Homenursing amd first aid notes PDF

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HOME NURSING AND FIRST AID9.1 INTRODUCTION TO HOME NURSINGThis module unit is designed to provide competencies relevant to the understanding of home nursing and functions of a home nurse Specific Objectives a) define terms b) explain the importance of home nursing c) State the reasons for caring for...

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HOME NURSING AND FIRST AID 9.1.27 INTRODUCTION TO HOME NURSING This module unit is designed to provide competencies relevant to the understanding of home nursing and functions of a home nurse Specific Objectives a) define terms b) explain the importance of home nursing c) State the reasons for caring for the sick at home. d) state the factors to consider when recommending home nursing e) state the qualities of a good home nurse f) identify the duties and responsibilities of a home nurse g) identify challenges in home nursing UNIT TASKS TASK 1: DEFINITION OF TERMS Nurse: this is a healthcare professional who, in collaboration with other members of a health care team, is responsible for treatment, safety, and recovery of ill individuals; health promotion and maintenance within families, communities and populations; and, treatment of lifethreatening emergencies in a wide range of health care settings. Home nurse: this is a health care professional trained to take care of patients in their home settings. He or she performs a range of clinical and non clinic al work to ensure the recovery of the patient concerned in a familiar environment. Home nursing: this is a profession where a skilled individual engages in the taking care of patients in their homes instead of a hospital or other institutions. There is a wide range of reasons why home nursing would be preferred in some cases including severity of disease being low, lack of money for hospitalization e.t.c. Clinical care: These are the activities done by a health care professional specifically targeting the elimination or reduction in severity of the disease. This could include dispensing medicine, cleaning and dressing wounds e.t.c. TASK 2: EXPLAINING THE SCOPE OF HOME NURSING Home nursing involves the following :           

Assessment of nursing requirement Assist in discharge of waste Assist in feeding Assist in leaving and returning to the house Bathing Consultation and coaching in special handling skills House calls Mobilization Morning / evening toilet Night attendance Positioning in bed (bedsore prophylaxis) Post-natal nursing (domiciliary after care – penjagaan selepas bersalin)

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Nursing of HIV/AIDS patients

(REFER TO THE TABLE BELOW) Basic Nursing

Includes: assistance in leaving and returning to bed. Shower or lapping, washing of hair, cleaning and cutting of finger nails, assistance in leaving and returning to bed, dressing and undressing with special consideration to medical conditions or handicaps, oral hygiene, combing and shaving.

2 Complete Toilet

Includes: assistance in leaving and returning to bed. Shower or lapping, washing of hair, cleaning and cutting of finger nails, assistance in leaving and returning to bed, dressing and undressing, oral hygiene, combing and shaving.

3 Partial Toilet

Includes: assistance in leaving and returning to bed, dressing and undressing, shower or bath, oral hygiene and combing.

4 Bathing

Includes: assistance in leaving and returning to bed, dressing and undressing, preparing the long bath (bath tub), assisting in bathing and leaving the long bath, oral hygiene, shaving and combing

5 Assistance in Discharge of Waste

Includes: Dressing and undressing, support in the discharge of urine or faeces inclusive of emptying of urine bag or stoma bag, removing and replacing of diapers or pads, cleaning the intimate area

6 Positioning in Bed

Includes: Organising the bed sheets, positioning as required, prevention of pressure ulcer, eventually with skin care.

7 Mobilisation

Includes: Specific movement of the limbs as prophylaxis in the prevention of contractures.

(Integrated)

(Special service)

To be carried out: On special advice of a physician, or according to a specific mobilisation plan.

9 Assistance in Feeding

This includes: preparation of the food (not cooking), assisting in the intake of food and drink, as well as all hygienic measures pertaining to

8 Mobilisation

it. 10 Enteral Feeding via PEG

Includes: The preparation and the dispensing of the enteral food preparation, supervision of apparatus if applicable.

11 Assistance in Leaving the House

Includes: Dressing and undressing, supporting at staircases, and assisting to the transporting vehicle and transportation of walking aids.

12 Assistance in Leaving Outside the House

Accompanying Includes: The constant presence near the patient, his safety, assistance in discharge of waste, assisting in the transport, handling of walking or transport aids, accompanying to home, and safe handing over to the home care taker.

13 Changing of Bed Sheets

Includes: The stripping and replacing of bed sheets and pillow covers, discharging the dirty clothing for recycling according to hygienic practise.

14 Attendance by Nurse/Nurses Aid

Includes: The continual supervision of the patient, attends to the normal needs, registers observations and communicates the same as appropriate. Takes care of the safety of the patient and intake of nourishment and medication (Other services are excluded).

The Nursing person shall keep a detailed report of any special happenings during the nursing attention period. In case of any unusual occurrence or conflict, sudden worsening of patient's condition, etc. inform the Home Nursing Providers Director/Nursing Officer

TASK 3: IMPORTANCEOF HOME NURSING SKILLS  

It saves on funds :-Lack of enough funds for hospitalization may necessitate home care which is cheaper. It eases congestion in hospitals:a) Diseases that are not life threatening or patients are nearly healed for example minor wounds could be taken care of at home

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b) Disease states that are long term but not requiring constant attention from doctors in hospitals e.g. already fixed fractures can be take care of at home One may chose home care to avoid the inevitable contracting of infections from long stays in hospitals. People who are emotionally vulnerable and part of their therapy requires emotional support will benefit more with home care than hospitalizations. Terminally ill patients in cases of cancer and AIDS spend their last days at home receiving palliative care.

TASK 4: FUNDAMENTALS OF HOME NURSING Basic nursing skills include the knowledge necessary for a nurse to perform the basic duties of obtaining vital statistics, changing bandages, cleaning wounds, bathing patients, and performing CPR. a) Vital Signs The basic skills that a nurse will learn include how to take patients' temperatures, how to take their blood pressure readings, how to find and measuring their pulses and take their respiration readings. b) Changing Bandages A nurse must learn the basic skill of how to remove and correctly apply bandages. C) Cleaning Wounds Cleaning wounds properly is another basic nursing skill. This basic skill includes the knowledge of how to treat different types of wounds. d) Bathing Patients Basic nursing courses cover proper methods of bathing patients including how to be gentle, make patients feel comfortable, and how to bathe patients who suffer from different ailments or have special bathing needs. e) CPR Learning to perform cardio-pulmonary resuscitation, or CPR, is a basic skill that nurses must learn. f) Hygiene Nurses also must have basic skills in proper hygiene, not only for patients but also for themselves. Nurses must learn how to properly protect themselves from infection from sick patients, and also to prevent spreading disease from patient to patient

TASK 5: QUALITIES OF A HOME NURSE  Honesty: the home nurse is entrusted with taking care of individuals who may not be in a position to take care of their valuables and he/she is expected to take care of them. They are also entrusted by the family with the home as they take care of their patients. The home nurse therefore has to be an honest person who will not steal from the patient or harm the patient.  Sympathy/ empathy: the home nurse should be a person capable of putting themselves in the suffering patient’s shoes. He/she should treat the patient like they would want to be treated when they are most vulnerable and helpless. This applies in performing clinical or non clinical duties to help the patient feel that someone cares for them.  Politeness: calmness when talking to the patient, not raising ones voice even when the patient becomes annoying is a quality that helps the patient compliant in terms of taking medications, being cooperative with the home nurse and also helps calm an agitated patient.  Patience: the patients, most of them in pain need a person who will not be in a hurry to complete their tasks in caring for them. The home nurse needs to perform his duties taking into consideration the feelings of the patient. Other patients especially the mentally ill, the elderly and children may be uncooperative or non responsive to instructions one gives. The home nurse has to cultivate tolerance with these patients so as to serve them.  Cheerfulness: a dull home nurse makes the patient retreat to themselves and their illness. Being cheerful influences the patients to also be cheerful and for a while forget their illness. It aids in recovery of the patient especially in patients with mental disorders especially depression.  Carefulness: this is an important quality. This is more so in dispensing of drugs. One who will give a dose of medicine without looking at the label on the bottle; or will spill out twenty drops when ten were ordered; or will upset a. breakfast tray on the bed; or leave a vessel under the bed for hours uncovered: or oversleep when the patient should have food or medicine, or let the fire go out; such an one is entirely unfit to have charge of a sick person.  Exactness in carrying out the orders of the physician is the first duty of a nurse. The doctor is responsible for the treatment of the case, and the patient and family are responsible for the choice of the doctor. The nurse should follow strictly the instructions of the doctor whether in dispensing of drugs or in diet since the doctor id better trained. Any suggestions on hoe to improve the patient’s condition should be made to the doctor and family to make a decision on. TASK 6: DUTIES AND RESPONSIBILITIES OF A HOME NURSE The home nurse is employed to fulfil the needs of a patient. This will include:  Feeding the patient: this also includes ensuring the meals are of the right quality, balanced diet or recommended diet is given.  Grooming the patient. Keeping the patient clean and smart is part of the job of the home nurse. They will be required to dress and undress the patient and keep the patient covered and warm.  The home nurse is expected to provide a secure environment for the sick. Unnecessary disturbances to the patient should be avoided, and the room should be free of hazardous materials that could injure the patient.

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The home nurse should also provide emotional support to the patient as this enables the patient to achieve quick recovery. Administration of drugs, cleaning of wounds and other simple medical procedures are in a home setting performed by the home nurse.

LEARNING RESOURCES  Text books  Journals  Magazines  Video shows  Resource persons EVALUATION 1. Define the following terms a) Home nursing b) Clinical care c) nurse 2. Explain the scope of home nursing. 3. Discuss the importance of home nursing skills. 4. Explain the fundamentals of home nursing. 5. List qualities of a home nurse 6. Discuss the duties and responsibilities of a home nurse.

9.1.28 UNDERSTANDING THE SICK AND THE INFIRM This module unit is designed to provide competencies relevant to the understanding of the needs of the sick and the infirm. Specific Objectives a) define terms b) explain the basic human needs and their fulfillment c) Explain effects of illness on an individual d) State the importance of patient motivation e) Explain patient motivation techniques UNIT TASKS TASK 1: DEFINING TERMS Infirm: This includes the elderly, the weak and the handicapped. Patient: The word originally meant 'one who suffers'. A patient is any person who receives medical attention, care, or treatment. The person is most often ill or injured and in need of treatment by a doctor or other health care professional. However, one who is visiting a physician for a routine check-up may also be viewed as a patient. Invalid: this is a person with an illness (patient) or a disability even if not currently ill. Convalescent: this is a person recovering from an illness. The patient is in the final stages of recovery from the illness.

Terminal illness: this term describes an active disease that cannot be cured or adequately treated and that is reasonably expected to result in the death of the patient Palliative care: is any form of medical care or treatment that concentrates on reducing the severity of disease symptoms, rather than provide a cure. The goal is to prevent and relieve suffering and to improve quality of life for people facing serious, complex illness. Motivation: It is a general term referring to the entire class of drives, desires, needs, wishes and similar forces. TASK 2: BASIC HUMAN NEEDS AND THEIR FULFILLMENT Maslow's hierarchy of needs Abraham Maslow's Hierarchy of Needs motivational model Abraham Maslow developed the Hierarchy of Needs model in 1940-50's USA, and the Hierarchy of Needs theory remains valid today for understanding human motivation, management training, and personal development. Abraham Maslow's book Motivation and Personality, published in 1954 (second edition 1970) introduced the Hierarchy of Needs, and Maslow extended his ideas in other work, notably his later book Toward A Psychology Of Being, a significant and relevant commentary, which has been revised in recent times by Richard Lowry, who is in his own right a leading academic in the field of motivational psychology.

Each of us is motivated by needs. Our most basic needs are inborn, having evolved over tens of thousands of years. Abraham Maslow's Hierarchy of Needs helps to explain how these needs motivate us all. Maslow's Hierarchy of Needs states that we must satisfy each need in turn, starting with the first, which deals with the most obvious needs for survival itself. Only when the lower order needs of physical and emotional well-being are satisfied are we concerned with the higher order needs of influence and personal development. Conversely, if the things that satisfy our lower order needs are swept away, we are no longer concerned about the maintenance of our higher order needs. Maslow's original Hierarchy of Needs model was developed between 1943-1954, and first widely published in Motivation and Personality in 1954. At this time the Hierarchy of Needs model comprised five needs. This original version remains for most people the definitive Hierarchy of Needs.

TASK 3: EXPLAINING EFFECTS OF ILLNESS ON AN INDIVIDUAL

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low productivity:- a person becomes less productive they do not have the energy to work due to the effects of the illness increased expenditure: this will accrue from the cost of accessing medical care Poor feeding due to lack of appetite which can lead to malnutrition and poor health Trauma: the trauma that accompanies some illnesses may make one to be socially withdrawn Reduces life-expectancy of an individual:-severe, recurrent or prolonged illnesses may reduce ones life expectancy

TASK 4: STATING THE IMPORTANCE OF PATIENT MOTIVATION a) Compliance The patient’s cooperation with the home nurse and doctors will mostly depend on how well they are motivated. Making the patient comfortable and promptly providing aid when required makes them respect the health care giver and will also want to play their role in restoring their health. This includes taking medication as prescribed, being courteous to the home nurse and doctor and taking care of injuries e.t.c. b) Quick recovery Motivating the patient helps in recovery from illness faster. Providing the medication in time and as required, providing a balanced diet, providing emotional and social support all go a long way in helping cure the patient of physical and emotional illnesses. c) Psychological health A patient feeling that they are a bother to those taking care of them will make them hide their discomforts and complaints and this affects them adversely in recovery. The patient needs to feel loved by those around them. Apart from compliance, it will also help the patient relax. For patients with depression, anxiety and other mental illnesses, this is paramount. TASK 5: EXPLAINING PATIENT MOTIVATION TECHNIQUES Patients motivation can be achieved by taking care of the following: - Physical needs - Nutritional needs - Emotional needs - Social needs - Psychological needs - Spiritual needs A) Physical needs These include rest and sleep in a comfortable well made bed and a clean environment, bathing and dressing, caring for the mouth and dealing with excretion. 1) Rest and sleep The patient spends a lot of time in bed and therefore needs to be as comfortable as possible. The bed should be made daily and the bedding changed frequently. Items required for bed making  2 clean bed sheets  2 blankets  1 or 2 pillow cases  A draw sheet

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Mackintosh: this is a form of waterproof garment made out of rubberized fabric. The Mackintosh is named after its Scottish Bed cover

Procedure for making a bed  Open the window and strip the beddings from the bed fold into three or four screens, place onto a chair and leave to air Picture  Turn the mattress  Replace the underblanket  Place the bottom sheet, right up and tuck in all round making a mitre at all four corners. How to make a mitred corner  Tuck in along the head of the mattress  Lift a flap of sheet from a point along the side about 30 cm from the corner and tuck in.  Drop the flap and tuck in along the side.  Place the mackintosh on the lower side of the bed.  Place a draw sheet on the mackintosh and tuck. Picture  Put on the top sheet, wrong side up, to reach just beyond the head of the mattress.  Put on blankets separately, to reach just short of the top sheet.  Make a fold at the centre, along the length of the bed and tuck along the bottom  Fold back all the bedding from the top sheet down to the width of the pillow. Picture  Tuck in the sides. Leave one side untucked for ease of putting the patient to bed.  Place the pillow in the pillow cases  Put the pillow on the bed with open ends away from the door.  The patient lying on a pillow on his back is a resting position allowing turning from side to side. Resting positions in bed The recovery position This position is used for the unconscious patients who lies with his lower leg stretched out behind him, and his upper leg bent infront of him. His shoulders are tilted so that the lower arm is behind him while the upper arm is bent infront of him. His head is turned to prevent the tongue from blocking the airway. Note that there are no pillows. This is to prevent the patient from chocking on his own vomit and to keep the neck comfortable. Picture The prone position The patent lies face down supported with pillows. This position is used for a sore back or buttocks. Picture The recumbent position The patient lies flat on 1 or 2 pillows. This is a restful position allowing turning from side to side.

Picture The semi-recumbent position 3 or 4 pillows support the patient’s back. This is a comfortable position that allows the patient to see surroundings, to eat and drink and converse without straining. Picture The upright position Here the patient sits up with the back supported by several pillows and a backrest. Two of the Pyjama suits can be adjusted to ease movement Pyjamas to be worn for a long time should have a U shaped crotch and raglan sleeve to make movement easier. Pictur...