Starting a career in research nursing during a global pandemic.

In the spring of 2020, two nurses (KR and AJ) commenced their research nurse careers amid the SARS-Cov-2 (COVID-19) global pandemic. This reflective article discusses their experiences of beginning a clinical research nursing career, presented as a case study of their learning journey, rather than detailing the randomised controlled trial they delivered via GP practices. The main study compared standard care to nurse-led management of irritable bowel syndrome, the details of which will be published separately. The article identifies three overarching concepts: 'Green as grass, keen as mustard', 'Spires and steeples', and 'Down the rabbit hole'. The article offers insight from the two nurses for other professionals contemplating a career in research.

Innovate to eliminate: a prerequisite in NTD programmes.

Innovation plays a critical role in progress towards achievement of the World Health Organization's road map for neglected tropical diseases 2021-2030. As disease prevalence decreases, the cost to identify and treat remaining cases goes up. Additionally, as programmes move to the surveillance phase, diagnostic tests need to be highly sensitive and affordable. Until the early end to the Ascend West and Central Africa programme, the Ascend Learning and Innovation Fund supported five projects from 2019 to 2021. Designed for innovation, the fund encompassed a range of activities, including operational research, product development and social behavioural change. This flexibility allowed innovation to bridge the gap between strategic policy and practical implementation, piloting and proving business models to respond to information found through Ascend.

Essentials of wound care: assessing and managing impaired skin integrity.

The assessment and management of impaired skin integrity as part of wound care is a common nursing task. Specific wound assessment tools may assist nurses to structure an assessment, but wider holistic factors also need to be considered. The TIMERS (tissue, inflammation and infection, moisture balance, edge, repair and regeneration, and social factors) tool offers a flexible approach to assessing wounds holistically and can be applied in all wound aetiologies. This article provides nurses with an overview of the assessment and management of impaired skin integrity using the TIMERS tool. It also discusses the importance of shared decision-making between nurses and patients when formulating a wound care regimen.

Future of Specialist Practice Qualifications in district nursing for band 6 leadership roles.

District nurse numbers in the UK are rapidly declining. To overcome this severe staff shortage, one community trust in a rural county appointed 'case managers' (nurses without Specialist Practice Qualifications in district nursing [SPQDN]) in band 6 leadership roles that were traditionally held by district nurses. Here, we aimed to establish the value of the SPQDN to determine if there is a future for the conventionally accepted DN role, instead of case managers. The study used an exploratory mixed-methods design. Using the classic e-Delphi technique, data were collected over 5 months from 10 purposively sampled senior nurse managers employed by the community trust who formed an expert panel. In round one, the panellists provided three responses each to the question 'what is the future for district nurse specialist practitioner qualifications in [the trust] for band 6 leadership roles?' In rounds two and three, they answered a close-ended questionnaire using a 3-point Likert scale. The core findings suggest that SPQDN and the district nurse role are considered extremely valuable (both achieving 100% consensus). Additional findings are linked to four core themes, namely, (1) SPQDN, (2) clinical practice educators, (3) workforce and (4) leadership. This study recommends continued investment in SPQDN and the district nurse role with the use of succession planning for workforce management.

Wound care in older adults.

Wound care in older adults is complex. A logical, structured approach should be taken, using a nursing process such as assessing, planning, implementing and evaluating. This clinical focus paper outlines the nursing process to support wound care in this patient group. It recommends considering dressing selection as a cost-effective, prescribing decision because of the risks and comorbidities associated with these patients.

Assessing success--a commentary on the necessity of outcomes measures.

Measurements for outcomes reporting are not fully formed and utilized in the American addiction industry, though formulated and adopted elsewhere in the world. While studies have established demographic information about those needing and receiving treatment as well as the facilities that offer such treatment, short- and long-term outcomes are scantily reported. This commentary serves as a call to action to developing such metrics in the US by illustrating the benefits to treatment providers and clients of creating outcomes standards, and the subsequent improvements in quality of care needed to reach those standards. Benefits of developing these metrics beyond improved quality of care may also include a more efficient allocation of resources, such as time and money. Additionally, the delivery of more effective, personalized, and outcomes-driven addiction treatment may increase client buy-in and foster a more open communication channel between clients and providers during and after treatment.

A literature review of two laxatives: lactulose and polyethylene glycol.

This paper presents a literature review of two commonly used osmotic laxatives, lactulose and polyethylene glycol (PEG). With increasing numbers of nurses in the community being non-medical prescribers, informed decisions on choice of laxatives is required. Nurses who do not prescribe will often have a view for the benefit of their patients. Following a literature search, eight papers were selected for review. The review leads to the conclusion that, while both preparations are useful, PEG is more effective in many instances and should be the laxative of choice unless there are contraindications arising from the assessment of the patient. Non-pharmacological approaches to the management of constipation should be addressed before considering laxative use.

Pilot study of interpersonal psychotherapy versus supportive psychotherapy for dysthymic patients with secondary alcohol abuse or dependence.

Interpersonal psychotherapy (IPT) has demonstrated efficacy for depression but yielded negative results for substance disorders. Alcohol abuse frequently complicates mood disorders. This pilot study compared IPT with brief supportive psychotherapy (BSP) for dysthymic disorder and alcohol abuse. We hypothesized that effect sizes would suggest greater IPT efficacy for both diagnoses, despite limited statistical power. Subjects with primary DSM-IV dysthymic disorder and secondary alcohol abuse/dependence were randomly assigned 16 weeks of IPT (N = 14) or BSP (N = 12). Patients in both treatments reported improved depressive symptoms and alcohol abstinence. IPT had a large and BSP a moderate effect size in depression, whereas BSP had a moderate and IPT a small effect size in percentage of days abstinent. This pilot study offers initial data on IPT and BSP for comorbid chronic depression and alcohol abuse/dependence. Results suggest IPT may have specific antidepressant benefits for dysthymic alcoholic patients but not in treating alcoholism.