Unique, practical knowledge for nurses responsible for daily management of patients with cardiovascular disease, diabetes and related conditions.

Friday, 27 February 2015

Frailty is a distinctive health state related to the ageing process in which multiple body systems gradually lose their in-built reserves. This means the person is vulnerable to dramatic, sudden changes in health triggered by seemingly small events such as a minor infection or a change in medication.

Category: Editorial
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Friday, 27 February 2015

A commonly heard clinical expression is "He/she is very frail". It provides a summary statement of an older person that implies concerns over vulnerability and prognosis. This is how we have conventionally considered frailty—as a descriptive label: 'the frail elderly'. In this article, we will re-frame frailty in a potentially more helpful way. We will examine frailty from the perspective of an abnormal health state that behaves just like a long-term condition. This conceptualisation of frailty opens up new approaches to helping people who are frail.

Category: Editorial
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Friday, 27 February 2015

The first section of this supplement made the case to consider frailty from the perspective of a long-term condition. This and the next section explore what this means in terms of applying some of the well-developed models for the care of long-term conditions to people who are living with frailty. First, we examine how the highly evidence-based model of supported self-management might be applied to frailty.

Category: Editorial
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Friday, 27 February 2015

Supported self-management is feasible and desirable for people with mild frailty, but care and support planning is more appropriate for individuals with moderate frailty. This section considers how the primary healthcare team can apply a whole person and personalised approach to care and support planning.

Category: Editorial
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Friday, 27 February 2015

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.

Category: Editorial
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Friday, 27 February 2015

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

Category: Back to Basics
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Friday, 27 February 2015

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.

Category: Back to Basics
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Wednesday, 03 December 2014

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?

Category: Editorial
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Wednesday, 03 December 2014

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.

Category: Editorial
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Wednesday, 03 December 2014

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.

Category: Editorial
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