Essential Nursing Skills, Clinical skills for caring, 4th Edition

Essential Nursing Skills

4th Edition Clinical skills for caring

By Maggie Nicol, BSc(Hons) MSc PGDipEd RGN, Director, Centre for Excellence in Teaching and Learning, School of Community & Health Sciences, City University, London, UK ; Carol Bavin, RGN, RM, Dipn(Lond), RCNT, Lecturer, St Bartholomew School of Nursing & Midwifery, City University, London, UK; Patricia Cronin, RGN, BSc(Hons), MSc(Nursing), DipN(Lond), Lecturer in Nursing, School of Nursing & Midwifery, Trinity College, Dublin, Ireland; Karen Rawlings-Anderson, RGN, BA(Hons), MSc(Nursing), DipNEd, Senior Lecturer, St Bartholomew School of Nursing & Midwifery, City University, London, UK; Elaine Cole, BSc, MSc, PgDipEd, RGN, Senior Lecturer Emergency and Trauma Care, City University, London, UK and Janet Hunter


1 Infection prevention and control

1.1 Standard precautions

1.2 Aseptic non touch technique (ANTT)

1.3 Hand washing 1.4 Use of masks

1.5 Use of aprons

1.6 Use of gloves (non-sterile)

1.7 Disposal of waste and care of equipment

1.8 Taking a swab

1.9 Isolation (barrier nursing)

2 Observation and monitoring

2.1 Temperature recording - oral & axillary

2.2 Electronic thermometer - oral & axillary

2.3 Temperature recording: Tympanic membrane thermometer

2.4 Cooling the patient

2.5 Pulse recording

2.6 Assessment of breathing and counting respirations

2.7 Blood pressure recording

2.8 Cardiac monitoring

2.9 Recording a 12-lead ECG

2.10 Assessment of level of consciousness

2.11 Weighing patients

2.12 Measuring waist circumference

2.13 Measuring height

2.14 Care of the patient having a seizure

2.15 Neurovascular assessment

2.16 Blood glucose monitoring

2.17 Pain assessment

2.18 Patient-controlled analgesia (PCA) and epidural analgesia

2.19 Assessment of the deteriorating patient

2.20 Measuring capilliary refill time

3 Resuscitation

3.1 Assessment of collapsed person and recovery position 3.2 Basic life support with cardiopulmonary resuscitation (CPR) 3.3 Ward-based cardiopulmonary resuscitation 3.4 Automated external defibrillator (AED)

4 Vascular access and intravenous therapy

4.1 Venepuncture 4.2 Intravenous cannulation 4.3 Preparing an infusion 4.4 Changing an infusion bag 4.5 Regulation of flow rate 4. 6 Care of peripheral cannula site 4.7 Visual infusion phlebitis (VIP) score 4.8 Removal of peripheral cannula 4.9 Care of arterial line 4.10 Intravenous pumps and syringe drivers 4.11 Central venous catheters: care of the site 4.12 Central venous pressure measurement 4.13 Removal of central venous catheters 4.14 Care of long term central venous catheters

5 Blood transfusion

5.1 Blood transfusion 5.2 Care and management of a transfusion

6 Nutrition and hydration

6.1 Nutritional assessment

6.2 Assisting adults with eating and drinking 6.3 Nausea and vomiting 6.4 Subcutaneous fluids (hyperdermoclysis) 6.5 Nasogastric tube insertion 6.6 Nasogastric feeding 6.7 Care of gastrostomy site 6.8 Feeding via percutaneous endoscopic gastrostomy (PEG)/radiologically inserted gastrostomy (RIG)

7 Medicines management

7.1 Storage of medicines 7.2 Self-administration of medicines 7.3 Drug calculations 7.4 Principles of administration of medicines 7. 5 Oral route 7.6 Nasogastric route 7.7 Controlled drugs 7.8 Subcutaneous injection 7.9 Intramuscular injection 7.10 Intravenous drug administration 7.11 Instillation of nose drops/ nasal spray 7.12 Instillation of ear drops 7.13 Instillation of eye drops or ointment 7.14 Topical application 7.15 Vaginal preparations 7.16 Administration of suppositories 7.17 Respiratory route - metered dose inhaler 7.18 Variable dose intravenous infusions

8 Elimination

8.1 Observation of faeces 8.2 Obtaining a specimen of faeces 8.3 Administration of an enema 8.4 Assisting with a bedpan 8.5 Assisting with a commode 8.6 Assisting with a urinal 8.7 Monitoring fluid balance 8.8 Observation of urine 8.9 Application of a penile sheath 8.10 Urinalysis 8.11 Midstream specimen of urine 8.12 Catheter specimen of urine 8.13 24-hour urine collection 8.14 Early morning urine specimen 8.15 Female catheterisation 8.16 Male catheterisation 8.17 Urethral catheter care 8.18 Care of suprapubic catheter 8.19 Emptying a catheter bag 8.20 Continuous bladder irrigation 8.21 Bladder washout/lavage 8.22 Catheter removal 8.23 Stoma care 8.24 Changing a stoma bag

9 Peri-operative Care

9.1 Wound assessment

9.2 Aseptic dressing technique

9.3 Removal of skin closures: sutures/staples

9.4 Wound drainage

9.5 Changing a vacuum drainage bottle

9.6 Removal of wound drain

9.7 Topical negative pressure wound therapy

9.8 Peri-operative care

10 Patient hygiene

10.1 Assisting with a bath or shower

10.2 Bed bath

10.3 Oral assessment

10.4 Mouth care for a dependent patient

10.5 Facial shave

10.6 Washing hair in bed

10.7 Eye care

10.8 Caring for fingernails and toenails

10.9 Last offices

11 Respiratory care

11.1 Assessment of breathing and counting respirations

11.2 Positioning the breathless patient

11.3 Face masks and nasal cannulae

11.4 Humidified oxygen

11.5 Use of nebuliser

11.6 Peak expiratory flow rate

11.7 Pulse oximetry (oxygen saturation)

11.8 Observation of sputum

11.9 Obtaining a sputum specimen

11.10 Oral suctioning

11.11 Care of a tracheostomy

11.12 Tracheal suctioning

11.13 Insertion and management of chest drains

11.14 Chest drain removal

11.15 Non-invasive ventilation

12 Reduced mobility

12.1 Principles of moving and handling

12.2 Risk assessment of pressure ulcers

12.3 Prevention of pressure ulcers

12.4 Complications of immobility

12.5 Fitting anti embolism stockings

12.6 Falls prevention