Making Best Practice, Every Day Practice
Well, how fast things change! The latest figures show that a massive proportion of practice nurses and nurse practitioners are going to retire in the next few years—me included, I guess. I am very aware that this exodus is already starting to have an impact on primary care, as I am receiving requests for advice from brand-new practice nurses, who may be established nurses but are not general-practice prepared. This is scaring me and should frighten everyone else.
A patient may present at any time suffering from the signs and symptoms of anaphylaxis, (a severe, life-threatening, generalised or systemic hypersensitivity reaction). This article explains how to recognise anaphylaxis and how to treat anaphylactic shock. It also outlines the responsibilities of practice nurses and other members of the primary healthcare team after a patient has had a suspected anaphylactic reaction.
I looked through the topics in this issue of the journal and thought: wow, so many ways to kill ourselves younger than we really intended! I had also just heard a programme on the radio about the perils of alcohol consumption, especially in ladies ‘just like me’, and wondered if I should ever have a meal, a drink or sex again—it all sounded so risky.
It has become increasingly clear that many people in this country are putting themselves at risk because they are continuing to drink above their recommended weekly units. Most of these people are not drunk drivers in police cells or antisocial drinkers arriving at A&E departments on Saturday night. They are people who come to see us at our chronic disease clinics or for treatment for an acute illness. The inclusion of questions about alcohol in NHS Health Checks is the ideal opportunity to discuss the potential risks of excessive drinking, and this special issue explains how we can help patients to choose a healthier approach to alcohol.
GPs, practice nurses and other primary healthcare professionals are now at the frontline of managing cardiovascular disease (CVD) and delivering preventive care. The aim of this study was to explore clinicians’ experiences and their views on the factors that influence their ability to fulfilthis demanding role. GPs and other primary healthcare professionals expressed similar views. In particular, they reported a sense of pressure and disempowerment, and voiced concerns about the ability of general practice to take on its greater role in reducing the burden of CVD.
Identifying those people at an increased risk of cardiovascular disease (CVD) who might benefit from a therapeutic intervention or lifestyle advice is an important challenge. We summarise here the performance of QRISK2 against the NICE version of the Framingham Risk Score.
We highlight in this article some of the issues on HIV and cardiovascular disease (CVD) to assist primary healthcare practitioners to improve the health outcomes, particularly in relation to CVD, of their HIV patients.
The number of deaths each year from cardiovascular disease (CVD) has nearly halved in the UK since the early 1980s. There are many reasons for this success, but 25%-50% of the decline in deaths from coronary heart disease (CHD) can be attributed to secondary prevention in high-risk patients. However, despite the hard work of GPs […]
“The hardest conviction to get into the mind of a beginner is that the education upon which he is engaged is not a medical course but a life course, for which the work of a few years under teachers is but a preparation.”Sir William Osler (1849-1919), from The Student of Medicine.
Exercise is a preventive tool in combating cardiovascular disease, type 2 diabetes and obesity: an extra 12 minutes a day could make a big difference.
People with schizophrenia have substantial premature mortality compared to individuals without schizophrenia. They also have a wide range of co-morbidities and multiple physical health conditions but are less likely than people without schizophrenia to have a primary care record of cardiovascular disease. This suggests a systematic underrecognition and under-treatment of cardiovascular disease, which may contribute to the increased mortality seen in this vulnerable patient group.
Drugs don’t work in people who don’t take them. This is a problem that affects 57% of all patients prescribed drugs to prevent heart attacks and strokes, according to a recent meta-analysis combining data from more than 370,000 patients.
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