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Biomedical subjects

Julie Bliss

Publications and source records attributed to Julie Bliss.

8 recordsLinked to original sources

What do informal carers need from district nursing services?

More than 5 million informal carers provide support to individuals who wish to remain within their own homes. The role of informal carers in maintaining people within their own homes has been identified as crucial. This article considers the assessment of need of informal carers in the primary care setting, placing particular emphasis on the role of the district nurse as an advocate for informal carers when working with other health and social care service providers. Central to working with informal carers and acting as an advocate is communication, and unless informal carers feel that they are involved in the decision-making process, and listened to, they are unlikely to access appropriate support.

Attitude of Health Personnel↗

Working in partnership with adult informal carers: policy and practice.

In England and Wales alone, more than 5 million informal carers provide support to individuals who wish to remain within their own homes. However, research has identified that there is a limited understanding of the informal carer role among health professionals, and deficits in information sharing and the involvement of informal carers in decision making in relation to care packages. This article considers recent policy relating to this area, placing particular emphasis on the role of the district nurse in working in partnership with informal carers.

Adult↗

Effective team management by district nurses.

This article considers the key role played by the district nurse in managing the district nursing team in order to provide high quality health care. It considers how the district nurse can use key managerial roles (interpersonal, informational and decision-making) in order to ensure unity within the team. The importance of shared goals and trust to achieve unity is explored and a strategy for managing conflict is discussed. Finally, the article suggests a set of ground rules which could be used to facilitate effective team working.

Community Health Nursing↗

Decision-making in palliative and continuing care in the community: an analysis of the published literature with reference to the context of UK care provision.

Palliative and continuing care in the United Kingdom (UK) is provided by a range of health and social care professionals who work within a variety of statutory and non-statutory organisations. This selective review of the literature focuses upon palliative and continuing care decision-making undertaken by district nurses and social workers as an exemplar of interprofessional decision-making. The decision-making process is complex and heavily influenced by the organisations employing district nurses and social workers. A model of strategic decision-making is identified which facilitates the exploration of events within the context of practice, thus providing a greater understanding of the process and outcomes to inform the professional development of practitioners.

Continuity of Patient Care↗

The development of palliative care in national government policy in England, 1986-2000.

Palliative care is an established and expanding speciality, important in many areas of service delivery within health and social services and the voluntary sector. Traditionally, palliative care is viewed as most closely linked to cancer services. National government policy has an inevitable impact on the organization and provision of such services. As part of a wider project, an investigation of the content and development of English government policy relating to palliative care was carried out. The development of policy follows a cycle that has no closure; it takes place within changing contexts, between multiple organizations and across sectors. Data collection involved the collation and close examination of policy documents and other documents that demonstrably influenced policy. This was in order to identify a national view of policy intentions for palliative care. In total, 53 policy documents were examined. The analysis revealed a number of pertinent issues relating to shifts in funding policies and an evolving definition of palliative care. There is an increasing recognition in the policy documents of the need for palliative care to extend beyond the traditional focus on cancer services and terminal illness. In tandem, is an increasing recognition of the need for partnership between sectors, reflected in more recent health and social services legislation.

Data Collection↗

Preventing blockage of long-term indwelling catheters in adults: are citric acid solutions effective?

Community health practitioners are frequently faced with the problem of indwelling catheters failing to drain. This mini-review examines the evidence regarding the effectiveness of citric acid-based bladder washout solutions (solution G, solution R), compared with saline for preventing blockage of long-term catheters in older adults. Although there is some evidence on the effect of citric acid solutions in laboratory conditions, the search yielded no evidence measuring catheter patency in humans. Only one randomized controlled trial addressing the use of citric acid solutions with human subjects was found. This provided some confirmation that solution G had immediate effect but gave no evidence of long-term benefit. No difference was apparent on examination of catheter tips. As the evidence is weak, practitioners should consider the use of citric acid maintenance solution as non-routine and only following formal evaluation in a one-off trial on appropriate patients.

Adult↗

Effective interagency and interprofessional working: facilitators and barriers.

In the UK the provision of palliative care is not the sole responsibility of the National Health Service (NHS); there is an overlap with continuing care, which falls within the remit of local authority social services departments. In addition, hospice and palliative care services are often considerably dependent on charities. Interagency and interdisciplinary working are, therefore, central to the successful delivery of palliative care. A multiple (four case) case study design was used to explore the provisions of palliative and continuing care. The analysis identified the antecedents, structures and processes involved in the delivery of interprofessional working, along with the consequences of these in either a good model or one where problems were likely to prevail. Individual activities, roles and specific service configurations seemed far less significant than the overall culture, stability and long-term commitment to a service in a given area. Time is required for new service configurations to stabilize so that staff are able to overcome barriers and develop the necessary facilitators for quality care provision.

Interinstitutional Relations↗

The nursing faculty shortage: Is there hope?

The present nursing faculty shortage is linked to the general nursing shortage. Without enough nurse educators to teach the increasing number of nurses that are needed, the health of U.S. residents is at stake. This article examines progress made on solutions proposed over the past decade such as increasing graduate and certificate programs for nurse educators, more aggressive recruitment of graduate students into faculty roles, and delayed retirement of current faculty. Potential new solutions are proposed. These include: fast-track bachelor's of science in nursing to doctor of philosophy curricula; recruiting advanced practice nurses (APNs) into faculty roles with arrangements made for clinical practice time; raising the image of nursing education as a prestigious career; developing national certification for nurse educators; and partnering with health care agencies. Linking the general nursing shortage with the faculty shortage may provide a stronger case for public policy and funding initiatives. There are signs that some initiatives are working. Present faculty need to maintain a culture of hope while potential solutions are being implemented.

Certification↗