Ch. 5

Patient Care

Caring for the patient

Patient Care is an

Active endeavor

Patient Care is making

Decisions that are right for this specific patient and their own circumstances

Patient Care is

Preventing harm to the patient while treating them

Differences

Age

Gender

Culture

Language

Religion

Sexual orientation

Educational background

Economic status

Infants: fears

Falling

Loud noise

Reflexes for infants: unlearned automatic responses

Grasping, stretching

Facial expressions as

Communication

Preventing physical harm to infants by

Careful handling and watching exposure levels radiation

Law of Bergonie and Tribondeau

Sensitivity of cells to ionizing radiation (limit exposure to radiation due to effects on cells in an infant's body because this law states the most sensitive cells are the ones that are rapidly dividing)

How does our care change with an infant?

• Careful handling

• Protection and support of the head

• Extra careful hand washing / disease prevention and radiation exposure levels

• Swaddling will soothe the baby

• Low soft voice

Adolescents

Teenage years: intense, troubling, emotional imbalances

Children: 1-3 years

Sense of

Right and wrong developing

1-3 years

Sense of

Property

1-3 years

Sense of

Appropriate behavior

And may not be consistent but at this age they know that some of the actions they do that are “bad” will result in consequences

1-3 years

Speak, make sentences and

Follow instructions

However they may choose not to do so which is common in healthcare setting

1-3 years

nvolve parent if

Necessary

How do we change our care from infant to child?

Use small sentences that they may understand

Use happy but calm faces and words

Gestures

Taking time to interact to gain trust

Talking with parent and showing a relationship with parent

= Gaining trust

3-12 years

Development of self during this time frame

3-12 years

____ & ____ is important

Doing a good job

Love & esteem

3-12 years

_______ at their school and in the world

Socialized

3-12 years

Concept of

Time

3-12 years

________ is much easier with this age group

Since they have a sense of self and worth, the best way to communicate with this age is to treat them like they can make their own decisions and ask for their help to get the exam done

Communication

Child abuse

You were required to report any indication or thought abuse.

There are many ways to report it and there are many professionals that work to help with this

Adolescents are

Longing for independence, but not yet mature enough

Adolescents want

To identify and to be treated as an adult

An adult approach to communication with an adolescent will be the most likely way to generate a response or cooperation from this age group

Legal guardian is the

Responsible party

Close relationship with

Peer group

Young adults

21-45 years

Young adults have moved past

The need for Independence and likely have chosen a partner and started a family

21-45 years

Responsibilities and obligations

Financial

family

career

21-45 years

_____-______ ______ may result in being overly concerned

Life-threatening illness

45-65 years

Middle age

45-65 year olds are

Settled in life, normally sharing their lives with others

Pattern activity

Middle age people experience

Empty nest syndrome in which they decide to travel, or do community involvement to help with that

Middle-aged people have a

Well defined value system

Middle-aged people are

Concerned with maintaining Independence and retirement

Senior citizens

65 or older

Fastest growing population in the United States is over

85 years

Senior citizens suffer from

Diseases

Senior citizens may

Continue working and volunteering

Senior citizens require

Gentle, respectful care

Senior citizens may need

Additional assistance

Senior citizens expect

Death and dying process

Senior citizens may experience

Elder abuse: often neglect, must be reported

Senior citizens need

Patient consent: legal consent to treat or do a procedure

Diverse conditions and populations

Culture

Respect patients beliefs

Interpreter, if necessary

Patience with addictive diseases

Alcohol, drug, communicable diseases

Diverse conditions and populations

Trauma patients

patients with medical devices

here's where the need to be a critical thinker and learning to adapt to patient comes into play because every patient is different

be

respectful

courteous

professional

Basic principles of patient care

Practice radiographic techniques for radiation safety

Prevent spread of disease and injury to others

Prevent complications of injuries or illness

Alleviate suffering by comforting patient

Provide services economically and timely well maintaining quality

Verification of patient identification and procedures requested

You must ensure you are verifying the patient identity with the proper patient, as well as doing the proper procedure

Internal policies: date of birth, ID band

Procedures for patient request of records can be established by administrator and or physician

Radiology physician director can cancel or terminate the procedure at any time

Patient transfer

Not all of our patients come directly to the radiology department for our care. Inpatients are inside the hospital and other areas and require transport to get to our department

Imaging staff must be CPR certified

We must transport equipment

Wheelchairs

Stretchers

Beds

We deal with ancillary equipment

IVs

Pumps

Monitors

Communication and proper transfer techniques are the only way you and the patient will remain safe

Patient transfer techniques

Body mechanics: action the and producing motion or posture

Center of gravity when standing is at center of pelvis

Gravity line: imaginary vertical line passes through the center of gravity, must be maintained

Base of support

Bend knees, not waste

Hold object close to body

Use legs, not back

Vital signs

Blood pressure, pulse, respiration, temperature (bodies homeostasis)

Stethoscope

Sphygmomanometer

Pulse oximeter

Done in accordance with institutional policy

What is a sphygmomanometer

an instrument for measuring blood pressure, typically consisting of an inflatable rubber cuff which is applied to the arm

Important to note

Changes in patient condition because this may affect patient care

Emergency carts

Isolation techniques

Hospital acquired infections- infections that are required while patients under care at the hospital - also called nosocomial infections

How do you prevent nosocomial infections

Cleaning of equipment, standard precautions, isolation unit, protective equipment, disinfectants, antiseptics

What are the standard precautions for cleanliness in healthcare?

1. Hand washing

2. Gloving

3. Personal protective equipment (PPE)

4. No needle recapping

5. Bios

Standard precautions for the care of all patients

Medical asepsis

Involves reducing the property of infectious organisms in transferred to a susceptible individual

Three levels:

Hand hygiene and other cleanliness

Disinfection- destroys pathogens

Sterilization - the tree items heat, gas, or chemicals

How can you fight the spread of infection?

Stay home when you are ill

Use tissue to cover your mouth when you sneeze or cough - the tissue isn't available use your elbow to sneeze into

We're clean uniform or hospital scrubs daily and remove them before you leave the hospital

Perform hand hygiene

He's established precautions and handling patients, linens, or items contaminated with body substances

How can you fight the spread of infection? Part 2

Change your contaminated gloves after handling patients

Practice good housekeeping methods in your work area

When you doubt the cleanliness of an object - don't use it

If linens touch the floor get a clean one. The floor is always considered contaminated.

Ask patients who are coughing or sneezing to cover their mouth with a tissue or a mask.

Hand hygiene

Medically aseptic hand washing is the easiest most effective method to control the transmission of infections

Alcohol-based hand rubs

Require less time

Convenient

More effective for standsrd hand washing than soap

More accessible than sinks

Reduce bacterial counts on hands

Improve skin condition

Sterile or aseptic technique

Sterilization- the complete removal or destruction of microorganisms

1. Sterile or non sterile

   It's one or the other - any doubt it's considered non

2. Kept wrapped until use

3. Only outside cover touched when opening

4. Sterile article handled with sterile instrument or gloves

Sterile or aseptic technique part 2

5. After removed from sterile container, not returned

6. Use forceps to remove sterile object

7. Dispose of contaminated containers

8. Avoid of reaching over the sterile field

9. Edges of sterile field are contaminated

10. Keep instrument handles out of sterile fields

11. Poor sterile solutions so that there is no contact with non-sterile surface