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Biological basis of child health 3: development of the cardiovascular system and congenital heart defects
This article is the third in a series on the biological basis of child health. It outlines how the cardiovascular system develops during gestation and how congenital heart defects (CHDs) may arise in the process. The article details the pathophysiology and treatment of some of the common CHDs, including patent ductus arteriosus, atrial septal defect, ventricular septal defect and transposition of the great arteries. It explains the possible causes of CHDs and explains how these defects are detected and diagnosed. The article also provides an overview of the initial management of acutely unwell infants and children who present with a CHD. The first two articles in the series looked at cells and genetics, and embryology.
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Newly Registered Nursing Associate Guide
This updated guide assists student nursing associates in their transition to a registered nursing associate. It includes information on standards of proficiency, advice on registration and revalidation, an overview of preceptorship and further ways in which the RCN can support members with advice on appraisals and wellbeing. Registered nursing associates may also find the guide helpful when revalidating.
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Improving safety by developing trust with a just culture
This article presents a simple conceptual road map for implementing a just culture in healthcare settings. The concept of just culture was developed as one of five fundamental elements of a safety culture by psychology professor James Reason in 1997. A just culture requires an unbiased method of judging human error and is designed to develop organisational trust so that adverse medical events (errors) are reported and corrected before they combine with other errors to cause injury or death. To implement a just culture properly so as to increase organisational safety, practitioners must understand its role in enabling the error reporting needed to develop a safety culture. This article reviews these foundational concepts and explores the human causes of errors that a just culture addresses, the psychological importance of a just culture in enabling error reporting and how to implement a just culture in organisations.
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Hilda Hand
Complete transcript of notebook
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Self-harm in young people: risk factors, assessment and treatment interventions
Self-harm, where an individual purposefully harms themselves with a non-fatal outcome, is common, especially among young people. A wide range of mental health issues are associated with self-harm and it increases the likelihood that the person will eventually die by suicide.This article explores the motivations for self-harming behaviours, risk and protective factors, the components of risk assessment and potential interventions. Self-harm can be associated with stigma and discrimination in society and in healthcare services. This article aims to support healthcare practitioners in providing non-judgemental, empathetic and respectful care to these young people and their families and carers.
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Hilda Hand
Complete transcript of photograph album
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Biological basis of child health 9: development of the liver and clinical features of childhood liver disease
This article is the ninth in a series on the biological basis of child health and follows on from the previous article, which discussed the gastrointestinal system. The liver is the largest solid organ in the body and has more than 500 functions. These functions include: producing bile, which serves as a vehicle for waste products and as an aid for the digestion of dietary fat; synthesising most coagulation factors, needed in the clotting cascade; and transforming glycogen into glucose for use as energy in cell metabolism. While most liver conditions seen in children are rare, it is important that children’s nurses can identify the clinical features of childhood liver disease. This article provides an overview of the embryological development of the liver, its anatomy and functions, liver function tests in children, and the clinical features and pathophysiology of childhood liver disease.
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Introducing mentalization and its role in mental health practice
The theory of mentalization describes the ability of individuals to make sense of their own and others’ behaviour in terms of mental states such as feelings, thoughts, beliefs and intentions. Mentalization is fundamental to people’s ability to manage relationships and emotions. Also, the process of mentalizing is core to the establishment of the therapeutic relationship and is a common factor in all therapeutic approaches. As such, mentalization is relevant to nurses and others working in a range of mental healthcare settings with any age group. This article introduces the theory of mentalization, including an explanation of its central principles, how individuals learn to mentalize during childhood, and how the ability to mentalize fluctuates in response to stress.
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Using the STARTER model to talk about sex in mental health nursing practice
People with mental illness are more likely to contract sexually transmitted infections and blood-borne viruses than the general population. They are also at higher risk of becoming victims of domestic or sexual violence and of having an unplanned pregnancy. Despite this, the sexual health of people with mental illness is often overlooked in the healthcare environment. This has an adverse effect not only on morbidity and mortality but also on quality of life and recovery outcomes.This article introduces a systematic approach for including sexual health enquiry and promotion in holistic mental health nursing practice. It is relevant for staff who work in inpatient and community settings.The STARTER model is a step-by-step tool that has been designed by the author for mental health nurses to encourage conversations about sexual health. It considers that mental health nurses may be limited by lack of training, and by personal or organisational barriers, but encourages them to look at how these can be overcome, as well as when it is necessary to refer to external agencies that can provide support and services that may be more appropriate for the individual patient.
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Implementing trauma-informed care in mental health services
It has been recognised that trauma underpins several mental health conditions, and that retraumatisation, in which a person re-experiences a traumatic event, is common in mental health services.This article explores the effects of childhood trauma on adult mental distress, and describes the symptoms and behaviours associated with trauma. Mental health practitioners, services and organisations need to ensure trauma-informed care is standard practice to enable service users to move beyond the traumatic events they have experienced. Trauma-informed care should be viewed as a concept rather than an intervention to promote a cultural shift from what is ‘wrong’ with a person to what has happened to them.
