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Part One Managing the patient journey
- Select to go to chapter navigation index2Assessment and discharge
- Select to go to chapter navigation index3Infection prevention and control
- Overview
- Infection prevention and control
- Aseptic technique
- Source isolation
- Protective isolation
- Prevention and management of inoculation injury
- Management of waste in the healthcare environment
- References
- Procedures
- Hand washing
- Hand decontamination using alcohol handrub
- Putting on and removing non‐sterile gloves
- Putting on and removing a disposable apron
- Putting on and removing a disposable mask or respirator
- Putting on or removing goggles or a face shield
- Surgical scrub technique
- Donning sterile gloves: open technique
- Donning a sterile gown and gloves: closed technique
- Aseptic technique example: changing a wound dressing
- Source isolation: preparing an isolation room
- Source isolation: entering the isolation room
- Source isolation: leaving the isolation room
- Source isolation: transporting infected patients outside the source isolation area
- Protective isolation: preparing the room
- Protective isolation: entering the isolation room
- Safe disposal of foul, infected or infested linen
Part Two Supporting the patient with human functioning
- Select to go to chapter navigation index4Communication
- Select to go to chapter navigation index5Elimination
- Overview
- Normal elimination
- Altered urinary elimination
- Altered faecal elimination
- Stoma care
- References
- Procedures
- Care of a patient who is vomiting
- Insertion of a nasogastric (NG) drainage tube
- Removal of a nasogastric tube
- Slipper bedpan use: assisting a patient
- Commode use: assisting a patient
- Penile sheath application
- Urinary catheterization: male
- Urinary catheterization: female
- Urinary catheterization: intermittent self‐catheterization patient guidance: male
- Urinary catheterization: intermittent self‐catheterization patient guidance: female
- Urinary catheter bag: emptying
- Urinary catheter removal
- Commencing bladder irrigation
- Care of the patient during bladder irrigation
- Nephrostomy tube: weekly dressing and bag change
- Nephrostomy tube: removal of locking pigtail drainage system
- Continent urinary diversion stoma: self‐catheterization
- Enema administration
- Suppository administration
- Digital rectal examination
- Digital removal of faeces
- Stoma siting
- Stoma bag change
- Stoma bridge or rod removal
- Select to go to chapter navigation index6Moving and positioning
- Overview
- Moving and positioning: general principles
- Definition
- Anatomy and physiology
- Evidence‐based approaches
- Legal and professional issues
- Pre‐procedural considerations
- Risk assessment: prevention of falls
- Positioning the patient: in bed
- Positioning the patient: sitting in bed
- Positioning the patient: side‐lying
- Positioning the patient: in a chair/wheelchair
- Moving the patient from sitting to standing
- Walking
- Moving and positioning the unconscious patient
- Moving and positioning the patient with an artificial airway
- Moving and positioning the patient with respiratory compromise
- Moving and positioning the patient with neurological impairment
- Moving and positioning of the patient with actual or suspected spinal cord compression or spinal cord injury
- Moving and positioning the patient with an amputation
- References
- Procedures
- Positioning the patient: supine
- Positioning the patient: sitting in bed
- Positioning the patient: side‐lying
- Positioning the patient: lying down to sitting up
- Positioning the patient: in a chair/wheelchair
- Moving from sitting to standing: assisting the patient
- Assisting the patient to walk
- Positioning the unconscious patient or patient with an airway in supine
- Positioning the unconscious patient or patient with an airway in side‐lying
- Positioning the patient to maximize V/Q matching with unilateral lung disease in a self‐ventilating patient
- Positioning the patient to maximize V/Q matching for widespread pathology in a self‐ventilating patient
- Positioning to maximize the drainage of secretions
- Positioning the neurological patient with tonal problems
- Log rolling for suspected/confirmed cervical spinal instability
- Positioning for suspected/confirmed cervical spinal instability: pelvic twist to right
- Log rolling for suspected/confirmed thoracolumbar spinal instability
- Early mobilization of the patient in bed
- Positioning the pre‐operative and post‐operative amputation patient
- Select to go to chapter navigation index7Nutrition, fluid balance and blood transfusion
- Overview
- Fluid balance
- Nutritional status
- Provision of nutritional support: oral
- Nutritional management of patients with dysphagia
- Enteral tube feeding
- Parenteral nutrition
- Transfusion of blood and blood components
- References
- Procedures
- Fluid input: measurement
- Fluid output: monitoring/measuring output if the patient is catheterized
- Fluid output: monitoring/measuring output if the patient is not catheterized
- Fluid output: measuring output from drains
- Fluid output: monitoring output from gastric outlets, nasogastric tubes, gastrostomy
- Fluid output: monitoring output from bowels
- Fluid output: monitoring output from stoma sites
- Measuring the weight and height of the patient
- Feeding an adult patient
- Nasogastric intubation with tubes using an internal guidewire or stylet
- Removal of a nasogastric tube
- Percutaneous endoscopically placed gastrostomy (PEG) tube care
- Radiologically inserted gastrostomy (RIG) tube care
- Removal of T‐fasteners
- Checking the balloon volume on a balloon gastrostomy
- Jejunostomy feeding tube care
- Enteral feeding tubes: administration of feed
- Enteral feeding tubes: administration of medication
- Enteral feeding tubes: unblocking
- Blood product request
- Blood sampling: pre‐transfusion
- Blood components: collection and delivery to the clinical area
- Blood component administration
- Select to go to chapter navigation index8Patient comfort and end‐of‐life care
- Overview
- Personal hygiene
- Eye care
- Ear care
- Mouth care
- Pain
- Pain management
- Acupuncture
- Epidural and intrathecal analgesia
- Regional analgesia: local anaesthetic nerve blocks and infusions
- Entonox administration
- Management of ascites
- End‐of‐life care
- References
- Procedures
- Bedbathing a patient
- Washing a patient's hair in bed
- Eye swabbing
- Eye irrigation
- Artificial eye care: insertion
- Artificial eye care: removal
- Contact lens removal: hard lenses
- Contact lens removal: soft lenses
- Mouth care
- Mouth care for the patient with dentures
- Pain assessment
- Acupuncture: preparation and administration
- Epidural/intrathecal sensory blockade: assessment
- Epidural/intrathecal exit site dressing change
- Epidural/intrathecal catheter removal
- Entonox administration
- Abdominal paracentesis
- Personal care after death
- Select to go to chapter navigation index9Respiratory care
- Overview
- Respiratory therapy
- Oxygen therapy
- Humidification
- High‐flow oxygen therapy
- Continuous positive airway pressure
- Chest drains
- Tracheostomy and laryngectomy care
- Cardiopulmonary resuscitation
- References
- Procedures
- Oxygen therapy
- Humidification for respiratory therapy
- High‐flow oxygen therapy
- Continuous positive airway pressure
- Chest drain: insertion
- Chest drainage: suction
- Chest drain: priming ambulatory chest drain bag
- Chest drain: changing the bottle
- Chest drain: removal
- Tracheostomy: dressing change
- Tracheostomy: suctioning a patient
- Tracheostomy: inner cannula change
- Tracheostomy: tube change
- Cardiopulmonary resuscitation
Part Three Supporting the patient through the diagnostic process
- Select to go to chapter navigation index10Interpreting diagnostic tests
- Overview
- Diagnostic tests
- Blood: obtaining samples from a peripheral vein (venepuncture)
- Blood sampling from a central venous catheter
- Arterial sampling
- Blood tests
- Blood cultures
- Post‐procedural considerations
- Antimicrobial drug assay
- Cerebrospinal fluid obtained by lumbar puncture
- Semen collection
- Cervical uterine smear (pap smear)
- Specimen collection: swab sampling
- Specimen collection: urine sampling
- Specimen collection: faecal sampling
- Specimen collection: respiratory tract secretion sampling
- Specimen collection: pleural fluid
- Endoscopic investigations
- Liver biopsy
- Radiological investigations: X‐ray
- Magnetic resonance imaging
- Computed tomography
- References
- Procedures
- Venepuncture
- Central venous access devices: taking a blood sample for vacuum sampling
- Central venous access devices: taking a blood sample for syringe sampling
- Arterial puncture: radial artery
- Arterial blood gas sampling: arterial cannula
- Blood cultures: peripheral (winged device collection method)
- Blood cultures: central venous access device
- Blood sampling: antimicrobial drug assay
- Lumbar puncture
- Semen collection
- Cervical uterine smear using a wooden spatula
- Cervical uterine smear using liquid‐based cytology
- Cervical uterine smear using an endocervical brush
- Swab sampling: ear
- Swab sampling: eye
- Swab sampling: nose
- Swab sampling: penis
- Swab sampling: rectum
- Swab sampling: skin
- Swab sampling: throat
- Swab sampling: vagina
- Swab sampling: wound
- Urine sampling: midstream specimen of urine: male
- Urine sampling: midstream specimen of urine: female
- Urine sampling: catheter specimen of urine (CSU)
- Urine sampling: sampling from an ileal conduit
- Urine sampling: 24‐hour urine collection
- Faecal sampling
- Sputum sampling
- Nasopharyngeal wash: syringe method
- Nasopharyngeal wash: vacuum‐assisted aspirate method
- Select to go to chapter navigation index11Observations
- Overview
- Observations
- Pulse (heart rate)
- Twelve‐lead electrocardiogram (ECG)
- Blood pressure
- Respiration and pulse oximetry
- Peak flow
- Temperature
- Urinalysis
- Blood glucose
- Neurological observations
- References
- Procedures
- Pulse measurement
- Electrocardiogram
- Blood pressure measurement (manual)
- Respiratory assessment and pulse oximetry
- Peak flow reading using a manual peak flow meter
- Temperature measurement
- Urinalysis: reagent strip procedure
- Blood glucose monitoring
- Neurological observations and assessment
Part Four Supporting the patient through treatment
- Select to go to chapter navigation index12Medicines management
- Overview
- Definitions
- Evidence base for medicines management in practice
- Legal and professional issues
- Self‐administration of medicines
- Controlled drugs
- Routes of administration
- Injections and infusions
- Intra‐arterial
- Intra‐articular
- Intrathecal administration of medication
- Intradermal injection
- Subcutaneous injection
- Subcutaneous infusion
- Intramuscular injections
- Intraosseous administration
- Intravenous injections and infusions
- Infiltration and extravasation
- References
- Procedures
- Medication: self‐administration
- Medication: controlled drug administration
- Medication: oral drug administration
- Medication: topical applications
- Medication: transdermal applications
- Medication: vaginal administration
- Medication: administration by inhalation using a metered dose inhaler
- Medication: administration by inhalation using a nebulizer
- Medication: eye administration
- Medication: nasal drop administration
- Medication: ear drop administration
- Medication: single‐dose ampoule: solution preparation
- Medication: single‐dose ampoule: powder preparation
- Medication: multidose‐vial: powder preparation using a venting needle
- Medication: multidose vial: powder preparation using equilibrium method
- Medication: injection administration
- Medication: intradermal injection
- Medication: subcutaneous injection
- Medication: subcutaneous infusion of fluids
- Medication: subcutaneous administration using a McKinley T34 syringe pump
- Medication: intramuscular injection
- Inserting an intraosseous needle
- Removing an intraosseous needle
- Medication: continuous infusion of intravenous drugs
- Medication: intermittent infusion of intravenous drugs
- Medication: injection (bolus or push) of intravenous drugs
- Extravasation management: peripheral cannula
- Extravasation: performing flush‐out following an extravasation
- Select to go to chapter navigation index13Perioperative care
- Overview
- Pre‐operative care
- Definition
- Related theory
- Evidence‐based approaches
- Legal and professional issues
- Patient information and education
- Consent
- Physical pre‐operative preparation
- Antiembolic stockings and prophylactic anticoagulation
- Pre‐operative fasting
- Skin preparation
- Marking skin for surgery
- Pre‐operative pregnancy testing
- Prevention of toxic shock syndrome from tampon use
- Latex sensitivity and allergy
- Pre‐operative theatre checklist
- Intraoperative care
- Post‐operative care
- Definition
- Evidence‐based approaches
- Post‐operative observations
- Haemodynamic instability
- Ineffective breathing pattern
- Fluid balance
- Surgical drains
- Surgical wounds
- Dressings for surgical wounds
- Surgical wound complications
- Urinary output and catheters
- Bowel function
- Nutrition
- Post‐operative pain
- Immobility
- Ongoing care on discharge
- Research Explanation
- References
- Procedures
- Step‐by‐step guide to measuring and applying antiembolic stockings
- Pre‐operative care: checking that the patient is fully prepared for surgery
- Caring for the patient in the anaesthetic room
- Operating theatre procedure: maintaining the safety of a patient while undergoing surgery
- Handover in post‐anaesthetic care unit: scrub nurse/ODP to recovery practitioner
- Safe management of the patient in the PACU
- Drainage systems: changing the dressing around the drain site for both open and closed drains
- Closed drainage systems: changing a vacuum bottle
- Wound drain removal: closed drainage system
- Wound drain shortening for open drainage systems
- Wound drain shortening for closed drainage systems
- Select to go to chapter navigation index14Vascular access devices: insertion and management
- Overview
- Vascular access devices
- Peripheral cannulas
- Midline catheters
- Peripherally inserted central catheters
- Short‐term percutaneous central venous catheters (non‐tunnelled)
- Skin‐tunnelled catheters
- Implanted ports
- Arterial cannulas
- References
- Procedures
- Central venous catheter: insertion site dressing change
- Vascular access devices: maintaining patency
- Central venous access devices: unblocking an occlusion
- Peripheral cannula insertion
- Midline catheter insertion
- PICC insertion using modified Seldinger technique with ultrasound
- PICC removal
- Short‐term central venous catheter (non‐cuffed/tunnelled) insertion into the internal jugular vein
- Short‐term central venous catheter (non‐cuffed/tunnelled): removal
- Central venous catheter (skin‐tunnelled): surgical removal
- Implanted ports: insertion and removal of non‐coring needles
- Arterial cannula insertion: preparation and setting up of monitoring set
- Arterial cannula: removal
- Select to go to chapter navigation index15Wound management
- Select to go to chapter navigation index16Administration of systemic anticancer therapies
- Overview
- Systemic anticancer treatment
- Safe handling of hazardous drugs
- Administration of cytotoxic medications by nurses
- Intravenous administration of systemic anticancer therapy
- Oral administration of systemic anticancer therapy
- Intramuscular and subcutaneous administration of cytotoxic drugs
- Topical application of cytotoxic drugs
- Intrathecal administration of cytotoxic drugs
- Intrapleural instillation of cytotoxic drugs
- Intravesical instillation of cytotoxic drugs
- Intraperitoneal instillation of cytotoxic drugs
- Intra‐arterial administration of cytotoxic drugs
- Side‐effects of chemotherapy
- Clinical research
- References
- Procedures
- Cytotoxic spillage management
- Cytotoxic therapy: intravenous administration of cytotoxic drugs
- Extravasation management: peripheral cannula
- Extravasation: performing flush‐out following an extravasation
- Cytotoxic therapy: education for patients on oral cytotoxic drugs
- Cytotoxic therapy: intramuscular administration of cytotoxic drugs (Z‐track)
- Cytotoxic therapy: topical application of cytotoxic drugs
- Cytotoxic therapy: intraventricular administration of cytotoxic drugs via an intraventricular access device (Ommaya reservoir)
- Cytotoxic therapy: intrapleural instillation of cytotoxic drugs
- Cytotoxic therapy: intravesical instillation of cytotoxic drugs
- Cytotoxic therapy: intraperitoneal instillation of cytotoxic drugs
- Intra‐arterial administration of cytotoxic drugs
- Scalp cooling