9781405101615

Quick reference to the guidelines

xiii

Contributors to sixth edition

xvii

Foreword to sixth edition

xxi

Acknowledgements

xxiii

Introduction

xxv

Context of care

(15)

Introduction

(1)

Evidence-based practice: doing the right thing

(3)

Consent

(8)

Conclusion

(1)

References and further reading

(2)

Communication and assessment

(27)

Introduction

(1)

Communication

(9)

Principles of assessment

(11)

Conclusion

(1)

References and further reading

(7)

Abdominal paracentesis

(7)

Reference material

(3)

Procedure guidelines: Abdominal paracentesis

(1)

Procedure guidelines: Removal of an intraperitoneal drain (short term)

(1)

Problem solving

(1)

References and further reading

(2)

Aseptic technique

(14)

Reference material

(6)

Procedure guidelines: Aseptic technique

(1)

Procedure guidelines: Hand washing

(3)

References and further reading

(3)

Barrier nursing: nursing the infectious or immunosuppressed patient

(86)

Barrier nursing

(1)

Reference material

(2)

Source isolation

(1)

Reference material

(3)

Procedure guidelines: Source isolation

(4)

Protective isolation

(2)

Reference material

(2)

Procedure guidelines: Nursing the neutropenic patient

(2)

Acquired immune deficiency syndrome (AIDS)

(1)

Reference material

(5)

Human immunodeficiency virus 2 (HIV 2)

(1)

Reference material

(1)

Procedure guidelines: Acquired immune deficiency syndrome in a general ward

(5)

Antimicrobial-resistant organisms

(1)

Reference material

(5)

Aspergillosis

(1)

Reference material

(2)

Clostridium difficile

(1)

Reference material

(1)

Cryptosporidiosis

(1)

Reference material

(2)

Hepatitis

101

(1)

Hepatitis A

101

(1)

Reference material

101

(1)

Procedure guidelines: Hepatitis A

102

(1)

Hepatitis B

103

(1)

Reference material

103

(3)

Procedure guidelines: Hepatitis B

106

(3)

Non-A non-B hepatitis

109

(1)

Reference material

109

(1)

Procedure guidelines: Non-A non-B hepatitis

110

(1)

Hepatitis C

110

(1)

Reference material

110

(1)

Hepatitis D

111

(1)

Reference material

111

(1)

Hepatitis E

111

(1)

Reference material

111

(1)

Hepatitis B genotype F

112

(1)

Reference material

112

(1)

Hepatitis G

112

(1)

Reference material

112

(1)

The herpes viruses

112

(1)

Cytomegalovirus

112

(1)

Reference material

112

(2)

Epstein--Barr virus

114

(1)

Reference material

114

(1)

Herpes simplex virus

115

(1)

Reference material

115

(1)

Varicella zoster virus

116

(1)

Reference material

116

(2)

Legionnaire's disease

118

(1)

Reference material

118

(1)

Listeriosis

119

(1)

Reference material

119

(1)

Pneumocystosis

120

(1)

Reference material

120

(1)

Tuberculosis

121

(1)

Reference material

122

(3)

Transmissible spongiform encephalopathies

125

(1)

Reference material

125

(2)

References and further reading

127

(23)

Breast aspiration and seroma drainage

150

(8)

Breast aspiration

150

(1)

Reference material

150

(3)

Procedure guidelines: Breast aspiration

153

(2)

Seroma drainage

155

(1)

Procedure guidelines: Seroma drainage

156

(1)

References and further reading

157

(1)

Cardiopulmonary resuscitation

158

(12)

Reference material

158

(7)

Procedure guidelines: Cardiopulmonary resuscitation

165

(4)

References and further reading

169

(1)

Discharge planning

170

(14)

Reference material

170

(9)

Procedure guidelines: Discharge planning

179

(3)

References and further reading

182

(2)

Drug administration: general principles

184

(44)

Reference material

184

(9)

Injections and infusions

193

(8)

Procedure guidelines: Self-administration of drugs

201

(2)

Procedure guidelines: Oral drug administration

203

(2)

Procedure guidelines: Administration of injections

205

(5)

Procedure guidelines: Administration of rectal and vaginal preparations

210

(1)

Procedure guidelines: Topical applications of drugs

211

(1)

Procedure guidelines: Administration of drugs in other forms

211

(2)

Procedure guidelines: Administration of intravenous drugs by continuous infusion

213

(2)

Procedure guidelines: Administration of drugs by intermittent infusion

215

(3)

Procedure guidelines: Administration of drugs by direct injection, bolus or push

218

(2)

Problem solving

220

(4)

References and further reading

224

(4)

Drug administration: cytotoxic drugs

228

(31)

Reference material

228

(2)

Procedure guidelines: Protection of the environment

230

(3)

Procedure guidelines: Protection of staff during accidental exposure to cytotoxic drugs

233

(1)

Routes of administration

234

(1)

Intravenous administration

234

(1)

Reference material

235

(1)

Procedure guidelines: Intravenous administration of cytotoxic drugs

236

(2)

Extravasation of vesicant drugs

238

(1)

Reference material

238

(4)

Procedure guidelines: Management of extravasation when using a peripheral cannula

242

(2)

Oral administration

244

(1)

Reference material

245

(1)

Intramuscular and subcutaneous injection

245

(1)

Reference material

245

(1)

Topical application

245

(1)

Reference material

246

(1)

Intrathecal administration

246

(1)

Reference material

246

(1)

Intrapleural instillation

247

(1)

Reference material

248

(1)

Procedure guidelines: Administration of intrapleural drugs

248

(1)

Problem solving

249

(1)

Intravesical instillation

249

(1)

Reference material

249

(1)

Procedure guidelines: Intravesical instillation of cytotoxic drugs

250

(1)

Problem solving

251

(1)

Intraperitoneal administration

252

(1)

Reference material

252

(1)

Procedure guidelines: Intraperitoneal instillation of cytotoxic drugs

253

(1)

Problem solving

254

(1)

Intra-arterial administration

254

(1)

Reference material

254

(2)

Problem solving

256

(1)

References and further reading

256

(3)

Drug administration: delivery (infusion devices)

259

(16)

Reference material

260

(5)

Infusion devices

265

(1)

Gravity infusion devices

265

(1)

Infusion pumps

266

(3)

Summary

269

(1)

Procedure guidelines: Subcutaneous administration of drugs using a syringe driver (e.g. Sims (Graseby) Medical MS26)

270

(1)

Procedure guidelines: Preparation of the syringe for 24-hour drug administration using the Sims (Graseby) Medical MS26 syringe driver

270

(1)

Procedure guidelines: Priming the infusion set

271

(1)

Procedure guidelines: Inserting the winged infusion set or cannula

271

(1)

Problem solving

272

(2)

References and further reading

274

(1)

Elimination: bladder lavage and irrigation

275

(10)

Reference material

275

(3)

Procedure guidelines: Bladder lavage

278

(2)

Procedure guidelines: Administering a catheter maintenance solution

280

(1)

Procedure guidelines: Continuous bladder irrigation

281

(1)

Bladder irrigation recording chart

282

(1)

Problem solving

283

(1)

References and further reading

283

(2)

Elimination: bowel care

285

(19)

Reference material

285

(7)

Enemas

292

(1)

Reference material

292

(1)

Procedure guidelines: Administration of enemas

293

(1)

Problem solving

294

(1)

Suppositories

295

(1)

Reference material

295

(1)

Procedure guidelines: Administration of suppositories

295

(1)

Digital rectal examination

296

(1)

Procedure guidelines: Digital rectal examination

297

(1)

Manual evacuation

298

(1)

Rectal lavage

298

(1)

Reference material

299

(1)

Procedure guidelines: Administration of rectal lavage

300

(1)

Problem solving

301

(1)

References and further reading

302

(2)

Elimination: continent urinary diversions

304

(12)

Reference material

304

(6)

Teaching intermittent self-catheterization of a continent urinary diversion stoma

310

(1)

Reference material

310

(1)

Procedure guidelines: Self-catheterization of a continent urinary diversion stoma

311

(1)

Procedure guidelines: Flushing of urinary drainage tubes

312

(1)

Problem solving

313

(1)

Useful addresses

314

(1)

References and further reading

314

(2)

Elimination: stoma care

316

(14)

Reference material

316

(8)

Procedure guidelines: Stoma care

324

(1)

Procedure guidelines: Collection of a specimen of urine from an ileal conduit or urostomy

325

(1)

Procedure guidelines: Removal of stoma bridge or rod

326

(1)

Problem solving

327

(1)

Useful addresses

328

(1)

References and further reading

328

(2)

Elimination: urinary catheterization

330

(18)

Reference material

331

(4)

Procedure guidelines: Urinary catheterization

335

(4)

Procedure guidelines for Patients: Intermittent self-catheterization

339

(2)

Procedure guidelines: Collection of a catheter specimen of urine

341

(1)

Procedure guidelines: Emptying a catheter bag

342

(1)

Procedure guidelines: Removing a catheter

343

(1)

Problem solving

343

(3)

References and further reading

346

(2)

External compression and support in the management of lymphoedema

348

(14)

Reference material

349

(1)

Assessment of the patient with lymphoedema

349

(1)

Measurement of limb volume

350

(1)

Reference material

350

(1)

Procedure guidelines: Calculation of limb volume

351

(1)

Phases of treatment

352

(1)

Maintenance phase of treatment

352

(1)

Intensive phase of treatment

353

(2)

Procedure guidelines: The application of elastic compression garments

355

(1)

Procedure guidelines: Standard multilayer compression bandaging

356

(4)

References and further reading

360

(2)

Gene therapy for the management of cancer

362

(10)

Reference material

362

(5)

Procedure guidelines: Care of patients receiving gene therapy

367

(4)

Further advice

371

(1)

References and further reading

371

(1)

Haematological procedures: specialist, diagnostic and therapeutic

372

(8)

Reference material

373

(3)

Procedure guidelines: Bone marrow aspiration and trephine biopsy

376

(1)

Problem solving

377

(1)

Procedure guidelines: Bone marrow harvest

378

(1)

References and further reading

379

(1)

Intrapleural drainage

380

(11)

Reference material

380

(4)

Procedure guidelines: Chest drain insertion

384

(4)

Procedure guidelines: Removal of a chest drain

388

(1)

Problem solving

389

(1)

References and further reading

390

(1)

Last offices

391

(11)

Reference material

391

(1)

Procedure guidelines: Last offices

392

(2)

Problem solving

394

(2)

Procedure guidelines: Requirements for people of different religious faiths

396

(3)

References and further reading

399

(3)

Lumbar puncture

402

(7)

Reference material

403

(2)

Procedure guidelines: Lumbar puncture

405

(2)

Problem solving

407

(1)

References and further reading

408

(1)

Moving and handling of patients

409

(11)

Reference material

409

(8)

Summary

417

(1)

Procedure guidelines: Moving and handling of patients

418

(1)

References and further reading

418

(2)

Nutritional support

420

(22)

Reference material

421

(9)

Procedure guidelines: Nasogastric intubation with tubes using an introducer

430

(2)

Procedure guidelines: Nasogastric intubation with tubes without using an introducer, e. g. a Ryle's tube

432

(2)

Procedure guidelines: Care of a percutaneous endoscopically placed gastrostomy (PEG) tube

434

(1)

Procedure guidelines: Care of a radiologically inserted gastrostomy (RIG) tube

435

(1)

Procedure guidelines: Care of a jejunostomy feeding tube

435

(1)

Procedure guidelines: Administration of drugs via enteral feeding tubes

436

(1)

Procedure guidelines: Unblocking an enteral feeding tube

437

(1)

Problem solving

438

(2)

References and further reading

440

(2)

Observations

442

(43)

Pulse

442

(1)

Reference material

443

(3)

Procedure guidelines: Pulse

446

(1)

12 Lead electrocardiogram (ECG)

446

(1)

Procedure guidelines: 12 Lead ECG

446

(2)

Blood pressure

448

(1)

Reference material

448

(6)

Procedure guidelines: Manual blood pressure

454

(1)

Respiration

455

(1)

Reference material

455

(6)

Procedure guidelines: Pulse oximetry

461

(1)

Peak flow

462

(1)

Reference material

462

(1)

Procedure guidelines: Peak flow reading using manual peak flow meter

463

(1)

Temperature

464

(1)

Reference material

465

(4)

Procedure guidelines: Temperature

469

(1)

Urinalysis

470

(1)

Reference material

470

(1)

Characteristics of urine

471

(2)

Procedure guidelines: Reagent sticks

473

(1)

Blood glucose

473

(1)

Reference material

474

(3)

Procedure guidelines: Blood glucose monitoring

477

(1)

Central venous pressure

478

(2)

Procedure guidelines: Reading central venous pressure

480

(1)

Problem solving

481

(1)

References and further reading

481

(4)

Observations: neurological

485

(11)

Reference material

485

(7)

Procedure guidelines: Neurological observations and assessment

492

(3)

References and further reading

495

(1)

Pain management and assessment

496

(17)

Reference material

496

(13)

Procedure guidelines: Patient assessment and Preparation before surgery: optimizing pain control

509

(1)

Procedure guidelines: Using a chronic pain chart

509

(1)

References and further reading

510

(3)

Pain management: Entonox administration

513

(6)

Reference material

514

(2)

Procedure guidelines: Entonox administration

516

(1)

Problem solving

517

(1)

References and further reading

518

(1)

Pain management: epidural analgesia

519

(17)

Reference material

520

(4)

Epidural analgesia for patients with intractable cancer pain

524

(1)

Procedure guidelines: Insertion of an epidural catheter

525

(1)

Problem solving: Management of side-effects associated with epidural infusions of local anaesthetic agents and opioids

526

(2)

Problem solving: Complications of epidural use and management

528

(1)

Procedure guidelines: Topping up epidural analgesia

528

(1)

Procedure guidelines: Removal of an epidural catheter

529

(1)

Procedure guidelines: Preinsertion management of an epidural for chronic pain

530

(1)

Procedure guidelines: Changing the dressing over the epidural exit site

530

(1)

Procedure guidelines: Postinsertion monitoring of respiratory and cardiac function in chronic pain management

531

(1)

Procedure guidelines: Setting up the epidural infusion (utilizing a syringe pump or driver)

532

(1)

Procedure guidelines: Setting up the epidural infusion (utilizing an ambulatory pump)

532

(1)

Procedure guidelines: Discharge planning

533

(1)

Problem solving

534

(1)

References and further reading

535

(1)

Perioperative care

536

(17)

Preoperative care

536

(1)

Reference material

536

(2)

Procedure guidelines: Preoperative care

538

(2)

Intraoperative care

540

(1)

Reference material

540

(2)

Procedure guidelines: Intraoperative care

542

(2)

Postanaesthetic recovery

544

(1)

Reference material

544

(1)

Procedure guidelines: Postanaesthetic recovery

545

(2)

Problem solving

547

(2)

Procedure guidelines: Postoperative recovery

549

(2)

References and further reading

551

(2)

Personal hygiene: eye care

553

(17)

Reference material

553

(9)

Procedure guidelines: Eye swabbing

562

(1)

Procedure guidelines: Eye swabbing for comatose patients

563

(1)

Procedure guidelines: Care of artificial eyes

564

(1)

Procedure guidelines: Care of contact lenses

565

(1)

Procedure guidelines: Instillation of eye drops

566

(1)

Procedure guidelines: Installation of eye ointment

567

(1)

Procedure guidelines: Eye irrigation

568

(1)

References and further reading

569

(1)

Personal hygiene: mouth care

570

(10)

Reference material

570

(5)

Procedure guidelines: Mouth care

575

(2)

Problem solving

577

(1)

References and further reading

577

(3)

Personal hygiene: skin care

580

(7)

Reference material

580

(4)

Procedure guidelines: Bed bathing a patient

584

(1)

References and further reading

585

(2)

Radioactive source therapy: sealed sources

587

(23)

Sealed radioactive source therapy

587

(1)

Reference material

587

(6)

Remote afterloading

593

(1)

Reference material

594

(3)

Procedure guidelines: Care of patients with insertions of sealed radioactive sources

597

(3)

Procedure guidelines: Care of patients with intraoral sources

600

(1)

Procedure guidelines: Care of patients with manually and after loaded iridium and caesium gynaecological sources

601

(1)

Procedure guidelines: Removal of gynaecological caesium and indium wires

601

(2)

Problem solving

603

(1)

Procedure guidelines: Care of patients undergoing Selection treatment

603

(1)

Procedure guidelines: Removal of Selectron applicators

604

(1)

Problem solving

605

(1)

Procedure guidelines: Care of patients with radioactive seeds (e.g. iodine-125)

605

(1)

Procedure guidelines: Care of patients with breast sources

606

(1)

Procedure guidelines: Interstitial perineal template (Hammersmith hedgehog)

606

(2)

Useful websites

608

(1)

References and further reading

608

(2)

Radioactive source therapy and diagnostic procedures: unsealed sources

610

(19)

Reference material

611

(9)

Procedure guidelines: Care of the patient before administration of iodine-131

620

(1)

Procedure guidelines: Care of the patient receiving iodine-131 thyroid treatment

620

(1)

Procedure guidelines: Care of the patient receiving iodine-131 mIBG treatment

620

(1)

Procedure guidelines: Care of the patient after administration of unseated source therapy

621

(2)

Procedure guidelines: Care of the patient receiving unsealed sources for diagnostic investigations

623

(1)

Procedure guidelines: Emergency procedures

624

(2)

References and further reading

626

(3)

Renal replacement therapy: peritoneal dialysis and continuous venovenous haemodiafiltration

629

(12)

Reference material

629

(1)

Peritoneal dialysis (PD)

630

(1)

Reference material

630

(2)

Continuous renal replacement therapy (CRRT)

632

(1)

Reference material

632

(1)

Procedure guidelines: Peritoneal dialysis

633

(2)

Problem solving

635

(2)

Procedure guidelines: Preparation of equipment for CWHDF utilizing a CWHDF device

637

(1)

Procedure guidelines: Commencement of CWHDF

638

(1)

References and further reading

639

(2)

Respiratory therapy

641

(15)

Reference material

641

(6)

Continuous positive airway pressure (CPAP)

647

(1)

Reference material

647

(3)

Procedure guidelines: Pre-continuous positive airway pressure (CPAP)

650

(1)

Procedure guidelines: Setting up continuous positive airway pressure (CPAP)

651

(1)

Procedure guidelines: Humidification

652

(1)

Problem solving: Oxygen therapy by nasal cannulae or oxygen mask

652

(1)

Problem solving: CPAP

653

(2)

References and further reading

655

(1)

Scalp cooling

656

(7)

Reference material

657

(2)

Procedure guidelines: Scalp cooling

659

(1)

Problem solving

660

(1)

References and further reading

661

(2)

Specimen collection for microbiological analysis

663

(14)

Reference material

663

(5)

Procedure guidelines: Specimen collection

668

(6)

Procedure guidelines: Analysis of drug levels in blood

674

(1)

References and further reading

675

(2)

Spinal cord compression management

677

(11)

Reference material

677

(3)

Procedure guidelines: Care of patients with spinal cord compression

680

(5)

Problem solving

685

(1)

References and further reading

686

(2)

Tracheostomy care and laryngectomy voice rehabilitation

688

(17)

Tracheostomy care

688

(1)

Reference material

689

(6)

Laryngectomy voice rehabilitation

695

(1)

Reference material

695

(3)

Procedure guidelines: Changing a tracheostomy dressing

698

(1)

Procedure guidelines: Suctioning a patient with a tracheostomy

698

(2)

Humidification

700

(1)

Procedure guidelines: Humidification

700

(1)

Procedure guidelines: Changing a tracheostomy tube

700

(2)

Problem solving

702

(1)

Procedure guidelines: Changing a Blom--Singer type non-indewelling voice prosthesis

703

(1)

References and further reading

703

(2)

Transfusion of blood, blood products and blood substitutes

705

(14)

Reference material

705

(11)

Problem solving

716

(1)

References and further reading

717

(2)

The unconscious patient

719

(5)

Reference material

720

(1)

Procedure guidelines: Care of the unconscious patient

721

(2)

References and further reading

723

(1)

Vascular access devices: insertion and management

724

(50)

Reference material

724

(5)

Peripheral cannulae

729

(1)

Reference material

729

(4)

Midline catheters

733

(1)

Reference material

733

(1)

Central venous access devices

734

(1)

Peripherally inserted central catheters

735

(1)

Reference material

735

(2)

Short-term percutaneous central venous catheters (non-tunnelled)

737

(1)

Reference material

737

(2)

Skin-tunnelled catheters

739

(1)

Reference material

740

(2)

Implantable ports

742

(1)

Reference material

742

(1)

Discharging patients home with a VAD in situ

743

(1)

Quality of life issues: living with a VAD

744

(1)

Procedure guidelines: Inserting a peripheral cannual

745

(1)

Procedure guidelines: Inserting a midline catheter

746

(2)

Procedure guidelines: Insertion and removal of a peripherally inserted central catheter (PICC)

748

(2)

Procedure guidelines: Changing the dressing on a central venous catheter insertion site

750

(1)

Procedure guidelines: Maintaining patency of a central venous access device

751

(1)

Procedure guidelines: Taking blood samples from a central venous access device

752

(2)

Procedure guidelines: Unblocking an occluded catheter

754

(2)

Procedure guidelines: Insertion and removal of non-coring needles in implantable ports

756

(2)

Procedure guidelines: Removal of a non-skin-tunnelled central venous catheter

758

(1)

Procedure guidelines: Surgical removal of a skin-tunnelled central venous catheter

758

(3)

Problem solving

761

(2)

Arterial cannulae

763

(1)

Reference material

763

(2)

Procedure guidelines: Setting up the monitoring set and preparation for insertion of an arterial cannula

765

(1)

Procedure guidelines: Taking a blood sample from an arterial cannula

766

(2)

Procedure guidelines: Removal of an arterial cannula

768

(1)

Problem solving

768

(1)

References and further reading

769

(5)

Venepuncture

774

(12)

Reference material

774

(5)

Procedure guidelines: Venepuncture

779

(3)

Problem solving

782

(2)

References and further reading

784

(2)

Violence: prevention and management

786

(61)

Reference material

787

(5)

Procedure guidelines: Prevention and management of violence

792

(2)

References and further reading

794

(2)

Wound management

796

(1)

Reference material

796

(14)

Leg ulceration

810

(1)

Reference material

810

(2)

Pressure ulcers or decubitus ulcers

812

(1)

Reference material

812

(6)

Fungating wounds

818

(1)

Reference material

818

(4)

Radiotherapy skin damage

822

(1)

Reference material

823

(2)

Plastic surgery wounds

825

(1)

Reference material

825

(1)

Scarring

826

(1)

Reference material

826

(1)

Procedure guidelines: Changing wound dressings

827

(1)

Procedure guidelines: Removal of sutures, clips or staples

828

(1)

Procedure guidelines: Drain dressing (Redivac -- closed drainage systems)

829

(1)

Procedure guidelines: Change of vacuum drainage system

829

(1)

Procedure guidelines: Removal of drain (Yeates vacuum drainage system)

830

(1)

Procedure guidelines: Shortening of drain (Penrose, etc., open drainage systems)

831

(1)

Procedure guidelines: Prevention of pressure ulcers

831

(1)

Procedure guidelines: Sharp debridement

832

(1)

Procedure guidelines: VAC ATS dressing

833

(2)

References and further reading

835

(8)

Appendices

Appendix 1: Contributors to previous editions

843

(2)

Appendix 2: Patient information booklets

845

(2)

Index

847

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The Royal Marsden Hospital Manual of Clinical Nursing Procedures, 6th Edition

140510161X

Summary

Author Biography

Table of Contents

Supplemental Materials

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