2. INTRODUCTION
The continued care of the patient is directed towards
the prevention of complications, rehabilitation and a
return to normal living.
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3. DEFINITION
A system of care in which patients are placed in units on the basis of
their needs.
The American Association of Critical Care Nurses recognizes
progressive care as part of the continuum of critical care.
It defines nursing practice based on the needs of the patient and the
characteristics of the nurse to attain optimal patient outcomes.
Progressive care defines the care that is delivered to patients whose
needs fall along the less acute end of that continuum. Progressive care
patients are moderately stable with less complexity, require moderate
resources and require intermittent nursing vigilance.
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4. CHARACTERISTICS OF PPC
Decreased risk of a life threatening event,
A decreased need for invasive monitoring,
Increased stability; and
An increased ability to participate in their care.
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5. PHILOSOPHY OF PPC
Initially, progressive care units housed post myocardial infarction
patients requiring cardiac monitoring, but not requiring intensive care
and observation. With the changing healthcare environment, the
acuity of patients admitted to hospitals steadily increased and caused
an increase in the demand for critical care beds. With the increased
demand and decreased availability of critical care beds, patients were
often transferred from critical care units while still requiring an
increased level of nursing care and vigilance. Patients admitted to
critical care units five to ten years ago are now routinely admitted to
progressive care.
Progressive care is the term the American Association of Critical‐Care
Nurses (AACN) uses to collectively describe areas that are also referred
to as Intermediate Care Units, Direct Observation Units, Step‐down
Units, Telemetry Units, or Transitional Care Units as well as to define a
specific level of patient care.
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6. BENEFITS OF PPC - Patients
The patient receives the specialized care.
The patients who are not critically ill are not deprived
of nursing and medical attention.
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7. BENEFITS OF PPC - Physician
The physician is given a greater assurance that his
patient is receiving a high quality nursing care.
Emergency treatment if necessary is in the immediate
vicinity
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8. BENEFITS OF PPC - Nurses
The nurse makes an effective use of her special
capabilities.
The problem of providing services by the nurses to
critically ill patient is reduced when the patients are
divided to various groups according to the degree of
illness.
It helps the nurses to plan the nursing care for the
patients better as the needs are of almost same degree
in each unit.
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9. BENEFITS OF PPC - Hospital
The beds, physical facilities, supplies and funds
available may be used efficiently.
Improves public image of the hospital in community.
Home care program as a part of PPC helps the hospital
to coordinate its activities with the community health
and social services.
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10. STAGES OF PROGRESSIVE PATIENT
CARE
1.
Intensive care,
2. Intermediate care, and
3. Minimal care.
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11. INTENSIVE CARE UNIT
Type of ICU : Generalized ICU
Specialized ICU
Type of Patients : Any patient in a serious condition who has the slightest
chance of recovery.
It is desirable not to admit patients here who are in the
terminal stage of disease.
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12. INTENSIVE CARE UNIT
Equipments:
Sound-proofing and Air Conditioning.
Centrally Placed Nurses’ Station.
Sterile Equipments like Trays etc.
Piped Oxygen and Piped Suction Apparatus.
Multi-parameter Monitors.
ICU Layouts:
Patients Area
Ancillary Area
Auxiliary Area
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14. INTERMEDIATE CARE UNIT
For Moderately ill Patients or Palliative Care.
May also have patients transferred from ICU.
It accommodates 60 – 70% of total hospitalized
patients.
A large number of patients are admitted and
discharged directly from this unit.
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15. INTERMEDIATE CARE UNIT
Intermediate Care Layout:
Bed Arrangement – Single, Double and 4-6 beds in a
room.
Ancillary Area
Nurses’ Station
Clean Room
Treatment Room, etc.
Supportive Area, like:
Clinical Teaching Room
Side Laboratory
Doctors’ Room, etc.
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16. MINIMAL CARE UNIT
Can be classified into
Self Care
Long Term Care
Home Care
Ambulatory Care
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17. MINIMAL CARE UNIT – Self Care
For Ambulant and Self Sufficient Patients.
Primarily for Supervisory or Health Education
Purpose.
More of Home Like Environment as patients for
diagnostic procedures, special treatments (like
radiotherapy) or preparation for major surgery are
admitted.
Helps in easy transition of Patient between Hospital &
Home environment.
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18. MINIMAL C.U. – Long Term Care
For Restorative or Rehabilitative care.
When care is required for a Prolonged Period.
Nurses’ Role :
Serves as administrator.
Coordinates care provided by others.
Provides direct care
Makes referrals.
Teaches patient and family.
Plans, implements and evaluates plan of care.
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19. MINIMAL C.U. – Home Care
For Preventive and Promotive Care of the Community.
Hospital based Home Care programs for patients can best
be cared at home with extended services from the Hospital.
Nurses’ Role:
Assesses home environment and patient.
Develops relationship based on mutual trust.
Provides direct care.
Plans, implements and evaluates plan of care.
Makes referrals.
Teaches patient and family and provide support to them.
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20. MINIMAL C.U. – Ambulatory Care
Care of the ambulatory patient requiring diagnostic,
curative, preventive and rehabilitative services.
Categories:
General Outpatient
Referred Outpatient
Emergency Outpatient
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21. Steps for Introduction of PPC
1.
2.
3.
4.
5.
6.
7.
8.
9.
10.
Familiarity with the PPC
Development of Teamwork
Evaluation of Needs
Orient Staff
Estimation of Costs
Formulation of Policies
Provide Flexibility
Adequate Staffing
Instruct Patients
Inform or Communicate Public
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