Principles of care for seriously ill patients

Nursing is an integral part of the therapeutic process, includes a set of measures aimed at alleviating the suffering of a patient and creation of optimal conditions for treatment.

Properly organized care determines the effectiveness of treatment and prognosis, therefore it is impossible to distinguish between the two concepts of "treatment" and "care".

Care helping a patient to meet their various needs:

eating, drinking, washing, moving, physical shipment.

The success of the treatment and prognosis of the disease determine much about the quality of care.

Nursing is an integral part of the whole treatment process, which affects a great extent on its effectiveness.

The amount of care activities depends on the characteristics of the course and severity of the disease, the age and gender of the patient, the patient's psyche, and other factors, so the tactics of care must be individualized for each patient.

Principles of care:

• Safety (preventing injury)

• Privacy policy

• Respect for the dignity of a patient (patient's consent, ensuring privacy)

• Effective communication with a patient and family members

Encourage a patient to independence

• Infectious safety

Care of patients at the hospital primarily carrying out nurse that can attract to implement some procedures paramedics or patient's relatives.

However, the physician should understand all the aspects of care, because he/she bears full responsibility for patient health.

There are two main areas of nursing care:

General duty and specialized nursing.

Total care includes general measures of care, regardless of the nature of the disease and is built on the principle of a protective regime, guardian and sparing the patient's psyche.

It includes compliance with sanitary procedure in place, the creation of favorable conditions for a patient (comfortable bed), patient hygienic maintenance (care when changing sheets and underwear, the toilets, thermometry, eating, physiological items, etc.), monitoring of changes in the condition of a patient, as well as measures to prevent the development of complications.

Special care specific care activities carried out only under certain conditions, surgical, gynecological, infectious diseases, etc.

For example, the preparation of a patient to urography or other x-ray examination methods.

2.1 Changing critically ill patient's bed sheets

One of the essential and complex procedures when caring for the seriously ill patients in the hospital is changing bed linen.

Changing of bed linen for seriously ill people who are not allowed to move, should be made with great care, encourage well-being, to eliminate the risk of skin infection, prevent the development of bedsores.

Before the procedure, you must prepare the kit clean bed linen (sheet, pillow, duvet cover) and a bag of dirty laundry.

Explain the procedure to a patient and get the patient's consent.

Evaluate the patient's condition and the possibility of his help

Wash your hands by hygienic way, put on disposable apron and gloves.

Changing of bedding must be carry out by two-person so on the part of the patient the minimum cost of physical strength.

Bed sheet must cover the mattress not only the top and sides, but also the ends.

Edges of sheets should not hang over, bend them under the mattress on all sides.

Dirty laundry is gathered in oilcloth bags and takes out of the room.

Before sending to the laundry, clothes should be stored in a dedicated room (dirty linen) in pots or containers.

There are several ways to change the bed linen, however, in daily practice the most popular are transverse and longitudinal.

The longitudinal method is used to change the bed linen in bedridden patients who are allowed to make active movements and turn over in bed (fig. 57 a).

Cross method is used when a patient cannot rotate a patient on his/her side, but it is possible to make him/her sit or raise patient’s upper body (Figure 57 b).

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Figure 57 b

Changing of bed sheets for seriously ill patient

а - longitudinal method, б -cross method

Changing of bed sheets for seriously ill patient with longitudinal method

The procedure:

1. Carefully turn a patient on his/her side, extract the pillow under the patient's head.

2. Take off the pillowcase from the pillow and put it in a bag for dirty linen, put on a clean pillowcase on the patient's cushion.

3. Roll up a half of a clean sheet along the length.

4. Move the patient to the edge of the bed, turning it on its side to yourself (it is recommended that assistant holds the patient's head).

5. Roll a dirty sheet in the form of a roller along the whole length toward the patient.

6. Spread a clean sheet on the free side of the bed.

7. Turn the patient on his/her back, then on the other side so that he is on a clean sheet.

8. Remove the dirty sheet, and spread a clean one, pull it and tuck the edges of the sheets under the mattress.

9. Put the used sheet in the bag for dirty laundry.

10. Place the patient in a comfortable position.

11. Put on ca lean duvet cover on the blanket and cover the patient.

12. Put the duvet cover in a bag for dirty laundry.

13. Close the bag and bring it to a matron for disinfection.

14. Take off the gloves.

15. Cleansing hands due to hygienic way.

Changing of bed sheets for seriously ill patient with transverse method

Procedure:

1. Roll a clean sheet in the transverse direction.

2. Carefully lift up the upper body of the patient, take out remove his pillow underneath the patient's head pillow (it is desirable that the assistant holding the patient).

3. Roll the dirty sheet from bed-head to the waist of the patient.

4. Roll out a clean sheet on the vacant side of the bed.

5. Put a pillow on a clean sheet and the patient’s head on it.

6. Ask the patient to bend his knees, lean his feet on the bed and lift his pelvis (if it is difficult for the patient, the assistant will enclose the left hand under the rump of the patient and help him to lift the pelvis).

7. Remove the dirty sheet and roll out a clean.

8. Ask the patient to low his pelvis.

9. Lift and hold the patient's leg in the crural region, continuing to move the dirty sheet and rolling out a clean.

10. Low the patient’s legs.

11. Throw the used linens in the laundry bag.

12. Give the patient a comfortable position.

13. Take off the gloves.

14. Wash your hands by hygienic way.

2.2 Change of seriously ill patient’s underwear

If the patient is obese or immobile, change bed linen alone is quite difficult and unsafe for the health of the nurse. In this case, the linen should be conducted with the assistant. Before change of underwear, the patient will need to prepare for the procedure, set of clean underwear and clothes, and a waterproof bag for used linen, medical gloves. Clean shirt must be larger than the size of the patient’s clothes (Fig. 58).

Picture 58

Changing of patient’s T-shit

The procedure:

1. First, you should slightly lift patient's head and remove a pillow.

2. Carefully lift the patient, put your hands under the patient's sacrum, grab the edge of the shirt and gently tighten it up to the armpits and the back up to the neck.

3. After this, you should raise both patients’ hands, rolled shirt at neck slide it over the patient's head and gently take it off without touching his face with dirty shirt.

4. Put the patient's head on the pillow.

5. Get free the patient's arms from sleeves:

first the healthy, then wounded.

6. Place the used clothes in a waterproof bag and give it to a matron for disinfection.

Put on a clean shirt for seriously ill patient, performing all steps exactly in reverse order:

1. Assemble a clean shirt on the back

2. Put the sleeve on the injured hand, then to a healthy one

3. Fold patient's arms beneath her/his breasts, while supporting the patient's head with your right hand, put on the shirt your left hand through neck hole on the patient's head

4. Pull it down.

Дата добавления: 2015-10-29