Details

<p>Brief table of contents v</p> <p>Foreword to the tenth edition xv</p> <p>Preface xvii</p> <p>Acknowledgements xix</p> <p>List of contributors xxi</p> <p>Quick reference to the procedure guidelines xxv</p> <p>How to use your manual xxix</p> <p><b>1 The context of nursing 1</b></p> <p>Overview 2</p> <p>Background 2</p> <p>Context of nursing 2</p> <p>Evidence-based practice 7</p> <p>Structure of the manual 8</p> <p>Structure of the chapters 9</p> <p>Finally 9</p> <p>References 10</p> <p><b>Part One Managing the patient journey 13</b></p> <p><b>2 Admissions and assessment 14</b></p> <p>Overview 16</p> <p>Inpatient assessment and the process of care 16</p> <p>Observation 24</p> <p>Physical assessment 24</p> <p><b>3 Discharge care and planning 45</b></p> <p>Overview 46</p> <p>Discharge care and planning 46</p> <p>Discharging patients from hospital: internal procedures 47</p> <p>Interface between primary and secondary care: external processes 53</p> <p>Informal carers 58</p> <p>The role of voluntary services 62</p> <p>References 62</p> <p><b>4 Infection prevention and control 64</b></p> <p>Overview 66</p> <p>Infection prevention and control 66</p> <p>Hand hygiene 75</p> <p>Personal protective equipment (PPE) 87</p> <p>Specific patient-related procedures 101</p> <p>Isolation procedures 105</p> <p>Environmental hygiene and the management of waste in the healthcare environment 111</p> <p>Prevention and management of inoculation injury 118</p> <p>Websites 119</p> <p>References 119</p> <p>4.1 Hand washing 79</p> <p>4.2 Hand decontamination using an alcohol-based handrub 80</p> <p>4.3 Surgical scrub technique using soap and water 82</p> <p>4.4 Surgical scrub technique using an alcohol-based handrub 84</p> <p>4.5 Putting on and removing non-sterile gloves 88</p> <p>4.6 Applying and removing a disposable apron 89</p> <p>4.7 Putting on and removing a disposable mask or respirator 91</p> <p>4.8 Putting on or removing goggles or a face-shield 93</p> <p>4.9 Donning a sterile gown and gloves: closed technique 94</p> <p>4.10 Donning sterile gloves: open technique 98</p> <p>4.11 Aseptic technique example: changing a wound dressing 102</p> <p>4.12 Source isolation: preparing an isolation room 106</p> <p>4.13 Source isolation: entering an isolation room 107</p> <p>4.14 Source isolation: leaving an isolation room 108</p> <p>4.15 Source isolation: transporting infected patients outside a source isolation area 108</p> <p>4.16 Protective isolation: preparing an isolation room 109</p> <p>4.17 Protective isolation: entering an isolation room 110</p> <p>4.18 Cleaning a hard surface without recontamination 112</p> <p>4.19 Safe disposal of foul, infected or infested linen 117</p> <p><b>Part Two Supporting patients with human functioning 123</b></p> <p><b>5 Communication, psychological wellbeing and safeguarding 124</b></p> <p>Overview 126</p> <p>Communication 126</p> <p>Providing information and making shared decisions 138</p> <p>Communicating with specific populations 141</p> <p>Psychological wellbeing 147</p> <p>Safeguarding, mental capacity and the Mental Health Act 169</p> <p>Websites 187</p> <p>References 187</p> <p><b>6 Elimination 194</b></p> <p>Overview 196</p> <p>Normal elimination 196</p> <p>Altered urinary elimination 200</p> <p>Altered faecal elimination 237</p> <p>Stoma care 257</p> <p>Websites 272</p> <p>References 272</p> <p>6.1 Slipper bedpan use: assisting a patient 198</p> <p>6.2 Commode use: assisting a patient 199</p> <p>6.3 Penile sheath application 202</p> <p>6.4 Urinary catheterization: male 208</p> <p>6.5 Urinary catheterization: female 210</p> <p>6.6 Changing a suprapubic catheter 214</p> <p>6.7 Urinary catheterization: intermittent self-catheterization patient guidance: male 216</p> <p>6.8 Urinary catheterization: intermittent self-catheterization patient guidance: female 217</p> <p>6.9 Urinary catheter bag: emptying 219</p> <p>6.10 Urinary catheter removal 219</p> <p>6.11 Commencing bladder irrigation 223</p> <p>6.12 Nephrostomy tube: weekly dressing and bag change and sample collection 227</p> <p>6.13 Nephrostomy tube: flushing technique 229</p> <p>6.14 Nephrostomy tube: removal of locking pigtail drainage system 230</p> <p>6.15 Flushing externalized ureteric stents 232</p> <p>6.16 Removal of externalized ureteric stents 233</p> <p>6.17 Continent urinary diversion stoma: self-catheterization 236</p> <p>6.18 Insertion of a faecal management system 240</p> <p>6.19 Insertion of a nasogastric drainage tube 247</p> <p>6.20 Removal of a nasogastric drainage tube 249</p> <p>6.21 Enema administration 250</p> <p>6.22 Suppository administration 252</p> <p>6.23 Digital rectal examination 254</p> <p>6.24 Digital removal of faeces 256</p> <p>6.25 Stoma siting 263</p> <p>6.26 Stoma bag change 264</p> <p>6.27 Obtaining a clean-catch urine sample from an ileal conduit 265</p> <p>6.28 Stoma bridge or rod removal 266</p> <p><b>7 Moving and positioning 278</b></p> <p>Overview 280</p> <p>Moving and positioning: general principles 280</p> <p>Moving and positioning an unconscious patient 293</p> <p>Moving and positioning a patient with an artificial airway 294</p> <p>Moving and positioning a patient with respiratory compromise 298</p> <p>Moving and positioning a patient with neurological impairment 301</p> <p>Moving and positioning a patient with actual or suspected spinal cord compression or spinal cord injury 313</p> <p>Moving and positioning a patient with raised intracranial pressure 325</p> <p>Moving and positioning a patient with an amputation 326</p> <p>Websites 329</p> <p>References 329</p> <p>7.1 Positioning a patient: supine 284</p> <p>7.2 Positioning a patient: sitting up in bed 285</p> <p>7.3 Positioning a patient: side-lying 286</p> <p>7.4 Positioning a patient: lying down to sitting up 288</p> <p>7.5 Moving a patient from sitting to standing: assisting the patient 289</p> <p>7.6 Positioning a patient: in a chair or wheelchair 291</p> <p>7.7 Assisting a patient to walk 292</p> <p>7.8 Positioning an unconscious patient or a patient with an artificial airway in supine 295</p> <p>7.9 Positioning an unconscious patient or a patient with an artificial airway in side-lying 296</p> <p>7.10 Positioning a neurological patient with tonal problems in bed 309</p> <p>7.11 Positioning a neurological patient with tonal problems in a chair 312</p> <p>7.12 Application of a two-piece cervical collar 318</p> <p>7.13 Log rolling a patient with suspected or confirmed cervical spinal instability (above T6) 319</p> <p>7.14 Log rolling a patient with suspected or confirmed thoracolumbar spinal instability (T7 and below) 321</p> <p>7.15 Early mobilization of a patient with spinal considerations 323</p> <p>7.16 Positioning a patient with an amputation 327</p> <p><b>8 Nutrition and fluid balance 334</b></p> <p>Overview 336</p> <p>Fluid balance 336</p> <p>Nutritional status 351</p> <p>Provision of nutritional support: Oral 359</p> <p>Nutritional management of patients with dysphagia 364</p> <p>Enteral tube feeding 365</p> <p>Parenteral nutrition 385</p> <p>Websites 389</p> <p>References 389</p> <p>8.1 Fluid input: measurement 345</p> <p>8.2 Fluid output: monitoring/measuring output if the patient is catheterized 346</p> <p>8.3 Fluid output: monitoring/measuring output if the patient is not catheterized 347</p> <p>8.4 Fluid output: monitoring/measuring output from drains 347</p> <p>8.5 Fluid output: monitoring/measuring output from gastric outlets, nasogastric tubes or gastrostomy 348</p> <p>8.6 Fluid output: monitoring/measuring output from bowels 349</p> <p>8.7 Fluid output: monitoring/measuring output from stoma sites 349</p> <p>8.8 Measuring the weight and height of a patient 356</p> <p>8.9 Feeding an adult patient 362</p> <p>8.10 Nasogastric intubation with tubes using an internal guidewire or stylet 369</p> <p>8.11 Removal of a nasogastric tube 374</p> <p>8.12 Percutaneous endoscopically placed gastrostomy (PEG) tube care 375</p> <p>8.13 Radiologically inserted gastrostomy (RIG) tube care 376</p> <p>8.14 Removal of T-fasteners 377</p> <p>8.15 Changing the balloon water and checking the volume of a balloon gastrostomy 378</p> <p>8.16 Jejunostomy feeding tube care including dressing change 379</p> <p>8.17 Insertion of a silicone gastrostomy stoma plug 380</p> <p>8.18 Enteral feeding tubes: administration of feed using an enteral feeding pump 381</p> <p>8.19 Enteral feeding tubes: administration of medication 384</p> <p>8.20 Enteral feeding tubes: unblocking 386</p> <p><b>9 Patient comfort and supporting personal hygiene 394</b></p> <p>Overview 396</p> <p>Personal hygiene 396</p> <p>Sleep promotion in a hospitalized patient 407</p> <p>Patient environment 409</p> <p>Eye care 413</p> <p>Ear care 423</p> <p>Mouth care 427</p> <p>Websites 439</p> <p>References 439</p> <p>9.1 Bedbathing a patient 401</p> <p>9.2 Washing a patient’s hair in bed 403</p> <p>9.3 Shaving the face: wet shave 405</p> <p>9.4 Shaving the face: dry electric shaver 406</p> <p>9.5 Making an unoccupied bed 410</p> <p>9.6 Making an occupied bed 412</p> <p>9.7 Eye swabbing 417</p> <p>9.8 Eye irrigation 418</p> <p>9.9 Artificial eye care: insertion 420</p> <p>9.10 Artificial eye care: removal 420</p> <p>9.11 Contact lens removal: hard lenses 421</p> <p>9.12 Contact lens removal: soft lenses 422</p> <p>9.13 Irrigation of the external auditory canal using an electronic irrigator 425</p> <p>9.14 Mouth care 436</p> <p>9.15 Mouth care for a patient with dentures 437</p> <p><b>10 Pain assessment and management 446</b></p> <p>Overview 448</p> <p>Pain 448</p> <p>Pain management 456</p> <p>Regional analgesia: local anaesthetic nerve blocks and infusions 462</p> <p>Epidural analgesia 469</p> <p>Entonox administration 481</p> <p>Non-pharmacological methods of managing pain 485</p> <p>References 491</p> <p>10.1 Pain assessment 455</p> <p>10.2 Peripheral nerve catheter removal 464</p> <p>10.3 Epidural sensory blockade: assessment 475</p> <p>10.4 Epidural exit site dressing change 475</p> <p>10.5 Epidural catheter removal 479</p> <p>10.6 Entonox administration 484</p> <p>10.7 Preparation for acupuncture and actions post-treatment 490</p> <p><b>11 Symptom control and care towards the end of life 496</b></p> <p>Overview 498</p> <p>End-of-life care 498</p> <p>Symptom control 515</p> <p>Verification and certification of death 526</p> <p>Care after death (last offices) 528</p> <p>Websites 534</p> <p>References 534</p> <p>11.1 Management of dyspnoea (breathlessness) 516</p> <p>11.2 Care of a patient who is vomiting 519</p> <p>11.3 Abdominal paracentesis 523</p> <p>11.4 Terminal sedation 526</p> <p>11.5 Verification of death 527</p> <p>11.6 Care after death 529</p> <p><b>12 Respiratory care, CPR and blood transfusion 538</b></p> <p>Overview 540</p> <p>Respiratory therapy 540</p> <p>Oxygen therapy 542</p> <p>High-flow oxygen via a nasal cannula 551</p> <p>Humidification 553</p> <p>Non-invasive ventilation 555</p> <p>Chest drain management 562</p> <p>Tracheostomy and laryngectomy care 578</p> <p>Basic life support 607</p> <p>Transfusion of blood and blood components 620</p> <p>Websites 645</p> <p>References 645</p> <p>12.1 Oxygen therapy 546</p> <p>12.2 High-flow oxygen therapy 552</p> <p>12.3 Continuous positive airway pressure (CPAP) 559</p> <p>12.4 Chest drain: assisting insertion 567</p> <p>12.5 Chest drainage: suction 572</p> <p>12.6 Chest drain: changing the bottle 573</p> <p>12.7 Chest drain: removal 576</p> <p>12.8 Tracheostomy: dressing and tube tape/tie change 587</p> <p>12.9 Tracheostomy: suctioning a patient (single-use suction catheter) 590</p> <p>12.10 Tracheostomy: changing an inner cannula 592</p> <p>12.11 Tracheostomy: changing a tube 594</p> <p>12.12 Tracheostomy: insertion and removal of a speaking valve 597</p> <p>12.13 Tracheostomy: decannulation 599</p> <p>12.14 Tracheostomy: emergency management 601</p> <p>12.15 Laryngectomy care 605</p> <p>12.16 Insertion of an oropharyngeal airway 616</p> <p>12.17 Basic life support 617</p> <p>12.18 Blood product request 634</p> <p>12.19 Blood sampling: pre-transfusion 635</p> <p>12.20 Blood components: collection and delivery to the clinical area 636</p> <p>12.21 Blood component administration 638</p> <p><b>Part Three Supporting patients through the diagnostic process 653</b></p> <p><b>13 Diagnostic tests 654</b></p> <p>Overview 656</p> <p>Diagnostic tests 656</p> <p>Blood sampling 660</p> <p>Venepuncture: obtaining blood samples from a peripheral vein 662</p> <p>CVAD sampling: sampling from a central venous access device 671</p> <p>Arterial blood sampling 675</p> <p>Blood cultures 683</p> <p>Antimicrobial drug assay 687</p> <p>Cerebrospinal fluid obtained by lumbar puncture 689</p> <p>Semen collection and analysis 694</p> <p>Cervical screening 697</p> <p>Specimen collection: swab sampling 701</p> <p>Specimen collection: urine sampling 710</p> <p>Specimen collection: faecal sampling 715</p> <p>Specimen collection: respiratory tract secretion sampling 717</p> <p>Specimen collection: pleural fluid 722</p> <p>Endoscopic investigations 723</p> <p>Liver biopsy 728</p> <p>Radiological investigations: X-ray 730</p> <p>Magnetic resonance imaging (MRI) 730</p> <p>Computed tomography (CT) 732</p> <p>Websites 733</p> <p>References 733</p> <p>13.1 Venepuncture 666</p> <p>13.2 Central venous access devices: taking a blood sample for vacuum sampling 672</p> <p>13.3 Central venous access devices: taking a blood sample for syringe sampling 673</p> <p>13.4 Arterial puncture: radial artery 678</p> <p>13.5 Arterial blood gas sampling: arterial cannula 680</p> <p>13.6 Blood cultures: peripheral (winged device collection method) 684</p> <p>13.7 Blood cultures: central venous access device 686</p> <p>13.8 Blood sampling: antimicrobial drug assay 688</p> <p>13.9 Lumbar puncture 692</p> <p>13.10 Semen collection 696</p> <p>13.11 Cervical uterine smear using liquid-based cytology 699</p> <p>13.12 Swab sampling: ear 702</p> <p>13.13 Swab sampling: eye 703</p> <p>13.14 Swab sampling: nose 704</p> <p>13.15 Swab sampling: penis 705</p> <p>13.16 Swab sampling: rectum 705</p> <p>13.17 Swab sampling: skin 706</p> <p>13.18 Swab sampling: throat 707</p> <p>13.19 Swab sampling: vagina 708</p> <p>13.20 Swab sampling: wound 709</p> <p>13.21 Urine sampling: midstream specimen of urine: male 711</p> <p>13.22 Urine sampling: midstream specimen of urine: female 712</p> <p>13.23 Urine sampling: catheter specimen of urine 713</p> <p>13.24 Urine sampling: sampling from an ileal conduit 713</p> <p>13.25 Urine sampling: 24-hour urine collection 714</p> <p>13.26 Faecal sampling 716</p> <p>13.27 Sputum sampling 719</p> <p>13.28 Nasopharyngeal wash: syringe method 719</p> <p>13.29 Nasopharyngeal wash: vacuum-assisted aspirate method 721</p> <p><b>14 Observations 740</b></p> <p>Overview 742</p> <p>Observations 742</p> <p>Pulse (heart rate) 744</p> <p>Electrocardiogram (ECG) 751</p> <p>Blood pressure 758</p> <p>Respiration and pulse oximetry 766</p> <p>Peak flow 777</p> <p>Temperature 781</p> <p>Urinalysis 788</p> <p>Blood glucose 793</p> <p>Neurological observations 800</p> <p>References 814</p> <p>14.1 Pulse measurement 749</p> <p>14.2 Electrocardiogram (ECG) 755</p> <p>14.3 Blood pressure measurement (manual) 763</p> <p>14.4 Respiratory assessment and pulse oximetry 775</p> <p>14.5 Peak flow reading using a manual peak flow meter 780</p> <p>14.6 Tympanic temperature measurement 786</p> <p>14.7 Urinalysis: reagent strip 792</p> <p>14.8 Blood glucose monitoring 797</p> <p>14.9 Neurological observations and assessment 811</p> <p><b>Part Four Supporting patients through treatment 819</b></p> <p><b>15 Medicines optimization: ensuring quality and safety 820</b></p> <p>Overview 822</p> <p>Medicines management 822</p> <p>Self-administration of medicines 833</p> <p>Controlled drugs 835</p> <p>Routes of administration 843</p> <p>Parenteral administration (injections and infusions) 869</p> <p>Infiltration and extravasation 918</p> <p>Websites 932</p> <p>References 932</p> <p>15.1 Medication: controlled drug administration 841</p> <p>15.2 Medication: oral drug administration 849</p> <p>15.3 Medication: topical applications 851</p> <p>15.4 Medication: transdermal applications 853</p> <p>15.5 Medication: vaginal administration 855</p> <p>15.6 Medication: administration by inhalation using a metered dose or dry powder inhaler 858</p> <p>15.7 Medication: administration by inhalation using a nebulizer 860</p> <p>15.8 Medication: eye administration 864</p> <p>15.9 Medication: nasal drop administration 866</p> <p>15.10 Medication: ear drop administration 868</p> <p>15.11 Medication: single-dose ampoule: solution preparation 872</p> <p>15.12 Medication: single-dose ampoule: powder preparation 873</p> <p>15.13 Medication: multidose vial: powder preparation using a venting needle 874</p> <p>15.14 Medication: multidose vial: powder preparation using the equilibrium method 876</p> <p>15.15 Medication: injection administration 877</p> <p>15.16 Medication: intradermal injection 879</p> <p>15.17 Medication: subcutaneous injection 882</p> <p>15.18 Medication: subcutaneous infusion of fluids 885</p> <p>15.19 Medication: subcutaneous administration using a CME Medical T34 syringe pump (previously McKinley) 886</p> <p>15.20 Medication: intramuscular injection 891</p> <p>15.21 Inserting an intraosseous needle 894</p> <p>15.22 Removing an intraosseous needle 897</p> <p>15.23 Medication: continuous infusion of intravenous drugs 909</p> <p>15.24 Medication: intermittent infusion of intravenous drugs 911</p> <p>15.25 Medication: injection (bolus or push) of intravenous drugs 914</p> <p>15.26 Extravasation management: peripheral cannula 925</p> <p>15.27 Extravasation: performing flush-out following an extravasation 928</p> <p><b>16 Perioperative care 940</b></p> <p>Overview 942</p> <p>Pre-operative care 942</p> <p>Intraoperative care 977</p> <p>Post-operative care 1001</p> <p>16.1 Measuring and applying antiembolic stockings 963</p> <p>16.2 Pre-operative care: checking that the patient is fully prepared for surgery 975</p> <p>16.3 Caring for the patient in the anaesthetic room 979</p> <p>16.4 Operating theatre procedure: maintaining the safety of a patient during surgery 992</p> <p>16.5 Handover in the post-anaesthetic care unit (PACU): scrub nurse or operating department practitioner to recovery practitioner 996</p> <p>16.6 Safe management of patients in the post-operative care unit (PACU) 997</p> <p>16.7 Drainage systems: changing the dressing around the drain site for both open and closed drains 1006</p> <p>16.8 Closed drainage systems: changing a vacuum bottle 1007</p> <p>16.9 Wound drain removal: closed drainage system 1008</p> <p>16.10 Wound drain shortening for open drainage systems 1010</p> <p>16.11 Wound drain shortening for closed drainage systems 1012</p> <p><b>17 Vascular access devices: insertion and management 1028</b></p> <p>Overview 1030</p> <p>Vascular access devices 1030</p> <p>Peripheral cannulas 1046</p> <p>Midline catheters 1068</p> <p>Peripherally inserted central catheters 1073</p> <p>Short-term percutaneous central venous catheters (non-tunnelled) 1090</p> <p>Skin-tunnelled catheters 1097</p> <p>Implanted ports 1102</p> <p>Arterial cannulas 1110</p> <p>References 1117</p> <p>17.1 Central venous catheter: insertion site dressing change 1042</p> <p>17.2 Vascular access devices: maintaining patency 1043</p> <p>17.3 Central venous access devices: unblocking an occlusion 1043</p> <p>17.4 Peripheral cannula insertion 1053</p> <p>17.5 Ultrasound-guided peripheral cannula insertion 1059</p> <p>17.6 Midline catheter insertion 1069</p> <p>17.7 PICC insertion using modified Seldinger technique (MST) with ultrasound 1082</p> <p>17.8 PICC removal 1089</p> <p>17.9 Short-term central venous catheter (non-cuffed and non-tunnelled) insertion into the internal jugular vein 1092</p> <p>17.10 Short-term central venous catheter (non-cuffed and non-tunnelled): removal 1096</p> <p>17.11 Central venous catheter (skin tunnelled): surgical removal 1099</p> <p>17.12 Implanted arm PORT insertion using modified Seldinger technique (MST) with ultrasound guidance and ECG technology 1104</p> <p>17.13 Implanted ports: insertion and removal of non-coring needles 1107</p> <p>17.14 Arterial cannula insertion: preparation and setting up of monitoring set 1112</p> <p>17.15 Arterial cannula: removal 1114</p> <p><b>18 Wound management 1128</b></p> <p>Overview 1130</p> <p>Wounds 1130</p> <p>Pressure ulcers 1143</p> <p>Surgical wounds 1152</p> <p>Negative pressure wound therapy 1154</p> <p>Websites 1157</p> <p>References 1157</p> <p>18.1 Dressing a wound 1142</p> <p>18.2 Suture removal 1153</p> <p>18.3 Clip removal 1153</p> <p>18.4 Negative pressure wound therapy 1155</p> <p>Part Five Looking after ourselves so we can support patients 1161</p> <p><b>19 Self-care and wellbeing 1162</b></p> <p>Overview 1164</p> <p>Self-care and wellbeing 1164</p> <p>Mindfulness 1172</p> <p>Eating and drinking 1173</p> <p>Physical wellbeing and musculoskeletal health 1175</p> <p>Websites 1181</p> <p>References 1181</p> <p>19.1 Working at low or floor level 1178</p> <p>19.2 Working with a patient lying in a bed or on another raised supportive surface 1179</p> <p>19.3 Carrying out clinical procedures in a seated posture (e.g. cannulation) 1180</p> <p>19.4 Working in a seated position: office work 1180</p> <p>Appendix: Standards of Proficiency for Registered Nurses 1183</p> <p>List of abbreviations 1185</p> <p>Index 1189</p>

<p>"...an excellent resource to improve and enhance clinical practice." (<i>Nursing Standard</i>)</p> <p>"...a worldwide 'oracle' for all clinical nursing procedures." (<i>Cancer Nursing Practice</i>)</p> <p>"Any nurse...will find a good reason to dip into this book at some time." (<i>Nursing Times</i>)</p> <p>"...a pleasure to read and difficult to put down." (<i>Emergency Nurse</i>)</p>

<p><b>Sara Lister</b>, Head of Pastoral Care, Psychological Support, and PALS, The Royal Marsden Hospital NHS Foundation Trust, UK.</p> <p><b>Justine Hofland</b>, Divisional Clinical Nurse Director - Cancer Services, The Royal Marsden NHS Foundation Trust, UK.</p> <b>Hayley Grafton</b>, Chief Nursing Information Officer, The Royal Marsden NHS Foundation Trust, UK.

<p><b>Praise for <i>The Royal Marsden Manual of Clinical Nursing Procedures</i></b> <p>"…an excellent resource to improve and enhance clinical practice."</br> <b>Nursing Standard</b> <p>"…a worldwide 'oracle' for all clinical nursing procedures."</br> <b>Cancer Nursing Practice</b> <p>"…a pleasure to read and difficult to put down."</br> <b>Emergency Nurse</b> <p>Now in its tenth edition, <i>The Royal Marsden Manual of Clinical Nursing Procedures</i> has been the definitive, market-leading guide to clinical nursing skills for over three decades. This internationally best-selling title sets the gold standard for nursing care; providing the procedures, rationale, and guidance required by qualified nurses to deliver clinically effective, patient-focused care with expertise and confidence. <p>With over two-hundred detailed procedures, this comprehensive manual presents the evidence and underlying theory alongside full-colour illustrations and photographs, and includes coverage of infection prevention and control, perioperative care, wound management, nutrition, diagnostic testing, discharge, medicines management, and much more. Loved and trusted by millions for over thirty years, <i>The Royal Marsden Manual of Clinical Nursing Procedures</i> continues to be a truly indispensable guide for nursing practice. <ul> <li>Written by nurses for nurses</li> <li>Empowers nurses to become informed, skilled practitioners</li> <li>Reflects current procedures and changes in modern adult nursing practice</li> <li>All procedures are supported by up-to-date evidence, including detailed rationales for each step of each procedure</li> <li>Considers the clinical governance around the procedures and nursing practice</li> <p><b>NEW to the Tenth Edition:</b> <ul> <li>Each chapter is linked to the NMC 2018 'Future Nurse: Standards of Proficiency for Registered Nurses' guidance</li> <li>Includes a brand-new chapter on 'Self-care and wellbeing,' helping nurses to care for themselves emotionally and physically</li> </ul> <p><b>The Royal Marsden Manual is also available online, fully searchable, and annotatable.</b></br> www.rmmonline.co.uk

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