2. OBJECTIVE OF THE COURSE
This course is designed to enable the
student to understand the principles of
nursing and apply basic nursing skills in
patient management
3. OUTLINE
History of nursing
Nursing process-plan of
care.
Monitoring and
evaluation;
Infection control
practices-aseptic
techniques, barrier
nursing,
Specimen collection,
storage and
transportation;
Admissions and discharge
procedures,
Care of equipment and
supplies, care of the dying
and the dead;
Nurse clinician
relationship
4. DEFINITION
Nurse - is a word derived from Latin ‘nutrix’
meaning – to nourish.
Nurse therefore was described as a person who
nourishes, fosters, protect a patient.
Nursing - is a profession within the health care
sector focused on the care of individuals, families,
communities so they may attain, maintain, or
recover optimal health and quality of life.
5. Historical background
One of the oldest practice. It was not considered
a profession, most times people mainly males
would be made to take care of the patient
during and after wars. Their roles in patient care
was social norms.
The following civilization are recorded to have
developed orders of nursing practice.
6. EGYPTIANS
Settled along River Nile in 18th Century
They developed common planning that helped to
avoid health related problems I. e. hygiene and
sanitation.
They developed the house of death and art and
embalming (preparation of dead bodies)
They used some of these days’ modern implements
to care for their sick people.
7. BABYLONIANS.
Believed sickness was a punishment from
sinning or displeasing God.
They developed some surgeons who used
crude instruments
They were fond of number 7 which is still
superstition in some countries till today.
Represent fullness of life (4 physical and 3
spiritual) symbol of eternal life.
8. CHINA
Remembered of worshipping gods and
emphasis for places for healthy bodies.
Introduced drugs from a tree to treat
respiratory problems.
Invented diagnosis theory method.
9. INDIVIDUALS AND NURSING
Women took Centre in providing nursing care in
different situations, the women religious
leadership were mainly in titles of deaconess.
10. PHOEBE
A Roman lady.
Was a visiting nurse.
Was referred as 1st deaconess.
She carried Paul’s letter, cared for him and
many others.
She was responsible for feeding the hungry,
caring for the prisoners, sick, shelters, burying
the dead.
11. DORCAS
Position of deaconess.
Provided old women with clothing and
blankets.
An elderly woman who looked after the sick.
12. ST MARCELLA.
Established the 1st monastery (religious home)
for women in her beautiful home which the
first nurse studied. St Jerome interpreted Bible
here – spiritual passage.
Fled her home to a nearby church where she
died.
13. FABIOLA
From a great wealthy family in Rome.
Divorced and remarried 2nd husband.
She became a Christian. And committed to
Christian life.
Started charity after death of 2nd husband
died.
Build 1st public hospital in Rome in 380 AD.
Died in AD 399.
14. ST. PAULA
Scholar of St Marcella’s school.
Wealthy and learned.
Assisted St Jerome in translation of prophets’
writings.
Devoted public hospitals for the pilgrims
Built large hospitals that have remained in Jerusalem.
Some credit her as the first teacher of nursing.
15. BEGINNING OF CHANGE.
In 1500 AD Spanish and Portuguese started travelling over the
world.
1st hospital immaculate Mission colleges were founded in
1524.
Many activities about medical discoveries took place.
British father of medicine, invented blood circulation/
described pathology.
Catholic nuns established school of Morden nursing called
kaisorswarth where Florence Nightingale the founder of
modern nursing studied for three years.
16. FLORENCE NIGHTINGALE.
Born May 12th 1820. 2nd born in a wealthy family.
Named after town of birth.
Well educated, cultured, and wanted to be a nurse.
She is the founder of modern nursing a career that is
respected to date.
She modified a systematic way of identifying patient
problem and solving them. The Nursing process and
other fundermental nursing skills
17. Nursing skills
Nursing skills used in care of patients include
The nursing process.
Infection prevention
Admissions and discharges
Equipment and supplies
Specimen handling.
18. THE NURSING PROCESS
It a systematic way of examining a patient with
view to providing interventions that would
lead you to solving patient’s problems.
Each individual patients has different nursing
care approach.
19. COMPONENTS OF NURSING PROCESS
Assessment. Checking for the needs of the
patient. New intervention or ongoing
Diagnosis. Identifying the a problem.
Planning. Guide to care to the patient. What
you want to do. Appropriate scheming of
planning.
20. CT’S
Implementation. Do actual care. Conduct what
was planned. Eg bed making, wound dressing.
Implement with priority.
Evaluation. Check if you have carried out your
nursing process, completed or refreshed, the
ultimate condition of the patient.
21. CT’S
Documentation. Work or procedure not
documented is no activity done. This remains
as a record. Legal, guide, for team work, moral
for the patient. Record findings and all the
processes.
22. 2. INFCTION PREVENTION AND
CONTROL
Infection prevention and control? Is Managing
the infection process of
Removal of the patient from the site of
infection.
Stop entry or spread of the pathogen into the
patient.
Contain the level of the infection in the
patient. Remove the infection.
23. Methods of infection control in
nursing.
Barrier and reverse barrier nursing. Isolating
patients with infectious disease and isolating
patients with low immunity from other owing to
ease of getting infected
Protective gears – Equipment for protection
against infection e. g. gloves, apron, Gumboots,
Goggles, mask, caps e.t.c.
Aseptic technique. use of sterile item in sterile
procedures.
24. Ct’s
Disinfection – use of chemicals for infection
control/prevention. Bactericidal or bacteriostatic.
Refuse aggregation Is a methods of refuse
separation and disposal a cording to how infectious
they are.
Avoid environmental- local or general hazards these
are environment that promote transfer of microbes.
Practice high level of sanitation
30. Ct’s
Tissues/Biopsy.
Cells- smears. Eg Blood smear or Pap smears.
Each specimen type has its specific method of
collection and container.
31. Principle of sample collection
1. Blood chemistry is not uniform throughout
the day
2. Correct collection and accuracy.
3. Labelling.
4. Correct storage.
5. Correct transportation and accuracy.
6. Self safety and disposal.
32. 4. ADMISSIONS AND DISCHARGE
PROCEDURES.
Admissions - This is based on the patient
whether
Ambulant,
Non-ambulant patients.
Supported,
Wheelchair
35. 1. Assessment
Areas of assessment includes;
1. The physiological state of the patient - tis is to
determine if the patient can tolerate admission
procedure or require emergency interventions an
optimization
2. Number of patients companions – to determine
enough space for seating and comfort.
3. Provisional diagnosis ( impression) – to determine
the type of room and bed to be assigned for the
patient.
36. 2. Planning
Areas of planning includes;
Self – Getting yourself ready to receive a new patient, hand
washing
Patient – Provide the patient and relative seats for comfort.
Explain the admission procedure ( requirement, no of ct’s,
their role and your role)
Equipment and supplies – Arranging admission items in a
trolley ready for use
Environment – Include room prepation to receive the patient
( well li room clean uniform, extra seat (s) resuscitative
apparatus if required , oxygen if required)
37. 3. Implementation
Is the actual enrolment of the new patient in the
ward which include;
Taking the patient to the bed, provide uniform,
and other utilities
Assess the patient using a nursing process
Inspect valuables and identify the ones to be
taken back home
be clear the number of relatives allowed to
remain if need be and ensure their comfort.
38. CT’S
Label, make list of items that must remain in
ward and store appropriately.
Introduce the patient to thither staff and
patients.
Ensure the patient takes bathe if able or assist
where necessary.
Administer due medications/treatment in time.
39. CT’S
Inform physician for review.
Develop nursing care plan.
Dispose of used equipment and supplies
appropriately.
Keep trolley and trays used in the right place.
Continue with monitoring and observation as
required.
40. 4. Evaluation
On this, find out the following;
Patient interaction with other staff
Patient orientation in the ward premises.
If the assessment is adequate for diagnosis
and plan of care.
The feeling of the patient relative(s) about
patient admission
41. 5. Documentation.
Is recording of information obtained from the
patient
Information to be documented include
History obtained
Patient assessment finding
Treatment given
43. DISCHARGE
Is the nursing care services/ intervention during
release of a patient from in-patient hospital
Its process also includes;
Assessment.
Planning.
Implementation.
Evaluation.
Documentation.
44. 1. Assessment
The following assessed;
Medical state of the patient on discharge.
Level of readiness of the patient to go home.
Level of preparedness of patient
relatives/guardian.
Mode of travel and residence in relation to
patient condition.
45. 2. Planning
Self
Patient notes.
Review discharge procedure and legal implication.
Prepare information to share with patient.
Assemble medication to taken at home.
Patient
Confirm awareness of patient discharge details.
Assist in the process of clearing hospital bills.
Plan for their transport if required.
46. 3. Implementation.
Is the release of the patient from the hospital.
It includes;
Sharing information with the patient on treatment on
his/her health condition, treatment and follow up
care as appropriate.
Giving instruction on how to take and keep/store
drugs.
Educate the patient on side effects of drugs given
and how to manage them.
47. 4. Evaluation
Find out if the following;
Patient understanding on his role in home
treatment and strengthen.
Extent to which the patient Is ready for
discharge.
Evaluate discharge notes, medication and
follow up schedules.
48. 5. Documentation
This is record of discharge process activities.
It includes
State of the patient on discharge.
Treatment to continue at home ( drugs on
discharge).
Follow up schedule.
Time and date of discharge.
expected destination of the patient.
Companion of the patient and relationship.
49. EQUIPMENT AND SUPPLY.
Requisition process and documents
Storage.
Stock taking.
Issues. Bin card,
Hand over.
Documentation.
50. CARE OF THE DYING.
Resuscitation - Emergency drugs and equipment.
Certification of the dead - Done by physician.
Dead before arrivals.
Last offices - Care of dead bodies
Transportation – ferrying dead bodies from the
ward to mortuary for Storage.
51. Nurse and clinician relationship.
Roles overlap.
Respect of one’s presence and opinion.
Collective responsibility to one another.
Both are for the patients.
Avoid arguments and bickering near patients.
Use educative and promotional languages near the
patients.
The nurse-clinician relationship should not be a threat
to the patient.
