Unit K: Nursing Skills

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Summer 2000 K.
1

Unit K: Nursing Skills



Program Area
:

Health Occupations Education


Course Title
:


Allied Health Sciences II



Number
: 7212


Unit Title
:


Nursing Skills


Suggested

Time for

Instruction
:


24 hours


Course Percent
:

9%


Unit Evaluation
:

66% Cognitive and
34% Performance





-------------------------------------------------------------------------------


Competency
:


2H11

Apply patient care skills in a clinical setting.


Specific Objectives:



2H11.01

Position, turn and transfer patients.



2H11.02


Make a
bed.


2H11.03


Administer personal care and apply restraints.








Summer 2000 K.
2

Unit K Master Outline


Unit K: Nursing Skills




2H11

Apply patient care skills in a clinical setting.


2H11.01

Position, turn and transfer patients.


A.

Normal body alignment

1.

Decubitus ulce
r

2.

Contracture

3.

Supports

B.

Dangling

C.

Mechanical lifts

D.

Moving the patient up in bed

E.

Turning the patient

F.

Transferring to a chair or wheelchair *

G.

Transferring to stretcher (conscious patient) *

H.

Transferring to a stretcher (unconscious patient)


2H11.02

Make a bed.


A.

Principles of bedmaking

B.

Making a closed bed

C.

Making an occupied bed *

D.

Opening a closed bed

E.

Placing a bed cradle


2H11.03

Administer personal care and apply restraints.


A.

Principles of administering personal hygiene

B.

Providing routine oral hygiene

C.

Cleaning d
entures

D.

Giving special mouth care

E.

Giving a complete bed bath (pt. with IV) *

F.

Measuring and recording intake and output

G.

Feeding a patient

H.

Assisting with a bedpan *

I.

Assisting with a urinal

J.

Providing catheter and urinary drainage unit care

K.

Collecting stool an
d urine specimens

1.

Routine urine

2.

Clean
-
catch/midstream voided

3.

24
-
hour urine

4.

Routine stool

5.

Stool for occult blood

L.

Principles of applying restraints

1.

OBRA legislation

2.

Conditions that may necessitate the use of restraints

3.

Kinds of restraints

4.

Safety consideratio
ns

5.

Complications

6.

Applying limb and jacket restraints *


Summer 2000 K.
3

Unit K



Nursing Skills


Competency 2H11:

Apply patient care skills in a clinical setting.


Materials/Resources


Simmers, Louise.
Diversified Health Occupations
. Delmar Publishers, 4
th

edition.


HOS
A Handbook, Section B
. Health Occupations Students of America, Flower Mound, Texas,
Latest Edition.





Here is a web site you may want to use as a resource for nursing skills:


North Carolina Board of Nursing
http://ww
w.ncbon.com/




















Teaching/Learning Indicators:

The following symbols are used to indicate specific
skills/areas required in the instructional activity.





Reading





Social Studies




Writing





Science




Math



The Arts




Health professional/parent/community involvement




Summer 2000 K.
4

Objective 2H11.01

Position, turn and transfer patients.


A.

Normal body alignment

1.

Decubitus ulcer

2.

Contracture

3.

Supports

B.

Dangling

C.

Mecha
nical lifts

D.

Moving the patient up in bed

E.

Turning the patient

F.

Transferring to a chair or wheelchair *

G.

Transferring to stretcher (conscious patient) *

H.

Transferring to a stretcher (unconscious patient)


Teaching/Learning Activities




Cognitive

Have students li
sten to a teacher prepared lecture using overheads or PowerPoint on
Positioning, Turning and Transferring patients. The teacher may wish to demonstrate
skills as she/he progresses in the lesson.




Employability Skills


Invite an Enterstomal Therapist to class to discuss the importance of skin care and
treatments for decubitus ulcers. Ask if they might have some slides or visuals to include
in their presentation.


Plan a field trip to a local long
-
term care facility.
Arrange an inservice to be done by
nursing home personal on the use of mechanical lifts. If possible, let students practice on
a mechanical lift.




Critical Thinking

Divide the students into groups of three to four students. Give students the followin
g
problem and set a certain time limit for them to come up with a solution (30 to 40
minutes.) At the end of the time limit, have the students present their solution to the
class.


Tell the students that their neighbor’s aunt, whom has suffered a severe
stroke, is coming
home from the hospital tomorrow. The stroke has left her with left side paralysis and
aphasia. The neighbor does not have a medical background and is very concerned about
the care her aunt will need. Because you are in a health occupat
ion class, your mother
has volunteered you to go next door and teach your neighbor how to care for her aunt.
You realize she will not be able to remember everything you say, so you create some
visuals for her. What do you need to make sure your neighbor

knows and how will you
help her remember it?




Cognitive

Use the worksheet on Positioning, Turning, Moving and Transferring Patients
(Appendix
2H1101A)

as a review, homework assignment or quiz.


Summer 2000 K.
5

Objective 2H11.01

Position, turn and transfer patients.


Te
aching/Learning Activities (continued)




Technology


Tell your students that a local nursing home has contacted your school about making
training videos concerning positioning, turning and transferring patients. Have the
students create the video and then see if they can show it at a local long
-
term care
facility.




Employability Skills

Students are to demonstrate transferring a patient to a chair or wheelchair
(Appendix
2H11.01B)

and transferring a conscious patient to a stretcher
(Appendix 2H11.01C).




HOSA

Using the HOSA guidelines for the Nursing Assista
nt Event, have students work in
groups of three and demonstrate how to transfer a patient to the chair. Have one student
be the nursing assistant, one be the patient, and one be the judge. They can alternate
these roles.




Special Needs

Each student will
reach the highest level of mastery in the least restrictive environment as
recommended in the student’s IEP.



























Summer 2000 K.
6

Objective 2H11.02

Make a bed.


A.

Principles of bedmaking

B.

Making a closed bed

C.

Making an occupied bed*

D.

Opening a closed bed

E.

Pl
acing a bed cradle

________________________________________________________________________

Teaching/Learning Activities




Cognitive


Have student read section 19:3, “Bedmaking” in
Diversified Health Occupations.

After
reading the information, have students complete the corresponding worksheet in the DHO
workbook.




Teamwork

Following a teacher demonstration, have students work in pair
s to practice making
occupied beds. One student can role
-
play the patient and also rate the student making the
bed using the rating sheet for making an occupied bed. (
Appendix 2H11.02A).




Critical Thinking


Using the story, ‘The Princess and the

Pea” as an example, have students create booklets
about how the skill of bedmaking relates to skin care and patient comfort. Share the best
stories with a local hospital or long
-
term care facility.




Technology

Have students view a nursing assistant vide
o about “Bedmaking in Health Care
Facilities.”




HOSA

Using the HOSA guidelines for the Nursing Assistant Event, have a “Bed
-
Making
Derby.” Have two to three student making beds at the same time. See which student can
finish fastest using correct proce
dures. Use the rating sheets in the Nursing Assistant
Event.




Special Needs

Each student will reach the highest level of mastery in the least restrictive environment as
recommended in the student’s IEP.












Summer 2000 K.
7

Objective 2H11.03

Administer personal c
are and apply restraints.


A.

Principles of administering personal hygiene

B.

Providing routine oral hygiene

C.

Cleaning dentures

D.

Giving special mouth care

E.

Giving a complete bed bath (pt with IV)*

F.

Measuring and recording intake and output

G.

Feeding a patient

H.

Assistin
g with a bedpan*

I.

Assisting with a urinal

J.

Providing catheter and urinary drainage unit care

K.

Collecting stool and urine specimens

1.

Routine urine

2.

Clean
-
catch/midstream voided

3.

24
-
hour urine

4.

Routine stool

5.

Stool for occult blood

L.

Principles of applying restraints

1.

OBRA legislation

2.

Condition that may necessitate the use of restraints

3.

Kinds of restraints

4.

Safety considerations

5.

Complications

6.

Applying limb and jacket restraints*

______________________________________________________________________________

Teaching / Lea
rning Activities






Cognitive

Have students listen to a teacher prepared lecture using overheads or PowerPoint on
personal care and applying restraints. The teacher may wish to demonstrate skills as
she/he progresses in the lesson.


Before and after the p
resentation, have students complete the worksheet “Social and
Ethical Issues Related to Bathing Patients”
(Appendix 2H11.03A)




Basic Skills


Have students listen to a teacher prepared lecture on ‘”Intake and Output” (Overhead
Transparency Masters). Following this lecture, have students complete “Calculating
Intake and Output.” (
Appendix 2H11.03B)


Have students keep a record of their person
al fluid intake for 3 days.




Cognitive

Review section 19:10, “Collecting Stool/Urine Specimens” in
Diversified Health
Occupations.
In pairs, have the students quiz each other on the content in this section.
Once students feel they have learned the inform
ation in this section, give them the
“Collecting Urine and Stool Specimens” worksheet for a quiz grade or homework
assignment. (
Appendix 2H11.03C)



Summer 2000 K.
8

Objective 2H11.03

Administer personal care and apply restraints.

__________________________________________
____________________________________

Teaching / Learning Activities (continued)




Teamwork

Following a teacher
-
led presentation on feeding patients (Overhead Transparency
Masters), have pairs of students practice feeding each other. Get food from the cafet
eria
or have students bring in foods such as Jell
-
O, soup, fruit, puddings, beverages, etc.

Note: Assign student that are role
-
playing the patient different disabilities such as
hemiplegia, visual impairments, etc..


Following the activity, have students
discuss the answer to the following question, “What
can a health care worker do to help make it easier for a patient to be fed?”




Teamwork

Divide the class into teams of two to four students. Have note cards prepared with the
different types of urine and
stool specimen that they may be asked to collect. Have each
group select one of the note cards.


Have the students role
-
play scenarios where they are instructing the patient about how to
collect the specimen. The teacher or the students may write these s
cenarios. Include
some challenges such as patients who do not speak English, patients who are incontinent,
babies who are not potty
-
trained, etc.






Teamwork


Divide students into three groups. Give each group a different scenario related to
restrain
ts (
Appendix 2H11.03D).

Allow students fifteen minutes to prepare than role
-
play their scenario for the class.




Employability Skills


Invite an administrator from a local long term care facility to class to discuss the changes
OBRA legislation has ma
ndated in the care of residents of long term
-
care facilities. Ask
them to be sure and address the role of restraints in their facilities. Also have them share
the educational / work requirements of the profession.




Employability Skills


Arrange for

students to shadow a nursing assistant as she does AM care for his / her
patients. Students can evaluate the nursing assistant’s care via a journal entry by using
the skills checklist for giving a complete bed bath.
(Appendix 2H11.03E).
Instruct
student
s to note both positive and negative things that they observed. Have the students
address this question: “Does anyone really suffer if a nursing assistant takes short cuts
with patient care?”


Summer 2000 K.
9

Objective 2H11.03

Administer personal care and apply restrain
ts.

______________________________________________________________________________

Teaching / Learning Activities (continued)




Technology

A great software program for these skills is “Patient Care Skills” by
Total Care
Programming, Inc.

This is a great pr
ogram that includes movie clips, clip art,
transparencies, application situations, and testing. You can obtain more information by
contacting their web site
http://www.totalcareprog.com

or email them at tcpinc

@total.careprog.com.




Employability Skills

Have students prove mastery of the following skills: Giving a Complete Bed Bath
(Appendix 2H11.03E),

Assisting with a Bedpan
(Appendix 2H11.03F),
and Applying
Restraints
(Appendix 2H11.03F).




HOSA



Using the

HOSA guidelines for researched persuasive speaking, have the students write a
paper and/or deliver a speech on the following topic: “Has the Nursing Home Reform
Legislation (OBRA ’87) resulted in better quality of care for the residents in long
-
term
care

facilities?”




Special Needs

Each student will reach the highest level of mastery in the least restrictive environment as
recommended in the student’s IEP.


Summer 2000 K.
10


Daily Lesson Plans


Unit H


Nursing Skills

Lessons:


16

Hours:


24 clock hours


Steps

Lesson #1

L
esson #2

Lesson #3

Focus and
Review

Have a picture of a very bad
decubitus ulcer. Ask students the
following question: “How could
positioning of patients prevented
this?”


Have students exchange papers
and grade “Positioning, Turning,
Moving, and Transfe
rring
Patients” in class.

Call out HOSA Bowl Questions
the students wrote during lesson
one and see if they can answer
them.




Statement of
Objectives

2H11.01 Position, turn and
transfer patients

2H11.01 Position, turn and
transfer
patients

2H11.01 Position, turn and
transfer patients

Teacher
Input

Discuss student answers to the
focus and review question.


Have students listen to a teacher
-
led presentation on body
alignment, decubitus ulcers, and
contractures.

Show a video on “Tran
sferring
Patients”
-

Mosby has a nursing
assistant video series

with this
type of video


Or

Invite a physical therapist to
demonstrate how to transfer
patients using correct body
mechanics.



Demonstrate how to transfer a
patient to a

chair or wheelchair.
Demonstrate how to transfer a
conscious patient to a stretcher.
After students have a change to
practice, complete skills check off.


Divide students into small groups
and to work on critical thinking
problem.

Guided
Practice

Have
students read the DHO
section on Positioning, Turning,
Moving, and Transferring Patients.


Have students write 5 HOSA
Bowl questions on this topic

Students working in teams of 2
-
3
students will perfect one of the
moving or transferring skills and
then demo
nstrate or role
-
play them
for the class. (
Could also do this
as a jigsaw)

Practice transferring patients to
chair or wheelchair. Practice
transferring patient to stretcher.


When not practicing skills, Have
students work in small groups on
the critical t
hinking problem.


Independent
Practice

Complete the “Positioning,
Turning, Moving, and
Transferring Patients” Worksheet

Give student the critical thinking
problem about their neighbor’s
aunt. Assign them to bring back
some written ideas to class the
next

day.

Have students read the DHO
sections on Bedmaking

Closure

Have students tell you one fact
they learned today and how they
will apply it to their clinical
practice.

Have students stand. Call out a
transferring skill and go around
the room having the
students tell
how the procedure is done with
each student telling the next step
in the sequence of the procedure.
Students must sit down if they get
it wrong. Last one standing gets a
reward

Teacher will make up some
scenarios related to positioning
and t
ransferring patients and have
students respond what they would
do and how they would do it.

Materials

Overheads and projector

DHO

Worksheet


Positioning, Turning,


Moving, and Transferring


Patients.

Certificate for guest speaker

Picture of Decubitus Ulcers


Video about “ Positioning and


Transferring Patients.”

Certificate for guest speaker

Note cards with positioning and


transferring skills on them

Critical Thinking Problem


Reward



DHO

“Transferring a Patien
t to Chair or


Wheelchair “ skill sheets

“Transferring a Patient to a


Stretcher” skill sheets

Critical Thinking Problem


Summer 2000 K.
11

Unit H:


Nursing Skills (Continued)


Steps

Lesson #4

Lesson #5

Lesson #6

Focus and
Review

In small groups stude
nts are to
present their solution to the critical
problem. Grade them using the
HOSA Creative Problem Criteria

Have students exchange papers
and grade the “Bedmaking”
Worksheet

Teacher made quiz on the first two
objectives. Have the students
exchange pa
pers and grade them.

Statement of
Objectives

2H11.02 Make a bed

2H11.02 Make a Bed

2H11.03 Administer personal care
and apply restrains

Teacher
Input

Show a nursing assistant video
about “Bedmaking.”


Teacher led presentation on
“bedmaking” (overheads i
n
appendix)


Demonstrate how to make an
occupied bed. After students have
a chance to practice, complete
skills check off.

Check off students on ‘Making an
Occupied Bed.”



Teacher led presentation on
“Personal Hygiene”


Teacher can demonstrate bathing a

patient, nail care, backrub, oral
hygiene and hair care.


Assign bath partners to practice
personal hygiene skills (
will be in
shorts and will just verbalize how

to do genital area
.). A cute way is
to have them draw a card and
match it with its mate su
ch as
washcloth and towel, comb and
brush, toothpaste and toothbrush.

Guided
Practice

Working in teams of two, students
will practice making an occupied
bed.

Practice making occupied beds

Students will complete the first
two columns of the K
-
W
-
L
activity
“Personal Hygiene
Procedures.”


Students will work on personal
hygiene material of skills software
package.


Students will practice personal
hygiene skills

Independent
Practice

Have students complete the
worksheet in the DHO workbook
about “Bedmaking.”

Students are to design and write a
booklet about the importance of
good bedmaking skills related to
the patient’s skin and health.


Have students make an occupied
bed at home following the steps
they have learned in class.

Have students read the DHO
sect
ions on “Administering
Personal Hygiene.”

Closure

Ask students to answer the
question


how important is
bedmaking to the patient’s health?

Have one student ask a question
related to bedmaking and choose
another student to answer it.

Tell students to bri
ng towels,
washcloth, soap, toothbrush,
toothpaste, and lotion to the next
class.

Ask students this question: Would
the patient really suffer any ill
effects if you took short cuts with
their personal care?

Materials

Overheads / projector

DHO Workbook



Bedmaking”

Bedmaking video

Occupied Bedmaking Skills


Sheets

2 flat sheet, pillowcases, draw


sheet, bedspread, laundry


bag.

Skill Sheets

Instructions about bedmaking


Booklets

2 flat sheet, pillowcases, draw

s
heet, bedspread, laundry bag.

Teacher Made Quiz

Patient Skills Software Package

Personal Hygiene Video

Towels, soap, bath thermometer,


washcloths, bath blanket,


lotion, toothbrush,


toothpaste, comb & brush.


nail

brush, patient gown,


bath basin, IV and tubing

Bed Bath Skill Sheets


Summer 2000 K.
12

Unit H:


Nursing Skills (Continued)


Steps

Lesson #7

Lesson #8

Lesson #9

Focus and
Review

Ask the students: “ How high to
you think patients would rate a
bath when it come
s to health care
procedures and why do you feel
this way?”

Ask students: Have you ever been
dehydrated and how did you feel?


Have you ever had too much fluid
in your body and how did that
make you feel?

Have students exchange papers
and grade the “Intake
and Output”
worksheet in class

Statement of
Objectives

2H11.03 Administer personal care
and apply restraints

2H11.03 Administer personal care
and apply restraints

2H11.03 Administer personal care
and apply restrains

Teacher
Input

Complete skills check of
f list for a
complete bedbath

Teacher
-
led presentation on intake
and output (overheads in the
appendix)


Demonstrate how to complete an
Intake and Output sheet


Set up some food and drink
situations (real or simulated0
along with some output situations.

Have students working teams,
measure these correctly.

Teacher

led presentation on
feeding patients (overheads in the
appendix)


Demonstrate how to feed a patient


Set up software related to patient
skills and feeding patients.


Prepare and bring to schoo
l some
foods that students might have to
feed to patients (Jell
-
O, soup,
applesauce, chicken, sandwiches,
juice, mashed potatoes, etc.) (
May
want to ask if students want to
bring in these items the day before.
You also can get foods in your
cafeteria.)

Guided
Practice

Practice the procedure for
complete bedbaths.


Have students that are not working
on their baths work in small
groups on making the video about
the importance of good skin care.

Students will solve intake and
output problems on transparenci
es.


Students will also start on the
worksheet


Intake and Output, to
see if they understand and / or they
can do intake and output
worksheets in the DHO book

Working teams of two, students
will take turns feeding each other.
(
For more fun
-

assign the s
tudents
a disability or special diet.)


Have students calculate the intake
of the classmate they fed.

Independent
Practice

Have students read the DHO
sections on Measuring and
Recording Intake and Output.



Have students complete the
“Intake and Output” w
orksheet


Have students measure their own
intake for three days.


Have students read the DHO
Section of “Feeding Patients.”

Have students read the DHO

Section of “Assisting win a
Bedpan / Urinal”

Closure

Ask students questions related to
the different

types of baths. Ask
students to discuss how
comfortable they would be giving
a bath in the clinical setting now?

Give students different amounts of
foods or liquids. Have the student
tell if the item is measured with
intake or output and convert it to
c
c’s.

Name different disabilities or diets
and have students tell you what
special feeding assistance or food
choices would be needed.

Materials

DHO Book

Towels, soap, bath thermometer,


washcloths, bath blanket,


lotion, toothbrush,


toothpaste, comb & brush.


nail brush, patient gown,


bath basin, IV and tubing

Bed Bath Skill Sheets


Overheads / Projector

Intake and Output Sheets

Containers used to measure


output



Overheads / Projector

Different ty
pes of food and drinks

Silverware,

Intake and Output sheet

Towel and washcloth

DOH



Summer 2000 K.
13

Unit H:


Nursing Skills (Continued)


Steps

Lesson #10

Lesson #11

Lesson #12

Focus and
Review

Have students write a short answer
to the following question: “How
would yo
u feel if you needed to go
to the bathroom, but had to rely on
someone to assist you.?”


Demonstrate putting a student on a
bedpan using wrong procedures.
Ask the students to note how you
did with the procedure. See if they
pick up on your mistakes.

Ask
a student the previous day to
volunteer and get to class early.
Have them retrained to a
wheelchair or bed. Offer them a
treat, but keep it out of reach. Ask
how they feel not being able to
have freedom of movement?


Statement of
Objectives

2H11.03 Ad
mimister personal
care and apply restraints

2H11.03 Administer personal care
and apply restraints

2H11.03 Administer personal cae
and apply restraints

Teacher
Input

Teacher
-
led presentation on
“Assisting with a bedpan or urinal
and providing catheter and
urinary
drainage care” (overheads in
appendix)


Demonstrate how to assist with a
bedpan, how to assist with a
urinal, and how to care for a
catheter and urinary drainage unit.


Teacher

led presentation on
“collection urine and stool
specimens.”


In group
s have student role
-
play
“Collecting Urine and Stool
Specimen Scenarios.” (
Included
some challenges such as a child,
does not speak English, etc.)


Teacher
-
led presentation on
“applying restraints” (overheads
in appendix)



Demonstrate ho
w to apply limb
and jacket restraints. After
students have a chance to practice,
complete skills check off.


In small groups have students role
play the “Restraints Scenarios” in
the appendix

Guided
Practice

In teams of two, students will
practice assist
ing a patient with a
bedpan


Teacher will do check
-
offs on
assisting a patient with a bedpan.


Note: Teacher will demonstrate
how to assist with a urinal and
how to care for a catheter and
urinary drainage bag. Students do
not need to be checked off on
these skills.

Have students review concepts of
“collecting urine and stool
specimens” in pairs, then try to
answer as many questions on the

“Collecting Urine and Stool
Specimens” worksheet as possible

In teams of two, students will
practicing applying lim
b and
jacket restraints.


In small groups, have students
come up with a list of alternatives
to restraints for caring for a
confused patient.


Students will work on their

skin care training videos when not
performing skills for evaluation.

Independent
P
ractice

Have students read the DHO
sections on “collecting stool and
urine specimens”

Complete the “Collecting Urine
and Stool Specimens” worksheet
for homework.


Have students read the DHO
section on “applying restraints.”

Assign a research persuasive pap
er
or speech “ Has the Nursing Home
Reform Legislation (OBRA ’87)
Resulted in Better Quality of Care
for the Residents in Long Term
Care Facilities?’

Closure

Have students stand. Go around
the room and see if students can
give the steps for assisting wi
th the
bedpan in the correct sequence.

Call out a type of urine or stool
specimen and have the student tell
you either what equipment they
will need and/or what special
instructions they would give to the
patient.

Let students tell you one thing
they lear
ned about restraints today
and how they will be able to use
this information in the clinical
area.

Materials

Overheads/ Projector

Bedpan/ Urinal/ Urinary Catheter


and drainage bag

Measurement containers

Alcohol swabs, paper towels

Bedpan Skills Sh
eets

DHO

DHO

Note cards with different


scenarios about collecting a


urine or stool specimens

Hemoccult card

24
-
hour urine collection bottle

Urine specimen collection


Container

Gauze sponges, antiseptic solution

Tongue Blade

Overheads

/Projector

Jacket and Limb Restraints

Restraint Skills Check Off Sheet

Restraint Scenarios

DOH Book

Certificate for guest speaker



Summer 2000 K.
14

Unit H:


Nursing Skills (Continued)


Steps

Lesson #13

Lesson #14

Lesson #15

Focus and
Review

Have students share their li
st of
alternatives for restraints. Review
how the tort “ false imprisonment”
would apply to restraints.


Call on students to share answers
to the homework assignments.

Have student share their journal
entries with the class


Statement of
Objectives

2H11.
03 Administer personal care
and apply restraints.

2H11.03 Administer personal care
and apply restraint and 2H11.01
Position, Turn, and Transfer
Patients


2H11.03 Administer personal care
and apply restraints.

Teacher
Input

Invite a guest speaker from a

long
term care facility to speak to the
class about OBRA legislation and
how it has affected the use of
restraints in long term care
facilities.

Arrange for a field trip to a local
long
-
term care facility. Ask if
someone in the facility could do a
brief

inservice on mechanical lifts

then have students shadow a
nursing assistant as they do AM
care.

Students will present skin care
videos and the teacher and
students will evaluate them.


Complete check
-
off skills that
have not been completed


Facilitate a

review game for the
test


Guided
Practice

Have students write down 10 facts
they learned from the speaker.


Have students complete the
worksheet on restraints in the
DHO book



Tape their video on skin care


Students are to shadow a nurse
assistant as th
ey do AM care for
patients. Students are to evaluate
the nursing assistant’s care of the
patient based on the procedures
they have learned.

Students will present skin care
video


Complete any skills check
-
offs
that have not been complete


In small groups

students can
review for the unit test on nursing
skills.



Independent
Practice

Work on their assigned researched
persuasive paper or speech.

Students are to write about their
clinical experiences in a journal
-
type entry. Have them note both
positive an
d negative things they
observed. Tell them to answer
this question: “Did you see the
staff taking any short cuts and do
you thing the paper suffered if
they did.”



Work on assigned researched
persuasive paper or speech.


Study for the unit test.


Cl
osure

Ask students how they would feel
if their parent or guardian had to
be restrained?

Ask each student what he or she
liked most about today’s
experience.



Review important aspects of
nursing skills.

Materials

Certificate for speaker

Limb and Jacket R
estraints

DHO worksheet on “Restraints”

Video Camera




Certificate for speaker and


nursing home

Field Trip Permission Form

Teacher made evaluation form for


skin care videos

Skills Check Lists

Items needed for review game.





Summer 2000 K.
15

Unit H:


Nursing

Skills (Continued)


Steps

Lesson #16



Focus and
Review

Play a short review game for the
test.



.


Statement of
Objectives

2H11.03 Administer personal care
and apply restraints.





Teacher
Input

Test on “Nursing Skills”


If time permits, grade the
test in
class.








Guided
Practice

Students can present their
researched persuasive paper or
speech ( if time permits)

(Use the competitive events score
sheets to grade projects.)








Independent
Practice

N/A








Closure

Tell students you will

be
beginning the Sports Medicine and
Therapeutic Skills unit


and to
look over the section in DHO









Materials

Nursing Skill Tests

Answer Key

Research Persuasive Speaking


Score Sheets












Summer 2000 K.
16


Unit K: Nursing Skills

Terminology List



1.

Align
ment

2.

Bed cradle

3.

Catheter

4.

Closed bed

5.

Complete bed bath (CBB)

6.

Contracture

7.

Dangling

8.

Decubitus ulcer

9.

Defecate

10.

Dehydration

11.

Edema

12.

Fanfolding

13.

Intake and output

14.

Mechanical lifts

15.

Micturate

16.

Midstream specimen

17.

Mitered corners

18.

Occult Blood

19.

Open bed

20.

Oral hygiene

21.

Partia
l bed bath

22.

Personal hygiene

23.

Restraints

24.

Stool Specimen

25.

Suppository

26.

24
-
hour urine specimen

27.

Urinal

28.

Urinary
-

drainage unit

29.

Urinate

30.

Urine specimen

31.

Void





Summer 2000 K.
17

Name ______________________________________

Date ______________________


Positioning, Turning, Moving and

Transferring Patients


1.

Place the correct vocabulary word beside the definition.


a. __________________

Tightening or shortening of the muscle

b. __________________

Sitting with the legs hanging down over the side of the bed

c. __________________

Pos
itioning body parts in relation to each other in to maintain correct
body posture

d. __________________

Caused by pressure that is applied to an area of the body and
interferes with circulation

e. __________________

Equipment that is frequently used t
o transfer weak or paralyzed
patients.


2.

Name three (3) reasons for maintaining normal body alignment for patients.



3.

Identify five (5) areas of the body you would examine closely for signs of decubitus ulcers while
bathing a patient.


4.

Describe the steps
in the formation of a decubitus ulcer.


5.

List seven (7) things that a nursing assistant or nurse could do to prevent decubitus ulcers.


6.

You are assigned to care for a patient who is unable to move their lower extremities. Your
supervisor tells you that yo
u need to be sure to prevent foot drop. What can you do to prevent
this?


7.

How often should a patient be turned?

8.

A family member wants to know why you are turning their mother so often? Answer their
question by emphasizing the benefits of frequent turning
.


9.

You are a nurse assistant in the hospital and you have been assigned to work with a health
occupation student today. She is to help a patient to a dangling position but she does not know
how. Explain to the student what they need to do and how to moni
tor the patient.


Appendix 2H11.01A


Summer 2000 K.
18

ANSWER KEY: Positioning, Turning, Moving, & Transferring
Patients



1.

Place the correct vocabulary word beside the definition.


a. __
Contracture
____ __ Tightening or shortening of the muscle

b. __
Dangling
______ __

Sitting with the legs hanging down over the side of the bed

c. __
Alignment
__
_
____ Positioning body parts in relation to each other in to maintain correct body


posture

d. __Decubitus Ulcer___ Cause
d by pressure that is applied to an area of the body and interferes


with circulation

e. __
Mechanical Lift
____ Equipment that is frequently used to transfer weak or paralyzed patients.



2.

Name three (3) reason
s for maintaining normal body alignment for patients.



a.

Helps patient feel more comfortable


c.

Prevents fatigue


b.

Prevents contractures



d.

Prevents decubitus ulcers


3.

Identify five (5) areas of the body you would examine closely for signs of decu
bitus ulcers while bathing a patient.

a. tailbone or coccygeal area

b. hips


c. knees


d. heels


e. elbows

4.


Describe the steps in the formation of a decubitus ulcer.

a.

First sign is a pale or reddened area on the skin.

b. Vesicle or blister m
ay form at site

c

As cells die, skin breaks down, and an ulcer, or open sore develops.

5.

List seven (7) things that a nursing assistant or nurse could do to prevent decubitus ulcers.

a.

Good skin care



b.

b. Prompt cleaning of urine and feces from the skin

c.

Massag
e in a circular motion around a reddened area.


d.

Light dusting of power to prevent friction in areas where skin touches skin

e.

Frequent turning.

f.

Positioning to avoid pressure on irritated areas

g.

Dry linens that are free from wrinkles

h.

Use of decubitus pads and

the use of egg crate, or alternating pressure mattresses

6.

You are assigned to care for a patient who is unable to move their lower extremities. Your supervisor tells you that you
need to be sure to prevent foot drop. What can you do to prevent this?

Kee
p the foot at a right angle to the leg by using footboards and /or high
-
top tennis shoes. Also would do range of
motion exercises to the foot and leg.

7.

How often should a patient be turned?
Turn patients at least every two hours

8.

A family member wants to
know why you are turning their mother so often? Answer their question by emphasizing the
benefits of frequent turning.

Frequent turning provided exercise for the muscles. It also stimulates circulation, helps prevents decubitus ulcers and
contractures, a
nd provides comfort to the patient.

9.

You are a nurse assistant in the hospital and you have been assigned to work with a health occupation student today. She is
to help a patient to a dangling position but she does not know how. Explain to the student wha
t they need to do and how to
monitor the patient.

Takes patient’s radial pulse. Assist patient to sitting position on side of bed. Stay with patient Note any change in
respiratory rate, color, amount of perspiration, complaints of vertigo or dizziness,
and / or an increase in pulse rate. If
note any of these, return patient to supine position. Take radial pulse again when in supine position




Summer 2000 K.
19

Name ______________________________________________ Date ____________________



2H11.01B


Transferring to
Chair/Wheelchair












MASTERY











YES NO


1.

Assemble equipment







_____ _____

2.

Washed hands








_____ _____

3.

Practiced standard precautions throughout procedure


_____ _____

4.

Greeted and identified patient






_____ _
____

5.

Introduced self







_____ _____

6.

Explained procedure and provided privacy




_____ _____

7.

Determined which side of bed to use and placed chair at

head of bed








_____ _____

8.

Locked wheels of wheelchair and folded up foot rest


___
__ _____

9.

Lowered bed and locked wheels





_____ _____

10.

Elevated the head of the bed






_____ _____

11.

Lowered the side rails on the exit side of the bed



_____ _____

12.

Fanfolded the bed linen to the foot





_____ _____

13.

Assisted
patient to dangle feet and maintained patient safety

_____ _____

14.

Put robe and slippers on patient





_____ _____

15.

Transferred patient into chair / wheelchair



a.

Assisted patient to stand at bedside




_____ _____


b.

Assisted patient pivot
and sit down in chair



_____ _____


c.

Adjusted footrest to wheelchair as needed



_____ _____

16.

Draped patient with blanket / sheet





_____ _____

17.

Attached safety belt / took safety measures for chair



_____ _____

18.

Checked to assure patien
t comfort with call bell and supplies

within reach








_____ _____

19.

Recorded / reported information accurately




_____ _____


-----------------------------------------------------------------

TOTAL


____ _____



Mastery


= 100% Yes

Non
-
M
astery


= Below 100%



Date ___________________ Evaluator _________________________________


Comments:


Summer 2000 K.
20

Name ______________________________________________ Date ____________________


2H11.01C

Transferring to a Stretcher (Conscious)












MASTERY











YES NO


1.

Checked order or obtained authorization





_____ _____

2.

Assembled equipment and supplies





_____ _____

3.

Washed hands and put on gloves if indicated




_____ _____

4.

Identified patient and explained procedure




____
_ _____

5.

Screened unit








_____ _____

6.

Elevated bed to level of stretcher





_____ _____

7.

Locked bed to prevent movement





_____ _____

8.

Lowered siderails on side of transfer





_____ _____

9.

Draped patient with bath blanket





_
____ _____

10.

Positioned stretcher parallel to bed





_____ _____

11.

Locked wheels on stretcher






_____ _____

12.

Held stretcher against bed with weight of body




_____ _____

13.

Held up bath blanket while patient slid across to stretcher


_
____ _____

14.

Assisted patient as needed






_____ _____

15.

Positioned patient in correct alignment





_____ _____

16.

Locked safety belt (s) across patient





_____ _____

17.

Elevated siderails on stretcher






_____ _____

18.

Transported with

two team members:

a.

One at head and one at foot





_____ _____

b.

Moved slowly on right side of hall




_____ _____

c.

Moved patient feet forward





_____ _____

19.

Returned patient to bed correctly by reversing transfer procedure


_____ _____

20.

Positioned patient in proper alignment





_____ _____

21.

Elevated siderails and lowered bed to lowest level



_____ _____

22.

Positioned call signal and supplies within reach




_____ _____

23.

Replaced equipment and leaves area neat and clean




_____ _____

24.

Washed hands








_____ _____

25.

Recorded or reported information accurately




_____ _____


---------------------------------------------------------------------

TOTAL


_____ _____


Mastery


= 100% Yes

Non
-
Mastery


= Bel
ow 100%



Date ___________________ Evaluator _____________________________________


Comments:






Summer 2000 K.
21

Name ______________________________________ Date____________________________


2H11.02A
Making an Occupied Bed





MASTERY













YES NO

1.

Assembled equipment and supplies

____ ____

2.

Wash hands










____ ____

3.

Practiced standard precautions throughout procedure




____ ____

4.

Greeted and identified patient








____ ____

5.

Identified sel
f, explained procedure, and provided privacy





____ ____

6

Adjusted side rails to provided safety







____ ____

7

Adjusted bed to appropriate height and locked wheels




____ ____

8.

Lowered side rail on working side








__
__ ____

9.

Loosened top covers from foot end of bed







____ ____

10.

Removed blanket (top sheet remains on for drape); discarded in





hamper (Can replace top sheet with bath blanket)





____ ____

11.

Assisted patien
t to turn to opposite side of bed





____ ____

12.

Fanfolded / rolled bottom linens up to patient’s body




____ ____

13.

Placed bottom sheet on bed with middle fold at center of bed and


fan
-
folded opposite side to patient







____ ____

14.

Tuck
ed in clean botton sheet at the head of the bed; made a mitered


corner at the head of the bed then tucked in entire side working from


the head to the foot of the bed







____ ____

15.

Placed drawsheet on bed; tucked under mattres
s; fanfolded to center


of the bed











____ ____

16.

Raised side rail

____ ____

17.

Assisted patient to turn to opposite side of bed





____ ____

18.

Moved to the opposite side of bed and lowered side rails





____ ____

19.

Removed soiled bottom linens and placed in hamper




____ ____

20.

Pulled the clean bottom sheet into place; made mitered corner at the


head of the bed and tucked bottom sheet under the mattress working


fr
om the head of the bed to the foot







____ ____

21.

Tucked drawsheet firmly under the mattress





____ ____

22.

Assisted patient to turn to center of bed; placed clean top sheet over


patient










____

____

23.

R
emoved soiled top sheet or bath blanket and placed in hamper


____ ____

24.

Placed blanket over patient; tucked top linens at foot of bed and


mitered corners










____ ____

25.

Raised side rails









____ ____

26.

Made toe pleat









____ ____

27.

Gently removed pillow; removed soiled pillow case and placed in hamper


____ ____

28

Applied clean pillow case appropriately






____ ____

29.

Positioned patient appropriately








____ ____

30.

Adjusted bed to lowest height







____ ____

31.

Positioned call bell and supplies within reach





____ ____

32.

Washed hands









___
_ ____

------------------------------------------------------------------

TOTAL



____ ____

Mastery


= 100%

Yes

Non
-
Mastery


= Below 100%


Date __________________ Evaluator ___________________________________




Summer 2000 K.
22

Name _________
_______________________________

Date___________________



Social and Ethical Issues Related to Bathing Patients


Many students are nervous or fearful of bathing a patient. A bath is often the best medicine a patient can
receive and is a very important
component of health care. To prepare for this procedure, first complete
the section on “What I know about administering personal hygiene to patients.” Next, complete the
section on “What I need to learn about administering personal hygiene to patients.”

After you read the
section on “administering personal hygiene” in your

Diversified Health Occupations

book, complete the
section on “What new information I learned about administering personal hygiene to patients.


What Do I Know About
Administering Pers
onal
Hygiene to Patients


( Males and Females)

What Do I Need to Learn
About Administering
Personal Hygiene to
Patients

What New Information Did I
Learn About Administering
Personal Hygiene to Patients

































Appendix 2H11.03A


Summer 2000 K.
23


Name ____________________________________


Date ________________________


Calculating Intake and Output


Convert the following fluids to cubic centimeters so that you could enter them on an Intake and Output
Sheet.


1.

4 oz of orange juice



=


________
___ cc’s

2.

8oz carton of milk



=


___________ cc’s

3.

¾ of a 12 oz can of soda


=


___________ cc’s

4.

½ of a 10 oz cup of coffee


=


___________ cc’s

5.

¾ of water in pitcher (1 pint)


=


___________ cc’s

6.

4 tablespoons of soup



=


___________ cc’s

7.

½ of ice cream cup (4oz)


=


___________ cc’s

8.

90 gtts of water




=


___________ cc’s

9.

6 teaspoons of pudding



=


___________ cc’s

10.

1 ½ quarts of tea



=


___________ cc’s


Calculate the intake and output of these patients for an eight
-
hour shi
ft.


1.

Katie

7:45 AM

Voided 425 ml of urine

8:15 AM

Ate 2 eggs; ½ of 4oz juice; 2 piece of bacon; ¾ carton of milk; and 2
pieces of toast

10:30 AM

Had ¾ of 12 oz can of soda

11:45 AM

Voided 3 ½ cups of urine

12:30 PM

Ate ½ of a club sandwich; 8 tablespo
ons of Jell
-
O; ¾ bag of potato
chips; ½ pint of tea; and 12 teaspoons of ice cream

1:50 PM

Vomited 100 cc of thick yellow emesis

2:30 PM

Had one formed stool and voided ½ quart of urine


Total Intake _________________ Total Output ______________


2.

Chr
istopher

7:15 AM

Drank 1 ¾ cups of coffee (10 oz cups)

7:45 AM

Voided 250 cc of urine and had ½ cup of liquid BM

8:45 AM

Had ½ of broth (200 cc bowl); ¾ of Jell
-
O (4 oz serving);



½ of 6oz Popsicle, and 1 cup of apple juice (8 oz cup)

10:25 AM

Had 120 dr
ops of X
-
ray dye for a diagnostic test

11:15 AM

Voided 2 ¾ cups of urine

1:00 PM

Ate ½ cup of mashed potatoes; 2 peach halves; 10 tbsp. of
soup;
2/3 of 12oz can of soda; and 7 tsp. of pudding
.


Total Intake _________________ Total Output _____________
____



Appendix 2H11.03B



Summer 2000 K.
24

ANSWER KEY: Calculating Intake & Ouput





120 cc’s

1.

4 oz of orange juice


240 cc’s

2.

8 oz carton of milk


270 cc’s

3.

¾ of a 12 oz can of soda


150 cc’s

4.

½ of 10 oz cup of coffee


375 cc’s

5.

¾ of water in a pitcher (
1 pint)


60 cc’s

6.

4 tablespoons of soup


60 cc’s

7.

½ of ice cream cup (4 oz)


6 cc’s

8.

90 gtts of water


30 cc’s

9

6 teaspoons of pudding

1500 cc’s

10.

1 ½ quarts of tea




Katie’s Total Intake

940 cc’s



Katie’s Total Output

1865 cc’s &
1 BM



Christopher Total Intake

1478 cc’s


Christopher’s Total Output


910 cc’s



















Summer 2000 K.
25

Name _____________________________________ Date________________________



Collecting Urine and Stool Specimens


Match the statement with th
e correct diagnostic test. You may use the answers more than once.



____

1.

Requires the patient to be catheterized



A. Routine Urine

____

2.

Urine is preserved by way of chemicals




Specimen




or cold storage in a special container from th
e



laboratory.







____

3.

You use a special card for this test.





B. Routine Stool
____

4.

You void a few drops than catch the




Specimen




rest in a sterile container.






____

5.

Specimen is used to check kidney
function and C. Sterile Urine



and components such as protein, creatinine,



Specimen



urobilinogen, and calcium.






____

6.

You collect the first urine voided in the AM.


D. Clean
-
Catch
___
_

7.

The laboratory checks this specimen for ova



or Midstream



and parasites.








Voided



____

8.

A fresh specimen should be collected just



Specimen




before meals or bedtime.







____

9.

Instruct you
r patients on how to clean the



E. Stool for Occult



genital area before collecting this specimen.



Blood

____

10.

This specimen must get to the lab within 30





minutes of collecting.







F. Glucose and


____

11.

Refrigerate this specimen if you cannot get



Acetone Test



it to the lab right away.






____

12.

This test is done to look for blood from the


G. 24
-
Hour Urine



intestinal tract.







Specimen



Yo
u are working for a doctor and he tells you to get a clean
-
catch urine specimen from Mrs.
Crawford. You gather your supplies and when you approach Mrs. Crawford, you

realize that she does not speak English. What directions do you need to give Mrs. Crawfo
rd and
how will you communicate them to her? Please include in your answer how you will verify her
understanding.






Appendix 2H11.03C



Summer 2000 K.
26




ANSWER KEY: Collecting Urine & Stool Specimens





__C__

1.

Requires the patient to be catheterized





__G_

2.

Urine is preserved by way of chemicals or cold



storage in a special container from the laboratory.






E

3.

You use a special card for this test.






_ D

4.

You void a few drops than catch the rest in a








sterile c
ontainer.







G

5.

Specimen is used to check kidney function and






components such as protein, creatinine,






urobilinogen, and calcium.







A

6.

You collect the first urine voided in the AM.




B

7.

The labo
ratory checks this specimen for ova






and parasites.











F

8.

A fresh specimen should be collected just








before meals or bedtime.








D__

9.

Instruct your patients on how to clean the




genital area before colle
cting this specimen.



B

10.

This specimen must get to the lab within 30





minutes of collecting.






_ A

11.

Refrigerate this specimen if you cannot get






it to the lab right away.






_ E__

12.

This test is done to look for bl
ood from the





intestinal tract.



























Summer 2000 K.
27


Restraints Scenarios



Scenario #1


You are a sales group for a restraint company. You have come to a hospital
administrator convention to market your restraints. A group of administrators is
in
terested in learning more about your product. You need to identify the different
types of restraints your company carries. Explain to your captive audience the
benefits of each type of restraint and how to use it (demonstrate) as part of your
sales pitch
. You have 15 minutes to prepare your demonstration.




Scenario #2


You are passing as a visitor in a long
-
term care facility,
but secretly you are from the government and your job is
to inspect this facility’s use of restraints. Make sure you
check al
l the points listed in your book. Role play this
secret inspection and tell what points your are checking
for. You have 15 minutes to prepare your presentation.



Scenario #3


You are the instructor for a group of nursing students. Your curriculum requi
res
you to explain what restraints are, conditions that require restraints, and

complications of restraints. Your students are sometimes difficult and your know
you must present this material in an interesting and creative way or you will lose
their att
ention. You have 15 minutes to prepare this lesson.




Appendix 2H11.03D


Summer 2000 K.
28

Name ____________________________________________________ Date ______________________


2H11.03E

Giving a Complete Bed Bath (Patient with an IV)












MASTERY











YES

NO

1.

Assembled equipment and supplies





_____ _____

2.

Washed hands and put on gloves





_____ _____

3.

Identified patient and explained procedure




_____ _____

4.

Screened unit








_____ _____

5.

Arranged equipment and supplies conveni
ently




_____ _____

6.

Elevated bed to proper working height and lowered siderail


_____ _____

7.

Draped patient with bath blanket / top sheet




_____ _____

8.

Obtains basin of bath water at 105 degrees




_____ _____

9.

Removed gown or pajamas (
arm with IV last)




_____ _____

10.

Made wash mitten







_____ _____

11.

Washed body correctly:

a.

Washed eyes







_____ _____

b.

Washed face, neck, and ears





_____ _____

c.

Washed arms







_____ _____

d.

Soaked nails in soapy water and cleane
d with brush or

orange stick







_____ _____


e.

Washed chest







_____ _____


f.

Washed abdomen






_____ _____


g.

Washed legs and feet






_____ _____


h.

Administers nail care to toenails if needed



_____ _____

12.

Changes water after
elevating siderails





_____ _____

13.

Lowered siderail







_____ _____

14.

Washed back








_____ _____

15.

Washed or helped patient with perineal area:

a.

Positioned patient on back





_____ _____

b.

Washed front to back on female OR washed penis
top to

bottom and under scrotum





_____ _____

16.

Put on clean gown / helped with pajamas (arm with IV first)


_____


_____

17.


Administered hair care:

a.

Parted / sectioned hair and combed / brushed thoroughly


_____ _____

b.

Combed with hand betw
een brush / comb and scalp


_____ _____

c.

Combed all parts of head: sides, top, and back



_____ _____

d.

Arranged hair, observing condition of hair / scalp


_____ _____

18.

Changed linen on bed







_____ _____

19.

Positioned patient in proper a
lignment





_____ _____

20.

Elevated siderails and lowered bed





_____ _____

21.

Placed call signal and other supplies within reach



_____ _____

22.

Cleaned and replaced all equipment





_____ _____

23.

Removed gloves if worn and washed hands




_____ _____

24.

Recorded or reported information appropriately




_____ _____

----------------------------------------------------------------------

TOTAL


_____ _____

Mastery


= 100% Yes

Non
-
Mastery


= Below 100%


Date _________________
Evaluator ______________________________________


Summer 2000 K.
29

Name __________________________________________ Date _____________________


2H11.03F

Assisting With a Bedpan











MASTERY











YES NO


1.

Assembled equipment







_____ _____

2.

Wash
ed hands and put on gloves





_____ _____

3.

Identified patient and explained procedure




_____ _____

4.

Screened unit








_____ _____

5.

Elevated bed to correct working height





_____ _____

6.

Lowered head of bed







_____ _____

7.

Lowe
red siderail







_____ _____

8.

Folded back covers, assisted with gown





_____ _____

9.

Instructed patient to flex knees and put weight on feet



_____ _____

10.

Places hand under small of back and signals patient to raise hips


_____ _____

11.

Slid bedpan into place







_____ _____

12.

Assisted if needed by turning patient on side and positioning

bedpan









_____ _____

13.

Supported patient on pan correctly





_____ _____

14.

Placed call signal and tissue within reach




_____ _____

15.

Elevated siderails







_____ _____

16.

Answered signal immediately






_____ _____

17.

Removed pan correctly







_____ _____

18.

Assisted with cleaning genital area as needed




_____ _____

19.

Allowed patient to wash hands






_____ __
___

20.

Positioned patient in correct alignment





_____ _____

21.

Elevated siderail and lowered bed





_____ _____

22.

Placed call signal and supplies within reach




_____ _____

23.

Took bedpan to bathroom






_____ _____

24.

Checked contents
of bedpan






_____ _____

25.

Saved specimen or measured output as necessary



_____ _____

26.

Emptied bedpan








_____ _____

27.

Rinsed bedpan in cold water and washed with soapy water


_____ _____

28.

Rinsed and dried bedpan






_____ ____
_

29.

Replaced bedpan in patient unit






_____ _____

30.

Removed gloves and washed hands





_____ _____

31.

Recorded or reported required information




_____ _____


---------------------------------------------------------------------

TOTAL


____
_ _____


Mastery


= 100% Yes

Non
-
Mastery


= Below 100%


Date _____________________ Evaluator ___________________________________


Comments:

Summer 2000 K.
30

Name ________________________________________ Date _________________________________


2H11.03G

Applying Li
mb or Jacket Restraint











MASTERY











YES NO


1.

Checks order or obtains authorization





_____ _____

2.

Assembles equipment







_____ _____

3.

Washes hand








_____ _____

4.

Identifies patient and explains procedure





_____

_____

5.

Screens unit








_____ _____


LIMB RESTRAINT

6.

Places soft edge against skin






_____ _____

7.

Wraps smoothly around limb






_____ _____

8.

Pulls restraints secure







_____ _____

9.

Checks fit by inserting two fingers
between skin and restraint


_____ _____

10.

Positions limb in comfortable position





_____ _____

11.

Limits movement only as much as necessary




_____ _____

12.

Secures straps to be frame






_____ _____


JACKET RESTRAINT

13.

Slips sleeves onto

arms







_____ _____

14.

Positions V
-
area on front






_____ _____

15.

Crosses straps in back







_____ _____

16.

Bring straps through hole in jacket





_____ _____

17.

Check tightness of jacket






_____ _____

18.

Positions patient comf
ortably






_____ _____

19.

Limits movement only as much as necessary




_____ _____

20.

Secures straps to bed frame






_____ _____

21.

Verbalizes steps for checking restraint and patient tolerance


per facility policy


a.

Color








_____ ___
__


b.

Temperature







_____ _____


c.

Return of color after blanching nails




_____ _____


d.

Edema or swelling






_____ _____


e.

Complaints of pain / numbness/tingling




_____ _____

22.

Verbalizes removal of restraints per facility policy



_____ _____

23.

Removes restraints when authorized





_____ _____

24.

Replaces all equipment







_____ _____

25.

Washes hands








_____ _____

26.

Reports results accurately






_____ _____

------------------------------------------------
----------------

TOTAL



_____ _____


Mastery


=100% Yes

Non
-
Mastery


= Below 100%


Date _____________________ Evaluator _____________________________________