British journal of community nursing
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Chyle leaks occur when there is interruption to the lymphatic ducts that transport chyle around the body. The loss of this protein-rich, calorie-rich fluid can cause serious complications including dehydration, malnutrition and immunosuppression. Treatment of chyle leaks depends on the underlying cause, which may be surgical, secondary to malignant invasion or the result of a medical condition. ⋯ Nutritional management options include total bowel rest with parenteral nutrition, enteral feeding with specialized formula, or oral diet with supplementation. At present there is no consensus regarding which approach is superior. In reality, most patients with chyle leaks are managed with a combination or oral and enteral feeding, but further work is needed to clarify the optimum management strategy.
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Having failed in their attempt to persuade the United Kingdom Supreme Court to allow health professionals to participate in assisting patients to end their lives, the hopes of campaigners now lie with Parliament passing Lord Falconer's private members' Assisted Dying Bill. This article reviews the Supreme Court's decision in R (on the application of Nicklinson) v Ministry of Justice [2014] and considers how likely it is that Parliament will enact an assisted dying law.
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Br J Community Nurs · Jul 2014
Review Case ReportsDoes paracetamol help or hinder healing in bacterial infections?
Community nursing teams, alongside other primary care services and nurses in working in community hospitals, are caring for people who are older, sicker and require more complex care. The nurse's ability to use evidence to make informed judgements is vitally important to patient care. ⋯ This practice is supported by guidelines from the National Institute of Health and Care Excellence and the British National Formulary. This article reviews the evidence and suggests that the administration of paracetamol in people with pyrexia should be reconsidered and given on an individualised basis rather than as a routine.
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Br J Community Nurs · Jul 2014
District nurse responsibilities in relation to 'do not attempt resuscitation' decisions.
The Court of Appeal has ruled that patients and their relatives have the right to be consulted prior to a 'do not attempt resuscitation' notice being placed on file by a health professional. Failing to do so would be in breach of the patient's right to respect for a private and family life under the European Convention of Human Rights, article 8. This article sets out the steps that district nurses must take to ensure that 'do not attempt resuscitation' notices placed on the file of their patients are lawful.
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Br J Community Nurs · May 2014
District nurses' crucial role in identifying unlawful deprivation of liberty.
A recent judgement by the UK Supreme Court has widened the criteria for the type of care and treatment that amounts to a deprivation of liberty in hospitals and care homes. Very many more vulnerable residents in care homes should now benefit from the protection of the Mental Capacity Act 2005 deprivation of liberty safeguards. ⋯ They are ideally placed to help identify care that amounts to a deprivation of liberty in the care homes that they visit. This article discusses how district nurses must inform their practice by making reference to the UK Supreme Court judgement on the use of the deprivation of liberty safeguards and the actions that district nurses must take if they suspect a care home is depriving a resident of their liberty without authorisation.