PROGRESSIVE PATIENT CARE.

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PROGRESSIVE PATIENT CARE.
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HISTORY OF PROGRESSIVE PATIENT CARE.

• ROLE OF JAPANESE
• CONTRIBUTION OF MISS FLORENCE NIGHTINGALE.
• ROLE OF SOME HOSPITALS.

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MEANING OF PROGRESSIVE PATIENT CARE.

• GIVING CARE ACCORDING TO NEED.

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.

• DEFINITIONS OF
• PROGRESSIVE PATIENT
• CARE

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BENEFITS OF PROGRESSIVE PATIENT CARE.

• FOR THE PATIENT
• FOR THE PHYSICIAN
• FOR THE NURSE
• FOR THE HOSPITAL.

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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.

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MAJOR CONCEPT OF PROGRESSIVE PATIENT CARE.

• -BETTER CARE THROUGH BETTER ORGANIZATION.
• -RIGHT PATIENT,IN THE RIGHT BED
• WITH THE RIGHT SERVICES AT RIGHT
• TIME.

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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.

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

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ELEMENTS OF PPC.

• INTENSIVE CARE.
• INTERMEDIATE CARE.
• SELF CARE.
• LONG TERM OR EXTENDED CARE.
• HOME CARE.
• AMBULATORY OR OUTPATIENT CARE.

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INTENSIVE CARE UNITS.

• Eg.CARDIAC CARE UNIT
• BURNS ICU.
• NEURO ICU.

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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.

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STAFFING IN ICU.

• DOCTOR
• GENERAL ICU-ANESTHETIST.
• SPECIALISED ICU-SPECIALIST.

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• NURSES.
• AT LEAST 2 NURSES PER DAY
• FOR ONE PATIENT .
• WESTERN CONTRIES-11 PER SHIFT
  
• OR 41 PER DAY.
• AUXILLARY PERSONS.
• ONE MALE AND ONE FEMALE.
  
  
  

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

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MANAGEMENT OF ICU.

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

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

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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.

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RESPONSIBILITIES OF A CRITICAL CARE NURSE.
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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.

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STAFFING .

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

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NURSES RESPONSIBILITIES IN INTERMEDIATE CARE
UNIT.

• SUBACUTE LEVEL.
• -POST ACUTE CARE LIKE
  VENTILLATOR CARE.
• -SPECIALISED NURSING SKILLS.
• -PERFORM CARE OF TERMINALLY ILL.

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• ACUTE LEVEL.
• TEACHINGREHABILITATION.
• PERFORMANCE OF ADL.
• ASSISTANCE IN DAILY CARE
• LONGTERM CARE
• ROUTINE CARE
• EFFECTIVE SUPERVISION.
• PALLIATIVE CARE.

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SELF CARE.

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

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PHYSICAL FACILITIES.
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NURSES RESPONSIBILITIES

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

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LONGTERM CARE.

• PATIENT WHO NEED MEDICAL AND NURSING CARE FOR A
  PROLONGED
• PERIOD.
• EgPATIENT HAVING CVA,MULTIPLE FRACTURES.

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PHYSICAL FACILITIES OF A LONG TERM CARE UNIT.
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NURSES RESPONSIBILITY.

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

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HOME CARE

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

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SERVICES REQUIRED.

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

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NURSES RESPONSIBILITY.
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AMBULATORY CARE.

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

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RESPONSIBILITIES OF A AMBULATORY CARE NURSE.
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ADVANTAGES OF PPC.

• TO THE PATIENT
• TO THE NURSING PERSONNEL.

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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.

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SUMMARY
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CONCLUSION