Oxford Handbook of Clinical Skills in Adult Nursing

694 Pages·2009·18.38 MB·English

by  Jacqueline Randle

OXFORD MEDICAL PUBLICATIONS
Oxford Handbook of
Clinical Skills in
Adult Nursing
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Oxford Handbook of
Clinical Skills
in Adult
Nursing
Jacqueline Randle
Associate Professor, School of Nursing,
Clinical Skills Lead for Masters of Nursing Science, School
of Nursing, Midwifery & Physiotherapy, University of
Nottingham, UK
Frank Coffey
Consultant in Emergency Medicine, Nottingham University
Hospitals NHS Trust, Associate Professor and Consultant
in Advanced Clinical Skills to the School of Nursing,
Midwifery & Physiotherapy, University of Nottingham, UK
Martyn Bradbury
Clinical Skills Network Lead, School of Nursing and
Community Studies, Faculty of Health and Social Work,
University of Plymouth, UK
OXFORD
UNIVERSITY PRESS
OXTORD
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First published 2009
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British Library Cataloguing in Publication Data
Data available
Library of Congress Cataloging in Publication Data
Oxford handbook of Clinical Skills in Adult Nursing / Jacqueline Randle ... [et al.].
Typeset by Cepha Imaging Private Ltd., Bangalore, India
Printed in China
on acid-free paper by
Asia Pacific Offset Limited
ISBN 978-0-19-921104-3
10 9 8 7 6 5 4 3 21
Oxford University Press makes no representation, express or implied, that the drug
dosages in this book are correct. Readers must therefore always check the product
information and clinical procedures with the most up to date published product
information and data sheets provided by the manufacturers and the most recent
codes of conduct and safety regulations. The authors and publishers do not accept
responsibility or legal liability for any errors in the text or for the misuse or misap-
plication of material in this work. Except where otherwise stated, drug dosages and
recommendations are for the non-pregnant adult who is not breast-feeding.
v
Preface
The range of clinical skills performed by nurses is expanding rapidly and
the boundaries that previously existed between healthcare workers
are blurring. Procedures once the preserve of doctors, such as detailed
patient assessment and complex practical procedures, are now being per-
formed by nurses. Although this book is aimed primarily at nurses, many
of the procedures are also undertaken by other healthcare workers. The
range and complexity of clinical skills can be as daunting for experienced
practitioners as they are for students and newly qualified practitioners.
We hope that the body-systems framework, alongside detailed evidence
based, step-by-step descriptions for each clinical procedure will enable
this book to be a practical workplace aid as well as a valuable teaching and
learning tool. We have endeavoured to incorporate many of the newer
skills performed by healthcare workers while ensuring that the core skills,
traditionally undertaken by nurses, are also included. The professional
issues that underpin the performance of all clinical skills are outlined at
the outset. The 'practice tips' and 'pitfalls' sections are a distinctive feature
of the book. The 'practice tips' offer helpful advice from the authors'
experiences to facilitate perfromance of the skill. The 'pitfalls' sections
alert the reader to potential difficulties and complications that may be
encountered.
Regardless of who is undertaking a clinial skill, it is paramount that the
patient receives the highest standard of care. It is important to remember
that clinical skills form part of the total care package and that concepts
underpinning high quality care, such as effective communication, clinical
governance and patient involvement should always be considered along
with the performance of the actual skill itself. Local guidelines may differ
for some of the procedures described in this book and we would urge you
to follow local policies and be aware of, and understand the reasons for
any differences. Finally, we hope that you learn as much from this book as
we have from editing it and the ultimate beneficiaries will be the patients
we care for.
JR
FC
MB
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vii
Contents
Preface v
Contributors ix
Abbreviations xi
1 Principles 1
2 Communication skills 15
3 Assessment of the patient 23
4 Infection control 75
5 Pain management and 'last offices' 105
6 Drug administration 125
7 Peripheral intravenous access and care 159
8 Care of the theatre patient 187
9 Emergency and high-dependency care J201
10 Respiratory system 285
11 Cardiovascular system 363
12 Gastrointestinal system 397
13 Genito-urinary system 455
14 Musculoskeletal system 493
15 Wound care 533
16 Neurology JIL
17 Ear-nose-throat system 609
18 Ophthalmology 633
19 Haematology 659
Index 673
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ix
Contributors
Janet Barker Pat Frakes
Associate Professor, Director Emergency Nurse Practitioner,
of Undergraduate Dipbma/BSc Emergency Department,
(Hons) in Nursing, School of Nottingham University Hospitals
Nursing, Midwifery & Physiotherapy, NHS Trust, UK
University of Nottingham, UK
Kate Johnson
Martyn Bradbury Formerly Senior Lecturer in
Clinical Skills Network Lead, Cardiac Nursing, City University,
School of Nursing and Community London, UK
Studies, Faculty of Health and
Keith Knox
Social Work, University of
Plymouth, UK Charge Nurse, Eye Casualty
Department, Head and Neck
Fiona Branch Directorate, Nottingham
Nurse Consultant, Critical Care University Hospitals NHS Trust,
Clinical Lead Specialist Support, UK
Nottingham University Hospitals
lain Neely
NHS Trust, UK
Clinical Nurse Trainer, Emergency
Brenda Clarke Department, Nottingham
Associate Lecturer, University Hospitals NHS Trust,
Open University, UK UK
Mitch Clarke Rachel Peto
Infection Prevention and Control Lecturer, School of Nursing,
Nurse Specialist, Nottingham Midwifery & Physiotherapy,
University Hospitals NHS Trust, University of Nottingham, UK
UK
Yvonne Powell-Richards
Frank Coffey Registered Nurse, Nottingham
Consultant in Emergency University Hospitals NHS Trust,
Medicine, Emergency Department, UK
Nottingham University Hospitals
NHS Trust, Associate Professor and Jacqueline Randle
Consultant in Advanced Clinical Associate Professor, Clinical Skills
Skills, School of Nursing, Midwifery Lead for Masters of Nursing
& Physiotherapy, University of Science, School of Nursing,
Nottingham, UK Midwifery & Physiotherapy,
University of Nottingham, UK
Paul Crawford
Professor, School of Nursing,
Midwifery & Physiotherapy,
University of Nottingham, UK