British journal of nursing (Mark Allen Publishing)
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Protecting the perineum from faecal enzymes and preventing faeces from spreading to wounds has been a major challenge for nurses and doctors. Clinicians whose patients are at risk of faecal contamination of wounds have used various methods and many non-standard devices have been trialled, including: large French urinary catheters; rigid rectal catheters; faecal collection bags; mushroom-tipped catheters; nasopharyngeal airway; pharmacological and dietary interventions; incontinence pads; and barrier creams. ⋯ The purpose of this paper is to consider the use of purpose-designed faecal or bowel-management systems-the ConvaTec Flexi-Seal® FMS and Hollister InstaFlo® and ActiFlo® bowel management systems (BMS)-available in Australia at the time of writing. Overall, the authors believe that such purpose-designed systems are more efficient and cost-effective than other ad hoc measures.
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Chemotherapy is increasingly being administered as a treatment for cancer and with it are a number of possible side effects. One, which has a negative impact on a patient's quality of life and their self-esteem, is that of chemotherapy-induced alopecia (CIA). ⋯ This article explores the issue of CIA from the patient's perspective and scalp cooling as a preventative measure, along with a review of the evidence around the risk associated with developing scalp metastases following scalp cooling. It also discusses why scalp cooling should be available for both male and female patients; along with the potential impact scalp cooling may have on clinical areas delivering chemotherapy.
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Significant psychological impacts, including post-traumatic stress disorder (PTSD), have been associated with patients under sedation in intensive care units (ICUs). However, it remains unknown if and how sedation is related to post-ICU psychological outcomes. This literature review explores the relationships between sedation, the depth of sedation and psychological disorders. ⋯ To ensure subject relevance pre-2006, non-English and paediatric-based research was excluded. Findings highlighted that reduced sedation levels did not significantly reduce the outcome of PTSD, yet reduced ICU length of stay and length of mechanical ventilation (MV) were both associated with lighter sedation. Further research is recommended into more specific factual and delusional memories post ICU in relation to the level of sedation and to psychological distress.
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Spirituality is a complex and subjective concept. However, spiritual wellness is an important component in a person's overall well-being and the spiritual support of patients is central to nursing care. ⋯ Spiritual care for people with dementia involves reflective practice and meaningful engagement with the person with dementia, so as to facilitate shared understanding. Furthermore, the support of the spiritual and religious beliefs of the person need to be facilitated within an individualised or person centred approach to care and delivered within a multi-disciplinary collaborative context.
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Personal experiences of aggression or violence in the workplace lead to serious consequences for nurses, their patients, patient care and the organisation as a whole. While there is a plethora of research on this topic, no review is available that identifies types of aggression encountered, individuals perceived to be most at risk and coping strategies for victims. The aim of this systematic review was to examine occupational anxiety related to actual aggression in the workplace for nurses. ⋯ After removal of duplicates and non-relevant titles, 137 papers were read in full. Physical aggression was found to be most frequent in mental health, nursing homes and emergency departments while verbal aggression was more commonly experienced by general nurses. Nurses exposed to verbal or physical abuse often experienced a negative psychological impact post incident.