This document discusses restraints used in healthcare settings. It defines restraints as intentional restrictions of voluntary movement or behavior. Restraints are used to ensure safety during exams/procedures, protect from injury, and maintain prescribed positions. They include physical, environmental, and chemical methods. The document outlines principles of restraint use, types of restraints, risks, guidelines, and the nurse's role in monitoring patients and ensuring comfort, safety, and proper documentation when restraints are employed.
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Temperature, pulse, respiration, blood pressure (BP), and oxygen saturation, are measurements that indicate a person’s hemodynamic status. These are the five vital signs most frequently obtained by health care practitioners (Perry, Potter, & Ostendorf, 2014). Vital signs will potentially reveal sudden changes in a patient’s condition and will also measure changes that occur progressively over time. A difference between patients’ normal baseline vital signs and their present vital signs may indicate the need for intervention (Perry et al., 2014). Checklist 15 outlines the steps to take when checking vital signs.
if you like this kindly give your comment and share to others for a education purpose. and follow to my account on slide share to know the update. i tried to give the all information in this slide in detailed. in hope its helpful for you all.
Temperature, pulse, respiration, blood pressure (BP), and oxygen saturation, are measurements that indicate a person’s hemodynamic status. These are the five vital signs most frequently obtained by health care practitioners (Perry, Potter, & Ostendorf, 2014). Vital signs will potentially reveal sudden changes in a patient’s condition and will also measure changes that occur progressively over time. A difference between patients’ normal baseline vital signs and their present vital signs may indicate the need for intervention (Perry et al., 2014). Checklist 15 outlines the steps to take when checking vital signs.
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Palliative care applicable to all serious health related suffering.
Palliative care is the active total care applicable from the time of diagnosis, aimed at improving the quality of life of patients and their families facing serious life limiting illness, through the prevention and relief of suffering from pain and other physical disability.
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This content provides an overview of preventive pediatrics. It defines preventive pediatrics as preventing disease and promoting children's physical, mental, and social well-being to achieve positive health. It discusses antenatal, postnatal, and social preventive pediatrics. It also covers various child health programs like immunization, breastfeeding, ICDS, and the roles of organizations like WHO, UNICEF, and nurses in preventive pediatrics.
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Growing Prevalence of Lifestyle Diseases
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Pediatric nurses play a vital role in the health and well-being of children. Their responsibilities are wide-ranging, and their objectives can be categorized into several key areas:
1. Direct Patient Care:
Objective: Provide comprehensive and compassionate care to infants, children, and adolescents in various healthcare settings (hospitals, clinics, etc.).
This includes tasks like:
Monitoring vital signs and physical condition.
Administering medications and treatments.
Performing procedures as directed by doctors.
Assisting with daily living activities (bathing, feeding).
Providing emotional support and pain management.
2. Health Promotion and Education:
Objective: Promote healthy behaviors and educate children, families, and communities about preventive healthcare.
This includes tasks like:
Administering vaccinations.
Providing education on nutrition, hygiene, and development.
Offering breastfeeding and childbirth support.
Counseling families on safety and injury prevention.
3. Collaboration and Advocacy:
Objective: Collaborate effectively with doctors, social workers, therapists, and other healthcare professionals to ensure coordinated care for children.
Objective: Advocate for the rights and best interests of their patients, especially when children cannot speak for themselves.
This includes tasks like:
Communicating effectively with healthcare teams.
Identifying and addressing potential risks to child welfare.
Educating families about their child's condition and treatment options.
4. Professional Development and Research:
Objective: Stay up-to-date on the latest advancements in pediatric healthcare through continuing education and research.
Objective: Contribute to improving the quality of care for children by participating in research initiatives.
This includes tasks like:
Attending workshops and conferences on pediatric nursing.
Participating in clinical trials related to child health.
Implementing evidence-based practices into their daily routines.
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Stewardship is the act of taking good care of something.
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
WHO launched the Global Antimicrobial Resistance and Use Surveillance System (GLASS) in 2015 to fill knowledge gaps and inform strategies at all levels.
ACCORDING TO apic.org,
Antimicrobial stewardship is a coordinated program that promotes the appropriate use of antimicrobials (including antibiotics), improves patient outcomes, reduces microbial resistance, and decreases the spread of infections caused by multidrug-resistant organisms.
ACCORDING TO pewtrusts.org,
Antibiotic stewardship refers to efforts in doctors’ offices, hospitals, long term care facilities, and other health care settings to ensure that antibiotics are used only when necessary and appropriate
According to WHO,
Antimicrobial stewardship is a systematic approach to educate and support health care professionals to follow evidence-based guidelines for prescribing and administering antimicrobials
In 1996, John McGowan and Dale Gerding first applied the term antimicrobial stewardship, where they suggested a causal association between antimicrobial agent use and resistance. They also focused on the urgency of large-scale controlled trials of antimicrobial-use regulation employing sophisticated epidemiologic methods, molecular typing, and precise resistance mechanism analysis.
Antimicrobial Stewardship(AMS) refers to the optimal selection, dosing, and duration of antimicrobial treatment resulting in the best clinical outcome with minimal side effects to the patients and minimal impact on subsequent resistance.
According to the 2019 report, in the US, more than 2.8 million antibiotic-resistant infections occur each year, and more than 35000 people die. In addition to this, it also mentioned that 223,900 cases of Clostridoides difficile occurred in 2017, of which 12800 people died. The report did not include viruses or parasites
VISION
Being proactive
Supporting optimal animal and human health
Exploring ways to reduce overall use of antimicrobials
Using the drugs that prevent and treat disease by killing microscopic organisms in a responsible way
GOAL
to prevent the generation and spread of antimicrobial resistance (AMR). Doing so will preserve the effectiveness of these drugs in animals and humans for years to come.
being to preserve human and animal health and the effectiveness of antimicrobial medications.
to implement a multidisciplinary approach in assembling a stewardship team to include an infectious disease physician, a clinical pharmacist with infectious diseases training, infection preventionist, and a close collaboration with the staff in the clinical microbiology laboratory
to prevent antimicrobial overuse, misuse and abuse.
to minimize the developme
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One of the most developed cities of India, the city of Chennai is the capital of Tamilnadu and many people from different parts of India come here to earn their bread and butter. Being a metropolitan, the city is filled with towering building and beaches but the sad part as with almost every Indian city
CRISPR-Cas9, a revolutionary gene-editing tool, holds immense potential to reshape medicine, agriculture, and our understanding of life. But like any powerful tool, it comes with ethical considerations.
Unveiling CRISPR: This naturally occurring bacterial defense system (crRNA & Cas9 protein) fights viruses. Scientists repurposed it for precise gene editing (correction, deletion, insertion) by targeting specific DNA sequences.
The Promise: CRISPR offers exciting possibilities:
Gene Therapy: Correcting genetic diseases like cystic fibrosis.
Agriculture: Engineering crops resistant to pests and harsh environments.
Research: Studying gene function to unlock new knowledge.
The Peril: Ethical concerns demand attention:
Off-target Effects: Unintended DNA edits can have unforeseen consequences.
Eugenics: Misusing CRISPR for designer babies raises social and ethical questions.
Equity: High costs could limit access to this potentially life-saving technology.
The Path Forward: Responsible development is crucial:
International Collaboration: Clear guidelines are needed for research and human trials.
Public Education: Open discussions ensure informed decisions about CRISPR.
Prioritize Safety and Ethics: Safety and ethical principles must be paramount.
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2. OUT LINE
Definition
Purpose
Indication
General Principles
Types of restraint
Risk and side-effect of restraint use
Restraint guideline
Role of Nurse
3. DEFINITIONS
• Restraint is defined as ‘the intentional restriction
of a person’s voluntary movement or behavior.
(Counsel and Care UK, 2002)
• Restraints are physical, chemical or
environmental measures used to control the
physical or behavioral activity of person or a
portion of his/ her body.
4. PURPOSE
• To carry out the physical examination.
• To provide safety.
• To protect from injury.
• To complete the diagnostic and therapeutic
procedures.
• To maintain the patient in prescribed position
5. INDICATIONS
• Displaying behavior that is putting themselves at risk
of harm
• Displaying behavior that is putting others at risk of
harm
• Requiring treatment by a legal order, for example ,
under the Mental Health Act 2007
• Requiring urgent life-saving treatment
• Needing to be maintained in secure settings
6. GENERAL PRINCPILES
• Should be selected to reduce client’s movement
only as much as necessary.
• Should carefully explain type of restraint and
reason for its use.
• Should not interfere with treatment.
• Bony prominences should be padded before
applying it.
• Always select the safe and appropriate restraint.
7. PRINCIPLES CONTD..
• Restraint should not be too tight; it should not
interfere with the normal circulation.
• Restraint should demonstrate to gain the
cooperation and reduce the anxiety.
• Always maintain comfort and maintain body
alignment.
• Should be changed when they become soiled or
damp.
• Should be secure away from a clients reach.
8. • Should be attached to bed frame not to side rails.
• Change the side to prevent pressure sore
• Observe the restraint every 20-30 minutes to prevent
any complications.
• Should be removed a minimum of every 2 hrs.
• Do the recording and reporting properly.
PRINCIPLES CONTD..
10. PHYSICAL RESTRAINT
Physical restraint is anything near or on the body
which limits a client’s movement. This may be
attached to a person’s body or create physical
barriers.
E.g. table fixed to a chair or a bed rail that cannot
be opened by a client
13. CHEMICAL RESTRAINT
Chemical restraint are any form
of psychoactive medication used
not to treat illness, but to
intentionally inhibit a particular
behavior or movement.
14. TYPES OF PHYSICAL
RESTRAINT
1. Mummy restraint
2. Elbow and knee
restraint
3. Extremity restraint
4. Abdominal restraint
5. Jacket restraint
6. Mitten or finger
restraint
7. Crib net restraint
8. Safety belt
9. Slide rails and splints
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19.
20.
21.
22.
23.
24.
25.
26. POTENTIAL RISKS AND SIDE
EFFECTS OF RESTRAINT USE
Psychological /Emotional
• Increased agitation & hostility.
• Feelings of humiliation, loss of dignity.
• Increased confusion.
• Fear.
27. •Pressure ulcers, skin trauma.
•Decreased muscle tone, strength, endurance.
•Contractures, loss of balance & Dislocations/
fracture.
•Reduced heart and lung capacity.
•Physical discomfort, increased pain.
•Increased constipation, increased risk of fecal
impaction.
PHYSICAL:
28. •Increased constipation, increased risk of fecal
impaction.
•Increased incontinence and urinary stasis.
•Obstructed and restricted circulation.
•Reduced appetite, Dehydration.
•Impaired Circulation.
•Death.
Physical Continue:-
29. RESTRAINT GUIDELINES
• Use only after written order by the physician, unless emergency
situation occurs.
• Patient is reassessed every 24 hours for continued need for
restraint.
• New order is required after 24 hours.
• No standing order allowed.
• Physician and nurse must document in their notes the indication for
restraint.
• Type of restraint to be used.
• The projected time restraint is to be employed.
30. ROLE OF NURSE
• Check for circulation, condition of
limbs.
• Attention should be given to
patient’s need including hydration,
elimination and nutrition.
• Vital signs.
• Follows instructions, directions.
• Calm, in control.
31. • Asks for assistance.
• Monitor signs for injury.
• Maintain comfort of the patient.
• Readiness for discontinuation of restraint.
• Release the patient, turn and position frequently.
Role of nurse continue…
32. • Follow institute a trial of restraint release.
• Maintain hydration and nutritional need.
• Proper reporting and documentation.
Role of nurse continue…