How pancreatic cancer impacts carers in the UK: why do we know so little?

BACKGROUND: Pancreatic cancer is a disease with poor life expectancy and high symptom burden. The experiences of the spouses, family and friends who care for this group is poorly understood, especially during palliative care and within the UK. AIMS: To highlight the current gaps within research and provide some insight into the challenges faced by carers assisting those living with pancreatic cancer, and how community nurses can support this group. METHODS: A total of five research databases were searched using the terms 'pancreatic cancer', 'carer' and 'experience'. Cancer and palliative charity websites were also referenced for grey literature. FINDINGS: There is limited research exploring pancreatic cancer carers experiences in the UK healthcare system and community. Available information suggests that this group is likely to face significant psychological and physical challenges to caring. CONCLUSIONS: It is vital for community nurses to have an awareness of challenges this group face, to better recognise and support these vulnerable carers.

The impact of COVID-19 on practice learning in nurse education.

The COVID-19 pandemic has impacted healthcare education and delivery, including both theory and practice learning. Academic staff responded rapidly to move teaching online during the first lockdown, with many returning to practice to deliver care or upskill practice staff to work in critical care. Many pre-registration students responded by becoming paid NHS employees, contributing to care delivery while remaining on their programme of study. Practice learning partners, despite the challenges of the pandemic, continued to support students to achieve their registration status. This occurred within the context of the Emergency and Recovery Standards, published by the Nursing and Midwifery Council between March 2020 and September 2021. This paper sets out the response of students, practice learning partners and higher education institutions involved in pre-registration nursing and midwifery programmes.

Fostering Transformation by Hearing Voices: Evaluating a 6-Second, Low-Fidelity Simulation.

BACKGROUND: The stigma of psychosis, with the accompanying symptoms of auditory and visual hallucinations, can affect a nurse's ability to provide safe, effective care. Increasing knowledge of the patient's perspective during auditory hallucinations can increase the nurse's ability to be empathetic and engage in a therapeutic alliance. OBJECTIVE: To evaluate the efficacy of a six-second auditory hallucination simulation to increase empathy in preclinical undergraduate nursing students. DESIGN: This descriptive, content analysis, qualitative study evaluated narratives written by students in a pre-licensure baccalaureate nursing student population, assessing empathy, insight, knowledge, and therapeutic communication. Students experienced the 6-second auditory hallucination simulation as part of preclinical instruction, and then they wrote a self-reflection. RESULTS: More than 200 self-reflections were collected, with a randomized final sample of 82 narratives evaluated. CONCLUSION: Self-reflections indicated that the experience of the 6-second hearing voices simulation increased efficacy, insight, knowledge, and intention to use therapeutic communication.

Chelsea, Pimlico and Belgravia District Nursing Association 1930-1939: A case study.

The case study explores how the expansion of the health services during the interwar period impacted upon the status of district nursing and examines how being a voluntary service shaped district nursing associations. A range of primary sources were used; the Association Annual Reports, the Medical Officer for Health Annual Reports for the Borough of Chelsea, the Ministry of Health records, the archives of the Queen's Nursing Institute (QNI) and the Borough of Chelsea Council Minutes. The Medical Officer for Health Reports and the Council minutes identify efforts to improve environmental factors that impacted upon health. These primary sources briefly note the contribution of the Association suggesting that it was integral to the health care provision but considered a constant. The impact of changes to the 1932 Sunday Entertainments Act provide an interesting juxtaposition between the acknowledged value of district nursing and the constant struggle to fundraise in order to provide home nursing. Throughout the 1930s the Association experienced staff shortages and challenges regarding recruitment. The complexities of payment for municipal health services following the 1929 Local Government Act contributed to the staffing challenges. The move to a block grant in 1938 provided increased stability with regards to income. The case study identifies a contradiction regarding the esteem and value placed upon district nursing associations providing home nursing and the constant challenge of resources. District nursing services face similar challenges and this is the 130th anniversary of the Queen's Nursing Institute.

Resting Doppler ankle brachial pressure index measurement: a literature review.

Peripheral vascular disease (PVD) is under-diagnosed in primary and acute settings. The use of Doppler ankle brachial pressure index (ABPI) is effective in diagnosing PVD , aid in determining aetiology of leg ulcers and is cost efficient in reducing the effects of atherosclerosis and cardiovascular events. The aim of this literature review was to review practitioners' experience in using Doppler ABPI, different skills used to measure ABPI and to examine practitioners' confidence in ABPI. The findings identified variation in method for Doppler measurement: including position of the artery, arm measurement, resting period and type of equipment for measuring blood pressure, variations in practitioners' training and experience have demonstrated variability in ABPI results. Although limited in number, the studies have demonstrated knowledge gap, and the need for training among health professionals.

Supporting life after stroke.

The National Stroke Strategy (Department of Health (DH), 2007) was developed by six expert groups representing health and social care professionals, non-statutory organizations and carers, to ensure that appropriate and effective treatment and ongoing support is available to individuals who have had a stroke. While prevention is considered the first line of defence, the importance of rapid treatment and ongoing support after the initial event should not be underestimated.

The impact of community nurse-led interventions on the need for hospital use among older adults: An integrative review.

BACKGROUND: Hospital avoidance services are important for older people who risk deteriorating health and independence when in hospital. However, the evidence base for nurse-led community services is equivocal. OBJECTIVES: To determine the impact of community nurse-led interventions on the need for hospital use among older adults. METHODS: The integrative review method of Whittemore and Knafl was employed and reported in accordance with PRIMSA guidelines. Medline, EMBASE and CINAHL were searched from January 2011 to January 2019. Outcomes were coded and findings reported by outcome domain to provide an integrated, narrative synthesis. RESULTS: Nine studies were included in the review. Whilst disparities in the evidence base persist, specialist high-intensity, team-based hospital-at-home services were significantly more likely to reduce hospital admissions than standard care. An individual case management services that incorporated self-help education for chronic disease management also reduced hospital admissions. Financial data suggest that whilst high-intensity services are costly, they can lead to significant efficiency savings in the longer-term. CONCLUSION: This topic remains an important area for further investment, managerial support and research because of the risks faced by older people when admitted to hospital, for whom health, quality of life and independence are vital considerations. IMPLICATIONS FOR PRACTICE: The provision of high-intensity team-based services and self-help education can optimise health outcomes and reduce the need for hospital use among older adults living in the community.