Laxatives are used to treat constipation and to prepare the bowel before surgery or other investigative procedures. But, if used inappropriately, they can be dangerous, which can cause problems as many are sold over the counter. Carol McLoughlin looks at the types of laxative available, and how to help patients use them properly.

Streamlining the use of oxygen therapy products across a single trust has the merits of removing the need to switch equipment as patients are moved from one area to another and reducing the confusion faced by staff having to use similar, but different, products; it also improves patient care. The trial described incorporated all these strands.

There are many reasons why patients need a catheter, and the length of time one is needed varies, depending on the condition and how well the patient is. This review looks at the range of catheters available and the advantages and disadvantages for individual patients of the different sorts.

Heart transplants are a proven effective therapy for selected patients with end-stage congestive heart failure. But selecting patients, waiting, receiving and recovery can be a long and anxious process. This article provides an overview of heart transplantation and the nurse's role in helping the patient during this time.

Heart failure is becoming increasingly common as the population ages. Ventricular assist devices are used as a bridge for patients whose heart failure can no longer be controlled by medication and require a heart transplant. This article examines the care, rehabilitation and education of these patients.

Preserving the skin's integrity is one of the primary jobs of the nurse and this is often a complex and difficult task, especially in the case of chronic wounds. This article identifies the factors associated with chronic wounds that can affect the surrounding skin and offer advice on the management and maintenance of skin integrity.

John Camm describes a range of initiatives targeted at increasing awareness about the causes of hospital-acquired infection and promoting greater staff compliance with effective hand hygiene. The campaigns involve encouraging patients to raise concerns with nurses and installing handwashing facilities next to each patient's bed

Patients need support to help cope with the effects of a gynaecological cancer diagnosis and treatment. The challenge is to meet their varied needs. Alison Griffiths discusses setting up a professionally led support group.

Following the development of a clinical skills practical room, Rotherham General Hospital NHS Trust realised that it needed to have a more robust system of training staff. It was crucial to not only have the right equipment but also to have appropriately skilled people to run training sessions. As a result, the trust set up a post to organise training and the clinical skills facilitator has the remit to work across professional boundaries, providing support to nursing and medical staff and students. Karen Shaw offers an insight into her working week.

Nurses at Barts and The London NHS Trust play a key part in initiatives such as a Patient at Risk team, shared governance, Smarten Up and a host of other initiatives to improve the patient experience and working life for staff.