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Behind the Rituals

All posts from: May 2012

Why do we under-treat pain caused by advanced disease?

28 May, 2012 Posted by: -

Why do we under-treat pain caused by advanced disease?

The National Institute for Health and Clinical Excellence has published a clinical guideline on prescribing opioids to relieve pain for patients receiving palliative care for chronic or incurable illnesses.

NICE said evidence suggested pain caused by advanced disease remains under-treated, with many patients worried about the long-term use of opioids, their side-effects and the possibility of becoming addicted.

Nurses should discuss concerns about addiction with patients who are being treated with strong opioids for pain relief when nearing the end of life, according to latest guidance.


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Why are medicine administration error rates higher in patients with dysphagia?

21 May, 2012 Posted by: -

Why are medicine administration error rates higher in patients with dysphagia?

A study, summarised in Nursing Times this week, identified a marked rise in the risk of medicines administration errors in patients with dysphagia compared to those without the condition. A further increase was noted when patients with an enteral tube. The study found the main causes of error was the wrong formulation and incorrect preparation of medicines.

A second paper describes the evaluation of an individualised medication administration guides for people with dysphagia. The results suggest that nursing practice could be enhanced by easy access to medicines information.

An article on the administration of medicines via an enteral feeding tube provides useful tips on safe practice.

We are discussing this issue in more detail in Putting it into Practice and on the Student Nursing Times section, Perfecting your Practice.

Is it derogatory to refer to overweight patients as obese?

14 May, 2012 Posted by: -

Is it derogatory to refer to overweight patients as obese?

Telling overweight patients they are obese could be seen as “derogatory”, a health watchdog has warned.

Public health workers have been told that patients may respond better if they are encouraged to achieve a “healthier weight” rather than being labelled obese, under draft guidance issued by the National Institute for Health and Clinical Excellence (NICE).

The advice is included in NICE’s paper entitled Obesity: Working with Local Communities and urges health professionals to use “appropriate language” to help obese patients.

It said: “The term ‘obesity’ may be unhelpful - while some people may like to ‘hear it like it is’, others may consider it derogatory.”

It continued: “Directors of public health and local government communications leads should carefully consider the type of language and media to use to communicate about obesity.

“For example, it might be better to refer to a ‘healthier weight’ rather than ‘obesity’ - and to talk more generally about health and wellbeing or specific community issues.”

Tam Fry, of the National Obesity Forum, told the Daily Telegraph: “There should be no problem with using the proper terminology. If you beat around the bush then you muddy the water.”

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Is older people's nursing a specialism?

7 May, 2012 Posted by: -

Is older people’s nursing a specialism? What do you think?

Nurses who work predominantly with older patients are still not seen as specialists, despite the increasingly complex nature of care in this area, according to a study on international nursing opinion.

Angela Kydd, a senior lecturer at the University of the West of Scotland, highlighted that historically working with older people was viewed as a “menial job”.

Her study set out to explore modern attitudes to caring for older people across Scotland and five other countries: the US, Slovenia, Germany, Sweden and Japan.

Nurses and healthcare assistants, including those that worked predominantly with older patients, were asked to complete a 20 question survey. In total 4,791 responses were analysed.

Dr Kydd said: “The results showed that although health care professionals and assistants in America reported a sense of professional esteem, the majority of the respondents in the five remaining countries did not.”

She said a “large number” of respondents stated that other people did not view those working with older people as specialists.

“It would appear that working with older people is still viewed as a job and not as a specialism,” she said. “Further studies are needed to explore methods necessary to improve the image of those who work with older people.”

The findings were presented on Tuesday at the Royal College of Nursing’s international research conference in London.

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