Making Best Practice, Every Day Practice
This resource is fully searchable using the search box at the top of the page, or to narrow down your selection using filters click on 'Knowledge hub' in the main navigation.
Here you will find:
More than 500 articles especially written by colleagues to support your care of patients with the cardiovascular diseases commonly seen in primary care.
Articles on the diagnosis and treatment of patients with cardiovascular conditions such as:
…and more.
Simple and informative infographics which will answer questions such as “How do these drugs work?”, “What causes this heart condition?” and much more.
I am keeping my fingers crossed as I write this that you are all having to apply sun protection factor 30 as a result of a glorious summer and that you are enjoying reading this issue of British Journal of Primary Care Nursing to the accompaniment of gently chinking ice cubes as drinks are served to you while you recline under a parasol! Well it was a nice thought!
Acute coronary syndromes (ACS) include common and high-risk conditions such as unstable angina, which can be difficult to diagnose, particularly in women, the elderly and diabetics. Early identification and appropriate management can significantly reduce the risk of death, morbidity and subsequent hospital admissions. This article aims to clarify what happens in ACS, how they present and how they should be managed.
Welcome to the latest issue of the British Journal of Primary Care Nursing (BJPCN). The NHS is currently in meltdown around the ears of primary care teams, with new mergers and reshuffles. There is great uncertainty about who will lead the new PCTs and the structures that will support the delivery of CHD and diabetes care. But, like many of you, I have been around long enough to know that things ‘go in circles’.
Disease registers are essential for practices to optimise the diagnosis, management and follow-up of patients with a particular condition, in addition to being an important feature of the Quality and Outcomes Framework. Practices are responsible for demonstrating that they have systems in place to maintain a high-quality register. In this article, we look at a ‘recipe’ for validating a coronary heart disease (CHD) register – but the same method used for validating and maintaining the register can apply to any disease, using appropriate diagnostic and treatment information.
Welcome to our second birthday edition of the British Journal of Primary Care Nursing (BJPCN). We can’t promise you cake and candles but we have a lot of goodies that should help smooth the way for primary care nurses in our efforts to improve the management of CVD and diabetes.
The metabolic syndrome is characterised by a cluster of metabolic risk factors which may include abdominal obesity, dyslipidaemia, high blood pressure and insulin resistance or glucose intolerance. Patients with this cluster are at increased risk of coronary heart disease, stroke, peripheral vascular disease and type 2 diabetes. The dominant underlying risk factors for the syndrome are abdominal obesity and insulin resistance – so the epidemic of obesity means that we will be seeing a major increase in cases of metabolic syndrome over the next few years. Management requires tight control of all risk factors, with weight loss and prevention of weight gain being important preventive measures.
Under the new GMS (nGMS) contract, practices can report patients as exceptions under certain circumstances. Exception reporting prevents a practice being penalised under the Quality and Outcomes Framework of nGMS for factors outside its control or for a range of other patient-related issues. In this article, we review when patients can be reported as exceptions, how to report exceptions and some practical examples of exception reporting.
Implantable Cardioverter Defibrillators (ICDs) have – quite literally – fired a major revolution in the management of patients at high risk for potentially life-threatening arrhythmias. More sophisticated than pacemakers, ICDs monitor the heart constantly, but only initiate an electrical signal when they detect an incorrect heart rhythm. ICDs can function as pacemakers for slow heart rates, but may also deliver high-energy electrical therapy for fast heart rates. In this article, we review how ICDs work, how they are used and what care we need to provide for patients who have had these devices implanted.
Practice-based commissioning – in which practices commission care directly – will be universal by December 2006. This means that it is no longer an option for practices to commission the care they need for their patients. We must either get involved and take control of this opportunity or allow someone else to do it for us. This may be our last chance to remain independent and to manage our practices rather than being managed by others. In this article, we look at what practice commissioning will involve and how it will affect practices and PCTs.
Chronic leg ulcers are a major health problem in the UK, affecting many older people and costing the NHS up to £600 million per year. Chronic leg ulcers are generally managed in primary care: more than 80% of chronic leg ulcers are cared for in the community. Healing rates are currently low and recurrence rates are higher than 67%. However, appropriate use of available treatments can reduce recurrence rates to between 20% and 30%. In this article, we review the causes of venous ulceration, how to spot the problem early and how to optimise leg ulcer healing.
Physical activity reduces the risk of developing heart disease and lowers the risk of death and further events in patients with cardiovascular conditions. This article reviews the benefits of exercise and shares some of the strategies our team uses to help patients with heart disease increase their levels of physical activity and keep active after they have completed phase 3 cardiac rehabilitation.
All in all, it’s been a good year for primary care in the UK. Results from the first year of the Quality and Outcomes Framework (QOF) showed practices have performed much better than anyone expected in terms of delivering very high quality care. BJPCN is designed to help you keep hitting the challenging targets practice teams will be aiming for in the year ahead.
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