Stephen Gaduzo explains how the PCRS-UK can help you deliver high value patient-centred care and support professional development.
Nurse revalidation is now likely to start in less than six months’ time and it has never been more important for general practice nurses (GPNs) to ensure that their skills and knowledge are up to date.
Leg ulcers present a common clinical problem for general practice nurses (GPNs). The need for assessment and maintenance can take up a great deal of time and issues such as pain, exudate volume and poorly applied compression bandaging have a serious effect on patients’ quality of life. The ‘gold standard’ treatment for venous leg ulcers has long been multilayer compression therapy (National Institute for Health and Care Excellence [NICE], 2012). However, as with any other technique, expertise can vary, meaning that clinicians sometimes do not apply the necessary sub-bandage pressures. Patients can also find multilayer compression ‘bulky’ and uncomfortable, and thus may not concord with treatment (Wicks, 2015).
Diabetes care takes up around 10% of the total NHS budget (Diabetes UK, 2015), and as type 2 diabetes mellitus (T2DM) makes up around 90% of all diabetes, it could be argued that prescribing for this largely preventable condition is the main culprit responsible for these costs. However, most of the money spent on treating diabetes is for managing its complications (Kerr, 2011). The key to preventing these complications is through effective prescribing aimed at reducing them. Possibly as a result of more clinicians thinking this way, prescribing costs for diabetes have been rising steadily (Health and Social Care Information Centre [HSCIC], 2014). So, how can clinicians be sure that newer and more expensive therapies are both clinically and financially effective? And crucially, how do clinicians ensure that patients are kept at the centre of all consultations and are fully involved in the decision-making process?
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
