Cultural safety is one approach to integrating cultural components into nursing care. It is based on a broad definition of culture and on nurses' analysis of their cultural selves and the impact these have on therapeutic encounters. It is the service user who judges whether the professional relationship feels culturally safe.
Background: Nutritional problems often manifest during late-stage dementia, and some families may request to instigate artificial nutrition and hydration (ANH) therapies. In the US, an estimated one-third of nursing home patients with a severe cognitive impairment have artificial feeding tubes inserted. Fear that a relative could experience extreme hunger or thirst if they are not mechanically fed tends to be the main driver behind family's requests to implement artificial or enteral feeding methods. In contrast, artificial hydration is rarely given to older people with dementia in the UK and this practice of non-intervention tends to apply across all healthcare and hospice type environments. Aim: This literature review aims to evaluate the evidence to support the use and non-use of ANH. Method: A literature review was undertaken to examine the evidence around ANH for patients with dementia to offer support to families or carers contemplating feeding choices. Conclusion: This paper challenges the implementation of invasive ANH worldwide. It highlights how resorting to ANH does not necessarily lead to improvements in comfort, survival or wound healing. The risk of aspiration does not appear to significantly alter either.
A number of relevant issues are considered which show that it is essential to address the issue of in-centre meals during dialysis. This discussion paper critically explores the potential complications posed to patients who consume a large calorific intake during their dialysis treatment. The mission is to appeal to more dialysis units and outpatient departments to gradually implement a 'no food' policy during regular scheduled dialysis treatment sessions. The authors aim to put forward the significances and challenges and offer some possible solutions when introducing a 'no eating policy' like this into dialysis units. Nutritional supplements could, however, be offered on an as required basis.
The information provided in this article has been developed to coincide with the recent findings from a National Confidential Enquiry into Patient Outcome and Death (2008) report, 'A Sickle Cell Crisis', which calls for nurses to learn more about the disorder in order to better support patients in their care. This article reiterates much of the previous written literature, which has made reference to compromised patient care due to the ongoing unfamiliarity surrounding sickle cell disorders among healthcare professionals in Western societies. Readers will be given an overview of the condition and general clinical guidance on the management of care for patients when they are experiencing a state of'crisis'. Readers should note that the term 'painful episodes' is sometimes used in preference to sickle cell 'crises'.
Long-term mechanical ventilation (in patients who require mechanical ventilation for longer than 24 hours) has been associated with prolonged anxiety, chest infections and high mortality rates. Prolonged mechanical ventilation is also costly, as it tends to be carried out in critical care environments which require high levels of staffing. Therefore, it would appear to be of great benefit to patients, relatives and all multidisciplinary healthcare professionals concerned in delivering respiratory care if patient ventilation was kept as brief as possible. Current opinions seem to suggest that nurses can be the key players in reducing the time on a mechanical ventilator for patients and can take the lead on the extubation process of ventilatory weaning.
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