British journal of nursing (Mark Allen Publishing)
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'Thousands of patients are annually starved in the midst of plenty for want of attention to the ways which alone make it possible for them to take food' (Florence Nightingale, 1860).
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Healthcare-associated infections (HCAIs) are a high priority for health professionals. Under the Health and Social Care Act (2008), NHS organizations that fail to comply with the duties in the act could, in extreme cases, be liable for prosecution. Saving Lives (2007) is a national strategy to prevent and control HCAIs which incorporates seven high-impact interventions or care bundles. ⋯ A steering group consisting of senior multidisciplinary team members was set up. One of the aims of the group was to reduce variations in practice and to standardize documentation and clinical practice. This article describes how phase I of the programme was implemented across the Trust and discusses the standardized documentation developed.
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All patients undergoing surgery are at risk of developing hypothermia; up to 70% develop hypothermia perioperatively. Inadvertent hypothermia is associated with complications such as impaired wound healing, increased blood loss, cardiac arrest and increased risk of wound infection. Anaesthesia increases the risk as the normal protective shivering reflex is absent. ⋯ Simple precautionary measures initiated by nurses can considerably reduce the amount of heat lost, minimize the risk of associated complications and ultimately improve patients' short- and long-term recovery. Minimizing skin exposure, providing adequate bed linen for the transfer to theatre and educating patients about the importance of keeping warm perioperatively are all extremely important. It is also worth considering using forced-air warmers preoperatively as research suggests that initiating active warming preoperatively may be successful in preventing hypothermia during the perioperative period.
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Diabetic ketoacidosis (DKA) and hyperglycaemic hyperosmolar state (HHS) are both diabetic emergencies associated with hyperglycaemia and can be fatal if healthcare professionals fail to recognize and intervene appropriately. While many students and qualified nurses may be able to recall common signs and symptoms related to DKA and HHS - for example polyuria, polydipsia and elevated blood sugars - understanding the physiological mechanisms behind abnormal observations and restoring homeostasis through appropriate management is far more complex. Health educators can play a significant role in contextualizing difficult concepts, such as DKA and HHS, so that these complex conditions can be recognized with greater confidence and competence in clinical practice.
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'Transforming community services' (Darzi, 2009) is the second healthcare report to be authored by Lord Ara Darzi, which was published in July 2009. As the title suggests, it targets community services and includes specific, and sometimes disingenuous, implications for tissue viability in the community setting.