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Urodynamic equipment varies in complexity and a range of urodynamics machines are available. The choice of system depends on operator requirements. The Buyers’ Guide: Urodynamic Systems by Centre for Evidence-Based Purchasing may help to inform choice [1,2].
Data quality and documentation of variance are key for urodynamics studies to be valid, and symptoms must be reproduced to be able to make a diagnosis. Accurate reporting requires knowledge of pathophysiological parameters and the ability to detect artefacts. If inaccuracies are discovered, they should be corrected contemporaneously. Spurious and inaccurate observations are known as artefacts. The Oxford dictionary defines artefacts as something observed in a scientific investigation or experiment that is not naturally present but occurs as a result of the preparative or investigative procedure.’
This manual is a concise, straightforward guide for learning how to perform high-quality urodynamic investigations. Experienced editors and contributors provide easy-to-follow practical information on pre-test assessment of urodynamic function, how to set up urodynamic equipment, and how to perform individual urodynamic techniques, including cystometry, videocystourethrography and ambulatory monitoring. The book covers modern equipment and its use, and outlines the new national standards in urodynamics, allowing readers to check their knowledge and standard operating procedures are adequate. It also gives valuable information on how to set up and run a urodynamics service. With clear illustrations and clinical case studies woven into the text, this is a must-have resource to facilitate training in urodynamics. It is also a refresher of the standards and protocols required for good urodynamic practice for gynaecologists and continence nurses.
A sound understanding of moral and legal obligations is critical to developing responsible nursing practice and building the nurse-patient relationship. Ethics and Law for Australian Nurses provides a practical framework for understanding the ethical and legal dimensions of nursing practice. The fourth edition has been thoroughly revised to include updates to legislation, the NMBA professional standards and case examples. A new chapter on the legal system and a fully revised chapter on duty of care and negligence provide a thorough overview of the law as it applies to nursing practice. The text also includes expanded material on the regulation of nursing practice, advanced care directives, cultural safety, practice in the context of digital environments, person-centred care and assisted dying. Written in an accessible and engaging style, Ethics and Law for Australian Nurses provides a comprehensive guide for nurses training and practising in clinical, research and policy settings.
This book has considered ethics in the context of human vulnerability. We are vulnerable because we can be affected by things across the life span, and we can be affected by things because we are physical beings – part of the world around us and subject to the passage of time. Consequently, a life can come to an end at any time. For this reason, death is not only completely normal, but inevitable. Nevertheless, death is typically regarded as something regrettable. Issues of personhood and autonomy lie at the centre of bioethical debates about the ending of human life, especially where this involves abortion and euthanasia. Against the backdrop of these issues, this chapter provides an overview of the main legal and ethical considerations relating to abortion and euthanasia.
The focus of this chapter is consent. Consent concerns the granting or withholding of permission to receive care. This chapter addresses the legal requirements of consent for adults and children, and looks at the place of guardianship and advocacy in decision-making. It also considers the situation of people who are not mentally competent who may require emergency care or who need to be restrained against their will. Consent is fundamental to the moral and professional principle that health care should be geared to the patient’s interests as the patient understands them. This is sometimes referred to as ‘patient-centred care’.
This chapter addresses the topic of information we receive about or from patients and introduces the concepts of privacy and confidentiality in relation to the management of patient information. In this chapter we also outline legal requirements for reporting harmful conduct of health professionals and others. Providing excellent nursing care for a patient requires that each nurse involved in the patient’s care acquire relevant information from the patient (or a representative) concerning the patient’s symptoms, their lifestyle, their medications, their concerns and their experiences. Therefore, nurses routinely see, hear, read and record things about other people that are not normally discussed outside the health-care setting, and have privileged access to matters of patient privacy. This brings with it certain legal and moral obligations. Therefore, managing information about patients is one of the most important ethical and legal roles nurses play in health care and, owing to modern technology (as we discuss below), it is arguably one of the greatest challenges faced by professional practice.
As a nurse, you will be called upon to support, care for and protect people who are vastly different from yourself. How you respond to the diversity of human beings will be a measure of your own humanity as well as your professionalism. Certainly, caring does not come as easily to some nurses as it does to others. So why do people want to support the ill or incapacitated? What is it about human nature that causes people to care for each other at all?This chapter will provide a response to this question through a description of the human person as a dynamic unity of personal factors (such as biology and psychology); interpersonal factors (such as relationships with immediate family and close friends); and social factors (such as type of education, or socioeconomic status). The concept of vulnerability will be discussed, where you will see that it is vulnerability that gives us the capacity to care for each other.
This Chapter will focus on one of the main parts of the civil law that is relevant for nurses: the law of negligence. The law of negligence is a part of the civil law that allows a person to bring legal proceedings against another person to correct a wrong or harm that the other person has done to them. Usually the person who has been harmed (the plaintiff) will seek payment of damages in compensation for their injury from the person whose act or omission caused the harm (the defendant). This Chapter will outline the key parts of the law of negligence. The particular focus of the Chapter will be on the special rules that have developed in the law of negligence in relation to health care professionals, including nurses. By understanding how the law will apply to things nurses do that cause people harm, it should be possible for nurses to better avoid acting negligently.
In examining the challenges facing the nurse in the area of aged care some of the philosophical and ethical aims of this book are most acutely demonstrated. In general, in advanced capitalist societies such as Australia, there is a tendency to regard ageing in a negative light. The importance that society attaches to productivity as a measure of value, and the decline of traditional family and community structures, have seen societal attitudes towards the aged shift, from one of respect to a more general disregard or devaluing of the possible contributions of the elderly. It is in this context that the role of the nurse as a builder of capability and a supporter of autonomy becomes most significant. While there are limits to the therapeutic benefit that a nurse can provide to a person’s physical health, nurses can play a substantial role in supporting and promoting the exercise of autonomy in the face of physical changes, especially in the context of ageing.
Just like everyone else, nurses sometimes make mistakes that can result in harm to others. The Nursing and Midwifery Board of Australia (NMBA) Code of Conduct for Nurses (NMBA 2018) makes a number of statements in relation to the safe conduct of nursing practice. These statements reflect the expectation that nurses are aware of and committed to industry-wide standards of safety and quality in their practice. Consequently, one could infer that nurses have a moral obligation to deal with clinical errors and incidents in an open, honest and constructive fashion. Some clinical incidents will be the result of clinical error, which is a failure by a clinician to observe the appropriate standards of knowledge and practice. The causes of mistakes can vary greatly too, from the simple and obvious, to complex and systematic problems of workplace culture. How you, as a nurse, respond to your own clinical errors and incidents and those of others is a measure of your professional and moral character and competency.