Duty 2. patient safety and comfort
- 1. Patient safety and comfort By Terefe k (RN, Bsc.N***)
- 2. General objective: At the end of the chapter the leaner will be able to • Identify condition needs utilization of comfort and safety device • Demonstrate how to apply sandbag, cotton and air ring, splint and bed cradles • Apply safety precaution when applying sandbag, cotton and air ring, splint and bed cradle
- 3. Safety and Comfort devices Safety • It is to protect oneself from harm. e.g. mechanical injury. • Safety is responsibility of everyone but this may not be applicable in the health care environment because of different reasons such as Altered level of consciousness Loss of ability to move Loss of ability to think clearly
- 4. Cont… Comfort Comfort is a feeling of physical and mental well being freedom from worry, fears or pain. Are the mechanical devices to promote comfort to the patient
- 5. Causes of discomfort: 1. Pain 2. Restriction of movements due to weakness 3. Wrinkled, soiled and wet sheet 4. Delayed or inadequate attention to meet the personal needs. 5. Lack of exercise 6. Temperature extremes 7. Too bright lights and glares 8. Fear and anxiety due to illness 9. Insecurity feeling 10. Lack of sleep 11. uncomfortable position 12. indigestion and irregular bowl movements
- 6. Purpose of patient safety and comfort To relieve pain and worry To provide position of comfort and ease To place patient in comfortable bed. To provide proper atmosphere to increase the moral of patient during illness. To adjust bed and other apparatus in the proper manner To give maximum rest and sleep during illness
- 7. Applying cotton rings Objectives: - At the end of this lesson, you will be able to:- Define cotton rings List the Purpose of cotton rings application Describe the indications of cotton rings application Demonstrate application of cotton rings Definition: - Cotton rings are small circle of cotton rolled with bandage or gauze with a hole in the middle.
- 8. Cont…
- 9. Cont… Purpose of cotton ring Used to lift the hip from bed to prevent bed sores or pressure sore or decubitus ulcer. To relieve pressure from small bony prominent areas such as heel, elbow, occipital. Improves the circulation. Indication – Bed ridden patients – Unconscious patients.
- 10. Cont… Size: - Based on the body areas we are going to apply. The size differs from small to medium size of bony prominent areas. Equipments 1. Cotton 2. Bandage 3. Chart showing human body prominent areas
- 11. Procedure 1. Explain the procedure to the patient 2. Wash hands 3. Assemble the necessary equipment 4. Prepare cotton ring based on the size of body to be applied. 5. Place cotton ring under the bony prominence such as elbow and heel 6. Wash hands 7. Document procedure
- 12. Applying foot – board Objectives: - At the end of this lesson, U will be able to:- 1. Explain Foot board 2. List the purpose of foot board application 3. State the indications of foot board application 4. Perform application of foot board Definition: - A footboard is a flat plane often made of wood or plastic placed at the foot of the bed.
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- 14. Cont… Purpose • To provide support for the client’s feet and maintain a natural foot position. • To keep the top bed covers of the client’s felt relieving pressure. • To make the foot comfortable/prevent foot drop • To prevent sagging of patient in to bed.
- 15. Cont… Indication – Unconscious patients – Patient with fracture – Bedridden patients Types of foot board: – Foot boards are often made in an L shaped – so that the base of L fits under foot of the mattress. – Some foot boards can moved along the mattress to adjust to the clients foot drop from their normal right angle.
- 16. Cont… Foot drop:-is a condition of plantar flexions or a muscular which occurs from poor foot or leg alignment. Cause –when patient in bed for long time with the top sheet and blanket are tightly tucked.
- 17. Cont… Equipments 1. A firm pillow 2. Box of board 3. Cotton/sheet of cotton 4. Bandage
- 18. Applying pillows Definition:-Pillows are used to give comfort, support and to position patient properly.
- 19. Cont… Pillows are placed – Under the head – Under the back – Between the knees – At the foot of the bed – Under the arm
- 20. Cont… Purpose: – To elevate body part – To support patient on side – To prevent pressure on the skin – To increase comfort Necessary equipments Pillows Pillows case
- 21. Applying air rings Objectives:- at the end of this lesson leaner will be able to:- 1. Explain air rings 2. Describe the purpose of air rings 3. State the indications of air ring application 4. Perform application of air ring Definition: Air rings are used to relieve pressure from the buttock and other bony prominent areas. For application they should be filled with air and covered with pillow case
- 22. Cont…
- 23. Cont… Purpose Used to lift the hip from bed to prevent bed sores or pressure sore or decubitus ulcer. To relieve pressure from small bony prominent areas such as heel, elbow, occipital. Improves the circulation.
- 24. Cont… Indication – Bed ridden patients – Unconscious patients Equipments: 1. Plastic air rings 2. Covering towel or pillow case 3. Chart showing body’s prominent areas
- 25. Procedure 1. Explain the procedure to the patient 2. Wash hands 3. Assemble the necessary equipment. 4. Support the appropriate site 5. Applying air ring to body prominent area. 6. Observe patient comfort status 7. Wash hands. 8. Document
- 26. Applying bed cradle Definition Bed cradle is sometimes called an Anderson frame. It is a device designed to keep the top bed clothes off the feet, leg, abdomen and chest of a client Types There are several types of bed cradles; the most commonly used is curved metal rod.
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- 28. Cont… Purpose • To keep top linen off the injured part of the body. • To prevent the weight of the bedding from resting on some part of the body. • To apply heat in case of drying plaster casts. • In case of electronic bed cradles are used to supply the desired warm in the case of shock. Indication Client with fracture or soft tissue injury. Client with burn Client with some skin lesions
- 29. Cont… Equipments: 1. Bed cradle 2. Roll gauze/bandage 3. Small size blanket
- 30. Procedure 1. Explain the procedure to the patient 2. Wash hands 3. Assemble the necessary equipment. 4. Loosen and remove top linen. 5. However the cradle on to patients bed. 6. Secure it in place. 7. Wrap gauze roll around both sides of the cradle. 8. Cover the cradle with top linen 9. Wash hands. 10. Document
- 31. Adjusting side rails of the bed Definition Adjustable full or half side rails are used on Hospital beds and stretchers to prevent accidents Types They can be of various shapes and sizes usually made of metal Position Side rails have two or three positions. These are high, intermediate and low. The down or low positions are employed when a side rail is not needed. The up or high side rail position is used when a client is in bed and requires protection.
- 32. Cont… Purpose • Help weak patient turn independently • Protects patient from falling out of bed
- 33. Cont… Indication: For unconscious patient. For weak and unable to control his/her body movement. For small children. For elderly patients Patient with seizure disorder Post operatively until the patient awake from anesthesia · When changing position. When making certain procedure
- 34. Cont… Equipment: bed with side rails Procedure Explain the procedure to the patient Wash hands Assemble the necessary equipment. Position the side rail to the needed height Secure lock and it should be far from reaching by the patient Wash hands. Document
- 35. Applying sand bag Definition: Sand bags are canvas, rubber or plastic bags filled with sand and sewed. Purpose To relive discomfort Sand bags are used for supporting or immobilizing limbs Used to support as in fracture bone They should be covered with towel and placed on either side of the limb To prevent foot drop or wrist drop To prevent contracture
- 36. Cont… Indication • Fractured limb • Amputated limb. Equipments: Bag Rope Sand Covering towel Weight scale Adhesive plaster for labeling
- 37. Procedure 1.Explain the procedure to the patient 2.Wash hands 3. Assemble the necessary equipment. 4. Positioning the patient 5. Apply the sand bags on the side of the area to be supported. 9. Wash hands. 10. Document and report
- 38. Applying splint Definition: • splints are devices applied to the arms, legs, or trunk to immobilize the injured part of the body when it is needed. Purpose To prevent movement of injured part of the body. To prevent further damage when transporting injured patient. To provide complete rest for injured part. To relieve pain and discomfort and encourage healing.
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- 40. Cont… Types of splint There are many varieties of splints available and they can also be made locally from different material. 1. Wooden: straight pieces of woods of varying length and width. 2. Metal: Splints made of a tin end of aluminum which are molded to fit with natural curvature of the body part 3. Wire: It can be quickly cut to required length and easily bent to support a limb in desired position 4. Plaster (P.O.P):-Often used by surgeon
- 41. Cont… Nursing consideration • There are a number of important points to remember. 1. Choice:-The splint chosen should be sufficiently strong and of suitable length and width. 2. Padding:-The splint should be covered with cotton wool to prevent discomfort or damage. 3. Molding:-Choose one which is most suitable mould to fit the natural curvature of the limb. 4. Fixation:-Splints must be fixed to the insured fracture limbs by bandage placed above and below the injured part. • Do not apply bandage directly on the injured part.
- 42. Cont… Equipment • Splints (wooden,metallic) • Dressing material (if there is open wound) • Glove • Padding for splint (rolled bandage to cover the splint) • Elastic bandage or roll bandage (to hold the splint in place)
- 43. Procedure 1.Explain the procedure to the patient 2.Wash hands 3. Assemble the necessary equipment. 4. Positioning the patient 5. First tie the bandage above the injured part 6. Joints must be immobilized above and below the location of injury. 7. Wash hands. 8. Document and report
- 44. Cont… Follow up phase:- Observation:-Look for the following condition Presence of adequate circulation Presence of adequate pulsation Presence of any color change Presence of numbness and tingling N.B:- Rings, bracelets and watch should be removed
- 45. Appling fracture board Objective: at the end of this lesson leaner will be able to:- 1. Explain Fracture board 2. Mention the purpose of fracture board 3. List the indications of fracture board 4. Perform application of fracture board Purpose • To maintain good body alignment • To prevent bed from sagging. • To support the injured part when the patient has fractured spine, hips, lower limps.
- 46. Cont… Equipment 1. Fracture board 2. Thin foam mattress Procedure 1. Explain the procedure to the patient 2. Wash hands 3. Assemble the necessary equipment. 4. Positioning the patient 5. First tie the bandage above the injured part 6. Joints must be immobilized above and below the location of injury. 7. Wash hands. 8. Document and report
- 47. Applying back rest • Back rest is used for elevating and supporting the head and back of the patient • When back rest is used for the patient is liable to slip down to the foot of the bed, therefore a foot board might be used.
- 48. Dear student , reading is the key for all. So read more and more !!! Thank you.