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Preventing, identifying and managing delirium in nursing homes and acute settings
Older people, particularly those in nursing homes, are vulnerable to delirium, which is a condition characterised by confusion. This article outlines the risk factors, prevention, identification and management of delirium in older people in nursing homes and acute settings. It uses a case study approach to encourage nurses to consider the challenges faced in these settings and how they could address delirium. The article also details the multicomponent interventions that can be used for prevention, as well as the available delirium assessment tools, with a focus on selecting tools based on the person’s health status and the healthcare setting.
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Sexually speaking: person-centred conversations with people living with a dementia
While sexuality is integral to being human and supporting sexual expression is fundamental to delivering person-centred care, many nurses find this area challenging. This is particularly true when working with people living with a dementia, irrespective of their age. However, it can be especially challenging in older adults.This article aims to support nurses in their work with individuals and couples living with a dementia. After briefly defining the term ‘sexuality’ and acknowledging the effects of the most common types of dementia, the article discusses the importance of person-centred conversations. It details a new person-centred paradigm that can assist nurses to learn about people’s sexuality and sexual wishes. Through enhanced understanding and increased objectivity, nurses can be better equipped to support people to continue living fulfilled sexual lives according to their choices and priorities. The article concludes by summarising the legal and professional context and nursing responsibilities involved in addressing sexuality with people living with a dementia, specifically when mental capacity becomes an issue.
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Making reasonable adjustments to cancer services for people with learning disabilities
People with learning disabilities do not access or engage with proactive cancer screening in line with those without learning disabilities. As a result, they often experience delays in diagnosis and treatment for cancer, leading to suboptimal health outcomes and, in some cases, premature mortality. This article explores how the legal requirement for public bodies to make reasonable adjustments to ensure people with learning disabilities can use their services can have a positive effect on patient outcomes and experience. In cancer services this applies across the patient pathway, from access to screening, assessment, diagnosis, treatment and discharge. The authors use case studies to illustrate how reasonable adjustments can be made for individuals with learning disabilities in accessing cancer care. They also provide readers with the opportunity to reflect on their own practice and explain how to make small, achievable reasonable adjustments in their clinical areas.
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Best practice in the transition to adult services for young adults who had childhood cancer
This article discusses the importance of a successful transition from children’s to adult services for young adults who had childhood cancer. It considers the role of nurses in children’s and adult services in supporting young adults to adequately prepare for the transition to adult services. Historically, the responsibility has been with children’s services to prepare young adults to transition to adult services; however, a joint approach between children’s and adult service providers is now recommended. A well-organised, person-centred, transition plan commenced early can contribute to a young adult’s successful transition to adult services.
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Conducting holistic pain assessments in patients with cancer-related pain
The incidence of cancer is increasing and people diagnosed with cancer are living longer, with and beyond cancer, and experiencing acute and long-term effects of their disease and its treatment. One such effect is pain, which may occur at any stage, from diagnosis to survivorship or end of life. The exact incidence of cancer-related pain is challenging to determine but it is estimated to affect between 39% and 66% of patients, according to the stage of their disease trajectory. Cancer-related pain is complex, multifactorial and multidimensional, and nurses need to be equipped with the knowledge and skills to assess it in a holistic way. This article explores how nurses working in cancer settings can support people in their care by conducting holistic pain assessments.
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Prehabilitation in cancer care: preparing people for treatment physically and mentally
Prehabilitation is the process of enhancing an individual’s functional capacity by optimising their physical and mental health to prepare them for treatment. Prehabilitation is the first stage of the rehabilitation pathway and comprises pre-assessment, interventions and follow-up. It is designed to reduce the risk of the physical and psychological complications of cancer and its treatment, thereby improving patients’ ability to recover as well as their long-term outcomes.This article highlights the principles of prehabilitation in cancer care and its benefits for patients, and explores the role nurses can play in delivering prehabilitation assessments and interventions and in encouraging positive behaviour change in their patients.
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Adult primary brain tumours: presentation, diagnosis, treatment and complications
Primary malignant brain tumours are aggressive tumours with limited treatment options, and as such they remain the largest cause of cancer-related deaths in men aged under 45 years and women aged under 35 years. Benign brain tumours are frequently treated with the intention to cure them. Both malignant and benign brain tumours often cause long-term, debilitating neurological effects, and if they recur can be fatal.This article outlines the updated World Health Organization classification of adult primary brain tumours, as well as their treatment and predicted outcomes. It also identifies the role of cancer specialist nurses in supporting patients and their families.
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How to support nursing students to develop community care planning skills
Care planning for patients is an important element of the nurse’s role, yet some nursing students may miss its relevance to their practice. However, they can learn many skills by care planning thoroughly in partnership with patients. They can also expand their knowledge of the wider aspects of holistic care, including the importance of empowering and educating patients.This article discusses how to structure care planning systematically and assists practice supervisors to guide nursing students working in the community in their learning, showing how to relate certain aspects of care to specific, measurable, achievable, realistic and timely (SMART) goals. The article also describes a structure for developing interventions for a care plan – professional values, assessment, treatment and education (PATE) – which nursing students can use to incorporate a chronological order into care that also encompasses health promotion.
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Nursing care plans in mental health
This article explores best practice in co-creating recovery-orientated care plans. Recovery is a holistic experience that involves the service user beginning to regain a sense of control, alongside a reduction or absence of symptoms of mental distress. A care plan documents the needs of the service user and the interventions that will support their recovery. The history and development of care plans are explored and the benefits of care planning, involving good-practice guidelines and co-production, with service users are discussed. A case study is used to show strategies for planning care and recovery tools, and troubleshooting suggestions are provided for when there is a lack of engagement from the service user.Care planning is an important part of a mental health nurse’s role, as a legal record of care given and as a therapeutic tool to encourage recovery.
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A nurse-led review of patient experience for development of quality services
This article gives an example of a nurse-led service review and explains the process of evaluating a service that includes nurse-led clinics, patient information and patient experience. The aim of the evaluation was to engage with patients to gather information about and understand their experience, to inform the development of quality services and patient pathways.
