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Care and management of children with a totally implanted central venous access device: portacath
Research and advances in technology have enabled children and young people with life-limiting conditions to live longer. To maintain their well-being and quality of life many of these children usually require some form of intravenous access for treatment.Children’s nurses should have the skills and training to ensure they are competent to practise using totally implanted central venous access devices such as portacaths (ports). This article addresses the care and management of these ports in children and the wide variation in practice that exists in the UK, and makes recommendations for practice.
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Supporting newly qualified nurses to develop their leadership skills
Leadership is not expected solely of managers. At any stage of their career, nurses are expected to be able to demonstrate leadership in their day-to-day role. However, newly qualified nurses, who often experience a challenging transition from nursing student to registered nurse, may lack the confidence to demonstrate leadership. Nurse managers can support junior nurses to develop their leadership skills, notably through training, mentoring, reflection and action learning. By guiding newly qualified nurses in the use of different leadership approaches, experienced nurses can contribute to enhancing the quality of patient care. This article discusses how nurse managers can support newly qualified nurses to develop their leadership skills.
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Using data analytics to enhance quality improvement projects
With the introduction of electronic health record systems in healthcare organisations, there is a significant opportunity within nursing, and as part of the multidisciplinary team, to access a wealth of data and use this to drive improvements in patient care and outcomes. Quality improvement has often involved the collection of data via manual audit, a time-consuming process with data fed back from small sample sizes over a short time period. In contrast, a data analytics approach enables data collection from larger sample sizes to be automated and for data to be presented in a way that is easy for staff to access and interpret. This article discusses the benefits and challenges of a data analytics approach as well as the resources required, the importance of stakeholder involvement, the setting and review of key performance indicators and how to optimise data presentation to achieve the greatest effect.
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Compassionate leadership: how to support your team when fixing the problem seems impossible
Stress, suboptimal mental health and an inadequate work-life balance are underlying and serious issues in the nursing profession, affecting staff recruitment and retention and potentially having a detrimental effect on patient care.While compassion towards patients is central to the nursing role, often ‘compassion towards the compassionate’ is lacking. The need for compassion is even more important now, and in the months ahead, due to the additional stressors experienced by nurses during the COVID-19 pandemic, whether they are on the front line, furloughed or shielding.This article includes reflections from nursing staff and uses their stories to encourage reflection on ethical and moral dilemmas experienced during the pandemic. The Compassion in the Workplace model is suggested as a tool that can be used by nurse managers to examine their compassion levels and to support the development of a compassionate workplace. In addition, this article offers some practical ideas on what compassionate leadership might look like in day-to-day practice.
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Chairing and managing formal workplace meetings: skills for nurse leaders
Few nursing staff from band 6 and above receive formal training on how to chair and manage formal business meetings, which can be a challenging experience for novices and when participants fail to engage with the discussion. This article gives an overview of how to lead and manage effective meetings, focusing on process, content, managing conflict and how to engage participants fully. This will give meetings more purpose and ensure participants feel their time is being used efficiently. Learning how to conduct effective meetings will enhance the quality of team working and team effectiveness.
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Teamwork in nursing: essential elements for practice
As any nurse working in the NHS knows, teamwork can be powerful. Successful teamwork can make a huge workload of unmanageable tasks manageable. However, unsuccessful teamwork can leave people struggling to cope. This article explores readers’ knowledge and skills related to teamwork and provides them with new skills and techniques to improve practice.
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Biological basis of child health 2: introduction to fertilisation, prenatal development and birth
This article is the second in a series called the biological basis of child health. It considers the period of development from fertilisation to birth, outlining the three stages of prenatal development – the germinal, embryonic and fetal stages. The article details how tissues and organs typically develop at each stage, and explains how and when deviations in development and congenital anomalies are likely to occur. It also describes some of the common congenital anomalies, their potential effects and their detection before or after birth. Information is also provided about the delivery of full-term infants, including the stages of labour.
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Action learning: staff development, implementing change, interdisciplinary working and leadership
Action learning (AL) is a process that supports problem-solving by applying a questioning formula to challenge issues and prompt actions. Initially developed to support organisational change, AL is now recognised as a motivating and influencing process for team development, individual goal setting, change initiatives, quality improvement and leadership development. Learning from observation and practice is central to its approach, which lends itself to healthcare settings. It is especially useful to managers seeking to implement change, enhance quality and promote teamwork in multidisciplinary settings.
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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.
