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This article describes the design of a health action plan included in a care package for a person with learning disabilities. It provides working knowledge and guidance to students, nurses and service providers who are currently undertaking similar interventions. The rationale for developing the health action plan is explained and the intervention is detailed in relation to the person's circumstances.

This article describes the aetiology of oesophageal varices, the variety of treatment options available and the physiological and psychological nursing needs of patients undergoing these treatment regimes. Its purpose is to produce a balanced overview, looking at nursing care in the acute period and the long-term support required to meet the complex needs of these patients and their carers. After reading this article you should be able to: Identify what lifestyle risk factors are associated with patients who have oesophageal varices. Describe the underlying physiology that promotes the development of oesophageal varices. State what treatment options are available and their associated complications. Recognise the needs of carers and staff when attending to this client group. Prepare an action plan for the long-term support of a patient prone to further bleeding episodes.

We know that health inequalities apply to people with mental health problems who have poorer physical health than the general population.

Patients and nurses may not appreciate the differences between acute care settings and rehabilitation units. The relative informality and 'hands-off' approach of nurses in the latter can lead to confusion and misunderstanding for people whose exclusive experience of nursing is in the acute sector. At the behest of concerned nurses on a rehabilitation unit, the author conducted interviews with discharged patients to try to establish what their perceptions of the unit were, and how these influenced their progress. The results suggested that the patients' misconceptions may have been hindering their rehabilitation potential. The nurses subsequently devised an action plan to improve understanding of the unit's aims and practices. Follow-up interviews after the plan's implementation showed that it had been successful in improving patients' understanding and engagement with the rehabilitation process.

Tackling sepsis - the potentially fatal over-reaction of the immune system to infection - must be given the same priority as reducing Clostridium difficile and MRSA infections, the government has said.

With tuberculosis on the increase in ScotlIand, nurses are at the heart of an action plan t reverse the trend.

I am a nursing student due to qualify next March. In my final theoretical block, I have to submit two 2,500- word assignments, a 2,000-word assignment, a 1,000-word CV/action plan and a 6,500-word portfolio, all to obtain a qualification that is unlikely to lead to employment. So forgive me if my enthusiasm is muted.

At the 1997 RCN Congress, the RCN Mental Health and Older People Forum put forward a matter for debate--how the definition of 'serious and enduring mental illness' affects services to people with dementia. Subsequently, the RCN agreed both a position paper, which includes dementia in the definition, and an action plan for dissemination and support of the RCN position. Alison Soliman describes the background to the position paper.

I am amused by the often-recited action plan, 'I'll stay at home while the kids are small but will return to nursing when they are settled at school.'

A major RCN survey into student hardship is being launched as part of the Association of Nursing Students' new drive to win proper government funding for members on all courses.