Section 1:
Demographic Information:
Client’s Initials __LH______ Age: __88____ Gender:__Female_
Data Collection/History:
A. Reason for admission (Disease, functionality, and/or surgical procedure:
Patient came in with unspecified CHF. Patient has a history of falling, muscle weakness and myocardial infarction.
B. Personal/Social History: (Ask questions about work history, marriage, children, support systems, living conditions, hobbies, pets, smoking, ETOH or drug use.
Patient is a Caucasian 88 year-old female who is widowed. She had one daughter that has passed away. She was a financial analyst in upstate New York, then moved to Florida and became real estate. She lived in the Villages when she was admitted. Her hobbies were Tai Chi and doing Bone Builders with weights. She isn’t a smoker or a drinker.
C. Allergies (include medications, foods, environmental):
Patient is allergic to hydrochlorothiazide and peanuts.
D. Current health problems and past medical history (including surgeries and hospitalizations, chronic illnesses):
Patient remembers having chickenpox at a young age but does not remember the exact age. She currently has COPD, CHF, and generalized muscle weakness, abnormalities of gaits & mobility, symbolic dysfunctions, pleural effusion, shortness of breath, chronic A-Fib, and obstructive uropathy. Patient also has a history of falling.
Human Dimensions:
A. What is this client’s ethnic/cultural background?
Patient is Methodist and lives by “No one is better than anyone else”.
B. What are the cultural considerations for this client? (Religious practies, foods, special religious/personal items, do they follow a special diet, attend church, need a copy of the bible or other special religious items; are they grieving or in spiritual crisis?)
Allowing the patient to have a bible with them could assist in keeping them comfortable. The patient follows a low sodium diet.
Section 2:
Erickson’s Psychosocial Developmental Stage:
(Google images, 2015)
A. Identify the developmental stage your client’s behavior represents?
The developmental stage that the patient’s behavior represents is Maturity.
B. What developmental stage should your client be in chronologically?
The developmental stage that the patient should be in chronologically is Maturity.
C. Upon completing your overall client assessment, what conflict stage does your client actually exhibit?
The conflict stage the patient actually exhibits is Maturity.
D. What things did your client tell you or do to make you arrive at this development stage? (List at least 3 things the client told you or did.)
She said she lived a full life; a successful life. Even though she is living in nursing home she gets visits from her sister and her friends. She said she never regrets anything she did in her life and also said like everyone else she had good times and bad times.
Section 3:
PATHOPHYSIOLOGY
Identify 3 Patho’s. Complete 3 current and/or pertinent past Medical Diagnoses.
Use your own words DO NOT CUT AND PASTE.
Diagnosis: Congestive Heart Failure
Pathophysiology:
Congestive heart failure (CHF) is an exceptionally basic ailment, conflicting roughly 4.8 million Americans. While numerous different types of coronary illness have turned out to be less basic as of late, CHF has been expanding relentlessly (Bianco, 2000). This might be on the grounds that more individuals with different types of coronary illness survive longer yet are left with harmed hearts, which prompts CHF (Bianco, 2000). There are more individuals at high danger of creating CHF. Roughly 400,000 new CHF cases happen every year, and it is the most widely recognized diagnosis in patients more than 65.
The reason for the heart is to pump blood, which contains oxygen and supplements, to whatever remains of the body. CHF is just the disappointment of the heart to play out this principle work sufficiently. Obviously, an absence of blood pumped to the body is just viewed as CHF if the heart really gets an adequate volume of blood from the approaching vessels in any case. At the point when there isn’t sufficient blood for the heart to direct out, the issue isn’t CHF. CHF happens when the stream of blood from the heart abatements, or liquid backs-up behind the coming up short ventricle, or both (Bianco, 2000).
One-sided heart failure: The heart is essentially two pumps in one, either side can fail freely of the other. Left-sided heart failure: When the left ventricle can’t direct sufficiently out blood, it gets upheld up in the lungs, causing pneumonic edema, a development of liquid in the lungs. In addition to other things, this achieves shortness of breath. Left-sided heart disappointment frequently prompts right-sided heart disappointment (Jurgens, 2015). Right-sided heart failure: The correct ventricle can’t draw sufficiently out blood, making liquid back up in the veins and after that in vessels of the body. Due to the back up, liquid breaks out of the vessels and develops in the tissues, a condition called foundational edema (Bianco, 2000). Edema is particularly perceptible in the legs in light of the fact that the lower half of the body channels into the correct side of the heart. In systolic heart failure, the heart experiences issues contracting and directing sufficiently out blood. This causes shortcoming, weariness and diminished capacity to work out. In diastolic heart failure, the heart can’t fill appropriately amid diastole, as a rule because of expanded filling weight. This causes foundational or pneumonic edema or both (Jurgens, 2015).
Textbook Signs and Symptoms:
Textbook signs and symptoms are persistent cough or wheezing with phlegm. Reduced ability to exercise. Experience shortness of breath when you exert yourself or when you lie down. Swelling in lower extremities. Rapid or irregular heartbeat.
Client’s Signs and Symptoms: (What is your client currently exhibiting related to this diagnosis?)
The patient is exhibiting shortness of breath, fatigue/weakness and swelling of lower extremities.
Recommended Treatments: (What does the literature say that the treatment is for this disease process?)
Literature on CHF says that beta-blockers, digoxin and diuretics are recommended treatments. Cardiac Resynchronization Therapy, LVAD, heart transplantation and angioplasty are the more invasive treatments for CHF.
Actual Treatments: (What treatments/medications is your client currently receiving?)
The patient is currently prescribed Furosemide (Lasix) 40mg once daily and digoxin 125mg.
Teaching: (What can you teach your client about their disease process or treatment?)
With CHF it is important to stay away from high sodium foods. Educate the patient that the heart will not pump blood as well as it should but don’t be alarmed. Shortness of breath and swelling of lower extremities will occur as the result of it. If difficulty breathing does occur prop up the upper body in order to help (Jurgens, 2015).
Prevention: (How could this disease be prevented from occurring in the first place?)
No smoking can prevent this disease, start eating heart healthy foods and lose weight if you are overweight.
Diagnosis: Chronic Obstructive Pulmonary Disease
Pathophysiology:
Aviation route narrowing and impediment are caused by aggravation interceded bodily fluid hypersecretion, bodily fluid stopping, mucosal edema, bronchospasm, peribronchial fibrosis, and demolition of little aviation routes or a mix of these systems. Alveolar septa are demolished, lessening connections to the aviation routes and accordingly encouraging aviation route conclusion amid lapse (COPD Symptoms, 2018).
Amplified alveolar spaces once in a while unite into bullae, characterized as airspaces ≥ 1 cm in measurement. Bullae might be totally unfilled or have strands of lung tissue navigating them in territories of locally serious emphysema; they once in a while possess the whole hemithorax. These progressions prompt loss of versatile backlash and lung hyperinflation.
Expanded aviation route opposition builds crafted by relaxing. Lung hyperinflation, in spite of the fact that it diminishes aviation route opposition, additionally expands crafted by relaxing. Expanded work of breathing may prompt alveolar hypoventilation with hypoxia and hypercapnia, in spite of the fact that hypoxia is additionally caused by ventilation/perfusion (V/Q) jumble (COPD Symptoms, 2018).
Textbook Signs and Symptoms:
Textbook signs and symptoms of COPD are chronic cough, shortness of breath while doing everyday activities, frequent respiratory infections, blueness of the lips/fingernail beds, fatigue and wheezing.
Client’s Signs and Symptoms: (What is your client currently exhibiting related to this diagnosis?)
Client is exhibiting a slight cough, shortness of breath and fatigue.
Recommended Treatments: (What does the literature say that the treatment is for this disease process?)
Recommended treatments for COPD are medications such as bronchodilators and steroids. Bronchodilators help open up airways of the lungs. Steroids reduce inflammation for tissue growth and repair. Self care such as physical exercise and smoking cessation. Supportive care such as oxygen therapy and pulmonary rehabilitation therapy (COPD Symptoms, 2018).
Actual Treatments: (What treatments/medications is your client currently receiving?)
Patient is undergoing oxygen therapy and pulmonary rehabilitation.
Teaching: (What can you teach your client about their disease process or treatment?)
Patients going to controlled COPD intricacies; maintain a strategic distance from hard work, evade outside when it is excessively cool, hot, or damp. High stickiness may make you wind up exhausted all the more rapidly (COPD,2018). Abstain from taking in rapidly and profoundly through your mouth in the wake of hacking. the significance of keeping away from bronchopulmonary aggravations, for example, cigarette smoking, modern air poisons, dust, powders, scents, vaporized showers. The patient was urged to utilization of bronchodilator nebulizers (COPD,2018). The patient was instructed in versatile breathing strategies, for example, profound breathing activities, hacking systems, pressed together lip breathing, and stomach relaxing.
Prevention: (How could this disease be prevented from occurring in the first place?)
There is no cure for COPD when developed; however the most common way to prevent COPD is to quit smoking. Avoid any second hand smoking, air pollution, occupational exposures and also always know family history.
Diagnosis: Hypertension
Pathophysiology:
Hypertension is an incessant rise of circulatory strain that, in the long haul, causes end-organ harm and results in expanded grimness and mortality. Circulatory strain is the result of heart yield and foundational vascular obstruction. It takes after that patients with blood vessel hypertension may have an expansion in cardiovascular yield, an increment in fundamental vascular opposition, or both. In the more youthful age gathering, the heart yield is regularly hoisted, while in more seasoned patients expanded foundational vascular opposition and expanded solidness of the vasculature assumes a prevailing part. Vascular tone might be hoisted as a result of expanded α-adrenoceptor incitement or expanded arrival of peptides, for example, angiotensin or endothelins. The last pathway is an expansion in cytosolic calcium in vascular smooth muscle causing vasoconstriction. A few development factors, including angiotensin and endothelins, cause an expansion in vascular smooth bulk named vascular rebuilding. Both an expansion in fundamental vascular obstruction and an increment in vascular firmness expand the heap forced on the left ventricle; this instigates left ventricular hypertrophy and left ventricular diastolic dysfunction.
Textbook Signs and Symptoms:
Textbook signs and symptoms for hypertension are severe headache, fatigue, vision problems, chest pain, difficulty breathing, and irregular heartbeat.
Client’s Signs and Symptoms: (What is your client currently exhibiting related to this diagnosis?)
The patient is exhibiting signs of fatigue, light chest pain and difficulty breathing.
Recommended Treatments: (What does the literature say that the treatment is for this disease process?)
Recommended treatments for hypertension are diuretics, beta-blockers, eating a healthy diet, lose weight if needed and quit smoking. Diuretics will help decrease sodium and extra fluid from the body. Beta-blockers will help decrease blood pressure.
Actual Treatments: (What treatments/medications is your client currently receiving?)
Patient is currently taking Furosemide 40mg once daily and metaprolol 50mg 3 times daily. Patient is also eating a low sodium diet.
Teaching: (What can you teach your client about their disease process or treatment?)
Patient on hypertensive desperation which is where the pulse is extremely lifted and that encountering hypertensive earnestness could conceivably encounter at least one of these indications: serious cerebral pain, shortness of breath, nosebleeds, and serious uneasiness, chest or back agony, deadness or serious shortcoming, change in vision or trouble talking. Patient and parental figure were encouraged to look for quickly restorative help as well as call 9-1-1 if any of these signs or side effects shows up. Patient should do at least 30 minutes of daily exercise and maintain a low sodium diet (Meyers et.al, 2014).
Prevention: (How could this disease be prevented from occurring in the first place?)
Eating foods with low sodium and high in potassium can prevent this disease. Eat plenty of fresh fruits and vegetables. Limiting alcohol intake and getting at least 30 minutes of exercise a day. Maintaining weight; if the patient is obese or overweight try to lose weight.
Section 4: Lab/diagnosis Results:
Chemistry Profile Reference Range Current: High/Low/WNL?
Sodium 135-145 mEq/L 140 mEq/L WNL
Potassium 3.5-5.0 mEq/L 4.4 mEq/L WNL
Chloride 95-105 mEq/L 100 mEq/L WNL
Calcium 9-11 mg/dl/4.5-5.5 8.8 mEq/L WNL
Magnesium 1.5-2.5 mEq/L 2.4 mEq/L WNL
Albumin 4-6 g/dL 2.8 g/dL Low
Protein 6-8 g/dL 6.6 g/dL WNL
Blood Urea Nitrogen 6-20 mg/dL 35 mg/dL High
Creatinine 0.6-1.3 mg/dL 1.10 mg/dL WNL
Glucose 65-99 mg/dL 84 mg/dL WNL
Complete Blood Count (CBC): Reference Range Current: High/Low/WNL?
WBC 5,000-10,000/mm^3 5500/mm^3 WNL
RBC 4.6-6.2 million/ mm^3 6.0 million/mm^3 WNL
Hemoglobin (Hgb) 13.5-18 g/dL 14.1 g/dL WNL
Hematocrit (Hct) 40-54% 63% High
Platelets 150,000- 450,000
mm^3 145,000 mm^3 Low
Neutrophil % 54-75% 63% WNL
Lymphocytes % 25-40% 33% WNL
Other important labs?
PT 11.6-14.2 27.5 High
INR 0.9-1.1 2.5 High
Reference range source:
Vallerand, A. H. (2016). Davis’s Drug Guide for Nurses, 15th Edition. [Bookshelf Ambassadored]. Retrieved from https://ambassadored.vitalsource.com/#/books/9780803660793/
BEDSIDE BLOOD GLUCOSE MONITORING
DATE TIMES BS
RESULTS NORMAL VALUES INSULIN
GIVEN TYPE & DOSE
AC (B) N/A N/A N/A N/A
AC (L) N/A N/A N/A N/A
AC (D) N/A N/A N/A N/A
HS N/A N/A N/A N/A
DATE TIMES BS
RESULTS NORMAL VALUES INSULIN
GIVEN TYPE & DOSE
AC (B) N/A N/A N/A N/A
AC (L) N/A N/A N/A N/A
AC (D) N/A N/A N/A N/A
HS N/A N/A N/A N/A
A. What lab results are RELEVANT that must be recognized as clinically significant by the nurse?
(All abnormal labs must be addressed below r/t your particular client’s problem/s. What does the abnormal lab represent? For example, very high glucose level indicative of client’s diabetes being out of control at this time.)
Relevant lab(s): Clinical Significance
High PT/INR
High Hematocrit
Low Platelet Count
Albumin
Blood Urea Nitrogen Patient’s blood is taking too long to form a clot and there is an increased risk of bleeding.
Patient has a low availability of oxygen.
Patient has low albumin levels due to her congestive heart failure.
Patient has elevated blood urea nitrogen due to her congestive heart failure.
B. Other diagnostic tests that are significant to the client’s diagnosis such as EKG’s, ABG, x-rays, urinalysis, wound cultures, etc.
URINALYSIS
Date/Time of Test:
Specific Gravity pH Protein Glucose Ketone Bilirubin Urobilinogen RBCs WBCs
Normal Range 1.010- 1.025 4.5-8 Negative
Or
Traces Negative Negative Negative Negative or traces <5 <5
Results 1.020 5 Negative Negative Negative Negative Negative 4 4
High/low/normal N/A N/A N/A N/A N/A N/A N/A N/A N/A
URINE CULTURE:
TEST DATE/TIME POSITIVE/
NEGATIVE CAUSING ORGANISM ADDITIONAL INFORMATION
N/A
N/A N/A N/A N/A
CULTURE RESULTS (wound, sputum, blood):
TEST DATE/TIME POSITIVE/
NEGATIVE CAUSING ORGANISM ADDITIONAL INFORMATION
N/A N/A N/A
N/A N/A
C. What diagnostic test results are RELEVANT that must be recognized as clinically significant by the nurse?
Relevant Diagnostic(s): Clinical Significance and is there an improving/worsening/stable trend to this data?)
High PT/INR
High Hematocrit
Low Platelet Count
Albumin
Blood Urea Nitrogen Patient’s blood is taking too long to form a clot and there is an increased risk of bleeding.
Patient has a low availability of oxygen.
Patient has low albumin levels due to her congestive heart failure.
Patient has elevated blood urea nitrogen due to her congestive heart failure.
Section 5:
Pharmacology:
Please list 5 medications that correlate both to the client’s pathophysiology and what the client is currently taking.
Use your own words DO NOT CUT AND PASTE.
Drug name (Generic AND Trade) Dose, Route, Frequency (prn meds need a reason for giving) Classification Mechanism of Action Nursing Considerations Reason for administration
Furosemide PO, 40mg once daily Loop diuretics It can treat edema and swelling caused by congestive heart failure
Assess for skin rash and fluid status Heart failure unspecified
Metoprolol PO, 50mg, 3x times a day Beta blocker Decreases BP and heart rate Monitor BP, ECG and pulse. Monitor vital signs. Monitor intake and output. Hypertension
Coumadin PO, 5mg, once daily Anticoagulant Prevention of thromboembolic events Assess for signs of bleeding, fall in hematocrit or BP, unusual bruising, black stools Chronic A-Fib
Digoxin PO, 125mcg, once daily Antiarrhythmics, Inotropics Increased cardiac output Monitor ECG, Notify health care provider if bradycardia or new arrhythmias occur Heart Failure unspecified
Milk of Magnesium suspension PO, 1200 mg/15mL 30cc
PRN if no bowel movement for 3 days Salines Evacuation of the colon Assess for abdominal distention, presence of bowel sounds.
Assess for color, consistency and amount of stool. Constipation
Vallerand, A. H. (2016). Davis’s Drug Guide for Nurses, 15th Edition. [Bookshelf Ambassadored]. Retrieved from https://ambassadored.vitalsource.com/#/books/9780803660793/
Section 6:
Client Centered Care Begins:
Assessment/General Survey/Head to Toe:
Current VS: COLDSPA Pain Information (5th VS)
T: 98.6 Character
P: 86 Onset:
R: 18 Location:
BP: 130/87 Duration:
O2 sat: 93 Severity:
Pain? (if so complete info to the right): Precipitating Factors
Aggravating/Alleviating Factors
Narrative Note on your client:
L.H. is a 88 year old female, widowed, alert and oriented x3 no present skin lesion, face is symmetrical and speech is clear and articulate. Muscle tone is appropriate for age and gender. Strength is equal bilaterally, all reflexes 2/ 4 equal bilaterally pulse 2+/4, no bruits present. Patient has hypoactive bowel sounds in all four quadrants. Blood pressure is elevated 130/ 85, temp is 98.9, breathing was labored at 18 breaths per minute but no use of accessory muscles. Rattling lung sounds present (rhonchi). A:P is equal, S1 S2 equal and extra heart sounds. Full range of motion. Edma 1+ around the feet and ankles. Last bowel movement was 3 hours ago with diarrheal formation. Patient was left in her chair with her call light in hand.
S Patel R,SN
Use your own words DO NOT CUT AND PASTE.
Section 7 Section 8 Section 9 Section 10 Section 11 Section 12
Nursing Problem
(Client Specific) Goals
(Short Term and Long Term Goal) are required for each Nursing Problem. Must be Client Focused: SMART
Simple, Measurable, Attainable, Reasonable Time-Specific)
Nursing Interventions
(List at least three Nursing Interventions for each Short & Long Term Goal
Client Specific & Cited)
(Meyers et.al, 2014) Rationale
(Provide Reason why Intervention is Indicated provide References &
Cited)
(Meyers et.al, 2014) Client
Education/
Teaching
(Client Specific & Cited)
(Meyers et.al, 2014) Outcome, Evaluation, Replanning
(Was Goal met? How would you Revise the plan of care according to the Client’s response to current plan?)
1. CHF- Restrict sodium intake and monitor symptoms that sodium effects
2. COPD- Assert the importance of following the treatment plan
3.Hypertension-Patient verbalized understanding of the disease and its long term effects on target organs
#1. Short Term Goal
Maintain fluid balance evidenced by a reduction of edema
#1. Long Term Goal
Follow low sodium meal plan and lower sodium levels
#2. Short Term Goal
Decrease shortness of breath symptoms by the end of shift
#2. Long Term Goal
Learn importance of specific therapeutic measures
#3. Short Term Goal
Patient will have decreased blood pressure by the end of shift
#3. Long Term Goal
Blood pressure will be maintained with recommended target range 1. Monitor presence of edema frequently by palpating lower extremities
2. Monitor daily weight
3. Auscultate lung sounds for labored breathing(Meyers et.al, 2014)
1. Introduce a new meal routine
2. Excess fluid volume
3. Identify and teach what foods that can or cannot be eaten
1. Mediate the correct care in order maintain normal breathing
2. Use tools such as a spirometer
3. Teach inhaling slowly and exhaling deeply
1.Teach pursed lip breathing; inhale slowly through nose and exhale twice slowly(Meyers et.al, 2014)
2. Teach forced expiratory technique; take a deep breath, exhale forcefully (Meyers et.al, 2014)
3. Walk; stop to take deep breath. Exhale slowly while walking
1. Provide a calming environment limiting noise
2. Monitor blood pressure and measure in both arms and teach ranges (Meyers et.al, 2014)
3. Monitor sodium intake
1. Promote relaxation techniques
2. Teach exercises that patient can do standing or seated
3. Teach importance of medications
To note any changes in present edema and if edema worsens (Jurgens, 2015).
Body weight is a more sensitive indicator of fluid or sodium retention. (Meyers et.al, 2014)
The failing heart may not be able to respond to increased oxygen demand. (Meyers et.al, 2014)
Education helps patients understand the complexities of their airway problems. (Meyers et.al, 2014)
Exercise strengthens muscles of respiration.
Exercise develops slowed, controlled breathing.
Exercise decreases air trapping and airway collapse
(Meyers et.al, 2014)
Teach patient to take medications at a timely manner (Jurgens, 2015)
Educate patient that eating a low sodium diet can decrease fluid intake that decreases hypertension (Meyers et.al, 2014)
Consistent medication schedule will minimize the chance of error and encourage better complicance with therapy (Meyers et.al, 2014)
Implementing changes is the cornerstone of treatment(Meyers et.al, 2014)
Hypertension is a chronic lifelong disease
Give information about the DASH diet
Side effects are the most common reason for noncompliance (Meyers et.al, 2014)
May falsely believe that only elevated diastolic blood
90% of hypertension is not related to a primary cause (Meyers et.al, 2014)
Aerobic exercise helps lowering BP
Medication schedule will minimize the chance worsening symptoms (Meyers et.al, 2014)
It is important to stay away from high sodium foods because of the excess sodium and fluid build up that effects BP, and cardiac output.
It is important to understand breathing techniques to promote lung expansion.
It is important to understand that hypertension is a chronic disease in which they have a vital role in effective management Patient’s edema still is at +1. Goal was not met. Continue to monitor sodium levels and edema.
Patient has an understanding of the breathing exercises and currently continuing therapy.
Patient’s BP is lowered however is not in the range desired. Will continue therapies and will continue to monitor BP.
Section 13:
Reporting off to the nurse next shift: ISBARR
Effective and concise handoffs are essential to providing excellent care and, if not done well, can adversely impact the care of this client. You have done an excellent job to this point, now finish strong and give the following SBAR report to the nurse who will be caring for this client: If you were walking into a client’s room what do you want to know about them to be able to provide excellent care?
Introduction
Patient, L.H. age 88 widowed
Situation: (“The client’s blood pressure has been fluctuating all shift. It has been anywhere from 145/92 to as high as 190/112.”)
The client’s blood pressure is 130/ 87, temp is 98.6, client has elevated albumin, PT/INR, hematocrit and blood urea nitrogen. Client has a low platelet count.
Background: (“This is a 75 year old male admitted for cerebrovascular accident 3 days ago. His BP has not been under good control since admission. He has been on diuretics and antihypertensives and has been undergoing multiple tests to determine what is going on.”)
This is a 88 year old female admitted with unspecified CHF. Patient has a history of falling, muscle weakness and myocardial infarction.
Assessment: (“This patient is unstable. I have been trying to reach his MD and have been told he will call back within the hour.”)
The patient is not critical, but is being monitored high blood pressure, fatigue and high lab values. MD has the patient being monitored for high BP, fatigue and high lab values. MD saw the patient last 2 hours ago.
Recommendation: (“I think this client needs to be watched closely and that the MD needs to see him ASAP so try to get him to do so.”)
“ I think the patient should receive education on CHF, COPD and hypertension. Patient should also be educated on how she can ease her symptoms such as breathing techniques, eating better meals and light exercise.” “MD should recheck the lab values again in a day and monitor PT/INR should be continued since patient is taking Coumadin”
Repeat (If you had received an order you would repeat it back to be sure it was correct.)
No Orders to Repeat
Section 14 – Length: 2 to 3 Pages (Completed according to APA format)
Safety:
A. Identify 1 Safety Theme
Must be Client Specific & Approved Safety Topic by your Clinical Instructor
B. Synopsis of 3 Nursing Peer Review Articles
C. Develop your Theme / Body of your Paper- from your Nursing Peer Review Articles
D. From your Research: What can you Share or Educate your Peers / Students to Improve Client Safety?
Hand washing is believed to be viable for the counteractive action of transmission of diarrheal pathogens. Notwithstanding, it isn’t indisputable that hand washing with cleanser is more viable at decreasing tainting with microscopic organisms related with looseness of the bowels than utilizing water as it were. Hand washing with non-antibacterial cleanser and water is more viable for the expulsion of microbes of potential fecal beginning from hands than hand washing with water alone and should, along these lines, be more helpful for the counteractive action of transmission of diarrheal sicknesses.
Support for hand cleanliness as a foundation of proof based practice from trust CEOs and senior directors are significant. Hand cleanliness is a basic mediation that ought to be attempted at the correct circumstances and in the correct path by all individuals from staff who contact patients (Perkins, 2017). Guaranteeing that all staff accomplish this relies upon both information and proof being converted into training dependably, including through state-of-the-art preparing and instruction sessions, and through building ability (Perkins, 2017). While disease aversion and control groups assume an essential part in this, contamination counteractive action isn’t the duty of these groups alone – it ought to be the obligation of everybody in medicinal services.
Keeping up consistence and managing hand cleanliness conduct after instruction, inspiration, and criticism is hazardous. Over and over again one sees here and now enhancements in consistence (Fox, et al., 2015). People are educated at an early age to clean hands in the wake of utilizing the latrine, before eating, and when ruined. These are educated practices that are natural in every one of us (Fox, et al., 2015).
The level of sullying or interventional assignment is over and over again how specialists are roused to clean hands. Medicinal services laborers are roused to clean hands when performing assignments where there is a more elevated amount of ruining, e.g., obvious soil or known danger of defilement (Martina, 2014). Be that as it may, certain undertakings, for example, contacting the occupant’s condition e.g., bedrails and attire, and contacting an inhabitant’s skin or taking temperatures or blood weights are not seen as an inspiring component to clean hands (Martina, 2014).
All staff and students should all hand washing protocols. At the clinical site I was at I rarely saw any CNAs or nurses wash their hands. The one person I did see wash her hands was the CNA who was pregnant with triplets. Millions of deaths could be prevented a year if hands are washed routinely. Contamination anticipation and control ought to be coordinated into each part of healthcare.
References
Bianco, C. (2000, August 01). Congestive Heart Failure 101. Retrieved August 12, 2018, from https://health.howstuffworks.com/diseases-conditions/cardiovascular/heart/congestive-heart.htm
Chronic Obstructive Pulmonary Disease (COPD) – Pulmonary Disorders. (n.d.). Retrieved August 10, 2018, from https://www.merckmanuals.com/professional/pulmonary-disorders/chronic-obstructive-pulmonary-disease-and-related-disorders/chronic-obstructive-pulmonary-disease-copd
COPD. (n.d.). Retrieved August 11, 2018, from https://www.nurseteachings.com/tag/copd
COPD Symptoms. (n.d.). Retrieved August 10, 2018, from http://www.lung.org/lung-health-and-diseases/lung-disease-lookup/copd/symptoms-causes-risk-factors/symptoms.html
Fox, C., Wavra, T., Drake, D. A., Mulligan, D., Bennett, Y. P., Nelson, C., . . . Jones, L. (2015, May 01). Cherie Fox. Retrieved August 12, 2018, from http://ajcc.aacnjournals.org/content/24/3/216#cited-by
Jurgens Y. Corrine RN. (2015, April 8). Retrieved August 10, 2018, from https://www.ahajournals.org/doi/abs/10.1161/hhf.0000000000000005
Martina, V. (2014, June 02). Evaluation of a patient education model for increasing hand hygiene compliance in an inpatient rehabilitation unit. Retrieved from https://www.sciencedirect.com/science/article/pii/S0196655303008150
Meyers, J. L., & Gulanick, M. (2014). Nursing Care Plans: Diagnosis, Interventions, and Outcomes. Philadelphia: Mosby.
Perkins, A. (2017, November/December). Hand hygiene : Nursing made Incredibly Easy. Retrieved August 11, 2018, from https://journals.lww.com/nursingmadeincrediblyeasy/Fulltext/2017/11000/Hand_hygiene.15.aspx
Treatment Options for Heart Failure. (n.d.). Retrieved August 10, 2018, from https://www.heart.org/en/health-topics/heart-failure/treatment-options-for-heart-failure
Vallerand, A. H., Sanoski, C. A., Deglin, J. H., & Mansell, H. G. (2015). Davis’s drug guide for nurses.
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