The trend for tattoos and body piercings has become increasingly popular in Europe and Western countries (Kluger, 2013). It has been estimated that 20% of the United Kingdom population has a tattoo and 10% of the adult population has a piercing of some kind, with a self-reported complication rate of 28% (Bone et al, 2008; White, 2012). It is therefore quite likely that general practice nurses (GPNs) will encounter wound-related problems, such as infection, associated with tattoos and piercings during their day-to-day clinical practice. This article explores some of the complications that can arise and provides an overview of how to manage them effectively.
The influenza immunisation programme in the UK started in the 1960s and has since been extended to offer protection to those groups most vulnerable to the infection. The extension of the programme to children aims to directly protect them and reduce transmission of the virus to those around them. Early results from pilots run in England reveal reduction of influenza in areas where all primary school-age children were offered immunisation. Uptake among pre-school children has remained low in the first three years of the programme and there are opportunities to increase acceptance among parents. General practice nurses (GPNs) are among those most trusted in informing and reassuring parents about the benefits of immunisation. This article gives GPNs the background and rationale for the programme, and outlines supporting information available to assist them in this challenging and important role as an immuniser.
Pre-travel consultations can be complex and time-consuming — none more so than those involving a cruise. Cruise travel is a booming industry and approximately two million cruises were taken by UK-based passengers in 2014 (Department of Transport, 2015) and it is estimated that globally 24 million people will take a cruise this year (Cruise Lines International Association [CLIA], 2016).
Cruise ships may carry anything from a few hundred passengers and crew to up to 5,000, and the cruise may last just a couple of days to several months. The trip may involve a long haul flight at either end, a land-based tour at the final destination or a round-trip from the UK. Although the Caribbean and editerranean are the most popular destinations, cruise operators are constantly adding new and varied ports of call. Cruise itineraries can often seem daunting, especially to the busy general practice nurse (GPN) and this article outlines what a pre-travel consultation should include.
Despite the widespread reported health benefits associated with increased physical activity (PA) and exercise, in reality, a large percentage of adults and children in the UK today are inactive and levels of obesity and life-threatening conditions associated with sedentary and unhealthy lifestyles are increasing (National Institute for Health and Care Excellence [NICE], 2015). Chronic diseases are on the increase, including diabetes, hypertension, bone and joint diseases, cancer and depression, and are affecting both the young and old. Regular PA can guard against these life-changing conditions (Public Health England [PHE], 2014). General practice nurses (GPNs) are ideally placed to advise patients about the benefits of PA. This article provides an overview of recommendations and any safety aspects, current fitness terminology, as well as the importance of exploring patient perspectives in terms of perceived barriers to PA.
Chronic constipation is a common disorder affecting 25% of the population at some point in their lifetime (Belsey et al, 2010). The statistical evidence shows a substantial financial burden on the NHS, with many people who have constipation recording unsatisfactory treatment and outcomes. It is difficult to define as professionals often classify the symptoms in a different way to the patient. It could be argued that as a symptom and not a disease, constipation is a condition that would be preventable in many cases if there was a better understanding among healthcare professionals and a more consistent approach to treatments offered. This article aims to highlight how thorough appropriate patient assessment, breaking down the social taboo around continence issues, and considering bladder and bowel issues as essential components of health and social care will lead to improved patient experience and satisfaction. General practice nurses (GPNs) are ideally placed to enable early detection of issues and offer appropriate advice or timely referral to specialist services.
Chronic preventable illness has a high financial and social cost. General practice nurses (GPNs) have the opportunity
in their daily work to help patients take steps towards health and wellbeing. Risk factors for many diseases are well known and the actions necessary to reduce risk are understood.
The routine national vaccination programme protects against a number of diseases that can have a significant impact on health. Not only does vaccination save lives, it can also mitigate disease severity and provide some protection for unvaccinated individuals.The UK schedule is also now a lifelong programme, with some neonates, such as those at risk of hepatitis B infection, being offered their first vaccine on their day of birth, and other vaccines, such as the influenza vaccine, being recommended every single year for those eligible. Although several new vaccines have been added to the schedule over recent years, clinicians can expect programmes such as the influenza one to continue to expand. To ensure that the optimum benefits of vaccination are achieved, it is essential to maintain high vaccine coverage in communities to protect both the individual vaccinated and offer some indirect protection for those who remain unvaccinated. This article reviews the current schedule, considers the impact of vaccination and highlights actions that can be put in place to achieve high coverage.
Skin cancer continues to be a major health problem in the UK (National Institute for Health and Care Excellence [NICE], 2011), despite representing a group of cancers which, in theory, is preventable. The single most important factor in the aetiology of skin cancer is solar radiation, also known as ultraviolet radiation (UVR). UVR is also responsible for other skin changes such as premature ageing, sunspots and sun-tanning. Sunshine does have some benefits in that, in general, it makes us feel physically and psychologically well (Kampfer and Mutz, 2013), and is needed for vitamin D synthesis. This article looks at the way that the sun can damage the skin and the signs that can indicate the development of malignancy. It also discusses the importance of staying protected from the harmful effects of the sun and ways to reduce the risk of skin cancer.
A pre-travel consultation should be a complete health promotion exercise and not merely a matter of administering vaccines. It needs to involve a full risk assessment during which the individual, the journey and destination are examined for potential hazards. Risk management strategies then need to be discussed. Essentially, general practice nurses (GPNs) should facilitate the patient’s choice of interventions by educating them appropriately and allowing them to make informed choices. The traveller needs to leave the consultation aware of the potential risks of their trip and how to prevent or manage them. In order to do this well, GPNs should have sufficient time and access to online resources. This article looks at best practice in the pre-travel consultation.
Statistics suggest that one in four adults are obese, and up to 33% of school-aged children are overweight or obese (National Obesity Forum, 2015). Thus, on a daily basis, it is likely that general practice nurses (GPNs) will engage in consultations with patients who are overweight or obese, quite often while presenting for advice for another condition. This article explores how to broach this sensitive issue and the GPN’s role to reduce weight stigma in line with the new Nursing and Midwifery Council Code (NMC, 2015). Practical advice for GPNs to support patients in managing their weight, and identifying appropriate onward referrals, including for bariatric surgery and eating disorders, will also be discussed.
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