Children and Young People's Nursing Skills at a Glance E-Book
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- Herausgeber: John Wiley & Sons
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- Serie: Wiley Series on Cognitive Dynamic Systems
- Sprache: Englisch
Children and Young People’s Nursing Skills at a Glance is the perfect companion for study and revision for pre-registration children’s nursing students. Highly visual, each clinical skill is covered in a two-page spread, with superb colour illustrations accompanied by clear informative text.
Providing up to date, evidence-based information on a wide range of clinical skills that are required by today’s children’s nurses, this comprehensive and accessible text makes it easy for the reader to grasp the fundamentals in order to meet the care needs of the child and family, both in the hospital and community setting. Structured around the key systems of the body, the book is divided into sixteen sections, and covers all the essential clinical skills, including:
- Principles of assessment
- Communication
- Record keeping
- Drug calculations and administration
- Safeguarding
- Care planning
- Respiratory and cardiac care
- Gastrointestinal care
- ECG reading and interpretation
- Neurological assessment
- Musculoskeletal care.
Aimed at both student nurses and those newly qualified, Children and Young People’s Nursing Skills at a Glance provides need to know, rapid information to ensure safe and effective clinical practice.
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Children and Young People's Nursing Skills at a Glance
Edited by
Elizabeth Gormley-Fleming
Head of Department for Nursing (Children's, Learning Disability and Mental Health) and Social Work School of Health and Social Work University of Hertfordshire Hatfield, UK
Deborah Martin
Senior Lecturer Children's Nursing University of Hertfordshire Hatfield, UK
Series Editor Ian Peate
This edition first published 2018 © 2018 John Wiley & Sons Ltd.
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The right of Elizabeth Gormley-Fleming and Deborah Martin to be identified as the authors of the editorial material in this work has been asserted in accordance with law.
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Library of Congress Cataloging-in-Publication Data are available
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CONTENTS
Contributors
Preface
Part 1: Assessing children: Principles
1 Initial assessment: subjective
Assessment overview
Subjective assessment
How to perform a subjective assessment
Subjective assessment according to age
Subjective assessment according to body system
Further reading
2 History taking
History taking overview
Communication skills in history taking
The history-taking process
Further reading
3 Principles of systematic assessment
Systematic assessment overview
The ABCDE approach
Primary – secondary – tertiary assessment
Systematic physical assessment
Assessment tools for a systematic approach
References
Further reading
4 Communication
Communication overview
Types of communication
Improving communication
5 Developmental considerations
Developmental considerations overview
6 Informed consent
Informed consent overview
Verbal, written and implied consent
Informed consent and capacity
Consent in under-16–18-year-olds
Parental responsibility
When consent is not necessary
Further reading
7 Safeguarding
Safeguarding policy drivers
Care, competence and engagement
Communication and compassion
Courage
References
Further reading
8 Family-centred care
Defining family-centred care
Competence in nursing assessment
Communication and negotiation of care
Participation in care
Reference
Further reading
9 Record keeping
Record-keeping overview
Principles of good record keeping
Care plan documentation
Handover documentation
Ethico-legal issues
Reference
Further reading
Part 2: Assessment of the child: Objective data
10 Planning care
Planning care overview
The nursing process
Models of nursing
References
Further reading
11 Airway and breathing
Airway and breathing overview
Difference between the child and adult airways
Signs of airway obstruction
Breathing in the lower airway
Physical examination and physical presentations
Further reading
12 Circulatory assessment
Circulatory assessment overview
Cardiac output
Inspection
Palpation
Auscultation
Fluid balance
13 Measuring blood pressure
Measuring blood pressure overview
Cuff size
Procedure for manual BP measurement with sphygmomanometer
Procedure for manual BP measurement with oscillometry
Invasive procedure
Further reading
14 Assessment of pain
Pain assessment overview
Assessing pain
Pain assessment tools
Behavioural assessment
Physiological assessment
Self-reported assessment
15 Moving and handling
Moving and handling overview
Legislation
Risk assessment
Anatomy and physiology
Principles of safe manual handling
Equipment
16 Measuring temperature
Measuring temperature overview
Choice of procedure
Equipment
Procedure
Further reading
17 Weight, BMI, height/length and head circumference
Weight, BMI, height/length and head circumference overview
Weight
Procedure for weighing infants
Procedure for weighing child
Body mass index (BMI)
Height and length
Head circumference
Further reading
18 Blood glucose monitoring
Blood glucose monitoring overview
Glucose and insulin
Why would you test blood glucose levels?
How is the test performed?
Normal blood glucose levels
Hyperglycaemia vs hypoglycaemia
Why do blood glucose levels needs to be controlled?
19 Skin integrity
Skin integrity overview
Tools for assessing skin integrity
Principles of skin care
References
Further reading
20 Pulse oximetry
Pulse oximetry overview
Normal value
Indications for use/clinical application
Limitations
Part 3: Drug administration
21 Principles of drug administration
Principles of drug administration overview
22 Drug calculations
Drug calculations overview
Dose by weight
Procedure
23 Administration of medication
Administration of medication overview
Oral drug administration
Administration via enteral tube
Intramuscular (IM) medication administration
Subcutaneous administration
Administration via the ear
Per rectum medication administration
24 Inhaled drug administration
Inhaled drug administration overview
Devices
25 Intranasal diamorphine
Intranasal diamorphine overview
Equipment
Patients
The nurse/practitioner
Contraindications
Administration
Additional points
Documentation
Reference
Further reading
26 Intravenous fluid administration
Intravenous fluid administration overview
Equipment
Procedure
Part 4: Respiratory
27 Spirometry
Spirometry overview
Technique
Procedure
Interpreting the results
28 Peak expiratory flow
Peak expiratory flow overview
Procedure
How is peak flow recorded and what are normal readings?
Reference
29 Arterial blood gas sampling
Arterial blood gas sampling overview
Procedure
Equipment
Blood gas interpretation
30 Oxygen administration
Oxygen administration overview
Administration of oxygen
Equipment
Procedure
Nasal cannulae
Simple face mask
Venturi mask
Non-rebreather mask
Head box
31 Suctioning
Suctioning overview
Clinical indications
Catheter size and suction pressure
Correct catheter length
Procedure
Complications of suctioning
32 Tracheostomy care
Tracheostomy care overview
Suctioning
Tape changes
Tube changes
Emergency care
Further reading
33 Non-invasive ventilation
Non-invasive ventilation overview
CPAP and BiPAP
Flow driver modes
Application of CPAP and nursing care
Procedure
Further reading
34 Underwater seal drain
Underwater seal drain overview
Care of the child
Part 5: Gastrointestinal
35 Infant feeding
Infant feeding overview
Choice of feeding method
Differences between breastmilk and formula milk
Supporting parents
36 Breastfeeding
Breastfeeding overview
Breastmilk
Principles to facilitate successful breastfeeding
Feeding/sucking pattern
Signs of successful breastfeeding
Tips to help mother with feeding
Breast feeding and HIV
References
37 Formula feeding
Formula feeding overview
Types of formula milk
Sterilizing equipment
Preparation of feeds
Feeding the baby
How much to feed the baby
38 Insertion of nasogastric and nasojejunal tubes
Insertion of nasogastric and nasojejunal tubes overview
Equipment
Insertion
Orogastric tubes
Nasojejunal tubes (NJT)
Equipment
Procedure
Insertion
Further reading
39 Nasogastric tube feeding
Nasogastric tube feeding overview
Equipment
Procedure
Bolus feed
Continuous feeding
Flushing out the NG tube
Further reading
40 Gastrostomy feeding
Gastrostomy feeding overview
Preparation and equipment
Procedure for bolus feed
Procedure for a pump feed
Part 6: Renal
41 Urine collection
Urine collection overview
General principles
Shared methodology
Methods of collection
42 Catheter insertion
Catheter insertion overview
Catheter selection
Procedure
43 Catheter care
Catheter care overview
Prevention of infection
General care principles
Removal of a catheter
Part 7: Neurological
44 Neurological assessment in children
Neurological assessment in children overview
Family involvement
Equipment
Primary assessment of neurological status
Secondary neurological assessment
Who does the assessment and for how long?
Documentation
References
45 Preparation for lumbar puncture
Preparation for a lumbar puncture overview
Role of the nurse
Equipment
Procedure
Side-effects of a lumbar puncture
Part 8: Musculoskeletal
46 Neurovascular assessment
Neurovascular assessment overview
47 Care of a cast
Care of a cast overview
Structure of a cast
‘Do’s and ‘don’t’s with a plaster cast
Compartment syndrome
48 Skin traction
Skin traction overview
Reasons for traction
Types of traction
Application types
Applying balanced traction
Types of extension tapes
Equipment
Procedure
Post-application care
Part 9: Skin
49 SteriStrip
TM
application
SteriStrip application overview
When to use SteriStrips
How to select the right size of SteriStrips
How to apply SteriStrips
Procedure
Care of SteriStrips
50 Wet wrapping in atopic eczema
Wet wrapping overview
Atopic eczema management
Topical corticosteroids in atopic eczema
Treatment using wet wrapping
Part 10: Cardiac
51 12-lead electrocardiography
12-lead electrocardiography overview
Preparation
Settings and artefact
Application of the leads
Record
Definitions
52 3-lead electrocardiography
3-lead electrocardiography overview
The conduction system
One complete cycle
Sinus rhythm
Calculating heart rate using the ECG
Factors that cause significant, life threatening ECG abnormalities
Reference
Part 11: Pre- and post-operative care
53 Pre-operative care and transfer to theatre
Pre-operative care and transfer to theatre overview
54 Post-operative recovery
Post-operative recovery overview
Part 12: Emergency Care
55 Basic life support (BLS)
Basic life support overview
Procedure
Basic life support (BLS) for an infant
Basic life support (BLS) for a child
Circulation check
Further reading
56 Advanced resuscitation of the infant and child
Advanced resuscitation of the infant and child overview
Definitions
Causes of cardiac arrest
ABCDE assessment
Parents
Human factors
Outcomes from cardiac arrest
Post-cardiac arrest care
57 Transfer of the critically ill child
Transfer of the critically ill child overview
Stabilization
Intubation/ventilation equipment and monitoring
Airway
Breathing
Circulation
Disability
Family
Part 13: Newborn
58 Phototherapy
Phototherapy overview
What is phototherapy?
Types of phototherapy
Equipment
Procedure
Potential hazards disadvantages
Further reading
59 Care of the umbilicus
Care of the umbilicus overview
Care at birth
Care after birth
Further reading
Part 14: Infection control
60 Hand washing
Hand-washing overview
Dangers of not carrying out hand hygiene
Carrying out hand hygiene
Hand hygiene movement steps
The five moments of carrying out hand hygiene
Hand care
61 Aseptic non-touch technique
Aseptic non-touch technique overview
What is ANTT?
Key parts
Infection control precautions
Non-sterile glove usage
Sterile glove usage
Clean working environment
Roles and responsibilities
Part 15: Haematology
62 Obtaining blood samples
Obtaining blood samples overview
Principles
Selection of a vein
Equipment
Procedure
Heel or finger prick
63 Transfusion of blood and blood components
Transfusion of blood and blood components overview
Why transfuse?
Blood groups
Transfusion procedure
Preparing the child for a transfusion
Receipt of blood component
The administration of blood/blood products
End of transfusion
Adverse reactions
Infective shock
64 Cannulation
Cannulation overview
Indications for use
Choice of device
Insertion site
Choosing a vein
Procedure
Equipment
Procedure
Cannula care
When to remove a cannula
How to remove a cannula
References
Part 16: End-of-life care
65 Care of the dying child
Care of the dying child overview
Communication
Involving children
Symptom management planning
Place of death
References
66 Care after death
Care after death overview
Legal requirements after death
Looking after the family
Care of the dead body
Storing the body after death
The grieving process
Supporting staff
Reference
Index
EULA
Guide
Cover
Table of Contents
Chapter
Pages
136
137
138
139
1
2
3
4
5
6
7
8
9
10
11
12
13
14
15
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E1
ix
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iv
C1
i
ii
iii
Contributors
Elizabeth Akers, Chapters 12, 51, 52
Ceri Baker, Chapters 15, 39
Catherine Beadle, Chapter 50
Hannah Chance, Chapter 32
Samia Choudhury, Chapter 57
Sue Collier, Chapter 7, 8
Julie Enright, Chapters 53, 54
Jenni Etchells, Chapters 65, 66
Erica Everett, Chapter 56
Lynn Fanning, Chapter 24
Liz Gormley-Fleming, Chapters 5, 11, 13, 14, 16, 17, 20, 21, 22, 23, 26, 30, 31, 34, 45, 46, 55, 62, 63
Heather Grant Davey, Chapter 6
Amy Halliday, Chapter 40
Anice Kavathekar, Chapter 29, 58
Sue Llewelyn, Chapters 47, 48
Gary Meager, Chapters 18, 61
Michele O'Grady, Chapters 25, 44
Amanda Parson, Chapters 49, 64
Julia Petty, Chapters 1, 2, 3, 9, 10, 19, 33, 59
Katrina Polfrey, Chapter 4
Sam Pollard, Chapter 11
Sarah Pratley, Chapters 27, 28
Sheila Roberts, Chapters 41, 42, 43
Gemma Tammas, Chapter 38
Maxine Wallis-Redworth, Chapters 35, 36, 37
Yasemin Zerzavatci, Chapter 60
Preface
The prime focus of this text book is to provide evidence-based information in an accessible and easy format for children's and young people's nurses. I hope that the reader will elicit the key points relevant to their practice to enable them to deliver care in a safe and effective manner. The information is delivered in a stimulating visual format along with succinct informative text.
It is not possible to capture the complete set of skills a children's nurse requires in this text book. As with any text book, the contemporary nature of practice is ever changing as new evidence becomes available and the contributors have aimed to keep abreast of this in the creation of this book. The emphasis has been placed on presenting the skills that are fundamental to the learner nurse to acquire during their period of pre-registration education to enable them to achieve competence by the end of their course. The challenge has been to condense the text into a format that identifies the pertinent points and omits unnecessary information. The drawing and photographs have been chosen to illustrate the key points and also to make this text appear interesting to a range of learners.
It must be acknowledged that the continuum of childhood ranges from the neonatal period through to arrival at adulthood, hence the inclusion of the age ranges where required. This is not an exhaustive set of clinical skills in this book pertinent to all within the continuum of childhood as there are other text books in this series such as those that address the neonate and learning disabilities, for example.
The education of nurses is currently undergoing significant changes and the challenge to provide up-to-date education remains constant. This At a Glance series will be of interest to current students, health care support workers who work with children and young people, registered nurses who wish to update or consult the literature, and to those future students undertaking associate nurse programmes or those on apprenticeship routes.
This book has been written by experienced practitioners and educators who are all passionate about delivering quality nursing care to the child or young person and their families. Without their contribution, this book would not have been possible, so thank you for contributing and for your time.
Liz Gormley-Fleming
Part 1: Assessing children: Principles
1Initial assessment: subjective
Assessment overview
Assessment is an important component of nursing practice, necessary for the planning and delivery of patient and family-centred care. A comprehensive nursing assessment includes both subjective (qualitative) and objective (quantitative/measurable) elements, namely, general appearance, patient history, physical examination and measurement of vital signs. Of these four components, the area of subjective assessment and observation of clinical appearance is the focus of the present chapter. Objective physical assessment, including history taking and monitoring will follow in subsequent chapters.
Subjective assessment
Subjective nursing assessment is an individualized, qualitative approach that does not use objective, measurements, tools or equipment. Rather, it is based on individualized clinical observation relating to the physical, emotional and behavioural characteristics of the child and family. Therefore, by its very nature, such a form of assessment can be open to interpretation and opinion. However, it also serves as an essential starting point to any holistic assessment of a child and family. Inspection and observation of general appearance and behaviour are therefore an integral part of an initial assessment before any objective data can be recorded. The skills of performing sound, clinical observation and judgement develop over time and through experience by nursing students and beyond into qualification. The importance of such skills should not be underestimated. It should also be remembered that parents or primary caregivers are best placed to recognize concerns and will report these based on subjective observations of changes in their child’s physical or emotional state. This information should be considered alongside nursing assessment data.
How to perform a subjective assessment
The initial nursing assessment of a child should be undertaken with a parent or known caregiver upon arrival to a ward, on pre-admission or, in the case of out-of-hospital care, at the first meeting following introduction to a new child and family in line with any referral for ongoing care. Ideally, initial assessment should be completed within 24 hours of admission and any key information should be documented clearly using appropriate records.
Observation can be carried out while taking the history and establishing rapport. This can be done in conjunction with observations by and from the parents, if present, along with sound clinical nursing judgement. For example, you can observe the child’s behaviour, level of understanding and general appearance on admission at first introduction and consider this with the parents’ own reports. General appearance of the child and family includes observation of their physical, behavioural and emotional state. At any age, considerations for the subjective assessment of the child or young person include:
Do they look well or unwell?
Are they pale, blue or flushed?
Are they moving, active or lethargic?
What is the general posture?
Are they agitated or calm?
Are they able to respond appropriately to questioning and are they obeying requests? Or are they resistant in their responses and reaction?
What is the family reaction and perceived emotional state?
Subjective assessment according to age
Care of the child encompasses a wide range of ages from newborn up to the adolescent period. Although some of the principles of assessing children are similar to assessing adults, children are not just small adults, and the approach to assessment and content can be quite different. Moreover, assessment changes in relation to what to observe as children develop and get older so that eventually, in the young person, it is similar to adults. The Figure aims to highlight the important differences to give some general principles and provide an outline of subjective assessment in different age groups. This emphasizes that the approach to subjective assessment is influenced by a child’s age, stage of development and level of understanding.
In the neonatal and infant period, physical assessment includes, for example, observation of facial features, symmetry, posture, movement and tone of the limbs. Behavioural elements include presence of a strong cry and normal responses to being held/consoled. Emotional elements include observation of interaction between them and their parents. In the young child, gross physical and fine motor skills can be observed according to age expectations, with refinement occurring as the child gets older. Age-appropriate speech and language can also be noted. Behaviour can be observed by a child’s mood and, again, interaction with parents. In an adolescent, similar points can be addressed but in line with behaviours applicable to teenage years, including level and type of communication and emotional reaction.
Subjective assessment according to body system
Subjective assessment can also be carried out according to the biological system, as is commonly used in the systematic approach to holistic physical examination. This will be covered in greater detail in Chapter 3. A full examination of all the systems is the most thorough way to gain a complete physical picture of the child or young person. The subjective components of these systems are displayed in the Figure.
To conclude, sound clinical judgement goes hand in hand with subjective nursing assessment and should be used to make decisions on the need for further, more objective, and possibly more invasive assessment methods.
Key points
Subjective nursing assessment should include inspection and general observation. These are the important parts of any initial assessment or examination, undertaken in conjunction with the parents or caregivers where possible.
Subjective assessment should include the physical, behavioural and emotional characteristics of the child or young person and their family.
The approach to subjective assessment is influenced by the age of the child or young person, their developmental stage and level of understanding.
Further reading
Broom, M. (2007) Exploring the assessment process. Paediatric Nursing,
19
(4), 22–25.
Engel, J. K. (2006)
Mosby’s Pocket Guide to Pediatric Assessment
, 5th edn. Mosby, New York.
Roland, D., Lewis, G. and Davies, F. (2011) Addition of a subjective nursing assessment improves specificity of a tool to predict admission of children to hospital from an emergency department. Pediatric Research, 70, 587.
3Principles of systematic assessment
Systematic assessment overview
Assessment of the child or young person and family is multi-faceted. The important components include subjective observation and history taking, as discussed in Chapters 1 and 2, along with objective measurements and monitoring data, depending on the individual situation. In order to manage the assessment process and ensure vital- elements are not missed, it is useful to employ a systematic approach to assessment that can guide the nurse through the process with a logical structure.
The ABCDE approach
The well-documented and recommended approach to systematic assessment is the ABCDE approach: Airway, Breathing, Circulation, Disability (Neurological), Exposure. Such a mnemonic-based approach has previously been highlighted by the use of SAMPLE for history taking (see Chapter 2) serving to guide assessment in a structured and logical way. The ABCDE mnemonic is endorsed by Resuscitation Councils worldwide. However, this approach does not just apply to resuscitation; it also applies to the context of emergency care or critical illness or injury as highlighted in the Figure.
The ABCDE approach is applicable in all clinical emergencies. It can be used in the street without any equipment or, in a more advanced form, upon the arrival of the emergency medical services, in emergency rooms, in general wards of hospitals, or in intensive care units. Each stage of the ABCDE approach is outlined in detail in the Figure.
The aims of the ABCDE approach are:
to provide life-saving treatment;
to break down complex clinical situations into more manageable parts;
to serve as an assessment and treatment algorithm;
to establish common situational awareness among all health professionals.
The ABCDE approach is applicable to all patients, both adults and children. The clinical signs of critical conditions are similar, regardless of the underlying cause. This makes exact knowledge of the underlying cause unnecessary when performing the initial assessment and treatment. The ABCDE approach should be used whenever critical illness or injury is suspected. It is a valuable tool for identifying or ruling out critical conditions in daily practice. Respiratory or cardiac arrest is often preceded by adverse clinical signs and these can be recognized by applying the ABCDE approach to potentially prevent this situation. ABCDE is also recommended as the first step in post-resuscitation care upon the return of spontaneous breathing and circulation.
It is important that the order from A through to E is maintained. For example, there is no point addressing circulation if the airway is not patent. In addition, regular reassessment is essential after each stage and remains the case in any event where a child deteriorates. The ABCDE approach and the importance of reassessment will be emphasized again in Chapters 56–59.
Primary – secondary – tertiary assessment
Systematic assessment can also be considered in relation to three phases: primary, secondary, and tertiary. ABCDE is part of primary assessment along with subjective observation (see Chapter 1). Once this has been undertaken and reassessment has confirmed a desired outcome (i.e. the situation is no longer life-threatening), then one can move to secondary assessment. This is a more thorough examination and focused history of the child or young person. History taking is covered in Chapter 2. Finally, further assessment by investigations and monitoring are part of the tertiary phase.
Systematic physical assessment
A structured approach to assessment can use the systems of the body in relation to the physical examination of a child. Such a method is used, for example, to examine newborn babies at discharge from hospital and neonates at their six-week postnatal check. A head-to-toe approach works through each of the systems. Conducting a head-to-toe assessment ensures that a nurse is thorough in the assessment of the child. By starting at the head and working down to the feet, this ensures that nothing is missed in any of the major body systems. This type of assessment means that a nurse is checking all systems for abnormalities and is less likely to miss any problems. The head-to-toe assessment follows a logical sequence starting at the head and neck, moves on to the chest, then to the abdomen and limbs.
Assessment tools for a systematic approach
In nursing practice, a systematic approach to assessment can be aided by the use of assessment tools. Mnemonics such as SAMPLE and ABCDE are tools in that they serve to guide practice logically in order to ensure a thorough assessment. Examples of other assessment tools are:
AVPU (
A
lert –
V
oice –
P
ain –
U
nresponsive): Measure the level of neurological response as part of the
D
(Disability / neurological) component of ABCDE: see later chapters.
Pain assessment tools: the presence of pain is assessed on a number of criteria comprising physiological, behavioural and biochemical signs. The score indicates the level of pain and guides appropriate analgesia. On a more simplistic level, pain can be assessed by asking a child to grade their pain from a selection of graded scores.
PEWS (
P
aediatric
E
arly
W
arning
S
core): see later chapters.
GCS (
G
lasgow
C
oma
S
cale); see later chapters.
Skin assessment tools (e.g. Braden Q and Glamorgan tools: see Chapter 19). Skin is assessed on a range of criteria, each one scored on a scale of 1–4 with the total score indicative of the risk of skin breakdown.
Key points
Assessment of the sick or injured child can be facilitated by a systematic approach, which gives a logical structure and avoids omissions.
The ABCDE framework is a well-documented and widely used systematic approach to assessment; an integral component of primary assessment.
Systematic assessment can be further assisted by the use of tools, which serve to guide assessment.
References
GOV.UK (2014) Newborn and infant physical examination: clinical guidance. Available at:
https://www.gov.uk/government/collections/newborn-and-infant-physical-examination-clinical-guidance
Resuscitation Council (UK) (2014) Guidelines and Guidance: The ABCDE Approach. Available at:
https://www.resus.org.uk/resuscitation-guidelines/abcde-approach/
Further reading
Dieckmann, R. A., Brownstein, D. and Gausche-Hill, M. (2010) The pediatric assessment triangle: a novel approach for the rapid evaluation of children. Pediatric Emergency Care,
26
(4), 312–315.
Jevon, P. (2012) Paediatric Advanced Life Support: A Practical Guide for Nurses, 2nd edn. Blackwell, Oxford.
NHS Institute for Innovation and Improvement (2013) PEWS charts. Available at:
http://www.institute.nhs.uk/safer_care/paediatric_safer_care/pews_charts.html
4Communication
Communication overview
Communication is an essential skill in the assessment and care of children, young people and their families. There are four main types of communication, each with sub-areas to aid the sharing and understanding of information.
Types of communication
Verbal
When communicating verbally, the type of language used should be considered, avoiding the use of jargon. For children and families whose first language is not English, interpreting services should be used, ensuring individual needs are met. The ability to understand, on the part of both child and family, should be considered, taking into account age, developmental level and cognitive ability, adapting the language and approach used as necessary.
