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Part One Managing the patient journey
- Select to go to chapter navigation index2Admissions and assessment
- Select to go to chapter navigation index3Discharge care and planning
- Select to go to chapter navigation index4Infection prevention and control
- Overview
- Infection prevention and control
- Hand hygiene
- Personal protective equipment (PPE)
- Specific patient‐related procedures
- Isolation procedures
- Environmental hygiene and the management of waste in the healthcare environment
- Prevention and management of inoculation injury
- References
- Procedures
- Hand washing
- Hand decontamination using an alcohol‐based handrub
- Surgical scrub technique using soap and water
- Surgical scrub technique using an alcohol‐based handrub
- Putting on and removing non‐sterile gloves
- Applying and removing a disposable apron
- Putting on and removing a disposable mask or respirator
- Putting on or removing goggles or a face‐shield
- Donning a sterile gown and gloves: closed technique
- Donning sterile gloves: open technique
- Aseptic technique example: changing a wound dressing
- Source isolation: preparing an isolation room
- Source isolation: entering an isolation room
- Source isolation: leaving an isolation room
- Source isolation: transporting infected patients outside a source isolation area
- Protective isolation: preparing an isolation room
- Protective isolation: entering an isolation room
- Cleaning a hard surface without recontamination
- Safe disposal of foul, infected or infested linen
Part Two Supporting patients with human functioning
- Select to go to chapter navigation index5Communication, psychological wellbeing and safeguarding
- Overview
- Communication
- Providing information and making shared decisions
- Communicating with specific populations
- Psychological wellbeing
- Safeguarding, mental capacity and the Mental Health Act
- Safeguarding
- Definition
- Related theory
- Clinical governance
- Pre‐procedural considerations
- Principles of mental capacity assessment
- Post‐procedural considerations
- Deprivation of Liberty Safeguards (2009)
- Related theory
- Evidence‐based approaches
- Pre‐procedural considerations
- Principles of using the Mental Health Act
- Post‐procedural considerations
- Related theory
- References
- Select to go to chapter navigation index6Elimination
- Overview
- Normal elimination
- Altered urinary elimination
- Altered faecal elimination
- Stoma care
- References
- Procedures
- Slipper bedpan use: assisting a patient
- Commode use: assisting a patient
- Penile sheath application
- Urinary catheterization: male
- Urinary catheterization: female
- Changing a suprapubic catheter
- Urinary catheterization: intermittent self‐catheterization patient guidance: male
- Urinary catheterization: intermittent self‐catheterization patient guidance: female
- Urinary catheter bag: emptying
- Urinary catheter removal
- Commencing bladder irrigation
- Nephrostomy tube: weekly dressing and bag change and sample collection
- Nephrostomy tube: flushing technique
- Nephrostomy tube: removal of locking pigtail drainage system
- Flushing externalized ureteric stents
- Removal of externalized ureteric stents
- Continent urinary diversion stoma: self‐catheterization
- Insertion of a faecal management system
- Insertion of a nasogastric drainage tube
- Removal of a nasogastric drainage tube
- Enema administration
- Suppository administration
- Digital rectal examination
- Digital removal of faeces
- Stoma siting
- Stoma bag change
- Obtaining a clean‐catch urine sample from an ileal conduit
- Stoma bridge or rod removal
- Select to go to chapter navigation index7Moving and positioning
- Overview
- Moving and positioning: general principles
- Definition
- Anatomy and physiology
- Evidence‐based approaches
- Clinical governance
- Pre‐procedural considerations
- Prevention of falls
- Positioning a patient: in bed
- Positioning a patient: sitting up in bed
- Positioning a patient: side‐lying
- Moving a patient from sitting to standing
- Positioning a patient: in a chair or wheelchair
- Walking
- Moving and positioning an unconscious patient
- Moving and positioning a patient with an artificial airway
- Moving and positioning a patient with respiratory compromise
- Moving and positioning a patient with neurological impairment
- Moving and positioning a patient with actual or suspected spinal cord compression or spinal cord injury
- Moving and positioning a patient with raised intracranial pressure
- Moving and positioning a patient with an amputation
- References
- Procedures
- Positioning a patient: supine
- Positioning a patient: sitting up in bed
- Positioning a patient: side‐lying
- Positioning a patient: lying down to sitting up
- Moving a patient from sitting to standing: assisting the patient
- Positioning a patient: in a chair or wheelchair
- Assisting a patient to walk
- Positioning an unconscious patient or a patient with an artificial airway in supine
- Positioning an unconscious patient or a patient with an artificial airway in side‐lying
- Positioning a neurological patient with tonal problems in bed
- Positioning a neurological patient with tonal problems in a chair
- Application of a two‐piece cervical collar
- Log rolling a patient with suspected or confirmed cervical spinal instability (above T6)
- Log rolling a patient with suspected or confirmed thoracolumbar spinal instability (T7 and below)
- Early mobilization of a patient with spinal considerations
- Positioning a patient with an amputation
- Select to go to chapter navigation index8Nutrition and fluid balance
- Overview
- Fluid balance
- Nutritional status
- Provision of nutritional support: Oral
- Nutritional management of patients with dysphagia
- Enteral tube feeding
- Parenteral nutrition
- References
- Procedures
- Fluid input: measurement
- Fluid output: monitoring/measuring output if the patient is catheterized
- Fluid output: monitoring/measuring output if the patient is not catheterized
- Fluid output: monitoring/measuring output from drains
- Fluid output: monitoring/measuring output from gastric outlets, nasogastric tubes or gastrostomy
- Fluid output: monitoring/measuring output from bowels
- Fluid output: monitoring/measuring output from stoma sites
- Measuring the weight and height of a patient
- Feeding an adult patient
- Nasogastric intubation with tubes using an internal guidewire or stylet
- Removal of a nasogastric tube
- Percutaneous endoscopically placed gastrostomy (PEG) tube care
- Radiologically inserted gastrostomy (RIG) tube care
- Removal of T‐fasteners
- Changing the balloon water and checking the volume of a balloon gastrostomy
- Jejunostomy feeding tube care including dressing change
- Insertion of a silicone gastrostomy stoma plug
- Enteral feeding tubes: administration of feed using an enteral feeding pump
- Enteral feeding tubes: administration of medication
- Enteral feeding tubes: unblocking
- Select to go to chapter navigation index9Patient comfort and supporting personal hygiene
- Overview
- Personal hygiene
- Sleep promotion in a hospitalized patient
- Patient environment
- Eye care
- Ear care
- Mouth care
- References
- Procedures
- Bedbathing a patient
- Washing a patient's hair in bed
- Shaving the face: wet shave
- Shaving the face: dry electric shaver
- Making an unoccupied bed
- Making an occupied bed
- Eye swabbing
- Eye irrigation
- Artificial eye care: insertion
- Artificial eye care: removal
- Contact lens removal: hard lenses
- Contact lens removal: soft lenses
- Irrigation of the external auditory canal using an electronic irrigator
- Mouth care
- Mouth care for a patient with dentures
- Select to go to chapter navigation index10Pain assessment and management
- Overview
- Pain
- Pain management
- Regional analgesia: local anaesthetic nerve blocks and infusions
- Epidural analgesia
- Entonox administration
- Non‐pharmacological methods of managing pain
- References
- Procedures
- Pain assessment
- Peripheral nerve catheter removal
- Epidural sensory blockade: assessment
- Epidural exit site dressing change
- Epidural catheter removal
- Entonox administration
- Preparation for acupuncture and actions post‐treatment
- Select to go to chapter navigation index11Symptom control and care towards the end of life
- Select to go to chapter navigation index12Respiratory care, CPR and blood transfusion
- Overview
- Respiratory therapy
- Oxygen therapy
- High‐flow oxygen via a nasal cannula
- Humidification
- Non‐invasive ventilation
- Chest drain management
- Tracheostomy and laryngectomy care
- Definition
- Anatomy and physiology
- Related theory
- Evidence‐based approaches
- Clinical governance
- Pre‐procedural considerations
- Tracheostomy: dressing and tube tape or tie change
- Tracheostomy: suctioning
- Tracheostomy: changing an inner cannula
- Tracheostomy: changing a tube
- Tracheostomy: applying a speaking valve
- Tracheostomy: decannulation
- Tracheostomy: emergency care and recannulation
- Laryngectomy
- Laryngectomy: humidification
- Laryngectomy: communication
- Laryngectomy: care and emergency management
- Basic life support
- Transfusion of blood and blood components
- Definition
- Anatomy and physiology
- Related theory
- Evidence‐based approaches
- Clinical governance
- Pre‐procedural considerations
- Post‐procedural considerations
- Complications: general
- Complications: pulmonary
- Complications: minor transfusion reactions
- Complications: major transfusion reactions
- Complications: delayed transfusion reactions
- References
- Procedures
- Oxygen therapy
- High‐flow oxygen therapy
- Continuous positive airway pressure (CPAP)
- Chest drain: assisting insertion
- Chest drainage: suction
- Chest drain: changing the bottle
- Chest drain: removal
- Tracheostomy: dressing and tube tape/tie change
- Tracheostomy: suctioning a patient (single‐use suction catheter)
- Tracheostomy: changing an inner cannula
- Tracheostomy: changing a tube
- Tracheostomy: insertion and removal of a speaking valve
- Tracheostomy: decannulation
- Tracheostomy: emergency management
- Laryngectomy care
- Insertion of an oropharyngeal airway
- Basic life support
- Blood product request
- Blood sampling: pre‐transfusion
- Blood components: collection and delivery to the clinical area
- Blood component administration
Part Three Supporting patients through the diagnostic process
- Select to go to chapter navigation index13Diagnostic tests
- Overview
- Diagnostic tests
- Blood sampling
- Venepuncture: obtaining blood samples from a peripheral vein
- CVAD sampling: sampling from a central venous access device
- Arterial blood sampling
- Blood cultures
- Antimicrobial drug assay
- Cerebrospinal fluid obtained by lumbar puncture
- Semen collection and analysis
- Cervical screening
- Specimen collection: swab sampling
- Specimen collection: urine sampling
- Specimen collection: faecal sampling
- Specimen collection: respiratory tract secretion sampling
- Specimen collection: pleural fluid
- Endoscopic investigations
- Liver biopsy
- Radiological investigations: X‐ray
- Magnetic resonance imaging (MRI)
- Computed tomography (CT)
- References
- Procedures
- Venepuncture
- Central venous access devices: taking a blood sample for vacuum sampling
- Central venous access devices: taking a blood sample for syringe sampling
- Arterial puncture: radial artery
- Arterial blood gas sampling: arterial cannula
- Blood cultures: peripheral (winged device collection method)
- Blood cultures: central venous access device
- Blood sampling: antimicrobial drug assay
- Lumbar puncture
- Semen collection
- Cervical uterine smear using liquid‐based cytology
- Swab sampling: ear
- Swab sampling: eye
- Swab sampling: nose
- Swab sampling: penis
- Swab sampling: rectum
- Swab sampling: skin
- Swab sampling: throat
- Swab sampling: vagina
- Swab sampling: wound
- Urine sampling: midstream specimen of urine: male
- Urine sampling: midstream specimen of urine: female
- Urine sampling: catheter specimen of urine
- Urine sampling: sampling from an ileal conduit
- Urine sampling: 24‐hour urine collection
- Faecal sampling
- Sputum sampling
- Nasopharyngeal wash: syringe method
- Nasopharyngeal wash: vacuum‐assisted aspirate method
- Select to go to chapter navigation index14Observations
- Overview
- Observations
- Pulse (heart rate)
- Electrocardiogram (ECG)
- Blood pressure
- Respiration and pulse oximetry
- Peak flow
- Temperature
- Urinalysis
- Blood glucose
- Neurological observations
- References
- Procedures
- Pulse measurement
- Electrocardiogram (ECG)
- Blood pressure measurement (manual)
- Respiratory assessment and pulse oximetry
- Peak flow reading using a manual peak flow meter
- Tympanic temperature measurement
- Urinalysis: reagent strip
- Blood glucose monitoring
- Neurological observations and assessment
Part Four Supporting patients through treatment
- Select to go to chapter navigation index15Medicines optimization: ensuring quality and safety
- Overview
- Medicines management
- Self‐administration of medicines
- Controlled drugs
- Routes of administration
- Parenteral administration (injections and infusions)
- Definitions
- Anatomy and physiology
- Evidence‐based approaches
- Pre‐procedural considerations
- Pre‐procedural considerations
- Intra‐arterial injections and infusions
- Intra‐articular injections and infusions
- Intrathecal administration of medication
- Intradermal injection
- Subcutaneous injection
- Subcutaneous infusion
- Intramuscular injections
- Intraosseous administration
- Intravenous injections and infusions
- Infiltration and extravasation
- Monoclonal antibodies
- References
- Procedures
- Medication: controlled drug administration
- Medication: oral drug administration
- Medication: topical applications
- Medication: transdermal applications
- Medication: vaginal administration
- Medication: administration by inhalation using a metered dose or dry powder inhaler
- Medication: administration by inhalation using a nebulizer
- Medication: eye administration
- Medication: nasal drop administration
- Medication: ear drop administration
- Medication: single‐dose ampoule: solution preparation
- Medication: single‐dose ampoule: powder preparation
- Medication: multidose vial: powder preparation using a venting needle
- Medication: multidose vial: powder preparation using the equilibrium method
- Medication: injection administration
- Medication: intradermal injection
- Medication: subcutaneous injection
- Medication: subcutaneous infusion of fluids
- Medication: subcutaneous administration using a CME Medical T34 syringe pump (previously McKinley)
- Medication: intramuscular injection
- Inserting an intraosseous needle
- Removing an intraosseous needle
- Medication: continuous infusion of intravenous drugs
- Medication: intermittent infusion of intravenous drugs
- Medication: injection (bolus or push) of intravenous drugs
- Extravasation management: peripheral cannula
- Extravasation: performing flush‐out following an extravasation
- Select to go to chapter navigation index16Perioperative care
- Overview
- Pre‐operative care
- Definition
- Related theory
- Evidence‐based approaches
- Clinical governance
- Patient information and education
- Consent
- Physical pre‐operative preparation
- Mechanical and pharmacological thromboembolism prophylaxis
- Pre‐operative fasting
- Skin preparation
- Marking skin for surgery
- Pre‐operative pregnancy testing
- Prevention of toxic shock syndrome from tampon use
- Latex sensitivity and allergy
- Pre‐operative theatre checklist
- Intraoperative care
- Post‐operative care
- References
- Procedures
- Measuring and applying antiembolic stockings
- Pre‐operative care: checking that the patient is fully prepared for surgery
- Caring for the patient in the anaesthetic room
- Operating theatre procedure: maintaining the safety of a patient during surgery
- Handover in the post‐anaesthetic care unit (PACU): scrub nurse or operating department practitioner to recovery practitioner
- Safe management of patients in the post‐operative care unit (PACU)
- Drainage systems: changing the dressing around the drain site for both open and closed drains
- Closed drainage systems: changing a vacuum bottle
- Wound drain removal: closed drainage system
- Wound drain shortening for open drainage systems
- Wound drain shortening for closed drainage systems
- Select to go to chapter navigation index17Vascular access devices: insertion and management
- Overview
- Vascular access devices
- Peripheral cannulas
- Midline catheters
- Peripherally inserted central catheters
- Short‐term percutaneous central venous catheters (non‐tunnelled)
- Skin‐tunnelled catheters
- Implanted ports
- Arterial cannulas
- References
- Procedures
- Central venous catheter: insertion site dressing change
- Vascular access devices: maintaining patency
- Central venous access devices: unblocking an occlusion
- Peripheral cannula insertion
- Ultrasound‐guided peripheral cannula insertion
- Midline catheter insertion
- PICC insertion using modified Seldinger technique (MST) with ultrasound
- PICC removal
- Short‐term central venous catheter (non‐cuffed and non‐tunnelled) insertion into the internal jugular vein
- Short‐term central venous catheter (non‐cuffed and non‐tunnelled): removal
- Central venous catheter (skin tunnelled): surgical removal
- Implanted arm PORT insertion using modified Seldinger technique (MST) with ultrasound guidance and ECG technology
- Implanted ports: insertion and removal of non‐coring needles
- Arterial cannula insertion: preparation and setting up of monitoring set
- Arterial cannula: removal
- Select to go to chapter navigation index18Wound management
Part Five Looking after ourselves so we can support patients
- Select to go to chapter navigation index19Self‐care and wellbeing
- Overview
- Self‐care and wellbeing
- Mindfulness
- Eating and drinking
- Physical wellbeing and musculoskeletal health
- References
- Procedures
- Working at low or floor level
- Working with a patient lying in a bed or on another raised supportive surface
- Carrying out clinical procedures in a seated posture (e.g. cannulation)
- Working in a seated position: office work
Part Six Cancer Nursing
- Select to go to chapter navigation index20Diagnostic investigations
- Overview
- Diagnostic tests and investigations
- Tumour markers
- Cervical uterine smear
- Diagnostic radioisotope procedures (nuclear medicine)
- Transrectal ultrasound (TRUS) prostate biopsy
- Flexible cystoscopy
- Breast diagnostics
- Genetic testing
- References
- Procedures
- Cervical uterine smear using liquid‐based cytology
- Unsealed radioactive sources for diagnostic investigations
- Transrectal ultrasound (TRUS) prostate biopsy
- Flexible cystoscopy
- Flexible cystoscopy with stent removal
- Flexible cystoscopy with bladder biopsy
- Flexible cystoscopy with argon plasma coagulation (APC)/cystodiathermy
- Clinical breast examination
- Core breast biopsy
- Breast fine‐needle aspiration (FNA)
- Breast punch biopsy
- Nipple discharge smear
- Select to go to chapter navigation index21Haematological procedures
- Select to go to chapter navigation index22Cancer pain assessment and management
- Overview
- Definition
- Anatomy and physiology
- Related theory
- Cancer pain assessment and management
- Interventional techniques for managing complex cancer‐related pain
- Entonox (nitrous oxide) administration
- References
- Procedures
- Acupuncture: preparation and administration
- Epidural/intrathecal sensory blockade: assessment
- Epidural/intrathecal exit site dressing change
- Epidural/intrathecal catheter removal
- Entonox administration
- Select to go to chapter navigation index23Administration of systemic anticancer therapies
- Overview
- Systemic anticancer treatment
- Safe handling of hazardous drugs
- Administration of cytotoxic medications by nurses
- Intravenous administration of systemic anticancer therapy
- Oral administration of systemic anticancer therapy
- Intramuscular and subcutaneous administration of cytotoxic drugs
- Topical application of cytotoxic drugs
- Intrathecal administration of cytotoxic drugs
- Intrapleural instillation of cytotoxic drugs
- Intravesical instillation of cytotoxic drugs
- Intraperitoneal instillation of cytotoxic drugs
- Intra‐arterial administration of cytotoxic drugs
- Side‐effects of chemotherapy
- Clinical research
- References
- Procedures
- Cytotoxic spillage management
- Cytotoxic therapy: intravenous administration of cytotoxic drugs
- Extravasation management: peripheral cannula
- Extravasation: performing flush‐out following an extravasation
- Cytotoxic therapy: education for patients on oral cytotoxic drugs
- Cytotoxic therapy: intramuscular administration of cytotoxic drugs (Z‐track)
- Cytotoxic therapy: topical application of cytotoxic drugs
- Cytotoxic therapy: intraventricular administration of cytotoxic drugs via an intraventricular access device (Ommaya reservoir)
- Cytotoxic therapy: intrapleural instillation of cytotoxic drugs
- Cytotoxic therapy: intravesical instillation of cytotoxic drugs
- Cytotoxic therapy: intraperitoneal instillation of cytotoxic drugs
- Intra‐arterial administration of cytotoxic drugs
- Scalp cooling
- Select to go to chapter navigation index24Radionuclide therapy
- Overview
- Radiation
- Radiation protection
- Unsealed source therapy
- Sealed source therapy
- Sealed source iodine‐125 seeds used in prostate malignancies
- Intraoral sealed sources
- References
- Procedures
- Radiation protection: major spillage of radioactive body fluids through incontinence and/or vomiting
- Radiation protection: contamination of bare hands by radioactive body fluids
- Radiation protection: death of a patient who has received unsealed radioactive source therapy
- Radiation protection: cardiac arrest of a patient who has received unsealed radioactive source therapy
- Radiation protection: evacuation due to fire of patients who have received unsealed radioactive source therapy
- Unsealed source therapy: entering and leaving the room of a patient who has received an unsealed radioactive source
- Unsealed source therapy: iodine‐131 (oral capsule/liquid): administration
- Unsealed source therapy: iodine‐131 mIBG treatment: patient care
- Sealed source therapy: caesium sources (manual or afterloading): patient care
- Sealed source therapy: low dose rate Selectron treatment
- Sealed source therapy: Selectron applicator removal
- Sealed source therapy: insertion of sealed radioactive sources into the oral cavity
- Select to go to chapter navigation index25Wound management
- Select to go to chapter navigation index26Acute oncology
- Overview
- Oncological emergencies
- Haematological emergencies
- Metabolic emergencies
- Side‐effects from chemotherapy agents
- Structural
- Pericardial effusion (malignant)
- Raised intracranial pressure due to malignant disease
- Research Explanation
- References
- Procedures
- Carotid artery rupture (CAR)
- Abdominal paracentesis
- Log rolling for suspected/confirmed cervical spinal instability
- Positioning for suspected/confirmed cervical spinal instability: pelvic twist to right
- Log rolling for suspected/confirmed thoracolumbar spinal instability
- Early mobilization of the patient in bed
- Select to go to chapter navigation index27Living with and beyond cancer
- Overview
- Introduction
- Welfare Advice
- Supporting Individuals with Sexual Concerns as a Consequence of Cancer
- Women's sexual concerns following cancer
- Men's sexual concerns following cancer
- Nutritional Status
- Compression therapy in the management of lymphoedema
- Non‐pharmacological management of breathlessness
- Physical activity for people with cancer
- Cancer‐related fatigue and sleep
- Communication for a patient with a laryngectomy
- NIPPLE TATTOOING
- Research Explanation
- References
- Procedures
- Conducting a holistic needs assessment (HNA)
- Developing and actioning a care plan
- Closure and follow‐up
- How a patient should make a claim for Personal Independence Payment (DWP )
- How a patient should make a claim for Attendance Allowance
- How a patient should make a claim for Carer's Allowance (DWP )
- How a patient should make a claim for Employment and Support Allowance (DWP )
- Assessing a patient's sexual health concerns
- Measuring the weight, height and waist circumference of the patient
- Compression therapy limb volume calculation: lower limb
- Compression therapy limb volume calculation: upper limb
- Compression bandaging (multilayer short‐stretch): bandaging an arm and the fingers
- Compression bandaging (multilayer short‐stretch): bandaging a leg and the toes
- Elastic compression garments: application to the leg
- Elastic compression garments: application to the arm
- Adjustable wrap compression system: application to the lower leg
- Adjustable wrap compression system: application to the arm
- Breathlessness management: using a handheld fan
- Breathlessness management: essential oil administration via an aroma stick inhaler
- Supporting physical activity
- Fatigue management
- Relaxation and anxiety management
- HME placement
- Voice prosthesis: cleaning
- Nipple tattooing
- Select to go to chapter navigation index28End of life care
