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Doody's Review ServiceReviewer: Donna Marie Minner, BSN, RN (University of Missouri-Columbia)
Description: This fifth edition of a book for certification of nursing assistants is well organized with a wealth of pictures to illustrate techniques and procedures.
Purpose: The purpose is to provide a book that enhances the learning ability of nurse aides who are studying for certification and wish to practice in long term care. The authors state an intent to provide only need-to-know information about topics and procedures that are relevant to their jobs, presented using principles of adult learning. The authors' intent is on target, but while well organized with wonderful pictures and easy to understand instruction, some of the book is very detailed with more physiology than necessary.
Audience: According to the authors, this book/workbook combination was written for certification instruction of nurse aides. This is accomplished well in most procedural instruction, but there is more background than may be necessary. Both authors have worked for many years in long term care and certainly know their way around a nursing home. However, I saw no indication of sources used for current standards of care implied in the book. The chapter covering dementia care is one example of need for a reference. There is current literature on standards of practice indicating that reality orientation should not be used in the care of demented individuals. The authors, while acknowledging this on a minor level, gave use of reality orientation equal billing with validation therapy as a means of communicating with the elderly demented! The title of one paragraph in the dementia section, "Controlling Difficult Behaviors," ignores the current standards of practice that look at behavior as a form of communication to be understood in order to improve care of the individual. The section that includes restraints indicated that certified nursing assistants (CNAs) should put side rails up on all residents unless otherwise instructed by their charge nurse. The literature indicates the opposite to be true with much evidence that side rails are very unsafe. There is also no warning in the section on prevention of pressure ulcers about the dangers of massaging bony prominences. This is stated by such authorities as the National Pressure Ulcer Advisory Panel and the recently reviewed Agency for Health Care Quality Research (AHQR) guidelines on pressure ulcer prevention.
Features: This book covers the body systems with anatomy, physiology, and procedures related to each. There are step-by-step instructions for each procedure, with wonderful illustrations and photographs. The book is well organized, thorough and easy to follow. The book's biggest shortcomings are the lack of references for stated standards of practice and the presentation of outdated practices in the areas of dementia care and restraints.
Assessment: This book has the potential to be an excellent book for instruction of CNAs. With its format, organization, illustrations, and photos it could be a solid addition to the search for good CNA instruction materials. It needs work in the area of current practice standards and references. A new edition with more attention to these details would make this book a valuable teaching tool.