Wednesday, January 11, 2017

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


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


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


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


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.

Sunday, January 1, 2017

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