Clinical Skills in Nursing
Clinical skills are the practical procedures that nurses perform as part of patient care. Competence in clinical skills is essential for safe, effective nursing practice. The NMC requires all registered nurses to be proficient in a range of clinical skills.
Vital Signs Monitoring
Vital signs are the basic measurements of body function. They include:
- Temperature — Measured orally, axillary, tympanic, or rectal
- Pulse — Rate, rhythm, volume (radial, brachial, carotid, pedal)
- Respiratory rate — Number of breaths per minute
- Blood pressure — Systolic and diastolic (manual or automated)
- Oxygen saturation — SpO2 measured by pulse oximetry
- Consciousness level — AVPU or Glasgow Coma Scale
Know the normal ranges for adults and children, and understand what abnormal readings may indicate.
Catheter Care
Urinary catheterisation involves inserting a tube into the bladder to drain urine. Nurses must:
- Use aseptic technique for insertion
- Secure the catheter to prevent traction
- Maintain a closed drainage system
- Record fluid balance accurately
- Monitor for signs of infection
- Provide perineal hygiene daily
- Remove as soon as no longer needed
Wound Care
Wound care involves assessing, cleaning, and dressing wounds to promote healing. The principles of wound care include:
- Assess the wound (location, size, depth, exudate, tissue type, signs of infection)
- Clean the wound with appropriate solution (usually normal saline)
- Choose appropriate dressing based on wound characteristics
- Document wound assessment and care
- Monitor for signs of infection (redness, swelling, heat, pain, purulent discharge)
- Refer to tissue viability nurse for complex wounds
Intravenous Therapy
IV therapy involves administering fluids, medications, or nutrition directly into a vein. Key responsibilities include:
- Checking the prescription and IV compatibility
- Using aseptic technique for cannulation and connection
- Calculating and setting the correct infusion rate
- Monitoring the IV site for phlebitis, infiltration, or infection
- Documenting fluid balance
- Changing giving sets according to local policy
Blood Glucose Monitoring
Capillary blood glucose monitoring is used to manage diabetes. Use a lancet to obtain a drop of blood from the side of the fingertip. Apply to the test strip and read the result. Record the result and act according to the hypoglycaemia or hyperglycaemia protocol.
Basic Life Support
All nurses must be competent in basic life support (BLS). The adult BLS sequence is: check safety, check response, open airway, check breathing, call for help, start chest compressions (30:2 ratio), use AED as soon as available.