Clinical skills are a fundamental aspect of nursing care of children and young people. The Great Ormond Street Hospital Manual of Children's Nursing Practices is an evidence-based manual of practical skills in children's nursing which builds on the extensive expertise developed at Great Ormond Street Hospital. It encompasses all aspects of children's nursing from the most basic aspects of everyday practice to advanced practice in high dependency and intensive care to provide a comprehensive resource for all qualified nurses, students, and other health-care professionals involved in caring for children, both in the hospital and the community setting.
Children's and young people's nursing presents unique challenges. The Great Ormond Street Hospital Manual utilises the latest clinical research and expert clinical knowledge to address these challenges, and provides the underlying theory and evidence for nursing care of children. It provides a definitive guide to clinical skills procedures in children's and young people's nursing which enables nurses working with children and young people to practice confidently and deliver clinically effective family-centred care.
Key features
Offers access to clinical procedures developed through the extensive expertise from Great Ormond Street Hospital
Contains evidence-based recommendations for expert care
Encompasses all aspects of children's care
Contains procedures guidelines students can rely on and effectively use in practice following qualfication
Highlights specific needs of neonates and adolescents
Placed in the context of inter-disciplinary care of the child
Includes the rationale for each procedure - the 'why' as well as 'how'
Information presented in a similar way to The Royal Marsden Manual of Clinical Nursing Procedures - offering continuity to those working in both adult and paediatric settings
Author(s): Susan Macqueen, Elizabeth Bruce, Faith Gibson
Edition: 1st
Publisher: Wiley-Blackwell
Year: 2012
Language: English
Pages: 0
Tags: Pediatric & Neonatal Nursing; Nursing Pediatrics
Foreword ix
Acknowledgements x
List of contributors xi
Introduction xvii
1 Assessment 1
Introduction 2
Measuring vital signs, height and weight 6
Review of systems 13
Blood pressure 21
References 35
2 Allergy and anaphylaxis 38
Introduction 39
Allergy and the immune response 39
Diagnosis and management of allergy 40
Management of anaphylaxis 41
Food allergy 43
Respiratory allergy 46
Allergens in the healthcare setting 48
Conclusion 51
Key texts 51
References 51
Useful websites 52
3 Biopsies 53
Introduction 54
Liver biopsy 54
Punch skin biopsy 60
Renal biopsy 66
Bone marrow aspirate and trephine 69
References 72
4 Administration of blood components and products 74
Introduction 75
An overview of blood transfusion 75
Administration of red cells 76
Administration of platelets 76
Administration of fresh frozen plasma (FFP) 76
Administration of cryoprecipitate 76
Administration of albumin 80
Administration of immunoglobulin 80
Administration of coagulation factors 86
Conclusion 86
References 86
5 Bowel care 87
Introduction 88
Constipation 88
Treatment of constipation 89
Diarrhoea 91
Transanal colonic irrigation 95
Stoma care 97
References 101
6 Burns and scalds 103
Introduction 104
Common causes of burns in children 104
Overview of anatomy of the skin 104
Classifi cation of burns 104
First aid following a burn 105
Fluid resuscitation for major burns 108
Wound healing and wound care 108
Which dressing? 111
Nutrition 112
Psychological care following a burn 112
References 115
7 Child protection 117
Introduction 118
The hospital setting 118
An individual and corporate responsibility 118
Defining child abuse and neglect 119
The effects of abuse and neglect 120
Sources of stress for families 120
Children with disabilities 121
Difference and culture 122
The legal framework, national and political infl uences 122
Learning from serious case reviews 123
A safeguarding culture 125
Implications for nursing practice 126
The Common Assessment Framework (CAF) 126
Practice guidance for the children’s nurse 127
Professional responsibilities of staff at Great Ormond Street Hospital 127
Procedures for children attending A&E 128
Procedures for children admitted to hospital 129
Fabricated or induced illness: concerns or suspicion 130
Pre-discharge planning procedure 130
A final word – communication with other agencies 131
Acknowledgements 131
References 131
8 Cytotoxic drugs 134
Chemotherapy administration 135
Legislation 135
Consent 135
Safe handling 135
Reconstitution and preparation of
chemotherapeutic agents 135
Personal protective equipment 136
Work practices 136
Safe administration of chemotherapy 136
Routes of administration 138
Intrathecal route 140
References 141
9 Fluid balance 142
Introduction 143
Fluid balance in the ill child 143
Vascular access 149
Haemofi ltration 151
Peritoneal dialysis 158
Interventions 163
References 164
Further reading 165
10 Personal hygiene and pressure ulcer prevention 166
Introduction 167
Bathing 167
Toileting 174
Nappy care 180
Nail care 187
Oral hygiene 189
Eye care 202
Ear care 206
Pressure ulcer prevention 208
Conclusion 216
References 217
Useful websites 220
11 Immunisations 222
Introduction 223
Routine childhood immunisation schedule in UK – 2010 223
Special risk groups 224
Immunity 224
Types of vaccine 225
General considerations 225
Specific diseases and the vaccines 227
Storage and administration of vaccines 231
Ensuring good uptake 231
Vaccine safety scares 233
Immunisation of healthcare professionals 233
Conclusion 234
References 234
Further resources 235
12 Infection prevention and control 236
Introduction 237
Financial burden of hospital acquired infection 237
Freedom of information 238
Bioterrorism 238
The chain of infection 238
Standard precautions 240
Hand hygiene and skin protection 241
Personal protective equipment 245
Isolation nursing 249
Aseptic non-touch technique 257
Management of exposure to blood and body fluids 259
Reporting of injuries, diseases and dangerous occurences regulations 260
Blood spillage 260
Decontamination of equipment and the environment 261
Laundry management 262
Waste disposal 263
Pest control 264
References 264
Further reading 266
13 Intravenous and intra-arterial access 267
Intravenous access 268
Peripheral venous catheters 268
Peripherally inserted central catheters 290
Non-tunnelled short-term percutaneous central venous catheters 292
Tunnelled central venous catheters: Hickman and Broviac lines 292
Implantable ports 293
Removal of central venous catheters: possible complications 309
Arterial lines 310
References 321
Appendix 13.1 Suppliers of stickers and certifi cates 324
14 Investigations 325
General introduction 326
Introduction to radiology 326
General radiology 330
Fluoroscopy 330
Intravenous urography 331
Micturating cystourethrogram 332
Dysphagia swallow using videofl uoroscopy 333
Upper gastrointestinal series 333
Tube oesophagram 334
Barium follow through 335
Barium enema 335
Contrast enema (and Gastrografi n enema) 335
Air enema 336
Tracheobronchography 337
Linogram 338
Ultrasound 339
Computed tomography 339
Nuclear Medicine 340
Magnetic resonance imaging 342
Interventional radiology 342
Collection of microbiological specimens 344
Blood samples 346
Biopsy material 347
Cerebro-spinal fl uid 347
Taking swabs 347
Faeces 350
Fungal samples of hair, nail and skin 351
Gastric washings 351
Naso-pharyngeal aspirate 352
Sputum 352
Urine 353
Vesicular fluid for herpes polymerase chain reaction (PCR) 354
References 355
15 Administration of medicines 357
Introduction 358
Child development considerations 359
Drug calculations 360
Oral administration 364
Enteral tube administration 366
Buccal and sublingual administration 369
Intranasal administration 370
Inhalation administration 372
Rectal administration 376
Injections 378
Intradermal administration 380
Subcutaneous administration 382
Intramuscular administration 384
Intravenous administration 387
Intraosseous administration 387
Intrathecal administration 389
Epidural administration 393
Skin patches administration 393
Acknowledgements 394
References 394
Further reading 395
16 Moving and handling 397
Introduction 398
Legislation 398
Risk assessment 399
Injury 400
Documentation 405
Equipment 406
Restraint and therapeutic holding 412
References 415
17 Neonatal care 416
Introduction 417
Neonatal thermoregulation 417
Vitamin K administration 424
Umbilical care 426
Newborn blood spot screening (formerly Guthrie testing) 428
Phototherapy – neonatal jaundice 431
References 434
18 Neurological care 436
Introduction 437
Neurological observations 437
Seizures 443
External ventricular drainage 447
Lumbar puncture 462
References 464
Bibliography 465
Appendix 18.1 The GOSH Coma Chart 466
Appendix 18.2 Types of painful stimuli 470
Appendix 18.3 Examples of motor responses 470
Appendix 18.4 An example of an algorithm for a convulsing child 471
19 Nutrition and feeding 473
Introduction 474
Nutritional requirements 474
Nutrition from preterm to adolescence 474
Breast feeding 480
Enteral feeding 485
Parenteral nutrition 499
Sham feeding 506
References 509
Supporting breast feeding – some useful addresses 511
20 Orthopaedic care 512
Introduction 513
Neurovascular observations 513
Plaster care 519
Crutches 526
Care of a child in traction 530
Key texts 538
References 538
21 Pain management 539
Introduction 540
General principles of pain management 540
Pain assessment 542
Administration of Entonox 548
Epidural analgesia 554
Patient and nurse controlled analgesia (PCA/NCA) 566
Prevention and management of opioid related complications 570
Sucrose 573
Key texts 574
References 574
22 Palliative care 577
Introduction 578
Assessment of symptoms 578
Nausea and vomiting 579
Constipation and diarrhoea 580
Dyspnoea 581
Anorexia and reduced fl uid intake 582
External haemorrhage 583
Seizures 583
Signs of impending death 584
After the child dies 585
Preparation of the body 591
Moving the child who dies in hospital 593
After care 594
Acknowledgements 596
Key texts 596
References 596
23 Peri-operative care 598
Introduction 599
Preoperative preparation 599
Perioperative care 603
Recovery 606
References 608
24 Play as a therapeutic tool 609
Introduction 610
The development of play in hospital 610
Normal play for development 611
The importance of play for children in hospital 611
Preparation for surgery and procedures 615
Distraction techniques 617
Therapeutic play – 1:1 sessions 620
Key texts 623
References 623
Further reading 624
25 Poisoning and overdose 625
Introduction 626
Non-accidental ingestion and self-harm 626
Common ingestions 627
Initial management following poisoning or overdose 628
Treatment of ingested poisons 629
Gastric lavage 630
References 634
26 Respiratory care 635
Introduction 636
Airway suction 636
Oxygen therapy 642
Chest drain management 648
Key texts and websites 660
References 660
27 Resuscitation practices 663
Introduction 664
Aetiology of cardiorespiratory arrest 664
Airway management 664
Recovery position 668
Advanced airway and breathing management 668
Circulation management 671
Basic life support 676
Choking 681
Cardiorespiratory arrest management 684
Defi brillation 688
Medications in cardiorespiratory arrest 689
Potentially reversible causes of cardiorespiratory arrest 690
Post-resuscitation care 690
Ethical considerations 690
References 691
28 Tracheostomy: care and management 693
Introduction 694
Caring for a newly formed tracheostomy 694
Humidifi cation 699
Management of an established tracheostomy 700
Resuscitation 706
References 714
Appendix 28.1 Tracheostomy tubes for children 715
29 Urinary catheter care 718
Introduction 719
Insertion of indwelling urethral catheters 719
Emptying, drainage and fl ushing 726
Obtaining a catheter specimen of urine 729
References 732
30 Drug withdrawal – prevention and management 734
Introduction 735
Withdrawal prevention 736
Withdrawal assessment 737
Withdrawal assessment tools 738
Management of withdrawal 740
Weaning protocols 741
References 744
Index 746
