Unit 20 Nurse Assistant Skills. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.2...

Unit 20 Nurse Assistant Skills

Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED. 2

20:1 Admitting, Transferring, and Discharging Patients

Procedures may vary slightly in different facilities

Basic principles apply to all facilities Alleviating anxiety and fear Admission forms Procedures performed on admission


Admitting, Transferring, and Discharging Patients (continued)

Protect patient’s or resident’s possessions Orient patient to facility Transfers Discharges Basic principles for admitting patient Basic principles for transferring patient Basic principles for discharging patient


Summary

Make every attempt to alleviate anxiety and fear during admissions, transfers, and discharges

Follow agency policy and use the proper forms

Care for the patient’s belongings and valuables and always obtain proper signatures when these items are checked


20:2 Positioning, Turning, Moving, and Transferring Patients

Responsibility of health care assistant If procedure done correctly, provides

patient with optimum comfort and care Also helps worker prevent injury to self

and patient Improper moving, turning, or transferring

can result in serious injury to patient


Positioning, Turning, Moving, and Transferring Patients (continued)

Correct body mechanics essential for any of these procedures

If you are unable to move or turn a patient by yourself, always get help

Alignment Basic principles of aligning the patient



Moves and turns Basic principles of moving patient to head

of bed Basic principles for turning patient Dangling Basic principles for dangling patient



Transfers Basic principles for transferring patient to

chair, wheelchair, or stretcher Basic principles for transferring a patient

with a mechanical lift


Summary

Always obtain proper authorization or orders before moving or transferring a patient

Never move or transfer a patient without correct authorization

Watch the patient closely during any move or transfer


Summary(continued)

If you note any abnormal changes, return the patient to a safe and comfortable position and check with your immediate supervisor

Supervisor will determine if the move or transfer should be attempted


20:3 Bedmaking

Correctly made beds provide comfort and protection for patients confined to bed for long periods of time

Care must be taken when beds are made Beds must be free from wrinkles


Bedmaking(continued)

Mitered corners Types of beds Draw sheets Body mechanics Infection control Standard precautions


Bedmaking(continued)

Basic principles of making a closed bed Basic principles for making an

occupied bed Basic principles for opening a closed bed Basic principles for placing a bed cradle


Summary

Follow correct procedures for bedmaking Observe infection control methods and

standard precautions at all times Use correct body mechanics to

prevent injury Be alert to patient safety and comfort


20:4 AdministeringPersonal Hygiene

Usually includes the bath, back care, perineal care, oral hygiene, hair care, nail care, and shaving when necessary

Must be sensitive to the patient’s needs and respect the patient’s rights to privacy while personal care is administered

Reasons for providing personal hygiene


Administering PersonalHygiene (continued)

Types of baths Oral hygiene Hair care Nail care Shaving Backrub Gowning


Administering PersonalHygiene (continued)

What to observe Standard precautions Respect patient’s rights Basic principles for providing oral hygiene Basic principles for administering a

complete bed bath


Summary

Providing personal hygiene is an important part of patient care

Follow correct procedures while providing personal hygiene

Observe standard precautions at all times Make careful observations during the

procedures, and report any abnormal conditions noted


20:5 Measuring and Recording Intake and Output

A large part of the body is fluid, so there must be a balance between the amount of fluid taken into the body and the amount lost from the body

Swelling and edema Dehydration I&O forms vary between facilities


Measuring and Recording Intake and Output (continued)

Intake: fluids taken in by patient What is included in intake Output: fluids eliminated by patient What is included in output Records must be accurate Fluids usually measured by metric system


Measuring and Recording Intake and Output (continued)

Agencies follow different policies for recording I&O

Careful instructions should be given to patients on I&O

Standard precautions Basic principles for completing

I&O records


20:6 Feeding a Patient

Good nutrition is an important part of a patient’s treatment

Make mealtimes as pleasant as possible Mealtimes are regarded as social time Proper preparation for mealtime Delay of meals Check food tray


Feeding a Patient(continued)

Allow patient to feed themselves whenever possible

Test temperature of food Principles to follow while feeding Relaxed, unhurried atmosphere Observe amount eaten Observe for any signs of choking


20:7 Assisting with a Bedpan/Urinal

Elimination of body waste is essential Terminology Many patients sensitive about using

bedpan/urinal Accurate observations important Standard precautions Basic principles of assisting with

bedpan/urinal


20:8 Providing Catheterand Urinary-Drainage Unit Care Catheters: hollow tubes usually made of

rubber or plastic French or straight catheter Foley catheter External condom catheter Urinary-drainage units


Providing Catheter and Urinary-Drainage Unit Care (continued)

Careful observation of catheter and drainage unit

When catheter and urinary-drainage unit in place, preferable to never disconnect unit

Catheter care Observation of urine


Providing Catheter and Urinary-Drainage Unit Care (continued)

Follow correct procedure to empty drainage unit to prevent contamination and infection

Bladder training program Principles of providing catheter care Basic principles for emptying a

urinary-drainage unit


Summary

Assisting patient with intake and output important part of care

Provide privacy and respect patient’s rights at all times

Observe standard precautions Follow correct procedures


20:9 Providing Ostomy Care

Ostomy: surgical procedure in which an opening, called a stoma, is created in the abdominal wall

Why ostomies are done Ostomies can be for draining urine from

the bladder or for emptying the bowel (stool or feces)


Providing Ostomy Care (continued)

Can be permanent or temporary depending on condition

Types of ostomies Ostomy bags or pouches Care of ostomy Psychological reactions to ostomy Observations while caring for ostomy Observe standard precautions


20:10 Collecting Stool/Urine Specimens

Laboratory tests are performed on the specimens

Specimens must be collected correctly in order for tests to be accurate

Routine urine specimen Clean-catch or midstream-voided

specimen


Collecting Stool/Urine Specimens (continued)

Sterile urine specimen 24-hour urine specimen Basic principles for collecting urine

specimens Routine stool specimen Stool for occult blood


Collecting Stool/Urine Specimens (continued)

Basic principles for collecting stool specimens

Label all specimens correctly Observe standard precautions


20:11 Enemas andRectal Treatments

Enemas Impactions Rectal tube Suppositories Standard precautions Basic principles for giving enemas Basic principles for inserting a rectal tube


Summary

Enemas and rectal treatments cannot be administered without a doctor’s order

Follow correct procedures at all times Observe standard precautions to prevent

spread of infection


20:12 Applying Restraints

Chemical restraints Physical restraints Conditions that may require restraints Types of physical restraints Points to remember when using restraints Complications of restraints


Applying Restraints (continued)

Most health care facilities have specific rules and policies regarding the use of restraints

Basic principles for applying restraints


20:13 Administering Pre- and Postoperative Care

Three phases of operative care Every patient will have some fears Preoperative care Basic principles for administering

preoperative care Skin preparation or surgical shave Basic principles for shaving the

operative area


Administering Pre- and Postoperative Care (continued)

Anesthesia Postoperative unit Basic principles for preparing a

postoperative unit Postoperative care Surgical or elastic hose


20:14 Applying Binders

Usually made of heavy cotton or flannelette with elastic sides or supports

Where applied Functions of binders Application of binders Straight binders Breast binders


Applying Binders (continued)

T-binders Precautions while using binders Basic principles for applying binders Montgomery straps


Summary

In order to properly care for a surgical patient, it is essential for health care assistants to know and understand all aspects of care that have been ordered

Good operative care can mean a faster recovery with fewer complications for the patient

Follow standard precautions


20:15 Administering Oxygen

Blood must have oxygen Signs of oxygen shortage Deficiency of oxygen Methods of administration of oxygen Humidifier Safety precautions


Administering Oxygen (continued)

Pulse oximeters Points to check while oxygen in use Legal considerations Basic principles of administering oxygen


20:16 Giving Postmortem Care

Care given to the body immediately following death

Begins when a doctor has pronounced the patient dead

Difficult, but essential part of patient care


Giving Postmortem Care (continued)

Dealing with death and dying Patient’s rights apply after death Family member may want to view body Procedure for postmortem care will vary

with different facilities Morgue kits


Giving Postmortem Care (continued)

Care of valuables and belongings Two people often work together to

complete care Basic principles for giving

postmortem care

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Unit 20 Nurse Assistant Skills. Copyright © 2004 by Thomson Delmar Learning. ALL RIGHTS RESERVED.2...

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