PubMed Health⌕ Search

Biomedical subjects

F Culley

Publications and source records attributed to F Culley.

10 recordsLinked to original sources
PubMed2001

The tissue viability nurse and effective documentation.

The problems associated with inadequate record keeping in tissue viability have been highlighted in a number of related legal proceedings, professional misconduct cases (UKCC 2001a,b), and investigations by the Health Service Commissioner (Ombudsman) (HSC, 2001). Each serves as a reminder of the importance of nursing documentation towards protecting the welfare of patients and clients. A rising tide in clinical negligence (National Audit Office, 2001), and in an increase in the number of nurses removed from the UKCC register (UKCC 2001c), indicate a greater likelihood of nurses (including specialists), being called to provide evidence of standards of care when investigating, predicting and managing clinical risk. This article examines the continued importance of documentary evidence to support such inquiries, clarifying the tissue viability nurse's responsibility in producing accurate and effective records in all aspects of an increasingly expanding role.

Humans↗
PubMed2001

Patient group directions: the legal and professional considerations.

Nurses have administered medicines 'according to protocol' for many years. Patient group directions have now been formalised. Nurses who supply and administer medications according to these directions must ensure that they have a clear understanding of their role. This paper seeks to clarify their use and to consider professional liability, accountability and development.

Diagnosis-Related Groups↗
PubMed1996

T helper type-1 (Th1)/Th2 profiles of peripheral blood mononuclear cells (PBMC); responses to antigens of Chlamydia trachomatis in subjects with severe trachomatous scarring.

Increased stimulation of Th2 cytokines may contribute to the development of persistent ocular chlamydial infection, resulting in the blinding pathological changes of trachoma. Proliferation and cytokine production profiles of PBMC in response to stimulation with antigens of Chlamydia trachomatis were compared in 30 patients with severe conjunctival scarring due to trachoma and in 30 age-, sex- and location-matched controls. Interferon-gamma (IFN-gamma) and IL-4 were detected at the single-cell level by ELISPOT assay. Transcription of the genes encoding IFN-gamma, IL-4 and IL-10 was detected in mRNA isolated from parallel cultures of PBMC using reverse transcriptase-polymerase chain reaction (RT-PCR). Incubation with the chlamydial heat shock protein (hsp)60 resulted in increased numbers of IL-4-producing cells in PBMC isolated from patients with scarring disease and increased secretion of IFN-gamma from PBMC of control subjects. Incubation with the chlamydial major outer membrane protein (MOMP) increased the number of IFN-gamma-producing cells in the control group only. Messenger RNA encoding IL-4 was only detected in PBMC of patients with scarring disease after in vitro stimulation with chlamydial antigens, but IFN-gamma mRNA and IL-10 mRNA were also more frequently detected in this group. Thirty-eight subjects were HLA-DRB1 and -DQB1 typed. Associations were observed between certain HLA class II alleles and cellular immune responses to chlamydial antigens. No HLA associations were found with clinical status, and overall we found no evidence of strong associations and the type of immune response. These data are consistent with a role for Th2 cells and cytokines in the pathogenesis of trachomatous scarring.

Adolescent↗
PubMed1996

Autoantibodies against bactericidal/permeability-increasing protein in patients with cystic fibrosis.

Cystic fibrosis (CF), a genetic disorder, is characterized by chronic pulmonary infection/inflammation which leads to respiratory failure. The presence of anti-neutrophil cytoplasmic autoantibodies (ANCA) has previously been observed in the sera of patients with CF. In view of the known relationship of ANCA with primary vasculitis and of their putative pathogenetic role in these disorders, we studied the presence, specificity and isotype of ANCA and their clinical associations in 66 adult CF patients. None of the 66 CF samples had autoantibodies to the major ANCA antigens, proteinase 3 or myeloperoxidase. However, 60/66 (91%) CF samples contained IgG, and 55/66 (83%) IgA, autoantibodies to bactericidal/permeability-increasing protein (BPI), a recently-characterized ANCA specificity. All the IgA anti-BPI-positive samples were also IgG anti-BPI-positive. The autoantibody specificity was confirmed by inhibition assay and immunoblotting of CF sera against a neutrophil granule preparation. Furthermore, in this cross-sectional study, anti-BPI levels were inversely correlated with the observed reductions in FEV1 and FVC (IgA anti-BPI & FEV1: r = -0.508, p < 0.0001), and both IgG and IgA anti-BPI levels were higher in CF patients with secondary vasculitis (n = 6) than in those without (p < 0.05). ANCA with specificity for BPI were present in the majority of CF sera in this study and autoimmune processes may be associated with the development of pulmonary injury in CF.

Adolescent↗
PubMedDate not supplied

Nursing aspects of pressure sore prevention and therapy.

Pressure sores remain a significant problem in hospitals and domestic settings, affecting people of all ages, social class and race. Associated complications may be life threatening, e.g. sepsis and osteomyelitis. Other less dangerous, but nevertheless compromising outcomes such as pain, discomfort and low self-esteem and body image can cause personal suffering, and may add extra demand for limited resources. The exact state of pressure sore occurrence remains difficult to determine, particularly in the community. Recent trends in pressure area management present a multidisciplinary approach, eroding traditional perceptions of pressure sores as a solely nursing problem. Written from nursing perspective, this article summarizes principles of good practice relating to pressure sore prevention and therapy, emphasizing the importance of documenting observed events, rather than assumptions or opinions, and the need for healthcare professionals to approach problems and needs from a collaborative stance. Pressure sore risk assessment and classification are discussed, and an overview of nutrition, moving a handling, selecting support surfaces, principles of wound management, and skin care are considered.

Bandages↗
PubMedDate not supplied

Tissue viability: the facts and the law.

Accountability remains an integral part of nursing, irrespective of occupational status or setting. The leaflet reminds nurses involved in direct care, as well as those in advisory, educational or promotional roles, of the need to consider and fulfil professional obligations towards a vulnerable and expectant public. The need to select resources that will support, not replace, skilled nursing is crucial. As nurses expand their practice they may face greater risk of litigation, but the boundaries should be clarified through job descriptions, employer approved policy statements and UKCC standards. Being asked to account for actions or omissions of care may be perceived as daunting. However, complaints may help drive quality improvement as well as staff development. A sense of perspective is needed to prevent defensive practice, allowing the potential of autonomous and accountable professionals being realised in the delivery of tissue viability services.

Humans↗