Royal College Of Nursing Research Articles

Training and Professional Development for Nurses and Healthcare Support Workers: Supporting Foundation for Quality and Good Practice for Care of the Acutely III Older Person

A wide range of formal taught and online professional nursing diploma/degree courses are currently available. In addition nursing education is available in most health care settings but it could be difficult to participate in such training events due to time and service constraints.

Hepatology: an important member of the GI family

Gastrointestinal NursingVol. 13, No. 10 Penny's pageHepatology: an important member of the GI familyPenny HarrisonPenny HarrisonSearch for more papers by this authorPenny HarrisonPublished Online:17 Dec 2015https://doi.org/10.12968/gasn.2015.13.10.56AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References British Society of Gastroenterology (2012) Commissioning Evidence-Based Care for Patient with Gastrointestinal and Liver Disease. British Society of Gastroenterology, London. http://tinyurl.com/crt8rnx (accessed 10 December 2015) Google ScholarClark C (2014) Promoting the 6 C's of nursing in patient assessment. Nurs Stand 28(44): 52–9 Crossref, Google ScholarCox C (2007) The advanced practice role in gastrointestinal nursing. Gastrointestinal Nursing 5(4): 26–31 Link, Google ScholarFullwood D (2011) Care of patients following liver transplantation. Nurs Stand 25(49): 50–6 Crossref, Google ScholarFullwood D (2012) Portal hypertension and varices in patients with liver cirrhosis. Nurs Stand 26(48): 52–7 Crossref, Google ScholarMacNaught N, Holt P (2015) Type 1 diabetes and alcohol consumption. Nurs Stand 29(50): 41–7 Crossref, Google ScholarNational End of Life Care Intelligence Network (2012) Deaths from Liver Disease: Implications for End of Life Care in England. http://tinyurl.com/mbk9585 (accessed 10 December 2015) Google ScholarRoyal College of Nursing (2015) Caring for People with Liver Disease. A Competence Framework for Nursing. Royal College of Nursing, London. http://tinyurl.com/q6k54eq (accessed 10 December 2015) Google ScholarTierney A (1998) Nursing models: extant or extinct? J Adv Nurs 28(1): 77–85. doi: https://doi.org/10.1046/j.1365-2648.1998.00766.x Crossref, Google Scholar FiguresReferencesRelatedDetails 2 December 2015Volume 13Issue 10ISSN (print): 1479-5248ISSN (online): 2052-2835 Metrics History Published online 17 December 2015 Published in print 2 December 2015 Information© MA Healthcare LimitedPDF download

New law on notifying female genital mutilation

British Journal of MidwiferyVol. 23, No. 12 LegalNew law on notifying female genital mutilationAndrew SymonAndrew SymonSearch for more papers by this authorAndrew SymonPublished Online:4 Dec 2015https://doi.org/10.12968/bjom.2015.23.12.905AboutSectionsView articleView Full TextPDF/EPUB ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareShare onFacebookTwitterLinked InEmail View article References Berg RC, Denison E (2013) A tradition in transition: factors perpetuating and hindering the continuance of female genital mutilation/cutting (FGM/C) summarized in a systematic review. Health Care Women Int 34(10):837–59. doi: https://doi.org/10.1080/07399332.2012.721417 Crossref, Google ScholarBerg RC, Underland V (2013) The obstetric consequences of female genital mutilation/cutting: a systematic review and meta-analysis. Obstet Gynecol Int 2013:496564. doi: https://doi.org/10.1155/2013/496564 Google ScholarDepartment of Health (2015) Doctors and nurses required to report FGM to police. http://tinyurl.com/phbvu6y (accessed 17 November 2015) Google ScholarGallagher J (2015) FGM: legal duty to inform police comes into force. www.bbc.co.uk/news/health-34681057 (accessed 17 November 2015) Google ScholarMinistry of Justice/Home Office (2015) Serious Crime Act 2015. Factsheet: Female Genital Mutilation. http://tinyurl.com/nedvfn2 (accessed 17 November 2015) Google ScholarOrchid Project (2015) What is FGC? http://tinyurl.com/OP-fgc (accessed 17 November 2015) Google ScholarRoyal College of Midwives, Royal College of Nursing, Royal College of Obstetricians and Gynaecologists, Equality Now, UNITE (2013) Tackling FGM in the UK: Intercollegiate Recommendations for identifying, recording and reporting. RCM, London Google ScholarRoyal College of Obstetricians and Gynaecologists (2015) Policy briefing: Mandatory reporting of Female Genital Mutilation (FGM). http://tinyurl.com/qdcusmm (accessed 17 November 2015) Google ScholarRogers J (2015) The first prosecution for FGM. www.criminallawandjustice.co.uk/features/First-Prosecution-FGM (accessed 17 November 2015) Google ScholarTrust for London (2014) New research: 137,000 women and girls in England and Wales affected by FGM. http://tinyurl.com/lbx3vzm (accessed 17 November 2015) Google ScholarTrust for London, City University London, Equality Now, Royal College of Midwives, Rosa (2015) Taking Local Action on FGM: An essential guide for local authorities. http://tinyurl.com/qj9mbv3 (accessed 17 November 2015) Google Scholar FiguresReferencesRelatedDetailsCited byWhat can be done to raise midwives' awareness of female genital mutilation?Jadesola Oginni12 September 2017 | British Journal of Midwifery, Vol. 25, No. 9 2 December 2015Volume 23Issue 12ISSN (print): 0969-4900ISSN (online): 2052-4307 Metrics History Published online 4 December 2015 Published in print 2 December 2015 Information© MA Healthcare LimitedPDF download

Enabling hospital staff to care for people with dementia.

This is the fourth and final article in a short series that presents case study examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. Dementia training in hospitals is often inadequate and staff do not always have sufficient knowledge of dementia to provide appropriate care. It can also be difficult for them to identify when patients with dementia are in pain, especially when their communication skills deteriorate. The case studies presented illustrate how two NHS trusts have worked to ensure that their staff are fully equipped to care for people with dementia in hospital. Basildon and Thurrock University Hospitals NHS Foundation Trust in Essex made dementia training a priority by including dementia awareness in staff induction across a range of roles and providing additional training activities tailored to meet staff needs. Nottingham University Hospitals NHS Trust focused on pain assessment, aiming to standardise its approach for patients with dementia. The pain assessment in advanced dementia tool was chosen and piloted, and is being implemented across the trust after a positive response.

Recommended frequency of ABPI review for patients wearing compression hosiery

This paper is a sequel to the article 'How often should patients in compression have ABPI recorded?' ( Furlong, 2013 ). Monitoring ankle brachial pressure index (ABPI) is essential, especially in those patients wearing compression hosiery, as it can change over time ( Simon et al, 1994 ; Pankhurst, 2004 ), particularly in the presence of peripheral arterial disease (PAD). Leg ulceration caused by venous disease requires graduated compression ( Wounds UK, 2002 ; Anderson, 2008). Once healed, compression hosiery is required to help prevent ulcer recurrence ( Vandongen and Stacey, 2000 ). The Royal College of Nursing ( RCN, 2006 ) guidelines suggest 3-monthly reviews, including ABPI, with no further guidance. Wounds UK (2002) suggests that patients who have ABPI<0.9, diabetes, reduced mobility or symptoms of claudication should have at least 3/12 Doppler, and that those in compression hosiery without complications who are able to report should have vascular assessment yearly.

Improving the hospital environment for people with dementia.

This article is the third in a series presenting examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. The hospital environment is often disorientating for people with dementia and can be particularly distressing when a patient is admitted in an emergency. Subsequent ward moves can also be disruptive and confusing, especially if they take place out of hours. Two NHS trusts aimed to improve the experience for patients with dementia by addressing the physical environment along with practical aspects of care provision at different stages in the hospital journey. The Queen Elizabeth Hospital King's Lynn NHS Foundation Trust in Norfolk enhanced its emergency department environment by redesigning four bays and an observation area to be dementia-friendly. The hospital has supported these changes by providing dementia awareness training for all staff in these areas. Walsall Healthcare NHS Trust focused on minimising ward moves by implementing procedures to identify patients who should not be moved. Since introducing the new process, adherence has been good and there have been fewer ward moves.

Feedback on ‘Tracheostomy management’, BJA Education, June 2015

Editor®I wish to comment on behalf of my colleagues who work with the National Tracheostomy Safety Project in response to the article by Katharine Hunt and Sue McGowan in the June edition of BJA Education.1Hunt K McGowan S. Tracheostomy management.BJA Education. 2015; 15: 149-153Abstract Full Text Full Text PDF Scopus (5) Google Scholar The article updates the reader on some of the progress in multidisciplinary tracheostomy care in the intervening years since a similar article in April 2008's CEACCP journal. It was refreshing to see the contribution of a nationally recognized Speech and Language Therapist in this latest article, emphasizing some of the progress in multidisciplinary care and management of tracheostomy patients. We were very surprised however not to find any mention of the National Tracheostomy Safety Project (NTSP), especially when many of the NTSP resources were considered as the benchmark in the 2014 NCEPOD report ‘On the right trach?’ referred to in the article. The Intensive Care Society Guidelines referenced in the article were updated in June 2014 and again emphasize the importance of standardized (NTSP) guidelines. The reproduction of Hunt and Regan's 2008 emergency management guideline figure was also surprising and potentially misleading for the readership of BJA Education. The NTSP published multidisciplinary emergency guidelines in 2012 (Fig. 1) which were endorsed by the Royal College of Anaesthetists, the Difficult Airway Society, the Intensive Care Society, ENT UK, the British Association of Oral and Maxillofacial Surgeons, the College of Emergency Medicine, the Resuscitation Council (UK) the Royal College of Nursing, the Royal College of Speech and Language Therapists, the Association of Chartered Physiotherapists in Respiratory Care, and the National Patient Safety Agency.2McGrath BA Bates L Atkinson D Moore JA Multidisciplinary guidelines for the management of tracheostomy and laryngectomy airway emergencies.Anaesthesia. 2012; 67: 1025-1041Crossref PubMed Scopus (134) Google Scholar The algorithms are universally taught in this country and beyond and were developed primarily in an attempt to standardize the response to tracheostomy emergencies. Whilst we certainly do not claim ownership of emergency care for tracheostomy patients, to publish alternative guidance without reference to the current national standard is confusing at best. The NTSP algorithms have been tested in both Anaesthetic and Intensive Care Medicine examinations and we would like to draw attention to this for your readership, especially those who are searching for up-to-date resources or specifically revising for such examinations. The article also makes valid reference to role anaesthetists can play as part of a multidisciplinary team managing in patients with a tracheostomy. The weaning process described is one of many published strategies and we would direct the reader searching for additional resources to the websites of the NTSP (www.tracheostomy.org.uk) or that of the Global Tracheostomy Collaborative (www.globaltrach.org).

Improving activity and engagement for patients with dementia.

This is the second in a short series that presents case study examples of the positive work achieved by trusts that participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. Staff often think that there is insufficient time to get to know patients and carers, especially with large and challenging workloads. Combined with a lack of activities and stimulation for patients with dementia in hospital, this can result in poor engagement and a disconnect between staff and patients. To improve these relationships and give staff more time with patients, Cambridge University Hospitals NHS Foundation Trust has introduced bay nursing for patients with dementia, where one nurse is responsible for monitoring a bay alongside a healthcare assistant for an entire shift. Part of Betsi Cadwaladr University Health Board, Glan Clwyd Hospital in north Wales has focused on improving stimulation by creating an activity room with a specially trained activity worker, providing a relaxed and friendly setting where patients with dementia can take part in a range of activities and have lunch together.

Transforming dementia care in acute hospitals.

This article provides an overview of current developments to support improvements in dementia care in acute general hospital settings. It considers the urgent need for improvement along with the effectiveness of current approaches in achieving change and delivering person-centred care. The process and outcomes of a development programme carried out by the Royal College of Nursing and evaluated by the University of Worcester are described. This programme supported clinical nurse leaders in developing dementia care in nine acute general hospitals by use of an action learning approach. Recommendations are made for a more systematic approach to developing practice that considers the context and culture of acute hospital care for people with dementia. The need for investment in clinical leaders and dementia specialists who can assist improvements and support change is emphasised.

There are just 1,186 fully qualified school nurses caring for 8.4 million pupils

As pupil numbers increase, the Royal College of Nursing is among those worried about our overworked and underfunded school nurses

Understanding the needs of people with dementia and family carers.

This is the first in a short series that presents case study examples of the positive work achieved by trusts who participated in the Royal College of Nursing's development programme to improve dementia care in acute hospitals. When a person with dementia is in hospital, poor understanding of individual needs and preferences can contribute to a lack of person-centred care. Similarly, the needs of family carers can often be overlooked and staff do not always appreciate these needs at such a stressful time. This article illustrates how three NHS trusts have addressed these issues. To help staff get to know patients with dementia, Salford Royal NHS Foundation Trust has implemented a patient passport. Similarly, The Shrewsbury and Telford Hospital NHS Trust has implemented a carer passport that overcomes the restrictions imposed by hospital visiting hours. Royal Devon and Exeter NHS Foundation Trust also focused on carers, holding a workshop to elicit feedback on what was important to them. This was a useful means of engaging with carers and helped staff to realise that even simple changes can have a significant effect.

Assessing and teaching female intermittent self-catheterization.

Intermittent self-catheterization (ISC) is the recommended method for bladder emptying in women with bladder dysfunction (National Institute for Health and Care Excellence (NICE), 2012; 2013; Royal College of Nursing, 2012). ISC is the insertion and removal of a catheter to drain the bladder, and is considered a safe and effective way of preserving renal function. Although the individual’s wishes should always be taken into consideration, for many women, ISC promotes independence and self-management, preserves intimacy and sexuality, and can improve quality of life (Nazarko, 2012; Vahr et al, 2013).

Management of 'Do Not Attempt Cardiopulmonary Resuscitation' (DNACPR) decisions in the perioperative period.

It is increasingly common for patients to be scheduled for anaesthesia and surgery with a 'Do Not Attempt Cardiopulmonary Resuscitation' (DNACPR) decision in place. Updated guidelines for the implementation and management of DNACPR decisions were published jointly by the British Medical Association (BMA), the Resuscitation Council (UK) and the Royal College of Nursing (RCN) in 2014 (BMA, RC(UK), RCN 2014). The Association of Anaesthetists of Great Britain and Ireland (AAGBI) published specific guidelines in 2009 to guide the perioperative management of such patients (AAGBI 2009). In this article, we explain these guidelines with a focus on how DNACPR decisions are made and how they can be modified in order to permit appropriate surgery to take place.

Shop-floor nous.

Dame Donna Kinnair can draw on a wealth of experience in her new role as head of nursing at the Royal College of Nursing, from health visiting to government adviser, but her early training as a retail management trainee also gave her some invaluable insights into how to commission what people need and want. She spoke to Jennifer Trueland

Nurses' attitudes to assisted suicide: sociodemographic factors.

This literature review seeks to explore the factors that influence nurses' attitudes towards assisted suicide. A poll conducted by the Royal College of Nursing (RCN) showed that 49% of nurses supported assisted suicide while 40% were opposed to it. A literature review resulted in 16 articles being identified for data synthesis using a recognised critiquing framework. The articles revealed four key themes: nursing specialty, level of education, geographical location and religion. It was concluded that these four themes are key to understanding a nurse's attitude towards assisted suicide. Nursing staff need to be aware of their own influences on this topic, since they will inevitably be involved in the process in some way or another, in countries where assisted suicide has been legalised.

Commissioning for infection prevention

The changing face of healthcare commissioning within England provided Infection Prevention Specialists with an opportunity to embed Infection Prevention and Control (IPC) into the heart of contractual arrangements. The Infection Prevention Society (IPS) collaborated with the Royal College of Nursing (RCN) to help support members in meeting the challenge of ensuring this key element to achieve quality and safety is embedded in the emerging commissioning landscape

Education for workforce planning

© 2 01 5 M A H ea lth ca re L td Lies, damn lies and statistics!’ The origins of this quotation remain a mystery, rather like the saying, ‘There are three degrees of falsehood: the first is a fib, the second is a lie, and then comes statistics’. While both may have originated in the 19th century, two centuries later the sentiments remain. April 2015 saw the publication of the final Royal College of Nursing’s (RCN) Frontline First campaign to monitor the impact of the coalition government’s budgetary efficiencies and their effect on the nursing workforce. It is common knowledge that the NHS faced mammoth financial cuts of £20 billion when the coalition government took office in 2010 (RCN, 2015). With about 70% of NHS provider costs attributed to staffing, frontline staff would necessarily take a direct hit. However, with various interpretations on the numbers, the picture is complex, and it is important to interrogate the figures and consider the impact The Government claimed that we have ‘more nurses than ever before’ (RCN, 2015). What has been interesting is that the publication of the second Francis Report (2013) halfway through the coalition’s term of office seems to have had a significant impact on staffing levels. Between 2010 and 2012, staff numbers dropped dramatically and from 2013 they began to rise again, particularly in the acute sector—the so-called ‘Francis effect’ (RCN, 2015). However, there were losses of qualified nurses in the community, in mental health and in learning-disabilities nursing; a rise of 33% in healthcare assistants (HCAs); a significant rise in the number of overseas recruitment; and a 150% increase in the spend of agency nurses, presenting an extremely volatile nursing workforce (RCN, 2015). Education matters. In their observational study of nine European countries, Aitken et al (2014) found a significant impact of qualified nurses’ educational level and workload on the quality of care. An increase in a nurses’ workload by one patient increased the chance of a hospitalised patient dying within 30 days of admission by 7%. They also found that an increase in nurses holding a bachelor’s degree is associated with Elizabeth Rosser

Highlights from the British Society for Heart Failure 17th annual autumn meeting: "yesterday's problems, today's solutions".

The 17th Annual Autumn meeting of the British Society of Heart Failure entitled "Yesterday's problems, today's solutions" took place on the 27-28 November 2014 at the Queen Elizabeth II Conference Centre in London. Over 700 delegates joined together from across the UK, Europe and as far away as Australia to attend this year's meeting. Professionals from a range of backgrounds including physicians, surgeons, nurses, psychologists, pharmacists and trainees highlighted the multidisciplinary nature of heart failure care. The symposium, which is accredited by the Royal College of Physicians and the Royal College of Nursing, delivered the key message this year of the importance of a holistic approach to patients with heart failure.

International Nurses Day: national and international perspectives.

© 2 01 5 M A H ea lth ca re L td On May 12 each year, nurses around the world commemorate Florence Nightingale’s birthday by celebrating International Nurses Day (IND). Nurses are the largest group of health professionals globally and indeed sometimes the only healthcare worker available to large populations in poorer, developing countries (International Council of Nurses (ICN), 2015). As such they significantly impact on healthcare worldwide. IND provides an opportunity for the global community of nurses to reflect on the influence of nursing, share expertise and inform future development to improve health outcomes at an international level. IND is an initiative that has been led by the ICN since 1965. The ICN is a federation of national nursing associations from across the world, representing over 130 countries. Somewhat controversially the UK is no longer represented since the Royal College of Nursing (RCN) opted to withdraw in 2013, mainly because of rising membership costs (Salvage et al, 2013). Jane Salvage and other very eminent UK nurse leaders argued vehemently against this action, given that the ICN represents millions of nurses and therefore is uniquely placed to discuss global healthcare issues and related nursing trends. While at the time there was limited opposition to withdrawal from RCN members, Salvage et al (2013) argued that this was in large part because of ignorance about the role of the ICN. Most health problems, for example, do not respect frontiers; Salvage et al (2013) contended therefore that such issues could only be effectively addressed by working collectively with our international colleagues. Despite the irony that the birthplace of Florence Nightingale is no longer represented at the ICN, this does not prevent UK nurses from celebrating IND. Indeed, following recent criticisms of health care and nursing in particular, in contrast IND has provided an opportunity to showcase excellence in nursing practice across the UK (NHS Careers, 2013). Notwithstanding the RCN withdrawal from the ICN, the organisation has remained in the forefront of the UK celebrations on its webpages (RCN, 2015) where it captures inspirational Janet Scammell

Incorporating the Principles of Nursing Practice and the 6Cs.

This article will demonstrate how the Royal College of Nursing's (RCN's) Principles of Nursing Practice (2010) and the 6Cs (Cummings and Bennett, 2012a ; 2012b) can be applied to stoma care nursing. The multidimensional role of the stoma care nurse means that he or she is well placed to improve quality and standards in stoma nursing care. Stoma care nurses provide direct patient care and can play a vital part in helping patients with a stoma, a long-term condition, ensuring that their patients get the best possible care (RCN, 2010). The poster contained within this article was displayed at the Association of Stoma Care Nurses (ASCN) national conference in Harrogate in October 2014 and was voted the overall winner. The authors of the article and the poster are stoma care nurses working in the acute and community settings and, between 2013 and 2014, they completed the RCN's Clinical Leadership Programme (RCN, 2005). The NHS Plan (Department of Health, 2000) identified the importance of leadership and the necessity of remodelling the NHS around the needs of service users. With this in mind, using the Principles of Nursing Practice and the 6Cs within stoma care demonstrates development with a consistent focus on patient care.