Oxford handbook of surgical nursing

787 Pages·2016·11.18 MB·English

by  Kisiel

OXFORD MEDICAL PUBLICATIONS
Oxford Handbook of 
Surgical Nursing
Published and forthcoming Oxford Handbooks in Nursing
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Health Nursing, 2e
Edited by Patrick Callaghan and
Catherine Gamble
Oxford Handbook of 
Surgical
Nursing
Edited by
Alison Smith
Lecturer,
University of Birmingham, UK
Maria Kisiel
Formerly Head of Department of Adult
and Critical Care Nursing,
Birmingham City University, UK
Mark Radford
Chief Nursing Officer,
University Hospitals Coventry
and Warwickshire NHS Trust,
and Professor,
Birmingham City University, UK
1
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v
Foreword
Florence Nightingale stated that ‘Apprehension, uncertainty, waiting,
expectation, fear of surprise, do a patient more harm than any exertion.’
The prospect of surgery can and does generate these emotions. This
Handbook offers nurses with an interest in and passion for surgical nurs-
ing a holistic perspective that can help to address not only these emo-
tions but also the physical and practical elements of practice.
The pace, scale, and sophistication of new treatments and technolo-
gies make surgery one of the fastest changing and exciting special-
ties. The ability to perform surgery on patients with complex medical
problems and chronic illness means that the skills required to provide
competent and compassionate care for these patients must extend
well beyond the fundamentals of pre- and post- operative care. Surgical
nurses require both a broad and deep knowledge and the necessary skills
if they are to be able to confidently assess patients’ needs and pre- empt
potential complications. This is more important than ever now that many
nurses are also undertaking more advanced procedures as part of the
multidisciplinary team.
This Handbook will both act as an aide- memoire and help to build
a knowledge base that will enable surgical nurses to understand their
core role and their contribution to the modern surgical team. It will be
of benefit to nurses and allied health professionals working on surgical
wards and also in the many settings in which surgical care is delivered,
including day- surgery, high- dependency, outpatient, and pre- operative
assessment clinics. It can be used by clinicians at different stages in their
professional development, including pre- and post- registration, as well
as those undertaking specialist and advanced practice.
This evidence- based, easily accessible, concise Handbook, which can
be used at the bedside, offers practical advice on how to effectively
assess, plan, implement, and evaluate surgical care. It also explains the
wider role of the surgical nurse in effective ward management and lead-
ership, and the implications for patient care.
Patients and their families deserve and expect a high- quality, digni-
fied, and safe experience when they have surgery. This requires skilled,
compassionate, and competent surgical clinicians who strive to con-
tinue to enhance and develop their knowledge, skills, and practice. This
Handbook without doubt supports the attainment of this. It is packed
with a wealth of information, and has the benefit of being written and
edited by credible, respected, and experienced clinicians and academics,
all of whom understand the challenges that face nurses and allied health
professionals working today in this dynamic and fast- moving field.
Janice Stevens CBE MA RGN
Director for Midlands and East
Health Education England
vi
Preface
Contributing to the writing and editing of this book has been both chal-
lenging and rewarding, and the end result is a product of the passion
and expertise of the many contributors for improving the care of the
surgical patient. It is hoped that, by using this key resource, the reader
will gain an insight into the diverse nature of surgical nursing and develop
confidence in their clinical practice. Each chapter has been written by
healthcare professionals with a passion for and expertise in their subject
area. The key references and suggestions for further reading at the end
of each section provide the reader with opportunities to supplement
their knowledge further.
Surgery is a complex and varied specialty that has seen significant
changes and technical advances in recent years. Central to this has been
the skill and support of the surgical nurse in ensuring improved outcomes
and compassionate care for patients. From the operating theatre to the
hospital bed, the surgical nursing specialty has developed and diversi-
fied to keep pace with the many advances and improvements in surgery.
Many textbooks in this subject area provide comprehensive information
in an attempt ‘to cover all bases’, which often means that these text-
books are large and not easily transportable to the bedside.
In developing the Oxford Handbook of Surgical Nursing, the editors have
aimed to adhere to the Oxford Handbook philosophy of providing high-
quality, quick- reference, pocket- sized resources that enable nurses to
easily check key clinical facts. It is hoped that this Handbook will also
complement and build upon other publications, while enabling nurses
and other allied healthcare professionals to quickly access concise rele-
vant information to support their clinical practice.
Alison Smith
Maria Kisiel
Mark Radford
2016
vii
Contents
Contributors ix
Symbols and abbreviations xi
1 Introduction to the surgical patient 1
2 Managing the surgical ward 29
3 Surgical care models 53
4 Pre- operative assessments and preparation 61
5 Pre- operative optimization 103
6 Transfer to other departments or theatre 115
7 Intra- operative care 123
8 Ward post- operative care 149
9 Pain management 167
10 Nutrition and hydration 193
11 Transfusion of blood products 213
12 Wound care 241
13 Skin assessment 257
14 Infection: prevention, control, and treatment 265
15 Post- operative complications 313
16 Surgical nursing procedures 335
17 Ophthalmology 361
18 Upper gastrointestinal and hepatobiliary surgery 395
19 Colorectal and lower gastrointestinal surgery 419
20 Trauma and orthopaedics 439
21 Vascular surgery 519
22 Urology and renal surgery 547
23 Neurological and spinal surgery 581
24 Burns and plastic surgery 613
viii CONTENTS
25 Thoracic surgery 651
26 Cardiac surgery 667
27 Breast surgery 695
28 Gynaecological surgery 725
Index 747
ix
Contributors
Debra Adams Helen Gibbons
(Chapter 14) (Chapter 17)
Head of Infection Prevention and Senior Lecturer
Control (Midlands and East) City University, London, UK
NHS Trust Development
Suzanne Hammond
Authority, UK
(Chapter 28)
Ann-M arie Cannaby Urogynaecology Clinical
(Chapter 2) Nurse Specialist
Executive Director of Nursing University Hospitals Coventry
Hamad Medical and Warwickshire NHS Trust, UK
Corporation, Qatar
Kim Harley
Ruth Capewell (Chapter 20, Chapter 23)
(Chapter 28) Formerly Senior Lecturer
MacMillan Gynaecology Clinical Birmingham City University, UK
Nurse Specialist (Oncology)
Suzanne Harrington
University Hospitals Coventry
and Warwickshire NHS Trust, UK (Chapter 28)
Modern Matron—G ynaecology
Anna Casey University Hospitals Coventry
(Chapter 14) and Warwickshire NHS Trust, UK
Clinical Research Scientist
Helen Holder
University Hospitals Birmingham
NHS Foundation Trust, UK (Chapter 10)
Senior Lecturer
Kirsty Cotterill Birmingham City University, UK
(Chapter 28)
Louise Jennings
Gynaecology Clinical
Nurse Specialist (Chapter 28)
University Hospitals Coventry Clinical Nurse Specialist
and Warwickshire NHS Trust, UK Gynaecology Outpatient
Department,
Kevin Crimmons University Hospitals Coventry
(Chapter 25) and Warwickshire NHS Trust, UK
Head of Adult Nursing
Sue Jones
Birmingham City University, UK
(Chapter 23)
Patricia Davies Formerly Senior Lecturer
(Chapter 12, Chapter 13) Birmingham City University, UK
Senior Lecturer
Aaron Kisiel
Birmingham City University, UK
(Chapter 1)
Suzanne Davies CT1 General Surgery
(Chapter 21) University Hospitals Birmingham
Vascular Nurse Specialist NHS Foundation Trust, UK
University Hospitals Coventry
and Warwickshire NHS Trust, UK