British journal of nursing (Mark Allen Publishing)
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Within the hospital environment patients can deteriorate rapidly and for many different reasons. Maintaining a patient's breathing is the main priority in any emergency situation--although achieving airway control can be difficult. All health professionals need to be able to safely undertake airway management and the key to the management of an airway is through a thorough assessment, to firstly ensure whether the airway is patent or not. This article will discuss airway management--both acute and chronic--as well as associated nursing care.
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John Tingle discusses the Department of Health's recent report on the review of arm's-length bodies (ALBs), particularly in relation to the National Patient Safety Agency (NPSA) which, along with several other ALBs, is set to be abolished.
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Silver (Ag) has been thought to improve wound healing and reduce instances of associated infections for many years. There are centuries-old records of silver being used in wound treatment, but the past two decades in particular have seen an increasing clinical application of silver-impregnated wound dressings and as such, have seen the number of research articles similarly increase. ⋯ The author also attempts to critically appraise the opposing literature related to the clinical relevance of microbial kill-time and the volume of silver contained in dressings, while investigating the efficacy of silver-impregnated dressings in the management of burns and chronic wounds. In order to collect literature relevant to this review, the author searched CINAHL, Medline, BMJ, Medscape, Journal of Advanced Nursing, the Electronic Medicines Compendium (EMC), and the Cochrane Library, using the terms silver, silver sulfadiazine, impregnated, wound, burn, dressing, review, quantative, efficacy, in vitro, in vivo, nanocrystalline, toxicity, infection, microbial kill-time, and comparison.
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This article addresses some of the contemporary issues in relation to providing palliative care for children in Ireland, particularly focusing on the creation of the specialist palliative care nursing outreach posts. The recent publication of an Irish national policy on palliative care for children with life-limiting illness is welcome news for paediatric nurses in Ireland. Children are valued members of society and have a right to receive quality health care and support appropriate to meet both children and the families' precise needs. ⋯ In addition, there are no specific palliative care educational programmes in Ireland with regard to end-of-life care for children. The challenges of providing palliative care to children and their families in relation to symptom control, controversial ethical and legal issues, and emotional and practical support, mean that advanced knowledge is required in order to progress the agenda and thus provide excellence in children's palliative care in Ireland. It is important that the agenda is moved forward so that children and their families requiring palliative care and nursing support do not suffer from a lack of professional provision for their needs.
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An advance decision (AD) to refuse treatment allows an individual to express his/her wishes regarding future treatment in the event of losing capacity to make decisions. Relevant and applicable ADs are legally binding, even when refusal of the specfied treatment will lead to the patient's death; but health professionals are required under the Mental Capacity Act to consider a number of factors in deciding whether a patient's AD should be followed. The decision for the health professional is not always clear-cut. For example, what happens when Alzheimer's changes an indivdual's personality so much that they seem to be a different person: does their previous decision still stand? This article examines the criteria to be considered in such a case, and highlights the wider principles to be followed in making any decision on whether to follow an individual's instruction to refuse treatment.