24,99 €
Mehr erfahren.
- Herausgeber: John Wiley & Sons
- Kategorie: Fachliteratur
- Serie: Rapid
- Sprache: Englisch
Rapid Adult Nursing is an essential read for all adult nursing students, as well as a refresher for qualified adult nurses, and a ‘dip into text’ for other healthcare professionals. Designed for quick reference, it maps on to the essential clinical skills and knowledge required for pre-registration adult nurses, and captures the essentials of adult nursing care in an easy to read, and highly accessible format.
Covering all the key topics in adult nursing, this concise and easy-to-read title is the perfect quick-reference book for student adult nurses.
Sie lesen das E-Book in den Legimi-Apps auf:
Seitenzahl: 192
Veröffentlichungsjahr: 2016
Ähnliche
Table of Contents
Cover
Title Page
Introduction
Acknowledgements
Part 1: Fundamentals of Nursing Care
A
Adult nursing
Assessment and monitoring
Audit
C
Communication
Continuing professional development
D
Dignity
Discharge planning
Documentation
E
Eating and drinking
Evaluation
Evidence‐based practice
F
Fundamentals of nursing care
H
Health education and promotion
I
Infection prevention and control
L
Leadership
M
Management
Medicines management
Moving and positioning
P
Practice development
Q
Quality improvement
R
Research
Risk assessment and management
T
Teamwork
W
Wound management
Part 2: Conditions
A
Acute coronary syndromes
Acute renal failure
Anaemias
Aneurysms
Angina
Appendicitis
Arrhythmias
Asthma
B
Breast lumps
Breathlessness
C
Cancer
Cardiovascular disorders
Cataracts
Cholecystitis
Chronic obstructive pulmonary disease
Chronic renal failure
Cirrhosis
Coagulation disorders
Constipation
Coronary heart disease
Crohn’s disease
D
Dementias
Diabetes mellitus
Diarrhoea
Diverticular disease
E
Eczema
Encephalitis
Endocrine disorders
End‐of‐life care
Epilepsy
F
Fractures
G
Gallstone disease
Gastritis
Gastroenteritis
Gastro‐oesophageal reflux disease
Glaucoma
Glomerulonephritis
Gout
H
Haemorrhoids
Hearing loss
Heart failure
Hepatitis
HIV
Hypertension
Hysterectomy
I
Immunodeficiency
Incontinence
J
Jaundice
L
Leukaemias
Life support: advanced adult
Life support: basic adult
Lymphomas
M
Macular degeneration
Meningitis
Multiple sclerosis
Myopathies
N
Nausea and vomiting
Neutropenia
O
Osteoarthritis
Osteomyelitis
Osteoporosis
P
Pain and discomfort
Pancreatitis
Parkinson’s disease
Peptic ulceration
Peripheral vascular disease
Platelet disorders
Pneumonia
Post‐operative care
Pre‐ and intra‐operative care
Prostate gland disorders
Psoriasis
R
Raised intracranial pressure
Respiratory failure
Rheumatoid arthritis
S
Sepsis
Shock
Spinal cord compression
T
Tension pneumothorax
Tinnitus
Tuberculosis
U
Ulcerative colitis
Urethritis
Urinary calculi
Urinary retention
Urinary tract infections
V
Vaginal discharge
Valve disease
Vascular disorders of the brain
Venous thromboembolism
References and Websites
Index
End User License Agreement
List of Illustrations
Chapter 01a
Figure 1 The clinical audit cycle.
Guide
Cover
Table of Contents
Begin Reading
Pages
iii
iv
viii
ix
2
2
3
4
5
6
7
8
9
10
11
12
13
14
15
16
17
18
19
21
22
23
24
25
26
27
29
30
32
33
34
35
36
37
38
39
40
41
42
43
44
45
46
47
48
49
50
51
52
53
54
55
56
57
58
59
60
61
62
63
64
65
66
67
68
69
70
71
72
73
74
75
76
77
78
79
80
81
82
83
84
85
86
87
88
89
90
91
92
93
94
95
96
97
98
99
100
101
102
103
104
105
106
107
108
109
110
111
112
113
114
116
117
118
119
120
121
122
123
124
125
Rapid Adult Nursing
Andrée le May
Professor Emerita of NursingSchool of Health SciencesUniversity of Southampton
This edition first published 2017 © 2017 by John Wiley and Sons, Ltd
Registered Office John Wiley & Sons, Ltd, The Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK
Editorial Offices 9600 Garsington Road, Oxford, OX4 2DQ, UKThe Atrium, Southern Gate, Chichester, West Sussex, PO19 8SQ, UK111 River Street, Hoboken, NJ 07030‐5774, USA
For details of our global editorial offices, for customer services and for information about how to apply for permission to reuse the copyright material in this book please see our website at www.wiley.com/wiley‐blackwell
The right of the author to be identified as the author of this work has been asserted in accordance with the UK Copyright, Designs and Patents Act 1988.
All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmitted, in any form or by any means, electronic, mechanical, photocopying, recording or otherwise, except as permitted by the UK Copyright, Designs and Patents Act 1988, without the prior permission of the publisher.
Designations used by companies to distinguish their products are often claimed as trademarks. All brand names and product names used in this book are trade names, service marks, trademarks or registered trademarks of their respective owners. The publisher is not associated with any product or vendor mentioned in this book. It is sold on the understanding that the publisher is not engaged in rendering professional services. If professional advice or other expert assistance is required, the services of a competent professional should be sought.
The contents of this work are intended to further general scientific research, understanding, and discussion only and are not intended and should not be relied upon as recommending or promoting a specific method, diagnosis, or treatment by health science practitioners for any particular patient. The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation any implied warranties of fitness for a particular purpose. In view of ongoing research, equipment modifications, changes in governmental regulations, and the constant flow of information relating to the use of medicines, equipment, and devices, the reader is urged to review and evaluate the information provided in the package insert or instructions for each medicine, equipment, or device for, among other things, any changes in the instructions or indication of usage and for added warnings and precautions. Readers should consult with a specialist where appropriate. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read. No warranty may be created or extended by any promotional statements for this work. Neither the publisher nor the author shall be liable for any damages arising herefrom.
Library of Congress Cataloging‐in‐Publication Data
Names: Le May, Andrée, author.Title: Rapid adult nursing / Andrée le May.Description: Chichester, West Sussex ; Hoboken, NJ : John Wiley & Sons, Inc., 2017. | Includes bibliographical references and index.Identifiers: LCCN 2016020348 | ISBN 9781119117117 (pbk.) | ISBN 9781119117124 (Adobe PDF) | ISBN 9781119117131 (epub)Subjects: | MESH: Nursing | Nursing Care–methods | Adult | HandbooksClassification: LCC RT51 | NLM WY 49 | DDC 610.73–dc23 LC record available at https://lccn.loc.gov/2016020348
A catalogue record for this book is available from the British Library.
Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.
Cover image: © sturti/iStock
Introduction
This book brings together up‐to‐date evidence and essential knowledge from various sources in an easy‐to‐follow, ‘quick’ introductory or revision text for student nurses.
It is designed to give you rapid access to key information. It is not designed to give you comprehensive information – you will need to read around the subject areas highlighted in this book to get that.
The first section provides information related to the essential components of excellent nursing, highlighting the skills that all students need to develop from the outset of their studies. The second section focuses on common conditions that you are likely to encounter.
Acknowledgements
The author is grateful to the following authors on whose works she drew in compiling this book.Brooker C and Nicol M (2011) (Eds) Alexander’s Nursing Practice. Edinburgh, Churchill Livingstone Elsevier.Davey P (2010) (Ed.) Medicine at a Glance. Oxford, Wiley Blackwell.Dougherty L and Lister S (2011) (Eds) The Royal Marsden Hospital Manual of Clinical Nursing Procedures. Student Edition. Oxford, Wiley Blackwell.Gabbay J and le May A (2011) Practice‐Based Evidence for Healthcare: Clinical Mindlines. Abingdon, Routledge.Grace P and Borley N (2009) (Eds) Surgery at a Glance. Oxford, Wiley Blackwell.le May A (2015) Adult Nursing at a Glance. Oxford, Wiley Blackwell.le May A and Holmes S (2012) Introduction to Nursing Research: Developing Research Awareness. London, Hodder Arnold.Macintosh M and Moore T (2011) (Eds) Caring for the Seriously Ill Patient. London, Hodder Arnold.O’Brien L (2012) (Ed.) District Nursing Manual of Clinical Procedures. Oxford, Wiley Blackwell.Peate I and Nair M (2011) (Eds) Fundamentals of Anatomy and Physiology for Student Nurses. Oxford, Wiley Blackwell.
Part 1Fundamentals of Nursing Care
A
Adult nursing
Definition
Adult nursing comprises the skilled, dignified care of adults. It focuses on acute and chronic physical conditions rather than mental illness. Adults are nursed in a variety of settings – the community, hospitals and longer‐term care settings.
Excellent care for adults through their lifespan is about what nurses do, and how nurses do it, in partnership with patients, their families and carers, as well as in collaboration with other members of the multi‐disciplinary health and social care team.
Fundamental to excellent nursing is the merging of technically competent care with the maintenance and/or enhancement of the patient’s (and their family’s and carer’s) dignity.
Care that is technically competent but does not promote the patient’s dignity is inadequate; care that promotes dignity but is not technically competent is also inadequate. Excellent nursing is therefore underpinned by the following:
Safeguarding dignity.
Skilled, appropriate communication.
Accurate assessment and monitoring.
Tailored symptom control and management.
Attentive risk assessment and management.
Tailored health education and promotion.
Thorough discharge planning.
Evaluation of the outcomes of care and care processes.
Use of the best evidence from research, theory, audit and service/practice development.
Nurses are accountable for the care they provide and must practise within the legal and ethical frameworks laid down by their professional and regulatory bodies.
Assessment and monitoring
Definition
Assessment is the systematic collection of key information to inform care. Monitoring is the regular updating of this information. Assessment and monitoring are iterative processes.
Accurate assessment and ongoing monitoring of a patient’s physical and mental health are critical to the provision of effective, safe and timely care and the plotting of progress/deterioration. Assessment and monitoring of the patient’s relatives’ responses to the illness/condition and its consequences also need to be conducted. All nurses, regardless of the healthcare setting in which they work, undertake various types of assessment and monitoring.
Skilled assessment is linked to the ability to prioritise care that needs to be done urgently (e.g. through using early‐warning scales) and care that can wait.
Successful assessment and monitoring involve nurses merging hard data (e.g. from measurement equipment and assessment scales) with soft data (e.g. from talking, watching and listening to patients, their families and their healthcare team members) to form a complete picture of the patient’s condition and their response(s) to it and to nursing care and treatments.
Assessments can range from the comprehensive (e.g. covering physical, psychological, social, emotional, spiritual and cultural dimensions) to the specific (e.g. taking a temperature or monitoring wound healing).
Making a comprehensive nursing assessment should be done in partnership with the patient and their family/carers and it underpins the delivery of care. All nursing assessments should inform and be informed by those made by other health and social care workers.
The specific assessment and monitoring of elements of a patient’s health can help in the early detection of general health problems (e.g. hypertension); in establishing the effectiveness of treatments (e.g. in type 1 diabetes); in determining the progression of an acute illness (e.g. an infection) or a long‐term condition (e.g. multiple sclerosis), the impact of one type of illness on another (e.g. an acute respiratory infection on asthma) and the generation of one illness because of another (e.g. depression resulting from chronic obstructive pulmonary disease).
Accurate baseline assessments are essential if improvement or deterioration of a patient’s health is to be identified swiftly and managed appropriately through ongoing monitoring.
The results of assessment and monitoring need to be accurately recorded in a patient’s care plan or notes.
Initial assessments and deviations from the expected course of a patient’s condition need to be effectively communicated to relevant healthcare team members. Using a structured approach to communicating your assessment and planning (e.g. SBAR: Situation, Background, Assessment and Recommendation) can be useful in effectively explaining requirements to patients, their families and members of the multi‐disciplinary team.
Following an initial nursing assessment, the majority of ongoing monitoring is likely to focus on four key areas:
The patient’s physical health and present condition set against the treatment plan.
The patient’s mental health and present condition set against the treatment plan.
Any special requirements the patient has.
The patient’s and the carer’s requirements for social support.
Audit
Definition
Audit is a cyclical process of measuring care against agreed criteria (or standards), deciding whether alterations need to be made to care, making changes, and measuring again to see whether the change has been effective. Audits are used to provide information that can help inform best practice and should be carried out regularly.
Figure 1 The clinical audit cycle.
Audit can be done either at a national or at a local level.
Copeland (2005, p. 16) provided the following criteria to help practitioners develop a good local audit:
Should be part of a structured programme.
Topics chosen should in the main be high risk; high volume or high cost or reflect National Clinical Audits, NSFs (National Service Frameworks) or NICE [National Institute for Health and Care Excellence] guidance.
Service users should be part of the clinical audit process.
Should be multidisciplinary in nature.
Clinical audit should include assessment of process and outcome of care.
Standards should be derived from good quality guidelines.
The sample size chosen should be adequate to produce credible results.
Managers should be actively involved in audit and in particular in the development of action plans from audit enquiry.
Action plans should address the local barriers to change and identify those responsible for service improvement.
Re‐audit should be applied to ascertain whether improvements in care have been implemented as a result of clinical audit.
Systems, structures and specific mechanisms should be made available to monitor service improvements once the audit cycle has been completed.
Each audit should have a local lead.
C
Communication
Definition
Communication is the transfer of information between one person and another, and their reaction to it. Communication permeates everything that nurses do, and being able to communicate effectively with patients, their families/carers and colleagues is an essential feature of skilled nursing practice. Skilled communication enhances care.
Communication includes a variety of different verbal and non‐verbal cues and skills. Verbal communication comprises speech and language – this includes the way we use words, tones and inflections; the way we phrase what we say; and the questions that we ask in order to communicate what we are thinking and feeling. Non‐verbal communication involves many things: touch, facial expressions, eye contact and the way we look at each other, gestures, body movements, posture and body positions, our use of space, the clothes we wear and our appearance, and even the timing of communication. Non‐verbal communication supports verbal communication, but it is a powerful way of communicating information on its own. Silence is also a powerful means of communication.
Written communications are important to convey information between members of the multi‐disciplinary team and to help patients and their families/carers retain information about their illness and treatment.
Communication is influenced by many things, including culture, age, mood, emotion, uncertainty, stress, anxiety, knowledge and skills. When considering patients and their families, it is important to remember that the effectiveness of communication can be affected by age‐related or disease‐linked problems, such as hearing loss, sight loss or alterations, speech alterations, emotions, mood, memory changes and cognitive impairment. Nurses need to minimise these barriers and also to reduce organisational barriers such as lack of privacy, having insufficient time to clarify uncertainties or misunderstandings, and communicating complicated information in noisy environments that make talking and hearing difficult. Altered mental capacity may mean that a patient is unable to communicate their wishes, understand information given to them or use it in decision making.
When communicating within the multi‐disciplinary team, it is also important to reduce barriers associated with busyness, stress and status. Using a structured approach to communication such as SBAR (i.e. giving details of the current Situation your patient is in, providing essential Background to this, giving your Assessment of what is happening and your Recommendation about what needs to happen next) is useful, especially in situations where urgent attention and clarity of information are needed.
Effective communication is about using the right verbal and non‐verbal skills for the person (or people) involved in each interaction. Useful communication skills include:
Establishing rapport.
Active and empathic listening.
Responding and being able to summarise information accurately.
Not being afraid to keep quiet (or to speak out).
Using questions to find out more (particularly open questions).
Using reinforcement (e.g. ‘go on’, nodding) to encourage communication.
Using story‐telling to find out more or engage people in conversation as appropriate.
Using touch appropriately, particularly expressive touch.
Observing people’s reactions and changing your communication style in response.
Being non‐judgemental and open.
Showing respect and maintaining dignity through both actions and words.
Remembering that the ‘little things’ (e.g. smiling and eye contact) are important.
Evaluating how well your interactions with people go is important in either reinforcing effective skills or improving things for next time.
Continuing professional development
Definition
Continuing professional development (CPD) is about ensuring that your knowledge and skills are up to date and that you remain competent to practise throughout your career. CPD is something that every healthcare professional has to do.
CPD is sometimes described as continuing personal and professional development (CPPD), and this reflects the breadth of opportunities that can count as CPD.
The Nursing and Midwifery Council (NMC) requirements for CPD must be met every time you renew your registration. For nurses working in the UK, CPD may include regularly updating skills and knowledge, reflecting on practice and their day‐to‐day work and teaching/mentoring others. All of these involve continuous learning and development. Taking part in and implementing the learning gained from these activities enables nurses to give safe, up‐to‐date, highly skilled care.
CPD is not, for instance, just about going on courses and collecting certificates – it involves thinking about how you will use your learning to develop yourself as well as your care. This self‐development can be structured by writing a personal development plan (PDP) and sharing it with your manager or mentor. A PDP helps you plan what you intend to learn or improve in the future. Clinical supervision also helps with your personal development.
All the CPD you do should be recorded in a portfolio. This will provide you with a useful record of what you have achieved, which will be helpful for constructing your curriculum vitae or for presentation to the NMC if it checks your CPD activities when you re‐register/re‐validate. Your portfolio should document what you have done, what you have learnt from it and how it has influenced your practice; it should make reference to your PDP.
CPD does not just have to be about developing clinical knowledge and skills. It is important to develop other skills as well in order to enhance the care that you provide. For example, you might choose to develop some managerial skills, delegation skills or leadership skills – all of these will make you a more competent practitioner.
All in all, CPD is about making you a more accomplished nurse.
D
Dignity
Definition
Dignity is often said to be hard to define. The available definitions tend to focus on either the professional view of dignity or the public’s view. The challenge is to integrate them.
Professional definitions of dignity are frequently abstract and are inclined to focus on the behaviours, values and attitudes that professionals need to have. For example, ‘Dignity is concerned with how people feel, think and behave in relation to the worth or value of themselves and others. To treat someone with dignity is to treat them as being of worth, in a way that is respectful of them as valued individuals’ (RCN, 2008).
Public reports (e.g. Francis, 2013) and research (e.g. Cairns et al., 2013), however, suggest that patients and the public see dignity in more pragmatic terms, focusing on whether or not certain important aspects of daily living can be completed while relying on others for assistance. These include having privacy, being able to go to the toilet when needed, being able to wash after using the toilet, having food and drink that can be consumed when needed and when wanted, being helped with eating and drinking if necessary, being listened to and having opinions respected.
Integrating the professional and the public views of dignity is important to the provision of excellent care, so that patients and their family feel that they have experienced competent, individualised care that allows them to maintain their dignity. Dignity is maintained in the following ways.
What nurses do, for instance:
Work with patients and their families/carers to identify and understand their individual needs and decide, with them, what care is required to meet these needs.
Undertake such care in a timely and respectful manner.
How nurses do it, for instance:
Treat each patient as an individual.
Listen to and respect their views.
Work in partnership with each patient and their family/carers.
Offer choice wherever possible.
Promote privacy.
Ensure that people can voice satisfaction and dissatisfaction with care without fearing reprisal.
When nurses do it, for instance:
