Orthopaedic nursing and the COVID19 pandemic: the first few months

This is an accepted manuscript of an article published by Elsevier in International Journal of Orthopaedic and Trauma Nursing on 17/06/2020, available online: https://doi.org/10.1016/j.ijotn.2020.100794 The accepted version of the publication may differ from the final published version.At the time of writing (early June 2020), the COVID19 pandemic has affected almost every aspect of life in every part of the globe. This frightening disease has devastated families, communities, and society. Despite this, the hard work and astounding adaptability of healthcare organisations and their staff has been making headlines everywhere. The planning, alterations to existing systems, new rules and guidelines and managing staff and patient expectations has created significant pressure and stress at all levels. The exisiting shortages of nurses and variations in nurses’ working conditions in some countries forms the background to this significant increase in activity. The global economic impact of the pandemic will ultimately lead to a deeper fiscal crisis in many economies that will place additional pressure on future resourcing of healthcare and, perhaps, motivate governments to rethink how healthcare is funded.Published versio

The early benefits of a problem-based approach to teaching social inclusion using an online virtual town

This article describes the delivery of a core pre-registration nursing and midwifery module centred on social inclusion. The module was previously delivered using a classroom-based problem-based learning approach. Difficulties with this approach led to changes to the module and its delivery. Logistic issues encouraged the module team to implement a blended learning approach using a virtual town to facilitate online learning and discussion activities. The paper describes and discusses the use of online learning technology to support student nurses and midwives. It highlights the benefits of this approach and outlines some of the experiences of the students including their evaluation of the virtual town. There is also an examination of some of the practical and theoretical issues related to both problem-based learning, online working and using a virtual town to support learning. This article outlines the approach taken and its implications

The value of nursing

EditorialPaul McLiesh, Rebecca Jester, Julie Santy-Tomlinso

Calm, irritated or infected? The experience of the inflammatory states and symptoms of pin site infection and irritation during external fixation: a grounded theory study.

Aim.  To explore patients' experiences of the symptoms of suspected wound infection in external fixator pin sites. Background.  Pin site infection is painful and distressing and can threaten the success of treatment. It is difficult for patients and clinicians to differentiate between pin site infection and irritation or foreign body reaction to the pin. There is no validated outcome measure for infection that enables the success of interventions for prevention and management to be evaluated. There is a need to develop accurate patient-orientated assessment criteria. Design.  Qualitative design, using grounded theory. Method.  Following written informed consent, a theoretical sample of 16 adults with an external fixation device that had been in situ for at least 12 weeks was recruited. They had experienced a pin site infection in the previous four weeks. Data were collected using semistructured interviews, and data collection was stopped when saturation was achieved. Analysis took place using constant comparative analysis. Results.  Participants described three 'clinical states' of pin site wounds: calm, irritated and infected. They described the differences in each state in relation to pain, redness, swelling, discharge and general symptoms. Symptoms were absent or varied in intensity depending on whether the pin sites were calm, irritated or infected. Conclusion.  This study provides insight into patients' experiences of the symptoms of pin site infection resulting in an emerging theory based on conceptualisation of this experience, which is that of dimensions of inflammatory pin site states. The detail given will enable clinicians and researchers to be more accurate in recognising infection and begins to clarify the difference between a wound that is irritated and a wound that is infected. The findings will enable the development of a patient-orientated outcome questionnaire for pin site infection. Relevance to clinical practice.  There is a need for patients and clinicians to be able to differentiate between infected, not infected and irritated pin sites

Nutrition Support in Older Adults

Malnutrition is observed in around one in three hospital inpatients; this harmful ICD10-AM-coded disease is a strong independent predictor of adverse older adult and healthcare outcomes, mortality, and treatment costs globally, particularly in multimorbid, older adults. Despite recognition of malnutrition as a disease, nutrition support prescriptions are often not valued as the medicine to treat it. This chapter is devoted to the common nutrition support prescriptions for treating malnutrition: (1) protein- and energy-dense and/or fortified foods, fluids, and menus (HPHE support); (2) oral nutrition supplements; (3) enteral tube feeding; and (4) parenteral nutrition.Peer reviewe

Overview of Nutrition Care in Geriatrics and Orthogeriatrics

Engaging older adults, and all those who care for them, is pivotal to providing high-value nutrition care for older adults. Nurses and other interdisciplinary team members are essential to this process. The aim of this chapter is to provide an overview of the rationale and evidence for interdisciplinary and systematised nutrition care as an effective nutrition care approach for older adults with or at risk of malnutrition. This chapter also serves as a guide to detailed chapters across this book to provide focal points on different aspects of nutrition care that should be considered across primary prevention, acute care, rehabilitation, secondary prevention and community settings (Dreinhöfer et al., Injury 49(8):1393–1397, 2018).Peer reviewe

Nursing care of fragility fracture patients

The challenge of caring for patients with fragility fractures is particularly acute for nursing teams who are in short supply and work with patients following fracture on a 24 h basis, coordinating as well as providing complex care. This paper considers the role of nurses within the orthogeriatric team and highlights the value of effective nursing care in patient outcomes. It explores the nature of nursing for patients with fragility fracture with a focus on the provision of safe and effective care and the coordination of care across the interdisciplinary team. It also highlights the need for specific skills in orthopaedic and geriatric nursing as well as specialist education. (C) 2018 Elsevier Ltd. All rights reserved

Nursing care of fragility fracture patients

The challenge of caring for patients with fragility fractures is particularly acute for nursing teams who are in short supply and work with patients following fracture on a 24 h basis, coordinating as well as providing complex care. This paper considers the role of nurses within the orthogeriatric team and highlights the value of effective nursing care in patient outcomes. It explores the nature of nursing for patients with fragility fracture with a focus on the provision of safe and effective care and the coordination of care across the interdisciplinary team. It also highlights the need for specific skills in orthopaedic and geriatric nursing as well as specialist education. (C) 2018 Elsevier Ltd. All rights reserved