Endometriosis is a condition that is often accompanied by painful symptoms and can have profound effects on a woman’s fertility and quality of life. This article aims to raise awareness of this common but often undiagnosed condition and to provide general practice nurses (GPNs) with an overview of endometriosis, its diagnosis and management. After reading this article, GPNs will be better placed to spot the signs and symptoms of the condition, be able to provide women with information about the various treatment options available, and know when to refer women to secondary care.
Wound assessment is a vital skill for general practice nurses (GPNs); however, time pressures can sometimes impede the effective assessment of wounds in primary care. This article aims to provide GPNs with a rapid wound assessment approach that is evidence-based and person-centred. The author details the main points of wound assessment and outlines a holistic approach that considers biological, psychological and social factors, with the aim of improving GPNs’ assessment skills. An approach to wound assessment known as TIMES (tissue, infection, moisture, edge and surrounding skin) will be discussed. This will enable GPNs to understand the key factors that influence wound healing. The investigations used to identify any underlying disease processes that may affect wound healing are also considered. The author aims to assist GPNs to improve their wound assessment skills, which will, in turn, help them to exercise their best clinical judgement at all times.
Wounds impact a patient’s quality of life, but research shows that this is often overlooked. Lifestyle concerns are haphazardly disclosed by patients, and not always recorded and addressed by nurses. Research (Green et al, 2013a; 2013b) led to the development of a leg ulcer consultation template (LUCT), which, in turn, raised the need for a generic tool to produce an overall, self-assessed ‘quality of life’ score for any patient with a wound. The principles of the LUCT were reviewed and a new ‘wound checklist’ developed, supported by an advocacy service, to ensure utility for all patient groups. Images, simplified questions and use of a ‘pain’ and ‘quality of life’ score improved the checklist’s accessibility, and aimed to show which areas of the patient’s life were affected by the wound. Results of an evaluation have been positive, and the new checklist is available as a paper version and is being developed as a digital resource.
Peripheral arterial disease (PAD) occurs when there is a narrowing or occlusion of the peripheral arteries, resulting in reduced blood flow to the leg (National Institute for Health and Care Excellence (NICE), 2015). This can lead to limb ischaemia and thrombosis. Patients with PAD have a reduced quality of life and are at risk of lower limb amputation and even death. This article addresses the need for early diagnosis of PAD to reduce the burden of the condition to patients and the NHS, and to try and reduce the number of lower limb amputations that occur in the UK every day. Promoting healthy arteries will raise awareness of the risk factors associated with PAD and encourage the population in the risk categories to be proactive in receiving ankle-brachial pressure index (ABPI) assessment. Healthcare professionals with improved knowledge of PAD will be better able to identify patients in the early stages of the disease and to advise them about lifestyle changes to improve their prognosis.
Long-term wounds in the UK are increasing at the rate of 12% per year. The rise in these numbers is partly due to the older population, who tend to have slower healing processes. The majority of wound care is provided by nurses, not all of whom will have received wound care education. Although patient outcomes demonstrate improvement when healthcare professionals receive postgraduate training, it has also been identified that collaborative care and a coordinated team approach can benefit patient care in preventing a wound becoming long term, as has been demonstrated by the Tower Hamlets project. This article explores these issues and the effects that a ‘never healing’ wound can have on a person.
Chronic wounds are a complex and challenging health problem for all concerned, but most importantly for patients who have to live with them. Chronic wounds impact negatively on patients’ quality of life, often accompanied by a loss of independence and, in many cases, a sense of hopelessness. The global prevalence of wounds is predicted to rise with an ageing population, and rapidly increasing numbers of people with obesity and diabetes. In an NHS with escalating costs and a shortage of qualified nurses, it is not sustainable for nurses to continue to manage all wounds. By incorporating shared decision-making and involving patients in their own care, it will be possible to improve outcomes for all concerned.
Bronchiectasis, formally known as non-cystic fibrosis bronchiectasis, is the dilation of the small airways resulting in persistent cough, sputum production and recurrent chest infection, and develops as a result of insult and damage to the airways. The disease is more common in women than men and has an increasing incidence and prevalence. Early recognition of the signs and symptoms of bronchiectasis will support prompt investigations and management to reduce disease progression. This article gives an overview of bronchiectasis, its causes, treatment and management. It also discusses the role of general practice nurses (GPNs) in identifying and treating patients with the condition.
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