scholarly journals An ethnographic exploration of the social organisation of general practice nurses’ knowledge use: more than ‘mindlines’?

2020 ◽  
Vol 25 (6-7) ◽  
pp. 604-615
Author(s):  
Judith Carrier
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Healthcare Delivery ◽  
Contextual Influences ◽  
Knowledge Use ◽  
Practice Nurses ◽  
Rural Primary Care ◽  
Knowledge Practice ◽  
The Uk ◽  
Primary Care Practices

Aim To explore contextual, organisational and educational issues impacting on access to, and application of knowledge to everyday practice by general practice nurses, working in two rural primary-care practices in the UK. Background Changes in primary-care healthcare delivery have resulted in substantive changes to practice nurses’ roles. Practice nurses have taken on enhanced roles for which they were not prepared for in their initial training, little is known about how they access and apply knowledge. Methods Ethnographic methods were used to gather data. Results Practice nurses take a blended approach to knowledge use, using elements of evidence-based practice to support professional judgement. This is subject to several contextual influences, organisational, educational and from individual patients. Tensions exist between the position in which general practice nurses are situated and the nature in which knowledge is disseminated and used in primary care. Whilst examples of clinical mindlines were evident, these differed to those previously observed in general practitioners, practice nurses did not always have the mindline on which to draw and used an approach to practice that resembled ‘bricoleur activity’. Conclusions The way in which general practice is structured results in variance in organisational structural arrangements for sharing and disseminating of knowledge. Despite a supportive organisational culture towards knowledge sharing, the position in which practice nurses are situated limits opportunities for discussion and reformulation of knowledge. Practice nurses are, however, prepared to adapt knowledge to meet the needs of individual patients.

scholarly journals Patient and practitioner views on cancer risk discussions in primary care: a qualitative study

BJGP Open ◽  
2021 ◽  
pp. BJGPO.2021.0108
Author(s):  
David N Blane ◽  
Sara MacDonald ◽  
Catherine A O'Donnell
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Qualitative Study ◽  
Cancer Risk ◽  
Lifestyle Modification ◽  
Structured Interviews ◽  
It Use ◽  
Practice Nurses ◽  
Primary Care Practitioners ◽  
The Uk

BackgroundIt is estimated that nearly 600,000 cancer cases in the UK could have been avoided in the last five years if people had healthier lifestyles, with the principle modifiable risk factors being smoking, obesity, alcohol consumption and inactivity. There is growing interest in the use of cancer risk information in general practice to encourage lifestyle modification.AimTo explore the views and experiences of patients and practitioners in relation to cancer prevention and cancer risk discussions in general practice.Design & settingQualitative study among patient and practitioners in general practices in Glasgow, UK.MethodSemi-structured interviews were conducted with nine practitioners (5 GPs and four practice nurses, recruited purposively from practices based on list size and deprivation status) and 13 patients (aged 30–60, with two or more specified co-morbidities).ResultsCurrently, cancer risk discussions focus on smoking and cancer, with links between alcohol/obesity and cancer rarely made. There was support for the use of the personalised cancer risk tool as an additional resource in primary care. Practitioners felt practice nurses were best placed to use it. Use in planned appointments (eg, chronic disease reviews) was preferred over opportunistic use. Concerns were expressed, however, about generating anxiety, time constraints, and widening inequalities.ConclusionsHealth behaviour change is complex and the provision of information alone is unlikely to have significant effects. Personalised risk tools may have a role, but important concerns about their use – particularly in areas of socio-economic disadvantage – remain.

scholarly journals Elbow joint disease in dogs attending primary-care practices in the UK

2017 ◽  
pp. 492-493
Author(s):  
Rebecca Hodge ◽  
Richard Meeson ◽  
David Brodbelt ◽  
David Church ◽  
Dan O’Neill
Keyword(s):  
Primary Care ◽  
Elbow Joint ◽  
Joint Disease ◽  
Care Practices ◽  
The Uk ◽  
Primary Care Practices

What practice nurses need to know about the NICE chronic kidney disease guidelines

2021 ◽  
Vol 32 (12) ◽  
pp. 468-472
Author(s):  
Peter Ellis
Keyword(s):  
Chronic Kidney Disease ◽  
General Practice ◽  
Kidney Disease ◽  
Kidney Function ◽  
Practice Nurse ◽  
Nice Guidelines ◽  
Practice Nurses ◽  
Health Related ◽  
The Uk

Chronic kidney disease is highly prevalent in the community. Peter Ellis looks at the role of the practice nurse in diagnosing and managing chronic kidney disease in general practice Chronic kidney disease (CKD) is defined as a reduction in kidney function, or damage to kidney structure, which has persisted for greater than 3 months and which is associated with other health-related issues. While there are many causes of CKD, the most prevalent in western societies, including the UK, are diabetes and hypertension. This article identifies the role of the practice nurse in applying the National Institute for Health and Care Excellence (NICE) guidelines for CKD.

scholarly journals Chronic kidney disease in cats attending primary care practice in the UK: a VetCompassTM study

2019 ◽  
Vol 184 (17) ◽  
pp. 526-526 ◽  
Author(s):  
Megan Conroy ◽  
David C Brodbelt ◽  
Dan O’Neill ◽  
Yu-Mei Chang ◽  
Jonathan Elliott
Keyword(s):  
Primary Care ◽  
Chronic Kidney Disease ◽  
Kidney Disease ◽  
Primary Care Practice ◽  
Blood Pressure Measurement ◽  
Clinical Signs ◽  
Care Practice ◽  
The Uk ◽  
Primary Care Practices ◽  
Nested Case Control

Chronic kidney disease (CKD) is a frequent diagnosis in cats attending primary care practice and the most frequent cause of death in cats aged over five years, yet there is limited published research for CKD in cats attending primary care practice. This study aimed to estimate the prevalence of CKD and investigate risk factors for diagnosis and survival of cats diagnosed with CKD in UK primary care practices. The study included cats attending VetCompassTM practices from January 1, 2012 to December 31, 2013. A nested case-control and cohort study were undertaken. From 353,448 cats attending 244 clinics, the prevalence of CKD was estimated as 1.2 per cent (95 per cent CI 1.1 per cent to 1.3 per cent). Most cats with CKD had clinical signs at diagnosis (66.6 per cent). Few cats underwent investigations or monitoring of serum creatinine (32.6 per cent), urine protein:creatinine ratio (14.9 per cent) or blood pressure measurement (25.6 per cent). A proprietary renal diet was the most frequently prescribed management (63.8 per cent). Median survival time following diagnosis was 388 days (IQR 88–1042 days). This study provides generalisable evidence from the wider cat population to aid veterinarians in improved diagnosis and management of CKD that can benefit the health and welfare of cats with CKD in the UK.

Is the primary care network the answer to increase student nurse capacity in general practice?

2019 ◽  
Vol 30 (12) ◽  
pp. 600-605
Author(s):  
Shaun Heath
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Community Of Practice ◽  
Learning Environments ◽  
Nursing Leadership ◽  
Student Nurse ◽  
Care Network ◽  
Practice Nurses ◽  
Effective Learning ◽  
Effective Learning Environments

Primary care networks have the potential to increase student nurse placements in general practice. Shaun Heath explores how effective learning environments can be created and the concept of the ‘community of practice’ This article explores how the emerging primary care networks (PCNs) could be used to increase student nurse placements in primary care, and how they could facilitate nurses in breaking free from isolative working. Known as a ‘community of practice’, working with our peers and colleagues from neighbouring practices alongside students could facilitate the growth of the network itself, share the educational load with the nurses in the PCN, and create nursing leadership with shared educational advancements. Could PCNs be what general practice nurses need to find their voices and develop their ambitions of becoming leaders?

scholarly journals Recognising and treating arrhythmias in primary care

2019 ◽  
Vol 30 (6) ◽  
pp. 270-275
Author(s):  
Dave Richley
Keyword(s):  
Primary Care ◽  
Chest Pain ◽  
Cardiac Arrhythmias ◽  
Accurate Diagnosis ◽  
Loss Of Consciousness ◽  
Specialist Care ◽  
Practice Nurses ◽  
Erroneous Diagnosis ◽  
The Uk ◽  
Electrocardiogram Ecg

As more and more people in the UK are being affected by cardiovascular conditions, it is increasingly necessary for practice nurses to keep up-to-date with the latest developments. Dave Richley explains common ECG readings that may be seen in primary care Cardiac arrhythmias may be asymptomatic or they may be responsible for a range of symptoms including palpitations, dizziness, chest pain and loss of consciousness. Accurate diagnosis, and therefore appropriate management, depends on careful interpretation of an electrocardiogram (ECG) recording of the arrhythmia, and this is often achievable in primary care. This article presents the arrhythmias most commonly encountered in primary care, as well as those seen rarely, and describes and illustrates their defining features. It will also discuss some of the pitfalls that can lead to erroneous diagnosis. While some arrhythmias can be managed appropriately in primary care, guidance is provided in regarding referral or admission to hospital for arrhythmias that may warrant further investigation or specialist care.

Next steps for student supervision and assessment

2019 ◽  
Vol 30 (10) ◽  
pp. 496-500
Author(s):  
Shaun Heath
Keyword(s):  
Primary Care ◽  
General Practice ◽  
Communities Of Practice ◽  
Student Nurses ◽  
Education Standards ◽  
Student Placement ◽  
Practice Nurses ◽  
Primary Care Settings ◽  
Student Supervision

Student nurses are the future of the profession. Shaun Heath explains how changes to the Nursing and Midwifery Council's education standards will effect those currently acting as mentors and how all practice nurses can get involved and contribute to student placement experiences This article explores the Nursing and Midwifery Council's 2018 education standards and how these will affect the role of general practice nurses in primary care settings. The differing roles found in the standards will be discussed, alongside how primary care and the emerging Primary Care Networks can support learners in general practice through communities of practice.

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