Making Best Practice, Every Day Practice
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This year there is more reason than ever for people to stop smoking, with the ban on
smoking in public places coming into force in July. How can we support smokers
who want to quit? In this article, we provide a comprehensive guide to resources
that can help.
Bless you for your support and best wishes for my fifth London Marathon that took place in
late April. My chosen charities this year (Arrhythmia Alliance, www.arrhythmiaalliance.org.uk
and Stars, http://stars.org.uk) are special for me as I have had a pacemaker for ten years. It
was a surprise to be informed that I would have a new box fitted just three weeks before the
Marathon. However those of you who know me would know that would not stop my attempt!
But there are times when even I have to admit defeat! After completing over half the course in
two hours, I decided to let my heart rule my head for once and bail out gracefully before I
collapsed from heat exhaustion! When I was overtaken by a large carrot I knew it was going
to be a real struggle!
The current treatment of asthma in the UK is rightfully seen as a triumph of chronic disease management within a primary care setting. Almost all routine asthma care and, increasingly, elements of acute asthma care, are now provided in general practice. Over the past twenty years, significant effort and investment have gone into the production […]
What a winter we have had! Many children have seen heavy snow fall for the
first time and London was completely immobilised due to the weather. At the
same time our hospitals have been battling to cope with patients suffering with
respiratory infections and exacerbations of their COPD. GP practices have been
stretched to the limit to cope with the additional burden of coughs and colds.
Building capacity is a real problem for everyone working in the health service and
patients’ demands and expectations continue to grow.
This brief article summarises some of the key points in the recent oxygen guideline
that are of particular relevance to health professionals working in primary care.
It includes the appropriate monitoring of patients with asthma and COPD as well as
the correct equipment required. For full information on the guideline refer to
www.brit-thoracic.org.uk – emergency oxygen guidelines.
Modern medical practice emphasises the use of objective measurements and
evidence. Nobody would diagnose hypertension without measuring the blood
pressure, or manage diabetes without measuring blood sugar and glycated
haemoglobin. Yet it is only relatively recently that any lung function
measurements to support diagnosis and guide management of respiratory disease were
undertaken in primary care.
Patients with recurrent pleural effusions have, to date, mainly been cared for in hospital.
Many have had to undergo repeated hospital admissions, extended hospitalisation,
discomfort and time away from home. This is particularly the case in patients with
recurrent malignant pleural effusion (MPE). However, new technologies mean that these
patients may be managed by close co-operation between primary and secondary care. This
article describes some exciting developments in the management of pleural effusions in a PCT.
We are about to hit the festive season, but it is also a time when many
people reflect on the past year and make plans for the next – including
thinking about giving up smoking. In this issue we reflect on the impact of
the smoking ban in the UK. Hilary Wareing and Nina Gotz from the Tobacco
Control Collaborating Centre show how there have been significant benefits
in terms of air quality and increased numbers of quitters since the
smokefree legislation came into force between March 2006 and July 2007.
This has been a significant step forward in improving public health, and
provides a foundation to encourage more of your patients to quit.
Nurses know from first-hand experience that although asthma treatment has come a long way over the past few years, many patients with asthma remain uncontrolled. This results in unscheduled hospital appointments for patients and unnecessary limitations on their lifestyle.
In the current political and social environment, health care is changing at a frenetic pace and
nurses may feel that they are being left behind. The British Thoracic Society (BTS) and
General Practice Airways Group (GPIAG) support and represent practitioners with an interest
in secondary and primary care respectively. They have set up a joint initiative called
IMPRESS to help respiratory clinicians to understand what is going on and how to get involved.
This article gives an update on what the initiative is, how it works and what it’s done so far.
The rising incidence of a range of respiratory disorders means an increasing emphasis
on treatment, management and care. Although some respiratory diseases are acute,
many are chronic, bringing with them a burden of morbidity affecting patients in many
areas of everyday life. One area of concern for patients may be sexual functioning so
somewhere in the process of management and care the practice nurse may need to address the
issues of sexuality (Petty 1986, Kaptein et al. 2008).
Allergic or other immunological mechanisms are thought to account for 6-20% of
all adverse drug reactions, but in most cases the mechanism is unclear. This
article provides an in-depth review of drug allergy – adverse drug reactions with
a known immunological mechanism or with clinical features that mimic an
immunological reaction.
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