It’s good to talk. Communicating effectively with our patients and their families is a key part of our jobs as primary care nurses and we have a major new communication job on our hands over the next few months. The new guideline from the National Institute for Health and Clinical Excellence makes ambulatory monitoring part of routine practice for diagnosing high blood pressure (BP), so we are going to need to explain to patients why we are sending them home with monitors rather than just taking BP readings in the practice.
Nine processes of care for diabetes
The National Institute for Health and Clinical Excellence (NICE) recommends that all people with diabetes should receive nine key tests at their annual diabetes review. These important markers ensure diabetes is well controlled and are designed to prevent longterm complications. The nine key tests are: weight, blood pressure, smoking status, HbA1c, urinary albumin, serum creatinine, cholesterol, eye examinations and foot examinations. This review discusses the importance of each marker of improved long-term care of patients.
Putting the NICE guideline on ambulatory blood pressure monitoring into practice
Heart failure: managing breathlessness and oedema
Heart failure is characterised by fatigue, breathlessness and retention of fluid. The update of the National Institute for Health and Clinical Excellence chronic heart failure guidelines has simplified its management by using a stepped approach to investigation and treatment. In this article, we focus on the practical aspects of managing the two main symptoms associated with heart failure – oedema and breathlessness.
One in five strokes warn you they are coming: treat transient ischaemic attacks as emergencies
Transient ischaemic attack (TIA) is a powerful warning sign of an impending, and potentially disabling, stroke. It is important to understand differences between stroke and TIA, how the FAST test can help you recognise the signs, and the use of the ABCD2 score to assess the level of stroke risk. Treating TIAs as emergencies is critically important in preventing a full stroke so urgent referral to your local TIA service is best practice.
Supporting people with communication problems after stroke
Communication problems are one of the most common after-effects of stroke, affecting about one in three people. Losing the ability to speak or understand language – aphasia – is frightening and frustrating. This article offers insights and practical tips to aid communication.
Back to Basics: The five key functions of the kidneys
Ensuring an early diagnosis of type 1 diabetes to prevent ketoacidosis
The onset of type 1 diabetes is usually rapid, taking patients and their relatives and friends, and even healthcare professionals by surprise. Diagnosis can involve some degree of diabetic ketoacidosis (commonly referred to as DKA). It is estimated that approximately 30% of newly diagnosed children seen by a healthcare professional have problems related to their diabetes before diagnosis, which suggests that practitioners are missing opportunities to diagnose type 1 diabetes at an earlier stage and possibly avoiding DKA. In this article, we explore how primary care staff can achieve earlier diagnosis of type 1 diabetes.
Preventing delayed diagnosis of type 1 diabetes: time to act
Explaining the concept of absolute cardiovascular risk to patients
Putting Prevention First – the national strategy for assessing cardiovascular risk in everyone between the ages of 40 and 74 years – is here to stay, regardless of any changes in the NHS. This strategy is based on assessing a patient’s individual risk of cardiovascular disease and, where this risk is significant, offering them measures to reduce this risk. In this article, we look at how to achieve a key step in this process: explaining the complex concept of absolute cardiovascular risk to patients so they understand what’s at stake when deciding whether or not to take their statin or antihypertensive.
BATMAN’s mission: reduce the impact of stroke
In this new series, BJPCN interviews key people leading major initiatives in the prevention and treatment of CVD and diabetes. Alastair Bailey, who leads the Brain Attack Team (BAT) at Leeds Teaching Hospitals Trust explains how the team ensures that patients with stroke receive prompt thrombolytic treatment to improve outcomes.
