PubMed Health⌕ Search

Biomedical subjects

Richard Griffith

Publications and source records attributed to Richard Griffith.

At least 19 recordsLinked to original sources
PubMed2006

Legal regulation of clinical waste in the community.

The European Union has led the way in regulating the management of waste and has compelled member states, including the United Kingdom, to introduce legislation to ensure that risks to public health and the environment from waste is minimized. Waste management is now highly regulated and it is essential that district nurses comply with the regulations when disposing of waste produced in the course of treating patients. This article describes how the health and safety, waste and carriage legislation governs how district nurses handle clinical and hazardous waste in the community.

Community Health Nursing↗
PubMed2006

Legal requirements for donating and retaining organs: the Human Tissue Act.

The Human Tissue Act 2004 came into force on 1 September 2006 and introduced significant changes in the way human body parts, tissue and organs are removed, stored and used. The Act seeks to remedy the poor availability of organs for transplant caused in part by laws that date back to the 17th Century and to right the concerns raised by the Liverpool Children's Inquiry that revealed widespread retention of organs by hospitals without permission. In this article Richard Griffith describes how consent is now the driving force underpinning such activity and how the wishes of the patient remain paramount even after death. He also outlines how the Human Tissue Authority will licence and inspect activities involving human tissue under the Act and discuss how the new law will affect district nurse practice.

Adult↗
PubMed2006

Compulsory removal from home under the National Assistance Act 1948.

District nurse Mary Thomas has had concerns about one of her older patients for some time. The lady, Miss Oates, is in her 80s and she lives alone in a bungalow with 30 cats. Her physical frailty is such that she is unable to care properly for herself or her cats. She has refused all offers of help from the social services authorities and only allows the district nurse in to dress an ulcer on her leg. The bungalow is filthy and stinks of urine. There is no heating or electricity. There is cat excrement and uneaten pet food everywhere. Today Sister Thomas has found her patient lying at the foot of her bed after falling the night before. She refuses to be helped into bed and seems determined to stay on the floor. Despite the urging of the district nurse and GP the patient has consistently refused to leave her bungalow. Both sister Thomas and the GP accept that the patient has no signs of a mental disorder or of mental incapacity, nevertheless they both consider that care and attention in a care home, even for a short period to allow her bungalow to be cleaned, would be of great benefit and wonder if the law could be used to compel Miss Oates to move to a care home.

Activities of Daily Living↗
PubMed2006

Protecting vulnerable adults and children from sexual abuse.

CASE STUDY: the Sexual Offences Act 2003 seeks to strengthen and modernize the law in relation to sexual crimes. The Act's focus is on extending protection from sexual exploitation for children and vulnerable adults by clarifying the key terms 'consent' and 'sexual' and introducing new offences specifically designed to protect the vulnerable. Child and vulnerable adult protection is an integral part of a district nurse's role so it is essential that you are aware of the key provisions of the 2003 Act in order that you may recognize and report unlawful sexual activity.

Adolescent↗
PubMed2006

Making decisions for incapable adults 1: Capacity and best interest.

The Mental Capacity Act 2005 is expected to come into force in April 2007. It will change the way decisions are made for incapable adults in England and Wales. District nurses, along with other health professionals, will be required to abide by the provisions of the Act when providing care and treatment to incapable adults. In a short series of articles, case studies will be used to illustrate how the new law will affect district nurse practice, beginning with the assessment of capacity and best interests. District nurse Mary Holt regularly visits a patient, 78-year-old Jane Harris, in her home to treat a chronic leg ulcer. Jane has been diagnosed with Alzheimer's dementia but is managing well with support from the local authority. However, Mary has noticed recently that Jane's behaviour has become a little strange. She looks unkempt and she is continually washing dishes that are not dirty. On her last visit, Jane refused to allow Mary to remove the dressing on her leg and treat the ulcer, which has become infected. Mary is concerned that Jane's wound needs to be treated to prevent further complications.

Adult↗
PubMed2006

Making decisions for incapable adults. 2: Advanced decisions refusing care.

In the second article focussing on the provisions of the new Mental Capacity Act 2005, Richard Griffith considers the impact on district nurse practice of advanced decisions refusing health care, that will allow a person to refuse even life-sustaining treatment in incapacity, and lasting powers of attorney, that will allow a person to appoint one or more people to make decisions concerning their personal welfare and property and affairs. For the first time in England and Wales a person will be able to appoint another to make consent-to-treatment decisions on their behalf that will be binding on district nurses and other health professionals.

Adult↗
PubMed2006

Making decisions for incapable adults. 3: Protection, guardians and advocates.

District nurse Jane Simmons has concerns about a patient in her care who she suspects of being abused by her son. The patient has been left paralysed and unable to communicate by a stroke and cannot confirm the district nurse's suspicions. Both the nurse and the GP feel that the patient would be better managed in a care home, but her son refuses to consider the possibility. A vulnerable adult case conference concludes that this is probably because of the patient's considerable personal wealth and property. When the police confirm that there is insufficient evidence to prosecute the son, the care team wonder if the provisions of the Mental Capacity Act 2005 can be used to protect the patient.

Aged↗
PubMed2006

Making decisions for incapable adults: the Scottish law.

With the law in England and Wales relating to incapable adult due to be given a new and improved structure with the implementation of the Mental Capacity Act 2005 in Spring 2007 (see last month's article) Richard Griffith outlines how the law in Scotland meets the needs of adults with incapacity through the Adults with Incapacity (Scotland) Act 2000.

Adult↗
PubMed2006

Controlled drugs and the principle of double effect.

The role of district nurses in the effective management of pain in palliative care has been strengthened by recent amendments to the Misuse of Drugs (Amendment) Regulations 2005 that allow district nurses who are independent or supplementary prescribers to prescribe and administer controlled drugs. However, the right to prescribe controlled drugs also brings increased responsibility and accountability for the safe management of these medicines. In this article Richard Griffith outlines the changes to the law relating to controlled drugs and calls for a clarification of the principle of double effect, to ensure patients in intractable pain receive the analgesia they require to manage their pain and district nurses avoid liability and prosecution under the law of murder.

Analgesics, Opioid↗
PubMed2006

Compensation for psychiatric injury: evolution of a law of nervous shock.

District nurses will be well aware that if a person receives an injury because of someone else's negligence they are entitled to compensation for the harm that has been caused. However, where the injury is in the form of psychiatric harm the law has traditionally imposed rules that set out the conditions to be met before a successful claim for damages can be made. Even in today's enlightened society the law still does not always treat a psychiatric injury in the same way as a physical injury. In this article Richard Griffith outlines the development of the law in relation to psychiatric injury--historically called "nervous shock"--and considers the current approach to claims for damages where a person suffers psychiatric harm because of another's negligent act.

Compensation and Redress↗
PubMed2005

The Mental Capacity Bill 2004: its impact on district nurse practice.

The government made clear its intention to reform the law relating to mentally incapable adults in the Queen's speech at the state opening of Parliament in November 2004. In this article Richard Griffith and Cassam Tengnah outline the main provisions of the Mental Capacity Bill and assess its likely impact on district nurses who care for adults with incapacity.

Adult↗
PubMed2005

Public health 2: Criminal liability for spreading disease.

Last month's article considered the role of the law in preventing the spread of infectious disease in cases such as tuberculosis and SARS where isolation, quarantine and treatment are effective in controlling the outbreak. Other forms of infectious disease that district nurses encounter--such as hepatitis B and C and the HIV virus that are spread through contact with blood or sexual intercourse--rely far more on the infected individual to act responsibly in preventing others from being infected. This month's article considers whether those who act recklessly and put others at risk of infection should be held criminally liable and prosecuted for their actions.

Communicable Diseases↗
PubMed2005

Public health 3: Legal regulation of tattooing and body art.

District nurse Mandy Grey is currently treating a thirteen year old girl who has a seriously infected tattoo on her buttock and infected tongue and nipple piercing all of which were performed at a local tattoo parlour. The teenager wanted the tattoo and piercing as all her friends have had similar body art and she felt pressured into having the same. Sister Grey wonders how this ever popular and increasingly intimate form of bodily adornment is regulated.

Adolescent↗
PubMed2005

Human rights and district nursing practice.

The main provisions of the European Convention on Human Rights were incorporated into UK law in the Human Rights Act 1998. Human Rights were described by Lord Hoffman in 'Matthews v Ministry of Defence' [2003] as the rights essential to the life and dignity of the individual in a democratic society. The fundamental nature of the rights demand that district nurses must inform their practice with a clear understanding of the main provisions of the Act and how they apply to health care.

Community Health Nursing↗
PubMed2005

Health protection and age-related legislation.

Community children's nurse Debbie James has developed an innovative scheme to allow secondary school children to obtain health advice by texting her service using mobile phones. As well as general advice about spots and rubella immunization, Sister James is also receiving inquiries about children's legal rights that also have a health protection purpose, such how old a child has to be before owning a pet or have an alcoholic drink. This article looks at how the law seeks to protect children by incrementally giving them legal rights as they develop to mature adults and how legal awareness can help inform community health practitioners' advice to their child clients.

Adolescent↗
PubMed2005

Community powers under the Mental Health Act: care or control?

District Nursing Sister Janet Jones had been visiting a young patient, Peter James, 20, at his bedsit on a weekly basis to assist him with the management of his diabetes. However some 6 months ago Peter stopped eating and began refusing to take his insulin because he believed that they had been contaminated by alien dust. Sister Jones and the GP also noticed that Peter was drinking considerable quantities of alcohol and there were reports of him engaging in bizarre sexual rituals. Concern about Peter's mental health and refusal of treatment resulted in him being detained under the Mental Health Act 1983. Sister Jones has now received a request from the mental health unit to visit Peter at his home during a period of leave he has been granted by his responsible medical officer (RMO) and to continue visiting as part of his aftercare arrangements when he is discharged. Sister Jones wonders if the mental health team will be able to manage Peter in the community given his previous reluctance to accept treatment and how Peter will afford the aftercare package of home care support and meals on wheels provided by the local authority.

Aftercare↗