Ray Higginson

The identification of competencies for an NHS response to chemical, biological, radiological, nuclear and explosive (CBRNe) emergencies

UNLABELLED Emergency planning is a new science and there is a lack of UK standardisation in regard to NHS emergency planning. A first step to achieving standardisation within emergency planning is elucidation of national training competencies. AIM This study was designed to find consensus amongst multi-agency chemical, biological, radiological, nuclear and explosive (CBRNe) experts on the factors that must be included in future NHS CBRNe competencies. METHODS Data was collected using an anonymised online Delphi study. Two rounds of study were completed. Experts were selected through a combination of purposive and snowball sampling. In total 43 experts agreed to take part in this study. Twenty-one experts responded to the first rounds single open-ended question. Fourteen experts responded to the second which contained 64 Likert-scored questions. Consensus was achieved in 46 questions. RESULTS The consensus of expert opinion generated 10 suggested core training competencies. CONCLUSION There is an urgent need to standardise national planning, training and evaluation of NHS staff who are expected to respond to CRBNe and other emergencies. Further research is needed to identify training and response templates so that lessons can be learned from these experiences and fed back to improve future response.

How to use a self-inflating bag and face mask.

Abstract Rationale and key points This article aims to help nurses to open and maintain an adults airway while providing breaths using a self-inflating bag and face mask. Maintaining a patients airway is vital in the management of acute, life-threatening illnesses and injuries. ▶ The nurse should address airway compromise immediately since it is a major factor in acute deterioration and may develop rapidly. ▶ The nurse should perform the head tilt and chin lift manoeuvre, or the jaw thrust manoeuvre for patients with suspected cervical spine injury, to maintain airway opening. Reflective activity Clinical skills 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. What you have gained from this article. 2. How this article will influence your practice. Subscribers can upload their reflective accounts at: rcni.com/portfolio .

Airway management in the hospital environment

In the hospital environment, patients can deteriorate rapidly and for many different reasons. Maintaining a patients breathing is the main priority in any emergency situation, although achieving airway control can be difficult. All health professionals need to be able to undertake airway management safely. The key is a thorough assessment to ensure first of all whether the airway is patent (open and clear) or not. This article will discuss airway management, both acute and chronic, as well as associated nursing care.

How to manage an arterial catheter.

 Any management of the arterial catheter should be explained to the patient to ensure they understand what is involved and to gain informed verbal consent for any action, where possible.  The arterial catheter should be inserted by an appropriately trained practitioner, usually an anaesthetist or a critical or emergency care doctor.  The practitioner inserting the arterial catheter requires the nurse’s assistance to hold the patient’s hand and forearm steady with the wrist slightly extended.  The nurse should ensure the necessary equipment is available, including: – An arterial catheter. – A catheter dressing. – A dressing pack. – 2% chlorhexidine in 70% alcohol. – Sterile gloves. – 2mL of 2% lidocaine. – 2mL syringe. – 27 gauge subcutaneous needle (smaller gauges may be used) – A transducer set. – A transducer plate or holder. – 500mL normal saline (0.9% sodium chloride), or heparinised saline depending on local protocols. – A pressure bag. – A pressure monitoring lead. – A multifunction monitor. – A spirit level. – Arterial catheter labels.

Rating course quality using the National Student Survey

Ray Higginson, Senior Lecturer, University of South Wales, discusses whether a multiple-choice questionnaire is a valid and reliable way of measuring course quality for nursing degree courses

Entering a new paradigm: emergency nursing into the 21st Century

Two National Audit Office reports were published in February 2010. The first was highly critical of emergency healthcare delivery in England and highlighted the ways in which staffing and resource allocations could be areas that could have a negative impact on morbidity and mortality. The second report highlighted the significant positive impact that current military emergency care is making with focused training and development of all professionals contributing to the care delivery strategies. This article evaluates the two publications and emphasises on the contribution that appropriately educated, prepared and trained emergency nurses could make within the NHS context.