Table of contents for The Royal Marsden Hospital manual of clinical nursing procedures / edited by Jane Mallett and Lisa Dougherty.


Bibliographic record and links to related information available from the Library of Congress catalog. Note: Contents data are machine generated based on pre-publication information provided by the publisher. Contents may have variations from the printed book or be incomplete or contain other coding.


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Contents
	Quick Reference to the Guidelines	ix
	Contributors to Fifth Edition	xi
	Contributors to Previous Editions	xiii
	Foreword to Fifth Edition	xv
	Forewords to Previous Editions	xvi
	Acknowledgements	xvii
	The Royal Marsden Hospital Strategy for 
Nursing: Principles of Person-Focused Care	xviii
	Introduction	xix
 1	Care in Context: Assessment, 
Communication and Consent	1
Introduction	1
Assessment	1
Communication	5
Consent to examination and treatment	22
Conclusion	28
 2	Abdominal Paracentesis	33
Reference material	33
Guidelines - Abdominal paracentesis	35
Guidelines - Removal of an intraperitoneal 
drain (short term) 	36
Nursing care plan	37
 3	Aseptic Technique	39
Reference material	39
Guidelines - Aseptic technique	44
 4	Barrier Nursing: Nursing the Infectious or Immunosuppressed Patient	47
Barrier nursing	47
Reference material	47
Source isolation	49
Reference material	49
Guidelines - Source isolation	52
Protective isolation	56
Reference material	57
Guidelines - Nursing the neutropenic patient	61
Acquired immune deficiency syndrome 
(AIDS)	63
Reference material	63
Human immunodeficiency virus 2 (HIV 2)	70
Reference material	70
Guidelines - Acquired immune deficiency 
syndrome in a general ward	72
Antibiotic-resistant organisms	77
Reference material	77
Aspergillosis	84
Reference material	84
Clostridium difficile 	85
Reference material	85
Cryptosporidiosis	87
Reference material	87
Hepatitis	89
Hepatitis A	89
Reference material	89
Guidelines - Hepatitis A	91
Hepatitis B	92
Reference material	92
Guidelines - Hepatitis B	96
Non-A non-B hepatitis	99
Reference material	99
Guidelines - Non-A non-B hepatitis	100
Hepatitis C virus (HCV)	100
Reference material	100
Hepatitis D 	102
Reference material	102
Hepatitis E	102
Reference material	102
Hepatitis B genotype F	103
Reference material	103
Hepatitis G 	104
Reference material	104
The herpes viruses	105
Cytomegalovirus (CMV)	105
Reference material	105
Epstein - Barr virus	107
Reference material	107
Herpes simplex virus (HSV)	108
Reference material	108
Varicella zoster virus (VZV)	109
Reference material	109
Legionnaires' disease	112
Reference material	112
Listeriosis 	114
Reference material	114
Pneumocystosis	115
Reference material	115
Tuberculosis	117
Reference material	117
 5	Bladder Lavage and Irrigation	123
Reference material	123
Guidelines - Bladder lavage	126
Guidelines - Continuous bladder irrigation	128
Bladder irrigation recording chart	129
Nursing care plan 	130
 6	Bowel Care	131
General introduction	131
Reference material 	131
Enemas	136
Reference material	136
Suppositories	137
Reference material	137
Manual evacuation	137
Rectal lavage	137
Reference material	138
Guidelines - Administration of enemas	139
Nursing care plan	141
Guidelines - Administration of suppositories	141
Guidelines - Administration of rectal lavage	142
Nursing care plan	144
 7	Breast Aspiration	146
Reference material	146
Guidelines - Breast aspiration	149
 8	Cardiopulmonary Resuscitation	151
Reference material	151
Guidelines - Cardiopulmonary resuscitation	158
 9	Continent Urinary Diversions	162
Reference material	162
Teaching intermittent self-catheterization of a continent urinary diversion stoma
	168
Reference material	168
Guidelines - Self-catheterization	169
Nursing care plan	170
10	Cytotoxic Drugs: Handling and 
Administration	172
Reference material	172
Guidelines - Protection of the environment	174
Guidelines - Protection of nursing staff when 
handling cytotoxic drugs	177
Routes of administration	179
Intravenous administration	179
Reference material	179
Guidelines - Intravenous administration of 
cytotoxic drugs	180
Extravasation of vesicant drugs	182
Reference material	182
Guidelines - Management of extravasation 
when using a peripheral cannula	185
Oral administration	187
Reference material	187
Intramuscular and subcutaneous injection	187
Reference material	188
Topical application	188
Reference material	188
Intrathecal administration	188
Reference material	188
Intrapleural instillation	189
Reference material	189
Guidelines - Administration of intrapleural 
drugs	190
Nursing care plan	191
Intravesical instillation	191
Reference material	191
Guidelines - Intravesical instillation of 
cytotoxic drugs	192
Nursing care plan	193
Intraperitoneal administration	194
Reference material	194
Guidelines - Intraperitoneal instillation of 
cytotoxic drugs	195
Nursing care plan	196
Intra-arterial administration	196
Reference material	196
Nursing care plan	198
11	Discharge Planning	200
Reference material	200
Guidelines - Discharge planning	207
12	Drug Administration	211
Reference material	211
Guidelines - Storage of drugs	214
Injections and infusions	221
Guidelines - Self-administration of drugs	230
Guidelines - Oral drug administration	231
Guidelines - Administration of injections	233
Guidelines - Administration of rectal and 
vaginal preparations	238
Guidelines - Topical applications of drugs	239
Guidelines - Administration of drugs in other 
forms	240
Guidelines - Administration of intravenous 
drugs by continuous infusion	241
Guidelines - Administration by intermittent 
infusion	244
Guidelines - Administration by direct 
injection, bolus or push 	246
Nursing care plan	249
13	Ear Syringing	255
Reference material	255
Guidelines - Irrigation the external auditory 
canal	259
14	Entonox Administration	261
Reference material	261
Guidelines - Entonox administration	263
Nursing care plan	264
15	Epidural Analgesia	266
Reference material	266
Epidural analgesia for patients with cancer 
and chronic pain	268
Guidelines - Insertion of an epidural catheter	269
Nursing care plan - Emergencies	270
Guidelines - Topping up epidural analgesia	272
Guidelines - Removal of an epidural catheter	273
Guidelines - Pre-insertion management of an 
epidural for chronic pain	274
Guidelines - Changing the dressing over the 
epidural insertion site	274
Guidelines - Postinsertion monitoring of 
respiratory and cardiac function in chronic 
pain management	275
Guidelines - Setting up the epidural infusion 
(utilizing a syringe pump or driver)	276
Guidelines - Setting up of epidural infusion 
(utilizing an ambulatory pump)	276
Guidelines - Discharge planning	277
Nursing care plan - Trouble shooting	279
16	External Compression and Support in the Management of Lymphoedema	280
Reference material	280
Assessment of the patient with lymphoedema	281
Measuring of limb volume	281
Reference material	281
Phases of treatment: introduction	282
Maintenance phase of treatment	282
Reduction phase of treatment	283
Guidelines - Calculation of limb volume	284
Guidelines - The application of elastic hosiery	286
Guidelines - Standard multi-layer compression bandaging	287
17	Eye Care	292
Reference material	292
Guidelines - Eye swabbing	300
Guidelines - instillation of eye drops	301
Guidelines - instillation of eye ointment	302
Guidelines - eye irrigation	303
18	Gene Therapy for the Management of 
Cancer	305
Reference material	305
Guidelines - Care of patients receiving gene 
therapy	309
19	Haematological Procedures: Specialist, 
Diagnostic and Therapeutic	313
Reference material	313
Guidelines - Bone marrow aspiration and 
trephine biopsy	316
Nursing care plan	317
Guidelines - Bone marrow harvest	317
20	Infusion Devices	319
Reference material	319
Infusion devices	323
Gravity infusion devices	323
Infusion pumps	324
Summary	328
Guidelines - Subcutaneous administration of 
drugs using a syringe driver (e.g. Graseby 
Medical MS16A)	329
Guidelines - Preparation of the syringe for 
12-hour drug administration using the 
Graseby Medical MS16A syringe driver	330
Guidelines - Priming the infusion set	330
Guidelines - Inserting the winged infusion set	331
Problem solving	332
21	Intrapleural Drainage	334
Reference material	334
Guidelines - Chest drain insertion	338
Guidelines - Removal of a chest drain	341
Nursing care plan	343
22	Last Offices	345
Reference material	345
Guidelines - Last offices	347
Nursing care plan	349
Guidelines - Requirements for people of 
different religious faiths	350
23	Lumbar Puncture	355
Reference material	355
Guidelines - Lumbar puncture	357
Nursing care plan	359
24	Mouth Care	360
Reference material	360
Guidelines - Mouth care	365
Nursing care plan	366
25	Moving and Handling (Manual Handling) 
Patients	368
Reference material	368
Summary	374
Guidelines - Moving and handling of patients	375
26	Neurological Observations	376
Reference material	376
Guidelines - Neurological observations and 
assessment	382
Nursing care plan	384
27	Nutritional Support	385
Reference material	385
Guidelines - Nasogastric intubation with tubes 
using an introducer	394
Guidelines - Nasogastric intubation with tubes 
without using an introducer, e.g. a Ryle's 
tube	396
Guidelines - Care of a percutaneous 
endoscopically placed gastrostomy (PEG) 
tube	397
Nursing care plan	398
28	Observations	402
Pulse	402
Reference material	402
Guidelines - Pulse	405
12 Lead electrocardiogram (ECG) 	406
Guidelines - 12 Lead ECG	406
Blood pressure	408
Reference material	408
Guidelines - Blood pressure	413
Respirations	414
Reference material	414
Temperature	419
Reference material	419
Guidelines - Temperature	423
Urinalysis	424
Reference material	424
Guidelines - Reagent sticks	427
Guidelines - Mid-stream specimen of urine	428
Blood glucose	428
Reference material	428
Guidelines - Blood glucose monitoring	431
29	Pain Assessment and Management	433
Reference material	433
Guidelines - Patient assessment and 
preparation before surgery: optimizing pain 
control	444
Guidelines - Using a Chronic Pain Chart	445
30	Peri-Operative Care	446
Pre-operative care	446
Reference material	446
Guidelines - Pre-operative care	448
Intra-operative care	450
Reference material	450
Guidelines - Intra-operative care	452
Postanaesthetic recovery	457
Reference material	457
Guidelines - Postanaesthetic recovery	459
Nursing care plan	461
Guidelines - Postoperative recovery	464
31	Peritoneal Dialysis and Continuous 
Venovenous Haemodiafiltration	466
Reference material	466
Peritoneal dialysis (PD)	466
Reference material	466
Continuous filtration methods	468
Reference material	468
Guidelines - Peritoneal dialysis	470
Nursing care plan	472
Guidelines - Preparation of equipment 
for continuous venovenous 
haemodiafiltration (CVVHD) utilizing a 
CVVHD machine	474
Guidelines - Commencement of CVVHD	475
32	Personal Hygiene	477
Reference material	477
Guidelines - Bed bathing a patient	481
33	Radioactive Source Therapy: Sealed 
Sources	483
Sealed radioactive source therapy	483
Reference material	483
Remote afterloading	488
Reference material	488
Guidelines - Care of patients with insertions 
of sealed radioactive sources	492
Guidelines - Care of patients with intra-oral 
sources	494
Guidelines - Care of patients with 
gynaecological sources	495
Guidelines - Removal of gynaecological 
caesium	496
Nursing care plan	497
Guidelines - Care of patients undergoing 
Selectron treatment	497
Guidelines - Removal of Selectron applicators	498
Nursing care plan	499
Guidelines - Caring for patients with 
radioactive seeds (e.g. iodine-125)	500
Guidelines - Care of patients with breast 
sources	500
34	Radioactive Source Therapy and Diagnostic Procedures: Unsealed Sources	502
Reference material	502
Guidelines - Care of patients before 
administration of iodine-131	510
Guidelines - Care of the patient receiving 
iodine-131 thyroid treatment	511
Guidelines - Care of the patient receiving 
iodine-131 mIBG treatment	511
Guidelines - Care of the patient after 
administration of unsealed source therapy	511
Guidelines - Care of the patient receiving 
unsealed source therapy for diagnostic investigations	513
Guidelines - Emergency procedures	515
35	Respiratory Therapy	517
Reference material	517
Continuous positive airway pressure (CPAP)	521
Reference material	521
Guidelines - Pre-CPAP	523
Guidelines - Setting up CPAP	524
Nursing care plan	525
36	Scalp Cooling	527
Reference material	527
Guidelines - Scalp cooling	530
Nursing care plan	531
37	Specimen Collection for Microbiological 
Analysis	533
Reference material	533
Guidelines - Specimen collection	538
Guidelines - Analysis of drug levels in blood	543
38	Spinal Cord Compression Management	544
Reference material	544
Guidelines - Care of patients with spinal cord compression	546
Nursing care plan	552
39	Stoma Care	554
Reference material	554
Useful addresses	560
Guidelines - Stoma care	562
Guidelines - Collection of a specimen of urine 
for an ileal conduit or urostomy	563
Nursing care plan	564
40	Tracheostomy Care and Laryngectomy 
Voice Rehabilitation	566
Tracheostomy care	566
Reference material	566
Laryngectomy voice rehabilitation	571
Reference material	571
Guidelines - Changing a tracheostomy dressing	574
Guidelines - Suction and tracheostomy 
patients	575
Humidification	576
Guidelines - Humidification	576
Guidelines - Changing a tracheostomy tube	577
Nursing care plan	578
Guidelines - changing a Blom - Singer type 
non-indwelling voice prosthesis	579
41	Transfusion of Blood, Blood Products and 
Blood Substitutes	581
Reference material	581
Nursing care plan	591
42	The Unconscious Patient	594
Reference material	594
Guidelines - Care of the unconscious patient	596
Nursing care plan	598
43	Urinary Catheterization	600
Reference material	600
Guidelines - Urinary catheterization	605
Guidelines for patients - Intermittent self-catheterization	609
Guidelines - Collection of a catheter specimen 
of urine	610
Guidelines - Emptying a catheter bag	611
Guidelines - Removing a catheter	612
Nursing care plan	612
44	Vascular Access Devices: Insertion and Management	615
Reference material	615
Peripheral cannula	618
Reference material	618
Midline catheter	621
Reference material	621
Central venous access devices	622
Peripherally inserted central catheter	622
Reference material	623
Short-term percutaneous central venous 
catheters (non-tunnelled)	624
Reference material	624
Skin-tunnelled catheters	625
Reference material	625
Implantable ports	627
Reference material	627
Discharging patients home with a VAD in 
situ	628
Quality of life issues: living with a VAD 	630
Reading central venous pressure	630
Guidelines - Reading central venous pressure	633
Guidelines - Inserting a peripheral cannula	635
Guidelines - Inserting a midline catheter	637
Guidelines - Inserting a peripherally inserted 
central catheter (PICC)	638
Guidelines - Changing the dressing on a 
central venous catheter insertion site	641
Guidelines - Maintaining patency of a central 
venous access device 	643
Guidelines - Taking blood samples from a 
central venous catheter	643
Guidelines - Unblocking an occluded catheter	645
Guidelines - Insertion and removal of 
non-coring needles in implantable ports	647
Guidelines - Removal of a non-skin tunnelled 
central venous catheter	649
Guidelines - Surgical removal of a 
skin-tunnelled central venous catheter	650
Nursing care plan	652
Arterial cannulae	655
Reference material	655
Guidelines - Setting up the monitoring set and preparation for insertion of an 
arterial 
cannula	656
Guidelines - Taking a blood sample from an 
arterial cannula	658
Guidelines - Removal of an arterial cannula	659
Nursing care plan	660
45	Venepuncture	662
Reference material	662
Guidelines - Venepuncture	667
Nursing care plan	670
46	Violence: Prevention and Management	673
Reference material	673
Summary	676
Guidelines - Prevention and management of 
violence	678
47	Wound Management	681
Reference material	681
Particular wounds: leg ulceration	687
Reference material	687
Pressure ulcers or decubitus ulcers	690
Reference material	690
Fungating wounds	693
Reference material	693
Radiotherapy skin damage	697
Reference material	697
Plastic surgery wounds	698
Reference material	698
Scarring 	699
Reference material	699
Guidelines - Changing wound dressings	705
Guidelines - Removal of sutures, clips or 
staples	706
Guidelines - Drain dressing (Redivac - closed 
drainage systems)	707
Guidelines - Change of vacuum drainage 
system	708
Guidelines - Removal of drain (Yeates vacuum drainage system)	708
Guidelines - Shortening of drain (Penrose, etc. 
open drainage systems)	709
Guidelines - Prevention of pressure ulcers	710
Index	711




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