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Advanced Practice

The diagnostic reasoning involved in interpreting blood results

The body produces blood cells by a process called haemopoiesis in the bone marrow, which is a spongy tissue found in the centre of the bones. Infants produce bone marrow in most of their skeleton but,...

History taking in patients with suspected haematological disease

Blood is essential for many roles, including oxygen synthesis, transportation of nutrients and fighting infection. There are many diagnoses that can arise from changes within blood components, some...

Observed structured clinical examination as a means of assessing clinical skills competencies of ANPs

OSCEs were primarily introduced in medical education as a means of assessing the skills and ability of surgical students, rather than a test of factual knowledge (Cuschieri et al, 1979). The use of...

Chronic kidney disease and renal replacement therapy: an overview for the advanced clinical practitioner

The following broad definition of CKD from the Kidney Disease Improving Global Outcomes group (KDIGO) has been widely adopted:.

The management of delirium in the older adult in advanced nursing practice

Delirium is broadly described as a neuropsychiatric disorder of cognition, attention, consciousness or perception (Maldonado, 2018). These symptoms generally develop over a short period and can...

Critical thinking and diagnostic reasoning when advanced practitioners assess and treat skin conditions

The possible list of differential diagnoses within the integumentary system is vast (Lynch, 1994). Although it is unlikely that those working outside the dermatology specialty will have a depth of...

Consultation and clinical assessment of the genitourinary system for advanced clinical practitioners

The quality of the communication during nurse–patient consultations can have a considerable impact on patient outcomes (O’Hagan et al, 2014). Therefore, the nurse should use a combination of verbal...

Conducting a consultation and clinical assessment of the skin for advanced clinical practitioners

As with any consultation, when obtaining a history, questions should be presented in an open and sensitive manner. This is particularly pertinent for a skin complaint as patients may not know the...

Critical thinking and diagnostic reasoning of the heart and cardiovascular system

Chest pain is a common complaint, comprising up to 25% of emergency department attendances (Byrne, 2014). Not all of these will have a cardiac complaint; however, it is crucial to recognise important...

Implementing a surgical first assistant role into that of a clinical nurse specialist at an orthopaedic specialist hospital

The Perioperative Care Collaborative (PCC) (2018) defines an SFA as ‘registered practitioner providing continuous, competent and dedicated surgical assistance under direct supervision of the operating...

Taking advanced clinical practice to the streets: an evaluation of the benefits and challenges in homeless health care

The definition of homelessness includes people sleeping rough, sofa-surfing or living in squats, emergency shelters or hostels (Homeless Link, 2014). Socially excluded people are 10 times more likely...

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