A survey of current practice in skeletal pin site management

The management of sites for external fixator pins and wires has been a matter of debate within orthopaedic and trauma nursing for decades. The literature outlining the conundrum goes as far back as the early 1980s. Sadly, none of this literature, to date, has resolved the question of how to most effectively prevent infection in these challenging wounds. This article reports on a UK survey that identifies current practice in pin and wire site wound management. It should help those planning to conduct research in this area to identify possible interventions, controls and variables that need to be taken into account when conducting randomised controlled studies.     

A forgotten need: paediatric resuscitation training

This article highlights the fact that there are currently no real official recommendations regarding the provision of paediatric resuscitation training in the UK. All too often, this teaching features as no more than an ‘add on’ to adult resuscitation sessions. This is a thoroughly inadequate situation as the relatively infrequent occurrence and different aetiology of paediatric arrests necessitates specific training, based on standard guidelines, and adapted to meet the needs of the various groups who have contact with children. A three-tiered package of training is recommended, starting with nationwide paediatric Basic Life Support (BLS) training for the general public. In addition to BLS, healthcare personnel need to be trained in appropriate use of airway adjuncts. Paediatric Advanced Life Support (ALS) is also essential for all medical, nursing and paramedical staff who come into contact with acutely-ill children. In an attempt to address the need for ALS, the PALS (Paediatric Advanced Life Support) course, has been implemented in the UK. Adapted from the American PALS course, it aims to provide appropriate personnel with a systematic, research-based approach to acutely-ill children in emergency situations.     

The Lautenbach method for chronic osteomyelitis: nursing roles, responsibilities and challenges

Osteomyelitis is serious for both the orthopaedic surgeon and the patient. Bone infection is very difficult to treat and if not eradicated has long-term effects for the patient. The current techniques available have a low success rate and sometimes the only alternative is amputation.This article discusses:

• What is bone infection and how it effects a person's life

• Existing methods of treatment and compares them with the Lautenbach method

• Pre, peri and post-operative care of patients undergoing the Lautenbach method of treatment

• A case study to illustrate how the method was used to successfully treat a patient.

Should relatives of patients with cardiac arrest be invited to be present during cardiopulmonary resuscitation?

Witnessing the attempted resuscitation of a loved one is likely to be traumatic and distressing. However, because the majority of patients requiring cardiopulmonary resuscitation (CPR) die, this raises the question, within the hospital environment, of whether relatives should be invited to be present. There is a distinct lack of nursing research available on this subject, particularly with regard to the possible long-term effects on relatives. Much of the information is anecdotal and focuses on the positive aspects of this practice. With particular reference to the intensive care unit (ICU), the discussion in this paper includes not only family presence during CPR from the perspective of the patient, relatives and healthcare professionals, but also the potential legal implications. Recommendations for nursing practice are offered.     

Nursing Children and Adolescents With Bipolar Disorder: Assessment, Diagnosis, Treatment, and Management

TOPIC:  The role of the mental health nurse in the assessment, diagnosis, treatment, and management of children and adolescents with bipolar disorder in community and hospital settings.
PURPOSE:  In many areas of clinical practice, mental health nurses have more contact with service users than any other professional group. They are therefore well placed to support children and adolescents with bipolar disorder during first contact with primary care services, through engagement with specialist mental health services, and in accessing early intervention and crisis services. This paper summarizes the contribution that child and adolescent mental health nurses make to the care of children and adolescents with bipolar disorder.
SOURCES:  This paper is based on evidence from systematic reviews; meta-analyses and best practice evidence from CINAHL; EMBASE; MEDLINE, PsychINFO; Cochrane Collaboration; National Institute for Health and Clinical Excellence; National Collaborating Centre for Mental Health; NHS Centre for Reviews and Dissemination; Oxford Centre for Evidence Based Medicine; United States Agency for Healthcare Research and Quality.
CONCLUSIONS:  Child and adolescent mental health nurses work with children and adolescents who have bipolar disorder in a range of settings. These include community mental health services, hospitals, and schools. Due to the multidisciplinary nature of the treatment and management of bipolar disorder during childhood and adolescence, nurses have a major role to play in providing frontline assessment services, monitoring treatment, and delivering psychosocial interventions.     

Components of life model in practice

This paper attempts to cover the stages recognised as being part of the research process in order to investigate the problem related to the lack of individualised patient care documentation and supporting theoretical framework, which is both understood and accepted by the staff within Accident and Emergency (A & E).With the advent of the United Kingdom Central Council's (UKCC) document Standards o f Record Keeping (1993), there is now greater need for a model to be implemented and accepted by those working in the department.The Components of Life model was introduced following a literature search, as this seemed to be a potential solution to the problem, since it emphasises the individual practising self-care activities in order to maintain independence.To initiate staff to the Components of Life model, a half study day was organised on the subject of models of care within A & E. Jones was invited to discuss his approach to A & E nursing care. Subsequently, a draft document relating to nursing care was created using the Components of Life model as a framework.The initial draft was followed with a printed document which was put into use for a trial period of 4 weeks, followed by a review. The review collected both positive and negative comments from the staff, the negative proved to be the most constructive as they served to make improvements within the care plan. Perhaps the most important success as a result of completing this project is that of increased staff enthusiasm and motivation - especially in wanting to make the documentation work.