patient safety and comfort

1. Patient safety and comfort
By Terefe k (RN, Bsc.N***)

2. General objective:
At the end of the chapter the leaner will be
able to
• Identify condition needs utilization of comfort
and safety device
• Demonstrate how to apply sandbag, cotton
and air ring, splint and bed cradles
• Apply safety precaution when applying
sandbag, cotton and air ring, splint and bed
cradle

3. Safety and Comfort devices
Safety
• It is to protect oneself from harm.
e.g. mechanical injury.
• Safety is responsibility of everyone but this may not
be applicable in the health care environment
because of different reasons such as
 Altered level of consciousness
 Loss of ability to move
 Loss of ability to think clearly

4. Cont…
Comfort
Comfort is a feeling of physical and mental
well being freedom from worry, fears or pain.
Are the mechanical devices to promote
comfort to the patient

5. Causes of discomfort:
1. Pain
2. Restriction of movements due to weakness
3. Wrinkled, soiled and wet sheet
4. Delayed or inadequate attention to meet the personal needs.
5. Lack of exercise
6. Temperature extremes
7. Too bright lights and glares
8. Fear and anxiety due to illness
9. Insecurity feeling
10. Lack of sleep
11. uncomfortable position
12. indigestion and irregular bowl movements

6. Purpose of patient safety and comfort
To relieve pain and worry
To provide position of comfort and ease
To place patient in comfortable bed.
To provide proper atmosphere to increase the
moral of patient during illness.
To adjust bed and other apparatus in the
proper manner
To give maximum rest and sleep during illness

7. Applying cotton rings
Objectives: - At the end of this lesson, you will be
able to:-
Define cotton rings
List the Purpose of cotton rings application
Describe the indications of cotton rings application
Demonstrate application of cotton rings
Definition: - Cotton rings are small circle of
cotton rolled with bandage or gauze with a hole
in the middle.

8. Cont…

9. Cont…
Purpose of cotton ring
Used to lift the hip from bed to prevent bed sores
or pressure sore or decubitus ulcer.
To relieve pressure from small bony prominent
areas such as heel, elbow, occipital.
Improves the circulation.
Indication
– Bed ridden patients
– Unconscious patients.

10. Cont…
Size: - Based on the body areas we are going to
apply. The size differs from small to medium
size of bony prominent areas.
Equipments
1. Cotton
2. Bandage
3. Chart showing human body prominent areas

11. Procedure
1. Explain the procedure to the patient
2. Wash hands
3. Assemble the necessary equipment
4. Prepare cotton ring based on the size of body to
be applied.
5. Place cotton ring under the bony prominence
such as elbow and heel
6. Wash hands
7. Document procedure

12. Applying foot – board
Objectives: - At the end of this lesson, U will
be able to:-
1. Explain Foot board
2. List the purpose of foot board application
3. State the indications of foot board application
4. Perform application of foot board
Definition: - A footboard is a flat plane often
made of wood or plastic placed at the foot of
the bed.

13. Cont…

14. Cont…
Purpose
• To provide support for the client’s feet and
maintain a natural foot position.
• To keep the top bed covers of the client’s felt
relieving pressure.
• To make the foot comfortable/prevent foot
drop
• To prevent sagging of patient in to bed.

15. Cont…
Indication
– Unconscious patients
– Patient with fracture
– Bedridden patients
Types of foot board:
– Foot boards are often made in an L shaped – so that
the base of L fits under foot of the mattress.
– Some foot boards can moved along the mattress to
adjust to the clients foot drop from their normal right
angle.

16. Cont…
Foot drop:-is a condition of plantar flexions or a
muscular which occurs from poor foot or leg
alignment.
Cause –when patient in bed for long time with
the top sheet and blanket are tightly tucked.

17. Cont…
Equipments
1. A firm pillow
2. Box of board
3. Cotton/sheet of cotton
4. Bandage

18. Applying pillows
Definition:-Pillows are used to give comfort,
support and to position patient properly.

19. Cont…
Pillows are placed
– Under the head
– Under the back
– Between the knees
– At the foot of the bed
– Under the arm

20. Cont…
Purpose:
– To elevate body part
– To support patient on side
– To prevent pressure on the skin
– To increase comfort
Necessary equipments
 Pillows
 Pillows case

21. Applying air rings
 Objectives:- at the end of this lesson leaner will be
able to:-
1. Explain air rings
2. Describe the purpose of air rings
3. State the indications of air ring application
4. Perform application of air ring
 Definition:
 Air rings are used to relieve pressure from the
buttock and other bony prominent areas.
 For application they should be filled with air and
covered with pillow case

22. Cont…

23. Cont…
Purpose
Used to lift the hip from bed to prevent bed
sores or pressure sore or decubitus ulcer.
To relieve pressure from small bony prominent
areas such as heel, elbow, occipital.
Improves the circulation.

24. Cont…
Indication
– Bed ridden patients
– Unconscious patients
Equipments:
1. Plastic air rings
2. Covering towel or pillow case
3. Chart showing body’s prominent areas

25. Procedure
1. Explain the procedure to the patient
2. Wash hands
3. Assemble the necessary equipment.
4. Support the appropriate site
5. Applying air ring to body prominent area.
6. Observe patient comfort status
7. Wash hands.
8. Document

26. Applying bed cradle
Definition
Bed cradle is sometimes called an Anderson
frame.
It is a device designed to keep the top bed
clothes off the feet, leg, abdomen and chest
of a client
Types
 There are several types of bed cradles; the
most commonly used is curved metal rod.

27. Cont…
27

28. Cont…
Purpose
• To keep top linen off the injured part of the body.
• To prevent the weight of the bedding from resting
on some part of the body.
• To apply heat in case of drying plaster casts.
• In case of electronic bed cradles are used to
supply the desired warm in the case of shock.
Indication
 Client with fracture or soft tissue injury.
 Client with burn
 Client with some skin lesions

29. Cont…
Equipments:
1. Bed cradle
2. Roll gauze/bandage
3. Small size blanket

30. Procedure
1. Explain the procedure to the patient
2. Wash hands
3. Assemble the necessary equipment.
4. Loosen and remove top linen.
5. However the cradle on to patients bed.
6. Secure it in place.
7. Wrap gauze roll around both sides of the cradle.
8. Cover the cradle with top linen
9. Wash hands.
10. Document

31. Adjusting side rails of the bed
Definition
 Adjustable full or half side rails are used on Hospital beds
and stretchers to prevent accidents
Types
 They can be of various shapes and sizes usually made of
metal
Position
 Side rails have two or three positions. These are high,
intermediate and low.
 The down or low positions are employed when a side rail is not
needed.
 The up or high side rail position is used when a client is in bed
and requires protection.

32. Cont…
Purpose
• Help weak patient turn independently
• Protects patient from falling out of bed

33. Cont…
Indication:
 For unconscious patient.
 For weak and unable to control his/her body
movement.
 For small children.
 For elderly patients
 Patient with seizure disorder
 Post operatively until the patient awake from
anesthesia ·
 When changing position.
 When making certain procedure

34. Cont…
Equipment: bed with side rails
Procedure
Explain the procedure to the patient
Wash hands
Assemble the necessary equipment.
Position the side rail to the needed height
Secure lock and it should be far from reaching by
the patient
Wash hands.
Document

35. Applying sand bag
Definition: Sand bags are canvas, rubber or plastic bags filled
with sand and sewed.
Purpose
To relive discomfort
Sand bags are used for supporting or immobilizing limbs
Used to support as in fracture bone
They should be covered with towel and placed on either
side of the limb
To prevent foot drop or wrist drop
To prevent contracture

36. Cont…
Indication
• Fractured limb
• Amputated limb.
Equipments:
 Bag
 Rope
 Sand
 Covering towel
 Weight scale
 Adhesive plaster for labeling

37. Procedure
1.Explain the procedure to the patient
2.Wash hands
3. Assemble the necessary equipment.
4. Positioning the patient
5. Apply the sand bags on the side of the area to
be supported.
9. Wash hands.
10. Document and report

38. Applying splint
Definition:
• splints are devices applied to the arms, legs, or trunk to
immobilize the injured part of the body when it is
needed.
Purpose
To prevent movement of injured part of the body.
To prevent further damage when transporting injured
patient.
To provide complete rest for injured part.
To relieve pain and discomfort and encourage healing.

39. Cont…
39

40. Cont…
Types of splint
 There are many varieties of splints available and they
can also be made locally from different material.
1. Wooden: straight pieces of woods of varying length
and width.
2. Metal: Splints made of a tin end of aluminum which
are molded to fit with natural curvature of the body
part
3. Wire: It can be quickly cut to required length and easily
bent to support a limb in desired position
4. Plaster (P.O.P):-Often used by surgeon

41. Cont…
Nursing consideration
• There are a number of important points to remember.
1. Choice:-The splint chosen should be sufficiently strong and
of suitable length and width.
2. Padding:-The splint should be covered with cotton wool to
prevent discomfort or damage.
3. Molding:-Choose one which is most suitable mould to fit
the natural curvature of the limb.
4. Fixation:-Splints must be fixed to the insured fracture limbs
by bandage placed above and below the injured part.
• Do not apply bandage directly on the injured part.

42. Cont…
Equipment
• Splints (wooden,metallic)
• Dressing material (if there is open wound)
• Glove
• Padding for splint (rolled bandage to cover the
splint)
• Elastic bandage or roll bandage (to hold the
splint in place)

43. Procedure
1.Explain the procedure to the patient
2.Wash hands
3. Assemble the necessary equipment.
4. Positioning the patient
5. First tie the bandage above the injured part
6. Joints must be immobilized above and below the
location of injury.
7. Wash hands.
8. Document and report

44. Cont…
Follow up phase:-
Observation:-Look for the following condition
Presence of adequate circulation
Presence of adequate pulsation
Presence of any color change
Presence of numbness and tingling
N.B:- Rings, bracelets and watch should be
removed

45. Appling fracture board
Objective: at the end of this lesson leaner will be able to:-
1. Explain Fracture board
2. Mention the purpose of fracture board
3. List the indications of fracture board
4. Perform application of fracture board
Purpose
• To maintain good body alignment
• To prevent bed from sagging.
• To support the injured part when the patient has
fractured spine, hips, lower limps.

46. Cont…
Equipment
1. Fracture board
2. Thin foam mattress
Procedure
1. Explain the procedure to the patient
2. Wash hands
3. Assemble the necessary equipment.
4. Positioning the patient
5. First tie the bandage above the injured part
6. Joints must be immobilized above and below the location of injury.
7. Wash hands.
8. Document and report

47. Applying back rest
• Back rest is used for elevating and supporting
the head and back of the patient
• When back rest is used for the patient is liable
to slip down to the foot of the bed, therefore
a foot board might be used.

48. Dear student , reading is the key
for all. So read more and more !!!
Thank you.