Comprehensive First Aid & Home Nursing Guide

This First Aid & Home Nursing Notes document is a comprehensive guide designed for students, caregivers, and anyone interested in emergency care. It covers essential first aid techniques, wound management, CPR procedures, and basic home nursing skills. Whether you're a healthcare student or just want to be prepared for emergencies, this resource provides step-by-step instructions and practical knowledge to handle medical situations confidently. HOME NURSING AND FIRST AID INTRODUCTION TO HOME NURSING THE SCOPE OF HOME NURSING Home nursing involves the following:- ● Assessment of nursing requirement ● Assist in discharge of waste ● Assist in feeding ● Assist in leaving and returning to the house ● Bathing ● Consultation and coaching in special handling skills ● House calls ● Mobilization ● Morning / evening toilet ● Night attendance ● Positioning in bed (bedsore prophylaxis) ● Post-natal nursing (domiciliary after care –penjagaan selepas bersalin) ● Nursing of HIV/AIDS patients (REFER TO THE TABLE BELOW) Basic Nursing Includes: assistance in leaving and returning to bed. Shower or lapping, washing of hair, cleaning and cutting of finger nails, assistance in leaving and returning to bed, dressing and undressing with special consideration to medical conditions or handicaps, oral hygiene, combing and shaving. 2 Complete Toilet 3 Partial Toilet 4 Bathing Includes: assistance in leaving and returning to bed. Shower or lapping, washing of hair, cleaning and cutting of finger nails, assistance in leaving and returning to bed, dressing and undressing, oral hygiene, combing and shaving. Includes: assistance in leaving and returning to bed, dressing and undressing, shower or bath, oral hygiene and combing. Includes: assistance in leaving and returning to bed, dressing and undressing, preparing the long bath (bath tub), assisting in bathing and leaving the long bath, oral hygiene, shaving and combing 5 Assistance in Discharge of Waste 6 Positioning in Bed Includes: Dressing and undressing, support in the discharge of urine or faeces inclusive of emptying of urine bag or stoma bag, removing and replacing of diapers or pads, cleaning the intimate area Includes: Organizing the bed sheets, positioning as required, prevention of pressure ulcer, eventually with skin care. 7 Mobilization (Integrated) 8 Mobilization (Special service) 9 Assistance in Feeding 10 Enteral Feeding via PEG 11 Assistance in Leaving the House 12 Assistance in Leaving Outside the House 13 Changing of Bed Sheets 14 Attendance by Nurse/Nurses Aid Includes: Specific movement of the limbs as prophylaxis in the prevention of contractures. To be carried out: On special advice of a physician, or according to a specific mobilization plan. This includes: preparation of the food (not cooking), assisting in the intake of food and drink, as well as all hygienic measures pertaining to it. Includes: The preparation and the dispensing of the enteral food preparation, supervision of apparatus if applicable. Includes: Dressing and undressing, supporting at staircases, and assisting to the transporting vehicle and transportation of walking aids. Accompanying Includes: The constant presence near the patient, his safety, assistance in discharge of waste, assisting in the transport, handling of walking or transport aids, accompanying to home, and safe handing over to the home care taker. Includes: The stripping and replacing of bed sheets and pillow covers, discharging the dirty clothing for recycling according to hygienic practise. Includes: The continual supervision of the patient, attends to the normal needs, registers observations and communicates the same as appropriate. Takes care of the safety of the patient and intake of nourishment and medication (Other services are excluded). FUNDAMENTALS OF HOME NURSING Basic nursing skills include the knowledge necessary for a nurse to perform the basic duties of obtaining vital statistics, changing bandages, cleaning wounds, bathing patients, and performing CPR. a) Vital Signs The basic skills that a nurse will learn include how to take patients' temperatures, how to take their blood pressure readings, how to find and measuring their pulses and take their respiration readings. b) Changing Bandages A nurse must learn the basic skill of how to remove and correctly apply bandages. C) Cleaning Wounds Cleaning wounds properly is another basic nursing skill. This basic skill includes the knowledge of how to treat different types of wounds. d) Bathing Patients Basic nursing courses cover proper methods of bathing patients including how to be gentle, make patients feel comfortable, and how to bathe patients who suffer from different ailments or have special bathing needs. e) CPR Learning to perform cardio-pulmonary resuscitation, or CPR, is a basic skill that nurses must learn. f) Hygiene Nurses also must have basic skills in proper hygiene, not only for patients but also for themselves. Nurses must learn how to properly protect themselves from infection from sick patients, and also to prevent spreading disease from patient to patient QUALITIES OF A HOME NURSE ● Honesty: the home nurse is entrusted with taking care of individuals who may not be in a position to take care of their valuables and he/she is expected to take care of them. They are also entrusted by the family with the home as they take care of their patients. The home nurse therefore has to be an honest person who will not steal from the patient or harm the patient. ● Sympathy/ empathy: the home nurse should be a person capable of putting themselves in the suffering patient’s shoes. He/she should treat the patient l helpless. This applies in performing clinical or non clinical duties to help the patient feel that someone cares for them. ● Politeness: calmness when talking to the patient, not raising ones voice even when the patient becomes annoying is a quality that helps the patient compliant in terms of taking medications, being cooperative with the home nurse and also helps calm an agitated patient. ● Patience: the patients, most of them in pain need a person who will not be in a hurry to complete their tasks in caring for them. The home nurse needs to perform his duties taking into consideration the feelings of the patient. Other patients especially the mentally ill, the elderly and children may be uncooperative or non responsive to instructions one gives. The home nurse has to cultivate tolerance with these patients so as to serve them. ● Cheerfulness: a dull home nurse makes the patient retreat to themselves and their illness. Being cheerful influences the patients to also be cheerful and for a while forget their illness. It aids in recovery of the patient especially in patients with mental disorders especially depression. ● Carefulness: this is an important quality. This is more so in dispensing of drugs. One who will give a dose of medicine without looking at the label on the bottle; or will spill out twenty drops when ten were ordered; or will upset a. breakfast tray on the bed; or leave a vessel under the bed for hours uncovered: or oversleep when the patient should have food or medicine, or let the fire go out; such an one is entirely unfit to have charge of a sick person. ● Exactness in carrying out the orders of the physician is the first duty of a nurse. The doctor is responsible for the treatment of the case, and the patient and family are responsible for the choice of the doctor. The nurse should follow strictly the instructions of the doctor whether in dispensing of drugs or in diet since the doctor id better trained. Any suggestions on hoe to improve the pat a decision on. DUTIES AND RESPONSIBILITIES OF A HOME NURSE The home nurse is employed to fulfill the needs of a patient. This will include: ● Feeding the patient: this also includes ensuring the meals are of the right quality, balanced diet or recommended diet is given. ● Grooming the patient. Keeping the patient clean and smart is part of the job of the home nurse. They will be required to dress and undress the patient and keep the patient covered and warm. ● The home nurse is expected to provide a secure environment for the sick. Unnecessary disturbances to the patient should be avoided, and the room should be free of hazardous materials that could injure the patient. ● The home nurse should also provide emotional support to the patient as this enables the patient to achieve quick recovery. ● Administration of drugs, cleaning of wounds and other simple medical procedures are in a home setting performed by the home nurse. EVALUATION 1. Define the following terms a) Home nursing b) Clinical care c) nurse 2. Explain the scope of home nursing. 3. Discuss the importance of home nursing skills. 4. Explain the fundamentals of home nursing. 5. List qualities of a home nurse 6. Discuss the duties and responsibilities of a home nurse. EFFECTS OF ILLNESS ON AN INDIVIDUAL ● low productivity:- a person becomes less productive they do not have the energy to work due to the effects of the illness ● increased expenditure: this will accrue from the cost of accessing medical care ● Poor feeding due to lack of appetite which can lead to malnutrition and poor health ● Trauma: the trauma that accompanies some illnesses may make one to be socially withdrawn ● Reduces life-expectancy of an individual:-severe, recurrent or prolong expectancy THE IMPORTANCE OF PATIENT MOTIVATION a) Compliance The patient’s cooperationanddoctorswillwithmostlydependtheon howhomewellthey nursearemotivated. Making the patient comfortable and promptly providing aid when required makes them respect the health care giver and will also want to play their role in restoring their health. This includes taking medication as prescribed, being courteous to the home nurse and doctor and taking care of injuries e.t.c. b) Quick recovery Motivating the patient helps in recovery from illness faster. Providing the medication in time and as required, providing a balanced diet, providing emotional and social support all go a long way in helping cure the patient of physical and emotional illnesses. c) Psychological health A patient feeling that they are a bother to those taking care of them will make them hide their discomforts and complaints and this affects them adversely in recovery. The patient needs to feel loved by those around them. Apart from compliance, it will also help the patient relax. For patients with depression, anxiety and other mental illnesses, this is paramount. PATIENT MOTIVATION TECHNIQUES Patients’ motivation can be achieved by taking car - Physical needs - Nutritional needs - Emotional needs - Social needs - Psychological needs - Spiritual needs A) Physical needs These include rest and sleep in a comfortable well made bed and a clean environment, bathing and dressing, caring for the mouth and dealing with excretion. 1) Rest and sleep The patient spends a lot of time in bed and therefore needs to be as comfortable as possible. The bed should be made daily and the bedding changed frequently. Items required for bed making ● 2 clean bed sheets ● 2 blankets ● 1 or 2 pillow cases ● A draw sheet ● Mackintosh: this is a form of waterproof garment made out of rubberized fabric. The Mackintosh is named after its Scottish ● Bed cover Procedure for making a bed ● Open the window and strip the beddings from the bed fold into three or four screens, place onto a chair and leave to air ● Turn the mattress ● Replace the under blanket ● Place the bottom sheet, right up and tuck in all round making a miter at all four corners. How to make a mitered corner ▪ Tuck in along the head of the mattress ▪ Lift a flap of sheet from a point along the side about 30 cm from the corner and tuck in. ▪ Drop the flap and tuck in along the side. ● Place the mackintosh on the lower side of the bed. ● Place a draw sheet on the mackintosh and tuck. ● Put on the top sheet, wrong side up, to reach just beyond the head of the mattress. ● Put on blankets separately, to reach just short of the top sheet. ● Make a fold at the centre, along the length of the bed and tuck along the bottom ● Fold back all the bedding from the top sheet down to the width of the pillow. ● Tuck in the sides. Leave one side un-tucked for ease of putting the patient to bed. ● Place the pillow in the pillow cases ● Put the pillow on the bed with open ends away from the door. ● The patient lying on a pillow on his back is a resting position allowing turning from side to side. Resting positions in bed