Critical thinking and diagnostic reasoning when assessing problems with the genitourinary system

Urological conditions have become increasingly common and early diagnosis is key to achieving better outcomes. This article discusses the importance of having a comprehensive understanding of urological disorders, having the skills to interpret relevant information, and recognising the relationships among given elements to make an appropriate clinical diagnosis.

Reflecting on the trainee nurse associate role uptake and impact

Sam Foster, Chief Nurse, Oxford University Hospitals, considers the lessons from research into the trainee nurse associate role and the implications for workforce planning

Adaptation of a stoma care pathway and use of telephone clinics during the pandemic: patient experience survey

With the arrival of the COVID-19 pandemic, outpatient clinics had to adjust and reduce the number of face-to-face appointments. The Cambridge stoma service has a recognised pathway of stoma care but needed to adjust this in line with government guidelines. The team took the opportunity to audit the current pathway and complete a patient experience survey to determine the future of the service and potential adaptations to the pathway in the future. Aim: To determine the need for adaptation and improvement of the standard stoma clinics pathway. Method: A survey was conducted using a postal questionnaire to all patients who attended stoma clinics between April and June 2020. Findings: 160 questionnaires were sent and 72 responses returned (45%). All elements of the virtual clinic were rated positive by more than 80% of respondents, with nearly 90% of them feeling that all their stoma care needs were met. When asked to indicate their preferred consultation methods (patients were allowed to choose more than one), face to face received 50 votes, telephone 32 votes and video clinic 5 votes. Conclusion: There is a need to adapt the standard clinic pathway to be able to offer standardised care but with flexibility to adjust to circumstances and patients' preferences.

Talking to children about their HIV diagnosis: a discussion rooted in different global perspectives

An online meeting was arranged with four professionals representing four countries to debate current practices and future steps in naming HIV to children (disclosing HIV status). This article considers the evidence and reports on the commentary and debate from the meeting. Naming HIV to children remains a challenge. Although studies identify some of the facilitators and barriers to informing children of their HIV diagnosis, further review of practice is required. This article presents a global perspective of naming practices from different settings. The article comprises commentary and a report of the online debate, along with supporting evidence. The four participating authors concluded that health professionals must work in collaboration with families to support early naming of HIV to children or having an open discussion about HIV in clinics. Naming when a child is younger reduces self-stigma and empowers children and young people to adhere to their medication, make informed decisions and share their own diagnosis appropriately. The authors concluded that health professionals play a key role in educating colleagues and the public to reduce stigma and discrimination. Professionals working with children and families living with HIV require support and resources to instil confidence in naming and facilitate naming of HIV status to a child.

Monitoring of blood glucose levels, ketones and insulin bolus advice using 4SURE products and app-based technology

With more people being diagnosed with diabetes and requiring insulin therapy as they live longer, an increasing number of individuals are needing access to blood and ketone monitoring that is simple to use and provides accurate results. Having access to a bolus advisor is equally important in order for people with diabetes to calculate accurate insulin doses based on the foods that they are eating. The use of app-based technology for healthcare purposes has increased over recent years and now includes the Diabetes:M application that can be used in conjunction with the 4SURE smart meters with no additional cost to the individual.

A referral pathway for stoma patients

Alison Roberts, Nurse Team Leader, Respond Healthcare ( [email protected] ) was a runner-up in the Stoma Nurse of the Year category of the British Journal of Nursing Awards 2021