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Rcn paeds framework


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Evesham 4th Jan 2012

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Rcn paeds framework

  1. 1. RCN Competences Competences: an education and training competence framework for capillary blood sampling and venepuncture in children and young people
  2. 2. AcknowledgementsWe would like to thank the NHS Modernisation Agency Review groupfor sponsoring the development of the original Anne Casey, Editor and Adviser, Royal College offramework, first published in 2005. We are grateful to Nursingthe following people for their assistance in theproduction of the original framework document and Jennie Craske, Pain and Sedation Clinical Nursethis updated version: Specialist, Royal Liverpool Children’s Hospital NHS TrustExpert group Annette K. Dearmun, Lecturer Practitioner, OxfordKaren Bravery, Nurse Practitioner/Practice Radcliffe Hospitals NHS TrustDevelopment Lead Intravenous Therapy for Infection, Ansley McGibbon, Senior Nurse, Practice, Research,Cancer and Immunity, Great Ormond Street Hospital for Development and Education Unit, Lothian UniversityChildren NHS Trust Hospitals, EdinburghPauline Brown, Lead Nurse IV Therapy, Royal Liverpool Steve McKenna, Charge Nurse, Paediatric AmbulatoryChildren’s Hospital NHS Trust Care/Outpatients, Royal Free Hampstead NHS TrustJulie Flaherty, Children’s Nurse Consultant, Unscheduled Fiona Smith, Adviser in Children and Young People’sCare, Salford Royal Foundation Trust Nursing, Royal College of NursingLiz Gormley-Fleming, Senior Lecturer, Children’sNursing, University of Hertfordshire We are also grateful to the Royal College of PaediatricsAlison Hegarty, Teacher Practitioner, IV Therapy, and Child Health for its support of the content of thisCentral Manchester and Manchester Children’s Hospital publication.NHS TrustValerie McGurk, Practice Development Facilitator,Paediatrics, Northampton General Hospital TrustLouise Mills, Nurse Practitioner for IntravenousTherapy, Great Ormond Street Hospital for ChildrenNHS TrustSally Ramsay, Independent Nursing Adviser, RamsayConsultingJo Rothwell, Lead Nurse, IV Therapy, CentralManchester and Manchester Children’s Hospital NHSTrustDisclaimerThis publication contains information, advice and guidance to help members of the RCN. It is intended for use within the UK but readers areadvised that practices may vary in each country and outside the UK.The information in this booklet has been complied from professional sources, but it’s accuracy is not guaranteed. While every effort has beenmade to ensure that the RCN provides accurate and expert information and guidance, it is impossible to predict all the circumstances in whichit may be used. Accordingly, the RCN shall not be liable to any person or entity with respect to any loss or damage caused or alleged to becaused directly or indirectly by what is contained in or left out of this information and guidance.Published by the Royal College of Nursing, 20 Cavendish Square, London, W1G 0RN© 2010 Royal College of Nursing. All rights reserved. No part of this publication may be reproduced, stored in a retrieval system, or transmittedin any form or by any means electronic, mechanical, photocopying, recording or otherwise, without prior permission of the Publishers. Thispublication may not be lent, resold, hired out or otherwise disposed of by ways of trade in any form of binding or cover other than that in whichit is published, without the prior consent of the Publishers.
  3. 3. ROYAL COLLEGE OF NURSINGCompetences:an education and training competence framework for capillary bloodsampling and venepuncture in children and young peopleApproved by the RCN Accreditation Unit until 31 July 2011Contents Introduction 2 1. Guidance for programme development 3 Education pathways 3 Teaching and learning strategies 3 Assessment 3 2. Competences, learning outcomes and indicative content 4 Domain 1: professional and legal issues 4 Domain 2: preparing self, child and family 4 Domain 3:performing capillary blood sampling and venepuncture 5 Domain 4: risks and hazards 6 3. References and further reading 8 4. Online resources 12 1
  4. 4. RCN COMPETENCES – CAPILLARY BLOOD SAMPLING AND VENEPUNCTUREIntroductionDeveloping skills in performing capillary blood sampling The framework should also be used to develop newand venepuncture can facilitate holistic care and timely programmes, and to review and revise existing ones. Bytreatment. For nurses working with children and young using this framework, other professionals and employerspeople this is usually regarded as an expanded role. Before can be confident in the standard and proficiency ofstarting a programme of education and training practitioners.practitioners should be should be competent andconfident to care for children and young people. Developing competence within age bandsCompetence can be defined as: “The state of having the There are considerable differences between children ofknowledge, judgement, skills, energy, experience and varying ages, and we recommend that practitionersmotivation required to respond adequately to the demands develop competence within specific age bands accordingof one’s professional responsibilities” (Roach, 1992). to their area of practice:This education and training competence framework for G 0 to 1 yearcapillary blood sampling and venepuncture in children G 1 to 5 yearsand young people is an important step forward. Firstpublished in 2005, it has been revised to reflect a number G 5 years and above.of current political and professional issues and initiatives,including:G Agenda for Change (DH, 1999)G the need for leadership in specialist nursingG the need for the development of standardsG High quality care for all: the NHS next stage review (DH, 2008) and its equivalents in Scotland, Wales and Northern IrelandG the increased focus on work-based and lifelong learning plus supervisionG the changing focus towards professional rather than academic accreditationG multi-skilling health care practitioners to effectively meet the needs of service users.This framework describes the competences, learningoutcomes and the indicative content necessary foreducation and training programmes to meet the needs ofchildren and young people. It aims to support consistentcurriculum and practice development so that practitionerscan develop and, maintain the ability to carry out this task,regardless of where they work. 2
  5. 5. ROYAL COLLEGE OF NURSING 1Guidance for programme developmentWhen either planning new courses or reviewing existing Assessmentcourses, we recommend that hospitals and universities usethis as their competence framework. As a minimum each programme needs to assess competence in practice. Practice assessments should reflect the competences and learning outcomes. There areEducation pathways various assessment methods that are appropriate:This framework can be used to develop hospital-based G observation under supervision and demonstrationtraining programmes for nurses working with children G reflective practiceand young people. Alternatively, it can be used to review G portfolio of evidence showing skills, experience andexisting programmes to ensure that they meet the needs of developmentchildren and young people. Training may be linked toother competences, such as those required for cannulation. G formal examination. Each of these relies on the use of practice assessors. Programme developers should consider who this may beTeaching and learning strategies and the criteria needed to become and maintain this status. We recommend that an assessor should beCapillary blood sampling and venepuncture in children experienced in capillary blood sampling andand young people is a practical skill, which is underpinned venepuncture in children and young people. Their abilityby theoretical knowledge. Teaching and learning strategies to assess others should be determined by a formalshould focus on developing the competence and assessment process. We also advise that they receive clearconfidence of the practitioner in performing the procedure guidance on their role and responsibilities.safely, and with minimum distress to the child or young Regular updating and assessment of skills can assist inperson. Assessment of prior knowledge, particularly in ensuring ongoing competence. We suggest that this takescaring for the child undergoing intravenous therapy, can place useful in developing programmes that reflect theindividual needs of the practitioner.A variety of new ways of learning can be used for theseprogrammes:G workbooksG problem-based learningG taught provisionG scenariosG supervised practiceG e-learningG simulationG blended learning. 3
  6. 6. RCN COMPETENCES – CAPILLARY BLOOD SAMPLING AND VENEPUNCTURE 2Competences, learning outcomesand indicative contentDomain 1: G reflect on own practice, identifying accountability and competence issues.professional and legal issues Indicative contentCompetences G Department of Health requirements for record-keeping.G Performs capillary blood sampling and venepuncture G The Nursing and Midwifery Council Code (NMC, 2008). in accordance with legal, professional and policy G Legal, professional and local policies regarding requirements. enhanced nursing roles.G Uses appropriate evidence to underpin best practice in G Accountability when performing capillary blood capillary blood sampling and venepuncture in children sampling and venepuncture. and young people. G Local policies and procedures for capillary bloodG Records and reports information in a manner that is sampling and venepuncture in children and young clear, concise, timely and accurate. people.G Reflects on own practice and takes action to develop G Evidence base for good practice in capillary blood and improve knowledge and skills. sampling and venepuncture.G Describes circumstances where it is inappropriate to G Policies and good practice guidance in obtaining perform capillary blood sampling and venepuncture informed consent. and the alternative action to take. G Policies and good practice guidance for holding andG Demonstrates best practice in gaining informed restraining children. consent from the child and family.G Demonstrates awareness of the limits of own skill/competence/knowledge. Domain 2: preparing self/child/familyLearning outcomesAt the end of a course of study and period of supervised Competencespractice the nurse will be able to: G Performs the preparatory processes for capillary bloodG discuss the legal and professional issues associated sampling or venepuncture in a safe and effective with performing capillary blood sampling and manner. venepuncture G Uses appropriate procedures for correctly identifyingG outline current evidence to support best practice in the patient. capillary blood sampling and venepuncture G Describes the anatomy and physiology applicable toG describe the process for obtaining informed consent capillary blood sampling and venepuncture. from the child/young person and family G Assesses the child’s physical and psychological needsG give an account of professional and local policies before, during and after capillary blood sampling and relevant to performing capillary blood sampling and venepuncture and uses these in preparing a care plan. venepuncture G Employs appropriate methods to select and prepareG describe the legal requirements for good recordkeeping suitable sites for capillary blood sampling and in relation to capillary blood sampling and venepuncture selects suitable collection devices and venepuncture equipment and gives rationale for choice. 4
  7. 7. ROYAL COLLEGE OF NURSINGG Demonstrates knowledge of pharmacological and non- G The use of play to communicate with children. pharmacological pain relief. G Distraction techniques.G Applies local anaesthetic cream correctly to an G Role of the play specialist and psychologist in appropriate site. preparing children for blood sampling procedures.G Identifies when other health professionals e.g. play specialist, child psychologist, should be involved in G Needles: helping to take away the fear (Action for Sick preparation. Children, 1994).G Uses strategies to minimise the risk of injury to others G Creating a safe, comfortable, calm and child-focused who may be present. environment. G Importance of the practitioner’s attitude (empatheticLearning outcomes rather than directive).At the end of a period of study and supervised practice the G Patient group directives.nurse will be able to: G Local anaesthetic preparations.G give an account of the anatomy and physiology of G Vein selection: influencing factors and methods. capillaries and veins, and describe the relevance for capillary blood sampling and venepuncture G Cleaning the skin.G explain the theory of capillary blood sampling and venepuncture in children and young people Domain 3: performing capillaryG describe the methods used to identify appropriate and inappropriate sites for capillary blood sampling and blood sampling and venepuncture venepunctureG develop a care plan appropriate to the child’s physical developmental and psychological needs before, during, and after capillary blood sampling and venepuncture CompetencesG demonstrate good practice when preparing self, child G Demonstrates the safe application of the principles of and family for capillary blood sampling and “restraining, holding still and containing children” venepuncture (RCN, 2003b).G create a safe environment for performing capillary G Demonstrates the correct procedures for minimising blood sampling and venepuncture infection, including hand washing, use of gloves, apron and aseptic technique.G identify the various devices and equipment used for capillary blood sampling and venepuncture for G Uses appropriate strategies for minimising pain children of different ages associated with capillary blood sampling and venepuncture.G explain the interventions that minimise a child or young person’s pain and anxiety during capillary blood G Applies pressure or a tourniquet appropriately and sampling and venepuncture safely.G describe the roles of other health professionals in G Takes appropriate action to prevent iatrogenic preparing children or young people for painful anaemia. procedures G Demonstrates practical ability and dexterity duringG give an account of the use of patient group directives. capillary blood sampling and venepuncture. G Responds appropriately to troubleshoot or overcomeIndicative content any difficulties experienced during the procedure.G Anatomy and physiology of capillaries, veins, arteries G Identifies the appropriate blood container and reagent and nerves. for the tests required, and fills them in the correctG Theory of capillary blood sampling and venepuncture. order.G Devices and equipment for capillary blood sampling G Fills, labels and dispatches containers correctly, and venepuncture and their use. demonstrating knowledge of factors that can adversely influence the results.G Cognitive development, and a child or young person’s perception of pain. G Identifies reasons why capillary blood sampling and 5
  8. 8. RCN COMPETENCES – CAPILLARY BLOOD SAMPLING AND VENEPUNCTURE venepuncture may be unsuccessful and describes G Blood volumes. actions to address this. G Containers, reagents, order of filling.G Describes correct care of the site following the G Laboratory requirements. procedure. G Emergency situations: their prevention and resolutionG Removes and disposes of devices and equipment in e.g. patient moving, arterial puncture, fainting. accordance with infection control and health and safety policies. G Labelling specimens.G Communicates with the child and family during and G Completing investigation request forms. after the procedure in a manner that minimises G Problems with sample quality that could lead to anxiety and encourages compliance. erroneous results.G Describes the indications for some frequently used G Encouraging and rewarding children. blood tests.Learning outcomes Domain 4: risks and hazardsAt the end of a period of study and supervised practice thenurse will be able to: CompetencesG perform checking procedures that maximise patient G Describes the risks and complications to self and child safety associated with capillary blood sampling andG wash his/her hands in accordance with good practice venepuncture, and acts to prevent these guidance G Explains the infection control and health and safetyG demonstrate good practice when holding the child or procedures required for safe capillary blood sampling young person still during the procedure and venepunctureG identify the containers and volumes required for G Recognises, reports and records errors or adverse effective blood sampling in children and young people incidents associated with capillary blood sampling and venepunctureG demonstrate knowledge of the correct sequence for filling blood containers to avoid contaminating G Follows appropriate policies and procedures when specimens disposing of equipment and hazardous substancesG calculate the maximum amount of blood that should G Takes action to maximise the safety of the child, family be taken from a child and self when performing capillary blood sampling and venepuncture.G perform capillary blood sampling and venepuncture safely on children and young people of varying ages Learning outcomesG identify strategies for minimising anxiety and pain At the end of a period of study and supervised practice the when performing capillary blood sampling and nurse will be able to: venepuncture G outline the risks and complications associated withG demonstrate knowledge of the indications for certain capillary blood sampling and venepuncture, their commonly used blood tests prevention and treatmentG access reference ranges to compare blood results G discuss infection control and health and safety policiesG describe factors that can lead to erroneous test results and procedures applicable to capillary blood sampling and venepunctureG describe techniques for encouraging and rewarding the child undergoing peripheral venous cannulation. G describe the procedures for reporting errors and adverse incidentsIndicative content G give account of relevant health and safety and infection control policiesG Effective hand washing. G demonstrate knowledge of factors that influence theG Restraining and holding still. safety of the child, family and self during capillaryG Communication strategies. blood sampling and venepunctureG Applying pressure and tourniquets. G create a safe environment for performing capillary 6
  9. 9. ROYAL COLLEGE OF NURSING blood sampling and venepuncture.Indicative contentG Safe practice in handling and disposing of sharps.G Role of the National Patient Safety Agency and Medicines and Healthcare Products Regulatory Agency, and equivalent organisations in Scotland and Northern Ireland.G Right patient – right care (NPSA, 2004a).G Health and Safety at Work Act 1974 and other regulations (HSE).G Government and NHS guidance on preventing infection.G Needlestick injuries: the point of prevention (RCN, 2009). 7
  10. 10. RCN COMPETENCES – CAPILLARY BLOOD SAMPLING AND VENEPUNCTURE 3References and further readingAction for Sick Children (1994) Needles: helping to take Cooke DA (1994) Potential inaccuracy of finger prickaway the fear, London: AfSC. blood samples, British Journal of General Practice, 44(378), p.42.Arrowsmith J and Campbell C. (2000) A comparison oflocal anaesthetics for venepuncture, Archives of Disease in Currer M (2008) Use of simulators in paediatric andChildhood, 82, pp.309-310. neonatal training, Infant, 4(4), pp.132-136.Bellieri CV, Cordelli DM, Rafaelli M, Ricci B, Morgese G and Department of Health (1999) Agenda for Change:Buonocore G. (2006) Analgesic effect of watching TV modernising NHS pay systems, HSC 1999/227, London:during venepuncture, Archives of Disease in Childhood, DH.91, pp.1015-1017. Department of Health (2000) NHS plan: a plan forBijttebier P and Vertommen H (1998) The impact of investment, a plan for reform, London: DH.previous experience on children’s reactions to Department of Health (2001a) Reference guide to consentvenepunctures, Journal of Health Psychology, 3, 1, pp.39- for examination or treatment, London: DH.46. Department of Health (2001b) Seeking consent: workingBoie ET, Moore GP, Chad BS, Nelson D (1999) Do parents with children, London: DH.want to be present during invasive procedures performedon their children in the emergency department? A survey Department of Health (2001c) Building a safer NHS forof 400 parents, Annals of Emergency Medicine, 34(1), patients: implementing an organisation with a memory,pp.70-74. London: DH.British Medical Association (2001) Consent, rights and Department of Health (2002) Guidance for clinical healthchoices in health care for children and young people, care workers, London: DH.London: BMJ Books. Department of Health (2003a) Getting the right start:Brook G (2000) Children’s competence to consent: a National Service Framework for children Standards forframework for practice, Paediatric Nursing 12(5) pp.31-34. hospital services, London: DH.Broome ME (1990) Preparation of children for painful Department of Health (2003b) Winning ways: workingprocedures, Paediatric Nursing, 16(6), pp.573-541. together to reduce health care associated infection in England. London: DH.Brykczynska G (1987) Ethical issues in paediatric nursing,Nursing, 23, pp.862-864. Department of Health (2004a) National Service Framework for children and young people who are ill,Buckbee K (1994) Implementing a pediatric phlebotomy London: DH.protocol, Medical Laboratory Observer, 26(4), pp.32-35. Department of Health (2004b) The NHS Knowledge andCaws L and Pfund R (1999) Venepuncture and cannulation Skills Framework (KSF) and development review process,in infants and children, Journal of Child Health Care, (2), London: DH.pp.11-16. Department for Education and Skills (2005) Common coreCoates T (1998) Venepuncture and intravenous of skills and knowledge for the children’s workforce,cannulation or: how to take blood and put up a drip, The London:DfES.Practicing Midwife, 1(10), pp.28-31. Eriksson M, Gradin M and Schollin J (1999) Oral glucoseCollier J and Robinson S (1997) Holding children still for and venepuncture reduce blood sampling pain inprocedures, Paediatric Nursing, 9(4), pp.12-14. newborns, Early Human Development, 55, pp.211-218.Collins M, Phillips S and Dougherty L (2006) A structured Fernald CD and Corry JJ (1981) Empathetic versuslearning programme for venepuncture and cannulation, directive preparation of children for needles,Nursing Standard, 20(26) pp.34-40. Children’sHealth Care, 10(2), pp.44-47. 8
  11. 11. ROYAL COLLEGE OF NURSINGFranck L and Jones J (2003) Computer-taught coping Kayley J, Bravery K and Dougherty L (2006) Strategies totechniques for venepuncture: prelimanry findings from reduce the risk of needle and sharps injuries, Nursingusability testing with children, parents and staff, Journal of Times, 102(10), pp.30-32.Child Health Care, 7(1), pp.41-54. Kennedy RM, Luhmann J and Zempsky WT (2008)Franklin L (1998) Skin cleansing and infection control in Clinical implications of unmanaged needle insertion painperipheral venepuncture and cannulation, Paediatric and distress in children, Pediatrics issues supplement, 122,Nursing, 10, 9, pp.33-34. pp.S130-S133.Frost S and Kelsey K (2008) ‘Venepuncture’, in Kelsey J and Lamb J (2008) Intravenous therapy in nursing practiceMcEwen G (editors) Clinical skills in child health practice, (2nd edition), Oxford: Blackwell Publishing.London: Churchill Livingstone Elsevier. Larsson BA, Tannfeld TG, Lagercrantz H and Olsson GLGaskell S, Binns F, Heyhoe M and Jackson B (2005) Taking (1998) Venepuncture is more effective and less painfulthe sting out of needles: Education for staff in primary than heel lancing for blood tests in neonates, Pediatrics,care, Paediatric Nursing, 17(4), pp. 24-28. 101(5), pp.882-886.Goodenough TB, Perrott DA, Champion DA and Thomas Lavery I. Ingham P (2005) Venepuncture: best practice,W (2000) Painful pricks and prickle pains: is there a Nursing Standard, 19 (49), pp.55-65.relation between children’s ratings of venipuncture painand parental assessments of usual reaction to other pains? Lavery I and Smith E (2008) Venepuncture practice andClinical Journal of Pain, 16(2), pp.135-143. the 2008 Nursing and Midwifery Code, British Journal ofGoren A, Laufer J, Yativ N, Kuint J, Ackon MB, Rubinshtein Nursing, 17(13), pp.824-828.M, Paret G and Augarten A (2001) Transillumination of the Lilley M (2006) ‘Venepuncture and cannulation’, in Trigg Epalm for venipuncture in infants, Pediatric Emergency and Mohammed TA (editors) Practices in children’sCare, 17(2), pp.130-131. nursing: guidelines for hospital and community, London:Halimaa SL (2003) Pain management in nursing Churchill Livingstone Elsevier.procedures on premature babies, Journal of Advanced Mallett J and Dougherty L (2008) Marsden manual ofNursing, 42(6), pp.587-597. clinical nursinq procedures (7th edition), Oxford:Health and Safety Executive (2002) Control of substances Blackwell Science.hazardous to health, London: HSE. National Association of Hospital Pay Staff (2002)Health Protection Scotland (2009) Occupational exposure Needleplay. Guidelines for professional practice (Numbermanagement including sharps policy and procedure. 6), Beaconsfield: NAHPS.Available from National Patient Safety Agency (2004a) Right patient –(Internet). right care, London: NPSA.Higgins D (2004) Practical procedures - venepuncture,Nursing Times 100(39), pp.30-31. National Patient Safety Agency (2004b) Seven steps to patient safety, London: NPSA.Hobson P (2008) Venepuncture and cannulation:theoretical aspects, British Journal of Healthcare NHS Education for Scotland (2004) Transferring the skills.Assistants, 2(2), pp.75-78. Quality assurance framework forHodgins MJ and Lander J (1997) Children’s coping with venepuncture, cannulation and intravenous therapyvenepuncture, Journal of Pain and Symptom Management, (draft), Edinburgh: NES.13(5), pp.274-85. NHS Scotland (2005) Framework for developing nursingJeffery K (2008) ‘Supportive holding of children during roles. Available for download from interventions’, in Kelsey J and McEwen G Nursing and Midwifery Council (2007) Guidelines for(editors) Clinical skills in child health practice, London: records and record-keeping, London: NMC.Churchill Livingstone Elsevier. Nursing and Midwifery Council (2008) The Code:Kolk AM, van Hoof R and Fiedeldij Dop MJC (2000) standards of conduct, performance and ethics for nursesPreparing children for venepuncture. The effect of an and midwives, London: NMC.integrated intervention on distress before and duringvenepuncture, Child: Care, Health and Development, 26(3), Pearch J (2005) Restraining children for clinicalpp.251-260. procedures, Paediatric Nursing, 17(9), pp. 36-38. 9
  12. 12. RCN COMPETENCES – CAPILLARY BLOOD SAMPLING AND VENEPUNCTURENursing Standard (2005) Venepuncture: quick reference Scottish Executive (2005) Building a health service fit forguide 5, Nursing Standard, 13(36), insert 2. the future, Edinburgh: TSO.Perry J (1994) Communicating with toddlers in hospital, Scottish Government (2007) An action framework forPaediatric Nursing, 6(5), pp.14-17. children and young people’s health in Scotland. Available from RK and Beckett M (2000) Step by step guide.Neonatal blood sampling: time for safer devices, Journal of Shepherd A, Glenesk A and Niven C (2006) A ScottishNeonatal Nursing, 6(3), p. 3 (unnumbered). study of heel prick blood sampling in newborn babies, Midwifery, 22(2), pp.158-168.Price S (1995) Paediatric variations of nursinginterventions in Campbell S and Glasper EA (eds) Whaley Shah VS and Ohlsson A (2009) Venepuncture versus heeland Wong Children’s Nursing, London: Mosby. lance for blood sampling in term neonates, The Cochrane Collaboration. Available fromPratt RJ, Pellowe C, Wilson JA, Loveday HP, Harper PJ, SRLJ, McDougall C, and Wilcox MH (2007) Epic 2: Skills for Health (2004) Children’s national workforcenational evidence-based guidelines for preventing health competence framework guide, London: infections in NHS hospitals in England.Journal of Hospital Infection 655(suppl), pp.S1-S64. Smalley A (1999) Needle phobia, Paediatric Nursing, 11(2), pp.17-20.Proudfoot C and Gamble C (2006) Site specific reactions toamethocaine, Paediatric Nursing, 18(5), pp.26-28. Stevens B, Yamada J and Ohlsson A (2003) Sucrose for analgesia in newborn infants undergoing painfulRoach MS (1992) The human act of caring, Ottowa, procedures, The Cochrane Library, (3), 2003.Ontario: Canadian Hospital Association, p.61. Taddio A, Sha V, Gilbert-MacLeod C and Katz J (2002)Rosenthal K (2005) Tips for venepuncture in children, Conditioning and hyperalgesia in newborns exposed toNursing, 35(12), p.31. repeated heel lances, Journal of the American MedicalRoyal College of Nursing (2003a) The recognition and Association, 288 (7), pp.857-861.assessment of acute pain in children: implementation Tak JH and Van Bon WHJ (2006) Pain and distress-guide London: RCN. reducing interventions for venepuncture in children, Child:Royal College of Nursing (2003b) Restraining, holding still Care, Health and Development, 32(3), pp.257-268.and containing children and young people: guidance for Thompson P (2008) Blood samplingnursing staff, London: RCN. (neonates):venepuncture versus heel lance. EvidenceRoyal College of Nursing (2005a) RCN standards for summaries, Joanna Briggs Institute.infusion therapy, RCN: London. Thurgate C and Heppell S (2005) Needlephobia – challenging venepuncture practice in ambulatory care,Royal College of Nursing (2005b) Competences: an Paediatric Nursing, 17(9), pp.15-18.integrated competence framework for trainingprogrammes in the safe administration of chemotherapy Tim JC, Adams J and Elliott TSJ (2003) Healthcare workers’to children and young knowledge of inoculation injuries and glove use, British Journal of Nursing, 12(4), pp.215-222.people, London: RCN. Twycross A (1998) Children’s cognitive level and theirRoyal College of Nursing (2005c) Good practice in perception of pain, Paediatric Nursing, 10 (3), pp.24-27.infection prevention and control: guidance for nursingstaff, London: RCN. Vessey JA (1994) Use of distraction with children during an acute pain experience, Nursing Research, 43, 6, pp.369-Royal College of Nursing (2009) Needlestick injuries: the 372.point of prevention. London: RCN. Welsh Assembly Government (2005) National ServiceShah V and Ohlsson A (2003) Venepuncture versus heel Framework for children, young people and maternitylance for blood sampling in neonates, The services in Wales. Available from, (2): 2003 (CD001452). Williamson D and Holt PJA (2001) Calcified cutaneousSaunders S (2008) Venepuncture: evidence summaries, nodules on the heels of children: a complication of heel sticksAdelaide: Joanna Briggs Institute. as a neonate, Pediatric Dermatology, 18(2), pp.138-140. 10
  13. 13. ROYAL COLLEGE OF NURSINGWillock J,Richardson J, Brazier A (2004) Peripheralvenepuncture in infants and children, Nursing Standard,18, 27, pp.43-50.Wilson KJW and Waugh A (2001) Anatomy and physiology(9th edition), Edinburgh: Churchill Livingstone.Wilson J (2006) Infection control in clinical practice (3rdedition), London: Baillière Tindall.Wolfram RW and Turner ED (1996) Effects of parentalpresence during children’s venepuncture, AcademicEmergency Medicine, 3(1), pp.58-64.Wood C. (2002) Introducing a protocol for procedure pain,Paediatric Nursing, 14(8), pp.30-33. 11
  14. 14. RCN COMPETENCES – CAPILLARY BLOOD SAMPLING AND VENEPUNCTURE 4Online resourcesG Action for Sick Children G Northern Ireland Practice and Education Council for Nurses and Midwives www.nipec.n-i.nhs.ukG Department for Education and Skills G NHS Education for Scotland Department of Health, Social services and Public safety, Northern Ireland G NHS Scotland Department of Health (England) G NHS Wales Evidence-based Practice in Infection Control G Nursing and Midwifery Council www.nmc-uk.orgG NHS Evidence G Royal College of Nursing Health and Safety Executive G Royal College of Paediatrics and Child Health National Association of Hospital Play Staff G Skills for Health UK Health and Safety legislation G Hand hygiene, Scotland www.washyourhandsofthem.comG Health Care Standards Unit National Patient Safety Agency NHS Litigation Authority www.nhsla.comG Infection Prevention Society Joanna Briggs Institute National Patient Safety Agency 12
  15. 15. The RCN represents nurses and nursing, promotesexcellence in practice and shapes health policiesNovember 2005, revised July 2010RCN 772 6100Published by the Royal College of Nursing20 Cavendish SquareLondonW1G 0RN020 7409 3333Publication code 003 004ISBN 978-1-906633-45-5