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Putting it into practice

All posts from: November 2012

How can nurses reduce pre-operative anxiety?

26 November, 2012 Posted by: -

Article: Mitchell M (2012) Anxiety management in minimal stay surgery. Nursing Times; 108: 48, 14-16.

5 key points

  1. Pre-operative anxiety before general anaesthesia is common
  2. A planned programme of information provision before minimal-stay surgery is vital
  3. Offering choices (real or perceived) and positive encouragement will benefit patients
  4. Therapeutic use of the self by nurses in brief exchanges with patients can help to promote a therapeutic environment
  5. Minimising the impact of the environment can dispel anxiety

Let’s discuss

  1. How has the move to day case surgery changed the relationship between nurses and patients?
  2. List the common causes of anxiety for patients having a general anaesthetic.
  3. What specific concerns are identified by patients having local or regional anaesthesia?
  4. How can nurses help patients retain control during a day case procedure?
  5. How can nurses reduce pre-operative anxiety? Are there gender differences in the way men and women manage their anxiety?
  6. What role does the environment play in reducing anxiety?

Comments (4)

What role should nurses have in mobilising and positioning patients after a stroke?

19 November, 2012 Posted by: -

Article: Keating M et al (2012) Positioning and early mobilisation in stroke. Nursing Times; 108: 47, 16-18.



  1. NICE guidance recommends early mobilisation and optimum positioning of people with acute stroke
  2. Early mobilisation and good positioning can help patients regain function and reduce complications
  3. Nurses have a vital role in early mobilisation as they are present 24 hours a day
  4. Patients benefit if nurses share working practices with the rest of the stroke unit team
  5. Specialist equipment should be used in collaboration with the therapy team



  1. How many deaths in the first 30 days post-stroke are due to immobility?
  2. List the complications of immobility following a stroke.
  3. How soon can patients mobilise after a stroke?
  4. What role should nurses have in mobilising and positioning patients after a stroke? What education and training is recommended for nurses?
  5. What are the key components of an individualised management plan?

Comments (3)

What are the advantages of using inhaled drugs to treat asthma in children?

12 November, 2012 Posted by: -

Key points

  1. One dose of inhaled medication contains 40 times less medication than a 4mg tablet of salbutamol, yet delivers the same benefits, when taken properly
  2. At least 50% of pMDI users have less than optimal technique and could benefit from using a spacer
  3. Younger children or those with poor dexterity are often unable to coordinate inhalation with activation of a pMDI and benefit from using a spacer
  4. Spacers should be cleaned regularly to avoid contamination with pathogens such as pseudomonas, klebsiella and staphylococcus
  5. Correct inhaler technique could reduce hospital admissions making considerable savings for the NHS


Let’s discuss

What difficulties do children have using pressurised metered dose inhalers?

When would you suggest using a spacer device to deliver inhaled drugs?

Why does static electricity accumulates on many polycarbonate and plastic spacers and what effect does it have on effectiveness of drug delivery? How can this problem be reduced?  

What advice would you give children and parents about care of their spacer device?

You can email questions to or tweet @eileenshepherd

How do you treat a soft tissue injury?

5 November, 2012 Posted by: -

  • Article: Williams K (2012) Evidence on NSAID use in soft tissue injuries.Nursing Times; 108: 45, 12-14.

Key points

  • Ankle sprains account for up to 10% of attendances at emergency departments
  • Rest, ice, compression and elevation (RICE) is the cornerstone of treatment of soft tissue injuries
  • For those requiring pain relief, paracetamol should be used as a first step
  • NSAID use may impede the inflammatory phase of healing
  • Gastro-intestinal symptoms are experienced by 10%-30% of people using NSAIDs

Let’s discuss

  • How do you treat a soft tissue injury? What advice would you give a patient presenting with a sprained ankle?
  • What analgesia would you recommend for pain?
  • After reading this article summarise the arguments against using non-steroidal anti-inflammatory drugs (NSAID) to treat soft tissue injury?
  • What drugs could you recommend as an alternative to NSAID?

You can email questions to or tweet @eileenshepherd

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