Clinical Skills the essence of caring

by Iggulden, Helen; Macdonald, Caroline; Staniland, Karen

• ISBN13: 9780335223565
• ISBN10: 0335223567
• Edition: 1st
• Format: Hardcover
• Copyright: 2009-03-01
• Publisher: Open University Press

Summary

This exciting new textbook and integrated website package makes teaching and learning nursing interactive!Organised around the DoH Essence of Care framework,Clinical Skills: the Essence of Caringcovers the compulsory clinical skills curriculum based on care benchmarks. It also considers the related professional issues and underpinning basic anatomy and physiology to take an holistic approach to the importance of delivering excellent care.Each chapter of the book corresponds to one of the Essence of Care benchmarks and covers all related skills and issues, with the aid of activity boxes, mini-case studies and case boxes which consider case material from the website distributed throughout the text to make it accessible and bring the topics to life.The website offers interactive material, including video clips, images, animations and self-test material, on the benchmarks and skill sets as well as in-depth case studies on the different nursing branches, making it perfect to use for classroom teaching, assignments or solo-study.The clear structure, accessible style and fully interactive web material make this package an essential learning resource for all CFP students.

Author Biography

Helen Iggulden is Lecturer in Nursing at Salford School of Nursing, University of Salford, UK. She also has a faculty wide role as Learning Technology Fellow.

..Caroline Macdonald is Senior Lecturer for Clinical Skills Development, School of Nursing and Midwifery at the Robert Gordon University, Aberdeen, UK.

..Karen Staniland is Senior Lecturer/Open Learning Lead within the School of Nursing, University of Salford, UK.

Table of Contents

Guide to the interactive Media Tool DVD	p. xiv
Guide to using the book	p. xxii
Acknowledgements	p. xxvii
Preface	p. xxx
About the editors	p. xxxi
About the contributors	p. xxxi
Clinical skills: the essence of caring	p. 1
Introduction to caring	p. 1
Introduction to evidence	p. 1
The Essence of Care	p. 2
Clinical skills and evidence-based practice	p. 3
Skills clusters	p. 3
Clinical skills and the student nurse	p. 4
References	p. 4
Communication	p. 5
Learning objectives	p. 5
Introduction	p. 6
Background physiology and communication	p. 6
Communicating non-verbally	p. 6
Communicating verbally	p. 6
How are communication and culture linked?	p. 6
Communication models	p. 7
The feedback loop	p. 8
Interpersonal skills	p. 9
Body language	p. 9
Genuiness and sincerity	p. 12
Smiling	p. 12
Eye contact	p. 12
Speaking and body language	p. 15
Body language and hearing impairment	p. 15
Personal and social space	p. 16
Words and word choice	p. 17
Openness, honesty and transparency	p. 18
Establishing rapport: active and empathic listening	p. 18
Rapport	p. 18
Empathy	p. 19
Self-awareness	p. 20
How does self-awareness work?	p. 20
Self-awareness in clinical situations	p. 20
Recognizing opportunities and sharing information	p. 21
Cross-cultural communication	p. 22
Communicating with young people and children	p. 22
Communicating with unconscious patients	p. 22
Assessing communication needs	p. 23
Information sharing	p. 23
Resources to aid communication and understanding	p. 23
Assessment to identify principal carer	p. 23
Empowering patients and carers	p. 23
Coordination of care	p. 23
Summary and key points	p. 24
References	p. 24
Answers	p. 25
Record keeping	p. 27
Learning objectives	p. 27
Introduction	p. 28
The importance of record keeping	p. 28
Principles of record keeping	p. 29
Communication	p. 29
Record keeping and vital signs	p. 31
The recording chart	p. 31
Recording the actual time	p. 33
Recording temperature	p. 33
Recording blood pressure	p. 34
Recording the pulse	p. 35
Recording respiration and oxygen saturation	p. 38
Local policy for record charts	p. 38
Further documenting of vital signs	p. 38
Record keeping and the administration of medicines	p. 38
Identifying the correct patient	p. 42
Medicine prescription	p. 42
Selecting the correct medicine	p. 42
Use of abbreviations	p. 43
Controlled drugs	p. 43
Record keeping and pressure ulcers	p. 43
Risk assessment	p. 44
Skin inspection	p. 44
Pressure-relieving devices and actions	p. 44
Patient compliance	p. 44
Ulcer development	p. 45
Access to healthcare records, confidentiality and security	p. 45
Legislation	p. 45
Accessing healthcare records	p. 49
Confidentiality	p. 49
Security	p. 50
Integration of records	p. 50
Patient and professional partnerships	p. 50
Professional and organizational boundaries	p. 50
Lifelong records	p. 51
Summary and key points	p. 52
References	p. 52
Answers	p. 53
The care environment	p. 55
Learning objectives	p. 56
Introduction	p. 56
First impressions: accessing the care environment	p. 56
From home to healthcare	p. 57
Wayfinding	p. 57
A supportive care environment	p. 58
Customer care	p. 58
Supportive environments	p. 58
Environments for older people	p. 59
End-of-life care	p. 59
Care homes	p. 60
Mental health environments	p. 60
Children and adolescents	p. 60
A supportive physical environment	p. 60
Noise	p. 61
Light	p. 61
Colour	p. 62
A clean environment	p. 62
National standards	p. 63
Roles and responsibilities	p. 63
Patient Environment Action Teams (PEATs)	p. 64
Hand hygiene	p. 64
Infection control	p. 65
Control of hazardous substances, spillages and disposal of hospital waste	p. 66
The Cleanliness Champions Programme	p. 67
Uniforms and workwear	p. 67
The personal healthcare environment	p. 69
Evidence base	p. 69
Control of the environment	p. 69
Surroundings and furnishings	p. 69
Summary and key points	p. 71
References	p. 71
Answers	p. 72
Privacy and dignity	p. 75
Learning objectives	p. 75
Introduction	p. 75
Background	p. 76
Attitudes and behaviour	p. 77
Autonomy and children	p. 78
What do we really mean by 'attitude'?	p. 78
How do attitudes develop?	p. 78
Habituation	p. 79
Recognizing examples of good practice	p. 80
Identity and the personal world	p. 80
What is a stereotype?	p. 81
What is prejudice?	p. 81
What is discrimination?	p. 81
Stereotyping, prejudice and older people	p. 81
Personal boundaries and space	p. 82
Personal space and personal territory	p. 82
Illness and personal space	p. 83
Professional boundaries	p. 83
Communication and courtesy	p. 83
Confidentiality of patient information	p. 85
Promoting privacy, dignity and modesty	p. 85
Clothing and dignity	p. 86
Contributing to patients' privacy and dignity	p. 86
Privacy and risk	p. 87
What is clinical risk?	p. 87
Clinical risk management	p. 88
Summary and key points	p. 88
References	p. 89
Answers	p. 89
Safety of patients with mental health needs	p. 93
Learning objectives	p. 93
Introduction	p. 94
Mental health and mental ill health	p. 94
Fed up or depressed?	p. 94
Cultural aspects	p. 95
Background theories	p. 95
Stress vulnerability theory and schizophrenia	p. 95
Anxiety as a mental health problem	p. 96
Self-harm	p. 96
Sociological issues	p. 97
Attitudes towards mental health	p. 97
The general care setting	p. 98
Helping patients adjust to the hospital environment	p. 98
Risk assessment	p. 100
Risk of harm to self	p. 100
Assessment	p. 100
Risk of harm to others	p. 102
Normal or abnormal emotions?	p. 103
Useful sources for risk assessment	p. 104
Observation versus privacy	p. 104
Managing risk	p. 106
Summary and key points	p. 108
References	p. 109
Answers	p. 110
Self-care	p. 113
Learning objectives	p. 113
Introduction	p. 113
Self-care, health and lifestyle	p. 114
What is self-care?	p. 115
Managing self-care	p. 116
Responsibility for self-care	p. 118
Rehabilitation and decision-making	p. 119
Services to support self-care	p. 120
Summary and key points	p. 122
References	p. 122
Answers	p. 123
Personal and oral hygiene	p. 125
Learning objectives	p. 125
Introduction	p. 126
General principles	p. 126
Communication	p. 126
Patient-centred care	p. 127
Privacy	p. 127
Cultural and religious preferences	p. 128
Assisting with personal and oral hygiene	p. 128
Standard infection control precautions	p. 129
Bathing	p. 129
Bed bath procedure	p. 130
Washing hair	p. 132
Assisted bathing	p. 133
Bathing a baby or infant	p. 134
Shaving	p. 134
Patient education	p. 136
Oral hygiene	p. 136
Assessment of oral hygiene needs	p. 136
Oral hygiene and dependent patients	p. 138
Denture care	p. 139
Tooth brushing	p. 139
Children	p. 140
Eye care	p. 140
Ear care	p. 142
Nasal care	p. 142
Hand and foot care	p. 142
Summary and key points	p. 142
References	p. 144
Answers	p. 144
Food and nutrition	p. 147
Learning objectives	p. 147
Introduction	p. 147
Screening and assessment	p. 148
The management of care	p. 152
A balanced diet	p. 153
Special diets	p. 153
Helping patients to eat and drink	p. 155
Swallowing	p. 156
Enteral feeding	p. 157
Intravenous routes	p. 157
Promoting healthy eating	p. 158
The eating environment	p. 159
Food safety	p. 160
Mealtimes	p. 160
Health promotion	p. 161
Summary and key points	p. 163
References	p. 163
Answers	p. 164
Continence, bowel and bladder care	p. 167
Learning objectives	p. 167
Introduction	p. 167
Continence	p. 168
Incontinence	p. 169
Causes	p. 169
Enuresis	p. 171
Encopresis	p. 171
Assessing risk	p. 171
Factors affecting elimination	p. 173
A suitable environment	p. 174
Common conditions	p. 175
Diarrhoea	p. 175
Urinary tract infection	p. 175
Catheterization	p. 176
Bladder training	p. 177
Assisting patients	p. 178
Constipation	p. 180
Continence beyond hospital	p. 182
Health education and promotion	p. 185
Summary and key points	p. 186
References	p. 187
Useful web resources	p. 187
Answers	p. 188
Pressure ulcers	p. 191
Learning objectives	p. 192
Introduction	p. 192
Skin integrity and blood flow	p. 192
Skin pigmentation	p. 193
How a pressure ulcer develops	p. 194
Other factors affecting vulnerability	p. 194
Classification	p. 196
Wounds	p. 196
Pressure ulcers	p. 196
Prevention	p. 197
Screening and assessment	p. 197
The Waterlow Risk Assessment Tool	p. 197
The Braden Scale	p. 198
Repositioning patients	p. 200
Prevention of injury during moving and handling	p. 200
Moving and handling assessment	p. 200
Repositioning a patient in a chair	p. 201
Types of mattresses and support surfaces	p. 201
Choosing a redistribution surface	p. 202
Should you reposition?	p. 202
Availability of resources and equipment	p. 203
Cleaning equipment	p. 203
Wound assessment	p. 204
Type of wound	p. 205
Location	p. 205
Shape and dimensions	p. 205
Photography	p. 205
Volume	p. 205
Type of tissue on the wound bed	p. 205
Type and amount of exudate	p. 206
Odour	p. 206
Margin and surrounding tissue	p. 206
Pain	p. 207
Infection	p. 207
Grading	p. 207
Dressings	p. 207
Healing	p. 207
Types of healing	p. 207
Aseptic techniques	p. 208
Changing a dressing	p. 209
Care planning	p. 210
Implementing the care plan	p. 210
Evaluating the care plan	p. 210
Interprofessional working	p. 210
Hospital directors and managers	p. 210
Doctors	p. 210
Tissue viability nurses	p. 210
Product evaluation nurses	p. 211
General nurses	p. 211
Student nurses	p. 211
Healthcare assistants	p. 211
Dieticians	p. 211
Occupational therapists	p. 211
Physiotherapists	p. 211
Porters	p. 211
Bioengineers and estates staff	p. 211
Equipment suppliers	p. 211
Patient involvement	p. 212
Summary and key points	p. 212
References	p. 213
Answers	p. 213
Glossary	p. 217
Index	p. 223
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