Clinical Skills for Healthcare Assistants and Assistant Practitioners

Clinical Skills for Healthcare Assistants and Assistant Practitioners is an accessible, easy-to-read guide, outlining the fundamental and core skills integral to clinical practice.

Fully updated in its second edition, this book is divided into three sections; the first looks at fundamental skills applicable to all staff, such as accountability, communication and record keeping. Section two explores core clinical skills such as respiratory care, pulse, blood glucose management and catheter care. Section three outlines complex clinical skills that require more in-depth training, such as medication and intravenous cannulation.

An invaluable resource for healthcare assistants and assistant practitioners, this book will also be of use to newly qualified practitioners, and students in health and social care.

Angela Whelan is a Senior Lecturer, Teaching and Learning Fellow, and Programme Lead, in the Faculty of Health and Social Care at Edge Hill University, UK.

Elaine Hughes is a Senior Lecturer in Adult Nursing, Deputy Programme Co-ordinator BSc(Hons), and a SOLSTICE Fellow, in the Faculty of Health at Edge Hill University, UK.

Preface xi

Acknowledgements xiii

Introduction xv

Section I: Fundamental skills

1 Accountability 3

Aim of this chapter 3

Regulation and registration 3

Healthcare assistants and assistant practitioners 4

Responsibilities and accountability 5

Delegation 8

Related aspects and terminology 10

Summary 16

References 17

2 Communication in healthcare 19

Aim of this chapter 19

Why good communication is important 19

Definition of communication 20

Communication methods 22

Strategies to improve communication 27

Related aspects and terminology 27

Common problems or communication barriers 29

Skills for the Health Care Certificate 31

Summary 31

References 32

Addendum 33

3 Psychological well-being 34

Aim of this chapter 34

What is meant by psychological care? 34

Psychological assessment in the healthcare setting 35

The importance of psychological care in the healthcare setting 37

Strategies to optimise psychological well-being 41

Pharmacological (drug-related) options 43

Non-pharmacological options 44

Therapeutic sense of self 44

Common problems 45

Summary 46

References 47

4 Documentation and record keeping 49

Aim of this chapter 49

The importance and purpose of documentation in relation to clinical skills 49

Confidentiality in records and documentation 52

Types of documentation 52

Legal aspects relating to documentation 53

Common problems 56

Related aspects and terminology 56

Strategies to improve standards of record keeping 56

Summary 57

References 59

Section II: Core clinical skills

5 Pulse 63

Aim of this chapter 63

What is a pulse? 63

Relevant anatomy and physiology 64

Related aspects and terminology 66

Factors affecting the pulse rate 67

Terminology 68

Automated devices 70

Fetal heartbeat 73

Documentation 75

Common problems 76

Summary 79

References 80

6 Blood pressure monitoring 81

Aim of this chapter 81

What is blood pressure? 81

Reasons for monitoring blood pressure 81

Who requests the test? 81

Who can take a BP reading? 82

What is done with the readings/information? 82

Relevant anatomy and physiology 82

Related aspects and terminology 86

Terminology 87

Korotkoff’s sounds 88

Equipment 89

Sites for recording blood pressure 93

Taking blood pressure 94

Documentation 96

Common problems 96

Summary 102

References 103

7 Temperature 105

Aim of this chapter 105

What is temperature? 105

Reasons for measuring temperature 105

Normal limits 106

Relevant anatomy and physiology 107

Related aspects and terminology 107

Terminology 113

Taking a temperature reading 116

Route 119

Taking a temperature reading 119

Documentation 121

Common problems 124

Summary 125

References 128

8 Pulse oximetry 130

Aim of this chapter 130

What is an oxygen saturation reading? 130

Who can perform the test? 130

Reasons for recording an oxygen saturation level 131

Relevant anatomy and physiology 132

Related aspects and terminology 132

The mechanics of pulse oximetry 132

Equipment 134

Normal readings 134

Using a pulse oximeter 136

Documentation 137

Common problems 137

Summary 141

References 142

9 Respiratory care 143

Aim of this chapter 143

What is respiratory care? 143

Relevant anatomy and physiology 144

Upper respiratory system 144

Lower respiratory system 145

Recording a respiratory rate 147

How to measure and record a respiratory rate accurately 151

Measuring and recording a peak expiratory flow rate 151

Performing suctioning 154

Related aspects and terminology 156

Common problems 157

Summary 158

References 162

Addendum 163

Reference 166

10 Urinalysis and faecal occult blood testing 167

Aim of this chapter 167

Reasons for performing urinalysis and FOB tests 167

Relevant anatomy and physiology 168

Urinalysis testing 170

Faecal occult blood testing 175

Related aspects and terminology 178

Common problems 178

Summary 179

References 183

Addendum 183

11 Urinary catheterisation and catheter care 185

Aim of this chapter 185

Urinary catheterisation 185

Relevant anatomy and physiology 186

Types of catheterisation 188

Patient preparation for catheterisation 193

Insertion technique 194

Catheter care 198

Sampling 199

Removal of catheter 200

Related aspects and terminology 208

Terminology 210

Common problems 210

Summary 210

References 212

12 Venepuncture 214

Aim of this chapter 214

Reasons for performing venepuncture 214

Relevant anatomy and physiology 214

Common sites for venepuncture 215

Infection 215

Hand hygiene 218

Aseptic (sterile) technique 219

Health and safety 219

Environment 220

Performing the skill: requirements and technique 220

Related aspects and terminology 227

Common problems 229

Summary 232

References 233

13 Blood glucose monitoring 235

Aim of this chapter 235

What causes diabetes? 235

Reasons for performing blood glucose measurement 235

Relevant anatomy and physiology 236

Related aspects and terminology 237

Blood glucose levels 241

Hypoglycaemia 247

Hyperglycaemia 248

Common problems 249

Summary 251

References 254

14 Fluid balance and intravenous maintenance 256

Aim of this chapter 256

Reasons for monitoring fluid balance 256

Related anatomy and physiology 256

Electrolytes 258

Related aspects and terminology 259

Fluid balance charts 261

The intravenous route 263

Care of the cannula 267

Discontinuing an IV infusion 267

Common problems 268

Summary 269

References 273

Section III: Complex clinical skills

15 Medicines 277

Aim of this chapter 277

The role of healthcare assistants and assistant practitioners in relation to medicine administration 277

Types of medicines 278

Medication prescribing and legal aspects 279

Related aspects and terminology 281

Common medications 286

Errors in administration and adverse reactions 291

Summary 292

References 292

16 Peripheral intravenous cannulation 294

Aim of this chapter 294

Reasons for cannulation 294

Why perform peripheral IV cannulation 295

Relevant anatomy and physiology 295

How to insert and remove a peripheral IV cannula 296

Environment 301

Performing peripheral IV cannula: requirements and technique 301

Patient education for peripheral IV cannulation 303

Related aspects and terminology 308

Common problems/potential complications of peripheral IV cannulation 309

Summary 314

References 317

17 Recording a 12-lead Electrocardiograph (ECG) 319

Aim of this chapter 319

Relevant anatomy and physiology 320

The cardiac conduction system 320

Reasons for recording a 12-lead ECG 322

How to perform a 12-lead ECG 323

Related aspects and terminology 330

Common problems and actions 331

Summary 332

References 335

Index 337

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