Glossary

A

Ablation An amputation, an excision of any part of the body, or a removal of a growth or harmful substance.

Aboriginal Refers here to both Aboriginal and Torres Straight Islander people.

Accountability Nurses and midwives must be prepared to answer to others, such as health care consumers, their nursing and midwifery regulatory authority, employers and the public for their decisions, actions, behaviours and the responsibilities that are inherent in their roles. Accountability cannot be delegated. The registered nurse or midwife who delegates an activity to another person is accountable, not only for their delegation decision, but also for monitoring the standard of performance of the activity by the other person, and for evaluating the outcomes of the delegation.

Additional (transmission-based) precautions Safeguards designed for patients who are known or suspected to be infected with highly transmissible or epidemiologically important pathogens for which additional precautions beyond standard precautions are needed to interrupt transmission in hospitals. There are three types of transmission-based precautions: airborne precautions, droplet precautions and contact precautions. They may be combined for diseases that have multiple routes of transmission, and, either singly or in a combination, are to be used in addition to standard precautions.

Advance directive A document that expresses the patient’s preferences for end-of-life issues.

Adverse event An incident in which unintended harm resulted to a person receiving health care.

Asepsis Absence of pathogenic microorganisms on living tissue.

Aseptic technique Any health care procedure in which added precautions are taken to prevent contamination of a patient, object or area by microorganisms.

Allograft Transplanted organ and tissue.

Arrhythmia A broad term used to describe any rhythm other than sinus rhythm.

Atraumatic Pertaining to therapies or therapeutic instruments and devices (e.g. needles) that are unlikely to cause tissue damage.

Australasian Donor Awareness Program Training (ADAPT) An Australasian program that provides a consistent and uniform approach to educating health professionals in the care and management of dying patients and their families, including patients who may become organ and tissue donors; in organ retrieval surgery; and in the organ and tissue donation process.

Australasian Transplant Coordinators Association (ATCA) An organisation that promotes communication and collaboration among organ and tissue donor and transplant coordinators, and promotes research, education and discussion of professional and ethical issues in the field in Australasia.

Australians Donate The peak body for the organ and tissue donation sector in Australia. Members include state and territory organ donation agencies, independent tissue and eye banks, community groups, clinicians, policy makers, academics and ethicists.

Autonomy The ethical principle of self-determination and independence.

B

Basic life support The support of life by the initial establishment of and/or maintenance of airway, breathing and circulation and related emergency care.

Brain death Death from confirmed irreversible cessation of all function of the person’s brain and/or absent intracranial blood flow.

Bronchospasm An excessive and prolonged contraction of the smooth muscle of the bronchi and bronchioles, resulting in acute narrowing and obstruction of the respiratory airway. The contractions may be localised or general and may be caused by irritation (e.g. secretions, airway equipment or pulmonary aspiration) or injury to the respiratory mucosa, infections, allergies, drug hypersensitivity or the rapid introduction of volatile anaesthetic agents. Bronchospasm is the chief characteristic of asthma and bronchitis. It is managed by increasing the level of inhalational anaesthesia, bronchodilators (e.g. salbutamol) and other drugs (e.g. steroids, ketamine or adrenaline) or repositioning the endotracheal tube in anaesthetised patients.

C

Cadaveric donor Donor of tissue and solid organs after death.

Cardiac arrest The cessation of cardiac mechanical activity with the absence of a detectable pulse, and unresponsiveness and apnoea (or agonal respirations).

Capnography Graphical representation of expired carbon dioxide (CO₂), often termed end-tidal CO₂. Measurement assists in early detection of technical catastrophes (e.g. oesophageal intubation) or changes in patient’s respiratory, circulatory or metabolic condition. An adaptor placed in the breathing circuit during general anaesthesia collects CO₂, which is then analysed and displayed as a wave form on a monitor.

Clinical decision making The cognitive processes and strategies that nurses use when utilising data to make clinical decisions regarding patient assessment and care.

Clinical practice guidelines Statements about appropriate health care for specific clinical circumstances that assist practitioners in their day-to-day practice.

Closed-wound suction Any of several techniques for draining potentially harmful fluids (e.g. blood, pus, serosanguineous fluid or tissue secretions) from surgical wounds. Postoperative drainage aids the healing process by removing dead space and helping to draw healing tissues together. Closed-wound suction devices usually consist of disposable transparent containers attached to suction tubes and portable suction pumps.

Coagulopathy Disorders of the clotting mechanism of the blood, which can be caused by pre-existing disease, medications (including herbal therapies), pathophysiological conditions (e.g. hypothermia and acidosis) or current treatments (e.g. massive blood transfusion).

Code of conduct A collection of standards and rules of behaviour.

Cognitive impairment Deficiency in the ability to think, perceive, reason or remember that may result in the loss of ability to attend to one’s activities of daily living.

Cold ischaemic time The time from cross-clamp to when blood supply is re-established to the organ during transplant surgery.

Compartment syndrome A pathological condition caused by the progressive development of arterial compression and consequent reduction of blood supply. Clinical manifestations include swelling, restriction of movement, brown urine, myoglobinuria, vascular compromise and severe pain or lack of sensation. Treatment includes elevation, removal of restrictive dressings or casts and, potentially, surgical decompression (often in the form of a fasciotomy, to relieve the pressure).

Competence Combination of skills, knowledge, attitudes, values and abilities that underpin effective and/or superior performance in a profession/occupational area.

Complementary therapies Treatments that have not been considered part of standard Western medicine but are increasingly being used in combination with standard medical treatments. These may include therapies for pain (e.g. massage and relaxation techniques) and some nutritional therapies.

Confidentiality The obligation of persons to whom private information has been given not to use that information for any purpose other than for the primary purpose for which it was given.

Cricoid pressure see Sellick’s manoeuvre.

Culture A set of learned values, beliefs, customs and behaviour that is shared by a group of interacting individuals.

Cultural safety the provision of effective health care to persons of dissimilar cultures, respecting difference and ensuring that care is not diminishing, demeaning or disempowering. Culture includes not only ethnicity or origin but also age, gender, disability, sexual identity, socioeconomic status, spiritual beliefs or migrant experience.

D

Debride To remove dirt, foreign objects, damaged tissue and cellular debris from a wound or a burn to prevent infection and to promote healing. In treating a wound, debridement is the first step in cleansing; it allows thorough examination of the extent of the injury. In treating a burn, debridement of the eschar may be performed in a hydrotherapy bath.

Defibrillation The application of a controlled electrical shock to the victim’s chest in order to terminate a life-threatening cardiac rhythm.

Deontological A philosophical view reflecting duty or a moral obligation to behave or act in a particular way.

Designated officer According to Australian law, a person(s) appointed by the governing body of health institutions to authorise consent for non-coronial post-mortem examinations, and organ and tissue retrieval for transplant and research.

Donation after death Also known as non-heart beating donation (NHBD): donor of selective solid organs and tissues after cardiac death rather than brain death.

E

Electronic health record (EHR) (or electronic medical record, EMR) an individual patient’s medical record in digital format. EHR systems coordinate the storage and retrieval of individual records with the aid of computers. EHRs/EMRs are usually accessed on a computer, often over a network. It may be made up of electronic medical records from many locations and/or sources. A variety of types of health care-related information may be stored and accessed in this way. Integrated electronic health records are increasingly seen as the way to achieve quality and continuity in treatment, fill the gaps in public health research and contain costs; however, such systems have created many concerns about privacy.

Electrosurgical unit (ESU) (diathermy machine) The ESU generates a high-frequency electrical current, which creates heat in body tissue, resulting in coagulation or desiccation of tissue. This provides haemostasis and a bloodless field during a surgical procedure. There are two main types—monopolar and bipolar; use of the former requires the placement of an indifferent electrode (diathermy plate) on the patient’s body, away from the operative site.

Endogenous Microorganisms causing infection that originate from the body’s own flora.

Endoscopy Visualisation of the interior organs and cavities of the body with an endoscope, which may be rigid or flexible. The gastrointestinal tract, renal system, upper and lower airway and female reproductive system can all be examined, and cytological and histological samples collected, and some conditions treated via an endoscopic procedure.

Endotracheal tube (ETT) A large-bore, disposable catheter made of silicone or PVC tubing inserted through the mouth or nose and into the trachea to the point above the bifurcation of the trachea. It is used to deliver anaesthetic gases and oxygen directly into the trachea through the vocal cords. ETTs may have a single or double lumen (for lung surgery). Adult-sized ETTs have a cuff at their distal end, which, when inflated with air, seals off the trachea, permitting positive pressure ventilation and decreasing the risk of aspiration.

Epidural anaesthesia/analgesia A type of central nerve anaesthesia block in which a local anaesthetic drug is injected via a fine catheter into the epidural space surrounding the dural membrane, which contains cerebrospinal fluid and spinal nerves. The catheter lies between the dura mater and ligamentum flavum at the L3–4 or L5–6 level. An epidural injection can be used to facilitate surgery of the lower half of the body and/or provide prolonged postoperative analgesia.

Error A generic term to encompass all of those occasions in which a planned sequence of mental or physical activities failed to achieve its intended outcome, and when the failure cannot be attributed to the intervention of some chance agency.

Eschar A scab or dry crust that results from trauma, such as thermal or chemical burn, infection or ulcerating skin disease.

Ethical/unethical Right or morally acceptable/wrong or morally unacceptable.

Ethics The study of morals and values.

Evidence-based nursing The conscientious, explicit and judicious use of theory-derived, research-based information in making decisions about care delivery to individuals or groups of patients.

Exogenous Microorganisms causing infection that originate from sources external to the body (e.g. other patients, staff or equipment).

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