Healthcare and Medicine Reference
Before attempting a new procedure it is essential to gain suffi cient
background knowledge to attempt the procedure competently. This
is not just 'how' to do a procedure but also why and when it should
be done, what contraindications to it exist, the anatomy behind the
procedure and its potential complications. This knowledge can be
attained from discussions, teaching sessions and prereading. This
book attempts to comprise the essential preprocedure reading for
each of the procedures covered.
Logbooks and assessment forms
It is essential to keep a logbook of the practical procedures you
perform. Many professions (e.g. anaesthesia) have mandatory
logbooks for all trainees provided by their governing body. A
logbook shows not only the number of procedures performed but
also how frequently and under what circumstances. The logbook
should not contain patients' personal details, although unique
identifi ers (e.g. their hospital number) are permitted.
Additionally, a number of the professions now encourage regu-
lar assessment of individuals' performance in practical procedures.
This may take the form of a practical mannequin-based test (ideal
to test emergency situations which infrequently occur) or an assess-
ment of how the procedure is performed for 'real'. It is essential that
assessments in whatever form evaluate knowledge, skills and abili-
ties; preferably in a multidimensional manner.
The practitioner should attempt to familiarise themself with the
equipment used for a procedure. Equipment will vary both between
hospitals and between departments within the same hospital.
Familiarise yourself before you have to perform a potentially
life-saving procedure; an emergency situation is not the time to
have to learn the basics.
Practical procedures form an essential part of diagnosis and treat-
ment, and may be life-saving. A healthcare professional due to
undertake a procedure must be satisfi ed that he or she possesses the
required knowledge and skills to perform it - in other words, that
he or she is competent. This competence may have been assessed
through informal supervision in a number of the procedures, or,
increasingly, through formal 'competency-based training'.
This topic provides the knowledge required to understand the
reasons for performing each of the procedures described herein,
together with their contraindications, the relevant anatomy and
potential complications. This, together with a step-by-step guide
to performing each procedure should provide the practitioner with
a robust grounding to proceed to practice under supervision and
Mannequins are a great way to familiarise yourself with a new proce-
dure and also maintain familiarity with a previously learnt procedure
in a safe way. They are especially useful for infrequently performed,
potentially dangerous procedures such as surgical chest drain inser-
tion. Mannequins alone are not an acceptable substitute for multiple
supervised procedures on 'real' patients. Other forms of substitute
training include the use of animal models, which carries ethical
implications, and high-fi delity simulation. This latter mode of train-
ing incorporates training in practical skills with realistic real-time
scenarios, and includes elements of interprofessional working.
Patients are not there to be practised upon without knowing the
experience and role of the practitioner. They should be made fully
aware of your position as a trainee and the role of your trainer.
A vast majority of patients will not withdraw consent: they
appreciate the need for junior HCPs to learn.