Respiratory disorders, in particular asthma and chronic obstructive pulmonary disease (COPD), have been recognised for many years and remain among the most common chronic long-term conditions that are seen in primary care. Despite the development of guidelines, standards and effective treatments, both diseases continue to carry a high morbidity and mortality, a significant societal cost in terms of lost school and work days, and high consultation and admission rates.This article follows the development of our knowledge of these common disorders and looks at how far we have progressed in our diagnosis, knowledge and treatments, as well as what the future may look like in terms of care management and treatment options.
Atrial fibrillation (AF) is the most common sustained adult cardiac arrhythmia with over one million people diagnosed with AF in the UK (Health and Social Care Information Centre, 2014; Information Services Division [ISD] Scotland, 2014; Department of Health, Social Services and Public Safety, 2014; Stats Wales, 2014). Many more people are thought to have undiagnosed AF (National Institute for Health and Care Excellence [NICE], 2014) and the true UK prevalence is currently estimated to be 2.4% (Public Health England [PHE], 2015). The number of people with AF could significantly rise due to the growing elderly population and the increasing prevalence of those living longer with associated long-term conditions. Clinicians working in primary care can expect to see a growing demand to provide high-quality care for people with or at risk of developing AF. This includes checking for it, treating people who are newly-diagnosed and providing onward monitoring of people with an established diagnosis of AF. This two-part series looks at how to improve the provision of AF management in primary care.
Frailty is a clinical syndrome which focuses on loss of reserve, energy and wellbeing. Currently, older people with frailty tend to present late and often in crisis to health and care services so their care may be hospital-based, episodic, and unplanned. There is a need to reframe frailty as a long-term condition that can be mainly managed within a primary and community care setting, with timely identification for preventative, proactive care underpinned by supported self-management and person-centred care. General practice nurses (GPNs) will play a vital role in this new paradigm for frailty as key workers, coordinators of care, and supporters to patients and their carers at all stages of the frailty trajectory.
The routine national vaccination programme protects against a number of diseases that can have a significant impact on health. Not only does vaccination save lives, it can also mitigate disease severity and provide some protection for unvaccinated individuals.The UK schedule is also now a lifelong programme, with some neonates, such as those at risk of hepatitis B infection, being offered their first vaccine on their day of birth, and other vaccines, such as the influenza vaccine, being recommended every single year for those eligible. Although several new vaccines have been added to the schedule over recent years, clinicians can expect programmes such as the influenza one to continue to expand. To ensure that the optimum benefits of vaccination are achieved, it is essential to maintain high vaccine coverage in communities to protect both the individual vaccinated and offer some indirect protection for those who remain unvaccinated. This article reviews the current schedule, considers the impact of vaccination and highlights actions that can be put in place to achieve high coverage.
This article uses the University College London Institute of Health Equity’s (IHE) 2013 report, Working for Health Equity: The Role of Health Professionals, as a framework for considering ways that nurses in clinical, educational, or managerial roles in primary care can help address health inequalities using a social determinants approach.
Although organisations such as the British Medical Association (BMA, 2011), the Royal College of Nursing (RCN, 2012), the Royal College of Physicians (RCP, 2010) and Public Health England (PHE, 2014) have set out how doctors and nurses can address inequalities, in the author’s opinion there is little written about how general practice nurses (GPNs), in commissioning, education or clinical roles, can specifically help.
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 the use of an advanced wound technology in clinical practice...
With the current shift in patient care away from hospitals, more and more patients with complex wounds are being seen in primary care settings. This challenge means that clinicians need to take a proactive approach and ensure that the wound dressings they choose will stimulate the biochemical process and create the optimum environment for healing. This article asks Heather Newton, a tissue viability nurse consultant, Royal Cornwall Hospitals NHS Trust and Corinna Mendonca, a dermatological consultant, Bolton NHS, why dressings with the TLC Healing Matrix (hydrocolloid particles and lipophilic substances which encourage new granulation tissue through fibroblast proliferation) are used in their clinical settings.
This piece was sponsored by an educational grant from Urgo Medical.
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.
Beverley Bostock-Cox, nurse practitioner, Mann Cottage Surgery, Moreton-in-Marsh; education lead, Education for Health
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, visit:
www.journalofpracticenursing.co.uk/learning-zone/
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.
Welcome to the second issue of GPN. We have had quite a remarkable spring, from new funding opportunities for our programmes of study to recognition of our clinical educators — a great deal has happened in the world of Education for Health.
With summer around the corner we’re really excited to be introducing a new range of modules which focus on the importance of prevention, a small taster of which can be found in this update. In addition, you’ll find information about our popular range of ARTP accredited spirometry courses.
We hope that you are excited about our news and this gives you cause to join us in working towards our vision: Everyone living with a long term condition receives high quality care and is empowered to manage their condition.
Practice matters: In each issue of the Journal of General Practice Nursing we investigate a hot topic currently affecting our readers. Here, Binkie Mais looks at how GPNs are placed in new models of care and asks the question...Can the GPN workforce meet the challenge of increased demand?
