Nurse prescribing in practice: patient choice in stoma care

In the first of a new series, Janice Lee examines the choices facing nurse prescribers when selecting items for stoma management. Studies have estimated that there are up to 100,000 people with a stoma in England and Wales, and stoma care therefore forms a significant part of community nursing caseloads. The enormous range of available items means that both patient and prescriber are likely to have difficulty selecting the correct device. Patient preferences, comfort and pricing all play a part in stoma appliance selection.     

A service evaluation of stoma care nurses' practice

• ? Stoma care nurses aim to meet the physical, psychological, social and spiritual needs of patients.
• ? Development of stoma care nursing services has varied, as it has been the responsibility of each nurse, resulting in differences in the mode of delivery.
• ? This qualitative and quantitative study involved stoma care nurses from six areas in Essex, to assess patient perception of the service they received.
• ? Overall, the satisfaction level was high despite differences in delivery of care, especially timing and frequency of visits at home.

     

How increased nurse prescribing can improve stoma care practice

Stoma care nurse specialists have a comprehensive knowledge of the range and use of stoma-related products, yet few are actually nurse prescribers. This article looks at why stoma care nurse specialists should consider becoming nurse prescribers and also examines ways to assist prescribing decisions.     

Changing professional practice in tuberculosis care: an educational intervention

AIM: This paper describes the development and implementation of an experiential, participatory in-service education programme focusing on patient-centeredness, problem-solving and critical reflection for primary providers delivering care to tuberculosis patients in South Africa. BACKGROUND: Tuberculosis is a major contributor to the disease burden in developing countries. In South Africa, approximately 90% of tuberculosis patients are managed by nurses at the primary level. Despite efforts to improve quality of care for these patients, many fail to complete their treatment as prescribed. Poor rapport between health care providers and patients with tuberculosis is a major reason for non-adherence to treatment. Methods of improving the quality of care delivery and communication between health care providers and patients with tuberculosis is therefore a priority. DISCUSSION: The paper outlines the stages of developing and implementing the education programme and reflects on this process. Data is drawn from an in-depth qualitative evaluation of the delivery and impacts of the intervention. The approach was acceptable to health care providers and adaptable to the needs of specific clinics. Participants evaluated the educational intervention positively, noting that it facilitated critical reflection on their work; encouraged problem-solving; and heightened their awareness of communication with patients and with colleagues. However, important structural barriers to practice change were identified, including conditions of service, relations with colleagues and support from management. CONCLUSIONS: Experiential, participatory in-service education can be implemented on a large scale in primary care settings. However, the process is resource intensive and the impacts of such education may be limited by barriers at other levels of the health system.     

造口伤口护理网络化管理的实践

造口伤口横向与纵向网络化的构建和完善改变了传统的造口护理模式,通过网络资源与教学资源共享,提高了造口伤口临床护理质量,改善了造口伤口患者的生活质量,规范了造口伤口人才培养,造口伤口护理信息的共享和造口护理技术的优势互补,提升了护理人员的积极性与主动性,提高了病人及家属的自我护理能力,对于造口伤口护理管理的科学化、规范化有重要的意义。     

Incorporating educational theory into critical care orientation

This article describes the development and implementation of a critical care total education system, which includes an orientation program. The educational process in this unit reflects Benner's model of novice to expert integrated with Schon's theory of reflective practice and Cranton's transformational learning theory. This program reflects an educational philosophy that facilitates learning on entry into the new workplace, and an established continuum of expected acquisition of knowledge, practice skills, attitudes, and critical thinking abilities promoting the transition from novice to expert.     

Practical stoma care

Patricia Black looks at the reasons behind and management of different types of stoma as well as outlining some of the possible problems associated with stomas. She emphasises the importance of caring for a stoma patient's psychological as well as physical wellbeing.