[Applying Swanson's Theory of Caring to ManagePowerlessness in an Older Patient With Vasculitis].

This case report describes a nursing care experience that applied Swanson's Caring Theory to a powerless elderly patient who was suffering from vasculitis problems that had made her incapable of walking and had delayed her discharge from the hospital. The associated health problems, including impaired physical mobility, infection, and powerlessness, were affirmed after an integrated physical, psychological, social, and spiritual assessment was conducted during the nursing care period, which lasted between April 26th and May 5th, 2018. The five categories (knowing, being with, doing for, enabling, maintaining belief) of Swanson's Caring Theory were applied. The patient was encouraged to participate in the treatment plan and motivated to participate in rehabilitation. In addition, the caring capacity and care confidence of family members was enhanced in order to support the patient's further care after discharge. Furthermore, religious support was involved, which allowed the patient to communicate her emotions, reduce her stress, and achieve spiritual comfort. By providing care in the realms of physiology, psychology, and spirit, the author helped the patient regain her self-worth and enhance her positive beliefs in the future. This case report is hoped to provide medical staffs with a reference for facilitating the recovery of elderly patients experiencing disease-related powerlessness.

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.

Vasculitis and biologic infusion therapies: implications for nursing.

Vasculitis is a heterogeneous group of uncommon, complex rheumatologic diseases. These diseases are known for their high mortality and morbidity rates due to the underlying disorders themselves, as well as complications of their conventional treatments. Oral and intravenous glucocorticosteroids and other immunosuppressive agents such as cyclophosphamide, methotrexate, and azathioprine are used to manage these diseases. These therapies are effective, but they have a global impact (often negative) on patients' immune systems and cause a number of nonimmunologic toxicities. They also are ineffective in inducing long-term remissions. Novel biologic infusion agents such as rituximab and infliximab are being prescribed off-label for some patients with vasculitis who have failed to respond to conventional therapy or because there are contraindications to standard-of-care treatments. This article provides an orientation to vasculitis, its standard of care, infusion biologics under investigation in these diseases, and the nursing implications for infusion professionals.

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.