vulnerable patients

1. MANGEMENT OF
VULNERABLE
PATIENTS
-Nursing educators

2. Definition:
 A patient who is or may be for any reason unable to protect
and take care of him or herself. Such patients are prone to
various risks within the hospital, such as fall, injury, neglect,
abuse, medical errors and acquiring of infections. Vulnerable
patient requires special care.

3. List of vulnerable category:
 Elderly above 65 years.
 Children's below 12 years.
 Physically challenged .
 Mentally challenged Eg: Mental retardation.
 Psychiatric patients Eg: BPAD.
 Sensory organ impairment Eg: Deaf and Dump, blind.

4.  Patient under sedation and anesthesia.
 Pregnant women
 Patient on dialysis
 Patient receiving chemotherapy
 Terminally ill patient
 Semiconscious / unconscious patient / comatose patient.
 Patient on mechanical ventilation.
 Severe nutritional deficiency Eg: PEM
 Domestic violence
 Child abuse and sexual abuse.

5. Assessment:
 Head to foot assessment .
 Neurological assessment.
 Psychological and mental status examination.
 Nutritional assessment.
 Fall risk assessment.
 Assessment for suspected abuse .

6. General:
 History collection.
 Ability to meet activities of daily living.
 Medical and surgical information.

7. Care of vulnerable patient:
 Identify vulnerable patient.
 Ward orientation to be given Eg : Nursing station,
washrooms etc.,
 Place orange color wrist band for correct Identification.
 Place identification sticker for case sheets.
 Set a separate cubic in ward and place the patient near to
nursing station.
 Keep necessary items near to the patient. Eg: water, phone,
specs.

8.  Always attender should accompany with patient .
 Every 4th hourly patient to be examined.
 Frequent visit from the nursing staff every half an hour.
 Prompt attention and service shall be provided while
minimizing waiting time in OPD and Investigation areas.
 One separate counter to receive vulnerable patient and to guide
them to appropriate department.
 Reorientation for confused patient. Eg : orientation regarding
date, time, place, family members etc.,

9. Safety measures for
vulnerable patients:
 Calling bells should be placed near to the patient and washrooms.
 Grab bars to be placed in washrooms and staircase and
explanation to be given for patient and relatives.
 Anti skid mat, and floors for fall prevention.
 Check patient footwear and advice them to use non-slip footwear.
 Keep floor clean and it should be dry.
 Maintain adequate lighting (Day and Night).
 Remove unnecessary items from patient area.

10.  Always put Side rails on beds .
 Bed should be in low position.
 Provide foot stool while getting on and off to bed.
 Bed should be in lock.
 While transferring patient ensure that wheel chair and stretcher belt
is properly locked.
 Iron grill windows for psychiatry patients.
 Ramp for wheel chair and stretcher accessibility .
 While mopping keep caution board and explain to the patient that
they should not go if the caution board is on floor.

11. Wrist band for vulnerable
patient

12. Calling bells

13. Adequate lighting

14. Grab bars for washroom and stair
cases

15. Anti skid mat and floors

16. Non slip footwear

17. Bed with side rails

18. Wheel chair belt

19. Stretcher belt

20. Caution board while mopping

21. Ramp

22. Foot stool and low level bed

23. Separate counter for vulnerable
patients

24. Note:
 The hospital doesn’t encourage the admission falling in the
above vulnerable categories, without an attendant.
 Mentally challenged are not admitted in the hospital, if their
legal guardian does not accompany them.
 Emergency treatment can be given, after try to locate his/her
family members or the responsible attendant.

25. Thank you