Progressive patient care is defined as the organization of hospital
facilities, services and staff as per the medical and nursing needs of the patient. -The basic principle of PPC is based on the nursing needs of the patient rather than by traditional hospital grouping according to economic status, age, sex or type of illness.
The concept of PPC is quite old and started in Military Hospitals and by
Florence Night angle in 1800 AD.
Modern application of PPC in hospitals started in 1950 to provide optimum
level of care to the patient as per nursing needs.
OBJECTIVE OF PPC PPC is to provide optimum level of care to the patient as per need in minimum cost. To raise the level of patient care of those critically ill patients with effective use of nursing personnel and facilities by grouping the patients as per their nursing care need. PPC is also seen as an important method of controlling cost with provision of nursing care as per need of various patients.
ELEMENTS OF PPC INTENSIVE CARE INTERMEDIATE CARE CONVALESCENT OR SELF CARE PPC AMBULATORY & OPD CARE HOME CARE LONG TERM CARE
INTENSIVE CARE It is concentrated around the patient. Who are unable to communicate their needs. Who requires extensive nursing care. Require constant observation and supervision. Require ventilatory support. Round the clock equipped and skilled service facilities. Facilities for mobilization of more resource on demand. Restriction of visitors to the area. MI, Head injury, shock, burns, premature babies etc.
INTERMEDIATE CARE Who requires moderate amount of Nursing Care (High end care) Patients are conscious and can express their needs. Constant observation not needed. Segregation of such patient in one area help distribution of Nursing Care. The vitals are under control and does not require constant monitoring. Cardiac Ward, renal, chest and paediatric surgery.
CONVALESCENT OR SELF CARE 1.Patients requiring convalescent care or diagnosis. They are physically self sufficient. Require least nursing and observation. Services are purely educational and supervisory such as diet, self medication, change in life style, exercises, physiotherapy etc. Patients are allowed a home type environment. Pre-surgery patients or patient prepare to discharge.
LONG TERM CARE They require skills and services not available at home. Convalescent patients from ICU. Post operative case with infection. Patients with poor progress but require skilled palliative treatment such as cancer cases, occupational therapy, physiotherapy. 5. Though nursing care is mandatory not repeated, only regular periodic assessment is needed.
HOME CARE The hospital services extends to home (Out reach services). Provision of community care services though social workers. The intensity of disease is less without requiring emergency attention like TB, leprosy, fracture cases, ANC cases, Delivery Cases. AMBULATORY OR OPD CARE Post operatives follow up. Promotive, preventive and rehabilitation services. Diagnosis and treatment and investigation.
RESISTANCE TO PPC Acceptance of some staff to PPC was not welcomed and slow. Rapid change of area and treating staff cuts away the patient staff relation. Patient not accepting self care service in the hospital. Observation of Nursing Care inadequate in long term care area. Patient’s resistance to being transferred between units. No separate male and female wards in different care areas. Level and Nature of duties of Nursing Staff not similar in different care areas.
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