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Personal experiences of aggression or violence in the workplace leads to serious consequences for nurses, the patient, patient care and the organisation. While there is a plethora of research on this topic no review is available that identifies types of aggression encountered, individuals perceived to be most at risk and coping strategies for victims. The aim of this systematic review was to examine occupational anxiety related to actual aggression in the workplace for nurses. Databases (Medline, CINAHL and Psyinfo) were searched resulting 1543 titles and abstracts. After removal of duplicates and non-relevant titles, 137 papers were read in full. The major findings of the review were that physical aggression was most frequent in mental health, nursing homes and emergency departments while verbal aggression was more commonly experienced by general nurses. Nurses exposed to verbal or physical abuse often experienced a negative psychological impact post incident.

In this paper, the role of the mentor in supporting student learning and development in clinical practice areas and promoting their socialization into their occupational roles is discussed and explored. Examining the literature relating to the mentor, the essential nature of this role is investigated and related to the socialization process of student nurses; with the importance of maintaining and developing an effective learning environment for the students being examined and considered. The paper concludes that the mentor role is essential in preparing students for their professional role and in ensuring that they reach the competencies required of a registered practitioner.

This article reports on research to explore if pre-registration nursing students felt prepared to manage patients' skin integrity effectively on registration. Final year nursing students completing adult, child and mental health fields were invited to complete questionnaires to investigate the amount of teaching sessions delivered in university in relation to managing skin integrity during their 3-year training programme, discover if pre-registration nursing students received supplementary management of skin integrity teaching in the clinical areas, explore which member of staff in the clinical areas supported the students' learning in the area of skin integrity. Data was collected on 217 final year students (196 females and 21 males) at two higher education institutions in the north of England. The majority of respondents (n=146; 68%) reported receiving less than 10 hours formal teaching at university on the subject of skin integrity over their 3-year courses. Of those registered on degree courses, 134 students (71%) reported receiving less than 10 hours formal teaching over their 3-year courses, compared with only 12 students (46%) registered on diploma courses. Some 198 (99%) of respondents reported that their clinical teaching was undertaken by registered nurses all or some of the time. Other health professionals were reported to provide substantially less clinical teaching; with the next largest contribution reported to be provided by specialist nurses, who provided all clinical teaching to 36 respondents (19%) and some clinical teaching to 115 respondents (59%). Some 149 respondents (70%) reported that the teaching they received had developed their knowledge and skills to maintain skin integrity for all patients. Respondents claimed that teaching received had developed their knowledge and skills, reporting an average of 16.9 hours spent in directed study; whereas those who did not claim that teaching they had received had developed their knowledge and skills reported an average of 7.6 hours spent in directed study. The results of this study suggest that diplomate nurses are likely to feel more confident and competent than their graduate counterparts, despite spending the same amount of time with mentors and their peers.

Wound bed assessment and optimum local wound care are essential to facilitate the wound healing process. The presence of devitalized tissue, for instance necrotic tissue or slough, is common in hard-to-heal wounds and acts as a barrier to healing. There are several debridement options available to the practitioner with the choice of wound debridement technique being made following a holistic assessment of the patient and the wound. The method of debridement should be discussed with the patient and family where appropriate and consent to treatment obtained prior to the procedure being undertaken.

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Background: Traditionally, infections are treated with antimicrobials (for example, antibiotics, antiseptics, etc), but antimicrobial resistance (AMR) has become one of the most serious health threats of the 21st century (before the emergence of COVID-19). Wounds can be a source of infection by allowing unconstrained entry of microorganisms into the body, including antimicrobial-resistant bacteria. The development of new antimicrobials (particularly antibiotics) is not keeping pace with the evolution of resistant microorganisms and novel ways of addressing this problem are urgently required. One such initiative has been the development of antimicrobial stewardship (AMS) programmes, which educate healthcare workers, and control the prescribing and targeting of antimicrobials to reduce the likelihood of AMR. Of great importance has been the European Wound Management Association (EWMA) in supporting AMS by providing practical recommendations for optimising antimicrobial therapy for the treatment of wound infection. The use of wound dressings that use a physical sequestration and retention approach rather than antimicrobial agents to reduce bacterial burden offers a novel approach that supports AMS. Bacterial-binding by dressings and their physical removal, rather than active killing, minimises their damage and hence prevents the release of damaging endotoxins. Aim: Our objective is to highlight AMS for the promotion of the judicious use of antimicrobials and to investigate how dialkylcarbamoyl chloride (DACC)-coated dressings can support AMS goals. Method: MEDLINE, Cochrane Database of Systematic Reviews, and Google Scholar were searched to identify published articles describing data relating to AMS, and the use of a variety of wound dressings in the prevention and/or treatment of wound infections. The evidence supporting alternative wound dressings that can reduce bioburden and prevent and/or treat wound infection in a manner that does not kill or damage the microorganisms (for example, by actively binding and removing intact microorganisms from wounds) were then narratively reviewed. Results: The evidence reviewed here demonstrates that using bacterial-binding wound dressings that act in a physical manner (for example, DACC-coated dressings) as an alternative approach to preventing and/or treating infection in both acute and hard-to-heal wounds does not exacerbate AMR and supports AMS. Conclusion: Some wound dressings work via a mechanism that promotes the binding and physical uptake, sequestration and removal of intact microorganisms from the wound bed (for example, a wound dressing that uses DACC technology to successfully prevent/reduce infection). They provide a valuable tool that aligns with the requirements of AMS (for example, reducing the use of antimicrobials in wound treatment regimens) by effectively reducing wound bioburden without inducing/selecting for resistant bacteria.

A wound offers an ideal environment for the growth and proliferation of a variety of microorganisms which, in some cases, may lead to localised or even systemic infections that can be catastrophic for the patient; the development of biofilms exacerbates these infections. Over the past few decades, there has been a progressive development of antimicrobial resistance (AMR) in microorganisms across the board in healthcare sectors. Such resistant microorganisms have arisen primarily due to the misuse and overuse of antimicrobial treatments, and the subsequent ability of microorganisms to rapidly change and mutate as a defence mechanism against treatment (e.g., antibiotics). These resistant microorganisms are now at such a level that they are of grave concern to the World Health Organization (WHO), and are one of the leading causes of illness and mortality in the 21st century. Treatment of such infections becomes imperative but presents a significant challenge for the clinician in that treatment must be effective but not add to the development of new microbes with AMR. The strategy of antimicrobial stewardship (AMS) has stemmed from the need to counteract these resistant microorganisms and requires that current antimicrobial treatments be used wisely to prevent amplification of AMR. It also requires new, improved or alternative methods of treatment that will not worsen the situation. Thus, any antimicrobial treatment should be effective while not causing further development of resistance. Some antiseptics fall into this category and, in particular, polyhexamethylene hydrochloride biguanide (PHMB) has certain characteristics that make it an ideal solution to this problem of AMR, specifically within wound care applications. PHMB is a broad-spectrum antimicrobial that kills bacteria, fungi, parasites and certain viruses with a high therapeutic index, and is widely used in clinics, homes and industry. It has been used for many years and has not been shown to cause development of resistance; it is safe (non-cytotoxic), not causing damage to newly growing wound tissue. Importantly there is substantial evidence for its effective use in wound care applications, providing a sound basis for evidence-based practice. This review presents the evidence for the use of PHMB treatments in wound care and its alignment with AMS for the prevention and treatment of wound infection.