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Explores Orem's self-care model in learning disability nursing in the U.S. Development of nursing knowledge; Use of the nursing theory and conceptual models for the survival of the discipline of nursing; Uses of the Orem's self-care model of nursing practice; Examination of the areas of self-care.

Examines the potential of Orem's self-care model to meet the needs of people with varying degrees of intellectual disabilities and additional physical care needs in hospital, community, and residential setting. Investigation of the benefits and deficits of Orem's self-care model; Analysis of intellectual disabilities, learning disabilities, and mental handicap; Background to the use of conceptual models of nursing.

Last year, a party of senior nurses visited the Fuenlabrada, an innovative and paperless hospital in Madrid. Here, Noel Scanlon describes what they found, and what it means for the future of the NHS. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To gain insight in how to demonstrate the impact arising from your research work • To understand the careful planning required at all stages of research to achieve impact • To gain an overview of strategies used in one study that could be transferred to other settings. Background: Several drivers are currently leading to greater emphasis of the importance of ensuring research has impact. Nursing research aims to improve patient care, safety and well-being, so it might be assumed results with the potential to effect such changes would automatically have an impact on clinical practice. However, experience suggests this is not the case and careful attention is needed for there to be an impact. Aim: To present the example of a project commissioned to develop a health communication tool to support people with learning disabilities in accessing healthcare. Discussion: The authors explore the importance of a planned approach to impact by referencing existing frameworks and providing examples of strategies used in the project. They also discuss the importance of framing the question using a range of approaches to actively engage stakeholders and of using diverse strategies to embed the development in practice. Conclusion: A planned approach is required to maximise impact from research. Planning and associated actions need to start at the very beginning of the research project and continue beyond the point of delivering the project report. Implications for practice: This paper relates to a specific context and patient group but the principles discussed are transferable to other clinical settings and patient groups. [ABSTRACT FROM AUTHOR]

The article presents information about nomination of articles for the reader prize. The article receiving most votes was "Hip Protectors: Interpreting the Evidence and Addressing Practicalities," by Nicky Hayes. The article tackles the debate about hip protectors in a way that helps nurses understand the role that they play in practicing evidence-based care. There is a degree of humor in wearing the hip protectors that the nurse can tap into in explaining the importance of wearing them, but they also enable the patient to feel that they are contributing to protecting themselves from damage following a fall, whereas more physiological factors are more difficult to influence.

The article discusses the British government's White Paper, entitled "Our health, our care, our say: A new direction for community services" about primary care reform. There are concerns about the failure to mention nurses in the British government's plan to strengthen and invest in primary care and over the move to put health services out to tender. Royal College of Nursing (RCN) General Secretary Beverly Malone claims that there is no mention of school nurses and health visitors who can play a vital role in preventing ill health.

Reports on the warning issued by the Great Britain Medicines and Healthcare Products Regulatory Agency regarding the use of blue litmus paper to check for correct placement of nasogastric tubes, as of September 2004. Alternate method of checking nasogastric tube placement.

The article reports on the white paper entitled Our Health, Our Care, Our Say: A New Direction for Community Services, published in January 2006 aimed at improving community health in Great Britain. According to Jan Harry, director of clinical standards at Mid Staffordshire Hospitals National Health Service (NHS) Trust, under the proposals, existing emergency departments would increasingly deal with only primary care and minor injuries, and that trauma care would be delivered in expert centres.

The article presents an editorial highlighting some of the features of the December 1, 2005, issue of the journal "Nursing Older People." For readers of Nursing Older People this has undoubtedly been the year of Methicillin-Resistant Staphylococcus Aureus or at least the year in which more people talked about it--whether as patients, concerned families, officials or politicians. A recent report from Joseph Rowntree Foundation published in this issue confirms that older people value "a little bit of help"--to sustain them through periods of difficulty--very highly indeed.

The article reports on the British government's white paper on health care outside hospital. According to the white paper entitled "Our Health, Our Care, Our Say," people with learning disabilities have not, historically, been treated well by the NHS. The overall aim of the white paper is to give people more choice about the care they receive in the community.

Why you should read this article: • To recognise the importance of involving service users in the care planning process • To understand how care planning practice could be improved in mental health organisations • To learn about a service improvement initiative that increased service user involvement in care planning and enabled the multidisciplinary team to contribute to this process The care planning process can provide meaningful therapeutic engagement with service users, and the concept of service users being collaborators in their care plans is central to best practice. However, it has been suggested that, in practice, care planning is largely a 'paper exercise' that is usually only performed by nurses, with service users often excluded from the process. This article discusses the development and implementation of a service improvement initiative – the Four Core Care Plans – which aimed to increase service user involvement in care planning and enable the multidisciplinary team to contribute to the process. It also details the organisational outcomes that were identified after the implementation of the Four Core Care Plans across a large independent mental health organisation. [ABSTRACT FROM AUTHOR]

A new green paper is an opportunity to join up a fragmented and unfair care system. Jennifer Trueland reports. [ABSTRACT FROM AUTHOR]

The article presents the views of two health care experts on health service proposals and predictions in Great Britain and its implications for district general hospitals. They comment on the Department of Health's white paper on the future of community care titled Our Health, Our Care, Our Say. They discuss issues tackled in the report Strengthening Local Services: The Future of the Acute Hospital, published by the National Leadership Network Local Hospitals Project.

Why you should read this article: • To recognise that being able to die well with dementia is of equal importance to living well with dementia • To consider why there may be a low uptake of advance care planning (ACP) in people with dementia • To learn about when to initiate an ACP discussion with a person with dementia. Recent policy focus in dementia care has been on living well with the condition; however, being able to die well with dementia is of equal importance. Advance care planning (ACP) enables people to consider, express and record their wishes and preferences for palliative and end of life care, however there is a low uptake of ACP in people with dementia. Although ACP discussions should be initiated as soon as possible after a diagnosis of dementia, there are other opportunities and transition points in the person’s care during which health and social care professionals could promote, engage in and support ACP discussions. This article considers the importance of ACP in dementia care and uses a case study to explore opportunities for initiating and engaging in ACP with people with dementia. [ABSTRACT FROM AUTHOR]

Most of the global cases of tuberculosis (TB) are found in Asia and Africa. This is largely due to deficient educational information, myths, beliefs and suboptimal service delivery as a result of inadequate infrastructure. Even though proper treatment can cure TB, bureaucratic difficulties and problems with caring for patients mean procedures to ensure that patients receive and complete treatment may stifle the treatment regimen. This paper looks at the service factors that affect adherence to TB treatment, while seeking to explore good practices to improve support for patients. It discusses a study that used a qualitative interpretive descriptive design involving interviews across health facilities in one district in Ashanti Region, Ghana. Ten patients were recruited in 2014 and interviewed. They revealed the challenges and facilitators that affected their adherence to their treatment. Three main themes were identified: institutional support, staff attitude and patients' unmet needs. Staff commitment, proper supervision of TB patients and individualising care encourages adherence, while organisational challenges, poor supervision of patients and unfriendly staff attitudes discourage the continuity of treatment. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To refresh your knowledge of holistic needs assessments (HNAs) • To consider how HNAs can be effectively delivered to patients with cancer as and when required • 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). Holistic needs assessments (HNAs) are interventions used by clinical nurse specialists (CNSs) and other members of the cancer team to deliver personalised care to people living with cancer. HNAs have been used since the launch of the National Cancer Survivorship Initiative in 2007, with many cancer services embedding them in routine patient care. However, shortcomings in HNA delivery remain, notably in terms of the number of people who receive them. This article prompts nurses to reflect on how HNAs can be effectively delivered to all patients with cancer as and when they need them. The author discusses the principles of personalised cancer care, the benefits of HNAs and when, where, how and by whom HNAs should be carried out. Recommendations to support nurses in cancer settings to increase and improve HNA delivery include CNSs, cancer support workers and allied health professionals joining forces and collaboration between secondary and primary care teams. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To read about the challenges experienced by people with co-occurring mental health issues, alcohol and drug use in accessing appropriate services • To enhance your assessment skills when working with people with co-occurring mental health issues, alcohol and drug use • 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). It is common for people with co-occurring mental health issues, alcohol and drug use to ‘fall between’ substance use and mental health services, leading to suboptimal health outcomes. There has been an acknowledgement in UK governments’ policies that more integrated services for this group are required. This article identifies why such people can be missed by healthcare services and the barriers that maintain this longstanding issue. The article discusses the need for effective assessment and intervention and how approaches such as motivational interviewing can provide support across services. The author also emphasises the benefits of joint working across agencies and the complexities involved in caring for this group of people. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To understand why exacerbations of chronic obstructive pulmonary disease occur • To familiarise yourself with the year-round patient management of chronic obstructive pulmonary disease • 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). In winter, exacerbations of chronic obstructive pulmonary disease (COPD) are frequent. These exacerbations are associated with increased hospital admissions, morbidity and mortality. Reducing the risk of winter exacerbations of COPD is crucial for alleviating pressures on health services and can be achieved by providing optimal year-round patient management. Identifying, reviewing and assessing patients at risk of COPD exacerbations well ahead of the winter season helps put in place preventive interventions such as checking inhaler technique, educating patients to recognise exacerbations and promoting self-management. This article highlights risk factors for COPD exacerbations, describes how to undertake a comprehensive review of a patient with COPD, and discusses interventions that community and primary care nurses can deliver to reduce the risk of winter exacerbations. [ABSTRACT FROM AUTHOR]

Why you should read this article: • To enhance your understanding of young people's use of digital technology • To learn how digital technology can be used to provide mental health services for young people • To recognise the importance of considering young people's abilities and preferences when implementing digital interventions Background: Digital technology affords opportunities to expand mental healthcare beyond the clinic setting, supporting sustainable delivery. A pilot qualitative study was undertaken with a view to using the experience gained from it to develop a substantive project in this area. Aim: To identify and better understand the perceived barriers and benefits to using digital technologies when delivering mental healthcare to young people. Method: In-depth semi-structured interviews were conducted with three young people under the care of a child and adolescent mental health service (CAMHS) team. The interview data were analysed thematically. Findings: Three main themes were identified from the interviews: digital identity and digital literacy; trusting and accessing digital health resources; and therapeutic relationships, choice and convenience. Conclusion: The findings of this pilot study reinforce the importance of avoiding a 'one-size-fits-all' approach to integrating digital technology in CAMHS. It was also identified that it is important to carefully consider the involvement of parents when conducting mental health research with children and young people. [ABSTRACT FROM AUTHOR]

The author comments on the 2007 edition of "Nurse Researcher." The author says that her personal goals as editor of the journal were to demystify research and writing for publication, and to encourage nurses and other healthcare professionals to publish their work and support them in these processes. The issue focuses on the novice researcher or those seeking a first time publication. The author also recognizes those contributors who have a wealth of knowledge and experience of their practical work settings.

The article offers information on the paper titled "Service Users' Views of Physical Restraint Procedures in Secure Settings for People With Learning Disabilities," by P. Jones and B. S. Kroese. This paper is useful to those engaged in supporting people with learning disabilities who reside in some form of secure setting. The author investigates the views of service users from secure residential facilities who are restrained frequently.

The article presents information on the arrival of the Health and Social Care White Paper, a product of the social care Green Paper Independence, Well-being and Choice. A parliamentary bill will follow the arrival, leading to a new Health and Social Care Act that will create the legislative framework to underpin further improvements to services in England. In the meantime commissioners and providers of health and social care will continue the journey that is bringing them ever closer. These proposals, with their explicit commitment to shift resources away from hospitals into community services, can expect to find a high degree of support among staff working with older people, and with older people themselves who have long supported the idea of a more co-ordinated and coherent response to their needs.

The article highlights an invitation for comments for the European Commission green paper "Promoting the Mental Health of the Population: Towards a Strategy on Mental Health for the European Union" and a framework of standards concerning the quality and integration of services for people with substance misuse problems from the Scottish Executive.

UK emergency departments (EDs) are high-pressure environments focused on delivering care in the most efficient way to patients with a range of health problems. For many people EDs are the front door of the NHS and are a focus of significant media and political interest. People who attend EDs are often anxious and a main element of their concern is waiting time for treatment. In UK EDs the four-hour target is a main NHS target and a cornerstone of evaluating ED performance. There is ongoing debate about whether spending additional time in EDs affects patient care and outcomes, with some research showing increased mortality associated with longer stays and some showing no effect on mortality. Evidence suggests that patients are spending longer in UK EDs and it is possible that those who remain longer than four hours could have worse outcomes. This article identifies the effects of prolonged ED length of stay through a systematic literature review of data published since implementation of the four-hour target to measure the relationship between breaching the target and morbidity and mortality. [ABSTRACT FROM AUTHOR]

The physical effects of multiple sclerosis (MS) mean participating in research requires considerable effort. Vignettes offer a less fatiguing and more efficient way of gathering preliminary data from such participants as they avoid intrusion into and disruption of healthcare interactions. However, despite their widespread use, no documented process describing how to develop them exists. This paper describes how we designed and crafted vignettes that investigated; how anger in MS patients is affected by nursing and communication styles; how to achieve equivalence; how vignettes should be rated; what statistics should be used to judge their reliability; and how to ensure that vignettes are measuring target variables. [ABSTRACT FROM AUTHOR]

This article reports on the White Paper released by the UK Department of Health. According to the White Paper, the government would like see one-stop-shops and multi-agency health centres located on school sites to enable health professionals to work alongside education and social care professionals, and to share information and expertise. It also says school nurses will help create and support the government's healthy schools initiative, which will have a special focus on nutrition. A new national target has been set to halt the year-on-year increase in obesity among children under 11 by 2010.

This paper describes the findings of a phenomenological study of professional fulfilment in nurses who care for older people. The author sought to uncover what brings career satisfaction to nurses who care for older people and subsequently what motivates these caregivers to continue to care. The findings have implications for clinical nurses who may see reflections of their own approaches to care in the narratives presented. The examples of care reported may inspire nurses who work with older adults by affirming their own nursing interventions. [ABSTRACT FROM AUTHOR]

Around half a million older people aged 65 or over live in care homes across the UK and substantial numbers end their lives in these care settings. The Liverpool Care Pathway for the dying patient (LCP) was developed to transfer the hospice model of care into other care settings. This paper describes a pilot project to introduce the LCP into care homes local to the Queen Mary's Sidcup NHS Trust with a view to reducing the number of very ill elderly patients who are transferred to the acute trust from care homes and then die in A&E. [ABSTRACT FROM AUTHOR]

Focuses on the transformation of mental health services from the dismantling of the overflowing institutions to the development of community-based care in Great Britain. Anticipation for the reaction of many mental health nurses currently providing services in the country; Challenges encountered by mental health services; Development of a network of community-based services.

Describes the System to Escalate and Monitor (STEAM), a paper-based tool that enables staff nurses to record the level of intensity of care being provided to each patient within a department and use the measurement as the basis for the risk assessment of the department's clinical capacity. Information on the clinical scoring that must be considered when taking assessments; Benefits that have been identified by using STEAM; Effectiveness of STEAM when it was introduced in a neonatal unit.

Explores how various approaches can be integrated to help someone create an effective person-centered health action plan, a key component of the British government's “Valuing People” White Paper. Key principles underpinning person-centered planning (PCP); Interface between PCP and health action planning (HAP); Advantages and disadvantages of different PCP models in relation to HAP; Examples of health action plans.

In the United Kingdom the Research Assessment Exercise (RAE) is a major method of assessing research from Higher Education institutions. Participation is not compulsory, and anecdotal evidence suggests that many eligible institutions did not enter the Unit of Assessment for nursing (UoA 10). In this paper, Bruce Lindsay, Michael Pfeil and Karen Bates describe a study designed to establish the approach to the 2001 RAE taken by institutions that were eligible to enter the nursing unit but had not done so. This included an assessment of their rationales for not entering UoA 10, and an analysis of the grades awarded to those that entered nursing research in other UoAs. The study identified a small group of researchers whose work informs a range of health and social care disciplines. Their non-submission to UoA 10 may have resulted from a lack of clarity about criteria for this Unit: future RAEs could improve the standard of UoA 10 by producing clearer guidelines for submissions. [ABSTRACT FROM AUTHOR]

Effective safeguarding supervision reduces risk to children and young people while identifying their needs. Safeguarding supervision also helps front-line practitioners to provide high-quality care, risk analyses and individual action plans. This article is part of a wider study that explores the author's leadership behaviours and their impact on effective safeguarding supervision. The role of the safeguarding leader is evolving and the article explores relevant literature to support or refute the role of the leader in effective safeguarding supervision. A literature review was undertaken using Aveyard (2014)'s critical appraisal tool to provide structure and accuracy. The review showed the interconnection between positive leadership behaviours and effective safeguarding supervision. It also highlighted the positive effect on the practitioner's well-being of being supported by experienced, effective and compassionate leaders. [ABSTRACT FROM AUTHOR]

The article covers nursing-related issues in Great Britain as of October 2009. A consultation is being done by health departments on how to set regulations on acupuncturists and practitioners of traditional Chinese medicine (TCM). The vision of the government for an equal and affordable health service in England has been presented in the paper "Shaping the Future of Care Together." An online survey on the possible priorities for future cancer studies has been unveiled by the National Institute for Health Research of the National Health Service (NHS).

The article focuses on a radical change to the British mental health workforce requested by the think tank Sainsbury Centre for Mental Health in London, England. The centre says, in the position paper "Implementing Recovery," every interaction with service users should prepare them to take control of their lives. Co-author Geoff Shepherd stressed the need for a major transformation in the culture of mental health services. It outlines 10 key challenges being set by the paper for such services, one of which is ensuring organisational commitment.

The article reports on a consultation for "Shaping the Future of Care Together," a green paper on adult social care issued by the British government. The paper outlines the plan of the government for adult social care and possible changes to it. According to Prime Minister Gordon Brown, the consultation is an opportunity for people to inform the government how care should be given.

The article presents two papers, "Use of Drug Therapy in Children With Attention Deficit Hyperactivity Disorder (ADHD): Maternal Views and Experiences" and "The Provision and Nature of ADHD Services for Children/Adolescents in the UK: Results From a Nationwide Survey." The first paper explores the views and experiences of mothers deciding whether or not to give their children medication for ADHD. The other described the range and accessibility of services for its treatment in Great Britain.

The article discusses the significance of genetics to primary care nurses in Great Britain. The issue as to how it affected to primary care nursing is presented on the paper issued by health authorities, which outlines the advances in knowledge that brings more accurate diagnosis, personalized prediction of risk, new drugs and therapies and better targeted preventions and treatment of disease, informed by an individual's genetic profile. Significant analyses of the implication are presented.

The article discusses the British government's White Paper about the primary care services needs of patients. The paper discusses the changes are needed to enhance primary care capacity. The British government wants to expand primary care services by opening up the market and extending choice. However, nurses feel uncomfortable about non-National Health Service (NHS) organizations moving into primary care.

This article presents information about various journals highlighting their relevance for nurses who work with older people. The concept of ‘complex adaptive systems’ attempts to model the many forces which impact upon staff in any organisation, so as to understand more fully their actions, and hence promote those managerial strategies which improve performance of medical care in American nursing homes. A study was carried out in a leg ulcer clinic in a day hospital or the elderly. This paper addresses the topical issue of opening access to a previously age-related service to adults of all ages. It presents the results of a retrospective survey of patients attending a leg ulcer clinic, after the previous lower age limit of 60 years had been removed.

Why you should read this article: • To enhance your knowledge of personalised cancer care and support planning for patients living with cancer • To increase your awareness of methods of delivering personalised care virtually to patients living with cancer • 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) Many people with cancer experience long-term physical and emotional challenges resulting from the disease and its treatment. Personalised care enables people to exercise choice and control over how their care is planned and delivered. The principles of personalised care are based on healthcare professionals focusing on what matters to people living with cancer. Personalised care enables people to use their individual strengths to ensure that they can have an active role in decisions about their care if they so choose. This article explores personalised nursing care in the context of people living with and beyond cancer. The author examines how nurses can adopt a personalised care model and how this supports improved quality of life and outcomes for patients with cancer. Additionally, the author explores how personalised care interventions have been affected by the coronavirus disease 2019 pandemic and how these might be delivered virtually. [ABSTRACT FROM AUTHOR]

The article reflects on the development of a band five nurse coordinators' competency pathway at the Sheffield Children's National Health Service (NHS) Foundation Trust hospital in England. It describes a mixed-methods approach involving qualitative and quantitative data collection to assess the effectiveness of competency pathway and simulation training. Data analysis presented reveals gender gap, length of nurses' experience and embedding of pathway in the trust, and training effectiveness.