Foundations of Nursing Practice

Themes, concepts and frameworks, fourth edition

by Richard Hogston and Barbara Marjoram

Chapter summaries

Part and Chapter Summaries

PART I – NURSING SKILLS AND CONCEPTS

Part one introduces key skills and concepts of nursing which underpin nursing practice

1 Managing Nursing Care
Richard Hogston
Chapter 1 introduces the Nursing Process, a systematic problem-solving framework that enables the nurse to manage and plan care. The five basic stages include assessment, diagnosis, planning, implementation and evaluation. Using the vehicle of structured activities, readers are given the opportunity to develop a care plan for a chosen client.

2 Communication and Professional Interactions
Phil Russell
Communication and the skill of working effectively in a team is a key part of nursing at all levels. The first section of Chapter 2 examines therapeutic communication, exploring the meaning of these terms before identifying the qualities required to enhance communication beyond just conveying information. It highlights that clients need more than scientific intervention as part of their care, they need compassion and to be heard. The second part of the chapter examines in more detail some of the tools available to start the process of developing good therapeutic skills that can be used with patients, families and colleagues.

3 Concepts and Challenges of Professional Practice
Steve Tee
This chapter introduces the reader to the realities of modern professional practice. It will help readers to understand and navigate through the many professional, statutory, local and national policy initiatives that will impact on their decision-making. The chapter also explores the philosophical principles that underpin the NMC Code of conduct (NMC 2008) and particular reference is made to consent, confidentiality, capacity and the implications for nurses’ accountability, as well as professional and legal responsibilities.

4 Developing Skills for Reflective Practice
Melanie Jasper
Chapter 4 presents the key elements of reflective practice as a requisite component of professional practice. Developing the skills of reflective practice empowers the practitioner in making judgements and supporting their decision-making, resulting in the development of practice theory and a knowledge base that derives from practice experiences.

PART II – NURSING INTERVENTIONS

Part two ‘enters’ the clinical context of practice introducing key areas of nursing intervention.

5 Infection Control
Somduth Parboteeah
This chapter describes the policies and principles which nurses must follow to prevent health care associated infections (HCAI). It focuses on the practical aspects of reducing HCAI, such as MRSA, in the day to day management of patients by following evidence based guidelines.

6 Administration of medications
Somduth Parboteeah
Chapter 6 describes some of the key aspects of safe practice in the administration of medicines. It highlights how the healthcare practitioner is responsible for assessing, planning, implementing and evaluating drug therapies, as well as educating patients about their drug regimens. It explains that an effective practitioner must have an understanding of the fundamental principles of drug action, the purposes of drug use and the actions necessary to bring about beneficial outcomes. By applying the principles described in this chapter, the healthcare practitioner can ensure that procedures are carried out safely, that patients are not harmed and that their care is optimized.

7 Eating and Drinking
Sue M. Green
Chapter 7 reviews the basic concepts of nutritional science. It explains the process of nutritional care, involving screening and assessing nutritional status, planning and implementing nutritional interventions and evaluating care given.

8 Elimination
Barbara Marjoram
This chapter explores both the urinary and faecal elements of elimination. It explains the normal anatomy and physiology and then identifies the abnormal processes of and influences on elimination. It explores possible treatments, the advice available and nursing care for the conditions identified. Chapter 8 helps help to dispel some taboos and myths about elimination, with a healthy emphasis on achieving and attaining relative normality across the life span.

9 Respiration
Jan Dean, Pam Diggens and Rob Haywood
Chapter 9 explores the nurse’s role in assessing and implementing the care of clients with difficulties of breathing. It provides an overview of the physiology and pathophysiology of the respiration system.

10 Circulation
Chris Walker
Chapter 10 explains the purpose of the circulatory system. It focusses upon the common disease processes which affect the circulatory system and details nursing assessments and interventions which are utilised when caring for patients. It also highlights the importance of nursing staff being able to detect life threatening situations, such as cardiac arrest and shock, and to initiate resuscitative measures.

11 Wound Management
Pam Jackson, Lynn Taylor and Nadia Chambers
The effective management of wounds and the prevention of pressure ulcers is a complex area of care, involving integrated and systematic assessment, the identification of problems, and the planning, implementation and evaluation of nursing interventions. This chapter gives an overview of the elements underpinning the principles of wound healing and management. It highlights the central role of the nurse; the importance of ongoing, evidence-based education to inform decision-making in practice and the value of reflection as a way of evaluating experiences. It also introduces a wide range of tools, frameworks and guidelines available to assist in making a professional judgement.

12 Moving and Handling
Wayne Arnett and Kevin Humphrys
This chapter explores the concepts inherent within moving and handling in the healthcare arena and daily life activities. It highlights the incredible importance of moving and handling procedures and also raises awareness that difficulty of movement and mobility affects not only the client, but also has an impact on nurses and how they aid and handle clients.

13 Dying, Death & Spirituality
Phil Russell
Chapter 13 explores death, dying, loss and bereavement. The chapter emphasises the individual nature of caring for people who are dying or bereaved and highlights that whether dealing with a dying child, an adult, older person, someone with mental health problems or a learning disability, each require their individual circumstances to be carefully considered. It also considers the role of religion and spirituality and how changes to health can make clients question or confirm their beliefs, particularly when life is limited.

14 Drug and Alcohol Misuse
Anita Green
Nurses often come into contact with people who use drugs and/or alcohol and therefore they play a vital role in the assessment, support, and treatment of their presenting health care needs. Chapter 14 discusses the nurse’s responsibility to understand substance misuse and to recognise the physical, psychological and social needs of the client. It also covers the legalities, policies, anxieties and complexities of caring in this area in order to aid decision-making and still offer person-centred care.

PART III – PROFESSIONAL ISSUES

Part three aids development of professional knowledge, introducing the complex nature of nursing and the personal awareness and understanding needed for effective practice.

15 Body image and Sexuality
Sid Carter and Anita Green
The expression of sexuality and body image appear to be inter-related particularly when associated with physical or mental illness, disease or physical trauma. Chapter 15 explores body image and sexuality, an area which demands sensitive and thoughtful care. This chapter explains the part nurses play in helping clients when body image and sexuality need to be addressed and their vital role in providing physical and psychological care, support and treatment.

16 Genetics Knowledge within an Ethical Framework
Delia Pogson
Chapter 16 introduces the structure and function of chromosomes and genes and explores the issues of inheritance of characteristics and genetic disorders, and the role of genetics and genomics in common diseases. It highlights related ethical issues, such as how genetic information is collected from individuals and then used, and how it is stored so as to preserve the principles of consent and confidentiality. This chapter also considers how genetics can help us to further understand human development, health and disease, mental health and mental disorders, and learning disabilities.

17 Nursing Practice in an Interprofessional Context
Janet McCray
Chapter 17 considers working within an interprofessional context and the importance of effective teamwork. It explores the need for collaboration to meet service users’ needs and therefore how working together with other professionals and healthcare staff will become part of everyday practice. The chapter also discusses key professional skills and concepts, including teamwork, collaboration, socialisation and shared professional values.

18 Public Health in Nursing
Elizabeth Porter
Chapter 18 analyses the contribution of the nurse to public health within the nine identified areas of public health activity, defined by Skills for Health & Public Health resource Unit 2008. These nine areas offer the framework for the chapter. The chapter also considers the nurse’s role in health promotion, health education, targeting risk in the population, tackling inequalities and improving health. It discusses how nurses are well placed to understand health and disease in society in order to provide better prevention services, do more to tackle inequalities and improve access to services.

19 Health Informatics
Adam Keen and Neil Hosker
Informatics is the collection, evaluation, organisation and dissemination of information. This chapter explores the role of information in healthcare provision, considering what information is needed and how information is shared. Health informatics is highly relevant in modern practice when one considers the role of computers, the internet and technology in nursing today. Chapter 19 also covers relevant legislation and current national policy including data protection, freedom of information and computer misuse.

20 Developing effective leadership & management skills
Yvette Cox
Chapter 20 explores the management and leadership skills required, even from an early stage, to develop into a registered autonomous practitioner. It explores relevant theories in order to shed light on what leaders and managers do, and the skills which are necessary to enable them to achieve the role successfully. The chapter examines the role of the manager in relation to planning, organising, directing and controlling.

21 Answers
At the end of each chapter you will find Test Yourself!’ questions. Chapter 21 contains the answers to these questions.