Community and Public Health Nursing E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 766

Veröffentlichungsjahr: 2013

Beschreibung

"An extremely popular and valuable resource to students, practitioners and managers in community health care nursing" - Journal of Advanced Nursing

The fifth edition of Community and Public Health Nursing is an essential source of information for all those working in primary and community healthcare.  Comprehensive and accessible, it draws on the knowledge of a wide range of experts and conveys all the information and skills nurses working in modern primary care settings require. It includes material on policy developments, research perspectives, health visiting, practice and district nursing, team working, advanced nursing practice, non-medical prescribing, inter-professional practice, and user involvement.

• New edition of the definitive textbook on community healthcare nursing
• Covers learning disability nursing, caring for patients with mental health conditions, and community children’s nursing and school nursing
• Written by experts in the field – providing authority and insight
• Thorough, comprehensive, and up-to-date with the latest policy guidelines

Community and Public Health Nursing is an invaluable resource for novice and experienced practitioners, and for all healthcare professionals who work in the primary care and community setting, including practice nurses, nurse practitioners, district nurses, community staff nurses, health visitors, school nurses, walk-in centre nurses and sexual health nurses.

This title is also available as a mobile App from MedHand Mobile Libraries. Buy it now from iTunes, Google Play or the MedHand Store.

Leseprobe

Contents

Notes on Contributors

1 The Context of Primary Healthcare Nursing

The changing context of service provision

The changing face of the community healthcare workforce

The primary care vision for the next decade

The impact of primary care policy changes on the role of the primary care nurse

The scope of primary care nursing practice within the context of a changing workforce

Conclusion

References

2 Community Development and Building Capacity

Introduction

The current context for community development practice

Defining the terms

The role of community health professionals

Conclusion

References

3 Multi-Sector Working and Self-Management, Community Health Care

Introduction

Context for multi-sector working in the United Kingdom

Key drivers for multi-agency working

Examples of multi-sector working and self-management initiatives

Dementia

Obesity

Asthma

Concluding reflections

References

4 Moving Care Closer to Home

Hospital provision: A brief history of the last 50 years

Health care: What does it mean?

Caring and nursing: Where are we now?

Nursing at the interface between paid and unpaid care

Public health and care closer to home

Conclusion

References

5 Evidence-Based Practice and Translational Research Applied to Primary Health Care

Introduction

Evidence-based practice

Designing the study

Translational research

Experiments, randomised controlled trials and quasi-experiments

Health impact assessments

Different methodologies and methods give you new insights

Participatory approaches for community research

Data collection methods

Data management, analysis and interpretation

General research issues

Presentation and dissemination

The internet or world wide web (www)

Research proposals

Ethical issues

IRAS

The NHS research passport

Conclusion

Acknowledgments

Further reading

References

6 Integrating the Children’s Public Health Workforce

Introduction

Health indicators

The policy context

The role of the specialist community public health nurse

The HCP

Delivering the HCP

Pregnancy and the first 5 years of life

The practitioner’s role in safeguarding and child protection

The practitioner role in improving emotional health and well-being

Conclusion: future development and challenges for practice

References

7 Community Children’s Nursing

Introduction

Early days

The NHS

NHS at home: Community children’s nursing services

Children with acute and short-term conditions

Children with LTCs

Children with disabilities and complex conditions, including those requiring continuing care and neonates

Technology dependence

Continuing care

Neonates

Children with life-limiting and life-threatening illness, including those requiring palliative and end-of-life care

Conclusion

References

8 Public Health Nursing (Adult): A Vision for Community Nurses

Introduction

The vision for health reform: the policy context

The public health outcomes framework (2012)

Health promotion versus public health

An upstream approach

Health protection

Community nursing and public health

Conclusions: the future

References

9 Caring for the Adult in the Home Setting

End of life

The policy context

Managing LTCs in the community

Case Study based upon complexities of patient care in the home setting

Maximising health and well-being: helping people to stay independent

Working with people to provide a positive experience of care

Adult safeguarding

Measuring impact of service through patient feedback

Delivering high-quality care and measuring impact

Building and strengthening leadership

Ensuring we have the right staff, with the right skills in the right place

Technology

Informal carers

Supporting positive staff experience

Conclusion

References

10 General Practice Nursing in Context

Introduction

Origins

The advent of contemporary general practice nursing

Practice nursing roles and functions

Core skills for the GPN

Education

Chronic disease management

Asthma management

Hypertension

The future

References

11 Occupational Health Nursing

OHNs as specialist practitioners

Historical perspective

Provision of OH services in the United Kingdom

The changing nature of UK workplaces

Changing work patterns

Workplace practices

The domains of OH nursing practice

The professional domain

The environmental domain

The educational domain of practice

Public health strategies

Specialist community public health nursing: Part 3 of the register maintained by the NMC

References

12 Caring for the Person with Mental Health Needs in the Community

Introduction

Background: Why bother with community mental health nursing?

Clinical profile: John

Recovery: Conceptual explanation

Development of therapeutic relationship

Assessment of needs

Instilling hope

Promoting life beyond distress

Promoting connectedness

Promoting personal responsibility

Principles of community mental health nursing

Conclusion

References

13 Caring for the Person with Learning Disabilities in the Community

Introduction

People with learning disabilities

The number of people who have learning disabilities

Service principles in learning disability services

Moving forward

The health of people with learning disabilities

What community nurses for people with learning disabilities do?

The future role of community nursing services for people with learning disabilities

Conclusion

References

14 Leadership: Measuring the Effectiveness of Care Delivery

Introduction

Influences on leadership

Government policies

Front-line staff

Spend some time looking at these four scenarios

Measuring the effectiveness of delivery

Conclusion

References

15 Social Innovation and Enterprise

Introduction

What is social innovation?

Research on social innovation

Characteristics of a social innovator

Social innovation and community health

Commissioning

Approaches to social innovation

Social innovation as a concept

Conclusion

References

16 Adult Vulnerability in the Community

Introduction

Adult safeguarding

Definitions of abuse of adults

Legal framework of adult safeguarding

Mental Capacity Act 2005

Recent adult safeguarding guidance

Domestic violence

The prevalence of domestic violence in the United Kingdom

Effects of domestic violence

Contextual issues

Substance and alcohol misuse

Conclusion

References

17 End-of-life Care

Whole systems approach

Assessment: The foundation to providing good care

Symptom management

Beyond the management of physical symptoms

Advance care planning

Advanced decisions to refuse treatment (ADRT)

Assisted suicide

Do not attempt resuscitation orders

Care in the last days of life

Models of interdisciplinary working: The road to successful end-of-life care

Community nurses: The lynchpins of successful end-of-life care in the community

Death of a child

Dementia

Care of the bereaved

Conclusion

References

18 Interprofessional Learning and Teaching for Collaborative Practice Community

Introduction

Inter-professional education and collaborative practice

Learning theory

Teaching and learning in practice

Responsibilities for teaching and learning of all members of the team

Adult safeguarding: an example

Conclusion

References

19 User Involvement, Self-Management and Compliance

The modern PPI system

The rationale for greater user involvement

The patient as co-producer

Co-production cannot be realised without support

Conclusion

Acknowledgement

References

Index

This edition first published 2013 © 2013 by John Wiley & Sons, Ltd© 1995, 2001 by Blackwell Science Ltd for first and second editions© 2005 by Blackwell Publishing Ltd for third edition

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Library of Congress Cataloging-in-Publication Data

Community health care nursing (Sines)Community and public health nursing / edited by David Sines, Sharon Aldridge-Bent, Agnes Fanning,Penny Farrelly, Kate Potter, and Jane Wright. – 5th edition.p. ; cm.Preceded by: Community health care nursing / edited by David Sines, Mary Saunders, Janice Forbes-Burford. 4th ed. 2009.Includes bibliographical references and index.

ISBN 978-1-118-39694-0 (paper)I. Sines, David, editor of compilation. II. Title.[DNLM: 1. Community Health Nursing–Great Britain. 2. Public Health Nursing–Great Britain.3. Primary Health Care–Great Britain. WY 106]RT98610.73′43–dc23

2013026529

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Cover image: iStockphoto.com/A-Digit.Cover design: Sarah Dickinson

Notes on Contributors

Sue AxeFaculty of Society and HealthBuckinghamshire New UniversityUxbridgeUKOwen BarrFaculty of Life SciencesUniversity of Ulster MageeLondonderryNorthern IrelandUKSharon Aldridge BentFaculty of Society and HealthBuckinghamshire New UniversityHigh WycombeUKZoe BerryFaculty of Society and HealthBuckinghamshire New UniversityUxbridgeUKMichelle BootFaculty of Society and HealthBuckinghamshire New UniversityUxbridgeUKJenni BurtonFaculty of Society and HealthBuckinghamshire New UniversityHigh WycombeUKRuth ClemowFaculty of Society and HealthBuckinghamshire New UniversityUxbridgeUKAgnes FanningFaculty of Society and HealthBuckinghamshire New UniversityHigh WycombeUKPenny FarrellyFaculty of Society and HealthBuckinghamshire New UniversityHigh WycombeUKAnne HarrissFaculty of Health and Social SciencesLondon South Bank UniversityLondonUKKate PotterFaculty of Society and HealthBuckinghamshire New UniversityHigh WycombeUKSusan ProcterFaculty of Society and HealthBuckinghamshire New UniversityUxbridgeUKMargaret RiogaFaculty of Society and HealthBuckinghamshire New UniversityHigh WycombeUKPeter SandyFaculty of Society and HealthBuckinghamshire New UniversityHigh WycombeUKJason SchaubFaculty of Society and HealthBuckinghamshire New UniversityHigh WycombeUKDavid SinesFaculty of Society and HealthBuckinghamshire New UniversityUxbridgeUKMark WhitingNurse ConsultantWest Herts PCT, Peace Children’s Centre WatfordUKJane WillsFaculty of Health and Social CareLondon South Bank UniversityLondonUKJane WrightFaculty of Society and HealthBuckinghamshire New UniversityHigh WycombeUKMaryam ZonouziPeer ExchangeLondonUK

1

The Context of Primary Healthcare Nursing

David Sines

Faculty of Society and Health, Buckinghamshire New University, Uxbridge, Middlesex, UK

The changing context of service provision

The population of the United Kingdom is projected to increase by 4.9 million from an estimated 62.3 million in 2010 to 67.2 million over the 10-year period to 2020. Projected natural increase (more births than deaths) will account for 56% of the projected increase over the next decade, resulting in an overall UK population increase to 73.2 million over the 25-year period to mid-2035. The population is also projected to continue ageing with the average (median) age rising from 39.7 years in 2010 to 39.9 years in 2020 and 42.2 by 2035 (Office for National Statistics 2011).

The key drivers for population growth within the United Kingdom relate to greater life expectancy and migration, particularly from Eastern Europe (migration being expected to account for 68% of population growth during this period). Over the 25-year period to 2035, the number of children aged under 16 is also projected to increase from 11.6 million in 2010 to 13.3 million in 2026 before decreasing slightly to 13.0 million in 2035, whilst the population is projected to become older gradually, with the average (median) age rising from 39.7 years in 2010 to 39.9 years in 2020 and 42.2 years by 2035. As the population ages, the numbers in the oldest age groups will increase the fastest. In 2010, there were 1.4 million people in the United Kingdom aged 85 and over; this number is projected to increase to 1.9 million by 2020 and to 3.5 million by 2035, more than doubling over 25 years (Office for National Statistics 2011). The age of the working population will also increase during this period, demonstrating unforeseen lifestyle patterns, which in turn will impact on those people of state pensionable age.

According to Mathers and Loncar (2006), the ten leading causes of death by 2030 will be ischaemic heart disease, cerebrovascular disease, upper respiratory tract and lung cancers, diabetes mellitus and chronic obstructive pulmonary disease (COPD). Within the top ten leading causes of death will also rank dementias, unipolar depressive disorders, alcohol use disorders, stomach and colon cancers and osteoarthritis. The combination of longer-term physical disorders and psychosocial challenges will demonstrate the importance of integrated service provision and workforce capability and capacity to respond to presenting co-morbidities. Other worldwide challenges relating to infectious diseases, such as HIV and tuberculosis, will provide additional pressures on our healthcare systems.

So how do society and its associated health and social systems respond to such challenges? In the first place, it can be assumed that societal change moulds the institutions that are created to respond to the needs of the population. Demands change over time, and in so doing, socio-demographic factors drive the process of change that in turn requires the National Health Service (NHS) to adapt its operational base. Examples of such changes relate to the needs of an increasingly demanding and complex population, a reduction in the number of available informal carers, advances in scientific knowledge and technological innovation and a heightened awareness of ethical challenges (such as gene therapy, stem cell research, embryology and euthanasia). In addition, the 2010 Coalition Government’s quest to locate healthcare delivery as ‘close to home’ as possible has placed greater priority on primary and community service developments.

Such changes were enshrined within the context of the Government’s inaugural healthcare White Paper ‘Equity and Excellence: Liberating the NHS’ DH (2010a). The 2010 White Paper placed much emphasis on sharing decision making between clinicians and patients, leading to their empowerment and ultimate engagement in sharing responsibility for their own care:

Too often patients are required to fit around services, rather than services around patients.

This is a key component of the Government’s ‘Big Society’ mandate, encouraging a move to self-care and a reduction in dependency on State-sponsored healthcare delivery.

The resultant ‘care closer to home’ initiative has been influenced by a range of external forces, driven by government pressure to drive down NHS costs and to reduce dependency on hospital admission (DH 2008a, b). Such changes however come at a price in their own right, and if the NHS is to succeed in responding effectively to the demands of the new community care culture organisation, then it will have to be prepared to face the demands of a changing environment of care practice and delivery (Buchan 2008).

Care closer to home has been defined by Nancarrow et al. (2006) as ‘shifting all resources and expertise to primary care trusts’. This somewhat simplistic definition was adopted throughout the NHS 5 years ago and became the foundation for healthcare reform in the United Kingdom (Ham 2011). For example, NHS London announced in September 2008 that it would develop a new community-focused workforce plan for the city by 2013 (Workforce for London – NHS London 2007). The Health Authority advised that it wanted to see a 50% shift of hospital-based activity into community and primary care. This ambitious plan included a 10% reduction in inpatient bed admissions and a 41% increase in outpatient attendances in community healthcare service facilities. In order to achieve this, the workforce was challenged with the need to work more flexibly alongside patients, across care pathways in a variety of settings closer to home (DH 2008a, b). The workforce strategy that accompanied the SHA plan (NHS London 2010) advised that 15 000 healthcare workers would need to be trained or retrained to work in the community. More specifically the community nursing workforce would need to expand from 22% of the total nursing population in London to 40%. This presents a major challenge for the NHS and its educational providers (Buchan 2008) and represents three decades of investment in community-focused health service reform.