Professional nurse (London, England)
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Patients and their relatives may feel unsupported in general wards and the community after the high level of care received in ICUs. Some general nurses may not have enough experience to deal with the high-dependency needs of patients discharged from ICUs to ward care. It is recommended that a follow-up nurse assess the needs of ICU patients and ensure provision has been made for their return to the community.
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A reduction in mobility, a poor gait, diminished mental capacity and continence problems may increase the risk of falls among older people. The consequences of falls can include physical injury such as fractures, a fear of future falls, anxiety, depression and loss of confidence. Greater disability or death may result. The use of a risk assessment tool may alert staff to the magnitude of the problem.
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Many of the adverse reports received by the Medical Devices Agency concern infusion pumps. Clinical governance aims to ensure that both employers and employees reduce the hazards related to device use. Full training is required to help staff avoid user errors.
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Organ donation rates are insufficient to meet the demand. Current legislation may be considered out of date but proposals for a new system raise difficult ethical problems. Nurses need to develop their knowledge and skills to come to terms with the complex ethical issues surrounding organ donation.
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Intensive care patients are at particular risk of pressure damage. Documentation does not always fully reflect practice. Pressure sore identification remains a subjective issue. Nurses do not always complete patient documentation.