Developing a nurse-led integrated 'red legs' service.

This project was developed to set up a nurse-led service based on the needs of patients diagnosed with 'red legs'. These patients are often wrongly admitted into hospital for treatment of cellulitis. Representatives from the specialties involved in caring for those individuals with red legs were invited to participate with patients to create a stakeholder group whose purpose was to develop integrated care pathways focused on referral criteria, diagnostics and treatment to inform a new nurse-led service. There was a commitment to utilising a number of facilitation techniques and practice-development methods in the progression of the project with the support of the Foundation of Nursing Studies. Much of the prescribed care can be carried out by the patients at home and only 25% patients have required a follow-up appointment within the new service. The service has now been fully commissioned and a secondment opportunity has been developed to lead the new service. Significant savings have been demonstrated and regular revision of the integrated care pathways with all groups, including the patients, will take place.

Systemically induced vasculitis in children.

Vascular diseases can be quite grave in children. Common diseases in children that cause a generalized vasculitis include Kawasaki disease, Henoch-Schonlein purpura, and Rocky Mountain spotted fever. Rheumatic fever, though preventable, is increasing in incidence and may cause arteritis, and therefore is discussed as a vascular disease. Developmental considerations should be considered when providing adequate care. Play therapy is a crucial part of every day in a child's life, even when ill with a vascular illness. Play helps a child gain control over the stress of a serious illness and hospitalization.