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1 Chapter 1Figure 1.1 Cartoon of Queen’s Nurses in 1918.Figure 1.2 Queen’s Nurse with a bicycle, c. 1900.Figure 1.3 The celebrated midwife’s case, 1925.Figure 1.4 Queen’s Nurses magazine advert, 1913.Figure 1.5 Ground floor plan of a district nurse’s cottage, 1945.Figure 1.6 Architect’s design for a district nurse’s cottage, 1945....

2 Chapter 2Figure 2.1 Insignia of Queen Victoria’s Jubilee Institute for Nurses, 1887....Figure 2.2 Queen’s Nurse’s Outdoor Uniform, 1905.Figure 2.3 Uniform hat for Queen’s Nurses, 1913.Figure 2.4 Queen’s Nursing Institute badge for Jamaican nurses.Figure 2.5 Queen’s Nurse’s indoor uniform, 1943.Figure 2.6 Queen’s Institute of District Nursing logo, 1928.Figure 2.7 Queen’s Nursing Institute logo, 1973.Figure 2.8 Modern Queen’s Nurse badge. Source: Queen’s Nursing Institute....

3 Chapter 3Figure 3.1 The three pillars supporting learning within the community settin...Figure 3.2 Individual learning styles.Figure 3.3 Quality in community education.

4 Chapter 4Figure 4.1 Examples of alternative practice placements.Figure 4.2 Examples of ‘hub and spoke’ practice placements.Figure 4.3 Guidelines for issues arising in practice placements.

5 Chapter 6Figure 6.1 Community preceptorship and mentorship.

6 Chapter 7Figure 7.1 A district nurse carrying equipment from a patient’s home.Figure 7.2 The novice to expert continuum.Figure 7.3 A district nurse on her rounds.

7 Chapter 8Figure 8.1 Evidence‐based practice as a continuous cycle.Figure 8.2 Hierarchy of evidence.

8 Chapter 9Figure 9.1 A mobile phone is a key piece of District Nursing equipment.Figure 9.2 Working with a laptop or tablet to record and share patient notes...Figure 9.3 Developing good relationships with family members and carers is e...

9 Chapter 10Figure 10.1 The multidisciplinary team.Figure 10.2 A district nurse visits a man living at home with complex health...

10 Chapter 11Figure 11.1 Safe caseload management methods and tools.Figure 11.2 Nine characteristics of good‐quality care in district nursing....

11 Chapter 12Figure 12.1 An illustration of nurses in the community, from an animated fil...Figure 12.2 An illustration of members of a multidisciplinary healthcare tea...Figure 12.3 Members of a multidisciplinary community healthcare team assess ...Figure 12.4 Staff members of a community healthcare organisation in the UK w...

12 Chapter 13Figure 13.1 District nurse and pharmacist discuss medications.Figure 13.2 Sources of support and information for non‐medical prescribers....

13 Chapter 14Figure 14.1 Yellow Card – making medicines safer.Figure 14.2 A district nurse prepares a needle and syringe for injection.

14 Chapter 15Figure 15.1 Writing up clinical notes in a patient’s home during a visit. Pa...

15 Chapter 16Figure 16.1 Risk matrix. 1–3 = Low risk; 4–6 = Moderate risk; 8–12 = High ri...

16 Chapter 17Figure 17.1 Quality of care pyramid. NHS England has developed a pyramid whi...Figure 17.2 The NHS Safety Thermometer was developed for the NHS by the NHS ...

17 Chapter 18Figure 18.1 Many district nurse visits will be to people living alone.Figure 18.2 Travel by car is usually the most efficient way to reach patient...Figure 18.3 Example of a ‘Wellbeing Tree’ poster for use in a community nurs...Figure 18.4 Example of a staff ‘Wobble Room’ poster for use in a community h...

18 Chapter 19Figure 19.1 Making every contact count.Figure 19.2 Behaviour change interventions mapped to NICE behaviour change: ...Figure 19.3 Example of a Likert Scale for use in healthcare settings.

19 Chapter 20Figure 20.1 Cultural competence builds on the concepts of cultural awareness...Figure 20.2 Cultural issues in nursing word cloud.

20 Chapter 21Figure 21.1 Maslow’s hierarchy of needs.Figure 21.2 Nurse at a homeless health clinic.Figure 21.3 Nurse examines feet of a person at a homeless shelter.

21 Chapter 22Figure 22.1 The spectrum of inequality.Figure 22.2 National Health Service comprehensive personalised care model.

22 Chapter 23Figure 23.1 Handwashing diagrams that can be shown to patients.Figure 23.2 Transmission routes of micro‐organisms.Figure 23.3 Human pathogen transmission.Figure 23.4 Hand hygiene at the point of care.

23 Chapter 26Figure 26.1 The individual being cared for may receive support from numerous...

24 Chapter 27Figure 27.1 Model of physicians’ adherence communication (expanded version)....Figure 27.2 Discussing a care plan with a patient one‐to‐one is key to effec...

25 Chapter 28Figure 28.1 A clinical bed provided for use in a person’s home.Figure 28.2 Assisting a person with mobility issues with eating and drinking...Figure 28.3 Supporting an elderly woman in the use of specialist equipment a...

26 Chapter 29Figure 29.1 The internet allows for a permanent interface between remote dev...

27 Chapter 30Figure 30.1 Community nurses are using mobile technology to create time to c...Figure 30.2 An example of a web‐based work scheduling tool used in District ...

28 Chapter 31Figure 31.1 Resident and nurse in a care home setting.Figure 31.2 Residents and nurse in a care home setting.

29 Chapter 32Figure 32.1 Key contributors to effective person‐centred dementia care in th...Figure 32.2 Some key elements in person‐centred care for individuals....

30 Chapter 34Figure 34.1 Carers’ Alert Thermometer (Edge Hill University).Figure 34.2 Carers’ Alert Thermometer – Guidance for Staff.

31 Chapter 35Figure 35.1 Triangle of care.Figure 35.2 Carers UK.Figure 35.3 Carers Trust.Figure 35.4 The Queen’s Nursing Institute learning resource.

32 Chapter 36Figure 36.1 A nurse and resident of a hospice.Figure 36.2 Therapy animals come in all shapes and sizes.Figure 36.3 A nurse and a resident in a hospice setting.Figure 36.4 Palliative care in a a hospice setting.

33 Chapter 37Figure 37.1 Aspects of spirituality from the personal perspective.Figure 37.2 Aspects of spirituality from a clinical perspective.Figure 37.3 A district nurse visiting a frail elderly person and family memb...

34 Chapter 38Figure 38.1 Taking time to discuss a person’s health and care is a key part ...Figure 38.2 The Kübler‐Ross grief cycle.Figure 38.3 Good communication is essential to building relationships in the...

35 Chapter 39Figure 39.1 Signposting to other services.Figure 39.2 Assessing health and expectations in order to negotiate care pla...Figure 39.3 Holistic assessment leads to achievable outcomes.

36 Chapter 40Figure 40.1 Taking baseline observations in the home.Figure 40.2 Heart rate (beats per minute).Figure 40.3 The six R’s.

37 Chapter 41Figure 41.1 Examples of some common long‐term conditions.Figure 41.2 Disease pyramid.Figure 41.3 The NHS and Social Care Long Term Conditions model.Figure 41.4 Self‐management and self‐care.Figure 41.5 House of care.Figure 41.6 Long‐term conditions and mental health.

38 Chapter 42Figure 42.1 Proper hydration is vital to physical and mental health.Figure 42.2 Ensure water is always available.Figure 42.3 A poster illustrating a QNI‐funded project, ‘Water for Wellbeing...

39 Chapter 43Figure 43.1 The Eatwell Plate. Use the Eatwell Plate to help you get the bal...Figure 43.2 Routes of enteral feeding.

40 Chapter 44Figure 44.1 General anatomy of the human kidney.Figure 44.2 Principal structure of the kidney.Figure 44.3 Glomerular capsule.

41 Chapter 45Figure 45.1 MaculesFigure 45.2 PapulesFigure 45.3 PlaquesFigure 45.4 WhealsFigure 45.5 VesiclesFigure 45.6 PustulesFigure 45.7 CrustFigure 45.8 Lichenification.

42 Chapter 46Figure 46.1 Continence aids.Figure 46.2 Anal plug.Figure 46.3 Anal irrigation kit.Figure 46.4 (a‐e) Examples of proprietary incontinence products used in comm...

43 Chapter 47Figure 47.1 The Bristol Stool Chart was developed by Dr. Ken Heaton at the U...Figure 47.2 Anatomy of the gastrointestinal tract.

44 Chapter 48Figure 48.1 A catheter.Figure 48.2 A drainage bag.Figure 48.3 Emptying a drainage bag.Figure 48.4 Tubing and bag secured to leg.

45 Chapter 49Figure 49.1 Lipoedema.Figure 49.2 Severe bilateral leg Lymphoedema, showing skin folds and skin ch...Figure 49.3 Secondary breast cancer related Lymphoedema.Figure 49.4 Hyperkeratosis and other skin changes are seen in chronic lympho...Figure 49.5 Dependent or gravitational oedema.Figure 49.6 Multi‐Layer compression bandaging treatment.

46 Chapter 50Figure 50.1 Typical sites for pressure ulcers.Figure 50.2 Risk factors.

47 Chapter 51Figure 51.1 Location of foot pulses.

48 Chapter 52Figure 52.1 Withdrawing medication from a vial.

49 Chapter 53Figure 53.1 Ischaemic heart disease.Figure 53.2 A human blood vessel.Figure 53.3 A Holter monitor applied to male patient.

50 Chapter 54Figure 54.1 Sources of indoor pollutants.

51 Chapter 55Figure 55.1 Symptoms of COPD.Figure 55.2 Medical interventions for COPD: bronchodilators.Figure 55.3 A nurse offers one‐to‐one support.Figure 55.4 Supporting a patient with inhaled therapy.

52 Chapter 56Figure 56.1 Lung function and disease trajectory in cancer and COPD.Figure 56.2 NICE summary of holistic care and pathways that patients with en...

53 Chapter 57Figure 57.1 A human Neurone.Figure 57.2 Acute spinal injury.Figure 57.3 Supporting and assessing a patient with paralysis.

54 Chapter 58Figure 58.1 Diagram of the human body showing those parts of the anatomy aff...

55 Chapter 59Figure 59.1 Time since diagnosis in people with cancer between 1991 and 2010...Figure 59.2 District Nurse administering chemotherapy in the home.

56 Chapter 61Figure 61.1 A District Nurse speaks with an elderly man in his bed at home a...Figure 61.2 Patient‐centred objectives of the Mental Capcity Act.

57 Chapter 62Figure 62.1 Healthy brain (left); advanced Alzheimer’s (right).Figure 62.2 Comparison of healthy and damaged neurons.Figure 62.3 Arterial supply to the brain, showing capillaries.Figure 62.4 Haemorrhagic and ischaemic stroke.Figure 62.5 Dementia with Lewy bodies.

58 Chapter 63Figure 63.1 Example of a hospital passport.

59 Chapter 64Figure 64.1 Kaiser Permanente triangle of population‐based health needs....

60 Chapter 65Figure 65.1 Voluntary services provide vital companionship to people.Figure 65.2 Voluntary services support people at home, including care homes.

61 Chapter 66Figure 66.1 Occupational health nurses and allied professionals.Figure 66.2 Specialist community public health nursing education.Figure 66.3 Some key components of occupational health.Figure 66.4 Barriers to effective occupational health.

62 Chapter 67Figure 67.1 Community learning disability nurses may provide health educatio...Figure 67.2 National Health Service Covid‐19 Grab and Go Guide for people wi...Figure 67.3 A young man with learning disabilities being supported to undert...

63 Chapter 68Figure 68.1 A chest x‐ray of a TB patient.Figure 68.2 Key actions to eliminate TB.

64 Chapter 69Figure 69.1 Considerations when prescribing in prison.Figure 69.2 The reception process.Figure 69.3 The prison environment.Figure 69.4 Prison nurse input.

65 Chapter 70Figure 70.1 A typical defence service hospital facility.Figure 70.2 Servicewoman receiving care from nurse.

66 Chapter 71Figure 71.1 Some risk factors for homelessness.

67 Chapter 72Figure 72.1 Six steps to improved wellbeing.Figure 72.2 Gardening, garden visiting and even images of gardens can have a...Figure 72.3 A couple opening their garden for the National Garden Scheme in ...Figure 72.4 National health service social prescribing model.

District Nursing at a Glance

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