Development of a tissue viability nursing competency framework.

In 1999, a sub-group of the National Association for Tissue Viability Nurse Specialists (Scotland) agreed to lead the production of a competency framework. The aims were to define tissue viability specialist nursing, to provide a framework for tissue viability nurse specialists (TVNSs) that would form a basis for clinical supervision and mentorship, and to inform curricular for tissue viability education. Using a combination of models, a framework evolved which defines the multifaceted nature of the role. The framework lists competencies, which are further broken down into specific role elements, matched with measurable performance criteria for the TVNS. The competency statements that are provided within the publication describe the attitude, knowledge and skills required to fulfil the TVNS role. The document, 'A Route to Enhanced Competence for Tissue Viability Nurse Specialists', was published in June 2002. This initiative meets the national need for definition of specialist practice and provides a standard by which the public can be assured of quality care from TVNSs in Scotland.

Hydrocolloids in wound management: pros and cons.

Hydrocolloids are interactive dressings which are well established in wound management. Because of their sophisticated composition, they can be used to manage a variety of wound types, from clean and granulating to sloughy and necrotic. While they may be more expensive per item than many other modern dressings, if used correctly they can be cost-effective, as they have a longer wear time. Hydrocolloid formulations appear to be changing and improving with ongoing research by manufacturers, but a significant limitation appears to be sensitivity reactions. Dressings that would benefit from improvement are those containing gelatin, and those containing colophony within the adhesive matrix. These known sensitizers are largely unpublicised, but can produce serious side effects in some individuals.

Injecting drug use: developing a drop-in wound care clinic.

The first part of this two-part series examined the difficulties facing nurses working with injecting drug users with skin problems (Finnie and Nicolson, 2002). This article describes the needs of homeless people with skin complaints and the innovative development of a specific drop-in wound care clinic within The Big Issue Scotland premises in Glasgow. It illustrates some practical and political difficulties of working with a unique and challenging client group, and of developing a wound care service outwith the NHS. Case studies illustrate individual people and their own challenges.

Nutritional care: implications and recommendations for nursing.

Nutrition is a basic human requirement with both physiological and psychosocial dimensions that affect well-being. In times of illness ensuring adequate nutrition is particularly important because of the central part it plays in healing and recovery. This article explores the premise that current nutritional care in nursing practice is often inadequate with the result that patients' nutritional requirements are not met. It investigates the causative factors of poor nutritional care in nursing practice, the implications of such practice for both the patient and the professional, and proposes a number of recommendations for future change.

Injecting drug use: implications for skin and wound management.

This article, the first of two parts, introduces the difficulties facing nurses working with injecting drug users with skin problems. Drug abuse is increasing globally, and has huge implications for healthcare practitioners. Increasing numbers of tissue viability nurses are also encountering drug injection-induced wounds in their practice, but there is a lack of evidence for management of chronic skin problems in this patient group. Together with rising numbers of injecting drug users, there are increased health implications such as bacteraemia, septicaemia, amputation and skin breakdown. Abscesses and chronic wounds as well as prolonged leg ulceration are common. Drug users may demonstrate chaotic lifestyles, which may inhibit access to usual healthcare provision. Issues relating to healing of these wounds are explored. The second part, which will appear in the next Tissue Viability Supplement, will describe the development of a specialist wound care clinic for homeless drug users.

Bandages and bandaging techniques for compression therapy.

Bandaging skills are essential for community nurses not only as a method of supporting joints, or retaining a dressing but also as an important treatment of leg ulceration. It is important to be able to choose the correct type, size, and composition of bandage and then apply it safely using the most appropriate technique, as incorrectly applied bandages may lead to pressure necrosis and subsequent limb amputation. Bandaging applications have changed little over the last 100 years and the two most commonly used techniques are still the spiral and the figure-of-eight methods. There are advantages and disadvantages of both, and successful bandaging depends on choosing the correct product and good technique, both in stretching the bandage to the correct tension, and ensuring proper overlap between layers.

From the Journals.

PSYCHOSOCIAL FACTORS AND LEG ULCER HEALING IN OLDER PATIENTSM THE USE OF NON-ADHERENT DRESSINGS IN SKIN-GRAFT MANAGEMENT VIDEO TECHNIQUE FOR MEASURING WOUND SIZE COMPRESSION HOSIERY AND VENOUS LEG ULCERS VENOUS LEG ULCERS AND QUALITY OF LIFE PRESSURE SORE GRADING SCALES AND INTER-RATER RELIABILITY VITAMIN SUPPLEMENTS AND DIETARY INTAKE IN OLDER PEOPLE.

From the Journals.

NOISE AND WOUND HEALING FOUR-LAYER BANDAGE STUDY MANAGEMENT SYSTEMS NECROTISING FASCIITIS DISFIGURING INJURIES.

From the Journals.

The use of ultrasound therapy in treating pressure sores Ischaemia and reperfusion injury in patients with intermittent claudication Transcutaneous oxygen pressure and pressure sore development Current practice in burn care Use of MRS to monitor healing of leg ulcers Effectiveness of a low air loss bed in treating pressure ulcers.