julie bliss - Academia.edu (original) (raw)

Papers by julie bliss

British Journal of Community Nursing, 2017

The case study explores how the expansion of the health services during the interwar period impac... more The case study explores how the expansion of the health services during the interwar period impacted upon the status of district nursing and examines how being a voluntary service shaped district nursing associations. A range of primary sources were used; the Association Annual Reports, the Medical Officer for Health Annual Reports for the Borough of Chelsea, the Ministry of Health records, the archives of the Queen's Nursing Institute (QNI) and the Borough of Chelsea Council Minutes. The Medical Officer for Health Reports and the Council minutes identify efforts to improve environmental factors that impacted upon health. These primary sources briefly note the contribution of the Association suggesting that it was integral to the health care provision but considered a constant. The impact of changes to the 1932 Sunday Entertainments Act provide an interesting juxtaposition between the acknowledged value of district nursing and the constant struggle to fundraise in order to provi...

Palliative Medicine, 2003

Palliative care is an established and expanding speciality, important in many areas of service de... more Palliative care is an established and expanding speciality, important in many areas of service delivery within health and social services and the voluntary sector. Traditionally, palliative care is viewed as most closely linked to cancer services. National government policy has an inevitable impact on the organization and provision of such services. As part of a wider project, an investigation of the content and development of English government policy relating to palliative care was carried out. The development of policy follows a cycle that has no closure; it takes place within changing contexts, between multiple organizations and across sectors. Data collection involved the collation and close examination of policy documents and other documents that demonstrably influenced policy. This was in order to identify a national view of policy intentions for palliative care. In total, 53 policy documents were examined. The analysis revealed a number of pertinent issues relating to shifts in funding policies and an evolving definition of palliative care. There is an increasing recognition in the policy documents of the need for palliative care to extend beyond the traditional focus on cancer services and terminal illness. In tandem, is an increasing recognition of the need for partnership between sectors, reflected in more recent health and social services legislation.

International Journal of Palliative Nursing, 2002

Journal of Interprofessional Care, 2000

... For example, in child protection research Fitzsimmons & White (1997) found that nurse... more ... For example, in child protection research Fitzsimmons & White (1997) found that nurses considered that a report that a child was in need ... It can be assumed that these philosophical differences will impact upon all aspects of interprofessional working. Henneman et al. ...

Journal of health services research & policy, Jan 30, 2015

Fast tracking is one strategy that organizations use to ameliorate workforce shortfalls by attrac... more Fast tracking is one strategy that organizations use to ameliorate workforce shortfalls by attracting new recruits, and accelerating their skills development and experience. In response to the Government's target of rapidly expanding the number of health visitors in England's National Health Service, the fast track initiative was launched to recruit newly qualified (fast track) as well as experienced (standard entry) nurses and midwives onto health visiting programmes. This paper evaluates the fast track initiative, from the perspective of fast track and standard entry students, practice teachers and health visitor managers. A mixed methods design was used comprising a questionnaire survey (n = 71 students), semi-structured interviews (n = 37 students), telephone interviews (n = 13 managers) and six focus groups (n = 24 practice teachers). Data were collected between April 2012 and July 2013. Descriptive statistics, t-tests and the Pearson Chi-square test were used to analys...

International history of nursing journal: IHNJ

Much has been written regarding the challenges facing district nursing in light of the constant c... more Much has been written regarding the challenges facing district nursing in light of the constant change and development of the NHS. This paper follows the chronological development of district nursing up to the reorganization of the NHS in 1974. The paper commences with a brief outline of the origins of district nursing as a charitable activity before the inception of the NHS and moves on to consider the relationship between district nurses and general practitioners. A review of policy and legislation identifies that district nurses, in the early days of the NHS, were working for the GP, no longer an autonomous practitioner of a charitable organization. Other challenges experienced by district nurses included being employed by the Local Health Authority, a separate organization to the NHS. By exploring the clinical practice of district nurses, alongside the management and organization of district nursing it is possible to critically discuss the challenges facing district nurses in the current health care climate of teamwork and collaboration.

London journal of primary care, 2014

General practitioners and district nurses have a long history of providing care outside the hospi... more General practitioners and district nurses have a long history of providing care outside the hospital setting. With health care increasingly moving out of the hospital setting, there are more opportunities for general practitioners and district nurses to work together to meet the health needs of the local population. However, the reduction in qualified specialist practitioner district nurses over the last decade is concerning. The need for an effective district nursing service has been recognised by the Department of Health in their own model - the nature of district nursing work, often over a long period, enables relationships to develop with the patient, family and informal carers as a basis for anticipatory care to manage long-term conditions. Communication and understanding of the role are central to enhance effective working between general practitioners and district nurses, which can be fostered by engagement in community-oriented integrated care and case management.

British journal of community nursing, Jan 1, 2003

Community health practitioners are frequently faced with the problem of indwelling catheters fail... more Community health practitioners are frequently faced with the problem of indwelling catheters failing to drain. This mini-review examines the evidence regarding the effectiveness of citric acid-based bladder washout solutions (solution G, solution R), compared with saline for preventing blockage of long-term catheters in older adults. Although there is some evidence on the effect of citric acid solutions in laboratory conditions, the search yielded no evidence measuring catheter patency in humans. Only one randomized controlled trial addressing the use of citric acid solutions with human subjects was found. This provided some confirmation that solution G had immediate effect but gave no evidence of long-term benefit. No difference was apparent on examination of catheter tips. As the evidence is weak, practitioners should consider the use of citric acid maintenance solution as non-routine and only following formal evaluation in a one-off trial on appropriate patients.

British Journal of Nursing, 2013

International Journal of Nursing Studies, 2003

Palliative and continuing care in the United Kingdom (UK) is provided by a range of health and so... more Palliative and continuing care in the United Kingdom (UK) is provided by a range of health and social care professionals who work within a variety of statutory and non-statutory organisations. This selective review of the literature focuses upon palliative and continuing care decision-making undertaken by district nurses and social workers as an exemplar of interprofessional decision-making. The decision-making process is complex and heavily influenced by the organisations employing district nurses and social workers. A model of strategic decision-making is identified which facilitates the exploration of events within the context of practice, thus providing a greater understanding of the process and outcomes to inform the professional development of practitioners. r

British Journal of Community Nursing, 1998

British Journal of Community Nursing, 2009

During end of life care for patients with cancer, hospital beds are often introduced into the hom... more During end of life care for patients with cancer, hospital beds are often introduced into the home setting. The impact of this intervention on sexuality and intimacy expression for couples is not known. A review of related literature revealed that intimacy expression at the end of life is important for patients but is generally regarded by nurses as a difficult and complex area of care. The relationship between sexuality expression and the provision of a hospital bed has implications for nursing practice.

British Journal of Community Nursing, 2008

Coronary Heart Disease (CHD) remains the most common cause of death and disability in many develo... more Coronary Heart Disease (CHD) remains the most common cause of death and disability in many developed and developing countries. The evidence presented so far, clearly shows that exercise training leads to favourable improvements in exercise capacity, lipid levels, weight and psychosocial variables for CHD patients. Nevertheless, despite recommendations and government support, the lack of physical activity remains a major health problem, particularly for people with established CHD. The aim of this review was to explore the effects of exercise training on physical and psychosocial function among CHD patients, by analysing the content of relevant research reports. The findings showed that although there is sufficient evidence that exercise training has a number of effects that are beneficial in treatment and secondary prevention of CHD, different aspects of exercise characteristics (mode, frequency, intensity and duration) for different cardiac patient groups, warrant additional investigation.

British Journal of Community Nursing, 2007

The growing number of older people has seen a concomitant increase in the number of people with c... more The growing number of older people has seen a concomitant increase in the number of people with chronic conditions who require continuing and palliative care increasing the need for the relevant professional groups and organizations to work together. This paper reports on a multiple case study which explores the different ways that district nurses and social workers work in delivering palliative and continuing care. Each professional group operationalized their care differently across five themes: assessment, care delivery, focus of care, place of care and funding of care. The balance between care organization and care delivery needs to be addressed within emerging primary care delivery structures as primary care nursing moves towards case management for long term conditions.

International Journal of Palliative Nursing, 2002

Palliative Medicine, 2003

Palliative care is an established and expanding speciality, important in many areas of service de... more Palliative care is an established and expanding speciality, important in many areas of service delivery within health and social services and the voluntary sector. Traditionally, palliative care is viewed as most closely linked to cancer services. National government policy has an inevitable impact on the organization and provision of such services. As part of a wider project, an investigation of the content and development of English government policy relating to palliative care was carried out. The development of policy follows a cycle that has no closure; it takes place within changing contexts, between multiple organizations and across sectors. Data collection involved the collation and close examination of policy documents and other documents that demonstrably influenced policy. This was in order to identify a national view of policy intentions for palliative care. In total, 53 policy documents were examined. The analysis revealed a number of pertinent issues relating to shifts in funding policies and an evolving definition of palliative care. There is an increasing recognition in the policy documents of the need for palliative care to extend beyond the traditional focus on cancer services and terminal illness. In tandem, is an increasing recognition of the need for partnership between sectors, reflected in more recent health and social services legislation.

Journal of Interprofessional Care, 2000

In the United Kingdom (UK) a range of professionals, who are employed within both statutory and n... more In the United Kingdom (UK) a range of professionals, who are employed within both statutory and non-statutory organisations, provide palliative care in the community. This paper explores how interprofessional working between these practitioners is facilitated, and considers how language and philosophies of care can impact upon the working relationship between professionals. It is suggested that often the dif® culties experienced when working with another professional are outside the remit of the individuals involved. When working within large organisations within a legislative framework practitioners must be prepared to acknowledge the strengths of different groups, and to understand how these can be utilised to provide effective and appropriate palliative care.

British Journal of Community Nursing, 2005

In England and Wales alone, more than 5 million informal carers provide support to individuals wh... more In England and Wales alone, more than 5 million informal carers provide support to individuals who wish to remain within their own homes. However, research has identified that there is a limited understanding of the informal carer role among health professionals, and deficits in information sharing and the involvement of informal carers in decision making in relation to care packages. This article considers recent policy relating to this area, placing particular emphasis on the role of the district nurse in working in partnership with informal carers.

British Journal of Community Nursing, 2012

Peripheral vascular disease (PVD) is under-diagnosed in primary and acute settings. The use of Do... more Peripheral vascular disease (PVD) is under-diagnosed in primary and acute settings. The use of Doppler ankle brachial pressure index (ABPI) is effective in diagnosing PVD , aid in determining aetiology of leg ulcers and is cost efficient in reducing the effects of atherosclerosis and cardiovascular events. The aim of this literature review was to review practitioners' experience in using Doppler ABPI, different skills used to measure ABPI and to examine practitioners' confidence in ABPI. The findings identified variation in method for Doppler measurement: including position of the artery, arm measurement, resting period and type of equipment for measuring blood pressure, variations in practitioners' training and experience have demonstrated variability in ABPI results. Although limited in number, the studies have demonstrated knowledge gap, and the need for training among health professionals.

British Journal of Community Nursing, 2017

The case study explores how the expansion of the health services during the interwar period impac... more The case study explores how the expansion of the health services during the interwar period impacted upon the status of district nursing and examines how being a voluntary service shaped district nursing associations. A range of primary sources were used; the Association Annual Reports, the Medical Officer for Health Annual Reports for the Borough of Chelsea, the Ministry of Health records, the archives of the Queen's Nursing Institute (QNI) and the Borough of Chelsea Council Minutes. The Medical Officer for Health Reports and the Council minutes identify efforts to improve environmental factors that impacted upon health. These primary sources briefly note the contribution of the Association suggesting that it was integral to the health care provision but considered a constant. The impact of changes to the 1932 Sunday Entertainments Act provide an interesting juxtaposition between the acknowledged value of district nursing and the constant struggle to fundraise in order to provi...

Palliative Medicine, 2003

Palliative care is an established and expanding speciality, important in many areas of service de... more Palliative care is an established and expanding speciality, important in many areas of service delivery within health and social services and the voluntary sector. Traditionally, palliative care is viewed as most closely linked to cancer services. National government policy has an inevitable impact on the organization and provision of such services. As part of a wider project, an investigation of the content and development of English government policy relating to palliative care was carried out. The development of policy follows a cycle that has no closure; it takes place within changing contexts, between multiple organizations and across sectors. Data collection involved the collation and close examination of policy documents and other documents that demonstrably influenced policy. This was in order to identify a national view of policy intentions for palliative care. In total, 53 policy documents were examined. The analysis revealed a number of pertinent issues relating to shifts in funding policies and an evolving definition of palliative care. There is an increasing recognition in the policy documents of the need for palliative care to extend beyond the traditional focus on cancer services and terminal illness. In tandem, is an increasing recognition of the need for partnership between sectors, reflected in more recent health and social services legislation.

International Journal of Palliative Nursing, 2002

Journal of Interprofessional Care, 2000

... For example, in child protection research Fitzsimmons & White (1997) found that nurse... more ... For example, in child protection research Fitzsimmons & White (1997) found that nurses considered that a report that a child was in need ... It can be assumed that these philosophical differences will impact upon all aspects of interprofessional working. Henneman et al. ...

Journal of health services research & policy, Jan 30, 2015

Fast tracking is one strategy that organizations use to ameliorate workforce shortfalls by attrac... more Fast tracking is one strategy that organizations use to ameliorate workforce shortfalls by attracting new recruits, and accelerating their skills development and experience. In response to the Government's target of rapidly expanding the number of health visitors in England's National Health Service, the fast track initiative was launched to recruit newly qualified (fast track) as well as experienced (standard entry) nurses and midwives onto health visiting programmes. This paper evaluates the fast track initiative, from the perspective of fast track and standard entry students, practice teachers and health visitor managers. A mixed methods design was used comprising a questionnaire survey (n = 71 students), semi-structured interviews (n = 37 students), telephone interviews (n = 13 managers) and six focus groups (n = 24 practice teachers). Data were collected between April 2012 and July 2013. Descriptive statistics, t-tests and the Pearson Chi-square test were used to analys...

International history of nursing journal: IHNJ

Much has been written regarding the challenges facing district nursing in light of the constant c... more Much has been written regarding the challenges facing district nursing in light of the constant change and development of the NHS. This paper follows the chronological development of district nursing up to the reorganization of the NHS in 1974. The paper commences with a brief outline of the origins of district nursing as a charitable activity before the inception of the NHS and moves on to consider the relationship between district nurses and general practitioners. A review of policy and legislation identifies that district nurses, in the early days of the NHS, were working for the GP, no longer an autonomous practitioner of a charitable organization. Other challenges experienced by district nurses included being employed by the Local Health Authority, a separate organization to the NHS. By exploring the clinical practice of district nurses, alongside the management and organization of district nursing it is possible to critically discuss the challenges facing district nurses in the current health care climate of teamwork and collaboration.

London journal of primary care, 2014

General practitioners and district nurses have a long history of providing care outside the hospi... more General practitioners and district nurses have a long history of providing care outside the hospital setting. With health care increasingly moving out of the hospital setting, there are more opportunities for general practitioners and district nurses to work together to meet the health needs of the local population. However, the reduction in qualified specialist practitioner district nurses over the last decade is concerning. The need for an effective district nursing service has been recognised by the Department of Health in their own model - the nature of district nursing work, often over a long period, enables relationships to develop with the patient, family and informal carers as a basis for anticipatory care to manage long-term conditions. Communication and understanding of the role are central to enhance effective working between general practitioners and district nurses, which can be fostered by engagement in community-oriented integrated care and case management.

British journal of community nursing, Jan 1, 2003

Community health practitioners are frequently faced with the problem of indwelling catheters fail... more Community health practitioners are frequently faced with the problem of indwelling catheters failing to drain. This mini-review examines the evidence regarding the effectiveness of citric acid-based bladder washout solutions (solution G, solution R), compared with saline for preventing blockage of long-term catheters in older adults. Although there is some evidence on the effect of citric acid solutions in laboratory conditions, the search yielded no evidence measuring catheter patency in humans. Only one randomized controlled trial addressing the use of citric acid solutions with human subjects was found. This provided some confirmation that solution G had immediate effect but gave no evidence of long-term benefit. No difference was apparent on examination of catheter tips. As the evidence is weak, practitioners should consider the use of citric acid maintenance solution as non-routine and only following formal evaluation in a one-off trial on appropriate patients.

British Journal of Nursing, 2013

International Journal of Nursing Studies, 2003

Palliative and continuing care in the United Kingdom (UK) is provided by a range of health and so... more Palliative and continuing care in the United Kingdom (UK) is provided by a range of health and social care professionals who work within a variety of statutory and non-statutory organisations. This selective review of the literature focuses upon palliative and continuing care decision-making undertaken by district nurses and social workers as an exemplar of interprofessional decision-making. The decision-making process is complex and heavily influenced by the organisations employing district nurses and social workers. A model of strategic decision-making is identified which facilitates the exploration of events within the context of practice, thus providing a greater understanding of the process and outcomes to inform the professional development of practitioners. r

British Journal of Community Nursing, 1998

British Journal of Community Nursing, 2009

During end of life care for patients with cancer, hospital beds are often introduced into the hom... more During end of life care for patients with cancer, hospital beds are often introduced into the home setting. The impact of this intervention on sexuality and intimacy expression for couples is not known. A review of related literature revealed that intimacy expression at the end of life is important for patients but is generally regarded by nurses as a difficult and complex area of care. The relationship between sexuality expression and the provision of a hospital bed has implications for nursing practice.

British Journal of Community Nursing, 2008

Coronary Heart Disease (CHD) remains the most common cause of death and disability in many develo... more Coronary Heart Disease (CHD) remains the most common cause of death and disability in many developed and developing countries. The evidence presented so far, clearly shows that exercise training leads to favourable improvements in exercise capacity, lipid levels, weight and psychosocial variables for CHD patients. Nevertheless, despite recommendations and government support, the lack of physical activity remains a major health problem, particularly for people with established CHD. The aim of this review was to explore the effects of exercise training on physical and psychosocial function among CHD patients, by analysing the content of relevant research reports. The findings showed that although there is sufficient evidence that exercise training has a number of effects that are beneficial in treatment and secondary prevention of CHD, different aspects of exercise characteristics (mode, frequency, intensity and duration) for different cardiac patient groups, warrant additional investigation.

British Journal of Community Nursing, 2007

The growing number of older people has seen a concomitant increase in the number of people with c... more The growing number of older people has seen a concomitant increase in the number of people with chronic conditions who require continuing and palliative care increasing the need for the relevant professional groups and organizations to work together. This paper reports on a multiple case study which explores the different ways that district nurses and social workers work in delivering palliative and continuing care. Each professional group operationalized their care differently across five themes: assessment, care delivery, focus of care, place of care and funding of care. The balance between care organization and care delivery needs to be addressed within emerging primary care delivery structures as primary care nursing moves towards case management for long term conditions.

International Journal of Palliative Nursing, 2002

Palliative Medicine, 2003

Palliative care is an established and expanding speciality, important in many areas of service de... more Palliative care is an established and expanding speciality, important in many areas of service delivery within health and social services and the voluntary sector. Traditionally, palliative care is viewed as most closely linked to cancer services. National government policy has an inevitable impact on the organization and provision of such services. As part of a wider project, an investigation of the content and development of English government policy relating to palliative care was carried out. The development of policy follows a cycle that has no closure; it takes place within changing contexts, between multiple organizations and across sectors. Data collection involved the collation and close examination of policy documents and other documents that demonstrably influenced policy. This was in order to identify a national view of policy intentions for palliative care. In total, 53 policy documents were examined. The analysis revealed a number of pertinent issues relating to shifts in funding policies and an evolving definition of palliative care. There is an increasing recognition in the policy documents of the need for palliative care to extend beyond the traditional focus on cancer services and terminal illness. In tandem, is an increasing recognition of the need for partnership between sectors, reflected in more recent health and social services legislation.

Journal of Interprofessional Care, 2000

In the United Kingdom (UK) a range of professionals, who are employed within both statutory and n... more In the United Kingdom (UK) a range of professionals, who are employed within both statutory and non-statutory organisations, provide palliative care in the community. This paper explores how interprofessional working between these practitioners is facilitated, and considers how language and philosophies of care can impact upon the working relationship between professionals. It is suggested that often the dif® culties experienced when working with another professional are outside the remit of the individuals involved. When working within large organisations within a legislative framework practitioners must be prepared to acknowledge the strengths of different groups, and to understand how these can be utilised to provide effective and appropriate palliative care.

British Journal of Community Nursing, 2005

In England and Wales alone, more than 5 million informal carers provide support to individuals wh... more In England and Wales alone, more than 5 million informal carers provide support to individuals who wish to remain within their own homes. However, research has identified that there is a limited understanding of the informal carer role among health professionals, and deficits in information sharing and the involvement of informal carers in decision making in relation to care packages. This article considers recent policy relating to this area, placing particular emphasis on the role of the district nurse in working in partnership with informal carers.

British Journal of Community Nursing, 2012

Peripheral vascular disease (PVD) is under-diagnosed in primary and acute settings. The use of Do... more Peripheral vascular disease (PVD) is under-diagnosed in primary and acute settings. The use of Doppler ankle brachial pressure index (ABPI) is effective in diagnosing PVD , aid in determining aetiology of leg ulcers and is cost efficient in reducing the effects of atherosclerosis and cardiovascular events. The aim of this literature review was to review practitioners' experience in using Doppler ABPI, different skills used to measure ABPI and to examine practitioners' confidence in ABPI. The findings identified variation in method for Doppler measurement: including position of the artery, arm measurement, resting period and type of equipment for measuring blood pressure, variations in practitioners' training and experience have demonstrated variability in ABPI results. Although limited in number, the studies have demonstrated knowledge gap, and the need for training among health professionals.