Читать книгу The Nursing Associate's Handbook of Clinical Skills - Группа авторов - Страница 2
Table of Contents
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10 Annexe A: Communication and Relationship Management Skills 1 Theories and Models of Communication Introduction Transmission Model of Communication The Interactive Model of Communication The Transactional Model of Communication Conclusion References 2 Approaches to Effective Communication Introduction Barriers to Effective Communication Conclusion References 3 Interpersonal Skills and Therapeutic Relationship Skills Introduction Maintaining Professional Boundaries The 6Cs References 4 Working in a Team Introduction Teams and Groups Personality Types Leadership Transactional Leadership Transformational Leadership Conclusion References 5 Listening Actively Introduction The Therapeutic Relationship The Importance of Active Listening How to Listen Actively Barriers to Active Listening Conclusion References 6 Information Gathering Introduction Therapeutic Nurse–Patient Relationship Knowing the Patient Emotional Intelligence Tools for Gathering Relevant Information Gathering Credible Literature Conclusion References 7 Escalating Concerns Introduction Assessment and Planning Ahead SBAR – A Structured Communication Tool RSVP Who to Escalate To? Challenges of Communication Conclusion References 8 Written Communication Introduction The Written Record Professional Requirements Legible and Clearly Written Language Jargon and Abbreviations Spelling Dated and Timed Speculation Safe Storage From a Legal Perspective References 9 Addressing Compliments and Complaints References
11 Annexe B: Procedures Unit 1: Procedures to Enable Effective Monitoring of a Person's Condition 10 Vital Signs Introduction Assessing the Pulse Atrial Fibrillation Assessing the Blood Pressure Assessing Respirations Temperature Body Mass Index (BMI) Calculating BMI Conclusion References 11 Venepuncture Introduction The Anatomy of the Vein Site Selection for Venepuncture Complications of Venepuncture Undertaking Venepuncture Haemolysed Samples Conclusion References 12 ECG Recording Introduction Machine Preparation Area Preparation (Environment) Patient Preparation Lead Placement Chest Lead Placement Recording the ECG Troubleshooting ECG Recordings Conclusion References 13 Blood Glucose Assessment Introduction Reasons to Measure Blood Glucose Blood Glucose Levels Urine Testing of Blood Glucose Point‐Of‐Care Blood Glucose Testing Coded Versus Non‐Coded Machines Quality Control of Blood Glucose Machines Laboratory Testing of Blood Glucose Conclusion References 14 Specimen Collection Introduction General Principles of Specimen Collection Transportation of Specimens Obtaining a Urine Specimen Obtaining a Faeces Specimen Procedure Obtaining a Sputum Sample Procedure Obtaining a Nasal Swab Procedure Conclusion References 15 Recognising and Escalating Signs of All Forms Abuse Introduction Recognising Signs of Abuse Communicating and Escalating Abuse in Practice Communicating with the Abused Individual Being Open – Duty of Candour Whistleblowing References 16 Recognising and Escalating Signs of Self‐harm and/or Suicidal Ideation Introduction Self‐Harm Communicating with an Individual About Self‐Harm Triage/Initial Assessment Consent Mental Capacity Psychosocial Assessment Following Self‐Harm Suicide Recognising Suicidal Ideation in Practice Communicating with Those Who Feel Suicidal References 17 Basic Mental Health First Aid Introduction Basic MHFA Basic MHFA and the Nursing Associate Mental Health Basic MHFA Approach, Assess and Assist Listen and Communicate Give Support and Information Encourage Appropriate Professional Help Encourage Other Support Anxiety, Panic Attacks and Post‐Traumatic Stress Disorder Depression Psychosis Professional Specialist Support References 18 Basic First Aid Introduction First Aid First Aid and Nursing Associates Primary Survey Danger Response Airway Breathing Circulation Secondary Survey Disability Head‐to‐Toe Examination History and Symptoms Basic Life Support Choking Bleeding Shock Burns Fractures Nosebleed Seizures References 19 Pain Introduction What is Pain? Pain Physiology Pain Sensation Pain Transmission Pain Interpretation Pain is an Individual Experience Deep or Superficial Pain Acute and Chronic Pain Acute Pain Acute Pain and Breathing Acute Pain and the Heart Acute Pain and Mobility Acute Pain and Nutrition Chronic Pain Pain Assessment Structured Pain Assessments Assessing the Physiological Impact of Pain Assessing the Impact of Pain on Well‐Being Conclusion References Unit 2: Procedures for Provision of Person‐Centred Nursing Care 20 Promoting Comfort in Bed Introduction The Importance of Patient Positioning Key Principles of Patient Positioning Positioning Aids How Pressure Ulcers Develop Areas of the Body at Risk Pressure Relief (Pressure Area Care) Pressure‐Relieving Equipment Bed Choices Mattress Choice Heel Protection/Offloading Commonly Used Patient Positions Less Commonly Used in Clinical Practice Other Factors Self‐Care Hydration Nurse Call System Conclusion References 21 Maintaining Privacy and Dignity Introduction Privacy Breach of Privacy/Confidentiality Caldicott Guardians Dignity Conclusion References 22 Promoting Sleep Introduction Fundamental Physiology of Sleep What are Circadian Rhythms? Controlling Circadian Rhythms Stages of Sleep Number of Sleep Hours Sleep Deprivation Consequences of Sleep Deprivation Sleep Disorders Nursing Associate’s Role in Promoting Sleep Conclusion References Unit 3: Provide Care and Support with Hygiene and The Maintenance of Skin Integrity 23 Reassessment of Skin Introduction General Considerations Common Dermatological Conditions Consent Privacy and Dignity Supporting Self‐Care Pain Assessment Escalation of Skin Changes Pressure Ulcers Skin Assessment Pressure Ulcer Categories Timing and Frequency of Reassessment in Accordance with Nice Guidance How to Carry Out an Effective Skin Assessment Documentation Pressure Ulcer Risk Assessment Psoriasis Assessment Impact of Skin Disease Assessment Occupational Skin Disease Questionnaire Body Maps References 24 Supporting a Person’s Skin Integrity Introduction Key Considerations Moisture Lesions Using Appropriate Products to Prevent and Manage Skin Breakdown Privacy and Dignity Supporting Self‐Care and Patient Education Documentation and Reporting Concerns References 25 Reassessment of Hygiene Status Supporting a Person’s Hygiene Needs Introduction Reassessment of Personal Hygiene Needs Assessment Across the Life Course Promotion of Independence with Personal Hygiene Communication Privacy and Dignity Infection Control/Risk Management Patient Preferences Skin Female Personal Hygiene Conclusion References 26 Providing Oral and Dental Care Introduction Anatomy and Physiology of the Oral Cavity Some Causes of Poor Oral and Dental Health Consequences of Poor Oral and Dental Health Assessment of The Oral Cavity Interventions to Maintain Oral and Dental Health Denture Care Referral Conclusion References 27 Providing Eye Care Introduction Eye Care References 28 Providing Nail Care Introduction Nail Care References 29 Monitoring of Wounds and Providing Wound Care Introduction The Skin Skin Changes and Age Types of Wound Classification of Wounds Wound Healing Monitoring Wounds Wound Care Measuring a Wound Wound Depth Conclusion References Unit 4: Provide Support with Nutrition and Hydration 30 Using Nutritional Assessment Tools Introduction Promoting Health and Preventing Ill Health Physical Health Factors Social Factors Psychological Factors Provide and Monitor Care – Nutritional Assessment Promoting Health and Preventing Ill Health Providing and Monitoring Care – Nutritional Assessment Height and Weight Measuring Height and Weight Body Mass Index Weight Loss History History of Illness Nutritional Intervention Types of Nutritional Intervention Complications of Nasogastric Feeding Complications of Gastrostomy Feeding Tubes Working in Teams – Nutritional Intervention Conclusion References 31 Assisting People with Feeding and Drinking Introduction Reasons Why People Require Assistance Being an Accountable Professional Swallow Assessment Working in Teams The Care Environment Guidelines on How to Assist a Person with Eating and Drinking Improving Safety and Quality of Care Monitoring Care and Promoting Health and Preventing Ill Health Integrated Care Discharge Planning Conclusion References 32 Fluid Balance Introduction Fluid and Electrolytes in the Body Movement of Fluid and Electrolytes The Maintenance of Fluid Balance Fluid Balance Fluid Overload Being an Accountable Professional Assessment Urine Weight The Fluid Balance Chart Fluid Input and Output – Measurement Working in Teams Complications and Management of Dehydration Complications and Management of Fluid Overload Practical Assistance Promoting Health and Preventing Ill Health Conclusion References Unit 5: Provide Support with Maintaining Bladder and Bowel Health 33 Observing and Monitoring Urinary and Bowel Continence Introduction Urinary Continence Bowel (Faecal) Continence The Importance of Individualised Assessment Conclusion References 34 Recognising Bladder and Bowel Patterns Introduction Urinary Incontinence Bowel Incontinence Underlying Causes of Bowel Incontinence and High‐Risk Groups Incontinence in Children Incontinence in Adults – The Importance of Assessment Conclusion References 35 Care and Management of People with Urinary Catheters Introduction Functions of the Urinary System Urinary Catheters Indications for a Catheter Risks and Potential Complications of Urinary Catheterisation Types of Catheter Catheterisation Providing Catheter Care How to Empty the Catheter Bag Measuring Urine Output How to Remove a Catheter Conclusion References 36 Assisting with Toileting, Choosing and Using Appropriate Continence Products Introduction Toileting Containment Products Conclusion References Unit 6: Provide Support with Mobility and Safety 37 Risk Assessment Tools Associated with Mobility and Falls Definition of a Fall Statistics and Incidence Those at Risk of Falling Consequences of a Fall Causes of Falls Assessment and Prevention in the Community (General) Assessment and Prevention – Home Assessment and Prevention – Hospital and Residential Health Facility If a Patient Has Had a Fall References 38 Using a Range of Moving and Handling Techniques, Aids and Equipment Introduction The Law and Moving and Handling The Health and Safety At Work Act 1974 (HSWA) The Management of Health and Safety at Work Regulations 1999 (MHSWR) Manual Handling Operations Regulations 1992 as Amended in 2002 (MHOR) Lifting Operation and Lifting Equipment Regulations 1998 (LOLER) and the Provision and Use of Work Equipment Regulations 1998 (PUWER) Lifting Operation and Lifting Equipment Regulations 1998 (LOLER) Provision and Use of Work Equipment Regulations 1998 (PUWER) Keeping Your Back, Neck and Shoulders Healthy Some Ways of Keeping the Back, Neck and Shoulders Healthy Key Safe Principles of Moving and Handling Risk Assessment Task Individual Capability Load or Person Environment Equipment Other Influencing Factors Practical Moving and Handling Use of Hoist and Slings Hoist and Sling Checks Slings Other Equipment Used for the Safe Moving and Handling of Patients References Unit 7: Provide Support with Respiratory Care 39 Managing the Administration of Oxygen Introduction Oxygen Oxygen in the Blood Medical Oxygen High Concentration Oxygen Therapy Low Concentration Oxygen Therapy Oxygen Requirements The Different Types of Oxygen Therapy Identifying the Need for Supplementary Oxygen Therapy Vital Signs Potential Complications of Oxygen Therapy Methods of Oxygen Delivery Nasal Cannulae Facemask Venturi Mask Reservoir Masks (Non‐Rebreathe Mask) Preparing the Patient for Oxygen Therapy References 40 Measuring Respiratory Status Introduction Oxygen Saturation Pulse Oximetry What a Pulse Oximeter Measures Preparation and Equipment Procedure Assessing the Need for Supplemental Oxygen Therapy Peak Flow Presentation Frequency of PEFR Recording When to Record PEFR Indications for PEFR Contraindications for PEFR Advantages of PEFR How to Measure PEFR Procedure Monitoring and Documentation References 41 Using Nasal and Oral Suctioning Techniques Introduction Suctioning The Different Types of Oral and Nasal Suctioning Indications for Suctioning Contraindications for Suctioning Complications of Suctioning Oral and Oropharyngeal Suctioning Naso and Nasopharyngeal Suctioning Yankauer (Tonsil Tip) Suction Catheter Procedure Informed Consent Safety Considerations References 42 Managing Inhalation, Humidifier and Nebuliser Devices Introduction Inhalers Choosing the Correct Inhaler Dry Powder Inhalers Pressurised Metered Dose Inhalers (MDI or pMDI) Breath‐Actuated MDI (BApMDI) Aerosol Holding Chamber (Spacer) Inhaler Technique Choosing Inhaler Types Comparing Inhaler Types Nebuliser Therapy References Unit 8: Preventing and Managing Infection 43 Recognising and Responding Rapidly to Potential Infection Risk Introduction Recognising and Responding to Infection Risks Policies and Procedures to Prevent and Control Infection Standard Precautions Detecting Infection – Diagnostic Tests MRSA Screening and Suppression Public Health Approaches to Prevent Infection Infection Control Glossary References 44 Using Aseptic Non‐Touch Technique Introduction Asepsis and Aseptic Non‐Touch Technique The Principles of Aseptic Non‐Touch Technique Key Parts Nursing Associate Proficiencies Associated with Aseptic Non‐Touch Technique Variations in Standardised Practice Applying the Principles: Preparing to Undertake an Aseptic Non‐Touch Technique Conclusion References 45 Using Appropriate Personal Protective Equipment Introduction Glove Use Gowns and Aprons Using Personal Protective Equipment: Individual and Organisation Issues Accessibility and Storage of Personal Protective Equipment Conclusion References 46 Implementing Isolation Procedures Introduction Source Isolation Contact Precautions Droplet Precautions Airborne Precautions Protective Isolation Conclusion References 47 Using Hand Hygiene Techniques Introduction Clean Hands Save Lives How Healthcare Workers Spread Infections Preparing to Perform Hand Hygiene Preventing Hai Requires Effective Hand Hygiene Techniques Safe Decision‐Making: ABHRS or Liquid Soap and Water? Undertaking Hand Washing Using Soap and Water Hand Drying and Skin Care When to Perform Hand Hygiene Techniques Best Practice Where Hand Hygiene Facilities are Limited How Hand Hygiene Embedded in Policy and Practice Conclusion References 48 Decontaminating Equipment and the Environment Introduction Cleaning Cleaning Levels Cleaning Products General Principles of Cleaning Disinfection Sterilisation Sterilisation Control Tests Conclusion References 49 Safely Handling Waste, Laundry and Sharps Introduction Colour‐Code System Single‐Use Devices Handling and Disposal of Sharps Laundry Washing Your Own Uniform Conclusion References Unit 9: Meeting Needs for Care and Support at the End of Life 50 Recognising and Responding to the Needs of Those at the End of Their Lives Introduction Diagnosing Dying Communication Multi‐Professional Approach to End‐of‐Life Care Advance Care Planning Preferred Place of Death Discussing Plans After Death Conclusion References 51 Review of Care for People and Their Families at the End of Their Lives Introduction Stopping Treatment Symptom Management Common Symptoms and How to Manage Them Spiritual Care Ethical Issues: Nutrition and Hydration in the Last Days of Life Conclusion References 52 Providing Care for the Deceased Introduction Communication Organ and Tissue Donation Care of the Deceased Body Procedure Removal of the Body Bereavement Support for Family/Close Friends Looking after Yourself Conclusion References Unit 10: Procedural Competencies for Administering Medicine Safely 53 Reviewing a Person’s Ability to Administer Their Own Medicines Introduction Self‐Administration of Medicines Self‐Administration: Maintaining Safety Risk Assessment Self‐Medication–Levels Conclusion References 54 Undertaking Accurate Drug Calculations Introduction Mathematical Concepts Whole Numbers and Fractions Proper, Improper and Mixed Fractions Example Decimals Mathematical Operations Metric System Multiplication By 10, 100 and 1000 Division By 10, 100, and 1000 Expression of Weight Expression of Volume Expression of Length Conversion of Large Units to Smaller Units Conversion of Small Units to Larger Units Clinical Calculations Solid Medications, that is Tablets, Capsules and Suppositories Compound Medications Liquid Medications, that is Syrups and Injections Infusion Rates Weight‐Related Calculations Conclusion References 55 Accountability in Ensuring the Safe Administration of Medicines Introduction Accountability Classification of Medications Capacity and Consent Process of Administration Covert Medication Routes of Administration and Adverse Effects Enteral Administration Oral Sublingual and Buccal Rectal Parenteral Administration Subcutaneous Injection Conclusion References 56 Administering Medicines Introduction Safe Drug Administration Administration of Oral Medication Administration of Topical Medication Administration of Injections Administration of Inhaled Medications Conclusion References 57 Managing the Effectiveness of Symptom Relief Medications Introduction Difference Between a Sign and a Symptom Nursing Process Therapeutic Effect Duration of Effect Pain Conclusion References 58 Recognising and Responding to Adverse Effects of Medications Introduction Recognising ADRs Allergic Reactions Anaphylaxis Anaphylaxis Presentation and Actions to Take Background to Medicine Safety Reporting ADRs Yellow Card System Safety Critical Medications References 59 Storage, Transportation and Disposal of Medicinal Products Introduction Legislation Regulatory Governance Medicines Requiring Ambient Temperatures Safe Disposal Conclusion References
12 Answers Chapter 1 Theories and Models of Communication Chapter 2 Approaches to Effective Communication Chapter 3 Interpersonal Skills and Therapeutic Relationship Skills Chapter 4 Working in a Team Chapter 5 Listening Actively Chapter 6 Information Gathering Chapter 7 Escalating Concerns Chapter 8 Written Communication Chapter 9 Addressing Compliments and Complaints Chapter 10 Vital Signs Chapter 11 Venepuncture Chapter 12 ECG Recording Chapter 13 Blood Glucose Assessment Chapter 14 Specimen Collection Chapter 15 Recognising and Escalating Signs of All Forms Abuse Chapter 16 Recognising and Escalating Signs of Self‐harm and/or Suicidal Ideation Chapter 17 Basic Mental Health First Aid Chapter 18 Basic First Aid Chapter 19 Pain Chapter 20 Promoting Comfort in Bed Chapter 21 Maintaining Privacy and Dignity Chapter 22 Promoting Sleep Chapter 23 Reassessment of Skin Chapter 24 Supporting a Person’s Skin Integrity Chapter 25 Reassessment of Hygiene Status Supporting a Person’s Hygiene Needs Chapter 26 Providing Oral and Dental Care Chapter 27 Providing Eye Care Chapter 28 Providing Nail Care Chapter 29 Monitoring of Wounds and Providing Wound Care Chapter 30 Using Nutritional Assessment Tools Chapter 31 Assisting People with Feeding and Drinking Chapter 32 Fluid Balance Chapter 33 Observing and Monitoring Urinary and Bowel Continence Chapter 34 Recognising Bladder and Bowel Patterns Chapter 35 Care and Management of People with Urinary Catheters Chapter 36 Assisting with Toileting, Choosing and Using Appropriate Continence Products Chapter 37 Risk Assessment Tools Associated with Mobility and Falls Chapter 38 Using a Range of Moving and Handling Techniques, Aids and Equipment Chapter 39 Managing the Administration of Oxygen Chapter 40 Measuring Respiratory Status Chapter 41 Using Nasal and Oral Suctioning Techniques Chapter 42 Managing Inhalation, Humidifier and Nebuliser Devices Chapter 43 Recognising and Responding Rapidly to Potential Infection Risk Chapter 44 Using Aseptic Non‐Touch Technique Chapter 45 Using Appropriate Personal Protective Equipment Chapter 46 Implementing Isolation Procedures Chapter 47 Using Hand Hygiene Techniques Chapter 48 Decontaminating Equipment and the Environment Chapter 49 Safely Handling Waste, Laundry and Sharps Chapter 50 Recognising and Responding to the Needs of Those at the End of Their Lives Chapter 51 Review of Care for The People and Their Families at the End of Their Lives Chapter 52 Providing Care for the Deceased Chapter 53 Reviewing a Person’s Ability to Administer Their Own Medicines Chapter 54 Undertaking Accurate Drug Calculations Chapter 55 Accountability in Ensuring the Safe Administration of Medicines Chapter 56 Administering Medicines Chapter 57 Managing the Effectiveness of Symptom Relief Medications Chapter 58 Recognising and Responding to Adverse Effects of Medications Chapter 59 Storage, Transportation and Disposal of Medicinal Products
13 Index
