British journal of nursing (Mark Allen Publishing)
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Two innovations in health care, NHS Direct and walk-in clinics, both designed to improve patient access, have been introduced by the Government. NHS Direct was one of the first NHS innovations introduced by the present Government and has been operating, on a restricted basis, for about 18 months. The Department of Health recently announced the setting up of more direct access clinics run by nurses, to which any person can go for assistance and advice on health care. This article considers the legal implications of these innovations.
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This article looks at the referral of a patient (Mr H) for parenteral nutrition and the subsequent insertion of a peripherally inserted central catheter (PICC) by the nutrition nurse (NN). It explores the issues directly related to the PICC insertion including the route of intravenous access, the ability of the NN to insert the PICC, preparation, communication and consent, and prevention of the mechanical and septic complications of insertion. ⋯ Mr H was satisfied with his care, offering positive feedback at follow-up visits to clinic. Critical analysis of the case study also revealed implications for further development of the role of the NN in ordering the check X-ray and the development of evidence-based standards and guidelines related to this procedure.