Tick-borne diseases: an update for general practice

2020 ◽  
Vol 31 (3) ◽  
pp. 112-117
Author(s):  
Sharon Graham
Keyword(s):  
General Practice ◽  
Viral Infections ◽  
Transmission Risk ◽  
Personal Protection ◽  
Practice Nurses ◽  
Tick Borne Disease ◽  
Avoidance Measures ◽  
The Uk

Practice nurses offering pre-travel consultations should be aware of tick-borne diseases. Sharon Graham outlines how to help prevent these diseases in travellers Ticks are the vectors for a number of bacterial and viral infections that can affect humans. This article will outline the general transmission, risk and prevention of tick-borne diseases. Many of these diseases are associated with travel outside of the UK. Where a vaccine for a disease is available in the UK, information will be provided, but not all tick-borne disease is vaccine preventable and people should be aware of personal protection and bite avoidance measures.

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.

Clinical academic careers for general practice nurses: a rapid evidence assessment

2020 ◽  
pp. 174498712095426
Author(s):  
Andrew Bradbury ◽  
Sue Shortland ◽  
Sarahjane Jones ◽  
Fraser Hewett ◽  
and Karen Storey
Keyword(s):  
General Practice ◽  
Cultural Change ◽  
Academic Career ◽  
Academic Careers ◽  
Direct Patient Care ◽  
Policy And Practice ◽  
Enabling Factors ◽  
Practice Nurses ◽  
Organisational Research ◽  
The Uk

Background Clinical academics are health professionals who provide direct patient care alongside engaging in health research. Despite the generally agreed consensus that such roles enhance evidence-based care, availability and uptake has been sporadic in non-medical professions. With no data readily available regarding general practice nurses undertaking clinical academic roles, there is a need to understand the barriers and enabling factors that impact general practice nurses considering or pursuing a clinical academic career. Aims This review aims to address the question ‘What are the barriers and enablers relevant to general practice nurses in the UK pursuing clinical academic careers?’ by providing an overview of the relevant existing literature and drawing out the implications for policy and practice. Methods Literature published in the past 10 years was systematically searched. Using agreed inclusion criteria, papers were first screened on titles and abstracts, with papers included at this stage reviewed as full texts. Results Thirteen papers met the criteria for inclusion. The extraction and synthesis of findings allowed for the development of three themes: roles and responsibilities; embarking on a clinical academic career; and organisational research culture. Conclusions Findings suggest that infrastructure developments are required across higher education institutions and general practice organisations to bring about a cultural change to equip and empower general practice nurses to consider and pursue clinical academic careers.

Understanding primary prevention of cardiovascular disease

2021 ◽  
Vol 32 (7) ◽  
pp. 278-281
Author(s):  
Beverley Bostock
Keyword(s):  
Risk Factors ◽  
Cardiovascular Disease ◽  
General Practice ◽  
Primary Prevention ◽  
Cvd Risk ◽  
Pharmacological Management ◽  
Practice Nurses ◽  
Reduction Strategies ◽  
The Uk ◽  
Risk Reduction Strategies

Cardiovascular disease causes significant morbidity and mortality across the UK. Beverley Bostock looks at the role practice nurses can play in the primary prevention of this condition Nurses working in general practice play an important role in identifying those at risk of developing cardiovascular disease (CVD) and implementing person-focused risk reduction strategies. The NHS Health Check programme was designed to identify people between the age of 40 and 74 years with risk factors for CVD. Nurses in general practice have a key role to play in encouraging people to attend Health Checks and helping people to understand the potential benefits of CVD risk assessment and reduction strategies. Lifestyle interventions and pharmacological management allow modifiable risk factors to be managed in an evidence-based and person-focused way.

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 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.

Travel and COVID-19: what the practice nurse needs to know

2020 ◽  
Vol 31 (9) ◽  
pp. 369-373
Author(s):  
Mary Gawthrop
Keyword(s):  
General Practice ◽  
Practice Nurse ◽  
Informed Choice ◽  
International Travel ◽  
Practice Nurses ◽  
Travel Health ◽  
Travel Restrictions ◽  
The Uk ◽  
Travel Abroad

As individuals start planning travel abroad again, Mary Gawthrop explains the key considerations for travel health consultations during the COVID-19 pandemic While COVID-19 continues to be a risk worldwide, lockdown and international travel restrictions are being eased in many countries, including the UK. General practice nurses have a role to play in assisting UK residents to make an informed choice about travelling abroad during this pandemic.

scholarly journals Quality improvement in general practice: what do GPs and practice managers think? Results from a nationally representative survey of UK GPs and practice managers

2021 ◽  
Vol 10 (2) ◽  
pp. e001309
Author(s):  
Jennifer Gosling ◽  
Nicholas Mays ◽  
Bob Erens ◽  
David Reid ◽  
Josephine Exley
Keyword(s):  
General Practice ◽  
Quality Improvement ◽  
General Practitioners ◽  
Service Improvement ◽  
Protected Time ◽  
Routine Work ◽  
Professional Interest ◽  
Quality And Outcomes ◽  
Nationally Representative ◽  
The Uk

BackgroundThis paper presents the results of the first UK-wide survey of National Health Service (NHS) general practitioners (GPs) and practice managers (PMs) designed to explore the service improvement activities being undertaken in practices, and the factors that facilitated or obstructed that work. The research was prompted by growing policy and professional interest in the quality of general practice and its improvement. The analysis compares GP and PM involvement in, and experience of, quality improvement activities.MethodsThis was a mixed-method study comprising 26 semistructured interviews, a focus group and two surveys. The qualitative data supported the design of the surveys, which were sent to all 46 238 GPs on the Royal College of General Practitioners (RCGP) database and the PM at every practice across the UK (n=9153) in July 2017.ResultsResponses from 2377 GPs and 1424 PMs were received and were broadly representative of each group. Ninety-nine per cent reported having planned or undertaken improvement activities in the previous 12 months. The most frequent related to prescribing and access. Key facilitators of improvement included ‘good clinical leadership’. The two main barriers were ‘too many demands from external stakeholders’ and a lack of protected time. Audit and significant event audit were the most common improvement tools used, but respondents were interested in training on other quality improvement tools.ConclusionGPs and PMs are interested in improving service quality. As such, the new quality improvement domain in the Quality and Outcomes Framework used in the payment of practices is likely to be relatively easily accepted by GPs in England. However, if improving quality is to become routine work for practices, it will be important for the NHS in the four UK countries to work with practices to mitigate some of the barriers that they face, in particular the lack of protected time.

Pharmacists in general practice: a qualitative process evaluation of the General Practice Pharmacist (GPP) study

2020 ◽  
Vol 37 (5) ◽  
pp. 711-718
Author(s):  
Oscar James ◽  
Karen Cardwell ◽  
Frank Moriarty ◽  
Susan M Smith ◽  
Barbara Clyne
Keyword(s):  
General Practice ◽  
Process Evaluation ◽  
Controlled Trial ◽  
Qualitative Approach ◽  
Structured Interviews ◽  
Practice Staff ◽  
Practice Nurses ◽  
Practice Team ◽  
Prescribing Quality ◽  
Descriptive Qualitative

Abstract Background There is some evidence to suggest that pharmacists integrated into primary care improves patient outcomes and prescribing quality. Despite this growing evidence, there is a lack of detail about the context of the role. Objective To explore the implementation of The General Practice Pharmacist (GPP) intervention (pharmacists integrating into general practice within a non-randomized pilot study in Ireland), the experiences of study participants and lessons for future implementation. Design and setting Process evaluation with a descriptive qualitative approach conducted in four purposively selected GP practices. Methods A process evaluation with a descriptive qualitative approach was conducted in four purposively selected GP practices. Semi-structured interviews were conducted, transcribed verbatim and analysed using a thematic analysis. Results Twenty-three participants (three pharmacists, four GPs, four patients, four practice nurses, four practice managers and four practice administrators) were interviewed. Themes reported include day-to-day practicalities (incorporating location and space, systems and procedures and pharmacists’ tasks), relationships and communication (incorporating GP/pharmacist mode of communication, mutual trust and respect, relationship with other practice staff and with patients) and role perception (incorporating shared goals, professional rewards, scope of practice and logistics). Conclusions Pharmacists working within the general practice team have potential to improve prescribing quality. This process evaluation found that a pharmacist joining the general practice team was well accepted by the GP and practice staff and effective interprofessional relationships were described. Patients were less clear of the overall benefits. Important barriers (such as funding, infrastructure and workload) and facilitators (such as teamwork and integration) to the intervention were identified which will be incorporated into a pilot cluster randomized controlled trial.

scholarly journals Diarylureas: Repositioning from Antitumor to Antimicrobials or Multi-Target Agents against New Pandemics

Antibiotics ◽  
2021 ◽  
Vol 10 (1) ◽  
pp. 92 ◽  
Author(s):  
Alessia Catalano ◽  
Domenico Iacopetta ◽  
Michele Pellegrino ◽  
Stefano Aquaro ◽  
Carlo Franchini ◽  
...  
Keyword(s):  
Anticancer Agents ◽  
Kinase Inhibitors ◽  
Viral Infections ◽  
Drug Repositioning ◽  
Biological Activities ◽  
Antiviral Treatment ◽  
Far East ◽  
Mild Disease ◽  
To Come ◽  
The Uk

Antimicrobials have allowed medical advancements over several decades. However, the continuous emergence of antimicrobial resistance restricts efficacy in treating infectious diseases. In this context, the drug repositioning of already known biological active compounds to antimicrobials could represent a useful strategy. In 2002 and 2003, the SARS-CoV pandemic immobilized the Far East regions. However, the drug discovery attempts to study the virus have stopped after the crisis declined. Today’s COVID-19 pandemic could probably have been avoided if those efforts against SARS-CoV had continued. Recently, a new coronavirus variant was identified in the UK. Because of this, the search for safe and potent antimicrobials and antivirals is urgent. Apart from antiviral treatment for severe cases of COVID-19, many patients with mild disease without pneumonia or moderate disease with pneumonia have received different classes of antibiotics. Diarylureas are tyrosine kinase inhibitors well known in the art as anticancer agents, which might be useful tools for a reposition as antimicrobials. The first to come onto the market as anticancer was sorafenib, followed by some other active molecules. For this interesting class of organic compounds antimicrobial, antiviral, antithrombotic, antimalarial, and anti-inflammatory properties have been reported in the literature. These numerous properties make these compounds interesting for a new possible pandemic considering that, as well as for other viral infections also for CoVID-19, a multitarget therapeutic strategy could be favorable. This review is meant to be an overview on diarylureas, focusing on their biological activities, not dwelling on the already known antitumor activity. Quite a lot of papers present in the literature underline and highlight the importance of these molecules as versatile scaffolds for the development of new and promising antimicrobials and multitarget agents against new pandemic events.

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