Preparation for patient care: ch. 3

Fundamental skills

Managing environment,Body mechanics,Communication

Of utmost importance

safety of patient and staff

Planning all steps in patient prep...

Increases likelihood of safe, efficient, and effective implementation

When patient prep begins

At the end of previous treatment session

5 patient preparations include...

clean and returned equipment to proper area, disposed used supplies properly,Unused supplies returned to proper storage area, Inform person in charge of purchasing supplies of low inventory,Tag equipment functioning incorrectly or unsafely to be removed from treatment area

Responsible for safe and clean patient environment

Everyone

Housekeeping in clinic

1. Change linens after each patient

2. Wipe mats after each patient

3. Keep items off floor

4. Enough room for treatment session

4 Preparations of area for patient

1. Prepare as much as possible before pt arrives

2. Extra linens/ pillows

3. Call bells/ call buttons placed in patient reach

4. Table position

Therapist responsibility during pt positioning

Do NOT leave patient unattended

5 rules of body mechanics

1. Load close

2. Appropriate BOS

3. Isometric muscle contraction

4. Lift with legs

5. NO twisting

Load close (body mechanics)

Center of gravity of person being lifted as close as possible to the person lifting

Center of gravity

place in body where force of gravity pulls the mass of body

Appropriate BOS (body mechanics)

area within the outermost boundaries of a person's contact with the supporting surface

Isometric muscle contraction (body mechanics)

contractions of skeletal muscle not creating joint movement,Creates rigid spine,Avoid valsalva maneuver (Do not hold breath under load)

Lift with legs (body mechanics)

Lower yourself by squatting and raising yourself, maintaining erect trunk

No twist (body mechanics)

Avoid rotation of spine under load

Position when guarding pt

1. Behind and slightly to the side of pt

2. Face direction of movement

3. Large BOS

Gait belt use

Safety equipment place on pt before transfer/ gait training

Reason for use of gait belt

1. Safety of pt and therapist

2. Can be required by facility

3. Hospital gown offers nothing to hold for support

4. Pt wounds reduce area therapist can use for support

5. Pt size may be too large to support w/o belt

5 Characteristics of giving pt instruction

1. Simple and informative w/ language pt understands

2. Therapist describes general sequence of event to occur

3. Explain expected responses from pt

4. Ask pt to repeat instructions

Draping

Appropriately covering pt to maintain modesty during treatment

4 characteristics of draping

1. Protects modesty

2. Provides warmth

3. Protects wounds/ clothing

4. Expose only body segment being treated

5 Types of pt equipment to be aware of

1. IV lines

2. chest tubes

3. catheters

4. Respirators

5. Cardiac monitors

Affect of pt equipment in PT

Tubes and lines may limit movement

IV line

intravenous line

Intravenous line

administers medicines/ fluids through needle inserted in vein

Catheter (3)

Flexible tube inserted through narrow opening into body cavity,particularly bladder,Removes fluid

2 types of catheter

1. Leg bag

2. Bedside bag

Catheter bag placement

Below pt hip/ bladder

2 types of oxygen administrations

1. oronasal

2. Nasal cannula

Oronasal oxygen

mask covering mouth and nose

Oronasal oxygen amount

5 to 15 liters

Nasal cannula

tubes inserted to nasal cavity

Nasal cannula oxygen amount

1 to 6 liters

Ostomy

opening in abdomen

colostomy

opening of colon

Negative pressure wound therapy

1. AKA wound V.A.C.

2. non-invasive wound care modality used to facilitate healing and manage drainage

Pt equipment prior to moving pt

1. Check movement allowed by equipment

2. Move equipment then pt

when to use wheelchair (w/c)

Pt unable to ambulate

w/c in pt transfer

Ensure brakes are locked prior to transfer

When pt is in w/c

1. Properly drape

2. All pt equipment follows pt

3. Bring additional pads/ pillows

methods to ascend/ descend curbs in w/c depends on...

1. curb height

2. Size/ weight of pt and w/c

3. Height/ strength of therapist

Descending curb in w/c

Backward method = less stress on therapist

Ascending curb in w/c

forward method = less stress on therapist

Door opens away from w/c

Position w/c away from door

Door opens toward w/c

Position w/c toward door

w/c wheelie function

Used for pt to ascend/ descend curbs when no ramps/ assistance is available (NOT just for fun)

w/c wheelie practice

Pt must be guarded in learning process to prevent injury