Care of the elderly: nursing homes and continuing care.
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Biomedical subjects
Publications and source records attributed to S Bond.
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Increasing interest in audit in the health service has focused attention on the tools and methods used to achieve it. These can be extremely expensive, so a tendency to opt for off-the-shelf packages has developed. This article reviews how one such instrument, The Central Nottinghamshire Psychiatric Nursing Audit, has been used in two settings over the past three years, with particular emphasis on its cost-effectiveness.
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One of the key achievements of the primary nursing system was to put the patient at the forefront of care and raise the status of clinical nursing. The values associated with primary nursing, however, need to be adopted by the whole organisation. The author highlights what actions need to be taken to maintain the momentum of primary nursing and urges the introduction of case management.
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To assess the effects of human immunodeficiency virus (HIV) for the work of community nursing staff, and to find out how community staff regard their contribution to the prevention of HIV infection, the care of people with AIDS and their preparation for this role was ascertained in a postal survey of one in five field staff carried out in Scotland. The 1,205 respondents represent an 85% response rate. While only 3% of respondents had experience of patients with AIDS, 11% had been involved with known asymptomatic HIV infection and 30% had encountered those they considered to be at high risk of infection. While the workload generated by HIV-infected patients for individual nurses at this time was small, there were variations in the proportions of staff involved according to type of staff and employing health board. Only one-fifth of those who had encountered HIV-positive patients had offered them health education, and fewer had referred patients to their general practitioners or offered counselling. However, community nursing staff do consider that they have a role to play in health education, counselling and terminal care, but feel ill equipped to carry out this role. There is an urgent need for policies which clearly specify the roles that community nursing staff should be playing and for in-service education programmes which assist them to draw on the knowledge and skills that they have to enable them to apply them to help patients with HIV infection.
Findings from a survey of community nursing staff in Scotland reveal that there is limited knowledge about many aspects of HIV infection. Respondents were concerned about their lack of experience and knowledge as well as the in-service education that they had received. A substantial minority of community nursing staff felt that they should have the right to refuse to care for HIV-infected patients and those whose lifestyle put them at risk of HIV infection. A majority of staff felt that health professionals who are most at risk of contact with HIV-infected materials should be informed of patients' HIV-antibody status without their consent. There were also some indications of a lack of confidence in service managers and recommendations are made regarding ways of increasing both the knowledge and confidence of front-line staff.