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Practice team blog

All posts from: October 2012

Making informed choices on healthy eating

26 October, 2012 Posted by: -

Levels of obesity in the UK are rising at alarming rates in all age groups, and its knock-on effects will be seen in terms of ill health for the individuals concerned and costs to health and social care providers. High fat and sugar intakes are also contributing to rising incidence of other long-term conditions such as heart disease and diabetes.

As the health professionals with the most patient contact, nurses in all settings are justifiably encouraged to offer healthy eating advice. But much of this advice is really only relevant to those who only ever buy and cook fresh ingredients. Processed foods and ready meals often sound healthy, but all too often when you read the label they are anything but - and in many cases making sense of the label requires a PhD in food science.

Like most people, even if I recognised all the obscure ingredients, I don’t have the time to read them. And those of us with failing eyesight can’t see the tiny print to check the calorie counts and percentages of recommended daily allowance.

Call me a cynic, but the only reason I can see for supermarkets and food manufacturers having dragged their feet on this issue is that they don’t want people to know what they are eating.

Of course a simple visual system can’t include all ingredients, but it can give shoppers information on the key dietary issues such as fat, sugar and salt content, and will make it far easier to offer clear and pragmatic advice on food selection. Nurses are ideally placed to offer health promotion advice, but if it is to be effective it needs to be achievable. Hopefully the new labelling system will give them a helping hand rather than acting as a barrier to shoppers making informed choices on healthy eating.

Comments (10)

Have you ever made a drug error?

19 October, 2012 Posted by: -

The dose was ten times larger than had been prescribed and the baby died. A registrar had prescribed 5ml of sodium chloride but the baby was wrongly given 50ml.

This case is a timely reminder of how mistakes can occur with sometimes devastating consequences.

Clear policies and procedures govern the administration of drugs yet nurses - like other health professionals who prescribe and administer medicines - sometimes do make errors, and near misses. These occur for lots of reasons; nurses are rushing, they get distracted, don’t check name bands, they fail to sign prescriptions or look up a drug in the BNF if they haven’t given it before. Ultimately they occur because health professionals are human beings, and human beings make mistakes from time to time. However, while mistakes will never be completely eradicated, practitioners must do what they can to minimize the risk.

The most frequently cited reason for giving the wrong dose of a drug is calculation error.

Nurses must be numerate to administer drugs safely. They have to be able to calculate doses and with increasingly complex drug regimens they need to be confident that their calculations are accurate.

Anyone administering medicines needs to be regularly reminded of what constitutes safe and effective practice but this is easy to say, less easy to make a reality when staffing is at a premium and opportunities for study leave is limited.

Nursing Times Learning has recognised these challenges and has launched an online unit on Drug Calculations in Practice. After studying it you will be able to:

  • Explain different units of measurements used for medicine dosages
  • Calculate dosages for medicines in tablet and capsule form
  • Calculate dosages for medicines for the weight of a patient
  • Calculate dosages for medicines in suspension or solution.
  • Calculate the administration rate for continuous IV infusions of medicines and fluids
  • Recognise incorrect dosages of medicines and know how to ensure patient safety

On 26 October at 4pm we are hosting a FREE clinical chat with the author of the learning unit, Kerri Wright, senior lecturer at University of Greenwich and author of Drug Calculations for Nurses, published by Palgrave. She will be joined by Philip Marini, retired headmaster and Ofsted registered inspector who worked for Brighton and Sussex University Hospital Trust and Western Sussex Hospitals NHS Trust, providing drug administration numeracy materials for newly appointed nurses and healthcare assistants.

If you aren’t able to take part in the webchat you can email questions to eileen.shepherd@emap.com or tweet them to @eileenshepherd then read the transcript later, but we hope as many of you as possible will join in to discuss this important issue.

Visit our Medicines Management page.

Participating in NT Clinical Chats can contribute to you CPD. How to get the most out of Clinical Chats:

  • Look at the topic in advance of the chat and plan questions you would like to ask
  • Participate in the chat by posting questions or comments
  • Download the transcript after the chat as evidence of your participation. This will be available here after the webchat.

Write a reflection on what you have learned and how you could use this information in clinical practice, to store in your portfolio.

Comments (4)

Is resilience more useful in healthcare than wellbeing?

10 October, 2012 Posted by: -

I have been hearing the term resilience used more and more in healthcare and have thinking that it works well in the place of the term wellbeing which is now so over used it is almost without meaning. 

Resilience is defined at the ability of a material to return to its original shape or form after being bent, stretched or compressed. In human terms it is about how people can cope with and recover from their experiences which can include illness, stress, emotional trauma, and social and cultural deprivation.

So if people’s resilience is high then their ability to cope and manage with whatever life offers them will be heightened. Resilience is the ability to bounce back.

Often nurses are caring for people with long-term conditions so an individual’s resilience or bounce back will help them to find their way and make best use of their resources. Considering someone’s resilience will give you an idea of how they will cope in the future.

Well-being can be  defined as a state of health, happiness and prosperity. In the current recession this seems less appropriate and for those with long-term conditions it seems too lightweight and fluffy. Wellbeing feels more like something that you have inherently whereas the positive about resilience is that it can be developed and nutured by a caring environment and the support of those around which makes it relevant to nursing.

Comments (4)

Are you up to date with bowel management?

3 October, 2012 Posted by: -

Bowel care is part and parcel of nurses work and it is worth reading this personal reflection to get a sense of how long term problems effect relationships, work and self esteem.

The author describes her experience of living with faecal incontinence, “I discussed how the worst experience for me was the loss of the physical side of our marriage. I learnt that many of the women were experiencing the same feelings or, even worse, it had resulted in divorce”.

This is a stark reminder of why careful and sensitive bowel assessment is an essential part of patient care. Nurses have an important role in identifying and assessing abnormal bowel function, exploring its impact on daily life as well as educating patients about managing their symptoms.

One of the most common gastro intestinal disorders encountered in clinical practice is constipation. It affects around 20% of people living in the community yet many people live with it for years before asking for help.

When patients get the courage to tell you about the problem is you knowledge up to date?

How would you assess a patient with constipation?

What laxative regime should beprescribed?

What advise should you give patients about fibre?

When should you use suppositories or enemas?

What training is required to do a digital rectal examination?

How should you treat constipation in people with spinal injuries?

If you sometimes feel uncertain when faced with a patient with constipation and have a question join our constipation clinical chat on 9th October at 1pm with clinical experts Wendy Ness, colorectal nurse specialist at Croydon University Hospital and Debra Ollerhead, continence lead at NHS Wirral Community Trust.

You can email questions to Eileen.shepherd@emap.com or tweet @eileenshepherd

You can learn more about constipation by taking part in our online learning unit: Advances in treatment of constipation.

Participating in NT Clinical Chats can contribute to you CPD. How to get the most out of Clinical Chats:

  • Look at the topic in advance of the chat and plan questions you would like to ask
  • Participate in the chat by posting questions or comments
  • Download the transcript after the chat as evidence of your participation. This will be available hereafter the webchat
  • Write a reflection on what you have learned and how you could use this information in clinical practice, to store in your portfolio.

 

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