Guided Reflection 2nd Edition

Abstract

This is the 2nd edition of Guided Reflection: A Narrative Approach to Advancing Professional Practice and when one sees the list of three other books on this subject by the editor one wonders how much meat there is left on the bone of reflection. This edition has expanded the themes to include art and performance and the latter is significant as unfortunately the narrative seems to play to the crowds far too much. Reflection or reflective practice as it is usually known can be a useful tool for some to help improve their care through insight into their actions, but books such as this have developed it beyond all recognition and usefulness to a point where it is of debatable benefit. The book itself is not well structured and uninspiring to read with long sections of text and far too much self referencing. There are neither counter-arguments to the techniques described nor description of their suitability in specific situations. I cannot recommend this book as useful and would suggest those looking for a reference book on reflective practice would be better off with something more practical. This edition of the Journal of Renal Nursing focuses on infection control, an area of increasing concern over the past few years. Hospital acquired infections (HAI) are a significant burden to the patient and society as a whole. As many as 10% of people will contract an HAI during their hospital stay, which often leads to an increased risk of complications and higher mortality rates. In addition, evidence from the National Audit Office suggest they cost the NHS in the region of £1 billion. In our specialist renal field, the risk of infection is particularly high due to the necessity for various forms of vascular access. Dialysis catheters are associated with the highest rates of infection and poor outcomes, and should be avoided for longterm treatment where possible. However, while the renal community recommends all patients have dialysis via some sort of native fistula or graft, there is a group of patients for whom this is just not possible or acceptable. It is this group of patients who we need to be particularly careful with to avoid any infections. Books such as these provide the clinical knowledge and evidence we should use in our daily practice. The real benefit of this book is its detail. There are chapters on all major infections and antibiotic treatments. Some chapters are likely to be used more often than others such as that on the recognition and treatment of intravascular catheter (IVC)-related infections. It describes in detail the different types of IVC infections such as exit or tunnel site, phlebitis or catheter colonization and suggests the most appropriate treatment. Recommendations are based on the latest evidence and there are useful statistics on the epidemiology of IVC related HAIs. Other useful chapters describe the potential infection problems associated with transplantation, the use of universal infection control precautions and barrier nursing, and an interesting chapter on hand washing. At first glance hand washing may not appear to be the most interesting subject, but there is much more to it than most would imagine, with a multitude of different organisms that require specific eradication techniques. This excellent book provides everything the renal nurse needs to prevent, diagnose and treat infections, and should be available on all renal wards, dialysis units and outpatient areas. Oxford Handbook of Infectious Diseases and Microbiology