Nurses in primary care have for many years drawn up insulin syringes in advance so that patients with diabetes who are unable to use an administration device, or who have some other impairment that prevents them doing this for themselves are able to take the pre- prepared insulin and self-administer. This has helped patients maintain their independence and has reduced the need for multiple visits from nursing teams that may not be convenient to the patient, as well as being time consuming for the team.
Currently in the UK there are almost seven million carers — that is one in ten people (Carer’s Trust, http://bit.ly/1QNAWZZ) — who perform a vital role in enabling people to lead independent lives in their own homes. To help nurses in primary care support these carers, the Queen’s Nursing Institute (QNI) has launched two new resources (online educational modules to help nurses support carers). These new resources are one of the main results of the QNI’s ‘Carers project’, which ran throughout 2014 with support from the Department of Health (DH).
Anne Moger gives her views on the current opportunities for general practice nurses.
Never has the spotlight on general practice nursing shone so brightly. Some may see this as an uncomfortable position to be in, and, in some ways, as part of the nursing family that sits outside the wider NHS family employed by independent contractors, it is. However, there is always a flip side, and the spotlight, if focused appropriately, will also be a guiding light, helping the profession to move forwards in line with the Five Year Forward View (5YFV) (NHS England, 2014).
Long-term conditions: chronic obstructive pulmonary disease.
The use of spirometry as an objective measurement in the diagnosis of chronic obstructive pulmonary disease (COPD) is widely acknowledged and discussed in guidelines about COPD, as well as those specific to spirometry (British Thoracic Society [BTS]/Association for Respiratory Technology and Physiology [ARTP], 1994; Levy et al, 2009; National Institute for Health and Care Excellence [NICE], 2010; Primary Care Commissioning [PCC], 2013). As a relatively simple test to undertake, it has been performed in primary care for several years now but with varying degrees of expertise and understanding (Strong et al, 2014). The standard of secondary care lung function testing (LFT) has never been questioned. Overall, this inequity of testing has resulted in an estimated 50% of people having an incorrect diagnosis (Tinkelman et al, 2006). This results in people taking medication they do not need, or not receiving treatment they do. This article will enable the reader to identify gaps in their own knowledge about the use of spirometry in COPD diagnosis.
Venous leg ulcers make up a large part of a nurse’s caseload, with the application of compression bandaging requiring competent and skilled practitioners. At Central and North West London Foundation Trust (CNWL) Camden Integrated Primary Care (IPC) Service recruiting and retaining community nurses is a challenge, a situation which is shared across all London boroughs. In particular, it is difficult to maintain consistent standards for wound cleansing and compression bandaging, resulting in the responsibility for a large caseload falling to a small number of practitioners. Following a review of innovative products on show at the European Wound Management Association (EWMA) conference in May 2014, an alternative to traditional compression bandaging was identified as a possible solution to this problem; namely, UCSTM for effective debridement and Juxta CURESTM as an alternative to compression bandaging (both medi UK Ltd, Hereford).
Long-term conditions: seasonal allergic rhinitis.
Allergic rhinitis (AR) is a common disorder which has a major impact on the lives of sufferers and families. Although currently there is no cure for this disease, a variety of therapeutic interventions can alleviate the symptoms. It is important that general practice nurses (GPNs) are able to differentiate allergic and non-allergic rhinitis (NAR) from viral upper respiratory tract infections (URTIs) in order to best manage their patients. It is also necessary to ask appropriate questions of those patients attending for asthma review, as they may have unrecognised and untreated disease. Familiarity with the range of medications and their administration is advocated. Patients with troublesome, non- responding symptoms need to be referred, as do those with red flag signs.
Skin cancer continues to be a major health problem in the UK (National Institute for Health and Care Excellence [NICE], 2011), despite representing a group of cancers which, in theory, is preventable. The single most important factor in the aetiology of skin cancer is solar radiation, also known as ultraviolet radiation (UVR). UVR is also responsible for other skin changes such as premature ageing, sunspots and sun-tanning. Sunshine does have some benefits in that, in general, it makes us feel physically and psychologically well (Kampfer and Mutz, 2013), and is needed for vitamin D synthesis. This article looks at the way that the sun can damage the skin and the signs that can indicate the development of malignancy. It also discusses the importance of staying protected from the harmful effects of the sun and ways to reduce the risk of skin cancer.
The introduction of revalidation for nurses and midwives from April 2016 will strengthen the renewal process with its new requirements.
Alongside the official NMC revalidation pilot projects, organisations are developing their own pilots to get ahead of the curve when it comes to revalidation to ensure that their workforce are fully prepared to meet the necessary requirements.
HeART, an online e-Portfolio based system which has been accredited by the Royal College of Nursing (RCN), is being evaluated by participants in NHS England Central Midlands as a tool to help portfolio development.
General practice nurses are using HeART to ensure that they can meet revalidation requirements when the time comes to apply for revalidation.
With the Government looking to cut costs across the healthcare landscape, nurses may wonder how they can help procurement secure the savings needed — identifying comparable but cheaper treatment options is one such way.
In each issue we speak to general practice nurses and ask about their role in primary care. Here,Yvonne Lee, integrated nursing team leader, Cerne Abbas Surgery, talks about an integrated nursing team.
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