Mouth care: why it matters - highlighting a neglected care need.

Oral health care is integral to general wellbeing, allowing people to eat, communicate verbally and socialise without discomfort or embarrassment. In relation to people being admitted to hospital, poor oral health care has been linked to longer hospital stays and increased care costs. It is also associated with an increase in hospital-acquired infections such as pneumonia and can affect nutritional intake, which is vital in supporting recovery. Assistance and encouragement with effective and daily mouth care can prevent deterioration in a patient's oral health, and yet it remains a neglected and overlooked area of care provision. Initiatives have attempted to address this neglected area of care but the pandemic and other priorities have allowed it to be lower on the healthcare agenda. Nurses, healthcare assistants and student nurses form the largest group of the healthcare workforce, providing or supervising the personal care of patients in hospitals and the community. Therefore, oral healthcare assessment and practical skills should be embedded in education and be given a strong focus and leadership to ensure that good practice is consistently implemented across all health and care settings. Mouth care really matters and should be integral to all health and care encounters. Further research and investigation into the important but neglected area of mouth care is also required.

Leadership and management for nurses working at an advanced level.

Leadership and management form a key part of advanced clinical practice (ACP) and work in synergy with the other pillars of advanced practice. Advanced clinical practitioners focus on improving patient outcomes, and with application of evidence-based practice, using extended and expanded skills, they can provide cost-effective care. They are equipped with skills and knowledge, allowing for the expansion of their scope of practice by performing at an advanced level to assist in meeting the needs of people across all healthcare settings and can shape healthcare reform. Advanced practice can be described as a level of practice, rather than a type of practice. There are four leadership domains of advanced nursing practice: clinical leadership, professional leadership, health system leadership and health policy leadership, each requiring a specific skill set, but with some overlaps. All nurses should demonstrate their leadership competencies-collectively as a profession and individually in all settings where they practice.

Writing for publication: Sharing your clinical knowledge and skills.

Clinical nurses are ideally placed to write for publication in addition to those who work in academia who have this as an accepted part of their role. Nurses generate new evidence from their work in practice by carrying out research and audits and being involved in practice development projects, for example. This resource of knowledge needs to be shared with others, ideally in an international arena so that nurses can learn from each other. Nursing in the United Kingdom is now an all graduate profession and many nurses go on to study at both Masters and PhD level, providing writing from all levels of academic study that can be adapted for publication. It seems wrong to undertake a study and obtain findings and then choose not share this widely. Both a lack of confidence and time are cited as reasons why nurses do not write; however, to share knowledge with others is a duty as part of any nursing role for the improvement of staff working practices and patient care. All nurses need knowledge that is practical, experiential, and scientific; clinical nurses who write for publication can provide this.

What do nurses do? Student reflections.

The art of caring and the science of curing are accepted elements of a nurse's role, with symbiosis and overlap between them. However, following the publication of the Francis report there is now greater emphasis on developing the caring roles of nurses. The chief nursing officer for England's vision for care staff places care and compassion as central to nurses' roles. Student nurses often enter the profession with idealistic lay beliefs of what a nurse's role exemplifies. These beliefs are then challenged when they are exposed to education and practice. A recent educational evaluative exercise used with adult nursing students highlights their thoughts in response to the simple question: 'What do nurses do?', and how they differ at different stages of their education and training.