For the first time, the Queen’s Nursing Institute’s (QNI’s) annual conference was a two-day event, with a range of speakers on the twin themes of inspiring quality and success in nursing and on shaping the future of the nursing workforce. The speakers — from England, Wales and Northern Ireland — spoke about the various challenges facing the nursing workforce and some of the new initiatives that are being introduced to address them.
Technology is all around us and while it enables us to do things that were not possible in the past, I still talk to nurses around the country who have very different levels of professional engagement with it.
The UK has one of the highest death rates from asthma in Europe (Global Asthma Network, 2014). Every day three people die from asthma, two-thirds of these deaths are preventable (Asthma UK, n.d.). Why asthma still kills: The National Review of Asthma Deaths. Confidential Enquiry Report (NRAD) was published in 2014 by the Royal College of Physicians (RCP). It is the largest worldwide study looking into why people die from asthma and the first to adopt a UK-wide focus. The NRAD identified that only a fifth of people with asthma are receiving all the basic elements of asthma care which could help them manage their asthma effectively and reduce their risk of experiencing an asthma attack. It provided valuable insights and clear practical recommendations which, if implemented, could improve care and reduce the number of asthma deaths (RCP 2014).
Four million — or one in 16 — adults in the UK have diabetes (whether or not they are aware of it), and this figure is predicted to increase to an estimated five million by 2025 (Diabetes UK, 2015). The majority have type 2 diabetes and the focus of this article will be on the role of general practice nurses (GPNs) in managing type 2 diabetes, although an overview of pre-diabetes, type 1 diabetes, gestational and steroid-induced diabetes will be provided. The author will also discuss the best current dietary advice that GPNs can provide for patients so that they can manage their own diabetes, as well as looking at the support available for GPNs to facilitate self-care in their day-to-day practice.
Atopic eczema is a common dry skin condition, and, as with any dry skin condition, emollients are a fundamental aspect of care. With so much choice there can be uncertainty around which product to use. Choosing one product over another can create confusion for both healthcare professionals and patients. This paper looks at emollients, the products available, how to use them and the current evidence and research relating to emollient use for atopic eczema. The reader is also directed to additional resources to support clinical practice.
The second in this two-part series on migrane focuses on how to treat patients to reduce disability and improve quality of life. Expectation is an important driver to treatment and patients and healthcare professionals should be ‘on the same page’. Unfortunately, this is not always true. Packard (1979) found in his study that doctors thought patients wanted pain relief (96%), medication (68%) and explanation (68%), but what patients actually wanted was explanation (77%), pain relief (69%) and a neurological investigation (31%). Ineffective communication leads to dissatisfaction with care and poor adherence to treatment in headache patients (Cottrell et al, 2002). Therefore, it is essential that patients are involved in the decision-making process when deciding on treatment.
Obesity and its consequences, such as diabetes and cardiovascular disease (CVD), have significant health and NHS cost implications. Relatively small reductions in weight (around 5–10%) have clinically important benefits (Pietrzykowska, 2016), but long-term weight loss maintenance is challenging. Behaviour change interventions have been identified as key for use in weight loss by authorities such as the National Institute for Health and Care Excellence (NICE, 2014). In particular, motivational interviewing (MI) — a form of behaviour change — has been identified as a successful approach to changing health behaviours (Rollnick and Miller, 2013).There is an abundance of evidence showing that just telling people what to do does not work as a way to change patients’ behaviour in order to achieve health gains (NICE, 2014). Furthermore, there is emerging evidence that MI does work and leads to long-term health gains. This article provides an overview of MI to help general practice nurses (GPNs) in their day-to-day practice.
The transition from secondary to primary care can be daunting for any healthcare professional due to the extreme changes in the working environment and clinical responsibilities/duties undertaken. Healthcare professionals may fear that their knowledge base is not up-to-date and that they will become ‘deskilled’ within the general practice setting. However, with the correct attitude and determination, a successful and varied career can be forged incorporating advanced skills and enhanced practice within the day-to-day work of a general practice nurse (GPN).
Identifying and managing malnutrition in patients with COPD is vital.
Matthew Hodson and Samantha Blamires explore how nutritional screening and appropriate management of malnutrition can improve outcomes for patients with COPD.
Chronic obstructive pulmonary disease (COPD) is an umbrella term for a number of lung diseases, including emphysema and chronic bronchitis. There are an estimated three million people living with the condition in the UK, however only 900,000 are currently diagnosed (National Institute for Health and Care Excellence [NICE], 2010). COPD is a major cause of morbidity and mortality, accounting for more than 28,000 deaths, 130,000 emergency admissions and 1.4 million GP consultations every year (NICE, 2010). Weight loss and being underweight are associated with poor prognosis and increased mortality, independent of disease severity (Ezzell et al, 2000), yet malnutrition is largely underrecognised and undertreated.
This piece was sponsored by an educational grant from Nutricia Advanced Medical Nutrition.
Welcome to GPN’s learning zone feature. By reading the article in each issue, you can learn about key principles of subjects that are vital to your role as a general practice nurse. Having read the article, visit www.journalofpracticenursing.co.uk/learningzone/ (‘Insight’ section) to evaluate your knowledge on this topic by answering the 10 questions in the e-learning unit; all answers can be found in the article. If you answer the questions correctly, you can download your certificate which can be used in your continuing professional development (CPD) portfolio as evidence of continued learning and contribute to your revalidation portfolio.
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