P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK BLBK201-Peate October 30, 2009 21:35 Nursing Care and the Activities of Living Second Edition Edited by Ian Peate EN(G), RGN, DipN (Lond), RNT, BEd (Hons), MA (Lond), LLM Head of the School of Nursing and Midwifery Faculty of Health and Human Sciences Thames Valley University Middlesex, UK A John Wiley & Sons, Ltd., Publication iii P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK BLBK201-Peate October 30, 2009 21:35 Nursing Care and the Activities of Living i P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK BLBK201-Peate October 30, 2009 21:35 Dedication This book is dedicated to all the student nurses who do make a difference. ii P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK BLBK201-Peate October 30, 2009 21:35 Nursing Care and the Activities of Living Second Edition Edited by Ian Peate EN(G), RGN, DipN (Lond), RNT, BEd (Hons), MA (Lond), LLM Head of the School of Nursing and Midwifery Faculty of Health and Human Sciences Thames Valley University Middlesex, UK A John Wiley & Sons, Ltd., Publication iii P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK BLBK201-Peate October 30, 2009 21:35 This edition first published 2010 ⃝C Blackwell Publishing Ltd Blackwell Publishing was acquired by John Wiley & Sons in February 2007. 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If professional advice or other expert assistance is required, the services of a competent professional should be sought. Library of Congress Cataloging-in-Publication Data Nursing Care and the Activities of Living / edited by Ian Peate. 2nd ed. p. ; cm. Rev. ed. of: Compendium of clinical skills for student nurses / edited by Ian Peate. 2005. Includes bibliographical references and index. ISBN 978-1-4051-9458-7 (pbk. : alk. paper) 1. Nursing–Textbooks. I. Peate, Ian. II. Compendium of clinical skills for student nurses. [DNLM: 1. Nursing Care–Great Britain. WY 100 C737 2010] RT41.C7445 2010 610.73–dc22 2009021836 A catalogue record for this book is available from the British Library. ⃝R Set in 9/12.5 pt Interstate Light by Aptara Inc., New Delhi, India Printed in Malaysia 1 2010 iv P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK BLBK201-Peate October 30, 2009 21:35 Contents Contributors xi Acknowledgements xv Introduction – Ian Peate xvii 1 The Nature of Nursing 1 Lynn Quinlivan Introduction 1 The Nursing and Midwifery Council 2 Registration and professional accountability 2 Standards of conduct and performance 3 Maintenance of a register of nurses and midwives 3 Duty of care 4 Fitness to practise 5 Nurses and accountability 5 Nursing hierarchy 6 Government directives 9 The structure of the NHS in England 13 The structure of the NHS in Scotland 15 The structure of the NHS in Wales 15 The structure of the NHS in Northern Ireland 15 Conclusions 16 References 17 2 Safeguarding Vulnerable Adults 19 Victoria Darby Introduction 20 Defining a vulnerable adult and abuse 20 Ethics and safeguarding the vulnerable adult 23 Policies and legislation for safeguarding the vulnerable adult 28 Safeguarding vulnerable adults from unprofessional nurses 32 Fitness to practise panels 32 Interprofessional collaboration 33 Reporting suspicions of abuse as a nurse 33 Assessing the seriousness of abuse 34 Reporting suspicions of abuse as a student nurse 34 Conclusions 35 References 36 v P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK BLBK201-Peate October 30, 2009 21:35 vi Contents 3 Assessing Needs and the Nursing Process 38 Lynda Sibson Introduction 39 Models of nursing 39 Activities of living 40 Organisation of nursing care 40 Nursing practice 41 Nursing history 41 Elements in nursing 42 Theories, concepts and models 43 Nursing process 46 Conclusions 57 References 58 4 Promoting Safety 60 Janet G. Migliozzi Introduction 60 Risk assessment 61 Common risks in health care 63 Common factors affecting patient safety 64 Minimising the risk of medication error 64 Minimising the risk of falls 66 Minimising the risk of health care-associated infection 68 Conclusions 79 References 80 5 Communicating Effectively 83 David Briggs Introduction 84 Talking to patients, carers and colleagues effectively and clearly conveying and receiving the intended message 85 Facilitating patients and their carers to communicate effectively 86 The importance of listening effectively 87 Potential communication difficulties 87 The differing methods of communication used by individuals 88 Communicating with people from different cultures 89 Coping in a very specific and difficult situation 90 Using body language effectively 90 Using the electronic means of distributing information 91 The ability to know when someone needs to know a piece of information 92 Information and record keeping 93 Communication and reflective practice 94 Conclusions 95 References 98 P1: SFK/UKS P2: SFK/UKS QC: SFK/UKS T1: SFK BLBK201-Peate October 30, 2009 21:35 Contents vii 6 Eating and Drinking: Fluid and Nutritional Care in Practice 100 Jane Say Introduction 101 Nutritional issues and clinical practice 101 Obesity 101 Undernutrition 102 Disease-related factors 102 Non-disease-related factors 103 Providing nutritional care in practice 103 Screening/assessment to identify patients’/clients’ nutritional needs 104 Body mass index 105 Weight loss 105 Recent dietary intakes 108 Stress factors/nature of current illness 108 Further action, assessment and referral 109 Planning, implementation and evaluation of nutritional care 109 Monitoring and re-screening 109 Factors that affect nutritional care: the hospital and care environment 110 Assistance with eating and drinking 111 Food provision 113 Nutritional support 114 Improving oral intakes 114 Oral supplements 114 Enteral (or tube) feeding 115 Specific nursing care associated with enteral feeding 116 Parenteral nutrition 120 Fluid management in clinical practice 121 Clinical assessment of fluid balance 121 Conclusion 125 References 126 7 Elimination – Alimentary and Urinary Tract 129 Muralitharan Nair Introduction 129 The oral cavity 131 Pharynx 132 Oesophagus 132 Stomach 133 Small intestine 134 Large intestine 134 The accessory organs 135 Care of patients with gastrointestinal disorders 137 Renal system 143 The prostate gland 144 Care of patients with urological disorders 145