Search

This article provides an overview of the wound healing process, outlining the four distinct phases of the healing cascade: haemostasis, inflammation, proliferation, and maturation. The different types of closure method are described and, specifically, the various types of surgical suture that can be used for wound closure, as well as the strengths and limitations of each. The article explains aspects of patient care that need to be considered such as obtaining informed consent, and the importance of nurses maintaining appropriate clinical skills. It concludes with a step-by-step outline of best practice on how to remove sutures.

Nursing programmes were flexible during the COVID-19 pandemic, offering simulation to replace clinical hours and adjusting supervision and assessment. However, second-year students in two modules had lower results despite no changes to the material, team or delivery. Objectives: A retrospective cohort study was conducted, on second-year adult nursing students who submitted written assignments, to analyse recurring patterns that could explain the failure rate. Method: Data were analysed from 265 university students to identify patterns of association in demographics, module results and student engagement indicators. Results: A positive correlation was found between age and assignment results, with older students achieving higher grades. Clustering identified three patterns of student engagement. Students demonstrating engagement with all aspects of the course (30.2%) performed significantly better than those in other clusters (P<0.001). Students with disabled student support recommendations performed notably worse than those without. All sizeable differences were resolved following the return to campus and the implementation of additional writing support. Discussion: Age, cross-medium engagement and preparation were all shown to have an impact on marks. These findings can influence how higher education institutions drive and monitor engagement, as this study suggests that all parts of a blended learning approach are equally important.

Pain is universally experienced and extremely complex, involving the mind as well as the body. It is activated by a variety of stimuli, including biological, physical and psychological. This article seeks to provide a deeper understanding of the physiology of pain and the various classifications used in clinical practice. It also aims to raise awareness of the skills that nurses require for the assessment and management of an individual patient's pain. It explores the tools available to assist with the assessment of pain and provides an introduction to some of the management strategies that can be used to manage pain. Some of the barriers to effective pain assessment and management are also examined

This article will provide clinical guidance on carrying out venepuncture on an adult. It will discuss site, equipment selection and aseptic non-touch technique. The aims are to increase knowledge of the anatomical structures associated with venepuncture, demonstrate the clinical procedural technique of venepuncture, and provide an awareness of the dangers and complications of this invasive technique.

This article provides clinical guidance on performing cannulation on an adult. The site, equipment selection and aseptic non-touch technique will be discussed. The clinical procedural technique of cannulation will be explained and the article will also provide an awareness of the dangers and complications of this invasive technique for both the patient and the health professional.

This is the first of two articles providing an overview of the female reproductive system. This article looks at the internal organs associated with the female reproductive system, as well as the vulva. The author describes the relevant pathophysiology and provides an outline of disorders associated with these reproductive organs. The role of health professionals in managing and treating these disorders is discussed, and the importance of providing women-centred care highlighted. A case study and care plan is used to illustrate the importance of individualised care, including history taking, assessment of the presenting symptoms, treatment strategies, health education and advice on follow-up actions. A second article will provide an overview of breasts.

This article aims to provide background information on blood pressure. It outlines the anatomy and physiology associated with the skill of blood pressure measurement, and the varying techniques for taking blood pressure readings, both invasively and non-invasively. It further explains the steps for taking a manual blood pressure and provides top tips for carrying out this procedure in clinical practice.

Government reports, studies and records are valuable an virtually unlimited sources of information on issues related to product safety. Access to and discovery of this information are often crucial to [...]

Part two of this series on the care of the surgical patient introduces readers to some of the additional risks associated with patients who are undergoing surgery and taking oral anticoagulants. It explores the use of vitamin K antagonists and heparin. Some of the management strategies and additional considerations that need to be addressed during the perioperative care continuum will also be discussed.

This article provides clinical guidance on the care of a patient undergoing an elective surgical procedure. It discusses preoperative care and the preparation of the patient. It aims to provide an awareness of the complications associated with perioperative care. Through the use of a patient case study, the authors demonstrate the care required across the full perioperative journey from diagnosis to discharge.

Katy Skarparis, Lecturer, Adult Nursing, Northumbria University (katy.skarparis@northumbria.ac.uk) and Claire Ford, Lecturer, Adult Nursing, Northumbria University describe how to select a suitable site and take a blood sample using vacuum collection tubes

Claire Ford, Lecturer, Adult Nursing, Northumbria University, Newcastle upon Tyne (claire.ford@northumbria.ac.uk) outlines the skills and tools health professionals use to help patients manage pain

Claire Ford, Lecturer, Adult Nursing (claire.ford@northumbria.ac.uk), and Laura J Park, Graduate Tutor, of Northumbria University, describe how to maintain good skin health to reduce the risk of infection

OBJECTIVE: To determine whether a combination of a selective serotonin reuptake inhibitor (SSRIs) and cognitive behaviour therapy (CBT) together with clinical care is more effective in the short term than an SSRI and clinical care alone in adolescents with moderate to severe major depression. Design Pragmatic randomised controlled superiority trial. Setting 6 outpatient clinics in Manchester and Cambridge. Participants 208 adolescents, aged 11-17, with moderate to severe major or probable major depression who had not responded to a brief initial intervention. Adolescents with suicidality, depressive psychosis, or conduct disorder were included. Interventions 103 adolescents received an SSRI and routine care; 105 received an SSRI, routine care, and CBT. The trial lasted 12 weeks, followed by a 16 week maintenance phase. MAIN OUTCOME MEASURES: Change in score on the Health of the Nation outcome scales for children and adolescents (primary outcome) from baseline with 12 weeks as the primary and 28 weeks as the follow-up end point. Secondary measures were change in scores on the mood and feelings questionnaire, the revised children's depression rating scale, the children's global assessment scale, and the clinical global impression improvement scale. RESULTS: At 12 weeks the treatment effect for the primary outcome was –0.64 (95% confidence interval –2.54 to 1.26, P=0.50). In a longitudinal analysis, there was no difference in effectiveness of treatment for the primary (average treatment effect 0.001, –1.52 to 1.52, P=0.99) or secondary outcome measures. On average there was a decrease in suicidal thoughts and self harm. There was no evidence of a protective effect of cognitive behaviour therapy on suicidal thinking or action. By 28 weeks, 57% were much or very much improved with 20% remaining unimproved. CONCLUSIONS: For adolescents with moderate to severe major depression there is no evidence that the combination of CBT plus an SSRI in the presence of routine clinical care contributes to an improved outcome by 28 weeks compared with the provision of routine clinical care plus an SSRI alone. Trial registration Current Controlled Trials ISRCNT 83809224.