Clinical Skills Ltd

Clinical Skills Ltd http://clinicalskills.net is a web-based learning programme and reference tool, regularly updated by our specialist authors and editors.

Anyone who is studying clinical skills will find that clinicalskills.net gives them invaluable help. This user-friendly set of illustrated clinical skills guidelines is a great reference tool. It will help you understand the principles of a particular skill, so that you make the most of your time in the skills lab. Those with more experience will want to check their practice against the evidence-b

ased best practice shown in clinicalskills.net. The package features a wide range of skills and all are regularly updated by our specialist authors and editors.

World Breastfeeding Week: 1st–7th August 2026 World Health Organization (WHO)
05/08/2026

World Breastfeeding Week: 1st–7th August 2026

World Health Organization (WHO)

News of a new guide and updates to two other guides in our Intrapartum Care category:https://app.clinicalskills.net/shar...
03/08/2026

News of a new guide and updates to two other guides in our Intrapartum Care category:
https://app.clinicalskills.net/shared/category/72

• Initial labour assessment

• Intrapartum fetal monitoring: Intermittent auscultation (NEW)

• Active third stage of labour

These fully illustrated guides have been authored by Sam Copping, Lecturer in Midwifery, University of Suffolk. The guides have also been double-blind peer reviewed.

Using continuous positive airway pressure (CPAP) in an acute setting – updated guidehttps://app.clinicalskills.net/share...
23/07/2026

Using continuous positive airway pressure (CPAP) in an acute setting – updated guide
https://app.clinicalskills.net/shared/procedure/90

This fully illustrated guide has been updated by a new author, Rachel Birch, Senior Lecturer in Adult Nursing at Manchester Metropolitan University. The guide has also been double-blind peer reviewed.

Continuous positive airway pressure (CPAP) therapy is a form of non-invasive respiratory support that increases pulmonary gas exchange by splinting (holding open) the lower airway in patients with atelectasis or type 1 (hypoxaemic) respiratory failure.

It can also be used to splint the upper airway for people with sleep apnoea.

CPAP delivers a constant level of positive airway pressure throughout the respiratory cycle, a distinction from bilevel positive airway pressure (BiPAP), which delivers two levels of pressure during inhalation and exhalation.

The early application of CPAP may provide a bridge to mechanical ventilatory support or help in weaning patients from invasive ventilation.

This guide provides an overview of pulmonary gas exchange and the CPAP system, as well as the contraindications to CPAP.

The guide includes information on how to manage the system and care for a patient who is receiving CPAP therapy. For example:

• Setting the oxygen flow rate and concentration;
• Setting the positive end expiratory pressure (PEEP) value;
• Fitting the mask, checking for leaks;
• Allowing the patient regular breaks from CPAP for food and drink, personal care and medication.

It is important to observe the patient’s vital signs during CPAP therapy in an acute setting; this is to ensure that, for example, oxygen saturation levels are improving and within the target range. Additional observations may include obtaining arterial blood gas samples, particularly in patients who are at risk of hypercapnia.

A competency checklist accompanies this guide, which can be used to assist with staff development and assessment.

Two updated guides from our Diabetes care category:https://app.clinicalskills.net/shared/category/39• Treatment of hypog...
21/07/2026

Two updated guides from our Diabetes care category:
https://app.clinicalskills.net/shared/category/39

• Treatment of hypoglycaemia in a community setting

• Treatment of hypoglycaemia in an acute hospital setting

These guides have been updated by Martha Stewart, Programme Lead and Senior Lecturer, Advancing Diabetes Care programme, at Birmingham City University.

The number of people diagnosed with type 1 and type 2 diabetes continues to increase. As a result, the number of prescriptions for insulin and its secretagogues (such as sulfonylurea medications) has also increased significantly. Hypoglycaemia is caused by an excess amount of circulating insulin that people have either injected or have produced in response to insulin secretagogue medication.

Hypoglycaemia is a serious, potentially life-threatening condition that is often a major barrier to achieving optimum blood glucose control in people with diabetes. Hypoglycaemia increases mortality, as well as the risk of cardiovascular disorders and cerebrovascular events. It is therefore essential that all healthcare professionals know how to recognise and treat hypoglycaemia effectively.

Hypoglycaemia is defined as a “lower than normal blood glucose level”, with the recommendation that any blood glucose level of less than 4.0 mmol/L is treated. In addition, people who frequently have high blood glucose levels may experience the signs and symptoms of hypoglycaemia when their blood glucose levels are lower than normal for them but higher than 4.0 mmol/L.

These guides focus on the management of mild, moderate and severe hypoglycaemia in adults, and cover community and acute hospital settings.

Administering an enteral feed via a nasogastric tube in children – updated guidehttps://app.clinicalskills.net/shared/pr...
16/07/2026

Administering an enteral feed via a nasogastric tube in children – updated guide
https://app.clinicalskills.net/shared/procedure/236

This fully illustrated guide has been updated by Gemma Kavanagh, Lead Nurse, Nutritional Care, and Michelle Moseley, Senior Specialist Nurse, Nutritional Care, at Birmingham Women’s and Children’s NHS Foundation Trust. The guide has also been double-blind peer reviewed.

Enteral feeding involves delivering nutrition directly into the gastrointestinal tract (stomach or small intestine) via a tube. For example, a nasogastric (NG) tube can be passed through the nose to deliver feed into the stomach.

This method of feeding offers a useful way to ensure the adequate intake of fluids and nutrients in patients who, for various reasons, are unable to use the oral route or to take adequate nutrients to thrive physically or developmentally.

Enteral feeding has a role in both short-term rehabilitation and long-term nutritional management, either as a supportive therapy, whereby enteral feed provides a proportion of the required nutrients, or as a primary therapy, providing all the necessary nutrients that the child needs.

Enteral nutrition should be administered by the most appropriate method for the child. It is important to regularly review the indications, route, risks and benefits of enteral feeding for the child.

This guide shows the procedure for administering an enteral feed via an NG
tube for a child who already has an NG tube in place.

Nebulisers – updated guidehttps://app.clinicalskills.net/shared/procedure/91This fully illustrated guide has been update...
14/07/2026

Nebulisers – updated guide
https://app.clinicalskills.net/shared/procedure/91

This fully illustrated guide has been updated by Mike Bulley, Advanced Care Practitioner, Kernow Health. The guide has also been double-blind peer reviewed.

A nebuliser is a device that converts liquid medication into aerosols to reach deeper parts of the respiratory tract.

Jet nebulisers use compressed gas, whereas ultrasonic nebulisers use a piezoelectric crystal vibrating at high frequency to produce the medical aerosol particles. Jet nebulisers include standard- and high-flow devices, and can deliver medicine through either a mask or mouthpiece at a faster rate than the patient’s inspiratory flow.

Nebuliser therapy should be considered for patients who are unable to use inhalers effectively, or those with severe symptoms (e.g., distressing or disabling breathlessness), even if they are receiving maximal therapy using an inhaler.

This guide demonstrates the use of a standard-flow jet nebuliser for an adult patient in a hospital setting. The principles described are also applicable in community and home-care environments, subject to local policies and available equipment.

A competency checklist accompanies this guide, which can be used to assist with staff development and assessment.

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Collecting a specimen of urine (children) – updated guidehttps://app.clinicalskills.net/shared/procedure/215This fully i...
09/07/2026

Collecting a specimen of urine (children) – updated guide
https://app.clinicalskills.net/shared/procedure/215

This fully illustrated guide has been updated by Sarah McDonald, Principal Lecturer in Children’s Nursing, Sheffield Hallam University. The guide has undergone double-blind peer review.

The testing of urine specimens can aid in the diagnosis of several paediatric conditions and can indicate early signs of disorders of the renal system, most commonly urinary tract infections (UTIs). UTIs are common bacterial infections found in infants and children, and their prevalence is higher in children who are not toilet-trained.

The National Institute for Health and Care Excellence (NICE, 2022) recommends collecting a sample of urine for testing (urinalysis) from children who have specific signs and symptoms that indicate that a UTI may be present. However, obtaining a urine sample can be challenging and each technique for obtaining a sample has its advantages and limitations.

NICE (2022) recommends using a clean-catch urine (CCU) method wherever possible. This guide describes how to obtain a CCU sample in infants and children.

The guide also shows how to obtain urine using alternative methods of sample collection, such as paediatric urine pads, paediatric urine bags and suprapubic aspiration.

A competency checklist accompanies this guide, which can be used to assist with staff development and assessment.

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