Understanding your role in reducing medication errors
Learn about patient identification, blood component checks and reducing potential hazards
Promoting a team approach to the procedure, which ensures risks to patients are minimised
ECG can assist in diagnoses of arrhythmias, hypertension, heart disease or heart failure
Identifying a suitable vein and the appropriate needle or butterfly device for the procedure
Using a structured approach and a variety of skills to determine nutritional status
Determining how and why a patient safety incident has occurred
Rationale and key points Effective insulin injection technique is essential to ensure optimal management of diabetes. Those who administer insulin should understand how it works, in particular its link to blood glucose levels. This article outlines how to administer an insulin injection, including: the competencies healthcare practitioners require to undertake this procedure; the steps they should undertake to safely administer insulin; and the evidence base supporting safe and effective insulin injection. » Insulin can be injected using either an insulin pen or a syringe and vial. There are various insulin regimens available, such as basal only, basal-bolus and mixed insulin. » Potential insulin injection sites include the abdomen, thighs, buttocks or arms. The presence of lipohypertrophy at an insulin site indicates that another site should be used. » Insulin should be injected into the subcutaneous tissue at a 90-degree angle. The skin should be raised to reduce the risk of injecting into the muscle; however, this risk is reduced with the use of shorter needles. Reflective activity ‘How to’ articles can help update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: 1. How you think you could use this article to improve your practice in administering insulin injections. 2. How you could use this resource to educate your colleagues about administering insulin injections.
Rationale and key points This article aims to improve nurses’ knowledge and understanding of the procedure for auscultating heart sounds in adults, as part of a cardiovascular examination. It focuses on auscultating normal heart sounds; it is beyond the scope of this article to discuss the pathophysiology of abnormal findings. » A stethoscope is used to auscultate for heart sounds. The diaphragm of the stethoscope is used to identify high-pitched sounds, while the bell is used to identify low-pitched sounds. » There are two normal heart sounds that should be elicited in auscultation: S1 (lub) and S2 (dub). » The practitioner should listen over each of the four main heart valve areas: the aortic, pulmonary, tricuspid and mitral valve areas. They should also listen for any additional sounds such as clicks, and heart murmurs. Reflective activity ‘How to’ articles can help update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: » How you think you could use this article to improve your practice in undertaking cardiac examinations. » How you could use this resource to educate your colleagues about auscultating for heart sounds.
Rationale and key points Before a wound can be cleaned and/or closed, the use of a local anaesthetic such as lidocaine is often required to enable the nurse to assess the wound thoroughly and plan the optimal method of repair. This article explains how to administer lidocaine safely and effectively, including how to infiltrate a wound with lidocaine before cleaning or suturing. There are potentially serious consequences associated with the use of local anaesthesia, but careful preparation will ensure patient safety and contribute towards a positive patient experience. » The nurse should have an understanding of how lidocaine functions, the speed at which it will take effect, and the duration of the mode of action. » The nurse should have knowledge and awareness of the risks associated with the use of lidocaine to ensure patient safety. » The nurse should prepare the equipment and the patient for the procedure. Reflective activity How to articles can help to update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: 1. How this article might improve your practice. 2. How you could use this information to educate your patients and colleagues on the appropriate technique for administering lidocaine in wounds.
Rationale and key points This article outlines the appropriate and effective technique for using a corticosteroid nasal spray. If these sprays are used inappropriately, they will be ineffective and might reduce the patient’s adherence to the treatment. Nurses can use the information in this article to advise patients on the appropriate technique for using a corticosteroid nasal spray. » Topical corticosteroid nasal sprays are commonly used to treat seasonal and persistent allergic rhinitis, which cause inflammation inside the nose and can lead to nasal blockage. Where inflammation inside the nose is the predominant symptom of nonallergic rhinitis, corticosteroid nasal sprays can also be used as a treatment modality. » Corticosteroid nasal sprays do not reduce inflammation immediately and can take up to two weeks before the patient experiences the benefits of using the spray. Patients should be made aware that a corticosteroid nasal spray does not work immediately and requires daily use to become effective. » Preparing the nose through cleansing, for example by performing nasal douching, is recommended as an adjunctive treatment. Reflective activity ‘How to’ articles can help update your practice and ensure it remains evidence based. Apply this article to your practice. Reflect on and write a short account of: » How you think this article will change your practice. » How you could use this information to educate your patients and colleagues on the appropriate technique for using a corticosteroid nasal spray.
Rationale and key points This article provides information on nasal douching, which nurses can use to advise patients on how to perform this procedure. It explains how to prepare and use a home-made solution for nasal douching, and discusses the various products available that can assist patients in undertaking this procedure. » Nasal douching, also known as nasal washout, irrigation or lavage, is recommended to clear mucus and allergens from the nose for people with rhinitis or rhinosinusitis. It is also recommended following nasal surgery to cleanse and aid healing inside the nose. » Nasal douching can be used as a baseline preparation treatment or alone to reduce the symptoms of sinonasal disease and/or allergy. It can also be performed 10-20 minutes before using a corticosteroid nasal spray, which increases the efficacy of this treatment. » Saline solutions used for nasal douching can be home-made or ready-mixed products. While it may be easier to use ready-mixed products to perform the procedure, they can be expensive. A balanced isotonic saline solution made at home using common household ingredients is considered equally safe and effective. Reflective activity ‘How to’ articles can help update your practice and ensure it remains evidence-based. Apply this article to your practice. Reflect on and write a short account of: 1. How you could use this article to enable patients to understand the benefits of nasal douching. 2. How you can support patients to perform nasal douching on a daily basis, to maximise the effectiveness of their treatment.