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Clinical Focus

Remote asthma consultations in primary care

In a speech on the future of healthcare delivered in July 2020, Matt Hancock, the secretary of state for health and social care, said that ‘Coronavirus has catalysed deep structural shifts in...

Management of bleeding in women on HRT

Post-menopausal bleeding is defined as unscheduled vaginal bleeding that occurs a year after the last natural menstrual period (SIGN, 2002), or any breakthrough bleeding on cyclical HRT, or...

Managing diabetes during the COVID-19 pandemic

The virus responsible for the disease known as COVID-19 was identified as SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2), which belongs to the coronavirus group of viruses that commonly...

Understanding and supporting children and young people with eating disorders

Eating disorders most often develop between the age of 15 and 35 years. With approximately 0.3–0.5% of the population up to 18 years developing anorexia nervosa, it is nevertheless a relatively rare...

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

On 4 July 2020, UK travel advice changed, with exemptions for travelling to certain countries and territories no longer considered to pose an unacceptably high risk for UK travellers. The UK...

Periwound skin care considerations for older adults

In relation to changes that occur within the epidermis, proliferation of keratinocytes reduces leading to a slower rate of epidermal turnover (Farage et al, 2013). The main role of keratinocytes is to...

Recognition and management of sepsis in the urgent care out of hours setting

Sepsis is a life-threatening and common condition prompted by a microbial infection that causes the immune system of the body to react robustly; failure to provide timely treatment could lead to death...

The overtreatment of type 2 diabetes in frail older people

The Action to Control Cardiovascular Risk in Diabetes (ACCORD) study found that people with tighter glycaemic control (HbA1c <42 mmol/mol) had excessive mortality, particularly in those with multiple...

SAFER PRACTICES in the COVID-19 pandemic

The first part of the mnemonic, SAFER, has two purposes. Firstly, to ensure that the clinician comes to the consultation with the medical knowledge, along with the clinical assessment skills and...

Assessing and treating adults with hearing loss in primary care

There are several recognised risk factors for hearing loss in adults that practice nurses should be aware of..

Responding to errors in the storage, handling, and administration of vaccines

Vaccines, like all biological substances, degrade over time. Exposure to extremes of heat, cold, sunlight or fluorescent light can accelerate this process. Recommended temperature ranges are detailed...

Understanding the NICE guidance on endometriosis

Endometriosis is an oestrogen-dependent chronic condition where endometrial tissue forms lesions outside the uterus (Figure 1), which induce a chronic, inflammatory reaction (Dunselman et al, 2014).

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