rare, chronic, inflammatory, subepidermal, blistering disease that primarily affects older people (Chan, 2020). The blisters are usually filled with clear fluid and the surrounding skin is often red and inflamed. These blisters can appear anywhere on the body but are typically found on the lower abdomen, groin, upper thighs and arms.
The prevalence of BP has doubled in 20 years, due to population ageing and other factors (Persson et al, 2021a). This article provides details of the latest guidelines, explains what can trigger BP, and how it is diagnosed and treated.

This article critically analyses the process of clinical decision-making (CDM) and associated theories that contribute to safe clinical judgement, allowing trainee advanced clinical practitioners (tACPs) to expand their knowledge, skills and attitude to CDM at an advanced level. The case included is from the author’s own clinical practice and is a reflective
piece involving CDM which embraces the four pillars of advanced practice. The relevant professional, legal and ethical issues that assist tACPs to follow the ‘Code of Conduct’ (Nursing and Midwifery Council [NMC], 2018) are also discussed in relation to this complex CDM case.