Assessment of diabetic foot ulcers: back to basics.

Diabetic foot ulceration affects up to 34% of the global diabetic population as a result of poor glycaemic control. Complications resulting from diabetic foot ulceration can be complex, expensive and challenging. It is important for risk factors to be recognised early and for regular assessment to take place. Streamlining a coordinated approach that enhances communication and guides treatment approaches can help to improve wound outcomes.

A guide to removing surgical staples.

This article provides a comprehensive overview of the wound healing process, emphasising the critical role of surgical staples in primary intention healing. It outlines the four distinct phases of wound healing including haemostasis, inflammation, proliferation, and maturation - and discusses the mechanisms by which surgical staples enhance this natural biological process. Special focus is given to the aseptic non-touch technique (ANTT), which is crucial in preventing infections during the staple removal procedure. The article further explores the procedural steps involved in the removal of surgical staples and highlights the holistic aspects of patient care that need to be considered. This includes strategies for effective pain management, ensuring informed consent, and maintaining a sterile environment. By integrating clinical skills with a thorough understanding of wound care, this article aims to improve nursing practices in surgical settings, promoting better patient outcomes and recovery.

Using the theory of planned behavior to predict factors influencing fast-food consumption among college students.

PURPOSE: The purpose of this research is to examine the behavioral factors that impact fast food consumption (FFC) among college students in Pakistan by applying the theory of planned behavior (TPB). METHODS: Cross-sectional survey was distributed to college students in Pakistan. The questionnaire examines the factors associated with six categories: demographics, FFC pattern, intention for FFC, attitudes toward FFC, Subjective Norms (SN), and Perceived Behavioral Control (PBC). Data analysis was conducted using SPSS and SPSS AMOS software using descriptive statistics, inferential statistics (chi-square, t-test, Pearson correlation, and multiple regression analysis), and structural equation modeling (SEM) Analysis. RESULTS: A total of 220 questionnaires were completed (97 males and 123 females). There were significant differences in FFC association with gender. Among the constructs of TPB, behavioral intention (BI) and SN are the strongest predictors of the FFC (p < .05). TPB has significantly predicted FFC behavior with a variance of R2 0.603. The SEM analysis shows that the data collected were incompatible with the theoretical TPB model, making it unfeasible to test our five hypotheses or interpret the results due to the poor fit of the model with the data. CONCLUSIONS: To ensure a good fit of the data with the specified TPB model in SEM analysis, the number of indicators should be limited (≤ 30), or the sample size should be greater (N ≥ 500). Pakistani college students' FFC is mainly influenced by friends and the increased popularity of fast food, despite their knowledge of its negative health effects. Educational programs should target specific harmful effects of fast food, and SN and BI are the strongest predictors of FFC among TPB constructs. These findings can be useful for developing targeted interventional health strategies and future research.

Altered pathophysiology in common neurological conditions.

This article provides an overview of the pathophysiology of several neurological disorders, including Alzheimer's disease, Parkinson's, multiple sclerosis, epilepsy, stroke and migraine. For each condition, the article highlights key changes that occur in the brain and how these changes contribute to the development and progression of the condition.

The vascular system and associated disorders.

The vascular system, also called the circulatory system, is made up of the vessels that carry blood and lymph fluid through the body. The arteries and veins carry blood all over the body, sending oxygen and nutrients to the body tissues and taking away waste materials. This is a complex system in the body and can be affected by diseases with different pathogenic mechanisms. This article describes the pathophysiology of the main diseases of arteries and the venous system.

Transanal irrigation at a glance.

This article provides a brief overview of transanal irrigation (TAI). It covers the rationale behind the procedure, the contraindications, possible complications and considerations for patient education and support.

Exploring the complexity of student nurse relationships with adolescent patients when placing nasogastric tubes.

This article aims to explore the complexity of student nurse relationships with adolescent patients when placing nasogastric tubes. The potential inter-connectiveness of this relationship is debated within this article and an evaluation of current practice identifies potential implications for both patients and nursing care.

The changing context of advanced practice nursing within the UK community care setting.

Advanced practice nursing (APN) roles have developed partly to address demand and workforce issues. In community care settings and general practice, an advanced nursing practitioner is generally understood to mean a nurse who has undertaken additional education and training in clinical assessment, including history-taking and physical examination, clinical reasoning and independent prescribing, so they can safely manage patients presenting with undifferentiated and undiagnosed conditions. Capabilities in the Skills for Health framework cover everything from communication and consultation skills, practising holistically and personalised care, to working with colleagues and in teams. The framework is intended to ensure advanced nursing practitioners work to an advanced level. It is also designed to support them to demonstrate and evidence their capabilities to service commissioners, employers, people accessing healthcare and the public.

Introducing advanced level practice and the scope of developing new roles.

Barry Hill and Aby Mitchell introduce a new series on advanced level practice. They describe the frameworks that outline advanced practitioner roles and explain how the roles affect patients, services and organisations.

Central venous pressure monitoring in critical care settings.

Patients who present with acute cardiovascular compromise require haemodynamic monitoring in a critical care unit. Central venous pressure (CVP) is the most frequently used measure to guide fluid resuscitation in critically ill patients. It is most often done via a central venous catheter (CVC) positioned in the right atrium or superior or inferior vena cava as close to the right atrium as possible. The CVC is inserted via the internal jugular vein, subclavian vein or via the femoral vein, depending on the patient and their condition. Complications of CVC placement can be serious, so its risks and benefits need to be considered. Alternative methods to CVC use include transpulmonary thermodilution and transoesophageal Doppler ultrasound. Despite its widespread use, CVP has been challenged in many studies, which have reported it to be a poor predictor of haemodynamic responsiveness. However, it is argued that CVP monitoring provides important physiologic information for the evaluation of haemodynamic instability. Nurses have central roles during catheter insertion and in CVP monitoring, as well as in managing these patients and assessing risks.

Tympanic thermometers support fast and accurate temperature monitoring in acute and alternative care.

This article explores body temperature and the physiological process of thermoregulation. Normal body temperature and body temperature changes are discussed, including comorbidities associated with body temperature and signs of hyperthermia and hypothermia, and the factors that affect intraoperative temperature regulation. The evidence base behind thermometry is discussed and is applied to contemporary clinical conditions and symptoms, including: sepsis and suspected COVID-19. After discussing clinical considerations and regulations that encompass thermometry, three case studies present the use of the Genius 3 Tympanic Thermometer in clinical practice, with user feedback supporting its benefits, which include speed, accuracy and ease of use.

Moisture-associated skin damage: an overview of its diagnosis and management.

This educational article introduces an explores moisture-associated skin damage (MASD) and the four forms it manifests as, namely, incontinence-associated dermatitis; intertriginous dermatitis; peristomal moisture-associated dermatitis; and peri-wound moisture-associated dermatitis. The aetiology and predisposing factors of each form are critically discussed, in addition to the treatments and interventions that can be used by nurses to support patient recovery. Nurses and other health professionals working with patients who are at risk of skin damage or who already require wound care, must be knowledgeable about all aspects of MASD. Fortunately, a plethora of evidence-based literature exists to support health professionals in their practice, although validated assessment and recording tools for incontinence-associated dermatitis are limited.

Stoma care: procedures, appliances and nursing considerations.

Several diseases and operations may necessitate the need for the formation of a stoma. Patients who are affected may be concerned about the effect of the stoma on their ability to carry out activities of daily living, as well as how it will affect their quality of life. Nurses who may be involved in the care of patients with a stoma should have an understanding of the reasons for stoma formation, and the types of stoma and appliances available, to enable them educate and support patients, and to allay any concerns.

Preparing nursing professionals fit for the evolving healthcare landscape.

The revised Nursing and Midwifery Council education curriculum, which came into force in January, has the potential to revolutionise nursing, says Barry Hill, Senior Lecturer, Northumbria University ( barry.hill@northumbria.ac.uk ).

Monitoring temperature.

This article explains the importance of temperature monitoring observations and highlights that the procedure is a fundamental aspect of nursing care. It discusses the physiology of temperature regulation, introduces different types of temperature monitoring devices and provides a step-by-step guide on how to take a temperature using a tympanic thermometer. It emphasises the importance of evidence-based practice to underpin temperature monitoring, as well as conditions that it is important for nurses to consider when recording patients' temperatures.