03 May 2016

INTEGRATING CARE FOR LONG-TERM CONDITIONS IS IMPORTANT

Improving management of people living with long-term conditions (LTCs) has been a key priority for the NHS since the 1990s. At the time, little evidence existed to understand the best practice on managing LTCs and the involvement of primary care. Today, we are in a stronger position where efficacy, safety and other positive outcomes are being demonstrated by implementing a variety of quality improvement approaches and service redesign, all underlined by the rhetoric of integrated care.

01 March 2021

None of the 13 million of us in the UK who watched the final of ‘Strictly Come Dancing’ 2020 will need convincing of the joy of dance and dancing with others — nor of the endurance, strength, flexibility and balance required. But, have you ever considered how dance can be used therapeutically? This article presents evidence and practice about the use of dance in chronic disease management, in particular, its role in alleviating breathlessness. One of the main causes of breathlessness is chronic obstructive pulmonary disease (COPD). Pulmonary rehabilitation (PR) is an effective treatment for COPD, including tailored exercise and education, but it is not available or suitable for everyone. There is potential for dance to be offered as a therapeutic intervention for people with COPD and other chronic respiratory diseases in several ways: by incorporation into existing programmes to increase the variety of exercise, post-PR as maintenance therapy, as an alternative for those who choose not to attend PR, and for those who are not offered PR.

10 August 2018

This article provides an overview of a collection of diseases collectively known as interstitial lung disease (ILD). The terminology and names have changed over time with an expanding, complex classification. This article discusses some of the more commonly recognised classes of ILD. These conditions are increasingly recognised but provide diagnostic and therapeutic challenges. General practice nurses (GPNs) are ideally placed for early symptom recognition and onward referral to secondary care specialist service for multidisciplinary team discussion, diagnosis and management.

01 September 2020

One of the key components of comprehensive holistic wound assessment, particularly of venous leg ulcers, is measuring a patient’s ankle brachial pressure index (ABPI), as this will help to rule out the presence of arterial disease and guide treatment decisions, i.e. the introduction of compression therapy. However, it has been identified that performing ABPI assessment is an area that needs improvement (Guest et al, 2015) to ensure that all patients get a timely diagnosis. Indeed, such meaurements should not only be taken at initial presentation, but regularly to ensure that there has been no deterioriation in a patient’s arterial status (National Institute for Health and Care Excellence [NICE], 2013; Wounds UK, 2016). This article outlines the impact on one GP surgery of implementing a standardised lower limb pathway, in addition to introducing new technology to calculate ABPI, which resulted in improved patient outcomes and effective use of nursing time and resources.

05 December 2023

Diagnostic spirometry is key to supporting a clinical diagnosis of lung impairment. As a result of Covid-19, spirometry services in primary care were all but cancelled. There was much debate about the potential risks associated with spirometry as a potential aerosol generated procedure (AGP); clarity was needed for patients and staff. The evidence is now clearer, spirometry is not an AGP, although spirometry-associated cough has the potential to release airborne particles in the air, associated with an increased risk of transmission of harmful viruses such as Covid, influenza and the common cold. This article explores recent evidence to support the safe re-introduction of quality-assured spirometry in primary care, looking at how risks can be mitigated to try to readdress the backlog of diagnostic spirometry thought to be in the region of 200–250 patents per 500,00 population. Spirometry is important to reduce health inequalities for patients yet to have a diagnosis of lung disease.

10 July 2023

Healthcare professionals make important decisions every day. The ability to make decisions is central to human experience and something we often take for granted. Some decisions are of little consequence, such as what to have for breakfast, other decisions are of greater consequence, such as whether to sell one’s house. For the most part, we make these decisions ourselves, perhaps in conjunction with another person and we act upon that decision. But what if we were unable to decide for ourselves and were reliant on other people deciding for us? How can we be sure that people making decisions about our lives are doing so in a correct way?

23 January 2018

05 April 2018

11 September 2023

Ever felt that you were working alone with no one to turn to? Or that your caseload was getting on top of you, and you just wanted to let off steam?

We’ve all been there at some point in our careers and while nursing is all about caring for others, it’s sometimes easy to wonder who is caring for us.

Getting support from your colleagues is a crucial part of working as a nurse, where long hours and the demands of patient care can mean that managing stress is not always easy. In acute hospitals, the number and accessibility of colleagues on any shift means that support is never far away. But in general practice, many of you spend a significant portion of your working day alone and it’s not always obvious who you should turn to after a distressing episode of care, or even if you’ve just had a rough day.

19 March 2018