Please note the journal has ceased publication at the present time so is not currently accepting submissions. This journal aims to provide a forum in which both undergraduate and postgraduate students in LJMU’s School of Nursing and Allied Health can discuss and share current practice in health and social care settings. It also provides an opportunity to share practice experience with a wider audience by publishing it in this journal. This could be experiences from an acute or community setting. Contributions may be reflections on practice using a recognised model of reflection such as Gibbs’ or articles on specific issues, examples might include: health promotion, long-term conditions, or safeguarding in a healthcare setting. We also welcome enquiries from practice staff who may be interested in disseminating their work using this journal. Enquiries would be welcomed to publish work that has a relationship to a health or social care topic or both. Contributions to the journal can be from one author or have multiple authorship.
Copyright is retained by the author and will be published under a CCBY-ND-NC (Creative Comons Attribution, no derivatives, non-commerical) license.
Recognition of sepsis in the paediatric patient: a reflective study
Sepsis affects around 100,000 people in the United Kingdom annually. Early recognition of this time critical medical emergency is vital to prevent the condition developing into life threatening septic shock. Paediatric mortality is between 13-34% in septic shock. Pre hospital recognition and treatment by paramedics is inconsistent. Education of the Sepsis Six pathway for pre hospital care providers, GP's and community care practitioners is vital for the rapid treatment and increased survival rates for the septic patient.
Anaphylaxis: a study of the condition and treatment
Anaphylaxis is a sudeen, severe and life threatening hypersensitivity reaction following exposure to a foregin protein. The majority of anaphylactic deaths are caused by envenomation from stings followed by adverse reactions to drugs and food. Treatment tends to be through the use of intra muscular adrenaline, nebulised salbutamo, anti histamines and steroids, although evidence has shown that the time required for the anti histamines and steroids to work shows little benefit for the patient in the early treatment stage. Given the nature of anaphylaxis, research on human subjects is fraught with ethical dilemas and a status quo in treatment regimes is likely for the foreseeable future
Exploring the Assessment and Communication throughout an Ectopic Pregnancy
The application of the Chapelhow framework for a female patient experiencing an ectopic pregnancy, focusing on the assessment and communication elements of patient care. Further exploring the patients journey from the emergency room to the ward, discussing the investigations and pathways utilised throughout and providing the rationale behind the decisions made. Highlighting the good and poor aspects of holistic care provided and the impact on the patient and her partner. Finally evaluating the standard of assessment and communication as high, however recommendations to focus further on patient centred care, to minimise anxiety and distress for the patient during a difficult time and improvements made to teamwork amongst the multidisciplinary team.
Health promotion and patient empowerment in the palliative setting: a case study.
This article discusses the concept of health promotion within a palliative care setting and the benefits of health promotion within this context. Promoting choice and autonomy benefits not only the patient but also impacts upon their family and friends. Three topics are considered; smoking, oral health and psychological wellbeing. Using case studies, I elucidate how individualised care planning benefits and empowers the patient. Barriers to promoting health such as lack of skill and time management are considered, and how these were overcome. The legal, ethical and policy contexts governing best practice nursing care are considered alongside the chosen topics.
Copyright (c) 2016 Sarah Ruth Moss Simons
Health promotion opportunities related to a person or group of people taking into account the legal, ethical and policy context
Abstract Health promotion in nursing is the process of supporting people to increase control over, and to improve their own health. The World Health Organisation (WHO) (1948) defined health “As a complete state of physical, mental, social and emotional well-being, not merely the absence of disease”. It moves beyond a focus of individual behaviour to a wide range of social and environmental interventions (WHO, 2015). Health promotion is “About improving the health status of individuals and the population as a whole” (Evans et al., 2014). Thinking like a health promoter enables nurses to integrate the principles of effective health promotion which is a fundamental aspect of nursing care (Piper, 2009). The Nursing and Midwifery Council (NMC) (2010) has set out standards for pre-registration nursing education which it considers necessary for safe and effective practice in relation to health promotion and public health. These standards involve “Supporting and promoting the health, wellbeing, rights and dignity of people”. Nurses must also “Understand public health principles and practice in order to recognise and respond to the causes and social determinants of health, illness and health inequalities” (NMC, 2010). For the purpose of this assignment three health promotion issues most relevant to my practice experience will be discussed. The legal, ethical and policy context in relation to these issues will be explored. The actual name of any patient/s or the trust will not be disclosed, this is to maintain confidentiality and consent was gained following the NMC (2008) Code of Professional Conduct.
Health Promotion with Cardiovascular Patients in the Clinical Setting: A students perspective
A study focusing on a student nurses personal experience of examining what is health promotion and giving advice and knowledge to a cardiovascular patient within a clinical setting. The study’s aim was to explore the three main health promotion topics the student decided was important to that particular patient but are also applicable to other cardiovascular patients in some form. The reasoning for choosing the three main topics were that studies have shown smoking, poor diet and lack of physical activity are all major risk factors in developing cardiovascular disease. In conclusion the student found the role health professionals play in health promotion is invaluable as they have direct access to the patients and can therefore offer primary and secondary expert knowledge and advice.
Copyright (c) 2016 Christine Elizabeth Kelly
The focus of this reflection is around an allegation of neglect of a baby. Using Gibbs model of reflection has enabled me to systematically explore the issues. It will explore some of the challenges that can be experienced by a practitioner when managing such issues. Recognition is given to the need for organisational and individual change if we are to improve practice in the management of safeguarding issues. It is acknowledged that we need to be able to recognise the challenges in the first instance if we are to improve practice.
An exploration of chronic kidney disease (CKD) focusing on a patient’s experience on admission to a nephrology ward. Causes of the disease include hypertension, diabetes and acute kidney injury, and progression could be slowed by medication to reduce blood pressure and glucose levels, along with dietary and lifestyle changes. As the average wait for a kidney transplant is around 3 years, finding a donor match is becoming increasingly difficult. Patients have several different treatment options, the most common being haemodialysis and peritoneal dialysis, both with advantages and issues. Complications of the disease include respiratory problems and fluid overload, with possible interventions being fluid monitoring and restrictions on fluid intake. Effects of the disease on the everyday life of patients include the need for regular invasive dialysis treatment, the necessary behavioural changes surrounding fluid intake and diet, and debilitating symptoms such as nausea and respiratory difficulty.
Copyright (c) 2016 Hannah Marie Oldfield
Role of the Nurse in Managing Asthma in the Community
This article will examine the role of nurses managing asthma patients in the community, investigating factors around the management of asthma, such as education, triggers and local initiatives to prevent future exacerbations of asthma. Further research suggestions include investigating a correlation between asthma deaths and whether the patient received the advised annual review.
Copyright (c) 2016 Danielle Kayleigh Mather
Whistleblowing as a means to raise concerns, or a means to an end!
This is a reflection on a whistleblowing policy in practice. This will be linked to a specific issue from practice. Consideration will be given to the impact of culture within an organisation of a staff member decision to use the whistleblowing policy. While whistleblowing is an option where a staff member has serious concerns about quality of care, it is one that is only taken when all other avenues are exhausted. It will explore some of the challenges that staff and students can encounter when making a decision to whistleblow. It will explain how a whistleblowing policy can support professionals in practice. It argues how those on the receiving end of care may have limited choice on the quality of that care, but as health professionals we do have choices and it is about what choices we make.
Perceptions of men in the nursing profession: historical and contemporary issues
Florence Nightingale’s perception and feminisation of nursing into a female only profession has resulted in fewer men pursuing nursing as a career. In contemporary society male nurses make up about 10% of nursing professionals (Walsh, 2016). Stereotyping and gender bias of men has helped create a less than inclusive and sometimes isolating experience for men in nursing (Duffin, 2006). Men in nursing are often treated differently to their female counterparts. It is important particularly for male nursing students to learn about men’s contribution to the history of nursing.
Health and social care research: a way of pragmatically addressing societal challenges
The management of nutrition in palliative care
In order to improve quality of life, nutrition in palliative care should be one of the main goals when managing a patient’s care. Malnutrition is a dominating factor when it comes to the palliative patient. Poor nutrition can not only hinder the patient but also their families as they see changes in their loved ones. The main aim of nutrition is to maximise food enjoyment and minimize food related discomfort. There are guidelines available for health care professionals to assist them in delivering high quality care to cancer and palliative patients. Nurses and other healthcare professionals play a vital role in the management of nutrition by providing both physical and emotional support for both the patient and their families. Ethical questions are also raised when it comes to artificial nutritional support which puts professionals, patients and family members in difficult positions.
Copyright (c) 2017 Padraig Dermot O'Hara
Health promotion regarding STIs in young people
This article explores health promotion techniques regarding STIs in one of the highest risk age groups, young people under 25 years of age. The article also explores the link between socioeconomic deprivation and poor sexual health. The role and responsibility of the nurse is promoting holistic wellbeing and sexual health is examined.
Copyright (c) 2017 Sarah Ruth Moss Simons
Synopsis Review of Negative Pressure Therapy as a treatment option for Diabetic Foot Ulcer
A synopsis review of four articles, which look at Negative pressure wound therapy (NPWT) as a treatment option for diabetic foot ulcers. Patients presenting with diabetic foot ulcers are on the increase which has a huge financial impact NHS, there is strong evidence that NPWT is a cost effective treatment. All four articles use a quantitative methodology. This synopsis will critically analyse the methodology, design, sampling, data collection and data analysis that the researchers have chosen to utilise. NPWT has been proven to be an effective treatment option for diabetic foot ulcers however the research is limited in regard to patient perspective of this treatment.
Inequalities in Access to Health Care for Transgender Patients
Abstract The last decade has seen a rise in the widespread recognition of trans individuals and a developing understanding of what it means to be trans. Although education is increasing across schools, communities and the National Health Service in the United Kingdom; are inequalities in access to health care services, a contemporary issue? Prejudice, stigma and discrimination on are the deterring fears of trans individuals when seeking health provision and interventions (House of Commons 2015). This paper will look at the campaigns, charities and Government publications on changing attitudes towards trans individuals; an analysis on care provision by nurses and health allies within the NHS, and the reasoning behind alleged transphobia in the UK.
Lessons learned through reflecting on a classroom observation
Using non-participant structured observation of classroom teaching as a method of collecting data was experienced; during a one hour session, the researcher noted who was speaking at 5-minute intervals. Preparation of a chart for 7 expected students became unwieldly when some 20 students attended, which was not anticipated. It soon became obvious that 5-minute intervals were too long, as many students spoke up but not at the points where speaking was recorded, so the final chart was unrepresentative of the classroom behaviour being observed. In addition, the researcher became involved in answering a question themselves, something that should not occur when using a non-participant approach.
Non-participant observation of classroom teaching
20 Minutes of Care – 2 Chapelhow et al Enablers
There are six fundamental skills that enable a health care practitioner to become an expert practitioner (Chapellhow et al 2005). This article discusses two of these skills, communication and risk management whilst feeding an individual during a work placement. An 81-year-old woman lives in a nursing home, has Alzheimer’s disease and is a type two diabetic. The element of care lasted for no more than 20 minutes but several examples of the communication and risk management enablers were present. Good communication skills promote person-centred care and examples of verbal and non-verbal communication are given. The management of risk associated with dysphagia, malnutrition, osteoarthritis and diabetes are also described.
Using the Chapelhow Framework to deliver patient care
The aim of this piece of work is to look at two enablers from Chapelhow et al.(2005), Communication and the effect gender has upon the individual and the importance of being able to actively listen but also when speaking knowing the importance of the choice of language used. As this can be the difference between therapeutic relationship for the patient or an incident due to the patient becoming agitated. The risk management and why it is a grey area surrounding positive risk. In conclusion it was found that more work needs to be done on the effect gender has upon communication such as male care providers upon female patients and what the grey areas are surrounding positive risk and how this is applied with risk management.
Obesity and the nurses’ role in reducing health inequalities through health promotion.
The obesity epidemic currently costs the National Health Service £6.1bn each year (Public Health England, 2015). This, combined with the co-morbidities associated with obesity means that the epidemic needs to be addressed. Nurses play a key role in reducing this epidemic through health promotion. However, it has become apparent that health inequalities exist with regards to obesity. As a result, nurses must be aware of the wider determinants of health in order to be equipped with the knowledge and skills to successfully promote health. The present training and guidelines nurses receive needs to be readdressed so this can be facilitated.
Copyright (c) 2017 Jennifer Elizabeth Upton
Smoking, alcohol and obesity: Health promotion opportunities relevant to acutely ill vascular and urology patients.
Alcohol, smoking and obesity are considered serious public health issues. This article examines the nurses’ role in health promotion and considers the legal, ethical and policy context relevant to a group of acutely ill patients on a vascular surgery and urology ward. It discusses how the majority of these patients suffer from vascular disease, primarily caused by modifiable risk factors and explores how to empower individuals to manage and improve their own health. The article concludes that nurses have a duty to help individuals to make informed decisions regarding their health. However, patients are entitled to make their own choices and the nurse must be respectful of their autonomy.
Why Chapelhow enablers are important when providing patient care
Chapelhow et al (2005) developed a framework based upon six fundamental concepts. These concepts are the building blocks that all healthcare professionals need in order to deliver patient care. Chapelhow et al (2005) refers to the concepts as enablers. There are six enablers, assessment, communication, risk management and managing uncertainty, professional judgement and decision making and documentation and record keeping. In this article, I look at two enablers; assessment and communication. I chose these two to discuss, because as a nurse these are essential skills to have when delivering patient care. It was apparent that both enablers are linked and are used together when caring for a patient and that assessment and communication skills are vital to have as a healthcare professional.
A review into teenage pregnancy and the potential influencing socio-economic contributors
The purpose of this article is to review pre-existing socio-economic factors that could potentially influence teenage pregnancy. Research shows that teenage pregnancy within England consistently remains the highest within Europe and gaps in current literature regarding the topic fail to prove why. This article provides a combination of both the social and economic factors that could predispose an individual to a teenage pregnancy and offers suggestions as to how healthcare practitioners can intervene. The main themes discussed within the article relate directly to an individual’s level of education being a fundamental aspect in the determination of one’s ongoing future decisions; the socio-economic status of an individual potentially pre-disposing one to a teenage pregnancy and a systemic review of the health promotion strategies that can be used by the nurse to ensure safe sexual health.
Copyright (c) 2017 Phoebe Kate Dickinson
Population Health Needs Analysis: Victims of Modern Slavery and Human Trafficking in the UK
Modern slavery and human trafficking in the United Kingdom presents a series of new challenges for those working within the healthcare sector (Dalphins, 2016). Healthcare professionals have unique access to those involved in modern slavery, with over 88 percent of survivors reporting that they had accessed medical care on numerous occasions throughout their ordeal (Polaris Project, 2016). The variation in victim demographic, the differing forms of exploitation experienced and the traumatic nature of their ordeal can greatly affect the health of modern slavery victims (Adams, 2012). The enormity of the issue must be acknowledged and pre-emptive action taken to overcome barriers to satisfactory health and ultimately end the cycle of exploitation.
Copyright (c) 2018 Eleanor C K Henderson