Most nurses are involved in the care of the 1% of the population currently nearing the end of their lives: that is, people considered to be in their final year, months, weeks or days of life. The Gold Standards Framework (GSF) programmes can help provide a structured framework in this challenging area, leading to more proactive and consistent standards of care, and enabling more people to live well and die well where they choose.
The walking speed test and the PRISMA 7 questionnaire are two simple, well-validated, frailty-specific tools that have been shown to identify frailty in older people, in particular those attending health clinics or receiving social service assessments
Frailty is the gradual loss of inner reserve as a result of the ageing process, leaving a person vulnerable to dramatic, sudden changes in health triggered by apparently small changes or events. Like other long-term conditions, frailty – if not managed – can rapidly result in acute illness and admission to hospital. A better, community-based, preventive approach to managing people with frailty is based on case-finding, followed by care that is appropriate to the individual, whether it is supported self-management, personalised care and support planning, or end-of-life care.
Non-alcoholic fatty liver disease (NAFLD) is currently the most common cause of abnormal liver function tests. Current advice is simply to monitor patients' liver function, but is this really correct? And how do we identify and manage people at risk of developing NAFLD?
Practice nurses are in the frontline of the fight against obesity, yet they face a moving target. Around 10 years ago, the 'centre ground' of the battle comprised patients with around 10 kg to lose; today, it is 20 kg. This has profound implications for weight management and a range of related conditions, but recent research is highlighting new solutions for this group of patients.
Atrial fibrillation (AF) is the commonest cardiac arrhythmia seen in primary care and, if left untreated, is a significant risk factor for stroke. New guidelines from the National Institute for Health and Care Excellence (NICE) include some practice-changing recommendations on diagnosing AF, the role of aspirin and the novel oral anticoagulants (NOACs), and shared decision-making to ensure patient-centred care.
Chronic heart failure (CHF) continues to be a leading cause of death and readmission to hospital in the UK. Since the availability of specialist CHF services is variable, many patients rely on practice nurses to review their care. The National Institute for Health and Care Excellence (NICE) guidelines have proved very helpful, but are now a cause for confusion as new evidence changes the management of heart failure.
In the UK, an estimated 1 million people with diabetes use injectable therapies, and these patients are increasingly being managed in primary care. As a result, more primary care nurses are taking responsibility for the initiation and continuing management of injectable therapies, including advising on and reviewing an individual patient's injection technique.
For years dieters have been trying to avoid fat, and low-fat products have been promoted as the healthier option. But there is now a great deal of publicity around sugar and its toxic effects on our health, including claims that it is the 'new tobacco'. The sweet white stuff is being blamed for the obesity epidemic and with it diseases such as diabetes and heart disease. So what is the evidence behind the hype, and what should we as health professionals be advising patients?
More people than ever are making trips overseas. Many of us have long-term conditions that we manage with lifestyle choices and medication or medical devices. You may have high blood pressure, angina, a previous heart attack, heart failure or another heart condition. This leaflet will help remind you of some of the advice given to you in a pre-travel consultation with your practice nurse or travel nurse.