Coronary heart disease is the UK’s biggest killer and has a devastating effect on families as well as placing extra cost and pressure on an already stretched healthcare system. Currently, there are around 155,000 deaths every year from heart and circulatory diseases, which includes heart attacks and strokes, accounting for over a quarter of all deaths in the UK. To add to this, there are around 491,000 hospital episodes related to coronary heart disease each year, and it is estimated that cardiovascular disease costs the UK economy around £15.2 billion each year.
The 2017 Primary Care Respiratory Society UK (PCRS-UK) annual conference, ‘Beyond the respiratory consultation: inspiring lifelong change’, offers a programme packed with plenary sessions, clinical updates and hands-on workshops designed to inspire nurses who are enthusiastic about providing holistic care.
With wound and skin care taking up a considerable part of general practice nursing time, the new GPN ‘nurse consultation’ series follows the therapy chain for the management of patients with venous leg ulcers and looks at the skills needed to ensure safe, competent and professional consultations with patients.
Diagnosis and treatment of chronic oedema remains sporadic in primary care, with many patients being treated for leg ulceration rather than the complication of chronic oedema when they present with a combination of ulceration and chronic oedema.
A considerable proportion of general practice nurse (GPN) visits are for patients with venous leg ulcers (Guest et al, 2015). However, clinicians’ skills and knowledge in managing these cases vary (Wounds UK, 2016), due to the increase in comorbidities and complexities of venous ulcer presentation (Newton, 2010). This article explores accurate venous leg ulcer assessment through analysing the best evidence available. Prevalence, as well as wound, holistic and Doppler assessment are covered to provide a detailed assessment plan that can be used to ensure evidence-based patient care. Management will not be discussed in detail, but appropriate techniques will be considered with compression therapy being referred to as the gold-standard treatment for venous ulceration (National Institute for Health and Care Excellence [NICE], 2016).
Breathing is a normal vital function which is spontaneous, regular, quiet and effortless and reflects the way that the respiratory system functions. Breathing pattern disorders or dysfunctional breathing, historically known as hyperventilation syndrome, are chronic abnormal respiratory patterns in relation to the efficiency of breathing, often resulting in dyspnoea and other non-respiratory symptoms (Clifton-Smith and Rowley, 2011). It is not a disease process, but alterations in breathing patterns that interfere with normal respiratory processes. Breathing pattern disorders can occur with an absence of disease or co-exist with many diseases such as chronic obstructive pulmonary disease (COPD), asthma, or heart disease, and in some cases, can mimic cardiac symptoms.
Ninety-three percent of elderly adults (over 65) living with malnutrition are residing in the community (Age UK, 2017), and at least one in 10 visits to a general practitioner are by adults that are experiencing malnutrition (British Association of Parenteral and Enteral Nutrition [BAPEN], 2015). General practice nurses (GPNs) will be exposed to patients with acute conditions such as a chest infection or a pressure ulcer, or chronic conditions such as chronic obstructive pulmonary disease [COPD), chronic kidney disease and dementia, which increase their risk of malnutrition. Oral nutritional supplementation is one of the treatments available to treat malnutrition. This article discusses the identification of malnutrition, treatment and appropriate prescribing, through initiation, monitoring and cessation of oral nutritional supplementation.
Pre-travel vaccine recommendations require a full individualised risk assessment. The traveller should then be informed about the specificity of the vaccines they should consider and told about their benefits and limitations. They should also be made aware of issues around certificate requirements and if these will apply to them. A well-informed traveller will understand that, although important, vaccines do not remove the need for precautions with food, water, insect bites and activities that increase risk. Routine immunisations and those recommended for special risk groups should not be neglected in favour of more rare and exotic vaccines. This article focuses on indications for travel vaccines only.
The impact skin disease has on the psychological wellbeing, social functioning and everyday activities of patients and their families and carers is often trivialised and given low priority. The quality of life of people with skin diseases such as psoriasis, atopic eczema and acne can be significantly impaired, and such impairment can be greater at times than for life-threatening conditions such as cancers (Schofield et al, 2009). Living with a family member with a skin condition impacts on many aspects of life, with issues such as leisure time (26%), social life (48%) and holidays (46%) highlighted as adversely affecting family life (Basra and Findlay, 2007). This paper provides practical advice and guidance that general practice nurses (GPNs) can give parents when planning leisure and holiday time with their children.
Primarily due to better treatment options, there are now over two and a half million people living with cancer in the United Kingdom and it is predicted that in the next fourteen years this number will increase to four million. This means that the numbers of people living with cancer in the UK has increased by approximately half a million in the last five years (Maddams et al, 2012). When all cancers are grouped together, someone diagnosed with cancer today has double the chance of being alive in ten years time compared to someone diagnosed with cancer during the 1970s (Quaresma et al, 2014). This paper will now take three of the four most common cancers in the UK and look at them individually, i.e. breast, prostate, and colorectal cancer.
