Chronic obstructive pulmonary disease (COPD) is a major cause of morbidity and mortality. It is estimated that over three million people in the UK have the disease, with just under a third actually having a diagnosis (National Institute for Health and Care Excellence [NICE], 2010a). It is defined as irreversible air flow obstruction, which is insidious and progressive with little day-to-day variability, predominantly caused by cigarette smoking, but with the recognition of ther contributory factors such as exposure to occupational irritants (NICE, 2010a).
Reducing the burden of COPD relies on early and accurate diagnosis before individuals are on the trajectory of functional decline (Department of Health [DH], 2011). This paper outlines the key steps that general practice nurses (GPNs) should take to make a good diagnosis and so make lifelong improvements for patients living with COPD.
While working as a district nurse in a GP practice, the author and a community pharmacist performed a small audit to establish the use of self-monitoring of blood glucose within the practice population. The results indicated that 79 patients were prescribed blood glucose test strips directly in contrast to National Institute for Health and Care Excellence (NICE, 2015) guidance. The results were then shared within the practice to initiate education and a education in unnecessary testing. The following article describes the audit in more depth and explores some of the available evidence on blood glucose monitoring in patients with non-insulin dependent type 2 diabetes.
Coeliac disease is a long-term condition which affects approximately one in 100 people in the UK. This article explores which patients may need to be screened for the condition and the symptoms they may present with. Once diagnosed with the condition, patients need to follow a lifelong gluten-free diet to prevent complications. This article looks at the many roles that general practice nurses (GPNs) have in promoting compliance with the treatment of a gluten-free diet, as well as discussing how they can help to manage the risk of complications such as osteoporosis and infectious disease.
Hay fever is one of the spectrum of allergic diseases that includes eczema and asthma (Wahn, 2015). It is a common condition and the symptoms are distressing and in severe cases may be extremely debilitating. Symptoms may impact upon work, study, outdoor activities and sleep — in fact, the whole lifestyle of a severely affected individual.
Depending on the cause and severity, treatment may be wholly or partially effective. The aim of treatment by avoidance, desensitisation or medication is to minimise or abolish symptoms, while also ensuring that side-effects of medication(s) are minimised. Where the specific trigger or allergen has been identified and had a seasonal effect, it is best practice to start treatment before the season begins.
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.
This feature asks experts in their particular field to take a look at a therapy area and examine some of the challenges that general practice nurses (GPNs) may face. In this issue, we look at wound cleansing and ask how...
A team of people with an interest in COPD, including two experienced respiratory nurse specialists, met to discuss the range of emotions that people and those around them typically experience when coming to terms with COPD.
The aim was to explore how a sufferer reacts to a COPD diagnosis and how their changing emotional state affects their ability/ willingness to self-manage their condition and develop a care pathway.
The team also considered the emotions of the carer along the pathway and their role in helping their loved one to change. The learnings from this work could help general practice nurses (GPNs) provide appropriate support to COPD patients to help them get to a stage where they are motivated and able to effectively self-manage.
In each issue of the journal we speak to general practice nurses and hear what they have to say about their role in primary care.
Spirometry is very easy to do, and very easy to get wrong (Martin, 2010; personal communication). Not only is quality
assured spirometry dependent on the effort exerted by the patient, and the technical ability of the spirometer operator,
but also on the understanding of the results by the person interpreting them.
Interpretation of the results is essential if any meaningful decision is to be made about the patient’s care.
Success!