Background: Adult community nursing services are evolving around the world in response to government policies and changing patient demographics. Amidst these changes, recruitment and retention of community nursing staff are proving a challenge. An integrative literature review has identified multiple factors that influence nurse retention in adult community nursing with sparse information on recruitment factors. Although factors impacting retention of community nurses have been identified, their generalisability around the world is a challenge as they are context and co-dependent. Indicating the need for this area of study to be explored at a local level, as the same factors present with different findings globally. Aim: To establish factors influencing recruitment and retention of registered nurses in adult community nursing services. Design: Integrative literature review. Data sources: Four electronic databases were searched in August 2019 from January 2008 to December 2018: CINAHL Complete, Web of Science, MEDLINE and PROQUEST. Both qualitative and quantitative studies focusing on factors influencing community nursing recruitment and retention were included. Review methods: An integrative literature review methodology by Whittemore and Knafl (The integrative review: updated methodology. Journal of Advanced Nursing 52, 546-553) was followed, supported by Cochrane guidelines on data synthesis and analysis using a narrative synthesis method. The Center for Evidence-Based Management (CEBMa) critical appraisal tools were used for study quality assessment. Results: Ten papers met the study inclusion criteria. Data synthesis and analysis revealed individual and organisational factors influencing the retention of community nurses with the following three dominant themes: (1) work pressure, (2) working conditions and (3) lack of appreciation by managers. Conclusion: The review identified context-dependent factors that influence adult community nurses' retention with limited generalisability. There is a lack of data on factors influencing recruitment into adult community nursing; further research is needed to explore factors affiliated to community nursing recruitment.

Background: Adult community nursing services are evolving around the world in response to government policies and changing patient demographics. Amidst these changes, recruitment and retention of community nursing staff are proving a challenge. An integrative literature review has identified multiple factors that influence nurse retention in adult community nursing with sparse information on recruitment factors. Although factors impacting retention of community nurses have been identified, their generalisability around the world is a challenge as they are context and co-dependent. Indicating the need for this area of study to be explored at a local level, as the same factors present with different findings globally. Aim: To establish factors influencing recruitment and retention of registered nurses in adult community nursing services. Design: Integrative literature review. Data sources: Four electronic databases were searched in August 2019 from January 2008 to December 2018: CINAHL Complete, Web of Science, MEDLINE and PROQUEST. Both qualitative and quantitative studies focusing on factors influencing community nursing recruitment and retention were included. Review methods: An integrative literature review methodology by Whittemore and Knafl (The integrative review: updated methodology. Journal of Advanced Nursing 52, 546–553) was followed, supported by Cochrane guidelines on data synthesis and analysis using a narrative synthesis method. The Center for Evidence-Based Management (CEBMa) critical appraisal tools were used for study quality assessment. Results: Ten papers met the study inclusion criteria. Data synthesis and analysis revealed individual and organisational factors influencing the retention of community nurses with the following three dominant themes: (1) work pressure, (2) working conditions and (3) lack of appreciation by managers. Conclusion: The review identified context-dependent factors that influence adult community nurses’ retention with limited generalisability. There is a lack of data on factors influencing recruitment into adult community nursing; further research is needed to explore factors affiliated to community nursing recruitment.

Venous leg ulcers are open lesions between the knee and the ankle joint, which occur in the presence of venous insufficiency. There are theories to explain the causes of venous insufficiency, which ultimately leads to venous hypertension and can result in leg ulceration. Although many patients present with evidence of venous hypertension, others do not, except for the manifestation of the ulcer. There are risk factors associated with venous insufficiency and a holistic approach must be taken in order to influence the management approach of venous leg ulceration. This article discusses venous insufficiency as a disease process, and explores the nursing assessment process, when assessing venous leg ulcers related to venous insufficiency.

There is a plethora of wound contact layer dressings on the market each with its own properties to promote healing, which makes dressing selection complicated. An effective and efficient choice of dressing depends on holistic patient assessment, along with an understanding of the wound-healing process, moist wound healing and wound bed preparation. This paper, supported by clinical case studies, demonstrates the effectiveness of the Lomatuell® Pro dressing (Lohmann & Rauscher) in the management of graft wounds, although it is known to be effective in the management of dermal and deep dermal wounds as well. Lomatuell Pro offers benefits of conformability, open mesh gel-forming wound contact properties and a low risk of adhering to the wound bed. It enables moist wound healing by allowing exudate to be absorbed by a secondary dressing. Lomatuell® Pro demonstrates excellence in maintaining a moist wound environment, allows atraumatic dressing removal and encourages a healthy periwound area.

Chronic wounds are defined as those that have failed to heal after three months. There are various intrinsic and extrinsic factors that may result in the development of chronic wounds, including comorbidities such as diabetes mellitus and venous insufficiency, and lifestyle factors such as obesity, alcohol consumption and smoking. Chronic wounds represent a significant burden on healthcare resources and can have a negative effect on patients' quality of life. This article discusses the assessment and treatment of non-healing chronic wounds. It examines the normal wound-healing process and the management of chronic wounds, including advanced interventions such as electrical stimulation therapy, negative pressure wound therapy and various dressings. This article does not focus on specific wound types; instead, it provides an overview of the factors that can lead to the development of chronic wounds and how these wounds can be managed in clinical practice.

Creating a stable wound bed is an essential part of the healing process, writes Edwin Chamanga

Our experts consider a hot topic of the day

This book could appeal to all levels of nursing researchers, academics, students and anyone trying to rise up the clinical research ladder.

Pressure ulcer prevention and management remain a challenge across all health-care settings, and the incidence and prevalence of pressure ulcers in nursing homes and residential homes continues to remain unknown. The use of suitable support surfaces has been found to be beneficial in the prevention and management of pressure ulcers. Carrying out a holistic assessment of the patient and recording the patient's at-risk score would help the clinician to determine the most suitable pressure-relieving surface for the patient. The clinician's clinical experience and judgment are also important. The Domus Auto (by APEX) mattress system and Dynamic Seat Cushion (by APEX) are effective dynamic, support surfaces in the prevention and management of pressure ulceration. They meet the recommendations by both national and international guidelines; they also partly fulfil the SSKIN bundle. From a four-week evaluation carried out in a nursing home, it has been demonstrated that, together with regular assessments and repositioning of the patients, these devices are useful tools in preventing patients' risk of tissue damage and improving the patients' quality of life.

Our experts consider a hot topic of the day

Our experts consider a hot topic of the day.

Our experts consider a hot topic of the day.

Our experts consider a hot topic of the day

Your article on how stereotypes about nurses are keeping men out of the profession really grabbed my attention (analysis, March 9).

Is stress an inevitable part of a nurse's job?

Should NHS staff working in London receive subsidised travel?

Our experts consider a hot topic of the day.

In light of new evidence casting doubt on the ‘weekend effect’ on death rates, should the government stop pushing staff to deliver a seven-day NHS?

Shear and pressure damage remain a significant issue for the NHS, explains Edwin Chamanga