SciCombinator

Discover the most talked about and latest scientific content & concepts.

Concept: District nurse

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There are over 400 000 cataract operations now being performed annually in the UK. With the majority of those patients being older people, comorbidities such as dementia or arthritis can prevent patients putting in their own post-operative eye drops. Where there is a lack of family or other support, district nursing services are often called upon to administer these eye drops, which are typically prescribed four times a day for 4 weeks, thus potentially totalling 112 visits for drop instillation per patient. To reduce the burden of these post-operative eye drops on district nursing services, administration of an intra-operative sub-Tenon’s depot steroid injection is possible for cataract patients who then do not require any post-operative drop instillation. As a trial of this practice, 16 such patients were injected in one year, thus providing a reduction of 1792 in the number of visits requested. Taking an estimated cost of each district nurse visit of £38, this shift in practice potentially saved more than £68 000; the additional cost of the injection over the cost of eye drops was just £8.80 for the year. This practice presents an opportunity to protect valuable community nursing resources, but advocacy for change in practice would be needed with secondary care, or via commissioners.

Concepts: Patient, United Kingdom, Nursing specialties, District nurse

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Your story about district nurse numbers falling in more than half of trusts comes as no surprise (news, 23 November). The shortage in community staff nurses makes caseloads impossible to manage safely.

Concepts: Nursing, Nurse, Nurses, Florence Nightingale, Nursing specialties, Nurse uniform, Nursing in the United Kingdom, District nurse

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Choices in care during the end stages of life are limited by the lack of resources and access for rural people. Nursing advocacy based on the holistic understanding of people and their rural communities may increase the opportunity for choice and improve the quality of care for people living and dying at home. Pragmatism and nurse agency theory were used for a practical exploration of how district nurses successfully advocate for rural Australian end-of-life goals to begin the development of a practice model. In two stages of data collection, rural district nurse informants (N = 7) were given the opportunity to reflect on successful advocacy and to write about their experiences before undertaking further in-depth exploration in interviews. They defined successful advocacy as “caring” that empowers people in the “big and small” personal goals important for quality of life. The concepts described that enable successful advocacy were organized into a network with three main themes of “willing” investment in holistic person-centered care, “knowing” people and resources, and feeling “supported.” The thematic network description provides deep insight into the emotional skill and moral agency involved in successful end-of-life nurse advocacy and can be used as a sound basis for modeling and testing in future research.

Concepts: Life, Nursing, National Health Service, Nurse, Nurses, Nursing specialties, Liverpool, District nurse

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Just five new district nurses were trained for the whole population of London in 2013. This startling fact was the catalyst for the annual audit of district nursing programmes now undertaken by the Queen’s Nursing Institute (QNI) across the UK.

Concepts: United Kingdom, Nursing, Nurse, London, Nursing specialties, Liverpool, District nurse

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The Nursing and Midwifery Council, the statutory professional regulator for registered district nurses, has introduced a revised code of standards that came into effect on 31 March 2015. The Code makes clear that while district nurses can interpret the values and principles for use in community settings, the standards are not negotiable or discretionary. They must be applied, otherwise the district nurse’s fitness to practice will be called into question. In the second of a series of articles analysing the legal implications of the Code on district nurse practice, the author considers the first standard, which requires district nurses to treat people as individuals and to uphold their dignity.

Concepts: Law, Nursing, Standard, Nurse, Nurses, Florence Nightingale, Nursing specialties, District nurse

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The revised Code of the Nursing and Midwifery Council (NMC), the statutory professional regulator for registered district nurses, makes clear that while district nurses can interpret the values and principles for use in community settings, the standards are not negotiable or discretionary. They must be applied or the district nurse’s fitness to practice will be called into question. In this article in the continuing series analysing the legal implications of the Code on district nurse practice, the author considers the fourth standard that requires district nurses to act in the best interests of people at all times.

Concepts: Law, Nursing, Nurse, Nurses, Florence Nightingale, Nursing specialties, Nurse uniform, District nurse

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As changes in society and health provision mean that one in four people over the age of 75 will require nursing care at home, pre-registration adult nurse education increasingly prepares student nurses for a future career within the community. District nurses undertake complex, multidimensional health and social assessments and care in a non-clinical setting and work in partnership with patients and their significant others to promote practical and psychological coping mechanisms and self-care. The district nurse’s first assessment visit is key to developing a therapeutic partnership and it is often during this visit that expertise in district nursing practice emerges. The holistic, contextual and dynamic aspects of nursing in the home setting can make district nursing expertise difficult to illustrate and demonstrate within the classroom setting. This article explores the ways in which an understanding of expertise development theory can enable the tacit expertise that occurs within the first assessment visit to be made visible to student nurses, using simulation and expert narrative as a pedagogical strategy.

Concepts: Educational psychology, Nursing, Nurse, Nursing specialties, Liverpool, District nurse

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The Queen’s Nursing Institute’s audit of district nurse education for this year shows a 38 per cent increase in the number of district nurses due to qualify this summer compared to 2013.

Concepts: Nursing, Nurse, Nursing specialties, Liverpool, District nurse

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The shortage of district nurses in England is such that the profession is ‘critically endangered’ and faces extinction by 2025, the RCN predicts.

Concepts: Endangered species, Nursing, Nurse, Nursing specialties, Liverpool, District nurse

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District nursing as a profession has been under significant threat over the last few years due to a lack of foresight and funding, resulting in an undervalued and underinvested workforce. The once-heralded specialist practitioner programme was slowly decommissioned in all but a handful of universities, leaving no alternative but for community trusts to employ staff nurses in team leader roles without the development the added qualification gave them. In light of the renewed focus on the fundamental advancement of district nurses and recent Government publications clearly reinforcing the district nurse’s role, this article argues for the need for educational commissioners and workforce planners to commit to continued investment in this vital profession.

Concepts: Nursing, National Health Service, Nurse, Nurses, Florence Nightingale, Nursing specialties, Liverpool, District nurse