22 September 2015

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.

19 March 2018

12 December 2019

Surgical wound dehiscence develops when the edges of a surgical incision separate along the suture line due to infection or suboptimal healing, leading to an open wound. Surgical wound dehiscence can have a significant impact on the patient’s quality of life, increases the demands on healthcare professionals’ time and is costly to the health economy. Over 50% of patients with surgical wound dehiscence are managed in the community and treating these types of wounds is challenging. General practice nurses (GPNs) need to be aware of those patients that are more likely to present with surgical wound dehiscence and take a preventative approach, as well as understanding the principles of best practice for assessment and management when caring for this group of patients.

01 September 2020

Venous leg ulcers (VLUs) present a huge burden, not just in terms of healthcare costs (Guest et al, 2017), but also in their negative impact on patient quality of life (Marczak et al, 2019). A holistic, multifaceted approach to assessment is needed to ensure that all factors contributing to their development are considered to allow optimal healing to take place. The European Wound Management Association (EWMA, 2016) however, has highlighted a disparity in care between community and specialist settings, with some nurses lacking the necessary skills needed to undertake effective assessment. Since wound assessment is a core component of wound management, impacting directly on therapeutic choices and thus healing (Lázaro-Martínez et al, 2018), it is imperative that general practice nurses (GPNs) are supported in being able to assess wounds accurately. This article discusses and reflects on the value of effectively assessing wounds in primary care using the Triangle of Wound Assessment framework, which focuses not just on the wound bed, but also the periwound skin.

06 September 2024

The mental health of children and young people (CYP) has markedly declined in recent years, a trend significantly accelerated by the Covid-19 pandemic. Accessing support for mental health issues is highly variable with long waiting lists for specialist child and adolescent mental health services (CAMHS) and inconsistent provision of mental health support in schools and educational institutions, meaning that supply does not meet demand. There is a gap in support for CYP who need a greater level of support than is currently available in education settings, but do not require specialist mental health
treatment (King’s Fund, 2024). Mental health issues may manifest as primary complaints in primary care settings or may be discovered incidentally during the evaluation of related physical or social problems. Consequently, it is imperative for general practice nurses (GPNs) to be able to recognise and accurately assess mental health issues that present to them. They should also be equipped to offer appropriate signposting, advice and guidance, as well as to facilitate necessary escalation or referral to specialist services when required. This article, the first in our series on CYP and mental health, focuses on history-taking and initial assessment.

29 March 2023

Hidradenitis suppurativa (HS) is a chronic long-term condition that occurs mostly in intertriginous areas of the skin. Unfortunately, HS is often not recognised and is poorly managed in clinical practice. Early detection and referral to an appropriate service such as dermatology is essential to reduce the long-term impact of the disease. Treatment is
multifactorial and includes management of associated comorbidities and lifestyle factors, such as obesity and smoking, medication, surgical intervention and managing depression and anxiety. This article explores the assessment and management options for general practice nurses (GPNs) to consider when presented with a patient with HS.

25 March 2019

Acne vulgaris is a common dermatological condition, with most adolescents experiencing ‘spots’ at some point. For most people, these will resolve by the time they are in their 20s. However, approximately 15% of people in the UK will seek treatment for persistent acne that does not resolve with the use of over-the-counter preparations. This equates to over three million visits per year in the UK to primary care clinicians, such as general practice nurses (GPNs), who are well-placed to support patients. This article outlines the types of lesions that patients can present with, provides guidance on effective skin care, and discusses the topical and oral therapies that may be prescribed and their side-effects. The authors also look at the optimal referral of patients for secondary care assessment, as well as signposting nurses to assessment tools that focus on the psychological, as well as the physical, signs of acne. The psychological effect of having a visible, albeit common, skin condition should not be underestimated.

10 December 2020

Eczema, also known as dermatitis, is a very common skin condition. There are several different types of eczema, affecting people throughout their lifespan. General practice nurses (GPNs) will see children and adults with eczema regularly and they are well placed to assess, manage and support them. Eczema is a chronic conditon and can have devasting effects on quality of life and mental health. GPNs can play an important role in supporting patients with eczema and their families in understanding how to self-manage this long-term conditon and help with coping strategies. This article outlines eczema as a long-term condition and provides practical advice for GPNs on assessment and treatment in primary care. Psychological effects and intervention and referral guidelines for eczema are also discussed.

05 September 2022

Fungating wounds can have a devastating effect on patient quality of life. Common symptoms, such as bleeding, odour, and excessive exudate production can also cause feelings of shame for the patient, resulting in social isolation. General assessment should determine the patient’s physical, psychological and emotional status, and how the family is coping. Wound assessment is crucial to determine the extent of any symptoms, to identify concerns of the patient and family, to form a baseline against which to measure wound progress, and to identify management goals. Use of a tool such as the Triangle of Wound Assessment promotes a systemic approach to wound evaluation, helps with data collection and recording, and can help to identify treatment goals. This article outlines the key principles of the assessment and management of fungating wounds, and presents a case report describing the use of the Triangle of Wound Assessment to successfully manage a patient with a fungating wound, using a conformable, silicone foam dressing impregnated with silver.

21 December 2018

Idiopathic pulmonary fibrosis (IPF) is a relatively rare chronic, progressive lung disease with a poor prognosis. General practice nurses (GPNs) have a pivotal role in supporting patients and their families at all stages of the disease trajectory. This article aims to raise the profile of this terminal lung condition and provide nurses with an introductory understanding of the disease, the diagnostic pathway, and treatment options available for patients. As core members of the multidisciplinary team, GPNs are well-placed to provide access to other healthcare professionals and services who together can improve the lives of patients living with this condition.