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

List of Tables

Chapter 1
1. Table 1.1 Common communication terms.
Chapter 2
1. Table 2.1 Planning communication encounters.
2. Table 2.2 The four different types of communication.
3. Table 2.3 Tips for effective communication with children and young people.
4. Table 2.4 The 7Cs of communication.
Chapter 4
1. Table 4.1 The roles.
2. Table 4.2 Introverts and extroverts.
3. Table 4.3 The Nine Dimensions.
Chapter 5
1. Table 5.1 SOLER.
Chapter 6
1. Table 6.1 Branches and characteristics of emotional intelligence theoretical fram...
2. Table 6.2 Skills to enhance information gathering.
Chapter 7
1. Table 7.1 The elements of a complete handover.
2. Table 7.2 An overview of the RSVP escalation method.
Chapter 8
1. Table 8.1 Some aspects of legislation that impacts record‐keeping.
Chapter 10
1. Table 10.1 Temperature measurement ranges.
Chapter 13
1. Table 13.1 Appropriate blood glucose levels.
Chapter 17
1. Table 17.1 Clinical features associated with anxiety.
Chapter 18
1. Table 18.1 Types of shock.
Chapter 19
1. Table 19.1 Some common misconceptions about the nature of pain.
Chapter 20
1. Table 20.1 The main aids: Pillows, towels and face cloths.
2. Table 20.2 Steps to be taken along with the rationale for Fowler’s position....
3. Table 20.3 Details concerning the steps to be taken along with the rationale for ...
4. Table 20.4 Details concerning the steps to be taken along with the rationale for ...
5. Table 20.5 Detail concerning the steps to be taken along with the rationale f...
Chapter 23
1. Table 23.1 Some internal and external factors underpinning skin problems.
Chapter 24
1. Table 24.1 Some factors underpinning skin integrity.
2. Table 24.2 An example of a good skin cleansing regimen.
3. Table 24.3 Emollient types and descriptions.
4. Table 24.4 Cleaning the compromised skin.
5. Table 24.5 Medications to support skin integrity.
Chapter 26
1. Table 26.1 Consequences of poor oral and dental health and descriptions.
2. Table 26.2 Oral hygiene assessment tool.
Chapter 27
1. Table 27.1 Effect of health conditions on the eye and associated structures
Chapter 28
1. Table 28.1 Common conditions and the effect on the nail bed.
Chapter 29
1. Table 29.1 Some underlying structures required for movement, support, protection ...
Chapter 30
1. Table 30.1 How to measure weight.
2. Table 30.2 How to measure height.
3. Table 30.3 BMI score and categories.
4. Table 30.4 An example of a daily food intake chart.
Chapter 32
1. Table 32.1 NEWS 2 observations, including normal values and expected values durin...
2. Table 32.2 Procedure to measure fluid input and output.
Chapter 35
1. Table 35.1 Functions associated with the urinary system.
2. Table 35.2 Types of catheters.
Chapter 36
1. Table 36.1 Standards of the British Geriatrics Society.
Chapter 37
1. Table 37.1 Abbreviated Mental Test Score (each question scores one point). A scor...
Chapter 39
1. Table 39.1 Oxygen therapy. Procedural guideline.
Chapter 41
1. Table 41.1 Excessive respiratory secretion in palliative care.
2. Table 41.2 Checklist: Oral Suctioning.
Chapter 42
1. Table 42.1 Features of Asthma inhalers.
2. Table 42.2 The procedure guideline for administration of inhalation by metered do...
3. Table 42.3 The procedure guideline for nebulisation. Procedure guideline 12.8 Med...
Chapter 43
1. Table 43.1 Sources of Infection Control Advice.
Chapter 44
1. Table 44.1 The principles of aseptic non‐touch technique.
Chapter 48
1. Table 48.1 Decontamination of reusable equipment.
2. Table 48.2 Risk categories related to functional areas and required service level...
3. Table 48.3 Microorganisms’ survival time.
4. Table 48.4 Disinfection levels.
5. Table 48.5 Chemical agents and actions.
6. Table 48.6 Medical devices and package symbols.
7. Table 48.7 Warnings and Pictograms adapted from Health and Safety Executive.
Chapter 53
1. Table 53.1 The platforms.
2. Table 53.2 Example of the content of a risk assessment tool
3. Table 53.3 Levels of self‐administration and supervision.
Chapter 54
1. Table 54.1 Commonly used prefixes.
Chapter 55
1. Table 55.1 Legal classifications of medicines.
Chapter 56
1. Table 56.1 Abbreviations for the most common medicine administration routes.
2. Table 56.2 Some abbreviations used on prescription charts and their meanings.
3. Table 56.3 Types of oral medications.
4. Table 56.4 Types of topical medications.
5. Table 56.5 Intramuscular injection sites.
Chapter 57
1. Table 57.1 Types of symptoms.
2. Table 57.2 Understanding a patient’s presenting history of a symptom.
3. Table 57.3 The nursing process as applied to pain.
Chapter 58
1. Table 58.1 Classification of adverse drug reactions.

List of Illustrations

Chapter 1
1. Figure 1.1 Transmission model of communication.
2. Figure 1.2 Interaction model of communication.
3. Figure 1.3 Transactional model of communication.
Chapter 3
1. Figure 3.1 Aspects of the therapeutic relationship.
2. Figure 3.2 The OARS model of motivational interviewing.
3. Figure 3.3 The person is at the heart of the 6Cs.
Chapter 4
1. Figure 4.1 The team cycle.
2. Figure 4.2 Action‐centred leadership.
Chapter 5
1. Figure 5.1 Peplau’s model of interpersonal relations.
Chapter 6
1. Figure 6.1 Hierarchy of evidence.
Chapter 8
1. Figure 8.1 An example of a specimen register used in a general practice.
Chapter 9
1. Figure 9.1 The NHS feedback and complaints procedure.
Chapter 10
1. Figure 10.1 Sites of the major pulses.
2. Figure 10.2 Radial pulse.
3. Figure 10.3 Sphygmomanometer and stethoscope.
4. Figure 10.4 Correct positioning of cuff.
5. Figure 10.5 Electronic blood pressure monitor.
6. Figure 10.6 Taking the temperature with a tympanic thermometer.
7. Figure 10.7 BMI chart.
8. Figure 10.8 Measuring arm length.
9. Figure 10.9 Measuring MUAC.
Chapter 11
1. Figure 11.1 Accessory cephalic, median cubital and basilic veins.
2. Figure 11.2 Insertion of a needle at a 15–30° angle.
Chapter 12
1. Figure 12.1 Limb lead position by colour.
2. Figure 12.2 Chest (precordial) lead placement.
3. Figure 12.3 Correct placement of V5 and V6 (note the horizontal placement)....
4. Figure 12.4 Incorrect placement of leads V5 and V6 (note the curvature of th...
5. Figure 12.5 Wandering baseline.
6. Figure 12.6 Muscle tremor.
7. Figure 12.7 Electromagnetic interference.
Chapter 13
1. Figure 13.1 Lancets.
2. Figure 13.2 Finger prick.
3. Figure 13.3 Dropping blood drop onto test strip.
Chapter 14
1. Figure 14.1 Obtaining an MSU from a male client.
2. Figure 14.2 Example specimen ports.
3. Figure 14.3 Specimen pot with integral spoon.
4. Figure 14.4 Collecting specimen of faeces.
5. Figure 14.5 Swab with transport medium.
6. Figure 14.6 Moisten the swab with 0.9% saline.
7. Figure 14.7 Insert the swab into the anterior nostrils.
8. Figure 14.8 Sweep the swab around the nares.
Chapter 15
1. Figure 15.1 Raising concerns.
Chapter 16
1. Figure 16.1 Examples of factors that can contribute to self‐harm.
2. Figure 16.2 The cycle of self‐harm.
3. Figure 16.3 Percentage difference between males and females who commit suici...
4. Figure 16.4 The National Suicide Prevention Alliance.
5. Figure 16.5 Risk factors associated with suicide.
Chapter 18
1. Figure 18.1 The head‐tilt/chin technique.
2. Figure 18.2 The recovery position.
3. Figure 18.3 Flowchart for basic life support.
Chapter 19
1. Figure 19.1 Pathway of pain transmission and interpretation.
2. Figure 19.2 The ascending pain pathway.
3. Figure 19.3 The verbal rating scale.
4. Figure 19.4 A numerical scale.
5. Figure 19.5 Visual analogue scale.
Chapter 20
1. Figure 20.1 Poor body alignment.
2. Figure 20.2 Areas of the body at risk.
3. Figure 20.3 Fowler’s position.
4. Figure 20.4 Semi‐Fowler’s position.
5. Figure 20.5 Lateral position and 30° tilt.
6. Figure 20.6 Tripod position and lean forward position.
7. Figure 20.7 Supine.
8. Figure 20.8 Prone.
Chapter 23
1. Figure 23.1 The three layers of the skin.
2. Figure 23.2 Atopic dermatitis.
3. Figure 23.3 Eczema.
4. Figure 23.4 Psoriasis.
5. Figure 23.5 A type of pain assessment. Visual analogue scale.
6. Figure 23.6 Common types of bacterial skin infections.
7. Figure 23.7 Common site for pressure ulcers.
8. Figure 23.8 Stage II pressure ulcer.
9. Figure 23.9 Pressure ulcer development.
10. Figure 23.10 An example of a body map.
Chapter 24
1. Figure 24.1 Three layers of the skin sweat and sebaceous glands.
2. Figure 24.2 Factors affecting skin integrity.
3. Figure 24.3 Pressure ulcer to the plantar aspect of the heel.
4. Figure 24.4 Pressure ulcer to the heel.
5. Figure 24.5 Incontinence‐associated dermatitis.
6. Figure 24.6 Pressure ulcer exacerbated by moisture lesion.
7. Figure 24.7 The Cavilon range of products, which act to protect the skin fro...
8. Figure 24.8 The impact of a wound on a person’s self‐esteem and body image....
Chapter 26
1. Figure 26.1 Structures of the mouth.
Chapter 27
1. Figure 27.1 Cross‐section of the eye.
2. Figure 27.2 Eyelids and nasolacrimal system.
Chapter 28
1. Figure 28.1 The nail.
2. Figure 28.2 Cut the toenail straight across and then smooth the corners.
Chapter 29
1. Figure 29.1 The skin.
2. Figure 29.2 Fibrin meshwork and formation is a clot.
3. Figure 29.3 An example of a wound assessment chart.
Chapter 30
1. Figure 30.1 Stadiometer.
Chapter 31
1. Figure 31.1 Adapted cutlery.
2. Figure 31.2 Red Tableware can highlight people who need help.
Chapter 32
1. Figure 32.1 Fluid distribution.
2. Figure 32.2 Sources of intake and output volumes.
3. Figure 32.3 Sample fluid balance chart.
Chapter 33
1. Figure 33.1 The bladder, pelvic floor, muscles and sphincters involved in el...
2. Figure 33.2 Rectal and anal muscles and sphincters involved in the eliminati...
3. Figure 33.3 Bristol stool scale.
Chapter 34
1. Figure 34.1 The bladder, pelvic floor, muscles and sphincters involved in el...
2. Figure 34.2 Rectal and anal muscles and sphincters involved in the eliminati...
Chapter 35
1. Figure 35.1 The organs of the renal system.
2. Figure 35.2 Intermittent and indwelling urinary catheter.
3. Figure 35.3 Indwelling urinary catheter.
4. Figure 35.4 Urinary catheters and local anaesthetic gel.
5. Figure 35.5 Catheter insertion into a male.
6. Figure 35.6 Catheter insertion into a female.
Chapter 37
1. Figure 37.1 Falls assessment.
2. Figure 37.2 An example of footwear with a non‐slip sole.
3. Figure 37.3 Bed rails assessment.
4. Figure 37.4 Falls prevention and assessment.
Chapter 38
1. Figure 38.1 Testing strength in patient’s legs.
2. Figure 38.2 Testing range of movement in patient’s legs.
3. Figure 38.3 Testing strength and range of movement in patient’s legs....
4. Figure 38.4 Testing strength in patient’s arms.
5. Figure 38.5 Encouraging the patient to move forward in the chair.
6. Figure 38.6 Checking the patient’s sitting balance.
7. Figure 38.7 Place your hand nearest the patient on their lower back.
8. Figure 38.8 Alternatively place your hand on the patient’s iliac crest....
9. Figure 38.9 Place your other hand on the patient’s shoulder.
10. Figure 38.10 Encourage the patient to stand using clear instructions.
11. Figure 38.11 Stay close to the patient when the stand.
12. Figure 38.12 Use a palm to palm grip with thumbs tucked in.
13. Figure 38.13 Fold slide sheet together with handles facing outwards.
14. Figure 38.14 Fold both slide sheets together and place under the patient’s p...
15. Figure 38.15 Both handlers face the head of the bed with palms facing upward...
16. Figure 38.16 Inner hand goes under the slide sheet with the outer hand on to...
17. Figure 38.17 Adopting a walk stance position pull the bottom section of the ...
18. Figure 38.18 Both handlers work in unison as the slide sheet is unravelled....
19. Figure 38.19 As the slide sheet goes under the patient the handler’s outer h...
20. Figure 38.20 Adopting a walk stance position hold the top slide sheet with y...
21. Figure 38.21 In a coordinated way move the patient up the bed using a weight...
22. Figure 38.22 Continue until the patient is in the desired position.
23. Figure 38.23 Alternatively if the bed head can be removed stand at the top o...
24. Figure 38.24 Alternatively using both hands grip the top slide sheet at the ...
25. Figure 38.25 If using both hands you must look at the opposite corner of the...
26. Figure 38.26 Remove the slide sheets by pulling under from opposite corners.
27. Figure 38.27 Keep your hands close to the patient as the slide sheet is remo...
28. Figure 38.28 Remove the slide sheets in unison..
29. Figure 38.29 Hoist showing SWL and service label.
30. Figure 38.30 Hoist showing service label in detail.
31. Figure 38.31 Hoist showing SWL in detail.
32. Figure 38.32 Hoist showing Stop button and batter release button.
33. Figure 38.33 Hoist showing emergency lower mechanism.
34. Figure 38.34 Hoist showing handset in detail.
35. Figures 38.35 Loop type sling.
36. Figure 38.36 Clip type sling.
37. Figure 38.37 Clip type spreader bar.
38. Figure 38.38 Loop type spreader bar.
39. Figure 38.39 Motorised standing and raising aid.
40. Figure 38.40 Non‐motorised standing and raising aid.
Chapter 39
1. Figure 39.1 Oxygen prescription on a medication card.
2. Figure 39.2 The NEWS2 Scoring System.
3. Figure 39.3 NEWS2 thresholds and triggers.
4. Figure 39.4 NEWS2 Chart.
5. Figure 39.5 Nasal Canulae.
6. Figure 39.6 Venturi valves.
7. Figure 39.7 Reservoir mask.
8. Figure 39.8 Titration guideline.
Chapter 40
1. Figure 40.1 Red and infrared light absorption by oxygenated and deoxygenated...
2. Figure 40.2 Pulse oximeter.
3. Figure 40.3 Pulse oximeter showing pulse detector and amplitude indicators....
4. Figure 40.4 A peak flow meter.
5. Figure 40.5 The airways and asthma.
6. Figure 40.6 An example of a peak flow chart.
Chapter 41
1. Figure 41.1 Oral suctioning.
2. Figure 41.2 Key structures associated with suctioning.
Chapter 42
1. Figure 42.1 Dry powder inhaler.
2. Figure 42.2 Pressurised metered dose inhalers (MDI or pMDI).
3. Figure 42.3 Breath‐actuated MDI (BApMDI).
4. Figure 42.4 Aerosol holding chamber (commonly called a ‘spacer’)....
5. Figure 42.5 Nebuliser.
6. Figure 42.6 Particle deposition in the airways and lungs.
Chapter 43
1. Figure 43.1 Common signs and symptoms of infection.
2. Figure 43.2 MRSA suppression.
Chapter 44
1. Figure 44.1 Key parts of sterile equipment are circled. Key parts identified...
2. Figure 44.2 Equipment laid out safely in blue tray using caps and covers to ...
Chapter 45
1. Figure 45.1 Different levels of PPE.
2. Figure 45.2 Protecting yourself and using Personal Protective Equipment (PPE...
3. Figure 45.3 Glove technique.
4. Figure 45.4 Glove Use Pyramid.
Chapter 46
1. Figure 46.1 Putting on and taking off PPE.
Chapter 47
1. Figure 47.1 Step‐by‐step guidance on how to effectively hand‐rub with ABHR....
2. Figure 47.2 Step‐by‐step guidance on how to effectively wash hands with soap...
3. Figure 47.3 The 5 moments when hand hygiene techniques must be performed to ...
Chapter 49
1. Figure 49.1 Colour‐code system for healthcare waste disposal.
2. Figure 49.2 Single‐use medical devices.
3. Figure 49.3 Sharps disposal.
Chapter 50
1. Figure 50.1 Multi‐Disciplinary Team Members.
Chapter 51
1. Figure 51.1 McKinley T34 Syringe Pump.
Chapter 52
1. Figure 52.1 A hospital shroud.
Chapter 56
1. Figure 56.1 Sublingual and buccal routes.
2. Figure 56.2 Subcutaneous injection sites.
3. Figure 56.3 Location of the gluteus medius muscle.
4. Figure 56.4 Location of the deltoid muscle.
5. Figure 56.5 Location of the rectus femoris and vastus lateralis muscles.
6. Figure 56.6 Z‐track injection technique.
Chapter 57
1. Figure 57.1 Minimum Effective Concentration.
Chapter 58
1. Figure 58.1 Anaphylaxis algorithm.
2. Figure 58.2 CE mark of approved devices.
Chapter 59
1. Figure 59.1 4 Governance Principles.