Background: Adult community nursing services are evolving around the world in response to government policies and changing patient demographics. Amidst these changes, recruitment and retention of community nursing staff are proving a challenge. An integrative literature review has identified multiple factors that influence nurse retention in adult community nursing with sparse information on recruitment factors. Although factors impacting retention of community nurses have been identified, their generalisability around the world is a challenge as they are context and co-dependent. Indicating the need for this area of study to be explored at a local level, as the same factors present with different findings globally. Aim: To establish factors influencing recruitment and retention of registered nurses in adult community nursing services. Design: Integrative literature review. Data sources: Four electronic databases were searched in August 2019 from January 2008 to December 2018: CINAHL Complete, Web of Science, MEDLINE and PROQUEST. Both qualitative and quantitative studies focusing on factors influencing community nursing recruitment and retention were included. Review methods: An integrative literature review methodology by Whittemore and Knafl (The integrative review: updated methodology. Journal of Advanced Nursing 52, 546–553) was followed, supported by Cochrane guidelines on data synthesis and analysis using a narrative synthesis method. The Center for Evidence-Based Management (CEBMa) critical appraisal tools were used for study quality assessment. Results: Ten papers met the study inclusion criteria. Data synthesis and analysis revealed individual and organisational factors influencing the retention of community nurses with the following three dominant themes: (1) work pressure, (2) working conditions and (3) lack of appreciation by managers. Conclusion: The review identified context-dependent factors that influence adult community nurses’ retention with limited generalisability. There is a lack of data on factors influencing recruitment into adult community nursing; further research is needed to explore factors affiliated to community nursing recruitment.

Venous leg ulcers are open lesions between the knee and the ankle joint, which occur in the presence of venous insufficiency. There are theories to explain the causes of venous insufficiency, which ultimately leads to venous hypertension and can result in leg ulceration. Although many patients present with evidence of venous hypertension, others do not, except for the manifestation of the ulcer. There are risk factors associated with venous insufficiency and a holistic approach must be taken in order to influence the management approach of venous leg ulceration. This article discusses venous insufficiency as a disease process, and explores the nursing assessment process, when assessing venous leg ulcers related to venous insufficiency.

The management of wound exudate remains a clinical challenge despite technological advances in products with better exudate-handling capacities. This clinical challenge is occasionally encountered when thick exudate (viscous exudate) is present, and when most modern dressings do not possess the capabilities to manage the viscosity while enabling exudate absorption. Maceration to the peri-wound area poses another challenge, irrespective of the number of topical barrier application products on the market and the innovation of dressing products that lock exudate away or those that encourage vertical wicking. In addition to all the above, in clinical practice, the assessment and documentation of wound exudate remains sporadic, leading to the challenges of effective wound exudate dressing selection and cost-effective dressings.

Chronic wounds are defined as those that have failed to heal after three months. There are various intrinsic and extrinsic factors that may result in the development of chronic wounds, including comorbidities such as diabetes mellitus and venous insufficiency, and lifestyle factors such as obesity, alcohol consumption and smoking. Chronic wounds represent a significant burden on healthcare resources and can have a negative effect on patients' quality of life. This article discusses the assessment and treatment of non-healing chronic wounds. It examines the normal wound-healing process and the management of chronic wounds, including advanced interventions such as electrical stimulation therapy, negative pressure wound therapy and various dressings. This article does not focus on specific wound types; instead, it provides an overview of the factors that can lead to the development of chronic wounds and how these wounds can be managed in clinical practice.

Chronic wound management remains challenging in clinical practice, especially in the presence of bacterial bioburden and slough. To resolve these clinical challenges, it is essential clinicians implement the TIME framework (tissue, inflammation/infection, moisture, edge of wound) as a model of effective wound bed preparation. As a result of advances in technology and wound care therapies, on the market today are products that can help reduce the wound bed clinical challenges recommended by the TIME framework. This article looks at a wound cleansing solution that reduces the wound bed bioburden by breaking down biofilms and debriding slough.