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Despite being largely preventable, oral diseases are the major contributor to chronic conditions nationally and globally. If left untreated, oral diseases have many harmful effects throughout life on our patients including pain and infection, and can lead to difficulties with eating, sleeping, socialising and wellbeing. Oral health inequalities exist across our population, and particularly affect vulnerable, disadvantaged and socially excluded groups in society. Oral health is a key indicator for overall health, and is inextricably interlinked with general health. Hence, existing health messages that community nursing teams provide contribute towards oral health. Community nurses are in an established position to provide and reinforce positive oral health messages to their patients, as well as signpost to available dental services. This paper aims to support community nurses with a practical resource for key evidence-based oral health preventative advice, and input into how their patients can access dental care. [ABSTRACT FROM AUTHOR]

The role of the wound care nurse has developed to meet the need for expert wound care advice. Internationally, the role has developed with a variety of different titles. Although all positions have some common tasks and obligations, there remain gaps in knowledge around the role of the wound care nurse. This article aims to determine the state of knowledge in relation to the context of practice, scope of practice and impact of the wound care nurse. An integrative review design was used to allow a broad search strategy and to gather papers from a variety of sources. A multi-method search strategy of the literature published between 1980-2011 was undertaken. This included 5 electronic databases, a thesis search and manual search. It was found that the characteristics of the patients wound care nurses care for reflect an ageing population and disease processes, including diabetes and obesity. Internationally, there is little consensus on the level of competence, educational requirements and qualifications required to practise as a wound care nurse. There was some evidence that the wound care nurse improved healing times and decreased pressure injury prevalence. [ABSTRACT FROM AUTHOR]

Motor neurone disease or amyotrophic lateral sclerosis is a rapidly progressive terminal neurodegenerative condition caused by degeneration of the upper and lower motor neurones in the central nervous system of the brain. The effects of motor neurone disease are multifaceted, leading to many adjustments in everyday life. This literature review asked what the experiences of people living with motor neurone disease was before and during the COVID-19 pandemic and during the COVID-19 pandemic, especially in terms of their condition and the support they received from health and social care services. A key theme identified was lack of knowledge among professionals when they cared for people living with motor neurone disease and their families. This lack of knowledge often resulted in delayed diagnosis and poor standards of care. COVID-19 impacted on the care of people living with motor neurone disease and their families, and there is a paucity of evidence on how services were perceived by these groups during the COVID-19 pandemic. The experiences of people living with motor neurone disease and their families are currently missing in the literature. In conclusion, further studies are required to include care of people living with motor neurone disease and their families. [ABSTRACT FROM AUTHOR]

Policies in long term conditions care continue to develop rapidly in England. Currently there is a focus on the integration of services and enabling patient and carer choice. Integration of care across disciplines and services is complex and community nursing services are commonly central to reorganization processes in long term condition care. This paper presents the findings of a mapping of the evidence on integration in long term condition services. Literature on horizontal integration including integrated teams will first be discussed, followed by an exploration of the evidence on vertical integration exemplified by integrated care pathways and disease management programmes. As a relatively recent service innovation, the mapping found a lack of evidence of the effectiveness of integration in long term conditions. Furthermore, the paper highlights the potential tension between vertical integration structures such as care pathways and the patient choice and empowerment agenda in long term conditions. [ABSTRACT FROM AUTHOR]

Nursing service development or innovation projects, even small-scale ones, can be difficult to deliver and evaluate, due to a lack of resources and support. Results can also be difficult to disseminate, limiting transfer of learning. This paper presents findings from a realist evaluation of 10 small projects supported by the Queen's Nursing Institute Homeless and Inclusion Health Programme to deliver innovation in health care for people experiencing homelessness and other marginalised groups. These nurse-led projects were funded by the Queen's Nursing Institute and the Oak Foundation, and were largely successful in achieving outcomes to support the improved health of people experiencing homelessness and other marginalised groups. This realist evaluation explores the factors that contributed to the delivery of positive outcomes. All were impacted by the context and the response (mechanisms) of people experiencing homelessness and staff within these settings. It is hoped that the lessons learned will enable better support for nurse innovation projects in the future. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic has impacted healthcare education and delivery, including both theory and practice learning. Academic staff responded rapidly to move teaching online during the first lockdown, with many returning to practice to deliver care or upskill practice staff to work in critical care. Many pre-registration students responded by becoming paid NHS employees, contributing to care delivery while remaining on their programme of study. Practice learning partners, despite the challenges of the pandemic, continued to support students to achieve their registration status. This occurred within the context of the Emergency and Recovery Standards, published by the Nursing and Midwifery Council between March 2020 and September 2021. This paper sets out the response of students, practice learning partners and higher education institutions involved in pre-registration nursing and midwifery programmes. [ABSTRACT FROM AUTHOR]

The provision of acute healthcare within patients own home (i.e. hospital in the home) is an important method of providing individualised patient-centred care that reduces the need for acute hospital admissions and enables early hospital discharge for appropriate patient groups. The Hospital in the Home (HitH) model of care ensures that this approach maximises patient safety and limits potential risk for patients. As HitH services have seen record numbers of patient referrals in the past 2 years, there is now a greater need to measure and understand the acuity and dependency levels of the caseload. Through an expert clinician development process at one NHS trust, aspects of procedural complexity, interdisciplinary working, risk stratification and comorbidities were used to quantify acuity and dependency. This paper uses a case study approach to present a new method of measuring this important concept. [ABSTRACT FROM AUTHOR]

This paper gives a broad overview of suprapubic catheterization. Community nurses can often feel they lack experience with suprapubic catheter general care and routine changes. This paper sets out the advantages and disadvantages of suprapubic catheters, the procedure for routine change and the golden rules for general care. The paper contains an introduction on trouble shooting. [ABSTRACT FROM AUTHOR]

This paper sets out to assess the evidence of the use of a case management approach when dealing with long term conditions in the UK. It draws on published papers, some of which emulated or adapted strategies that were used in the USA. The review found that despite there being a unified definition of case management, patients and carers reported benefits of being case managed. However, the wide differences in the factors relating to outcome measures resulted in inconclusive evidence about the effectiveness of case management. [ABSTRACT FROM AUTHOR]

While very much in its infancy in terms of becoming an established tool, the use of digital technology in community nursing is steadily growing, despite the persistent barriers to, and challenges encountered in its uptake and implementation. The mobile nature and high workload of a community nurse's daily practice should facilitate the rapid uptake of time-saving technology. However, there are indications that technology may not be the panacea it was originally proclaimed to be. Francesca Ramadan elaborates on the past and present applications of digital technology in community nursing and delves into the principles that should shape the future potential of tools such as artificial intelligence, automation technologies and clinical decision support systems. [ABSTRACT FROM AUTHOR]

Adults ≥65 are more susceptible to influenza infection and its associated complications. This paper critically reviews the literature, identifying the need for and priorities of a public health strategy to improve vaccination awareness and uptake among older adults. Four electronic databases were searched for peer-reviewed articles in English published between 2001 and 2016. Twelve studies were included. Three themes were identified on analysis: impact on healthcare services; barriers and motivators influencing influenza vaccination uptake; and health promotion interventions. Studies suggest vaccination may reduce the health-care costs of influenza-associated infection. Socioeconomic factors, information about vaccination and cultural beliefs may influence an individual's decision. Multicomponent interventions, such as home visits combined with reminders, support increased uptake. Interventions are identified that could be adopted at the community level in Singapore and other countries to improve influenza vaccination uptake among older adults. [ABSTRACT FROM AUTHOR]

The fundamental principles of why specific people become homeless, can be grounded in a simple rationale or founded within sophisticated reasoning. For instance, people who suffer from substance abuse, addiction, alcohol, gambling, have mental health concerns or financial difficulties may be susceptible to homelessness. It is also identified that persons who experienced violence in their childhood or abuse by a partner are at a higher risk of becoming homeless. Homelessness knows no ethnic, cultural, religious or gender boundaries, and can impact all individuals' health and well-being. A health problem and worldwide phenomenon that affects all cohorts of the population, including the homeless, is urinary incontinence. The aim of this article is to increase the awareness of incontinence and highlight the impact it has on the lives of people that experience homelessness. [ABSTRACT FROM AUTHOR]

This paper describes a ten-year journey in managing a district nursing service using caseload analysis as a method of workforce planning and performance management. Caseload management is at the heart of district nursing practice and the process of measuring and comparing caseload information can be used to improve the quality of care. However, it is crucial to assess the information provided by district nurses for reliability and validity. Allocating staff to teams on the basis of accurate information on patient case-mix, nursing need, and dependency can result in every member of the population gaining equitable access to a consistent quality nursing service. [ABSTRACT FROM AUTHOR]

District nursing services in Northern Ireland face increasing demands and challenges which may be responded to by effective and efficient workforce planning and development. The aim of this paper is to critically analyse district nursing workforce planning and development methods, in an attempt to find a suitable method for Northern Ireland. A systematic analysis of the literature reveals four methods: professional judgement; population-based health needs; caseload analysis and dependency-acuity. Each method has strengths and weaknesses. Professional judgement offers a 'belt and braces' approach but lacks sensitivity to fluctuating patient numbers. Population-based health needs methods develop staffing algorithms that reflect deprivation and geographical spread, but are poorly understood by district nurses. Caseload analysis promotes equitable workloads but poorly performing district nursing localities may continue if benchmarking processes only consider local data. Dependency-acuity methods provide a means of equalizing and prioritizing workload but are prone to district nurses overstating factors in patient dependency or understating carers' capability. In summary a mixed method approach is advocated to evaluate and adjust the size and mix of district nursing teams using empirically determined patient dependency and activity-based variables based on the population's health needs. [ABSTRACT FROM AUTHOR]

In England, there has been a long standing tendency to seek to reform health services via large-scale structural reorganization and via seeking (at least in principle) to boost the power of health care commissioners to redesign services. Based on a review of community nursing services in an urban Primary Care Trust, this paper argues that such an approach has led to a situation where positive service development has stalled as senior managers prepare for the next reorganization (rather than focus on service improvement); where the underlying causes of failure to bring about universal transformation of community health services have not been addressed by ongoing organizational changes; and where providers now seem to look to commissioners to change services (rather than changing them themselves). In contrast, the paper argues that there is significant scope for those working in and managing community health services to focus on what is within their power to change—rather than waiting for others to do it for them. [ABSTRACT FROM AUTHOR]

Intrinsic changes to the skin are a normal part of the ageing process. Careful assessment of the skin for any abnormalities should be included in any patients' holistic assessment. It is essential that all health care professionals have a fundamental knowledge of the structure and function of the skin in order to be able to assess any changes to normal skin; identify existing skin problems and potential risk factors. Only by carrying out a detailed and systematic examination, we can implement effective strategies of management This is the first of two papers. This paper will describe the structure and functions of the skin and explore skin assessment. The second paper will describe some of the more common skin conditions seen in ageing skin and their management. [ABSTRACT FROM AUTHOR]

This article is the second of a series focusing on long-term conditions. It explores supported self-care identifying that this is the most appropriate approach to managing long-term conditions in 70-80% of patients with a chronic illness. The paper focuses on the Department of Health for England and Wales flagship initiative; the Expert Patient Programme. This lay-led self-management programme for people affected by a physical long-term condition is currently being rolled out by PCTs throughout the NHS and is seen as a key mechanism for empowering individuals and reducing resource demand in long-term conditions. The history, content, current and future models of the Expert Patient Programme will be described and the paper concludes by discussing future challenges for the programme as illuminated by two external evaluations. [ABSTRACT FROM AUTHOR]

This article aims to provide an overview on loneliness in older people, with an emphasis on how insights from this body of literature can significantly contribute to the enhancement of care provided by community nurses. This review aims to provide a nuanced understanding of the factors contributing to loneliness, its impact on the physical and mental health of older individuals, and the role community nurses can play in mitigating and addressing loneliness. [ABSTRACT FROM AUTHOR]

Effective communication to ensure maintenance of a seamless quality service for patients being transferred to the community from the acute sector with negative pressure wound therapy (NPWT) is essential. This paper reports the findings of a focus group convened to explore the decision making process; controversy or conflict surrounding the decision-making process; perceived barriers to seamless discharge and potential benefits of developing a UK standardized NPWT discharge documentation. A proposed algorithm is presented as a template for practitioners to use when discharging patients to the community to enhance timely and effective transfer. [ABSTRACT FROM AUTHOR]

This paper outlines two challenges to community nurses as they work with unpaid carers. These reflect a changing culture in the way that health care will be delivered in the coming decade. The first of these challenges is a shift towards focusing on outcomes for both service users and adult carers. Outcomes evidence the impact a service has on a person's life. The second is the increasing focus on the concept of carers as partners in care. [ABSTRACT FROM AUTHOR]

The Department of Health in England want to see NHS commissioners and providers capitalize upon the expertise of the independent sector for the benefit of NHS patients. In preparing for the future what does the sector have to offer NHS nurses and how will this benefit patient care? This paper examines the role of independent providers and the way they are helping NHS commissioners and providers to break new ground in delivering more accessible and convenient care for NHS patients at home. [ABSTRACT FROM AUTHOR]

In 2005 John Reid, the then Secretary of Health, announced the need for 3 000 community matrons to be appointed to coordinate the care of the growing numbers of people living with long term conditions. Although by the date agreed there were only 1 348 in post, according to Snow (2007), some PCTs have decided not to recruit further community matrons. Following the first evaluations of the role there also appears to be some confusion as to the title used by professionals who case manage this client group. The title of community matron has been used interchangeably with case manager, and therefore requires some clarification. This paper attempts to review the role of community matron and case manager, identify the professionals who take up these posts, and the professional qualifications and preparation required for the roles. [ABSTRACT FROM AUTHOR]

Policy making is a very complex area to those that are not directly involved in it, however it is essential that nurses understand the process, how it impacts on professional practice, and have the ability to analyse relevant policies. The aim of this paper is to encourage nurses to undertake a policy analysis by providing a 'real' example while examining research utilization and policy-making theory. A six stage approach developed from Benton and Cormack's (2000) framework to review literature is used to analyse the policy, Visible, Accessible and Integrated Care-a report of the review of community nursing in Scotland (Scottish Executive, 2006a). [ABSTRACT FROM AUTHOR]

This paper describes how district nurses decide what products to start prescribing and explores the reasons why prescribing patterns change. It is based on semi-structured interviews with fourteen nurses from one primary care trust. The first products prescribed immediately following qualification depended on the route taken to becoming a prescriber. These were either the same products they had been using before qualifying as a prescriber or if prescribing was included with their district nurse training then it was the same products that their mentor prescribed. The two drivers for changes in prescribing patterns were patients, whose current therapy was ineffective, and products, where patients were selected to try new products on. Representatives from the pharmaceutical industry and fellow nurses had the greatest influence on product selection for those prescribers that changed their prescribing. The nurse's own experience had the greatest impact on the decision to continue prescribing a new product. [ABSTRACT FROM AUTHOR]

Dry eye symptoms and watering eyes increase with age and are relatively common among older people. The conditions cause distress which can be ameliorated if patients are advised appropriately. Accurate diagnosis of the underlying cause provides the basis for management. This paper outlines key features of the conditions and the range of therapies available. [ABSTRACT FROM AUTHOR]

In social care, there has for some time been the option for individuals to use direct payments to manage their own support, and more recently individual budgets have been piloted. While this approach has not been available for healthcare payments, there is the potential for this to change. This paper outlines the implementation of direct payments and personal budgets and then discusses some of the issues which should be considered if such arrangements are introduced in healthcare. These include: preparing existing staff for such changes in funding and the implications for them; clarifying the new roles and responsibilities of community nursing teams, training opportunities for staff who are employed directly by individuals; staff recruitment and retention, and designing evaluation mechanisms which assess quality as well as cost. [ABSTRACT FROM AUTHOR]

Progressive long-term neurological conditions are relatively rare, and policy attention has only recently been directed at community services for people with these conditions. This literature review draws together findings from 16 UK studies relating to the provision of care in the community for people with progressive long-term neurological conditions. The purpose is to identify elements of best practice which could be promoted at a national level to improve services. The findings point to the uneven coverage of services and their lack of flexibility. Multidisciplinary care delivery was considered essential and patients and carers highly valued the use of key workers. The studies also highlighted the potential for self-managed care. This evidence can be used to inform service developments for the delivery of community care for people with progressive long-term neurological conditions. [ABSTRACT FROM AUTHOR]

Nurse prescribing is a key government initiative which aims to enhance patient care. The aim of this study was to investigate the prescribing practice of specialist nurses working in cancer and palliative care and to explore the benefits of and barriers to uptake of nurse prescribing training. A national postal survey of 2252 Macmillan nurses was undertaken using a structured questionnaire with open-ended questions. Data were analyzed using thematic content analysis for 1575 respondents (70% response rate). Only 13% (203) had undergone prescribing training and of these 105 provided responses to the open questions concerning training and of the 87% (1372) who had not undergone the training, 423 provided details on barriers to nurse prescribing training. The data presented in this paper draw from this data. The findings indicate that those who prescribed gave the prospect of improving care as the main reason for undertaking nurse prescribing training. The main reasons why these specialist nurses did not undertake training were: resource issues particularly with respect to backfill while training, lack of medical support and mentorship, concerns about the relevance of prescribing as a nursing role and prioritizing other courses. If nurse prescribing is to be more widely available for cancer and palliative care patients it is important in both primary and secondary care to address the resource and support issues. [ABSTRACT FROM AUTHOR]

Digital health was given impetus by the COVID-19 pandemic and demonstrated its potential for the delivery of safe care in the community. Remote monitoring and virtual wards are becoming mainstreamed across the UK. Artificial intelligence (AI) software has the potential to transform healthcare delivery but its trustworthiness is a key challenge. Positive staff attitudes towards digital health and new ways of working require staff education and engagement. Continued attention is required to meet the needs of those without access to digital technology and its use. [ABSTRACT FROM AUTHOR]

In October 2008 the National Institute for Health and Clinical Excellence issued guidance supporting the use of spinal cord stimulation for people with chronic neuropathic pain, considering it to be a cost-effective use of resources within the NHS. This paper will provide an overview of chronic neuropathic pain. Spinal cord stimulation (SCS) will be explained, including the physiological mechanism and technology behind this treatment. The recent NICE guidance will be discussed along with information relating to the potential impact the guidance will have on Primary Care Trusts, GPs and community practitioners. A guide is provided for clinicians in primary care regarding access to this treatment and routes for referral. [ABSTRACT FROM AUTHOR]

Patient empowerment is a frequently promoted aim for patients but is rarely put in to clinical practice. This paper describes the basic principles behind a club enabling treatment and prevention of leg ulceration in the community. These principles include patient ownership of the club, community involvement and a non-medical environment. The practical issues involved in setting up a Leg Club® are described in detail including engagement of healthcare professionals, community volunteers and appropriate transport. [ABSTRACT FROM AUTHOR]

Antibiotic resistance presents a growing threat to health systems and patients at a global scale. Point of care (POC) C-reactive protein (CRP) measurement, as an adjunct to exacerbation assessment, has been studied in primary and secondary care and may represent a useful tool for community teams. A retrospective service review was conducted to determine the effect of CRP measurement on antibiotic provision in a community respiratory setting, with chronic obstructive pulmonary disease (COPD) and bronchiectasis exacerbations. This review compared antibiotic provision for COPD and bronchiectasis patients for those where CRP was measured versus those where it was not. It was found that antibiotic provision dropped by almost 25% points for COPD exacerbations, and almost 59% in bronchiectasis, when a CRP measurement was taken as a component of a respiratory assessment. Antibiotics were also provided at a greater amount based on symptom presentation. Therefore, it is concluded that CRP measurement correlates with a reduction in antibiotic provision, highlighting its use alongside symptom assessment in future work. [ABSTRACT FROM AUTHOR]

Infection control has long been the focus of the attention of anyone working in healthcare, due to the risks posed to patients and staff if appropriate infection control procedures are not followed properly. This article explores a recap of important infection control measures and also outlines the Government's policy for tackling antimicrobial resistance, and its link to infection control procedures. The article covers the key points of the recent publication from NHS England on the topic of infection control. [ABSTRACT FROM AUTHOR]

As we move into a new century and care moves out of hospital and into the community, there is a drive to seek new models for providing nursing care to patients in their homes. Following a Caseload Analysis report, the District Nursing Modernization Project was launched in April 2004, aimed to redesign the structure and delivery of the district nursing services in South and East Belfast. The service was totally re-engineered within the existing budget and workforce. Nursing careers changed as new supporting services were developed and new job opportunities became available within the service. The structure of the services was designed on the basis of caseload analysis gathered over a number of years. Evaluation of the project indicated that the project aim and objectives had been achieved. Caseload Analysis was instrumental in establishing the need to modernize district nursing services and how this should be carried out. [ABSTRACT FROM AUTHOR]

Community matrons have a key role to play in the management of patients with long-term conditions. With the expected increase in prevalence of Chronic Obstructive Pulmonary Disease (COPD), largely due to cigarette smoking, the management and care of patients with COPD is a priority for the NHS. This paper examines the current and future role of community matrons in the management of patients with COPD. Community matrons have a potential role in providing evidence based care and could fill a gap in the implementation of effective interventions to help patients and family members stop smoking. A family focused approach to assessment and case management are important to achieving quality care and management of these patients. Recommendations are made with respect to the improvement of service provision for individuals and families with COPD. [ABSTRACT FROM AUTHOR]

Constipation affects the quality of life of many ‘at risk’ groups of people. Laxatives are the dominant management strategy whose long-term use is ineffective and very costly to the NHS prescription bill and in the use of health staff resources. The development of a user-friendly, evidence-based clinical guideline (The effective management of constipation in primary care) has the potential to change the present situation by providing health-care practitioners with an aide-mémoire to assist clinical reasoning, in order to re-evaluate current practice and suggest combined alternative treatment strategies. Early indications of use of the guideline suggest holistic individualised bowel management programmes can significantly reduce laxative use and nursing interventions and lead to improved quality of life. [ABSTRACT FROM AUTHOR]

There is increasing demand for nurses to work in primary care. This is driven in part by the need to retain current levels but also by the modernisation plans for primary care services, which require new roles for nurses, new ways of working and more nurses in primary care settings. While campaigns for increased recruitment of hospital nurses and doctors has been largely successful in recent years, primary care has still to see the impact. This article reports on a Department of Health (England) funded project that aimed to identify strategies and exemplars to assist primary care trusts (PCTs) and the workforce development confederations (WDCs) in strategic health authorities in attracting and retaining nurses to primary care at registered nurse level. It reports on the range of initiatives identified, the perceived benefits and challenges. It concludes by proposing a strategic model for planning for the recruitment and retention of primary care nurses. [ABSTRACT FROM AUTHOR]

Part VI. Looks at some of the key issues that need to be considered when preparing research findings for dissemination in Great Britain. Importance of writing for a specific audience; Guidelines on how to report qualitative and quantitative research; Outline of some of the key criteria editors use when reviewing a paper for publication.

Advanced practice nursing (APN) roles have developed partly to address demand and workforce issues. In community care settings and general practice, an advanced nursing practitioner is generally understood to mean a nurse who has undertaken additional education and training in clinical assessment, including history-taking and physical examination, clinical reasoning and independent prescribing, so they can safely manage patients presenting with undifferentiated and undiagnosed conditions. Capabilities in the Skills for Health framework cover everything from communication and consultation skills, practising holistically and personalised care, to working with colleagues and in teams. The framework is intended to ensure advanced nursing practitioners work to an advanced level. It is also designed to support them to demonstrate and evidence their capabilities to service commissioners, employers, people accessing healthcare and the public. [ABSTRACT FROM AUTHOR]

Over the past 30 years, the Government has been promoting the transition of care from the acute setting to the community setting. Within the community setting, district nurses are described in the latest reports as endorsers of the care close to home. However, with the surge in hospital discharge, the district nursing workforce is faced with further pressure to cope with the drive to move care into the community. The purpose of this extended literature review (ELR) was to deconstruct the available data on the challenges and hurdles experienced by district nurses to manage hospital discharge. On reviewing the selected data, it was found that fragmented communication between secondary and primary sectors poses problems for effective care in the community. Additionally, the lack of understanding of the district nursing service and its remits creates obstacles for effective hospital discharge. Some practical solutions to resolve these problems are proposed. [ABSTRACT FROM AUTHOR]

The COVID-19 pandemic of 2020 has led to considerable changes in how healthcare is delivered, as it has pushed people to think outside the box technologically. Mobile working is becoming more widespread, useful and valuable in this innovative period in the NHS. Point-of-care (POC) technology encompasses mobile devices and systems that support health professionals in their daily activities of patient care. It allows the user to safely assess and diagnose individuals at the point of care, providing actionable information to allow rapid clinical decision-making. POC technology also has the ability to support and educate patients with health needs, encouraging patients and their carers to assume greater more control of and responsibility over their health. Providing patients individual care plans to maintain their health will help realise the future of self-care. This article describe the development of a mobile app--Juzo Care --designed to enhance the management of chronic oedema and lymphoedema in mobile working settings. [ABSTRACT FROM AUTHOR]

This article outlines the steps taken in a change management project to develop and implement a national caseload management framework for clinical nursing activities within public health nursing services in the Republic of Ireland. It involved the development of metrics, definitions, data collection resources and relevant written procedures. It was developed and implemented over a period of 12 months and involved the engagement and involvement of approximately 2000 frontline, management and administrative staff. Implementation was challenging due to the lack of software systems to collect and return data and support caseload management. Alternative IT-based data collection systems were identified, and work is ongoing to develop additional metrics and resources that will continue to support caseload management. [ABSTRACT FROM AUTHOR]

Faecal incontinence can be a distressing and undignified experience, and is particularly a care delivery need for those at the end of life. There are various publications by national bodies including NHS England, the Department of Health, NHS Scotland and others, discussed in this article, to inform readers of the best way to care for someone experiencing faecal incontinence who is being looked after through palliative care in the community. The article will also discuss the application of recommended faecal collection devices and some of the associated risks. The devices discussed are: anal pouches, rectal tubes and catheters, and rectal trumpets. The article aims to inform the practice of community and district nurses providing palliative care. [ABSTRACT FROM AUTHOR]

To meet the challenges of an increasingly ageing and multimorbid population, patients must be fully engaged to work in partnership with their health professional (HP) in the management of their condition(s). The NHS Long Term Plan (2019) outlines goals to manage the increasing demands on the health service—hospital admission avoidance, shorter length of hospital stays through enhanced recovery pathways, increased management of patients within primary care and ensuring a person-centred approach to care provision. Meeting these goals is predicated on HPs being equipped to activate patients using the skills of motivational interviewing, person-centred care and a willingness to share decision making. This article presents a range of psychological theories that could explain the everyday challenges faced in care delivery. Awareness of these theories may help HPs target their approach to care delivery more effectively, to understand patient responses and, therefore, optimise the provision of person-centred care. [ABSTRACT FROM AUTHOR]

Patients with wounds pose an important healthcare challenge. Many of these wounds are managed in community care and can take weeks or months to resolve. Delays in wound healing can be perpetuated by clinicians who make poor treatment choices, fail to recognise complications and/or do not seek timely advice. Improving patient outcomes requires a proactive approach to care that includes accurate and timely assessment and re-assessment, treatment of the underlying cause using a multidisciplinary team approach and the use of evidence-based practice and clinical judgement to develop an appropriate treatment plan. A structured approach to care, such as the newly developed T.I.M.E. clinical decision support tool, has the potential to improve wound healing outcomes and reduce the burden of chronic wounds in community nursing services. [ABSTRACT FROM AUTHOR]

The role of the district nurse is imperative in the care of patients in a district nursing team's caseload. Through the role of care manager, district nurses are accountable for the overall coordination of the care patients receive. Their responsibilities include caring for acutely ill patients, those with long-term conditions and people who require end-of-life care, in addition to health promotion and patient education. They provide personcentred, preventive and coordinated care, which reduces unnecessary hospital admissions and enables patients who have a range of complex needs to remain at or return to home. In this article, a case study is used to provide an overview of the role and accountability of the district nurse in the care of patients who have complex needs. [ABSTRACT FROM AUTHOR]

The article focuses on community health nursing services in Great Britain. The Department of Health has set out targets, reconfigurations and ambitions for the future. There are however much restatement of previously published policies with commitment to give priority to prevention. A health assessment is expected to promote healthy lifestyles.

Highlights the conference on wound care held on November 15-17, 2004 in Great Britain. Estimated number of delegates attended; Topics discussed in the meeting; Presentation of works in the practice of wound management.

Focuses on the guideline for the clinical management of wound. Components of wound bed preparation; Emphasis on the impact of the clinical approach in practice; Application of the methods in different types of tissue trauma.

In the article, the author discusses the issues involving the response by the British government to the COVID-19 pandemic, particularly the move to discharge patients from hospital care to home care without a carefully planned transfer process. Also cited are the scandal facing the Department of Health and Social Care's (DHSC) alleged failure to prevent the spread of the virus in care homes, as well as the key role played by community nurses in the shift to home care.