Objective: To investigate whether nursing/care home staff regard pressure ulceration as a safeguarding issue; and to explore reporting mechanisms for pressure ulcers in nursing/care homes.Methods: Sixty five staff members from 50 homes within one clinical commissioning group completed a questionnaire assessing their experiences of avoidable and unavoidable pressure ulcers, grading systems, and systems in place for referral to safeguarding teams. Understanding of safeguarding was assessed in depth by interviews with 11 staff members.Results: Staff observed an average of 2.72 pressure ulcers in their workplaces over the last 12 months; judging 45.6% to be avoidable. Only a minority of respondents reported knowledge of a grading system (mostly the EPUAP/NPUAP system). Most respondents would refer pressure ulcers to the safeguarding team: the existence of a grading system, or guidance, appeared to increase that likelihood. Safeguarding was considered a priority in most homes; interviewees were familiar with the term safeguarding, but some confusion over its meaning was apparent. Quality of written documentation and verbal communication received prior to residents returning from hospital was highlighted. However, respondents expressed concern over lack of information regarding skin integrity. Most staff had received education regarding ulcer prevention or wound management during training, but none reported post-registration training or formal education programmes; with reliance placed on advice of district nurses or tissue viability specialists.Conclusion: Staff within nursing/care homes understand the fundamentals of managing skin integrity and the importance of reporting skin damage; however, national education programmes are needed to develop knowledge and skills to promote patient health-related quality of life, and to reduce the healthcare costs of pressure damage. Further research to investigate understanding, knowledge and skills of nursing/care home staff concerning pressure ulcer development and safeguarding will become increasingly necessary, as levels of the older population who may require assisted living continue to rise.

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This article discusses the experience in one University when implementing a web based e-portfolio into their non-medical prescribing (NMP) modules. Pertinent screen shots will illustrate the e-portfolio and its use. The e-portfolio adopted has all the elements of the former paper-based document. However, a key advantage of implementing an e-portfolio is the contribution it makes to the National Information Board's (2015) digital priorities for health and social care. In this case, in equipping NMP students as part of the wider healthcare workforce with such digital knowledge skills as are deemed appropriate to their role and impending prescribing role too.Adopting an e-portfolio within the NMP modules has brought many benefits. These include strengthened assessment methods in terms of authenticity, reliability, validity and mentor preparation. The main challenges that were experienced concur with those reported by Moule et al (2011) and were related to the IT literacy skills of participants as well as computer/internet access issues within their own workplace environment. The module team overcame these through continual review of the assessment strategies being deployed as well as the functionality of the e-portfolio.

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Background Fatigue is a common and distressing symptom of long term illness, palliative care conditions and cancer, and a concern for families, carers and healthcare practitioners. Attention Restorative Theory (ART) was developed by Kaplan (2001) following his interest in restoring mental attention within the ‘person-environment interaction’. Within this framework, restorative activities have aspects of ‘being away’ (ie, distinct from routine), ‘fascination’, ‘extent’ (ie, scope) and ‘compatibility’. Aims To explore the routines and activities of fatigue suffers to determine which activities are enjoyed and could be seen to reduce mental fatigue. To analyse identified activities within an ART framework to determine core attributes of potentially beneficial interventions. Method A qualitative ethnographic approach was used to obtain knowledge about a discrete population of people who suffer from fatigue as a result of a long term illness or palliative care condition. A purposive sample of 25 participants was selected according to diagnosis, age and disability from identified contacts within the local hospice, a podiatry clinic and service user representative groups. Those who had severe mental illness, a chronic fatigue syndrome or were under 18 years of age were excluded.Semistructured interviews lasting no more 45 min were conducted using an interview guide where the emphasis was on describing activities that are enjoyed, rather than dwelling on the limitations of fatigue. Results Early analysis has identified activities such as: involvement in creative arts, baking, reading (all sorts), watching motor bike racing, singing or having a facial, as would be expected based upon individual personalities and characteristics. Upon further examination, two clear attributes emerged; activities had to have an aspect of assured safety or social interaction. Mental restoration attributes were also prominent. Conclusions The ART approach has interesting prospects and scope within fatigue management. Further research is required to explore and test potential implications.