What more can community nurses do to manage adult malnutrition.

This article gives an outline of the key groups at risk of malnutrition in the community and the effects and clinical consequences of not identifying and managing these groups. It outlines the potential health and social costs of not identifying and treating malnutrition in the community and advises how malnutrition arises in these 'at-risk' groups. As 93% of those affected by malnutrition are living in our communities, advice is given on how community nurses can play a pivotal role in identifying malnutrition by initiating conversations about dietary intake with patients and integrating screening and nutritional care into pathways of care.

Enteral feeding tubes: an overview of nursing care.

This article provides a brief overview of the most common types of enteral feeding tubes, their placement and the problems that may be encountered in the care of patients with tubes in situ. It is important that nurses are aware of safety aspects around the insertion and maintenance of feeding tubes, and acquaint themselves with safety guidelines and local policies to ensure that patients do not come to any harm. They must also ensure that they have appropriate training to make certain that they are competent.

Defining Patient Safety: a Student Perspective.

Background: Patient safety is recognised as an important aspect of the undergraduate medical curriculum. However, packed medical curricula have been slow to evolve despite repeated mandates and large-scale tragedies resulting from unlearnt lessons. The aim of this work was to explore students' perspectives on patient safety to inform curriculum re-design.

Reviews of theoretical frameworks: Challenges and judging the quality of theory application.

Background: Rigorous reviews of available information, from a range of resources, are required to support medical and health educators in their decision making.

Aim: The aim of this article is to highlight the importance of a review of theoretical frameworks specifically as a supplement to reviews that focus on a synthesis of the empirical evidence alone. Establishing a shared understanding of theory as a concept is highlighted as a challenge and some practical strategies to achieving this are presented.

Assessing interprofessional competence using a prospective reflective portfolio.

The assessment of interprofessional competence or capability following interprofessional education (IPE) remains essential if we are to ensure future practitioners who are able to work in teams and collaborate for improved health outcomes. Any IPE curriculum must design and describe its theoretical stance and this also applies to how learning will be assessed. This article reports on a study of the use of an IPE portfolio by students across 10 professions as a flexible framework for students to demonstrate their learning.

Successful early cannulation of a superficial femoral vein transposition angioaccess in a patient without other alternatives.

Early cannulation of a native fistula is defined by Dialysis Outcomes and Practice Patterns Study and Kidney Disease Outcomes and Quality Initiative as between 2 and 12 weeks postoperatively. We present a case of a patient in whom anatomical and hematological barriers prevented early cannulation graft placement, and in whom temporary catheterization was not feasible as a result of central venous occlusion. Successful cannulation at the fifth postoperative day of a native angioaccess was performed and the reasons and challenges faced behind this choice under the circumstances were discussed.

Inflow reduction by distalization of anastomosis treats efficiently high-inflow high-cardiac output vascular access for hemodialysis.

The arteriovenous fistula used for vascular access for hemodialysis may contribute to development of congestive heart failure. Theses patients can present with frequent episodes of congestive hear failure. Traditional management of high-inflow, a high-cardiac-output fistula generally involves either closure or banding.

Complex bypasses and fistulas for difficult hemodialysis access: a prospective, single-center experience.

The purpose of this article is to describe several complex vascular access procedures and the outcomes achieved with them in 24 patients (mean age 60 years) undergoing hemodialysis in whom all other accesses had failed and neither peritoneal dialysis nor transplantation was possible. Patients underwent either a necklace bypass (n = 5), axillary loop (n = 1), contralateral internal jugular vein bypass (n = 6), femorofemoral crossover bypass (n = 1), superficial femoral vein transposition (n = 5), axillary artery to popliteal vein bypass (n = 5), or femoral artery to right atrium bypass (n = 1). All grafts implanted were 6 mm, internally reinforced prostheses made of expanded polytetrafluoroethylene (Gore-Tex Intering Vascular Graft).

Self-help books for depression: how can practitioners and patients make the right choice?

Background: Depression is a common and important public health problem most often treated by GPs. A self-help approach is popular with patients, yet little is known about its effectiveness.

Aim: Our primary aim was to review and update the evidence for the clinical effectiveness of bibliotherapy in the treatment of depression.