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Living with paediatric chronic illness: What are the developmental challenges?

12 Feb, 17 | by atwycross

 

Abbie Jordan (@drabbiejordan), University of Bath and Line Caes (@LineCaes5), University of Stirling will be leading this week’s EBN Twitter Chat (#ebnjc) on Wednesday 15th February between 8-9pm UK time focusing on the developmental challenges of living with a paediatric chronic illness.

 

 

 

Participating in the Twitter Chat requires a Twitter account; if you do not already have one you can create an account at www.twitter.com. Once you have an account contributing is straightforward:

  • Go to your Twitter account
  • Follow the discussion by searching for #ebnjc once linked to the discussion, click “all tweets” to keep up-to-date with recent tweets
  • Add the EBN chat hash tag (#ebnjc) to your tweets to join in, this allows everyone taking part to view your contribution

Chronic illness in childhood is common, with figures estimating as many as one in four families in the US reporting caring for a child or adolescent with an ongoing health condition (Compas et al., 2012).  As noted by Christie and Katun (2012), receiving a diagnosis of a chronic condition marks the start of a long and challenging journey for children and their families. This journey may change along the way as children grow up and develop new skills. To explore this, research has focused on exploring what it is actually like for children and their families to live and grow up with a chronic condition (Compas et al., 2012; Palermo et al., 2014).  In addition to the challenges associated with managing a chronic illness (e.g. repeated hospital appointments, daily treatment requirements), a substantial number of children who live with a chronic illness experience emotional and social difficulties. Not only the child, but their entire family is affected, with some parents and siblings reporting emotional distress and poor relationship functioning (Knecht et al., 2015; Palermo and Eccleston, 2009).

more…

Nursing attitudes to deliberate self-harm

6 Feb, 17 | by hnoble

Clare Carswell, Undergraduate mental health nursing student  & Dr Helen Noble, Lecturer, Queens University Belfast

Deliberate self-harm is a term that can be used to describe a variety of behaviours that involve an individual inflicting some form of physical harm to their own body. It is most typically associated with self-inflicted lacerations and self-poisoning. Self-harm is a growing issue, with an increase in the incidence within Britain and worldwide. A longitudinal examination of presentations to Irish hospitals for self-harm found an increase of 2-6% per year between 2006 and 2009 [See Perry et al 2012 http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0031663]. The most recent report by the Royal College of Psychiatrists (2010) also noted that self-harm is one of the five top causes of hospital admissions, although this report is due for review. http://www.rcpsych.ac.uk/pdf/position%20statement%204%20website.pdf

A number of studies suggest that only 10-20% of people who self-harm present to hospital or seek treatment and as the incidence of self-harm is typically measured by the number of people who present to hospital the scope of the issue could be vastly underestimated. While the increase in rate of self-harm globally, coupled with the existing high incidence, is valid justification for developing an understanding for practice in this area; another rationale for exploring the topic is the link between self-harm and suicide. Self-harm has been shown to be the most important factor when assessing risk of suicide meaning that appropriate early intervention is essential. Mental health trained practitioners are the professionals typically associated with providing comprehensive assessment and interventions, however the vast majority of individuals who self-harm will make first contact with emergency department personnel. It is crucial that the practice of emergency department nurses is compassionate, empathetic and effective in assessing and treating these patients, especially due to the associated risk of repeat episodes of self-harm and suicide following an initial presentation.

Attitudes can have a significant effect on behaviour meaning that the attitudes nurses hold can have an impact on their nursing practice. Patients who self-harm report high levels of stigma and negative attitudes, stating that they have been called ‘attention seeking’ or ‘manipulative’ as a result of the self-injurious behaviour. The text Blades, Blood and Bandages tells the stories of 25 people’s experiences of self-injury and investigates how those who self-injure are ‘affected by suffering, ritual and stigma’ http://www.palgrave.com/br/book/9780230252813

These negative attitudes and beliefs have originated from not only their friends and family, but also from medical professionals and emergency department personnel following presentation for their injuries. These attitudes can be interpreted through the professional’s behaviour and can have a profound effect on the patient. They can determine whether the patient decides to stay in the hospital for assessment, treatment or referral and whether they are instilled with a sense of hope and validation which in turn can help reduce the risk of further incidents of self-harm and even suicide. Attitudes can also have a more direct impact on nursing practice, for example nurses may feel unequipped or unprepared to perform a comprehensive assessment or to refer on to specialist mental health services. Referral to services can be problematic with this patient group. An understanding of the attitudes held by emergency department nurses may be able to inform areas for improvement in the education and practice of general nurses. One potential area for improvement could be a need for further education or training on the subject of self-harm, as an increased knowledge of self-harm has been shown to improve attitudes towards this patient group. Another area for improvement may be in the practice of emergency department nurses and improved access to mental health services, either through a mental health liaison nurse, a crisis intervention team or an unscheduled care team. More collaborative working between emergency departments and acute or community mental health services, and the opening of the lines of communication between services, may also be an appropriate change to practice. NICE Guidelines (2004) on self-harm recommend that emergency department services and mental health services should play a joint role in developing training on the treatment, assessment and management of self-harm. Emergency department nurses may feel that they do not have the resources, the capabilities, the appropriate skill set or be in the correct setting to adequately address the needs of the patient group meaning that involvement of mental health nurses could be crucial to improving the service provision for individuals who self-harm.

 

 

 

The power of reflection in nursing

30 Jan, 17 | by dibarrett

Lizzie Ette. Lecturer in Nursing, The University of Hull

This week’s EBN Twitter Chat is on Wednesday 1st February between 8-9 pm (UK time).

The chat will be led by Lizzie Ette (j.ette@hull.ac.uk ), Lecturer in Pre-registration Nursing, The University of Hull.

Participating in the Twitter chat requires a Twitter account; if you do not have one you can create an account at www.twitter.com. Once you have an account, contributing is straightforward. You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ adding #ebnjc (the EBN Twitter chat hash tag) to your tweet, this allows everyone taking part to view your tweets

The power of reflection in nursing

As is so often the case, professional and personal lives are intricately related, and the recent experience of losing our family cat Reggie, following a road traffic accident at Christmas, really got me to reconsider the power of reflection on a personal level, and this got me thinking deeply about how important reflection is in my professional capacity, as a nurse.

  Reggie: 2000-2017

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Turning Japanese – the global inequalities of ageing

22 Jan, 17 | by josmith

Dr Fiona McGowan, School of Health Care Studies, Hanze University of Applied Sciences, Eyssoniusplein Netherlands f.e.mcgowan@pl.hanze.nl

We are all very much aware of how societies are ageing and this ‘demographic transition ‘ is widely recognised as a global phenomenon. How this shift in population composition impacts health and illness is not so conclusive. While trends have emerged indicating the rise in non-communicable diseases such as heart disease, cancer and diabetes, global patterns of health problems also reflect disparities between and within countries. Different ‘ peoples’ experience ageing in different ways and these are not equal.

WHO (World Health Report 2013) showed that health inequalities remain ingrained globally and reflect disparities marked by sex, age, socio economic status, education, place and other more specific factors including migrant status, race, ethnicity and religion. Mortality data shows that in high-income countries, 7 in every 10 deaths are among people aged 70 years and older. People predominantly die of chronic diseases. Only 1 in every 100 deaths is among children under 15 years. In low-income countries, nearly 4 in every 10 deaths are among children under 15 years, and only 2 in every 10 deaths are among people aged 70 years and older. People predominantly die of infectious diseases and complications of childbirth. (World Health Statistics 2015). These facts illustrate the contrast between what an ageing society looks like in a developed, high-income country and in a low income, developing country (a further example being expected years of retirement which is 24 years in France but only 9 years in Mexico – both countries have retirement age at 65) This also highlights how our knowledge and understanding of ageing societies has been shaped by inequality. The focus remains on how westernised societies experience ageing. The social constructionist approach to ageing largely applies to societies in which people are living longer and sufficiently long enough to experience what Laslett (1996) has defined as a ‘Third Age’. A period post retirement, conceptualised as ‘the crown of life’, a time of self- fulfilment and achievement(Jones et al. 2008).

More recent theorising in the field of social gerontology, categorises the third age and later life as a ‘new cultural and social field’ particular to Westernised consumer society marked by sustaining a youthful appearance, and a ‘performing fit, healthy and sexualised lifestyle’ is maintained (Gilleard & Higgs, 2005). While this presents a more positive approach to ageing – in contrast to dependency and disengagement theories – again the focus is on a specific demographic cohort and this ‘generational field’ is not globally situated. Whether a ‘later life’ is experienced mirrors the accumulative process of ageing and the extent to which illness and disability are suffered. While the worldwide ‘epidemiologic shift’ that has accompanied socioeconomic development is reflected in both individual and population health, inequality remains as a powerful determining force. Global health then is dependent on the global context – environmental, economic, political and social. How a society ages is similarly shaped. As Michael Marmot writes in The Health Gap, “ Societies have cultures, values and economic arrangements that set the context through the life course that influence health” (2015, p259). This is clearly supported by Life expectancy indicators (OECD 2016) which show, for example, Nigeria – 54.5 years, Japan – 83 years.

References

Gilleard, C. & Higgs, P. ( 2005) Contexts of Ageing: Class, Cohort and Community. Polity Press. Cambridge.

Jones, I. , Hyde, M. , Victor, C., Wiggins, R. , Gilleard, C. and Higgs, P (2008) Ageing in a Consumer Society: From passive to active consumption in Britain. The Policy Press. Bristol.

Laslett, P. (1996) A Fresh Map of Life: The Emergence of the Third Age ( 2nd ed). Palgrave MacMillan.

Marmot, M. (2015) The Health Gap: The Challenge of an Unequal World. Bloomsbury. London.

Organisation for Economic Co-operation and Development (OECD) (2016) OECD Data: Life Expectancy at Birth. https://data.oecd.org/healthstat/life-expectancy-at-birth.htm Accessed 2nd July 2016.

World Health Organisation (WHO) National Institute on Aging (2011) Global Health and Aging. http://www.who.int/ageing/publications/global_health.pdf?ua=1 Accessed 1st July 2016.

World Health Organisation (WHO) World Health Report 2013. Research for universal health coverage. http://www.who.int/whr/en/ Accessed 2nd July 2016.

World Health Organisation (WHO) (2015) Global Health Observatory (GHO) Data

World Health Statisitics 2015. http://www.who.int/gho/publications/world_health_statistics/2015/en/ Accessed 1st July 2016.

 

Using Technology to Support Learning – confident, terrified or indifferent?

15 Jan, 17 | by josmith

 

This week’s EBN Twitter Chat on Wednesday 18th January between 8-9 pm (UK time) will be lead by Kirsten Huby, Lecturer in Children’s Nursing, University of Leeds, @KirstenHuby focussing on learning technologies. Participating in the Twitter chat requires a Twitter account; if you do not have one you can create an account at www.twitter.com. Once you have an account, contributing is straightforward. You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ adding #ebnjc (the EBN Twitter chat hash tag) to your tweet, this allows everyone taking part to view your tweets.

We are surrounded by technology that assists us in every aspect of our life and education is no exception. It has never been easier to access information and learning resources on an almost infinite number of topics. We can collaborate and attend conferences in virtual spaces and share ideas in real time or whenever we have a minute spare! Our learning can incorporate teacher-led instruction, be led by our own interest and desire to learn or a combination; what is becoming apparent is that social learning in digital forums is enhancing learning by bringing interested parties together (Simon Nelson 2017). As health professionals continually learning and demonstrating how this learning has occurred in the digital world is opening doors and making digital learning easier. Whilst digital learning enables us to be flexible in our learning it also requires a degree of digital literacy. This has been defined by the European commission (2010) as “the confident critical use of ICT for work, leisure, learning and communication”. Digital literacy is a wider concept than just being able to use specific tools it also encompasses the ability to find, manage and evaluate the information that is available and understand how data is stored and shared in order to remain safe in virtual spaces. Ultimately educational technology is there to help improve education and facilitate student learning (Forest, 2015), the educational goals should be identified first but we need to be able to engage with the technology if we are to enhance our learning.

Within the Twitter chat I would like to explore:

  1. What technologies you currently use to support your learning and how effective you think they are?
  2. The reasons why you would choose or not choose to learn using technology?
  3. The facilitators that help you to engage with learning using technology?
  4. The barriers you have encountered to engaging with learning using technology?
  5. And finally the one app, device or program that you wouldn’t want to be without!

For those that feel they would like to learn more about working and learning in digital ways FutureLearn (a digital platform that hosts courses produced by educational institutions, organisations and businesses) offer a number of free online courses to get you started. https://www.futurelearn.com/courses?utf8=%E2%9C%93&filter_category=online-and-digital&filter_availability=new-and-upcoming

European Commission, 2010. Digital Literacy European Commission Working Paper and Recommendations from Digital Literacy High-Level Expert Group. [online]. [Accessed 12 January 2017]. Available from: http://www.ifap.ru/library/book386.pdf

Forest, E., 2015. Educational technology: An Overview. 18 November. Educational technology [online]. [Accessed 12 January 2017]. Available from: http://educationaltechnology.net/educational-technology-an-overview/

Nelson, S. 2017. DigiFest Keynote – Simon Nelson, CEO, FutureLearn. Student Education Conference and Digital Festival, 5 January, Leeds.

Diaries for critical care patients

8 Jan, 17 | by josmith

Angela Teece (A.M.Teece@leeds.ac.uk)  Trainee Lecturer in Adult Nursing, University of LeedsAngela

Critical care is primarily concerned with curative interventions and the use of technology, and nursing and medical care to maintain life. Patients are frequently sedated for long periods of time that can causes memory loss and unusual perceptual experiences which can make it difficult for survivors to piece together the time they spent in critical care (Samuelson and Corrigan, 2009). The presence of delirium, which occurs in 35-80% of critical care patients (Collinsworth et al., 2016) further complicates recovery. The frequently nightmare dreams are more vivid than fragmented true recollections and can prevent patients developing an illness narrative and understanding the traumatic episode (Jones et al., 2001).

Critical care nurses have a duty to provide rehabilitative care (NICE, 2009). So how can nurses make a positive impact on their patients’ psychological recovery? Patient diaries are increasing in popularity in the UK after originating in Scandinavia. The subject of a recent Cochrane review (Ullman et al., 2015), the evidence base for diaries and guidance for those completing them remains scanty. However, the premise is simple and low cost. Nurses complete entries throughout the patient’s critical care admission, describing events and the environment in layman’s terms. The diary is given to the patient after discharge, often at a follow-up clinic where further support can be accessed. The aim is, simply, to fill in memory gaps and encourage discussion.

What do patients think of their diaries?

‘It was hard… to realise that it was actually about me, and that I could have died’ (Storli and Lind, 2009)diary

‘It is frustrating not to have all the information about one’s critical illness, and much energy is expended trying to piece information together’ (Engström et al., 2009)

‘It’s fantastic that you’ve gone to the trouble of doing this for me!’ (Storli and Lind, 2009)

Have you written in a patient diary?

Reading:

COLLINSWORTH, A. W., PRIEST, E. L., CAMPBELL, C. R., VASILEVSKIS, E. E. & MASICA, A. L. 2016. A Review of Multifaceted Care Approaches for the Prevention and Mitigation of Delirium in Intensive Care Units. J Intensive Care Med, 31, 127-41.

ENGSTRÖM, A., GRIP, K. & HAMRÉN, M. 2009. Experiences of intensive care unit diaries: ‘touching a tender wound’. Nursing in Critical Care, 14, 61-67.

JONES, C., GRIFFITHS, R. D., HUMPHRIS, G. & SKIRROW, P. M. 2001. Memory, delusions, and the development of acute posttraumatic stress disorder-related symptoms after intensive care. Critical Care Medicine, 29, 573-580 8p.

NICE 2009. Rehabilitation after critical illness. In: HEALTH, D. O. (ed.). London: Department of Health.

SAMUELSON, K. A. M. & CORRIGAN, I. 2009. A nurse-led intensive care after-care programme – development, experiences and preliminary evaluation. Nursing in Critical Care, 14, 254-263.

STORLI, S. L. & LIND, R. 2009. The meaning of follow-up in intensive care: patients’ perspective. Scandinavian Journal of Caring Sciences, 23, 45-56.

ULLMAN, A. J., AITKEN, L. M., RATTRAY, J., KENARDY, J., LE BROCQUE, R., MACGILLIVRAY, S. & HULL, A. M. 2015. Intensive care diaries to promote recovery for patients and families after critical illness: A Cochrane Systematic Review. International Journal of Nursing Studies, 52, 1243-1253.

‘Loosing the child’s voice’ and ‘the captive mother’- an inevitable legacy of family-centred care?

2 Jan, 17 | by josmith

This week’s EBN Twitter Chat on Wednesday 4th January between 8-9 pm (UK time) in conjunction with @WeCYPnurses will focus on child & family cunknown-3unknownentred care.

The chat wll be lead by Professor Linda Shields (@lshields50), Charles Stuart University, Australia; Professor Philip Darbyshire (@PDarbyshire), global healthcare consultant; Sarah Neil (@SarahNeill7) University of Northampton, UK; and Dr Joanna Smith
IMG_0206(@josmith175) theUniversity of Leeds, UK.unknown-2

Participating in the Twitter chat requires a Twitter account; if you do not have one you can create an account at www.twitter.com. Once you have an account, contributing is straightforward. You can follow the discussion by searching links to #ebnjc, or contribute by creating and sending a tweet (tweets are text messages limited to 140 characters) to @EBNursingBMJ adding #ebnjc (the EBN Twitter chat hash tag) to your tweet, this allows everyone taking part to view your tweets.

Professor Linda Shield’s recent publication (Shields Linda (2016) (Family-centred care: the ‘captive mother’ revisited, Journal of the Royal Society of Medicine; 109; 4: 137-140 (http://jrs.sagepub.com/content/109/4/137.full.pdf+html) revisited Roy Meadow’s acclaimed article ‘The captive mother’ (Arch Dis Child 1969; 44: 362–367), where he eloquently described the “captive mother” who was forced to accompany her school aged child to hospital when in reality they would spend little time together. Family-centered care has evolved since that time is espoused as the dominant philosophy underpinning care in children’s hospitals around the world. We postulate that that although family-centered care is embedded within most health services policies for children, it is largely untested. Evidence suggests problems with the implementation of family-centred care, with some parents feeling resentful that they have to undertake some of their child’s care. We postulate that Meadow may have been right & that expecting a mother (or other carer) should stay with a hospitalized school aged child, we are not operating within the ethos of family-centred care, potentially compromising the care given.

screen-shot-2016-12-10-at-16-56-52

 

The article is already generating debate: with suggestions that concepts such as the ‘captive patient’ and ‘family-centred care’ are no longer relevant in today’s world of personalised care and offering care delivery choices (http://jrs.sagepub.com/content/109/11/408.1.full). The child must be treated as an individual, with rights & choices having a voice in their cared.

This Twitter chat provides a chance for nurses to discuss their experiences of working with children & families, & identify some of the common challenges of embedding child & family-centred care into practice such as:

  1. Is family-centred care relevant within contemporary healthcare contexts?
  2. Does family-centred care marginalise the voice of the child?
  3. Given that evidence of its effectiveness is not available, is it ethical to continue pushing for family-centred care?

2016 @ EBN

25 Dec, 16 | by josmith

The holiday season is well underway & here at Evidence Based Nursing (EBN) we recognise that may nurses will be working to provide care & support to people with health issues over the festive period, but hope that for many you are all having a well deserved break. This year, as in previous years, the challenges facing nursing & healthcare have often dominated the news. The weekly EBN blog has enabled the editorial team & our guest bloggers to raise a range of issue relevant to contemporary nursing practice, often responding quickly to current policy and health issues.

Below are some of the highlights & initiatives that occurred at ENB in 2017:

  • In March, we had the pleasure of Dr Kate Granger (doctor, terminally ill cancer patient, founder of t #hellomynameis) hosting a twitter chat focusing on the#hellomynameis campaign. As anticipated the chat was high successful generating 2,842,612 impressions; 524 tweets; 210 participants. A summary of the chat and Storify can be found at:

http://ebn.bmj.com/content/19/3/68.full.pdf+html?sid=0b2fe014-af24-44ba-b04e-565eb1220e81 https://storify.com/josmith175/hellomynameis

Sadly, Kate passed way earlier this year.

  • Our EBN Opinion series is going from strength to strength, which summarises out Twitter chats. The latest article focuses on m
    eeting the needs of families: facilitating access to credible healthcare information:

http://ebn.bmj.com/content/20/1/2.short?g=w_ebn_current_ta

  • October was the launch of EBN Perspectives which brings together key issues from the commentaries in one of our nursing topic themes, the first article summarised commentaries on child health issues:

http://ebn.bmj.com/content/19/4/107.extract

screen-shot-2016-12-23-at-17-33-00screen-shot-2016-12-23-at-17-36-11With the latest focusing on advanced care planning & palliative care:
http://ebn.bmj.com/content/20/1/5.short?g=w_ebn_current_tab

  • Our Research Made Simple series continues to be popular offering a concise summary of key issues in research methods & their practical application; the next article focuses on the ethical context of nursing research:

http://ebn.bmj.com/content/20/1/7.short?g=w_ebn_current_tab

  • This year we presented at two important conferences; the International Academy of Nursing Editors (INANE), conference in August & the Royal College of Nursing International Centenary Conference in November both presentations focused on the ways social media activities can be used in nursing and nursing journals to promote evidence based practice.

We are looking forward to restarting our Twitter chats in January, beginning with

‘Loosing the child’s voice’ and ‘the captive mother’- an inevitable legacy of family-centred care? 4th January 2017, 8-9pm UK time

Learning technology in nurse education 18th January 2017, 8-9pm UK time

Helping Older People with End Stage Kidney Disease make Decisions about Treatment

19 Dec, 16 | by hnoble

Dr Helen Noble, Lecturer & Clare Carswell, Undergraduate mental health nursing student, Queens University Belfast

me-1

There are at least 59,000 adult patients receiving renal replacement therapy to treat end stage kidney disease (ESKD) in the United Kingdom. In addition there are over 1.8 million people being treated globally – 77% treated with chronic dialysis and 23% living with a transplant. Kidney disease is categorised into five stages depending on the estimated glomerular filtration rate and evidence of kidney damage. The most severe of these stages is stage 5 Chronic Kidney Disease where the eGFR is < 15 ml/minute/1.73m (table 1).

bcmj_50_vol16_table1_stages

The number of older patients with ESKD is increasing annually as the population ages. The UK population aged over 65 is predicted to increase by 60%, from 10.3 to 16.9 million by 2035 [https://esa.un.org/unpd/wpp/], and increased numbers of older patients will commence dialysis worldwide. Older patients who require dialysis report a higher burden of “geriatric syndromes”. These include frailty, falls, and cognitive impairment. There is also evidence that dialysis initiation may be associated with accelerated rates of functional and/or cognitive decline [https://www.ncbi.nlm.nih.gov/pubmed/15507063]

Renal replacement therapy includes haemodialysis, peritoneal dialysis or transplantation but choices regarding treatment are perplexing. One particularly difficult decision concerns older people with ESKD, unsuitable for transplantation, who have to decide between dialysis and conservative management. Dialysis involves coming to hospital three times a week for four hours each visit and requires attachment to a dialysis machine which filters the blood and replaces the role of the damaged kidneys. Conservative management offers a supportive and palliative approach to care, without dialysis. Patients are supported and followed up by a multidisciplinary team often in their own homes. Some people regret their decision to start dialysis and some may go on to withdraw from treatment. Others report that they didn’t fully understand the decision they were making. There is a need to ensure that patients making decisions between dialysis and conservative management are supported through this process. Decision-aids may help people who are facing these difficult health treatment decisions.  Decision-support interventions encourage people to be more actively involved in decision making, improve risk perceptions and congruence between the choice made and their personal values. They may also help improve communication between patients and staff.

There are limited decision-support interventions available to assist with complex decision-making in people who are choosing between dialysis and conservative management. The OPTIONS decision-aid has been developed in Australia and is being tested in a multisite randomized controlled trial [http://www.readcube.com/articles/10.1111/jan.12921]. A similar tool is being developed in Ottawa, Canada. In the UK, The excellent ‘Dialysis Decision Aid’ has been developed to help people make decisions about renal replacement therapy but it has less of a focus on conservative management and is aimed at all age groups [https://www.kidneyresearchuk.org/DialysisDecisionAid].

In the UK there is a need to develop a UK specific decision-aid for people deciding between dialysis and conservative management in order help patients with kidney disease make the best possible decision. In order to test such an aid a randomised trial similar to the one in Australia is recommended.

The importance of public health in the nursing curriculum

12 Dec, 16 | by dibarrett

 

Lizzie Ette – Lecturer in Nursing, University of Hull

It’s easy to imagine that public health is falling out of favour in the UK in the current era of austerity, which has ushered in cuts for local authorities, who are now predominantly responsible for the public health of their local population. With the Local Government Association (LGA) itself expressing concern and disappointment in the government’s approach to the funding of this essential remit, it would be easy to believe that improvements to public health are a fading aspiration.

However, the NHS’s own Five Year Forward Plan commits to ‘getting serious about prevention’, and cites examples of integrated models of care which are aimed at addressing health needs and promoting better health.

So what does this mean for nurses?  And what kind of nurse education do we need to deliver to ensure that future nurses are as equipped as possible to embrace and contribute to this challenging future?

determinants-of-health

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