Progressive patient care

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