Welcome to this latest issue of GPN, which we hope you enjoy reading. We are delighted to share our news with you and hope to see you learning with us soon. Please visit www.educationforhealth.org to find out more about us or follow us on Twitter and Facebook.
Improving the care of people in the early stages of dementia
Dementia diagnosis and care has become a national priority, for it is estimated that the number of people with dementia will double to 1.4 million by 2038. Linked to the NHS Knowledge and Skills Framework — and delivered by expert clinicians with practical experience in dementia diagnosis and care — Education for Health’s one day workshop will help you to recognise the symptoms of dementia and to work with other providers to coordinate effective diagnosis and support.
In each issue of the Journal of General Practice Nursing we investigate a topic currently affecting our readers. Here, Louise Ross, stop smoking service manager, Leicester, looks at: Nicotine: time for a rethink?
Anne Moger gives her views on the new national framework.
Professor Jane Cummings, Chief Nursing Officer for England, officially launched Leading Change, Adding Value: a framework for nursing, midwifery and care staff on 18 May 2016. The event was held in London and live streamed, and with 1,200 devices linked in and connections through Twitter using the hashtag #Lead2Add the estimated reach to people participating globally was over 3.5million.
The framework follows the success of Compassion in Practice (NHS England, 2012) and positions all nursing, midwifery and care staff as leaders who will shape the actions needed to meet the challenges of today and the changing health and care landscape of the future. One of the great legacies created through Compassion in Practice is the 6Cs, and these will remain the foundation of our value base and central to reducing unwarranted variation.
Inspiring the next generation of nurses to work in primary care.
In collaboration with the Queen’s Nursing Institute (QNI) Scotland, the QNI are working to update the standards for general practice nursing (GPN) education and practice (http://bit.ly/1tvBCKb).
There are only a few universities accredited by the Nursing and Midwifery Council (NMC) for the general practice nurse specialist practitioner qualification (GPN SPQ). However, in recent years, there has been a range of newer educational
developments aimed at providing the knowledge and skills needed for nurses moving into general practice — hence the need to update the ‘standards’ to ensure consistency across the four UK countries and the universities that offer this course.
Lung function or spirometry testing is a primary activity for many general practice nurses (GPNs). Spirometry testing is most commonly used to help diagnose chronic obstructive pulmonary disease (COPD), and is likely to increase in importance as the proportion of individuals living with the condition is on the rise in the UK (Gibson et al, 2013).
In the UK, there are an estimated one million, one hundred thousand people over the age of 65 who are chronically lonely (Victor et al, 2005).
In 2015, a report by the Campaign to End Loneliness, Hidden Citizens, explored current understandings of and approaches to identifying loneliness and offered innovative insights into how policymakers and healthcare professionals can improve their outreach. Since its launch, public and political attention to loneliness has continued to sharpen as the social, economic and moral case for tackling loneliness grows in awareness, evidence and support.
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.
