While multilayer compression bandaging has traditionally been seen as gold standard therapy for venous leg ulcers, success of treatment depends on the competency of the nurse applying the bandages and patient concordance (Scottish Intercollegiate Guidelines Network [SIGN], 2010). Furthermore, wearing compression is a lifelong commitment as, following healing, it is still needed to prevent ulcer recurrence and skin breakdown.
During this maintenance phase, compression hosiery is usually prescsrbed (Nelson and Bell-Syer, 2012). However, som patients also find it difficult to concord with compression hosiery (Jull et al, 2004). juxtalite (medi UK) is an alternative maintenance system for those patients who cannot tolerate or apply compression garments.
The State of the Nation report published in 2015 makes a case for prioritising the prevention of type 2 diabetes (T2D) (Diabetes UK, 2015). This report identified T2D as a major challenge fo the NHS which uses a significant proportion of NHS resources - almost 10% of total NHS spending, in fact - yet the Word Health Organisation (WHO) estimated that over three quarters of T2D is preventable (WHO, 2005). Thus, the prevention of diabetes needs to be a priority for the NHS (Diabetes UK, 2015), and it makes sense that general practice nurses a priority for the NHS (Diabetes UK, 2015), and it makes sense that general practice nurses (GPNs) should be at the forefront of this strategy.
There are many components to consider when performing an annual asthma review. The Quality and Outcomes Framework (QOF) can help by prompting healthcare professionals to include such tasks as inhaler technique, peak flow and the Royal College of Physicians’ three questions (RCP3Q). However, these are only process measures. To perform a review adequately, it is important also to understand the more subtle aspects of asthma management in order to achieve the best outcomes for the patient. The ‘SIMPLES’ approach is one way in which this might be achieved (Ryan et al, 2013).
Chronic urticaria is a relatively common complaint in clinical practice. It often has an unknown aetiology or a difficult-to-avoid trigger and although rarely life-threatening, it has a profound impact on quality of life, reaching beyond the
impairment directly related to physical symptoms. All these aspects make its management complex and often frustrating both from a patient and professional perspective. Most patients with urticaria will be seen first in primary care, often by practice or community nursing staff. With good knowledge on diagnosis and management, up to 80% of these patients can be managed adequately in primary care.
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.
Put simply, exudate is the fluid that leaks from the capillaries during the healing process. It helps to create a moist wound environment and assists with healing by removing devitalised tissue, repairing damaged cells and providing nourishment to assist with epithelialisation. Exudate is produced in the initial wound-healing process as part of the inflammation stage.
Exudate is created in response to injury as neutrophils migrate to the wound site and cytokine messengers instruct the surrounding blood vessels to become more porous and leak protein-rich fluid into the wound bed. Exudate is full of nutrients and growth factors and, when produced in the right amount, ensures that there is a moist wound environment, which is essential for timely healing.
In each issue we speak to general practice nurses and ask about their role in primary care. Here, Amanda Brookes, business manager, Bradford on Avon and Melksham Health Partnership, talks about the effect of positive ideas on patients’ lives.
Welcome to GPN’s learning zone. By reading the article in each issue, you can learn all about the key principles of subjects that are vital to your role as a general practice nurse. Once you have read the article, 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 your continued learning and contribute to your revalidation portfolio.
This article helps to explain how C-reactive protein point-of-care works, and why using this diagnostic kit can help to reduce antibiotic prescribing.
Education and training updates!
Welcome to this spring edition of the Journal of General Practice Nursing.
We are delighted to share the latest news in the world of Education for Health with you and hope to see you learning with us soon!
We have some great opportunities for you to get involved with us — our new general practice nursing courses are already attracting a lot of interest and it’s not too late to get involved.
As always, we hope that you enjoy this issue and our news update.
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