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.
Welcome to this issue of the journal, with holidays a distant memory and the ‘back to work’ feeling which September brings. A little like January, September is a time of year associated with starting again, perhaps because we remember returning to school for the new academic year. BJPCN provides key information to help you negotiate your way successfully through the latest ‘timetable’ for general practice, ensuring that you are in the right place at the right time.
In the fourth article in our series on the Quality and Outcomes Framework (QOF) we will look at stroke and transient ischaemic attack (TIA). This is an area that has probably been ignored in many practices with regard to secondary prevention. It was not included in any of the previous NSFs and there had been no targets to encourage evidence-based treatment in Primary Care, up until the arrival of the QOF.
Heart failure has gradually emerged from the ‘shadows’ of cardiovascular medicine, to a condition that is now actively investigated, treated and monitored. Appropriate diagnosis and management of heart failure is rewarded in the GMS QOF points. In this article, we will briefly review the impact and causes of heart failure, and then explore how many patients with heart failure you can expect to have on your register and how many new cases you should be aiming to find each year.
The concept of networks – groups of different people working together – is not new, as health professionals have been working collaboratively for the benefit of patient care for many years. What is new is the formalising of clinical networks that focus on connecting teams and organisations to improve the patient pathway. The Department of Health considers that networks have a key role in delivering improvements to patient care as part of meeting the Planning and Performance Framework targets for heart disease. An ‘open culture’ is being promoted to embrace modern ways of working through teams and networks rather than hierarchies and formal systems. This article aims to update you on what’s going on in cardiac networks.
Unstable angina describes a syndrome that is intermediate between stable angina and myocardial infarction: an accelerating or ‘crescendo’ pattern of chest pain that lasts longer than stable angina, occurs with less exertion or at rest, or is less responsive to medication. Unstable angina – like myocardial infarction – is an acute coronary syndrome (ACS), in contrast to stable angina, which is a chronic condition. It affects approximately six out of every 10,000 people. In this article, we review what causes unstable angina and how it should be diagnosed and treated.
In this second article in our series on the Quality and Outcome Framework (QOF), we will discuss how to maximise points in the secondary prevention of coronary heart disease (CHD) and heart failure. This will include lipid management and smoking cessation.
Welcome to the first year anniversary issue of the British Journal of Primary Care Nursing (BJPCN). It has been an eventful year for primary care nurses, with new challenges coming from all directions. In each issue of the journal we have tried to provide practical information and tools to help you find your way through the expanding universe of primary care in cardiovascular disease and diabetes – to boldly go where no primary care nurse has gone before!
Type 2 diabetes and the metabolic syndrome (where a patient has a cluster of metabolic risk factors, including atherogenic dyslipidaemia, raised blood pressure and insulin resistance) are growing problems. Most researchers believe that the key is central obesity – fat stored in the abdomen around internal organs, which produces inflammatory mediators such as tumour necrosis factor (TNF). This leads to insulin resistance, when the normal amount of insulin secreted by the pancreas is no longer able to activate receptors on body cells, resulting in impaired glucose metabolism. However, this is an evolving science and the precise details are not yet fully understood. The insulin resistance/metabolic syndrome often leads to type 2 diabetes as the pancreas becomes less responsive, but this is not inevitable.
For people with long-term conditions, self-care can have as much, if not more, influence on their health than prescribed medication and treatment. Yet, in many cases, healthcare professionals become frustrated when attempts to improve peoples’ self-care behaviours prove unsuccessful. This article looks at some of the reasons why it can be difficult to encourage people with diabetes or cardiovascular disease to look after themselves effectively; what types of practice can help us to increase people’s success in managing long-term conditions; and how we can incorporate empowering techniques in our day-to-day consultations.
Rehabilitation after a myocardial infarction (MI) includes all aspects of a patient’s life – medical, physical and social. Sexual functioning is an important part of most people’s lives. Fears about whether having sexual intercourse could trigger another heart attack is the question many post-MI patients want to ask but embarrassment may stop them. Giving accurate information about sex after an MI is just as much a part of patient education as telling them about cholesterol and blood pressure and can go a long way to helping recovery and preventing further problems such as sexual dysfunction.
Stroke is common, affecting around one in four people over the age of 45 at some time in their lives. Increasing age is a major risk factor for stroke, so the numbers of people suffering a stroke will increase with the ageing population. Primary care teams have a central role in providing effective secondary prevention, but because patients often fall between primary and secondary care, things may be missed. Taking a systematic approach to assessing risk factors, such as blood pressure, and treating them effectively can significantly reduce further stroke risk.
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