PROGRESSIVE PATIENT CARE. - PowerPoint PPT Presentation

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PROGRESSIVE PATIENT CARE.

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  1. PROGRESSIVE PATIENT CARE.

  2. HISTORY OF PROGRESSIVE PATIENT CARE. • ROLE OF JAPANESE • CONTRIBUTION OF MISS FLORENCE NIGHTINGALE. • ROLE OF SOME HOSPITALS.

  3. MEANING OF PROGRESSIVE PATIENT CARE. • GIVING CARE ACCORDING TO NEED.

  4. . DEFINITIONS OF PROGRESSIVE PATIENT CARE

  5. BENEFITS OF PROGRESSIVE PATIENT CARE. • FOR THE PATIENT • FOR THE PHYSICIAN • FOR THE NURSE • FOR THE HOSPITAL.

  6. OBJECTIVES OF PROGRESSIVE PATIENT CARE. • TO PROVIDE OPTIMUM CARE AS PER NEED IN MINIMUM COST. • TO UTILISE RESOURSES EFFECTIVELY. • TO RAISE THE LEVEL OF PATIENT CARE IN CRITICALLY ILL.

  7. MAJOR CONCEPT OF PROGRESSIVE PATIENT CARE. -BETTER CARE THROUGH BETTER ORGANIZATION. -RIGHT PATIENT,IN THE RIGHT BED WITH THE RIGHT SERVICES AT RIGHT TIME.

  8. EDUCATIONAL REQUIREMENTS OF NURSE IN PPC. • DYSRHYTHMIA MONITORING SKILL. • BASIC AND ADVANCED LIFE SUPPORT • DRUG CALCULATION &MONITORING. • PRE,INTRA &POST PROCEDURE CARE • HEMODYNAMIC MONITORING SKILL.

  9. ASSESSMENT OF INDICATION FOR VENTILLATION. • ABG INTERPRETATION • CARE OF VENTILLATOR PATIENT . • WEANING OF VENTILLATION. • RECOGNISE INDICATION &COMPLICATION OF ENTERAL AND PARENTRAL NUTRITION.

  10. ELEMENTS OF PPC. • INTENSIVE CARE. • INTERMEDIATE CARE. • SELF CARE. • LONG TERM OR EXTENDED CARE. • HOME CARE. • AMBULATORY OR OUTPATIENT CARE.

  11. INTENSIVE CARE UNITS. • Eg.CARDIAC CARE UNIT BURNS ICU. NEURO ICU.

  12. EQUIPMENTS NEEDED IN ICU. • ALL LIFE SAVING DRUGS. • CARDIAC MONITORING EQUIPMENTS. • EQUIPMENTS FOR RESPIRATORY RESUSCITATION. • SETS FOR VENESECTION,LP, CATHETERIZATION. • IV RODS. • WALL MOUNTED SPHYGMOMANOMETER.

  13. STAFFING IN ICU. • DOCTOR GENERAL ICU-ANESTHETIST. SPECIALISED ICU-SPECIALIST.

  14. NURSES. AT LEAST 2 NURSES PER DAY FOR ONE PATIENT . WESTERN CONTRIES-1:1 PER SHIFT OR 4:1 PER DAY. • AUXILLARY PERSONS. ONE MALE AND ONE FEMALE.

  15. ONE WARD CLERK. • ONE SWEEPER. • TECHNICAL STAFF. -PHYSIOTHERAPIST. -INHALATION THERAPIST. -ECG TECHNICIAN. -BIOMEDICAL ENGINEER -LAB TECHNICIAN -ELECTRONIC TECHNICIAN.

  16. MANAGEMENT OF ICU. • ICU COMMITTEE. • INCHARGE IS MEDICAL OFFICER. • POLICIES AND PROCEDURES. -ADMISSION DISCHARGE CRITERIA. -BED UTILIZATION -SPECIAL OBSERVATION CHART -RULES FOR VISITORS.

  17. -INFORMATION SYSTEM TO RELATIVES. -DISCHARGE SUMMARY. -DIETRY SERVICES. -STAFF TRAINING. -STANDING ORDERS. -PROCEDURE MANUEL. -RESOURCE AVAILABILITY.

  18. PROBLEMS IN ICU WHILE INTRODUCING PPC. • INFRASTRUCTURE OF ICU. • LOCATION OF ICU. • STAFFING THE UNIT. • SUPPLIES TO THE UNIT. • ADMISSION AND TRANSFER. • MAINTENANCE OF EQUIPMENTS. • UNHEALHTY TEAM RELATIONS.

  19. RESPONSIBILITIES OF A CRITICAL CARE NURSE.

  20. INTERMEDIATE CARE UNITS. • INTERMEDIATE CARE UNITS ARE THOSE UNITS WHERE PATIENTS ,WHO ARE EITHER MODERATELY ILL OR FOR WHOM THE TREATMENT CAN BE PALLIATIVE ARE CARED FOR.

  21. STAFFING . • CARE REQUIREMENT-4 HOURS MORNING SHIFT-6 PATIENTS EVENING SHIFT-8 PATIENTS. NIGHT SHIFT-12-15 PATIENTS

  22. NURSES RESPONSIBILITIES IN INTERMEDIATE CARE UNIT. • SUBACUTE LEVEL. -POST ACUTE CARE LIKE VENTILLATOR CARE. -SPECIALISED NURSING SKILLS. -PERFORM CARE OF TERMINALLY ILL.

  23. ACUTE LEVEL. • TEACHING&REHABILITATION. • PERFORMANCE OF ADL. • ASSISTANCE IN DAILY CARE LONGTERM CARE • ROUTINE CARE • EFFECTIVE SUPERVISION. • PALLIATIVE CARE.

  24. SELF CARE. • AMBULATORY PATIENTS WHO ARE CONVALESCING OR REQUIRE DIAGNOSIS OR THERAPY MAY BE CARED FOR IN A SELF CARE UNIT. Eg;PATIENT RECEIVING RADIATION OR PHYSICAL THERAPY.

  25. PHYSICAL FACILITIES.

  26. NURSES RESPONSIBILITIES • SUPERVISION OF ACTIVITIES. • IDENTIFICATION OF HEALTH PROBLEMS. • HEALTH EDUCATION. • DEMONSTRATING PROCEDURES. • PERFORM SPECIALISED TREATMENT. • HELP IN COPING.

  27. LONGTERM CARE. • PATIENT WHO NEED MEDICAL AND NURSING CARE FOR A PROLONGED PERIOD. Eg;PATIENT HAVING CVA,MULTIPLE FRACTURES.

  28. PHYSICAL FACILITIES OF A LONG TERM CARE UNIT.

  29. NURSES RESPONSIBILITY. • ASSISTING IN MEETING THE DAILY NEEDS OF CLIENT. • ROUTINE CARE. • ASSESSMENT &PLANNING OF NURSING CARE. • SUPERVISION • INTERDEPARTMENTAL COORDINATION.

  30. HOME CARE • SERVICES WHICH ARE DONE FOR PATIENTS WHO CAN BEST BE CARED AT HOME WITH EXTENDED SERVICE FROM THE HOSPITAL WHENEVER NEEDED.

  31. SERVICES REQUIRED. • DIAGNOSTIC AND THERAPEUTIC PROCEDURES. • PHYSIOTHERAPY. • OCCUPATIONAL THERAPY • SPEECH THERAPY. • HEALTH INSTRUCTIONS. • ROUTINE CARE.

  32. NURSES RESPONSIBILITY.

  33. AMBULATORY CARE. • CARE UNIT IN WHICH SERVICES ARE GIVEN TO THE NEEDY PEOPLE WHO VISITS THE HOSPITAL.

  34. RESPONSIBILITIES OF A AMBULATORY CARE NURSE.

  35. ADVANTAGES OF PPC. • TO THE PATIENT • TO THE NURSING PERSONNEL.

  36. DEMERITS OF PPC. • RAPID CHANGE IN PATIENT AREA. • REDUCED PATIENT STAFF RELATION. • RESISTANCE FOR TRANSFERRING. • IMPROPER RELATIONS. • DIFFICULT TO MEET ALL CRITERIAS OF EACH UNIT.

  37. SUMMARY

  38. CONCLUSION