This paper presents a literature review of two commonly used osmotic laxatives, lactulose and polyethylene glycol (PEG). With increasing numbers of nurses in the community being non-medical prescribers, informed decisions on choice of laxatives is required. Nurses who do not prescribe will often have a view for the benefit of their patients. Following a literature search, eight papers were selected for review. The review leads to the conclusion that, while both preparations are useful, PEG is more effective in many instances and should be the laxative of choice unless there are contraindications arising from the assessment of the patient. Non-pharmacological approaches to the management of constipation should be addressed before considering laxative use.
District nurse numbers in the UK are rapidly declining. To overcome this severe staff shortage, one community trust in a rural county appointed ‘case managers’ (nurses without Specialist Practice Qualifications in district nursing [SPQDN]) in band 6 leadership roles that were traditionally held by district nurses. Here, we aimed to establish the value of the SPQDN to determine if there is a future for the conventionally accepted DN role, instead of case managers. The study used an exploratory mixed-methods design. Using the classic e-Delphi technique, data were collected over 5 months from 10 purposively sampled senior nurse managers employed by the community trust who formed an expert panel. In round one, the panellists provided three responses each to the question ‘what is the future for district nurse specialist practitioner qualifications in [the trust] for band 6 leadership roles?’ In rounds two and three, they answered a close-ended questionnaire using a 3-point Likert scale. The core findings suggest that SPQDN and the district nurse role are considered extremely valuable (both achieving 100% consensus). Additional findings are linked to four core themes, namely, (1) SPQDN, (2) clinical practice educators, (3) workforce and (4) leadership. This study recommends continued investment in SPQDN and the district nurse role with the use of succession planning for workforce management.
In this case report the development of a vitamin K deficiency in a neutropenic adolescent receiving parenteral nutrition following bone marrow transplantation is described. The parenteral nutrition solution did not provide vitamin K and the patient had been receiving oral antibiotics prior to and during use of the intravenous feeding. Oral intake was minimal. Standard adult oral and intravenous multivitamin preparations for use in individuals older than 11 years do not routinely contain this vitamin. The function of vitamin K and causes for development of a deficiency are reviewed. Recommended intakes and guidelines for supplementation are also discussed.
Innovation plays a critical role in progress towards achievement of the World Health Organization's road map for neglected tropical diseases 2021–2030. As disease prevalence decreases, the cost to identify and treat remaining cases goes up. Additionally, as programmes move to the surveillance phase, diagnostic tests need to be highly sensitive and affordable. Until the early end to the Ascend West and Central Africa programme, the Ascend Learning and Innovation Fund supported five projects from 2019 to 2021. Designed for innovation, the fund encompassed a range of activities, including operational research, product development and social behavioural change. This flexibility allowed innovation to bridge the gap between strategic policy and practical implementation, piloting and proving business models to respond to information found through Ascend.
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