Some facts about alcohol consumption, since the early 1980s, alcohol sales and the amount that people drink has steadily increased, until peaking in 2008 and declining slightly since.

Some of this decline is due to more adults choosing to be teetotal, as well as fewer under 18’s drinking alcohol. However, drinking behaviour varies between different groups. It’s the people who already tend to drink less that are cutting back, while those who are at high risk of health conditions, because they drink heavily, are drinking more now than they did before.

According to the UK Chief Medical Officers’ low-risk guideline and increase their risk of alcohol-related ill health. In England, over 10 million people consume alcohol at above the guideline.

There are:

–  8.5m drinking at increasing risk

–  1.9m drinking at higher risk

–  Increasing risk defined as drinking 14 to 50 units a week for men and 14 to 35 units a week for women.

–  Higher risk defined as drinking >50 units for men and >35 units for women.

In hospitalisation: 1 in 10 patients has an emergency alcohol-specific readmission within 30 days following an alcohol-specific admission.

In economic burden of alcohol is estimated at between 1.3% and 2.7% of annual gross national product (GDP).

Looking at the health condition, alcohol misuse contributes (wholly or partially) to 200 health conditions, with many leading to hospital admission. This is due either to acute alcohol intoxication, or to the toxic effect of alcohol misuse over time.

The following are the UK chief medical officer’s guideline that applies to adults (both men and women) who drinks regularly or frequently:

• To keep healthy risks from alcohol to a low level, it is safe not to drink more than 14 units a week on a regular basis.
• If you regularly drink as much as 14units per week, it is best to spread your drinking evenly over 3 or more days. If you have 1 or 2 heavy drinking episodes a week, you increase your risks of death from long term illness and from accidents and injuries.
• The risk of developing a range of health problems (including cancers of the mouth, throat and breast) increases the more you drink on a regular basis.
• If you wish to cut down the amount you drink, a good way to help achieve this is to have several drinks-free days each week.

As a nurse or healthcare professional, you can access free online training to become confident in identifying those at risk from alcohol and delivering brief advice to change behaviour.

You should ask patients about alcohol and provide simple, brief advice and support to help them minimise harmful alcohol consumption.

Identifying risk usually means asking a set of questions from a validated questionnaire, and scoring the answers then feedback to the patient what their score indicates about their health risk.

Encourage patients to think about their health risk and provide a patient information leaflet.

Direct patients who are drinking above low risk to trusted sources of information such as the NHS website.

Make yourself aware of the local specialist services through your local authority public health team or the use of alcohol addiction services search facility.

If the patient show signs of alcohol dependence, refer them to specialist services.

I leant about smoking, that it is important to make every contact count (MECC) making the best of every appropriate opportunity to raise the issue of healthy lifestyle.

Systematically promoting the benefits of healthy living

Asking individuals about their lifestyle and changes they may wish to make

Responding appropriately to the lifestyle issue/s once raised

Taking the appropriate action to either give information, signpost or refer service users to the support they need.

We had a group activity on these: to discuss and list the reasons why people smoke? What are the perceived benefits of smoking? Estimate the proportion of the population that smokes.

For my group, the reasons we listed are:

• To release stress.
• Anxiety
• Depression
• Peer group
• Socialisation

For the perceived benefits of smoking, we stated the following:

• Cope with peer group
• Stimulate to weight control
• Appetite control to name but a few.

The estimated proportion of the population that smokes:

• 3% as at 2021 equivalent to 6.6 million people.
• 7% as at 2018 equivalent to 7.2 million age range from 18 and above.

Smoking and cultures, peer influence; girls concerned with appearance, popularity and weight.

If parents smoke, then child statistically more likely to smoke.

Smoking influenced by religious beliefs and cultural norms.

I learnt about smoking and mental health. The percentage of mental health patients and smoking:

• 22% of population smoke
• 40% of people with psychosis.
• 42% of cigarettes in UK smoked by people with Mental Health problems.
• Highest usage in people with schizophrenia or bi-polar disorder (up to 75%)
• Average more than 30 cigarettes per day.
• Smoking in general population reducing, but little change over 20 years in people with MH problems

The following are the reasons people with mental health smoke:

• Self-medication.
• Smoking helps with distressing symptoms
• Cognitive effects
• Nicotine may help enhance cognitive negative symptoms
• Socialisation
• Smoking culture in MH settings
• Desire to bond and relieve boredom.

According to the Royal College Physicians (2013), stated the following:

• Stopping does not worsen symptoms
• In some conditions (depression) smoking makes mental illness worse
• Same interventions that work in rest of population do work in MH patients
• Nicotine replacement does help cessation
• Many MH in-patient services have banned smoking completely
• Most predicted problems can be answered
• Note symptoms of withdrawal and MH condition can be similar.

The second set of activity was to write and discuss the answers to the following questions. What is in a cigarette? Are e-cigarettes a good option? How does smoke effect the body – respiratory and other systems?

The answers to the above questions are as follows:

For the first question we say cigarettes are:

• Nicotine ( insecticide)
• Carbon monoxide
• Tar
• Benzene
• Cadmium ( batteries)
• Stearic acid (candle wax)
• Hexamine ( barbecue lighter)
• Toluene (industrial solvent)
• Ammonia (toilet cleaner) to name but a few.

The second question asking weather e-cigarette is a good option. The answer to this question is NO.

The third and final question, how does smoke affect the body?

The answer is:

• smoking causes cancer
• causes lungs disease
• causes heart disease
• Diabetes to name but a few.

The effects of smoking on respiratory system are as follows:

• Cilia that line airway become damaged, eventually disappear.
• Mucus cannot be swept away
• mucus secretions can provide bacteria with nutrients to multiply
• Immune cells attack bacteria and tar but also release enzymes which destroy proteins that normally keep lung tissue elastic.
• Blood capillaries are damaged and less surface area for gas exchange.

The following are the condition or diseases linked to smoking:

• Reduced Fertility, IVF -less successful implantations 50%.
• Erectile dysfunction / lower sperm count and ↓sperm motility.
• Risk of miscarriage –approximately 5,000 in UK/year, premature baby – 2,200/year, Peri-natal deaths 300/year. Babies around 30% smaller, quarter of all cot deaths linked to smoker in the home.
• In children ↑asthma, cot death, glue ear, meningitis, pneumonia and respiratory infections.
• Learning difficulties, attention deficit and hyperactivity disorders linked to smoke during pregnancy and having a smoker in the home.
• Congenital defects e.g. orofacial clefts, neural tube defects, facial/eye defects, missing digits or club food.
• Risk of embolisms in smokers who take oral contraceptive pill.
• Earlier menopause (linked to cigarette chemicals interacting with hormones)-
• COPD e.g. Emphysema, Bronchitis.
• Risk of Vascular Dementia and Alzheimer’s.
• Cancers: 85-90% lung cancer.
• High blood pressure, cardiovascular disease (coronary heart disease e.g. angina and M.I) Cerebrovascular disease (embolism, aneurysm, stroke) and Peripheral vascular diseases.

The role of a healthcare professional are as follows:

• Good understanding of the risks
• Awareness of your attitude to smokers/smoking
• Know where to access information
• Know how to refer someone for support
• Making Every Contact Count
• Role Model
• Supporter

 

 

 

 

 

 

 

 

KSB ADDRESSED.

K1: Understand the code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC 2018), and how to fulfil all registration requirements.

K4: Understand the principles of research and how research findings are used to inform evidence-based practice.

 

K5: Understand the meaning of resilience and emotional intelligence, and their influence on an individual’s ability to provide care.

 

K6: Understand and apply relevant legal, regulatory and governance requirements, policies, and ethical frameworks, including any mandatory reporting duties, to all areas of practice.

 

K7: Understand the importance of courage and transparency and apply the Duty of Candour.

 

K8: Understand how discriminatory behaviour is exhibited.

K9: Understand the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people.

K10: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes.

K11: Understand the principles of epidemiology, demography, and genomics and how these may influence health and well-being outcomes.

K12: Understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical, and behavioural health, and well-being.

K13: Understand the contribution of social influences, health literacy, individual circumstances, behaviours, and lifestyle choices to mental, physical, and behavioural health outcomes.

 

K15: Understand human development from conception to death, to enable delivery of person-centred safe and effective care.

K16: Understand body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology, social and behavioural sciences as applied to delivery of care.

K17: Understand commonly encountered mental, physical, behavioural, and cognitive health conditions as applied to delivery of care.

 

K18:  Understand and apply the principles and processes for making reasonable adjustments.

K19: Know how and when to escalate to the appropriate professional for expert help and advice.

K20: Know how people’s needs for safety, dignity, privacy, comfort, and sleep can be met.

 

K21: Understand co-morbidities and the demands of meeting people’s holistic needs when prioritising care.

 

K22: Know how to meet people’s needs related to nutrition, hydration and bladder and bowel health.

K23: Know how to meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity.

K24:  Know how to support people with commonly encountered symptoms including anxiety, confusion, discomfort, and pain.

K25: Know how to deliver sensitive and compassionate end of life care to support people to plan for their end of life.

 

K26: Understand where and how to seek guidance and support from others to ensure that the best interests of those receiving care are upheld.

 

K27: Understand the principles of safe and effective administration and optimisation of medicines in accordance with local and national policies.

K28: Understand the effects of medicines, allergies, drug sensitivity, side effects, contraindications, and adverse reactions.

K29: Understand the different ways by which medicines can be prescribed.

 

K30: Understand the principles of health and safety legislation and regulations and maintain safe work and care environments.

 

K33: Understand when to seek appropriate advice to manage a risk and avoid compromising quality of care and health outcomes.

 

K36: Understand the roles of the different providers of health and care.

K39: Understand the principles and processes involved in supporting people and families with a range of care needs to maintain optimal independence and avoid unnecessary interventions and disruptions to their lives.

K40: Understand own role and contribution when involved in the care of a person who is undergoing discharge or a transition of care between professionals, settings or services.

 

K41: Know the roles, responsibilities, and scope of practice of different members of the nursing and interdisciplinary team, and own role within it.

 

 

SKILLS:

 

S1: Act in accordance with the Code: Professional standards of practice and behaviour for nurses, midwives, and nursing associates (NMC, 2018), and fulfil all registration requirements.

S2: Keep complete, clear, accurate and timely records.

S5: Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018).

 

S17: Safely demonstrate evidence-based practice in all skills and procedures required for entry to the register: Standards of proficiency for nursing associates Annex A & B (NMC 2018).

 

S18: Recognise when capacity has changed recognise and how a person’s capacity affects their ability to make decisions about their own care and to give or withhold consent.

 

S21: Monitor the effectiveness of care in partnership with people, families and carers, documenting progress, and reporting outcomes.

 

S23: Work in partnership with people, to encourage shared decision making, to support individuals, their families and carers to manage their own care when appropriate.

S25: Meet people’s needs for safety, dignity, privacy, comfort, and sleep.

S26: Meet people’s needs related to nutrition, hydration and bladder and bowel health.

 

S27: Meet people’s needs related to mobility, hygiene, oral care, wound care and skin integrity.

 

S28: Support people with commonly encountered symptoms including anxiety, confusion, discomfort, and pain.

 

S30:  when a person’s condition has improved or deteriorated by undertaking health monitoring, interpreting, promptly responding, sharing findings, and escalating as needed.

 

S32: Work collaboratively and in partnership with professionals from different agencies in interdisciplinary teams.

 

S35: Accurately undertake risk assessments, using contemporary assessment tools.

 

 

 

BEHAVIOUR:

B1: Treat people with dignity, respecting individual’s diversity, beliefs, culture, needs, values, privacy, and preferences.

B2: Show respect and empathy for those you work with, have the courage to challenge areas of concern and work to evidence based best practice.

B3: Be adaptable, reliable, and consistent, show discretion, resilience, and self-awareness.