Diagnosis, prevention and treatment of fungal infections .

Most fungi live harmlessly in the environment, but some species can cause disease in the human host. Nurses working in primary care are likely to see patients with superficial fungal infections and are well placed to offer advice about treatment and measures to prevent the spread of infection in the home. Patients with weakened immune function admitted to hospital are at high risk of developing serious, invasive fungal infections.

MRSA: implications for hospitals and nursing homes.

Meticillin-resistant Staphylococcus aureus (MRSA) is a major infection prevention and control challenge globally. In the UK, the occurrence of MRSA has fuelled public concern about hospital safety and had a major effect on health policy. Guidelines emphasise the importance of surveillance, decolonisation strategies, standard infection prevention and control precautions, and antibiotic stewardship to reduce the risk of transmission.

Prevention, control and treatment of scabies.

Scabies is a common, but neglected, skin condition that is becoming increasingly prevalent globally. It causes distress and is frequently regarded as a stigmatising condition, although it can affect anyone of any age or social class. Understanding the epidemiology and life cycle of the mite Sarcoptes scabiei which causes scabies, is the key to effective prevention and control.

Effective strategies for prevention and control of Gram-negative infections.

Infections caused by Gram-negative bacteria such as Pseudomonas, Klebsiella, Proteus and Acinetobacter have been a major problem in healthcare settings for many years. Overlooked in government targets and unknown to patients, these infections present considerable challenges for effective infection prevention and control. Key strategies for prevention and control focus on contact precautions, the management of invasive devices and maintaining a clean, dry environment to prevent the build-up of environmental reservoirs and cross-infection.

Identifying key factors associated with aggression on acute inpatient psychiatric wards.

Aggressive behaviour is a critical issue for modern acute psychiatric services, not just because of the adverse impact it has on patients and staff, but also because it puts a financial strain on service providers. The aim of this study was to assess the relationship of patient violence to other variables: patient characteristics, features of the service and physical environment, patient routines, staff factors, the use of containment methods, and other patient behaviours. A multivariate cross sectional design was utilised.

The demography of nurses and patients on acute psychiatric wards in England.

Aims And Objectives: To describe the ethnic and demographic composition of staff and patients on acute psychiatric wards in England.

Background: A significant proportion of the UK population (7.6%) belong to an ethnic minority and there are concerns that ethnic minority patients are not well served by psychiatry, in particular that they are subject to excessive force and coercion.

Developing interprofessional education in the pre-registration curricula: mission impossible?

Interprofessional education has long been cited in health and social care policy as a remedy to improve many of the problems faced by the National Health Service (NHS) around co-ordination and collaboration of staff. More recently, this form of education has been acknowledged as having a key role in delivering the government's modernisation agenda to produce a more 'flexible' workforce. Given the large number of logistical problems connected to developing interprofessional education before registration, this type of activity more often occurs after registration.

Clinical placement exchanges for pre-registration nursing students: maximising opportunites.

A challenge for both practitioners and educationalists is to provide a rich variety of quality placements to ensure that a student is able to meet the UKCC outcomes required for registration. An innovatory scheme within one education consortium (now work force development confederation) is described an analysed where two universities were able to offer students a placement 'exchange'. This enriched the variety of practice placements available for students, thereby enhancing the learning opportunities for both groups of students.

The matron's role in acute National Health Service trusts.

Aim: The aim of this study was to describe how matrons in an acute National Health Service trust perceive and undertake their role since its reconfiguration in 2005 and to investigate their needs for continuing professional development.

Background: Matrons returned to acute National Health Service trusts in 2002 to provide a senior, authoritative nursing presence throughout clinical areas. Their function is to promote high standards of clinical care and leadership; ensure that administrative and support services are in place to deliver high standards of care; and provide a visible, accessible and authoritative presence in ward settings.

Chest drain removal.

This article provides a step-by-step approach to the removal of chest drains and offers a rationale for practice. It also discusses indications for chest drain removal and potential complications associated with the procedure.

Preventing and treating constipation in later life.

Constipation is not an inevitable part of ageing. With good diet, adequate fluids and regular activity the risks can be minimised. Giving information, support and providing care involves a high level of skill.

Respiratory assessment.

This article, part of Nursing Standards clinical skills series, discusses the 'look, listen and feel' approach to respiratory assessment. This will assist nurses to carry out a basic respiratory assessment of the patient.

Morale is high in acute inpatient psychiatry.

Background: Morale on acute psychiatric wards has been considered to be problematic, and is reported to contribute to low quality patient care.

Aim: To assess the relationship of staff morale to patient, service environment, physical environment, patient routines, conflict, containment, staff demographics, and staff group variables.

Method: A multivariate cross sectional study was undertaken collecting data on morale, as measured by the Maslach Burnout Inventory, and other variables on 136 acute admission psychiatric wards in England.

Stakeholders' perceptions of a research capacity development project for nurses, midwives and allied health professionals.

Aims: To evaluate stakeholders perceptions of the extent to which a research facilitator post was addressing aims of: * providing academic support to enable research involvement of nurses, midwives and allied health professionals; * supporting dissemination of research into practice; * contributing to research strategy development.

Background: Barriers to research capacity development have been recognized for nurses, midwives and allied health professionals. A project established in a London NHS trust aimed to address these.

Intramuscular injection techniques.

The administration of intramuscular (IM) injections is an important part of medication management and a common nursing intervention in clinical practice. A skilled injection technique can make the patient's experience less painful and avoid unnecessary complications.

Subcutaneous injection technique.

This article outlines the procedure for administering subcutaneous injections, including site selection and prevention of complications.

Assessing and managing patients with musculoskeletal conditions.

This article discusses the anatomy and physiology of the musculoskeletal system and some common presenting complaints. Examination techniques and principles of nursing care are considered.

Talking with the experts: evaluation of an online discussion forum involving mental health service users in the education of mental health nursing students.

The Chief Nursing Officer's recent review of mental health nursing called for the widespread involvement of mental health service users in the education of mental health nurses. This paper describes an innovative project that involved mental health service users in the education of pre-registration mental health nursing students through an online discussion forum that blended e-learning with enquiry-based learning (EBL). The findings of an evaluation are presented, drawing on quantitative and qualitative methods.

Leadership across boundaries: a qualitative study of the nurse consultant role in English primary care.

Aim: To explore the emerging role of nurse consultant in an English primary care setting.

Background: Nurse consultants have been introduced in England since 1999 as senior, non-managerial nurse leaders. They have generally found it that it takes time to negotiate manageable work-loads.

The subjective experiences of people who regularly receive depot neuroleptic medication in the community.

Little has been written on the subjective experiences of people who receive depot injections in the community. The authors of this paper have identified distinct gaps in the literature in terms of the views of service users regarding this particular intervention. Existing studies tend to focus upon the side effects of depot neuroleptic medication and the attitudes of Community Mental Health Nurses (CMHNs) towards administering depot medication and issues of compliance and non-compliance.

Neurovascular assessment.

The ability to carry out a neurovascular assessment on a patient's limb is an important skill for all registered nurses. All nurses, whether working in primary or acute care environments, are exposed to patients who have sustained injury or trauma to a limb or have a cast or restrictive bandages in place. The ability to detect a compromised limb through careful observation enables prompt referral and subsequent treatment, which may otherwise result in a permanent deficit.

The challenge of healthcare-associated infection outside hospital.

Infection control is an area of healthcare practice subject to rapid development in line with changes in the behaviour of pathogens, advances in technology, the altered profile of people undergoing healthcare, the settings in which that care is delivered and the impact of new ways of working throughout the National Health Service. This article describes how micro-organisms responsible for healthcare-associated infection can be transferred between hospital and community settings and explains the risks of disseminating infection in relation to two types of pathogen carrying resistance to antibiotics: methicillin resistant Staphylococcus aureus and glycopeptide resistant enterococci. Ability to read current literature critically, to be aware of changing policy and its impact on the risk of infection forms an important part of the community nursing role.