Medical Asepsis
What are the two types of asepsis?
What is the one most significant action to break the chain of infection?
Hand hygiene
Which population is most at risk for falls?
The older adult
What is nonverbal communication?
Nonverbal communication includes the five senses and everything that does not involve the spoken or written word.
examples are eye contact, gestures, facial expression, and body positioning
Why is a healthcare consent required?
A patient’s signed consent form is necessary for admission to a health care agency, performance of invasive procedures such as intravenous central line insertion, surgery, some treatment programs such as chemotherapy, and participation in research studies
What is standard precaution?
Table 28.6
When should healthcare professionals wash hands?
Before, after, and between direct patient contact (e.g., taking a pulse, lifting a patient)
• Before putting on sterile gloves and before inserting invasive devices such as a peripheral vascular catheter or urinary catheter
• After contact with body fluids or excretions, mucous membranes, nonintact skin, and wound dressings (even if gloves are worn)
• When moving from a contaminated to a clean body site during care
• After contact with surfaces or objects in the patient’s room (e.g., overbed table, IV pump)
• After removing gloves
What are some alternatives to restraining a patient?
Orient patients and family members to the environment; explain all procedures.
• Provide companionship and supervision; use trained sitters; adjust staffing and involve family.
• Offer diversional activities: music, puzzles, activity aprons, folding towels. Use ideas of the patient and/or family.
• Assign confused or disoriented patients to rooms near nurses’ stations, and observe frequently.
• Use de-escalation, time-out, and other verbal intervention techniques when managing aggressive behaviors.
• Provide visual and auditory stimuli (e.g., family pictures, a clock, music).
• Remove cues that promote leaving the room (e.g., close doors to block view of stairs; do not allow inpatient to wear street clothes).
• Promote relaxation techniques and normal sleep patterns.
• Institute exercise and ambulation schedules as allowed by patient’s condition.
• Attend frequently to patient’s needs for toileting, food and liquid, and pain management.
• Camouflage intravenous lines with clothing, stockinette, or Kling gauze dressing.
• Evaluate all medication effects and ensure timely and effective pain management.
• Discontinue bothersome treatments (e.g., nasogastric tubes or Foley catheters) as soon as possible.
• Use protective devices such as hip pads, helmet, skidproof slippers, and nonskid strips near bed.
What are some barriers to effective communication?
Barriers include:
lack skills to communicate
Lack of skills to listen effectively.
Lack of skills to express self
Culture
Language barriers
What are three strategies that nurses can implement to reduce their legal risks?
Develop and use your clinical judgment to identify patient needs and make sound clinical decisions.
Remain present for your patients (be acutely aware of the patient's needs and care)
Assess the patient carefully
Identify patterns and needs.
Respond to patient needs in a timely manner.
Provide accurate patient education and verify that your patients understand your instructions.
Ensure that your patients understand their treatment plans and have been provided the opportunity to give informed consent when required.
Document clearly and in a timely manner
Alert your patient’s health care provider when your patient’s health status changes.
Clarify unclear medical orders
Speak up if you have concerns about patient safety.
What are the stages of infection?
Incubation stage
Prodromal stage
Illness stage
Convalescence stage
What are the categories of personal care?
Early morning care
Routine morning care
Afternoon care
Evening, or hour-before-sleep, care
What is PASS for fire safety?
Pull the pin to unlock handle.
Aim low at the base of the fire.
Squeeze the handles.
Sweep the unit from side to side
What are two types of medical provider orders?
verbal and telephone orders
What are three guidelines that nurses should follow for professional ethics?
Advocacy
Responsibility
Accountability
Confidentiality.
What are the most common HAIs?
Urinary tract infection
Respiratory infections
wounds
Blood stream infections
What are the types of bath?
Complete bed bath: Bath administered to totally dependent patient in bed.
Partial bed bath: Bed bath that consists of bathing only body parts that would cause discomfort if left unbathed, such as the hands, face, axilla, and perineal area. Partial bath also includes washing back and providing back rub. Dependent patients in need of partial hygiene or self-sufficient bedridden patients who are unable to reach all body parts receive a partial bed bath.
Sponge bath at the sink: Involves bathing from a bath basin or sink with patient sitting in a chair. Patient can perform part of the bath independently. Nurse helps with hard-to-reach areas.
Tub bath: Involves immersion in a tub of water that allows more thorough washing and rinsing than a bed bath. Patients may require nurse’s help. Some agencies have tubs equipped with lifting devices that facilitate positioning dependent patients in the tub.
Shower: Patient sits or stands under a continuous stream of water. The shower provides more thorough cleaning than a bed bath but can be tiring.
Disposable bed bath/travel bath: The bag bath contains several soft, nonwoven cotton cloths that are premoistened in a solution of no-rinse surfactant cleaner and emollient. The bag bath offers an alternative because of the ease of use, reduced time bathing, and patient comfort
Chlorhexidine gluconate (CHG) bath: Antimicrobial agent used to reduce incidence of hospital-acquired infections on skin, invasive lines, and catheters
What are the factors that influence patient safety?
Developmental stage
individual risk factors
impaired mobility
Environmental
workplace culture
lifestyle
sensory deficits
What are the purposes of the medical record?
Page 389
Allow members of the health care team to efficiently document and retrieve clinical data, track patient outcomes, and facilitate continuity of care.
A patient's record provides a detailed account of the level of quality of care delivered.
Document provides evidence of the quality of care
Document is available for the regulatory agencies to provide details about nursing care rendered
The document is available to help insurance companies with the reimbursement structure in the health care system
Difference between spirituality and religion
Spirituality is awareness of one's inner self and sense of connection
religion is an organized belief, outward expression of beliefs and practices
What is transmission-based precautions?
For use with specific types of patients when pathogen is isolated.
Table 28.6
What are factors that influence personal hygiene?
social practices
Cultural practices
personal practices
socioeconomic practices
health beliefs
motivation
developmental stage
physical condition
How does the nurse start the assessment for a patient who is at risk for falls?
begin by exploring the patient's perception of safety
What are some nontherapeutic communication techniques?
asking personal questions
changing the topic
providing personal opinions
false reassurance
sympathy
defensive responses
asking 'why' questions to a client's replies
passive aggressive replies
State the difference between ethical dilemma and moral distress
Dilemma, with two opposing but justifiable options
Moral distress, taking a specific action while believing that action to be wrong