Need for change

THE CASE of R v Bournewood ( 1998 ) highlights the flaws in current legislation and emphasises the need for change. In this case, a 43-year-old man with autism who clearly lacked capacity was detained as a voluntary patient under the Mental Health Act 1983.

How clinical governance can enhance care for older people

This article suggest that nurses can use clinical governance continually to update and improve the quality of care offered to older people. Although nurses have made great efforts to improve care over the past 25 years and have succeeded in creating isolated areas of excellence, many older people continue to experience suboptimal care. Health care providers now recognise that older people require teams with specialist knowledge to ensure that they are provided with the best possible treatment.

Consent to clinical decisions when capacity is absent. part 1: Making decisions

IN JUNE last year, the government announced its intention to publish a Mental Incapacity Bill. The bill is now published in draft form and aims to give people with impaired capacity in England and Wales the same legal protection already enjoyed by people in Scotland.

Rehabilitation and continence promotion following a stroke

About 100,000 people in England and Wales experience a stroke each year. Nine out of ten strokes affect people aged over 55 years and 300,000 people are living with disability caused by stroke. About a third of people who experience a stroke will die within the first year, one third will make a good recovery and the final third will experience moderate to severe disabilities (Westcott, 2000).

Meeting the National Service Framework Standards for Diabetes

Diabetes is not simply a disorder of the metabolism but a chronic disease that affects every aspect of a person's body and life and is becoming increasingly common This paper outlines the National Service Framework for Diabetes standards and how they aim to reduce the incidence and the risks of complications of this condition.

Trust me, I'm a nurse

It's Saturday morning and I've been called to see Edith Smith, who has been admitted to a care home for two weeks' rehabilitation following a hip replacement. Everything has being going well but today there are problems. She is in bed and complaining of pain in her hip. I examine her and it's clear that her hip replacement has dislocated. She confirms the diagnosis, saying: 'I think my new hip has slipped, don't you?'

Questioning qualifications

VIRGINIA, DEBBIE AND AGNES all have two years' nurse training. All of them trained abroad and recently came to the UK. Virginia is a deputy manager in a nursing home; because they cannot register, Debbie and Agnes are working as care assistants.

Reducing the risks of malnutrition by ensuring adequate dietary intake

Nurses are responsible for ensuring that patients have a diet rich in nutrients and vitamins. This paper discusses factors that can affect an older person's nutritional status such as medication and the effects of ageing, describes how to recognise malnutrition, and suggests ways of planning care for this client group to ensure that they receive an appropriate diet.

Caring for older people through the National Service Framework

The National Service Framework for older people could be described as the most important of the Government's frameworks because it covers the greatest number of people. This paper summarises key aspects of the NSF's eight standards for caring for older people and discusses the implications for nursing practice in hospitals, residential care homes and the community.

The impact of national minimum standards on care homes

Nursing and residential homes have escaped the numerous reorganisations and initiatives introduced to the NHS in recent years. However, this month new legislation is introduced that will dramatically change the way care is delivered and inspected. This paper describes how the new Care Standards Act will affect the lives of staff and residents in care homes.

Rehabilitation part 3: setting up a service

WHEN THE government announced that £600 million would be provided for rehabilitation services (DoH 2000) providers calculated that this would mean each health authority having over £6 million a year to spend on rehabilitation in the independent and voluntary sector. If the average cost of a rehabilitation bed was £400 a week the local health authority would be purchasing 288 beds for 52 weeks a year. A more realistic figure might be £500 a week, meaning the health authority would be purchasing 230 places a year.