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Foreword to the ninth edition

As the Chief Nurse of the Royal Marsden Hospital NHS Foundation Trust, and a contributor and clinical user of the manual for many years, it is a special pleasure and honour to be asked to introduce the ninth edition of The Royal Marsden Manual of Clinical Nursing Procedures. The manual is internationally renowned and used by nurses across the world to ensure their practice is evidence based and effective. As information becomes ever more available to the consumers of healthcare, it is essential that the manual is updated frequently so that it reflects the most current evidence to inform our clinical practice.
More than ever in 2015, nurses need to be able to assure the public, patients and their families that care is based on the best available evidence. As nurses seeking to improve our care, it is essential that we are able to critically analyse our judgements in the light of current knowledge. For all of us working with patients and their families, there is an imperative to question and renew our practice using the many sources of knowledge available to us. In the busy world of clinical practice in a ward, unit or in the community, it can be challenging to find time to search for the evidence and this is where The Royal Marsden Manual of Clinical Nursing Procedures is a real practical help.
As in the eighth edition, reviewing the evidence or sources of knowledge has been made more explicit with each level of evidence graded. This grading provides the reader with an understanding of whether the reference comes from a randomized controlled trial, national or international guidance, or from expert opinion. At its best, clinical nursing care is an amalgam of a sensitive therapeutic relationship coupled with effective care based on the best evidence that exists. Some areas of practice have attracted international research such as cardiopulmonary resuscitation and infection prevention and control; other areas of practice have not attracted such robust research and, therefore, it is more of a challenge to ensure evidence‐based care. Each time a new edition of the manual is prepared we reflect on the gaps in research and knowledge; this provides the impetus to start developing new concept analyses and develop further research studies. In this new edition, the chapters have incorporated risk management, and legal and professional issues, as well as more guidelines for advanced nursing procedures, e.g. intraosseous injections. In addition, the procedures were tried out by the student nurses from Kingston University and St Georges University of London to ensure they worked in practice.
As you look at the list of contributors to the manual you will see that this edition has continued to be written by nurses who are expert and active in clinical practice. This has the double advantage of ensuring that this manual reflects the reality of practice, but also ensures that nurses at the Royal Marsden Hospital NHS Foundation Trust are frequently reviewing the evidence and reflecting upon their care.
A textbook devoted to improving and enhancing clinical practice needs to be alive to the clinical practitioner. You will see that this edition has continued the improvement in format, including many more figures and photographs to make the manual more effective in clinical care.
As I commend this ninth edition of The Royal Marsden Manual of Clinical Nursing Procedures to you, I am aware that it will be used in many different countries and settings. Having had the privilege of visiting and meeting nurses across the world I know that there are more commonalities than differences between us. The common theme is, of course, the need to ensure that we as nurses provide care that is individually and sensitively planned and that it is based on the best available evidence. The Royal Marsden Manual of Clinical Nursing Procedures is a wonderful resource for such evidence and I hope it will be widely used in all clinical settings across the world.
Finally, I would like to pay a warm tribute to the excellent work undertaken by the two editors, Lisa Dougherty and Sara Lister, and to all the nurses and allied health professionals at the Royal Marsden Hospital who have worked so hard on this ninth edition.
Dr Shelley Dolan
Chief Nurse
The Royal Marsden Hospital NHS
Foundation Trust
Clinical Director
London Cancer Alliance