CHARTING
The
nurses are required to report and record their observations. She reports her
findings to the professional nurse and to the physician.
Recording
of the observations is called charting. The nurses should chart their
observations correctly. All chartings should be brief, concise, account and
complete.
Charting helps physicians, nurses and others to under-stand
the condition and progress of the patient. The chart is also used for legal
procedures and research.
A
patient's chart includes records maintained by physicians and nurses. A nurse
should be able to maintain records related to nursing and she should be able to
understand the notes made by physicians and others.
Safety and Comfortable Environment
The
environment in which the patient is placed should be comfortable and safe and
it should contribute to his well being and should not retard his recovery.
Safety and comfort measures
Safety
means protection from possible injury. Many factors contribute towards the
safety of patients in the hospital.
The hospital buildings should be structurally sound for
ensuring safety for patients with physical limitations such as, blind, aged or
handicapped.
The
nursing personnel must be safety conscious and they should take all efforts to
prevent accidents in the hospital. She should report all accidents promptly and
take measures to prevent them from happening again. A register should be
maintained for recording accidents.
Mechanical Devices for comfort
measures
To
hospitals use many mechanical devices for ensuring safety/patients.
Bed bars (side rails) are used to prevent patients from
falling out of bed. Patients who requires this safety measure are post
operative patients, unconscious, semi-conscious mentally disturbed, sedated,
blind or children or very old patients.
Back rest: These are usually made of metals. These are used
to support the back of the patient in upright position.
Over
bed table: The table such as the cardiac table is placed in front of the
patient and the top of the table is adjusted to the desired height. As pillow
is arranged on the top of the table so that the patient can lean forward on it
for support. When he wants to take food, read or write.
Foot-boards: (Foot- rests): These are made of wood and are L
shaped, so that one end can be slipped under the mattress to hold the other end
in a firm upright position. The patient is placed in supine position to rest
the bottoms of the feet flat against the surface of the foot-board (covered
with sheet). These are used to prevent foot drop by maintaining good alignment.
Sand-bags: These are canvas, rubber or plastic bags filled
with sand and are 1,5 and 10 lbs in weight. These are used to immobilize the
body part, placing them snugly next to the part. Eg. On either side of the feet
to maintain the position of the feet on the foot-board, immobilize the
fractured limb.
Blocks (shock blocks): These are made of wood, may be high
or low. These are placed under the foot of the bed for various reasons. Eg.
surgical shock, traction and postural drainage. This may be placed under the
head of bed to promote drainage and improve cerebral circulation.
Hand rolls : These are made of cloth that is rolled into a
cylinder about 4-5 inches long and 2-3 inches in diameter and stuffed firmly.
These are used to keep the fingers form being held in a tight fist leading to
flexion contracture in patients who are unable to move the hands due to paralysis,
injury or disease
Thigh rolls: These are made by folding a sheet to a desired
length of 2-3 feet and then rolled into a tight cylinder. These are used to
support the hips and thighs, preventing them outward rotation and keeping the
feet in good alignment, in case of paralysis, fracture of the femur or hip
surgery. To use the roll, place the lose end (flap) under the patients hips and
thighs with the role under the flap end
and then tucking snugly along the hip and thigh
Cradle: These are mostly semicircular in shape, made of wood
or metal. These are used to prevent the weight of top bedclothes on patient' s
feet and toes. To use the cradle, Place it over the bottom bedclothes and the
top bedclothes are then brought over the cradle. These are used for patients
affected by burns.
Restraints are devices used to prevent agitated patients,
persons who get out of bed at night in their sleep and small children, from
falling out of bed.
Wire mesh for windows and doors are fixed to prevent
insects.
Common Hazards
Patients should be safeguarded from fire accidents and from
careless application of heat. Fire accidents occur mainly due to allowing
patients to smoke in bed, use of faulty electric appliances, and careless use
of oxygen cylinders.
Patient may get injured from careless application of hot
water bags, electric pads and application of medications on the skin.
Poisonous
drugs should be kept under lock and key with specific red label.
Patients may come to harm through bacteriological sources,
insects and rodents. Food and water should be made safe for consumption.
Insects and rodents should be eliminated.
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