Nursing standard (Royal College of Nursing (Great Britain) : 1987)最新文献

Rationale and key points: In hospitals and nursing homes, the maintenance of feeding tubes used in enteral nutrition, such as percutaneous endoscopic gastrostomy (PEG) (the placement of a feeding tube directly into the stomach through the abdominal wall), is often a nursing responsibility. Therefore, it is vital nurses understand how to care for this patient group safely and effectively. Incorrect PEG procedures, inadequate infection prevention and control practices, and a lack of appropriate stoma care, can negatively affect patient outcomes. Nurses administering enteral feeding via PEG must have the knowledge and skills required to do so safely and must work within their level of competence. • Enteral nutrition such as PEG aims to meet the nutritional requirements of patients who have an intact gastrointestinal (GI) tract but whose oral intake is inadequate. • Management of the PEG feeding tube and care of the stoma site are vital, and nurses should be able to recognise common complications of PEG feeding. • A non-touch technique should be used when administering enteral feed via PEG to reduce the risk of bacterial contamination. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when administering enteral feed via PEG. • How you could use this information to educate nursing students or colleagues about safe enteral feeding with PEG.

Rationale and key points: Peak expiratory flow rate (PEFR) is an important test in the diagnosis and monitoring of respiratory conditions, especially asthma. PEFR measures the speed at which air is forcefully exhaled from full inspiration, expressed in litres per minute (L/min). It involves using a peak flow meter - a simple, affordable, portable and widely available device that can be used in clinic or home settings. Nurses obtaining a patient's PEFR must have the knowledge and skills required to do so safely and effectively and must work within their level of competence. • PEFR is a simple-to-obtain measure that records the maximal flow rate of air that can be achieved in one forceful expiration following a full inspiration. • Where possible, it is advisable that patients and/or carers learn how to perform the test themselves, so that they can self-manage and monitor conditions such as asthma and chronic obstructive pulmonary disease. • The procedure is simple to teach, but it is necessary to use the correct technique to achieve accurate results. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when obtaining a patient's PEFR. • How you could use this information to educate nursing students or colleagues about the technique for obtaining an accurate PEFR.

Rationale and key points: A 12-lead electrocardiogram (ECG) is a painless procedure commonly undertaken in healthcare practice. An ECG machine uses cables or 'leads' attached with stick-on electrodes to specific parts of the body to create a series of ECG traces, which are then printed onto graph paper. This provides a recording of the cardiac electrical activity measured from different angles or perspectives. • A 12-lead ECG is a valuable diagnostic tool that has proven effective in detecting various cardiac abnormalities or enabling healthcare professionals to rule them out. • It is a cost-effective investigation that can be performed by any appropriately trained healthcare professional. • Careful preparation and correct electrode and lead placement are crucial to ensure accuracy when recording a 12-lead ECG.

Reflective activity: How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when recording a 12-lead ECG. • How you could use this information to educate students or colleagues about the preparation and recording of a 12-lead ECG.

The sharp increase in the cost of living in the UK over the past few years has affected all populations, including higher education students. Many higher education students, including nursing students, are experiencing financial difficulties and concerns, which adversely affect their mental health and can cause them to consider leaving their course. This article reports the findings of an online survey undertaken in one university in Glasgow, Scotland, that aimed to explore the effects of financial stress on second and third-year nursing students. Most respondents had experienced financial worries since starting their preregistration nursing degree programme; many were concerned about the cost of living, and financial worries adversely affected their academic performance and clinical placements. The authors suggest there is a need for a collaborative partnership between universities and practice placement areas to adopt a student-centred approach to identifying solutions to nursing students' financial concerns as well as a review of the available funding for this cohort.

A priority in wound care is preventing wound infection, because this can cause delays in healing and increase the risk of hospital admission. Moreover, the diagnosis of a wound infection is not always straightforward, and the presence of biofilms may mean that an infection is particularly challenging to treat. This article outlines the main aspects of diagnosing, treating and preventing wound infections. It explains that treating wound infection is multifactorial and may include topical antimicrobials, antibiotics and wound bed preparation techniques. The author discusses various preventative measures that can support patients and healthcare organisations, while also contributing towards effective antimicrobial stewardship.

Nurses have an important role in providing high-quality care to meet the needs of diverse populations, including people with mental health issues. Developing rapport is essential for engaging with service users and promoting a person-centred approach in the context of mental health care. However, in practice this may not always come naturally to all nurses. In this article, the author discusses several evidence-based methods for effective communication with people who have mental health issues, such as making a good introduction, active listening, using open questions, using silence and being aware of body language. The author also explains how nurses can communicate compassionately, demonstrate cultural sensitivity and develop trust within a therapeutic relationship, thereby enabling them to effectively explore service users' thoughts, feelings and needs.

Rationale and key points: Accurate measurement of a patient's blood pressure (BP) is essential to identify hypotension or hypertension and to inform subsequent management and treatment decisions. The auscultatory, or manual, method remains the gold standard for non-invasive BP measurement, so it is vital that nurses are able to undertake this procedure accurately. This article explains how to take and record a manual BP measurement using an aneroid sphygmomanometer and a stethoscope. Nurses and nursing students undertaking this procedure must be equipped with the knowledge and skills to do so proficiently and work within their scope of practice. • BP measurement comprises two pressure readings, systolic and diastolic, which are measured in millimetres of mercury (mmHg) and expressed in documentation as a 'fraction'. • Inaccurate BP measurement, whether overestimation or underestimation, can result in diagnostic errors and incorrect risk assessment and decision-making. • Various factors can influence the accuracy of BP measurement, including patient positioning, cuff size, arm position and correct use of the stethoscope. • It is vital to ensure regular maintenance and recalibration of BP measuring equipment, in accordance with the manufacturer's instructions, to ensure accuracy of readings. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when taking a manual BP measurement. • How you could use this information to educate nursing students or your colleagues on the appropriate steps when taking and recording a manual BP measurement.

This article explores the use of effective communication for nurses when interacting with people experiencing mental health issues. Emphasis will be on the importance of nurses adopting person-centred communication styles that prioritise empathy, with the aim of developing a therapeutic rapport. The article underscores the role of the nurse in promoting positive mental health outcomes through the use of techniques such as active listening, empathy and validation. The author also details some of the barriers to effective communication and how nurses can address them.

Approximately 3.8 million people in the UK are affected by acute or chronic wounds each year and it is essential that nurses are equipped with the knowledge and skills to assess and manage these patients. This article covers the main aspects that nurses need to consider to provide evidence-based care to patients with a wound, including skin anatomy, normal wound healing physiology and the factors that can delay healing. The author also discusses holistic wound assessment, including wound healing risk factors, wound bed preparation and wound management products, providing nurses with a practical overview of the complex topic of wound care.

Rationale and key points: Peripheral intravenous (IV) cannulation in adults is one of the most commonly performed healthcare procedures. It involves the insertion of a small tube into a vein using a needle, enabling the administration of fluids, blood products and nutrition, and the collection of blood samples. Healthcare professionals performing this procedure must undergo training to be able to undertake it effectively and safely. • Knowledge of vein anatomy and understanding the risks and benefits of the procedure supports safe practice, reduces errors, costs and infection risk, and improves the overall patient experience. • To provide holistic care, nurses should understand the indications for peripheral IV cannulation, which can be a short-term intervention for administering medicines, fluids and blood products, and for parenteral nutrition • Various pharmacological interventions and psychological techniques can be used to alleviate or minimise the pain and anxiety experienced by some patients during cannulation. • Following the successful insertion of a peripheral IV cannula, nurses must provide ongoing care to preserve the cannula's patency and safeguard the patient. REFLECTIVE ACTIVITY: 'How to' articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: • How this article might improve your practice when undertaking peripheral IV cannulation. • How you could use this information to educate nursing students or your colleagues on the appropriate and safe methods for undertaking peripheral IV cannulation.