Evidence and Practice

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Clinical

Understanding obesity and addressing stigma: the role of healthcare professionals

Why you should read this article: • To enhance your knowledge of the prevalence of obesity and overweight in the UK • To increase your understanding of obesity as a complex multifactorial disease • To learn ways to advocate for respectful policies and practices in relation to overweight and obesity The coronavirus disease 2019 (COVID-19) pandemic has further emphasised the importance of recognising obesity as a health issue for adults and children, with associated increases in obesity prevalence and risk of severe illness and death from COVID-19. Obesity is highly visible and highly stigmatised. It is frequently regarded as a result of lifestyle choices and behaviours, with a focus on personal responsibility rather than as a complex, multifactorial disease with a strong genetic component. Healthcare professionals, including nurses, have an important role in supporting behaviour changes, and discussing weight with patients in neutral and respectful ways. This article outlines the effects of the COVID-19 pandemic on weight and weight-related behaviours and discusses the complexity of obesity and weight stigma. It also emphasises the importance of nurses advocating for action to address the obesogenic environment.

Moral distress in advanced practice nurses during the COVID-19 pandemic

Why you should read this article: • To familiarise yourself with the principles of moral distress • To understand how moral distress may have affected advanced practice nurses during the coronavirus disease 2019 (COVID-19) pandemic • To appreciate how burnout caused by moral distress can have a negative effect on nurse retention in the NHS Background Moral distress arises when a person is aware of the right course to take but is prevented from acting on it by institutional constraints. While this concept has been considered by nursing ethicists for many years, it has been particularly associated with the unprecedented healthcare conditions caused by the coronavirus disease 2019 (COVID-19) pandemic. Aim To investigate the level of moral distress affecting advanced practice nurses (APNs) in the UK during the COVID-19 pandemic. Method This was a mixed-methods study in which a bespoke cross-sectional survey was sent to 243 APNs from across the UK who had been recruited to a broader longitudinal cohort study. The survey asked about their experiences, well-being and moral distress. Open-ended questions asked about their concerns regarding the health and well-being of their patients and colleagues. Findings A total of 97 APNs completed the survey, yielding a 40% response rate. Levels of moral distress were significantly higher among APNs working in secondary care (P=0.026) compared with those working in primary care. All of the respondents expressed concerns about patients due to delayed care and about the mental well-being of their colleagues, particularly those who were redeployed to COVID-19 wards. Conclusion The COVID-19 pandemic has caused moral and psychological distress for APNs. However, the type of distress and its direct causes varied among these practitioners. Tailored support is required to address moral distress and subsequently improve staff retention.

Managing symptoms at the end of life: a guide for non-palliative care nurses

Why you should read this article: • To understand the role of non-palliative care nurses in providing end of life care • To recognise the signs and symptoms that can indicate a person is in the last days or hours of life • To enhance your knowledge of the interventions that can be used to manage common symptoms at the end of life Nurses, regardless of their area of practice, may have to care for a person in their last days and hours of life. However, many nurses outside of specialist palliative and end of life care settings do not feel adequately prepared for this. Nurses can usually obtain advice from specialists working in local hospices or palliative care centres, but they may still find it challenging to act on that advice if it is not underpinned by their own knowledge base. This article provides a guide to assist non-palliative care nurses in recognising dying and managing common symptoms at the end of life.

Genetic haemochromatosis: diagnosis and treatment of an iron overload disorder

Why you should read this article: • To increase your awareness and understanding of genetic haemochromatosis, an iron overload disorder • To recognise the signs and symptoms of genetic haemochromatosis • To enhance your ability to support patients who require life-long treatment for genetic haemochromatosis Genetic haemochromatosis is a potentially serious iron overload disorder, yet there is a lack of awareness of the condition among the public and many healthcare professionals. In the UK, around one in 150 people have the genetic mutations that cause the condition, meaning that they are at increased risk of developing iron overload. If undiagnosed, prolonged iron overload can lead to liver, heart and endocrine failure and may be fatal; however, early diagnosis, treatment and maintenance can enable patients to have a normal lifespan. This article provides an overview of genetic haemochromatosis, including its types, origins, signs and symptoms, diagnosis, screening and treatment.

Essentials of wound care: assessing and managing impaired skin integrity

Why you should read this article: • To recognise the holistic factors that need to be considered when assessing and managing wounds • To enhance your awareness of the available tools that can be used to structure a wound assessment • To acknowledge the importance of shared decision-making in developing wound care regimens The assessment and management of impaired skin integrity as part of wound care is a common nursing task. Specific wound assessment tools may assist nurses to structure an assessment, but wider holistic factors also need to be considered. The TIMERS (tissue, inflammation and infection, moisture balance, edge, repair and regeneration, and social factors) tool offers a flexible approach to assessing wounds holistically and can be applied in all wound aetiologies. This article provides nurses with an overview of the assessment and management of impaired skin integrity using the TIMERS tool. It also discusses the importance of shared decision-making between nurses and patients when formulating a wound care regimen.

Access to pain management from a legal and human rights perspective

Access to pain management from a legal and human rights perspective

Understand healthcare professionals’ legal, moral and professional obligations

CPD articles

An overview of the prevention and management of wound infection

An overview of the prevention and management of wound infection

Pathophysiology, risk factors and signs and symptoms of wound infection

Breaking bad news

Breaking bad news

Communication skills to help you engage in challenging conversations with patients

Understanding and mitigating low health literacy

Understanding and mitigating low health literacy

Source techniques to assist you in communicating with people who have low health literacy

Identifying and managing acute kidney injury

Identifying and managing acute kidney injury

Learn its pathophysiology, staging, signs and symptoms, and treatments

Prevention, identification and management of malnutrition in older people in the community

Management of malnutrition in older people in the community

Understand the elements of a person-centred care plan for individuals who are malnourished

Understanding and managing common drug interactions

Understanding and managing common drug interactions

Enhance your knowledge of some of the mechanisms of drug-drug interactions

How to

How to cleanse a wound

How to cleanse a wound

Learn about the different techniques and products to use

How to write an action plan with a nurse or nursing student

How to write an action plan with a nurse or nursing student

Objectives should be SMART – specific, measurable, achievable, realistic and time-bound

How to interpret arterial blood gas results

How to interpret arterial blood gas results

The steps involved when evaluating respiration and circulation in deteriorating patients

How to undertake effective mouth care and oral assessments

How to undertake effective mouth care and oral assessments

Learn ways to promote oral health and comfort, and prevent or treat disease

How to change a suprapubic catheter effectively

How to change a suprapubic catheter effectively

Recognise the potential complications and how to avoid them

How to safely collect and deliver blood components for transfusion

How to safely collect and deliver blood components for transfusion

Learn methods to minimise the risk of adverse events, including handling and storage errors

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