Nursing Procedure: How to Provide Evening Care to Patients

Definition

Evening care to patients is a way to refresh and prepare them for sleep. This also promotes relaxation on the patient. Learn on how to provide evening care to patients.

Purpose

1. To refresh the patient and prepare him for sleep
2. To promote muscular relaxation
3. To prevent bedsore

Preparation of Patient and Environment

A tray containing:

• Basin of warm water
• Alcohol 70%
• Soap in soap dish
• Talcum powder
• Hair comb or brush
• Bath towel & wash cloth
• Pitcher of warm water
• Mouth wash tray with
• Mouth wash solution
• Tooth brush
• Kidney basin
• Linen required

Procedure

1. Allow patient to brush his teeth, wash his face, hands and forearms. If patient is unable to help himself, do it for him.
2. Turn patient to his side, unfasten his camisa or hospital gown and bathe her back.
3. Massage back with alcohol 70% or skin lotion paying particular attention to the bony prominences and other reddish spots on the back.
4. Dust with powder
5. If the patient is wearing a binder, remove it when giving care to the back. Inspect dressing for bleeding or discharge and changes or reinforce p.r.n. Return the binder in place.
6. Brush and comb hair. Protect back and camisa with towel
7. Fasten patient’s camisa Move patient to one side brush crumbs or dirt from the bed.
8. Tighten beddings.
9. Fluff up pillows and replace
10. Replace ice cap or hot water bag p.r.n
11. Give bedtime medicine if any. Attend to all patient’s request
12. Place signal cord or bell within the reach of the patient.
13. Remove all unnecessary things from the room: trays, dishes, etc. Empty wastebasket.
14. Adjust screen or blinds and light.
15. Document

Types, Indicators & Procedures of Hand Hygiene

Types of Hand Hygiene

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The following are the types of hand hygiene:

• Routine handwash. Use of water and non-antimicrobial soap for the purpose of removing soil and transient microorganisms.
• Antiseptic handwash. Use of water and antimicrobial soap (e.g., chlorhexidine, iodine and iodophors, chloroxylenol [PCMX], triclosan) for the purpose of removing or destroying transient microorganisms and reduce resident flora.
• Antiseptic handrub. Use of alcohol-based handrub.
• Surgical antisepsis. Use of water and antimicrobial soap (e.g., chlorhexidine, iodine and iodophors, chloroxylenol [PCMX], triclosan) for the purpose of removing or destroying transient microorganisms and reduce resident flora. Recommended duration is 2-6 minutes.

Indicators of Hand Hygiene

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According to the World Health Organization (WHO), there are Five Moments for Hand Hygiene:

1. Before Patient Contact.
2. Before and Antiseptic Task.
3. After Body Fluid Exposure Risk.
4. After Patient Contact.
5. After Contact with Patient Surroundings.

Supplies Needed

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The following materials or equipment are needed to perform hand washing:

• Soap or detergent
• Warm running water
• Paper towels
• Alcohol
• Optional: Antiseptic cleaner, fingernail brush, plastic cuticle stick

Procedures

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Below are the step-by-step guide for different hand hygiene methods:

Antiseptic Handrub

The use of alcohol-based handrub.
1. Ensure jewellery has been removed
2. Apply quantity of alcohol-based hand hygiene product as per manufacturer’s recommendations into cupped hand.
3. Rub hands palm to palm
4. Right palm over left dorsum with interlaced fingers and vice versa.
5. Palm to palm with fingers interlaced
6. Backs of fingers to opposing palms with fingers interlaced
7. Rotational rubbing of left thumb clasped in right palm and vice versa
8. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left
palm and vice versa
9. Rubbing hands together until hands are dry before continuing with patient care, do not rub off excess product

Antiseptic Handwash

Also known as clean technique, includes procedures used to reduce the number of organisms on hands.
1. Gather the necessary supplies. Stand in front of the sink.
2. Wet the hands and wrist area. Keep hands lower than elbows to allow water to flow towards the fingertips.
3. Cover all areas of hands with soap.
4. With firm rubbing and circular motions, wash the palms and backs of the hands, each finger, the knuckles, wrists, and forearms. Continue this friction motion for 30 seconds.
5. Rinse thoroughly with water flowing towards the fingertips.
6. Pat hands dry, beginning with the fingers and moving upward towards forearms, with a paper towel and discard immediately.
7. In the absence of sensors or foot pedal, use another clean paper towel to turn off the faucet.

Surgical Antisepsis

Also known as sterile technique, prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery.
1. Remove all pieces of jewelry.
2. Wet hands using sterile water with water closest to your body temperature.
3. Wash hands using antimicrobial soap and/or povidone-iodine.
4. Clean subungual areas with a nail file.
5. Scrub each side of each finger, between the fingers, and the backs and fronts of the hands for at least 4 minutes.
6. Proceed to scrub the hands, keeping the hand higher than the arm at all times to prevent bacteria-laden soap and water from contaminating the hands.
7. Rinse hands and arms by passing them through the flowing water in one direction only, from fingertips to elbow.
8. Proceed to the operating room holding hands above elbows.
9. Dry hands and arms using sterile towel observing aseptic technique.

Nursing Procedure: How to Antiseptic Hand Washing Used Hand Rub

Definition

Hand washing is the act of cleaning one’s hands with the use of any liquid with or without soap for the purpose of removing dirt or microorganisms. It is the most effective measure in reducing the risk of transmitting infectious diseases. It cannot be said too often that hand washing is the most important and most basic technique in preventing and controlling infections. It is the single most effective infection control measure.
Hand washing is under the umbrella of hand hygiene. Hand hygiene is defined by the World Health Organization as a general term that applies to hand washing, antiseptic hand wash, antiseptic hand rub or surgical hand antisepsis.

Nursing Procedure: How to Antiseptic Hand Washing Used Hand Rub. Sumber gambar: widitaputra.files.wordpress.com

Terms

To understand this study guide better, familiarize yourself with the terms used:

• Hand Hygiene. It is a general term that applies to hand washing, antiseptic hand wash, antiseptic hand rub, or surgical hand antisepsis
• Hand Washing. It is defined as the washing of hands with plain (i.e., non-antimicrobial) soap and water.
• Antiseptic Hand wash. A term that applies to hand washing with an antimicrobial soap and water.
• Surgical Hand Antisepsis. Commonly called as a surgical hand scrub. This is to remove as many microorganisms from the hands as possible before the sterile procedure.

Goals

The purposes of hand hygiene are:

• Hand washing can prevent infection
• Avoid pathogenic microorganisms and to avoid transmitting them
 

 

Equipment

The following materials or equipment are needed to perform hand washing:

• Hand rub / hand sanitizer
• Paper towels
• Optional: Antiseptic cleaner, fingernail brush, plastic cuticle stick

 

Nursing Action (Procedures)

Antiseptic Handrub

The use of alcohol-based handrub.
1. Ensure jewellery has been removed
2. Apply quantity of alcohol-based hand hygiene product as per manufacturer’s recommendations into cupped hand.
3. Rub hands palm to palm
4. Right palm over left dorsum with interlaced fingers and vice versa.
5. Palm to palm with fingers interlaced
6. Backs of fingers to opposing palms with fingers interlaced
7. Rotational rubbing of left thumb clasped in right palm and vice versa
8. Rotational rubbing, backwards and forwards with clasped fingers of right hand in left
palm and vice versa
9. Rubbing hands together until hands are dry before continuing with patient care, do not rub off excess product

Nursing Procedure: How to Surgical Antiseptic

Surgical Antiseptic

Surgical Antiseptik Hand Washing

 

Also known as sterile technique, prevents contamination of an open wound, serves to isolate the operative area from the unsterile environment, and maintains a sterile field for surgery.
1. Remove all pieces of jewelry.
2. Wet hands using sterile water with water closest to your body temperature.
3. Wash hands using antimicrobial soap and/or povidone-iodine.
4. Clean subungual areas with a nail file.
5. Scrub each side of each finger, between the fingers, and the backs and fronts of the hands for at least 4 minutes.
6. Proceed to scrub the hands, keeping the hand higher than the arm at all times to prevent bacteria-laden soap and water from contaminating the hands.
7. Rinse hands and arms by passing them through the flowing water in one direction only, from fingertips to elbow.
8. Proceed to the operating room holding hands above elbows.
9. Dry hands and arms using sterile towel observing aseptic technique.

Nursing Procedure: How to Massage (Back & Chest Physiotherapy)

Definition
Another way of providing relaxation to patients is by initiating back care and giving them a massage. Learn on how you can be a pro-masseur and a nurse at the same time.

Purpose

1. To stimulate the circulation and give general relief.
2. To prevent bedsore / decubitus
3. To give comfort to the patient.

Equipment Needed

• Coconut oil
• Talcum powder
• Bath towel

Procedure

1. Help the patient to turn on his abdomen or on his side with his back toward the nurse and his body near the edge of the bed so that he is as near the operator as possible. If the supine position is used and the patient is a woman, pillow under the abdomen removes pressure from the breasts and favor relaxation.
2. Raise the gown.
3. Apply to back rubbing lotion or talcum powder to reduce friction. In rubbing the back use firm long strokes and kneading motions (see below). The amount of pressure to exert depends upon the patient’s condition. Begin from neck and shoulders then proceed over the entire back.
4. Massage with both hands working with a strong stroke. In upward then in downward motions. Give particular attention to pressure areas in rubbing (Alcohol 25%) to 50% is generally used for its refreshing effect, but rubbing lotion may be used.
5. Powder again the area at the completion of the rubbing process which should consume from 3-5 minutes.
6. Turn patient on his back and put on the gown.
7. Fix and make patient comfortable.

Movements Used

Effleurage Techniques

1. Effleurage (stroking) —is a long sweeping movement with palm of hand conforming to the contour of the surface treated, over small surface (on the neck) the thumb and fingers are used. Strokes should be slow, rhythmical and gentle with pressure constant and in the direction of venous stream.
2. Kneading—performed with the ulnar side palm resting on the surface and the fingers, and thumb grasping the skin and subcutaneous tissues which move with the hand of the operator.
3. Friction—is performed with the whole palmar surface of the hand or fingers and thumbs over limited areas. This movement is a circular form of kneading with pressure against the underlying part of tissue which cannot be grasped.

5 Moments For Hand Washing (Hand Hygiene)

Indicators of Hand Hygiene

Hand washing is the act of cleaning one’s hands with the use of any liquid with or without soap for the purpose of removing dirt or microorganisms. It is the most effective measure in reducing the risk of transmitting infectious diseases.

It cannot be said too often that hand washing is the most important and most basic technique in preventing and controlling infections. It is the single most effective infection control measure.
Hand washing is under the umbrella of hand hygiene. Hand hygiene is defined by the World Health Organization as a general term that applies to hand washing, antiseptic hand wash, antiseptic hand rub or surgical hand antisepsis.

According to the World Health Organization (WHO), there are Five Moments for Hand Hygiene:

1. Before Patient Contact.
2. Before and Antiseptic Task.
3. After Body Fluid Exposure Risk.
4. After Patient Contact.
5. After Contact with Patient Surroundings.

The following materials or equipment are needed to perform hand washing:

• Soap or detergent
• Warm running water
• Paper towels
• Alcohol
• Optional: Antiseptic cleaner, fingernail brush, plastic cuticle stick

5 Moment For Hand Hygiene

Principles and concepts surrounding hand hygiene:

• You must use running water in a sink that drains out instead of using a basin.
• You may use soap – antibacterial soap if necessary.
• You must rub your hands against each other for at least 30 seconds to facilitate removal of microorganisms.
• Long nails and jewelry trap germs. It is best to keep fingernails short. If you wear a ring, it is better not to remove the ring before hand washing so that it can be washed too.
• It is always better to use disposable paper towels than to use cloth towel when drying hands to ensure that you can only use those once.
• The faucet is always considered dirty and it is recommended to turn it off using a paper towel in the absence of the ideal sensor or foot pedal.
• Dispensers of soap should be used until completely empty. Once emptied, it should be washed before refilled.

Nursing Procedure: How to Antiseptic Hand Washing

Definition

Hand washing is the act of cleaning one’s hands with the use of any liquid with or without soap for the purpose of removing dirt or microorganisms. It is the most effective measure in reducing the risk of transmitting infectious diseases. It cannot be said too often that hand washing is the most important and most basic technique in preventing and controlling infections. It is the single most effective infection control measure.
Hand washing is under the umbrella of hand hygiene. Hand hygiene is defined by the World Health Organization as a general term that applies to hand washing, antiseptic hand wash, antiseptic hand rub or surgical hand antisepsis.

Terms

To understand this study guide better, familiarize yourself with the terms used:

• Hand Hygiene. It is a general term that applies to hand washing, antiseptic hand wash, antiseptic hand rub, or surgical hand antisepsis
• Hand Washing. It is defined as the washing of hands with plain (i.e., non-antimicrobial) soap and water.
• Antiseptic Hand wash. A term that applies to hand washing with an antimicrobial soap and water.
• Surgical Hand Antisepsis. Commonly called as a surgical hand scrub. This is to remove as many microorganisms from the hands as possible before the sterile procedure.

Goals

The purposes of hand hygiene are:

• Hand washing can prevent infection
• Avoid pathogenic microorganisms and to avoid transmitting them
 

 

Equipment

The following materials or equipment are needed to perform hand washing:

• Soap or detergent
• Warm running water
• Paper towels
• Optional: Antiseptic cleaner, fingernail brush, plastic cuticle stick

 

Nursing Action (Procedures)

Antiseptic Hand wash

Also known as clean technique, includes procedures used to reduce the number of organisms on hands.

1. Gather the necessary supplies. Stand in front of the sink.Wet the hands and wrist area. 
2. Keep hands lower than elbows to allow water to flow towards the fingertips. 
3. Cover all areas of hands with soap. 
4. With firm rubbing and circular motions, wash the palms and backs of the hands, each finger, the knuckles, wrists, and forearms. Continue this friction motion for 30 seconds.
5. Rinse thoroughly with water flowing towards the fingertips.
6. Pat hands dry, beginning with the fingers and moving upward towards forearms, with a paper towel and discard immediately.
7. In the absence of sensors or foot pedal, use another clean paper towel to turn off the faucet.