The Royal Marsden Hospital Manual of Clinical Nursing Procedures - Lisa Dougherty [4]
More than ever in 2011, nurses need to be able to assure the public, patients and their families that care is based on the best available evidence. As students on placement in the busy world of clinical practice, either in a ward, unit or in the community, it can be challenging to find time to search for the evidence and this is where the Student edition of The Royal Marsden Hospital Manual of Clinical Nursing Procedures is a real practical help.
As in previous editions, reviewing the evidence or sources of knowledge has been made more explicit with each level of evidence graded. This grading provides the reader with an understanding of whether the reference comes from a randomized controlled trial, national or international guidance or from expert opinion. At its best, clinical nursing care is an amalgam of a sensitive therapeutic relationship coupled with effective care based on the best evidence that exists. Some areas of practice have attracted international research such as cardiopulmonary resuscitation and infection prevention and control; other areas of practice have not attracted such robust research and therefore it is more of a challenge to ensure evidence-based care. Each year as the manual overview is designed we reflect on the gaps in research and knowledge and this provides the impetus to start developing new concept analysis and develop further research studies. This year there are new areas covered including a chapter on risk management and a section on preparing the patient for diagnostic investigations such as endoscopy or CT scans.
As you look at the list of contributors to the manual you will see that this edition has continued to ask clinically active nurses to share their practice in their chapters. This has the double advantage of ensuring that this manual reflects the reality of practice but also ensures that nurses at the Royal Marsden NHS Foundation Trust are frequently reviewing the evidence and reflecting upon their care.
A textbook devoted to improving and enhancing clinical practice needs to be alive to the clinical practitioner. You will see that this edition has a new overall format designed to make the manual more effective in clinical care.
As nurses we provide care that is individually and sensitively planned, and based on the best available evidence. The Student edition of The Royal Marsden Hospital Manual of Clinical Nursing Procedures is a wonderful resource for such evidence and I hope it will be widely used by students across the country.
Finally, I would like to pay a warm tribute to the amazing amount of work undertaken by the two editors, Lisa Dougherty and Sara Lister, and to all the nurses and allied health professionals at the Royal Marsden Hospital NHS Foundation Trust who have worked so hard on this eighth edition.
Shelley Dolan
Chief Nurse
The Royal Marsden
Hospital NHS
Foundation Trust
Introduction and guidelines for use
The first edition of The Royal Marsden Hospital Manual of Clinical Nursing Procedures was produced in the early 1980s as a core procedure manual for safe practice within The Royal Marsden Hospital, the first cancer hospital in the world. Thirty years and eight editions later the staff of the hospital are still working together to keep it updated, ensuring that only current evidence-based practice is recommended.
The type of evidence that underpins procedures is made explicit by using a system to categorize the evidence, which is broader than that generally used. It has been developed from the types of evidence described by Rycroft-Malone et al. (2004) in an attempt