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Why you should read this article: • To recognise the factors that may be affecting communication within your team • To be aware of how interpersonal relationships and organisational culture can affect team communication and performance • To consider strategies that you could use in your practice to enhance communication with your colleagues. Effective communication within nursing and multiprofessional healthcare teams is essential to promote patient safety. However, communication is a complex concept comprising various elements and variables that affect how messages are delivered, received and interpreted. In this article, the author explores communication within healthcare teams and provides some insight into the factors that affect team communication, such as interpersonal relationships. The author also explores organisational culture and cultural sensitivity, and discusses some evidence-based approaches to enhancing communication within healthcare teams. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the causes of peripheral neuropathic pain and its effects on patients’ quality of life • To be aware of the non-pharmacological interventions that may be used to manage peripheral neuropathic pain • To consider how you could support patients to self-manage their peripheral neuropathic pain. Peripheral neuropathic pain is a complex condition that can adversely affect people’s quality of life. Alongside pharmacological interventions, nurses can support patients to self-manage their pain using non-pharmacological interventions such as lifestyle changes and exercise. To do this effectively, nurses should be able to recognise the signs and symptoms of peripheral neuropathic pain and be able to educate patients on appropriate self-management approaches. It is important that nurses provide education, advice and information in a way that patients can understand and check this understanding. This article provides an overview of how nurses can support patients to self-manage peripheral neuropathic pain by using various non-pharmacological interventions. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of various elements of communication • To recognise the skills required to communicate effectively and provide person-centred care • To learn about different communication models to support effective non-verbal and verbal communication. Communication is a process of sharing information and developing relationships through interaction. It is essential for nursing care, providing a basis for nurses to establish therapeutic relationships and trust with patients and their families. It is often assumed that nurses can intuitively communicate well; as a result, traditionally there has been a lack of formal training in this area. However, communication is a skill that can be developed and enhanced. This article explains the elements of communication and discusses the skills required by nurses to communicate effectively and provide compassionate, person-centred care. The author outlines two communication models to demonstrate how nurses can use these skills to deliver bad news and support people in distress. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To increase your knowledge of the physical and psychological effects of anorexia nervosa • To recognise the challenges of providing care to patients with anorexia nervosa in acute hospital settings • To enhance your ability to deliver psychologically informed care to patients with anorexia nervosa Anorexia nervosa is a challenging and highly distressing illness associated with significant and often debilitating symptoms that affect the person's physical and mental well-being, as well as their wider social networks. Although some patients can make important steps in their recovery in the community, many will become significantly unwell and require medical stabilisation and refeeding in an acute medical ward as a result of significant weight loss. This article describes some of the challenges experienced by adult nurses when caring for patients with anorexia nervosa on acute medical wards and explores how the patient's distress may manifest and complicate the recovery process. The article also discusses the principles of psychologically informed care and therapeutic interactions that nurses can use to promote recovery and ensure optimal practice. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To familiarise yourself with the basic principles of person-centred care • To enhance your knowledge of the benefits and barriers to providing person-centred care at the end of life • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Providing person-centred care that takes into account each patient's individual needs and priorities is crucial at the end of life. Nurses need to be aware of the main aspects of person-centred care, such as supporting shared decision-making, developing therapeutic nurse-patient relationships, and considering the patient's physical, psychological, social and spiritual needs. This article discusses the concept of person-centred care in the context of providing end of life care to patients and their families. It explains the benefits and barriers to providing person-centred end of life care, and outlines some of the areas that nurses and other healthcare professionals need to consider to promote effective care. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the role of nurses in the prevention of non-communicable diseases • To enhance your ability to initiate and engage in effective healthy conversations with service users • To be aware that training can provide nurses with the knowledge, skills and confidence to discuss health with service users, and that it is available to all NHS staff Nurses in all settings have an important role in preventing non-communicable diseases such as cardiovascular disease, cancer, respiratory disease and diabetes mellitus. They have multiple daily opportunities in their practice to discuss health with people, with the aim of supporting behaviour changes that reduce the risk of non-communicable diseases and the associated health-related and economic challenges. Incorporating the principles of healthy conversations into all daily interactions provides opportunities for nurses collectively to promote health on an individual basis to millions of people. However, many nurses have not received training in such behaviour change interventions. This article explains the principles and potential benefits of healthy conversations, and emphasises the importance of training to promote nurses' knowledge, skills, confidence and motivation to engage in such conversations. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of how to identify and assess pain in people with dementia • To consider approaches that could be used to manage pain in people with dementia • To contribute towards revalidation as part of your 35 hours of CPD (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) There is little evidence to suggest that people with dementia experience less pain than those without dementia, however they are less likely to report their pain due to the cognitive impairments they experience as their dementia progresses. A comprehensive pain assessment that involves family members, carers and/or friends in the process is crucial to gain an understanding of a person's medical and pain history, and to ensure effective pain management in people with dementia. This article describes the identification, assessment and management of pain in older people with dementia. The author includes a fictional case study with the aim of supporting nurses to reflect on possible indicators of pain in a person with dementia and to consider the tools they may use when identifying and assessing this pain. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the importance of effective communication in end of life care • To appreciate the challenges for healthcare professionals in engaging in end of life discussions with patients and families • To recognise ways in which end of life communication skills can be enhanced among healthcare professionals Skilled and compassionate communication with patients and their families is a priority in all areas of clinical practice. This is particularly important in palliative and end of life care, where people may feel frightened and vulnerable and require clear, honest and compassionate communication from healthcare professionals. However, many patients and families have reported dissatisfaction with their interactions with healthcare professionals in end of life care, including a lack of compassion and understanding of their emotional well-being. This article explores the literature on end of life communication with patients and families and discusses how improvements can be made in this area of practice. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To learn about the principles and types of brief behaviour change interventions • To recognise the importance of motivational interviewing in supporting behaviour change • To identify various tools and techniques that you could use in your practice to deliver brief interventions Nurses are well placed to deliver brief opportunistic health promotion interventions during routine encounters with patients. Brief interventions have been shown to be effective in prompting behaviour change among people who engage in harmful drinking or substance misuse. Nurses can use their communication, relationship-building and partnership-working skills to support people to consider behaviour change. This article explains the concepts that underlie brief behaviour change interventions, which include motivational interviewing and the transtheoretical model of behaviour change. The article also describes practical tools and techniques that nurses can use to deliver such interventions. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the importance of effective communication when escalating care of the deteriorating patient • To increase your knowledge of how to conduct a systematic assessment of the deteriorating patient • To enhance your ability to effectively convey your concerns about a deteriorating patient using a structured communication tool Evidence suggests that improvements in clinical practice are required to ensure that deteriorating patients are rapidly identified and assessed in a systematic manner. The important step of escalating care involves a detailed handover to the most appropriate colleague so that interventions can be put in place to reverse or optimise the patient's condition. However, multiple issues can hinder this handover process, including a lack of confidence among nurses and suboptimal team dynamics or cultures. Using structured communication tools such as situation, background, assessment, recommendation (SBAR) can assist nurses in delivering a handover that results in the desired outcome. This article explains the steps involved in identifying, assessing and escalating the care of deteriorating patients, and describes the components of an effective handover. [ABSTRACT FROM AUTHOR]

The article discusses some of the barriers to breaking bad news effectively to patients and the communication skills needed to engage in challenging conversations. Topics include communication skills required to engage in challenging conversations, process involved in breaking bad news, and mnemonic protocols that can be used to structure challenging conversations with patients face to face and over the phone.

The article describes factors affecting health literacy of nurses which is said to be one of the main barriers preventing healthcare professionals from adequately transmitting information to people in their care. Topics include consequences of low health literacy, strategies to mitigate low health literacy, and communication techniques to mitigate low health literacy.

Why you should read this article: • To enhance your understanding of vaccine hesitancy and its determinants • To recognise the potential effects of negative and conflicting vaccination information on social media platforms • To consider strategies you could use to address vaccine hesitancy and misinformation on social media in your practice Vaccine hesitancy, defined as the refusal or delay of acceptance of vaccines, is a threat to the elimination and/or eradication of vaccine-preventable diseases, and therefore has significant implications for global health. Negative and conflicting vaccination information on social media can lead to vaccine hesitancy, including among parents who need to decide whether to have their children vaccinated. This article discusses the dissemination and content of vaccination information on social media, and explores the effects this can have on vaccine hesitancy and uptake. It also outlines various strategies that nurses can use to address vaccine hesitancy and misinformation on social media. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand how trans and non-binary patients may have a negative experience when accessing healthcare • To learn how enhanced communication can result in a positive healthcare experience for trans and non-binary patients • To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) There is increasing evidence to suggest that transgender (trans) and non-binary people encounter significant societal discrimination, stereotypical and misleading representation in the media, and frequent misgendering. They may also experience several barriers to accessing healthcare, as well as discrimination from staff and other patients. This article explores how and why trans and non-binary people experience discrimination, and discusses how healthcare professionals, including nurses, can enhance the care experience for these patients, with a particular emphasis on language and communication. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise the reasons why medicines-related harm remains an issue • To refresh your knowledge of the aims of medicines optimisation • To identify potential strategies that you could use in your area of practice to reduce the risk of medicines-related harm Effective medicines optimisation involves the use of medicines to control disease while ensuring that adverse effects are kept to a minimum. However, medicines-related harm and symptom mismanagement represent significant risks to patients, particularly those with long-term conditions. These risks are accentuated by inadequate patient monitoring, with some nurses and other healthcare professionals being unaware of their responsibility to monitor patients and avoid medicines-related harm. This article explores strategies that will enable nurses to take an increasingly active role in medicines optimisation. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand the various lay concepts of health • To understand how lay concepts of health can inform people's experiences of treatment and influence their attitude to self-care • To update your knowledge of the importance of person-centred care Health is a concept that is central to nurse education and nursing practice. It remains a dynamic concept, however, that has evolved over time and can be examined from contrasting perspectives. This article explores the various perspectives of health, for example lay concepts of health and factors such as happiness and well-being and their effect on people's perceptions of health. It is recommended that nurses use a person-centred approach to explore patients' concepts of health, which can influence their capacity to self-care. [ABSTRACT FROM AUTHOR]

When faced with undergoing anaesthetic, and thoughts of risk factors, surgical instruments and a possible long recovery, it is understandable for patients to feel nervous ahead of surgery. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To understand how to incorporate spiritual care into your day-to-day nursing practice • To be aware of the competencies and personal qualities required to provide effective spiritual care • To familiarise yourself with the concepts of availability and vulnerability in relation to spiritual care An awareness of the concept of spirituality is integral to the provision of person-centred holistic care. However, the nurse's ability to provide spiritual care is often impeded by time pressures and the prioritisation of clinical tasks. Confusion about the meaning of spirituality and its relationship to religion may also compound the challenges involved in providing spiritual care, and nurses often feel ill-equipped to address this area of care. This article discusses the challenges associated with the concept of spirituality, and describes the competencies and personal qualities that nurses require to achieve spiritually competent practice. It also explains the concepts of availability and vulnerability, which can support the personal development required for nurses to become spiritually competent. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To recognise the importance of effective drain management to optimise patient care and safety • To understand how you can ensure drain safety • To maintain your knowledge of drain-related complications The literature indicates that drain monitoring is a frequently undervalued aspect of patient care, and that the drain care provided is often inconsistent and inadequate. There are numerous potential implications of suboptimal drain care for patients, nurses, teams and healthcare organisations. Since acute care is increasingly being delivered in the community, there is a greater need for nurses to have an understanding of effective drain care. This article describes the rationale for drain insertion and its associated complications. It uses a case study to illustrate how suboptimal drain monitoring and documentation can negatively affect patient care and safety. This article also discusses several important issues raised in the case study, such as suboptimal documentation, and how these may have consequences for nurses, teams and healthcare organisations. Recognition of these elements supports initiatives that nurses could apply to practice to reduce the occurrence of similar incidents. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To identify the range of individual personality types • To understand how knowledge of personality types can improve your communication with colleagues and patients • To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Understanding personality types can assist nurses in enhancing their understanding of themselves and their colleagues, which in turn can support effective communication. This article outlines the principles of the Myers-Briggs Type Indicator (MBTI) – a personality inventory that aims to improve the understanding of psychological types – and details the characteristics of the MBTI's 16 different personality types. The article explores how these 16 personality types can influence communication within healthcare teams and between healthcare professionals. It also discusses how these personality types affect styles of nurse leadership and how an understanding of personality types can improve nurses' communication with patients. [ABSTRACT FROM AUTHOR]

AUTH Why you should read this article: • To recognise the importance of communicating effectively with patients to optimise their outcomes and enhance their experience • To enhance your knowledge of the principles and methods that you can use to inform your approach to communicating effectively with patients • To count towards revalidation as part of your 35 hours of CPD, or you may wish to write a reflective account (UK readers) • To contribute towards your professional development and local registration renewal requirements (non-UK readers) Communication between a nurse and a patient may seem intuitive. However, communicating effectively with patients while applying the principles of person-centred care can be challenging. Patients' perceptions of suboptimal care and healthcare services may be influenced by how nurses communicate with them, since communication may be used as a quality indicator, as well as an indicator of patient experience. This article considers how nurses can communicate effectively with patients to optimise care. It explores the theoretical principles of interpersonal and professional communication, and discusses practical methods of listening and speaking to patients that nurses can apply in their clinical practice. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To recognise that pain is a subjective experience that can be challenging to assess and manage • To develop an awareness of the various pain assessment tools available • To understand how you can observe patient behaviours that may indicate pain Pain is a personal, individual and subjective experience. The complex and dynamic nature of pain makes its assessment and management challenging for healthcare professionals. Various pain scales are available that can assist in identifying the patient's experience of pain; however, these tend to reduce this experience to a measure of pain intensity. The use of pain scales also requires patients to communicate and describe their pain; when this is not possible, it is necessary for healthcare professionals to observe patient behaviours that may indicate pain. Various observational pain assessment tools have been developed to assist in recognising and assessing pain. This article discusses the various pain scales and observational pain assessment tools that are available, and the evidence to support their use. [ABSTRACT FROM AUTHOR]

Enhanced Recovery After Surgery (ERAS) programmes are an innovative approach to optimising patient outcomes in the perioperative period and have been implemented in various surgical departments across a range of specialties, with varying degrees of success. ERAS is an evidence-based, multimodal programme that has repeatedly demonstrated a reduction in post-operative complications and reduced the length of hospital stays following elective surgery. However, despite extensive evidence to support these benefits, several barriers to ERAS implementation have been identified. This article outlines the components of ERAS, focusing on the barriers to its implementation and how these could be overcome. It also discusses the implications of ERAS for patients, nurses and healthcare organisations. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your awareness of the challenges and facilitators in providing effective end of life care to dying patients in the intensive care unit (ICU) • To consider your role in enhancing important aspects of end of life care, such as timely communication and patient involvement in decisions about their care • To be aware of the emotional challenges involved in caring for dying patients and how effective communication practices can be a source of support for yourself and your colleagues Caring for patients who are at the end of their lives is an essential aspect of practice in intensive care units (ICUs). While intensive care is one of the fastest-growing healthcare specialties as a result of technological and scientific advances, a significant proportion of patients admitted to an ICU in the UK will not survive their ICU stay. Therefore, it is important to examine ways to enhance practice in this area and the factors that might affect the care provided to patients and their families. Aim: To identify the challenges and facilitators that members of the ICU multidisciplinary team encounter in the delivery of end of life care to dying patients in ICUs. Method: A scoping literature review was undertaken. Cumulative Index to Nursing and Allied Health Literature (CINAHL) Plus with full text, MEDLINE Complete and the EBSCOhost E-Journals Database were searched electronically to identify literature from April 2007 to April 2017, alongside hand-searching. Critical appraisal tools were used and thematic analysis was undertaken to analyse the data and identify themes. Findings: Ten articles were included in the literature review, which identified various challenges and facilitators in providing effective end of life care in ICUs. The main themes identified were: communication, family involvement, personal factors and the ICU environment. Conclusion: All of the studies included in the literature review identified several important challenges related to communication, such as time constraints, disagreements among healthcare professionals, and a lack of knowledge among healthcare professionals about how to conduct challenging conversations with patients and families. Future developments in practice should consider the role of effective multidisciplinary team-working in end of life care. [ABSTRACT FROM AUTHOR]

Tracheostomy insertion and management is increasingly common in critical care units and general wards. Therefore, it is important that nurses are equipped with the appropriate knowledge and skills to meet the individual needs of patients with a tracheostomy safely and competently. This article aims to enhance nurses' understanding of the potential challenges that patients with a tracheostomy may experience, and to guide nurses in providing effective care and support to these patients. It outlines the care that should be provided for patients with a tracheostomy who are critically ill, including methods of humidification and endotracheal suctioning. This article also discusses the effects that a tracheostomy may have on a patient's communication and psychological well-being, and explains the actions that nurses should take in an emergency and if complications occur. [ABSTRACT FROM AUTHOR]

The author discusses some studies and insights from professionals about the spiritual need of patients. A 2011 Royal College of Nursing poll showed a high level of uncertainty on spirituality and nursing. A 2016 investigation by the Royal College of Physicians found that 15 percent of people dying in acute hospitals in England had discussions on their spiritual needs documented. Guidelines have been set out by the National Institute for Health and Care Excellence on the care of dying people.

Nurses require effective communication and interpersonal skills to provide optimal care, and to ensure that patients and their families and carers have a positive experience of receiving care. The new Nursing and Midwifery Council standards of proficiency for registered nurses, and for nurse education and training, published in May 2018, recognise that future nurses will be practising in increasingly complex roles and environments. This article identifies the essential communication skills that will be required by nurses in the future, summarising the characteristics of a modern nurse communicator. It also suggests various approaches that nurses can use to develop their communication skills. [ABSTRACT FROM AUTHOR]

Healthcare-associated infections and antimicrobial resistance are significant threats to public health. As resistant organisms continue to emerge and evolve, and antimicrobial agents become less effective, infection prevention and control remains a vital aspect of maintaining public health, particularly among vulnerable patient groups such as older people and young children. Because of the increasing complexity of healthcare treatments and interventions, patients are becoming increasingly susceptible to healthcare-associated infections and resistant organisms. This article outlines some of the challenges that nurses may [ABSTRACT FROM AUTHOR]

Families ('family' will be used in this article to refer to anyone the patient considers significant, whether they are an actual family member or not) of patients who are critically ill have heightened communication needs. Nurses are an important source of information, particularly about day-to-day patient events and progress. Intensive care unit (ICU) nurses are valued by families because they provide clear, jargon-free information about the patient and their condition. However, they have sometimes been criticised for focusing on short-term issues while avoiding potentially difficult conversations about long-term outcomes and prognosis. A family conference or meeting is held when bad news has to be communicated to families, prognosis discussed or major decisions made, particularly about treatment withdrawal or resuscitation. These meetings should involve physicians and ICU nurses. Despite family conferences, family members' understanding of patient prognosis, diagnosis and treatment is often suboptimal. A planned and structured approach for these meetings, using quantitative statements for prognostic information, recording and communicating what has been said, and supporting meetings with written information, can improve their effectiveness. These supportive strategies increase understanding and consensus, and prevent the provision of conflicting information. It is important for nurses to be willing to follow up these meetings by supporting families to clarify their understanding and encouraging them to raise concerns and ask questions. [ABSTRACT FROM AUTHOR]

Aim To increase awareness of the needs of patients with dementia in the trauma and orthopaedics unit of one acute hospital, and to collaborate with staff on the unit to identify ways of improving the care experienced by these patients and their families. Method An action research approach was used and three action research cycles were completed. Data were obtained retrospectively for 20 patients with dementia who were admitted to the unit for treatment. Deficiencies in the care of these patients were identified and related to communication, pain management and the recognition of delirium. In response, a dementia toolkit was developed by nurses and implemented on the unit to improve the care of patients with dementia. Findings Comparison of pre-implementation and post-implementation audit results indicated a significant improvement in all aspects of care for patients with dementia in the trauma and orthopaedics unit, as a result of the implementation of the dementia toolkit. Education and training were provided to staff on the ward to ensure the toolkit was implemented appropriately. Conclusion It is important to consider the specific needs of patients with dementia in acute care settings, not only the primary reason for their admission. The involvement and inclusion of staff in determining what change was needed on the unit, how change would be undertaken and the positive effects of change, demonstrates how action research can inform and improve clinical practice. [ABSTRACT FROM AUTHOR]

Aim: To facilitate a multidisciplinary collaborative approach to developing person-centred practice in hip fracture care for older people. Method: Collaborative inquiry, a form of action research, was used to collect data for this study. It involved exploration of dilemmas, questions and problems that are part of human experience. Clinical leaders from different disciplines (n=16), who work with older people with hip fractures at different stages of the care pathway, participated in a series of facilitated action meetings. The practice development techniques used in this study included: identifying the strengths and limitations of the current service, values clarification, creating a shared vision, sharing clinical stories, reviewing case records, and reflecting on the experiences of three older people and two caregivers. Findings: Hip fracture care was based on meeting service targets, national guidelines and audits. Care was fragmented across different service delivery units, with professional groups working independently. This resulted in suboptimal communication between members of the multidisciplinary group of clinical leaders and care that was process-driven rather than person-centred. Spending time away from clinical practice enabled the multidisciplinary group to collaborate to understand care from the patients' and caregivers' perspectives, and to reflect critically on the care experience as a whole. Conclusion: To develop a person-centred workplace culture, the multidisciplinary team requires facilitated time for reflection. Ongoing facilitative leadership would enable the multidisciplinary team to collaborate effectively to deliver safe, effective person-centred practice in hip fracture care for older people. [ABSTRACT FROM AUTHOR]

Aim: To assess family satisfaction with care provided to patients in critical care units in Islamabad. Method: care units at two private hospitals in Islamabad, Pakistan. The purposive sample consisted of 3 A descriptive cross-sectional study was conducted in 11 medical and surgical critical 23 immediate family members and other relatives and friends (referred to as family members in this article) of 323 patients admitted to the critical care units for at least 24 hours. The revised Critical Care Family Satisfaction Survey was used for data collection. Descriptive statistics were used for data analysis. Findings: A total of 149/323 (46%) family members were 'very satisfied' with the honesty (openness) of staff in explaining the patient's condition, and 137/323 (42%) family members were 'very satisfied' with the nurses' availability to speak to them. A total of 143/323 (44%) family members were 'satisfied' with the honesty (openness) of staff in explaining the patient's condition, and 131/323 (41%) were 'satisfied' with the nurses' availability to speak to them. A few family members (21/323, 6%) were 'very dissatisfied' with the flexibility of the visiting hours and a few (20/323, 6%) were 'very dissatisfied' with the noise level in the critical care units. Some family members (38/323, 12%) were 'not satisfied' with the flexibility of the visiting hours, and some (18/323, 6%) were 'not satisfied' with the noise level in the critical care units. Conclusion: The majority of family members (244/323, 75%) were 'satisfied' or 'very satisfied' that their relatives' needs were being met in the critical care units. However, qualitative data indicate that most family members wanted greater involvement in decision making. These findings should be considered by staff working in critical care settings to ensure high-quality patient care. [ABSTRACT FROM AUTHOR]

The article deals with the use of the ReSPECT scheme to help patients plan for a potential health crisis. It explores the use of advance discussions by the scheme to make care choices for a future emergency. The importance of immediate decision-making by professionals responding to a crisis is discussed, as well as the support given by the Royal College of Nursing (RCN) to the ReSPECT process.

The Jones Dependency Tool can be used in emergency departments to improve patient care and identify the required staffing and skill mix. Using the tool, the nurse can accurately identify a patient's specific nursing needs. The dependency tool is used to evaluate patients' needs in six areas: communication; airway, breathing and circulation; mobility; eating, drinking, elimination and personal care; environmental safety, health and social needs; and triage. Appropriate nursing care can be tailored to the dependency level, depending on whether the dependency level is low, moderate, high or total dependency. [ABSTRACT FROM AUTHOR]

Teamwork requires co-operation, co-ordination and communication between members of a team to achieve desired outcomes. In industries with a high degree of risk, such as health care, effective teamwork has been shown to achieve team goals successfully and efficiently, with fewer errors. This article introduces behaviours that support communication, co-operation and co-ordination in teams. The central role of communication in enabling co-operation and co-ordination is explored. A human factors perspective is used to examine tools to improve communication and identify barriers to effective team communication in health care. [ABSTRACT FROM AUTHOR]

This article defines shared decision making in patient care and describes the background to this philosophy. The shared decision making approach is part of a wider initiative to promote patient-centred care and increase patient involvement in clinical decisions. Shared decision making recognises patients' rights to make decisions about their care and is used to assist them to make informed and individualised decisions about care and treatment. As well as reviewing the principles of shared decision making, the article offers practical guidance on how nurses can implement this initiative, including information on sharing expertise, agenda setting, assessing risks and benefits, setting goals, and support and follow up. [ABSTRACT FROM AUTHOR]

One of the key aspects of successful collaborative working is the relevant and effective exchange of information between professionals. Boundaries exist not only between health and social care in a community setting, but also in acute care between and within departments and professions. Patients continuously cross these boundaries during transfers and transitions, when nurses interact with other professionals and are in a prime position to demonstrate exemplary interprofessional relationships and seamless patient care to other staff and to students. Mentors act as role models for students of all professions and are expected to promote opportunities that will maximise student learning and enhance patient care. This article provides mentors with some suggestions for maximising these opportunities. Mentors are encouraged to reflect on practice-based learning opportunities for students, particularly situations that are challenging and involve critical judgement. The article focuses on learning opportunities in the peri-operative department, however the same challenges are experienced in other clinical areas and the principles of good interprofessional care can be applied to any team that aspires to work collaboratively. [ABSTRACT FROM AUTHOR]

This article outlines the process of taking a history from a patient, including preparing the environment, communication skills and the importance of order. The rationale for taking a comprehensive history is also explained. [ABSTRACT FROM AUTHOR]

Patient safety incidents have physical and emotional consequences for those involved, including patients, carers, relatives and healthcare staff. This article, the fifth of seven in this series, focuses on Step Five of the Seven Steps to Patient Safety (National Patient Safety Agency (NPSA) 2004): involve and communicate with patients and the public. The article discusses how to communicate with patients and their carers who have been involved in a patient safety incident that led to moderate harm, severe harm or death. [ABSTRACT FROM AUTHOR]

Aim To identify the most appropriate method of breaking news of a patient's death to unrelated stem cell donors, and to establish best practice guidelines based on the findings. Method In this retrospective study, 100 unrelated stem cell donors from the Welsh Bone Marrow Donor Registry were interviewed regarding their experiences of receiving news of a patient's death. Results were analysed by counting responses to the interview schedule, and identifying common themes from the open comments. Results Of the 100 participants, 78 had been informed of the patient's death by letter and 22 by telephone with the option of a follow-up letter. Overall, 61 per cent {n=61) of donors interviewed preferred to be contacted by telephone, 25 per cent (n=25) by letter and 13 per cent (n=13) by face-to-face contact at a visit. Conclusion There is no easy way to break bad news, and each individual responds to grief in a unique way. By building up a trusting relationship with the donor, the healthcare professional can assess the individual to ascertain which method of receiving news of a patient's death would be most appropriate. [ABSTRACT FROM AUTHOR]

Aim To explore the reasons given by a disability, assessment and rehabilitation team (DART) for perceived difficulties in discussing sexual problems with male patients with multiple sclerosis (MS), and to compare them with the views of a sample of patients. Method Data were gathered from a multidisciplinary team who were responsible for assessment and rehabilitation of patients with MS, using a focus group and semi-structured interviews with 11 male patients. Data were analysed thematically, with reference to An non's (1976) model of communication. Findings Patients felt a need to discuss problems with sexual dysfunction, and would welcome the introduction of the topic in a straightforward way. Health professionals were worried about intrusiveness and lack of information and training. Team members and the patients indicated that nurses are the best people to deal with these issues. Conclusion Rehabilitation teams need training to deal with patients' sexual problems, and the nurse is likely to be identified as the specialist in this area. [ABSTRACT FROM AUTHOR]

The author reflects on the lessons she learned as a healthcare support worker with regards to communication between staff and casual healthcare workers. The author said poor communication in a team can lead to agency staff feeling isolated. She said nursing students have the 6Cs approach to patient care drilled into them. She urges nurses and care staff to reflect on how they treat agency workers.

Some nurses cope with 'difficult' patients by ignoring them, but there is a better, more compassionate way, writes Erin Dean. [ABSTRACT FROM AUTHOR]

Done well, an apology can be healing; on the one side there is accountability and on the other there may be forgiveness. Being able to make a sincere, empathetic apology to a patient or their family is an important part of compassionate care. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to an article by Jane Bates in the October 16, 2013 issue, which discusses an older man's guilty about enjoying the company of children.

The article presents answers to a question of whether every British hospital patient should have a named nurse which were submitted by several British nursing professionals, including assistant director of nursing Paul Jebb, nurse Kate Tantam and respiratory nurse Jane Scullion.

Linda Watterson brings together the chief nursing officer for England's 6Cs with the RCN's Principles of Nursing. [ABSTRACT FROM AUTHOR]

Choosing is confusing, says Jane Bates. [ABSTRACT FROM AUTHOR]

Assertiveness is the ability to express clearly what you want, think or feel. It is as important in nurses' home lives as it is at work. [ABSTRACT FROM AUTHOR]

Robin Lewis argues that the safety of patients in hospital can be improved by using tools to monitor their vital signs. [ABSTRACT FROM AUTHOR]