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Sacral neuromodulation (SNM) is a therapy system used to improve bladder function, including in people with overactive bladder (OAB). It is safe and can improve quality of life. SNM helps improve symptoms through direct modulation of nerve activity; it involves electrically stimulating the sacral nerves that carry signals between the pelvic floor, spinal cord and the brain and is thought to normalise neural communication between the bladder and brain. If patients with OAB do not respond to non-surgical and conservative options, minimally invasive procedures can be offered, including SNM. SNM is performed in two stages the trial phase, to assess whether it would be effective in the long term; and permanent implantation. This year, the National Institute for Health and Care Excellence (NICE) released guidance on the Axonics SNM System® for treating refractory OAB. The Axonics System is rechargeable and lasts at least 15 years, minimising the need for repeat surgery. NICE suggests the Axonics System may have cost advantages for the NHS. Having more than one SNM therapy option available increases options for patients, offering them a choice of handsets and rechargeable versus non-rechargeable implants. Three case studies illustrate how the system works in practice.Current NHS policy is to reduce the number of catheter-associated urinary tract infections (CAUTIs). To achieve this, guidance suggests reducing the use of catheterisation as much as possible. For those patients requiring catheterisation, Norfolk and Norwich University Hospitals NHS Foundation Trust (NNUH) ensured that a medicinal anaesthetic, antiseptic lubricant containing chlorhexidine and lidocaine was used for all catheterisations. Between 2011 and 2018 the Trust reduced CAUTIs by around 50%. This article discusses catheterisation, national policy in reducing CAUTIs, and how NNUH achieved this reduction.Mark Gourlay was an MSc Adult Nursing (Pre-registration) Student, University of Dundee, and is now General Practice Nurse, Taycourt Surgery, Dundee.Sam Foster, Chief Nurse, Oxford University Hospitals, reflects on how the pandemic has progressed the use of digital platforms to interact with patients, and how this approach can exclude some patient groups.
Catheter-associated urinary tract infection (CAUTI) can significantly affect patients' quality of life and increase healthcare costs.
This study aimed to capture patients' and nurses' experience of catheter maintenance using a polyhexanide-based solution (PS) in everyday practice.
Retrospective analysis of data was collected for a product evaluation. PS was used twice a week for five weeks.
The study included 42 patients, 30 (71%) men and 12 women (29%). After five weeks of rinsing catheters with PS, nine patients reported no or decreased frequency of CAUTI, eight a better quality of life, eight reduced blockage, seven a decrease in odour and five fewer catheter changes. Three patients reported no benefit from PS use. Nurses reported that fewer visits were needed and consumption of disposables was lower.
User experiences suggest that, as a novel means of catheter maintenance, PS has the potential to reduce catheter-associated complications such as CAUTI, improve quality of life and reduce healthcare costs.
User experiences suggest that, as a novel means of catheter maintenance, PS has the potential to reduce catheter-associated complications such as CAUTI, improve quality of life and reduce healthcare costs.John Fowler, Educational Consultant, explores academic writing.Nurses have a vital role in providing nursing care to patients requiring mobile radiography. Mobile radiography is requested when a patient's condition makes it impossible for them to be transported to the radiology department. All health professionals involved in mobile radiography, such as nurses, medical doctors and radiographers should be knowledgeable in this area. This is even more important in current practice, where nurse consultants and nurse advanced practitioners are assessing and referring patients for limited radiological examinations. However, there is little literature to equip nurses with knowledge about mobile radiography. The aim of this article is to raise awareness of this subject at a time when the number of patients requiring mobile radiography has increased globally, due to the outbreak of coronavirus. Critically ill patients with COVID-19 require portable chest X-rays to diagnose complications of the disease, such as pneumonia.Nurses continue to experience challenges when caring for culturally diverse patients and while working with staff from different cultural, ethnic and linguistic backgrounds. The widening landscape of cultural diversity in the nursing classroom provides a vehicle for intercultural learning, supporting intercultural competence development. However, students must embrace culturally diverse learning environments and maximise opportunities to learn with, from and about students from different cultural backgrounds. This requires developing the courage, curiosity and commitment to maximise all intercultural learning opportunities. Drawing on experiences of international students studying in culturally diverse classrooms, this article presents some practical suggestions for meaningfully engaging and capitalising on intercultural learning opportunities.John Tingle, Lecturer in Law, Birmingham Law School, University of Birmingham, discusses some recent national and global patient safety reports.Emeritus Professor Alan Glasper, from the University of Southampton, discusses the Prime Minister's personal campaign to reduce the impact of COVID-19 by addressing rising levels of obesity in society.
To assess divided-attention performance when driving under the influence of cannabis with and without alcohol. Filanesib molecular weight Three divided-attention tasks were performed following administration of placebo, cannabis, and/or alcohol.
Healthy adult cannabis users participated in 6 sessions, receiving combinations of cannabis (placebo/low-THC/high-THC) and alcohol (placebo/active) in randomized order, separated by washout periods of ≥1 week. At 0.5 hours post-dosing, participants performed simulator drives in the University of Iowa National Advanced Driving Simulator (NADS-1), a full vehicle cab simulator with a 360° horizontal field of view and motion base that provides realistic feedback. Drives contained repeated instances of three tasks a side-mirror task (reaction to a triangle appearing in the side-mirrors), an artist-search task (select a specified artist from a navigable menu on the vehicle's console), and a message-reading task (read aloud a message displayed on the console). Blood THC and breath alcohol concentration (BrAC) were interpolated using individual power curves from samples collected approximately 0.
