Community Organizing Participatory Action Research (COPAR) Nursing

Community Organizing Participatory Action Research (COPAR) - is a continuous and a sustained process of:

1. Educating the people - to understand and develop their critical consiousness
2. Working with people - to work collectively and effectively on their immediate and long term problems
3. Mobilizing with people - develop their capability and readiness to respond, take action on their immediate needs towards solving the long term problems

The process and structure through which members of a community are/or become organized for participation in health care and community development activities

Process:
- the sequence of steps whereby members of a community come together to critically assess to evaluate community conditions and work together to improve those conditions.

Structure:
- refers to a particular group of community members that work together for a common health and health related goals.

Emphasis of COPAR:

1. Community working to solve its own problem
2. Direction is established internally and externally
3. Development and implementation of a specific project less important than the development of the capacity of the community to establish the project
4. Consciousness raising involves perceiving health and medical care within the total structure of society

Importance of COPAR:

• COPAR maximizes community participation and involvement
• COPAR could be an alternative in situations wherein health interventions in Public Health Care do not require direct involvement of modern medical practitioners
• COPAR gets people actively involved in selection and support of community health workers
• Through COPAR, community resources are mobilized for selected health services
• COPAR improves both projects effectiveness during implementation

Phases of COPAR Process:

1. Pre-Entry Phase - is the intial phase of the organizing process where the community organizer looks for communities to serve and help. Acitivities include:

Preparation of the Institution

• Train faculty and students in COPAR.
  
• Formulate plans for institutionalizing COPAR.
• Revise/enrich curriculum and immersion program.
• Coordinate participants of other departments.

Site Selection

• Initial networking with local government.
• Conduct preliminary special investigation.
• Make long/short list of potential communities.
• Do ocular survey of listed communities.

Criteria for Initial Site Selection

• Must have a population of 100-200 families.
• Economically depressed.
• No strong resistance from the community.
• No serious peace and order problem.
• No similar group or organization holding the same program.

Identifying Potential Municipalities

• Make long/short list.

Identifying Potential Barangay

• Do the same process as in selecting municipality.
• Consult key informants and residents.
• Coordinate with local government and NGOs for future activities.

Choosing Final Barangay

• Conduct informal interviews with community residents and key informants.
• Determine the need of the program in the community.
• Take note of political development.
• Develop community profiles for secondary data.
• Develop survey tools.
• Pay courtesy call to community leaders.
• Choose foster families based on guidelines.

Identifying Host Family

• House is strategically located in the community.
• Should not belong to the rich segment.
• Respected by both formal and informal leaders.
• Neighbors are not hesitant to enter the house.
• No member of the host family should be moving out in the community.

2. Entry Phase - sometimes called the social preparation phase. Is crucial in determining which strategies for organizing would suit the chosen community. Success of the activities depend on how much the community organizers has integrated with the commuity.

Guidelines for Entry

• Recognize the role of local authorities by paying them visits to inform their presence and activities.
• Her appearance, speech, behavior and lifestyle should be in keeping with those of the community residents without disregard of their being role model.
• Avoid raising the consciousness of the community residents; adopt a low-key profile.
  

Activities in the Entry Phase

• Integration - establishing rapport with the people in continuing effort to imbibe community life.
  
  • living with the community
  • seek out to converse with people where they usually congregate
  • lend a hand in household chores
  • avoid gambling and drinking

• Deepening social investigation/community study
  • verification and enrichment of data collected from initial survey
  • conduct baseline survey by students, results relayed through community assembly

Core Group Formation

• Leader spotting through sociogram.
  

  Key persons - approached by most people
  Opinion leader - approach by key persons
  Isolates - never or hardly consulted

3. Organization-building Phase

Entails the formation of more formal structure and the inclusion of more formal procedure of planning, implementing, and evaluating community-wise activities. It is at this phase where the organized leaders or groups are being given training (formal, informal, OJT) to develop their style in managing their own concerns/programs.

Key Activities

• Community Health Organization (CHO)
  • preparation of legal requirements
  • guidelines in the organization of the CHO by the core group
  • election of officers
• Research Team Committee
• Planning Committee
• Health Committee Organization
• Others
• Formation of by-laws by the CHO
  

4. Sustenance and Strengthening Phase

Occurs when the community organization has already been established and the community members are already actively participating in community-wide undertakings. At this point, the different committees setup in the organization-building phase are already expected to be functioning by way of planning, implementing and evaluating their own programs, with the overall guidance from the community-wide organization.

Key Activities

• Training of CHO for monitoring and implementing of community health program.
• Identification of secondary leaders.
• Linkaging and networking.
• Conduct of mobilization on health and development concerns.
• Implementation of livelihood projects.

RESEARCH NOTES

RESEARCH

Research – systematic inquiry to answer questions or solve problems
 Primary objective: present facts
Nursing Research – application of scientific inquiry to the phenomena of concern to nursing Practice
Purpose:
 Build a body of nursing knowledge
 Validate improvements in nursing
 Make healthcare efficient and cost-effective

FUNCTIONS OF RESEARCH
1. Answer the question, solve problems, make decisions
2. Enable us to see & understand how & why a situation or problem exists – predict, explain and expand the body of knowledge
3. Help us discover new things & ideas
 New knowledge – new skills /practices = improve
 New technology – new tools = improve
4. Validate existing theories or generate new one

ETHICS IN NURSING RESEARCH
Ethics – set of moral behaviors, principles, rules, instructions that determine which action is right or wrong

Principles
1. The subject should be protected from harm and discomfort
2. Participation in the studies should be voluntary (right to self-determination)
3. Balancing the benefits and risk in a study
4. Protect the participants/ subject’s privacy
a. Anonymity –even the researchers don’t known the participants
b. Confidentiality – pledge any information given by the participants would be private; people who are not involve in the research have no access

GENERAL TYPES OF RESEARCH
Types of Non-Experimental Study - observational research (rather than interviewing)
 Correlational Research – interrelationship/association between variables; answer question: who, how, why, what  [in human adults, height & weight tend to be correlated]
 Descriptive Research – describe, to document and to observe aspect of situation [who, what, when, where, how]
 A researcher is interested in women’s experiences during menopause

Experimental Research – intervention or treatment (manipulation of dependent variable) – also called as intervention research

OTHER CLASSIFICATION OF RESEARCH
1. Basic Research – attempts to describe a situation; not aimed to find solution to a problem
 Discovering the principles of human behavior
 A research may do a study to better understand/determine normal grieving process without having explicit nursing applications in mind
2. Applied Research - solution to a problem
 A study to determine the effectiveness of a nursing intervention to ease grieving
3. Quantitative Research – numerical data (# of children, income)
 Often requires statistical analysis – objective measurement
 What causes the phenomena, samples of data
4. Qualitative Research – non- numerical data (ideas, perception) –subjective
 Explain how does phenomenon exist

 Shallow and labored breathing
 AVOID
o High altitude
o Crowded places
o Extremes of temperature
o Active exercises

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AGING NOTES

Immunologically speaking
 Aging is primarily due to cessation of some organs to produce hormones
 Prone to develop various types of allergies and easily develops infection brought by alteration in immune defenses or altered immune system

NEUROMUSCULAR SYSTEM
 Bones becomes brittle
 Decreases elasticity of muscle tension
 Often dies as a result of falls & not due to aging

Implementation: Neurological
 Maintain safety precaution
o Evaluate reflex reactions to protect against accidents
o Evaluate level of alertness
 Monitor dietary intake and fluid intake
 Provide adequate lightings to prevent falls
o Natural lighting best
o Avoid glare
o Night light at all times in bathroom halls
 Encourage sensory stimulation
o Large print books
o Changes in environment
o Colors client can see
 Maintain reality orientation
o Calendars
o Clocks
o One-to-one visits
 Keep client warm – prevent hypothermia
 Check sedative or hypnotic abuse for poor sleep patterns
 Check for anti-depressant drugs

Implementation: Musculoskeletal
 Ambulate within limitations
 Change in position q 20, align correctly
 Prevent osteoporosis by providing exercises against resistance, calcium, Vitamin D supplements
 Provide active and passive exercises
o Rest periods necessary
o Paced throughout the day
 ROM exercises to all joints 3x a day
 Educate family that allowing client to be sedentary is not helpful
 Encourage walking, best single exercise for elderly & swimming

CARDIAC RHYTHM
 Decreased heartbeat = low blood volume = easy fatigability

Implementation: Cardiac
 Monitor vital signs – Pulse, BP
o Apical pulse for 1 minute so premature heartbeats are not missed
o Take BP in both arms
 Monitor medications: digitalis, diuretics
 Maintain dietary restrictions: low salt diet
 Change position slowly, from horizontal to vertical, to prevent hypotensive reaction
 Maintain circulatory homeostasis
o Encourage activity to increase circulatory stimulation: leg exercise, leg elevation while sittiung
o Provide warmth by applying blankets and clothing
o Use gentle friction during baths
o Avoid tight-restrictive clothing

RESPIRATORY AND CIRCULATORY FUNCTION
 Decreased due to wear & tear phenomenon

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NUTRITION NOTES

PD 491 – Nutrition Act of 1975
RA 8976 – Food Fortification Law
RA 832 – Rice Enrichment Act

Fortification – addition of nutrients in EXCESS amount of those originally present
Enrichment – replacement of loss nutrients (GRAINS) B1, B3 & Fe

Father of Philippine Nutrition – DR. FLEMING SANTOS
Father of Nutrition – Lavoiser
Father of Sanitation – Moses

Nutrition – foundation of life based on food requirements of human
Nutrients – substances that human body utilize from food

Macronutrients – need in body in large quantities  H2O, CHO, CHON, Fats
Micronutrients – needed in small quantities

Nutrient Density
1. High Nutrient Density
2. Low Nutrient Density

Six Classifications of Nutrients
1. Water
2. CHO
3. CHON
4. Fats
5. Vitamins
6. Minerals

NUTRITIONAL GUIDELINES
1. Food Pyramid Guide – visual representation of the 5 basic food groups
Legumes – MEAT GROUP; Bacon – fat, oil, sweet groups
2. Exchange List System – DM – exchange should be within the same food group
3. Vegetarian Diet – (+ decrease Cancer formation, CAD, Obesity); (- decrease CHON, Vit B12)
a. Vegan – strict vegetarian
b. Lacto-Vegetarian – veggies with milk
c. Lacto-Ovo Vegetarian- milk with egg with veggies
d. Pesco Vegetarian- with fish & veggies
e. Pollo Vegetarian- with chicken
4. Food Labeling – not exceed 20% of the daily values when it comes to fat (2,000-2,500 kcal)

NUTRITIONAL ASSESSMENT
History
1. Dietary intake record
2. 24-Hour Food Recall
3. Food Diary – eating disorders  emotions & cravings

ANTHROPOMETRIC MEASUREMENTS
1. Height – tape measure, wingspan
2. Weight
3. BMI – wt (kg)/ht2(m)
Below 18.5- underweight
18.5-24.9 – normal
25-29.9 overweight
30 & above – obese
4. BMR – measure the O2 consumption while at rest – resting body rate
- involuntary activities (pumping of the heart)
Increase: Pregnancy, Lactation, (increase demands of O2 consumption), smoking,
growth periods
Decrease: stress (decrease BMR)
5. Skinfold Measurement – distribution of fats vs. muscles in the body (caliper)

LABORATORIES
• Albumin – best method to measure the nutritional status of patient  3.5g/dl up
• Transferrin – measures the Fe storage in the body  2.5 - 4.2 g/L
• Hemoglobin – measures the Fe intake  M = 14 – 17g/dl; F = 12 – 16g/dl

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PEDIATRIC NURSING NOTES

GROWTH AND DEVELOPMENT

GROWTH – increase in body size
- ht, wt, bone size, dentition
- Growth hormone somatotropin

ANTERIOR PITUITARY GLAND (STORES & SECRETES HORMONES)
GH/ somatotropin
TSH
Prolactin
Aadrenocorticotropic hormone
LSH
FSH
MSH

POSTERIOR PITUITARY GLAND (PPG)
Oxytocin
ADH/ Vasopressin

Hypothalamus- responsible for the production

Development- Increase capacity to function at more advance level

PATTERNS (TRENDS) OF GROWTH & DEVELOPMENT
1. Directional Pattern
a. Cephalocaudal
b. Proximodistal – from the center of the body; symmetrical – gross & fine motor development
i. Gross Motor- grasping 5th month
ii. Fine motor – pincer grasp 9th month
c. Mass to specific- master simple operations a complex ones
2. Sequential Pattern
3. Secular Pattern – universal trends in the rate and age of maturation
a. Accelerated growth – infancy & adolescence
b. Decelerated growth

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PEDIATRIC NURSING DISORDERS NOTES

SPINA BIFIDA- CNS Defect
 Neural tube failure to close during embryonic development
Cause: Unspecific
Contributing Factors:
 Late maternal age
 Poor nutrition/vitamin A deficiency (folic Acid)
 Genetic influence
Diagnostic Test
 Amniocentesis
 UTZ
 Myelogram
 AFP- ALPHA FETO PROTEIN – Dx of choice
o N (<15 ng/ml), ↑ in spina bifida, ↓ down syndrome
2 TYPES
1. Spina Bifida Occulta – no sac; dimpling at the base of the spine
 Tuffs of hair, NO PARALYSIS, no surgery

2. Spina Cystica- sac, COULD BE PARALYSIS, requires surgery
 Meningocele- CSF, meninges
 Meningomyocele- CSF, meninges, nerves, spinal cord
o PARALYSIS, SAC IS VERY THIN- sac will be prone to rapture and leakage
o Most relevant Nursing Diagnosis 1st 120 of life: Risk for infection

Transillumination- to check & measure the amount of CSF
No Transillumination- AP can’t measure the CSF accurately
- the portion of spinal cord has entered the sac
LUMBO-SACRAL AREA- most common site

ASSESSMENT
1. Visible spinal defect
2. flaccid paralysis of the legs
3. Altered bladder and bowel function
4. Hip and Joint deformities

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ONCOLOGY NURSING NOTES

Cancer- abnormal cell growth in the body
 rapidly dividing cell
 60% with pain
 Cause: UNKNOWN

Common cellular terms used in alterations
• Hyperplasia- increase in the # of cell
• Hypertrophy- increase in the size of the cell
o Frequently used inflammation
o DILANTIN (Phenytoin) – gingival hyperplasia
o Nursing Responsibility: oral care, soft bristled tooth-brush
• Atrophy- decrease in size of cell
• Metaplasia- conversion of one type of cell into another type
o Normal lung is line with epithelial cell  smoke change into epithelial cell
• Dysplasia- disorganized cell – change of size, shape and function
• Anaplasia- complete undifferentiation of the cell
o Differentiation- ability of the daughter cell to copy the characteristics of the parent cell
o MOST MALIGNANT
• Neoplasm- mutant change in the cell

Categories of Malignant Neoplasm
1. Carcinoma – epithelial cell  all linings of organs, SKIN ca Basal cell carcinoma, Squamous cell carcinoma
2. Sarcoma- connective tissue – bone, joints, cartilage, muscle, fats, skin, blood vessels
3. Lymphoma- Lymphatic tissue  Hodgkin’s Disease
4. Leukemia/Myeloma- blood-forming organs  bone-marrow
5. Adenocarcinoma – glandular tissue- mucous glands

Pathogenesis
1. Cellular Transformation and Derangement Theory – environmental & exposure to carcinogen
2. Failure of immune Response Theory- physiologic

AGE- single most important risk factor for Ca

Carcinogenesis
1. Infiltration Stage- 1st time that normal cell is exposed to carcinogen
 Genetic change- still reversible
2. Promotion – subsequent exposure to carcinogen
 Dysplacia – anaplastic cell
3. Progression stage- irreversible change in the cell metastasize

Metastases- spread of Ca cells to other organs
 Area with increase vascularity or increase in blood supply
 Nearest organ
Primary site- where the Ca develops originally

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NURSING BOARD EXAM NOTES

To all nursing students especially to those taking up the board exams, I have good news for you!
One of my friends Cha shared her nursing notes on her board exam! These are the topics:

• Cancer
• Pedia
• Pedia Disorders
• Fats Soluble Vitamins
• Nutrition
• Systems
• Research

Just Open or download the files at this page

http://nursingreviewers.googlepages.com/nursingreviewers

GOOD LUCK AND GOD BLESS TO ALL NURSING STUDENTS TAKING UP THE BOARD EXAM!

POST-MORTEM CARE: ROLE OF THE NURSE

I. Purpose:
To clean the patient's body and prepare it for removal from the hospital after death.

II. Responsibilities of the Nurse

1. Care of the Valuables

a) Valuable with the patient at the time of death should be identified, accounted for and sent to the proper department of the institution for safe keeping until family claims for it.
b) Valuables taken or given to the patient's family should be voted on the form sheet specified by the institution.


2. Care of the body

a) Post mortem care of the body is not rendered unless the physician has pronounced the patient to be dead
b) Indicate the chart time the patient was pronounced dead and the physician pronouncing
c) Have the body cleaned and properly identified
d) If the patient is communicable the water used in cleaning must be medicated
e) Inform medico legal Officer if accident, suicide, homicide, or illegal therapeutic practices causes death
f) Prevent all means of distortion, discoloration or scarring of the body as it is distressed to the family.

3. Accomplishment of necessary papers related to death. Death certificate is sent to the local health Department. It is accomplished by the physician and signed by him and by pathologist if autopsy has been performed.

4. Attitude towards the family. Provide all means to comfort the family and relatives who may be around.

BED SHAMPOO: PERFORMANCE CHECK LIST

I. Purpose of bed shampoo

1. To cleanse the hair
2. To eliminate the oil glands
3. To stimulate circulation in the scalp
4. To remove excess oil
5. To remove dandruff

II. Preparation for bed shampoo

1. Kelly pad
2. Rubber sheet
3. Pitchers for water (2 Quarts capacity)
4. Shampoo
5. Three bath towels
6. Face towel
7. Washcloth
8. Rubber pillowcase
9. Cotton balls
10. Hair brush or comb
11. Large pail
12. Bath blanket
13. Lemon juice or vinegar
14. Sponge bowl
15. Bath thermometer

III. Procedure/Check list

1. Check the chart for a written order
2. Wash your hands
3. Explain the procedure and offer the bedpan or urinal
4. If able, assist the patient to sitting position. Arrange pillor and line with rubber sheet
5. Line with a (first) towel the rubber sheet
6. Place kelly pad or rolled rubber sheet and line it with the second towel
7. Assist patient to recumbent position with the kelly pad under the patient's shoulders
8. Brush the hair thoroughly
9. Place one cotton ball to each ear.
10. Place the third towel over the chest
11. Place damp wash cloth over eyes
12. Test the temperature of the water
13. Wet the hair and apply shampoo. Rinse well
14. Wet the hair again and apply shampoo. Rinse well
15. Apply the lemon juice. Rinse with water
16. Remove the kelly pad or rolled rubber sheet and place it in the pail
17. Return pillo to its proper postion under the head
18. Remove earplugs and damp wash cloth.
19. Dry and comb the hair
20. Tidy up the place
21. Return articles to their proper places clean and dry
    

TEMPERATURE, PULSE RATE AND RESPIRATORY RATE: PERFORMANCE CHECK LIST

I. Definitions

1. Temperature - is the degree of heat maintained by the body as measured by a predetermined scale. It is the balance between the heat production and heat loss of the body
2. Pulse - the rhythmic expansion of an artery produced by increased volume of blood forced into by contraction of the left ventricle at each heart beat
3. Respiration - the exhange of gases between an organism and its environment

II. Preparations
A tray lining containing:

1. A wide mouth container containing cotton balls soaked on soap solution
2. A wide mouth container with plain water
3. A wide mouth container with clean oral thermometer in disinfectant solution
4. A wide mouth container with clean dry cotton balls
5. A wide mouth container for soiled cotton balls
6. A watch with swift second hand
7. Paper and pencil
8. Hand towel

III. Procedure/Check list

ORAL TEMPERATURE

1. Wash hands
2. Explain procedure to patient
3. Obtain proper thermometer
4. Wipe thermometer bulb to stem
5. Check for proper lighting
6. Shake the thermometer down to 35 degrees
7. Place the thermometer under the tongue
8. Instruct to gently close the mouth
9. Leave in place for eight minutes
10. Remove thermometer
11. Wipe thermometer from stem to bulb
12. Read thermometer at eye level
13. Place thermometer in container
14. Record finding

AXILLARY TEMPERATURE

1. Wash hands
2. Explain procedure and elicit cooperation
3. Pat the axilla dry
4. Obtain proper thermometer
5. Wipe thermometer from bulb to stem
6. Shake the thermometer down to 35 degrees
7. Place the thermometer in the axilla directed upward. Place arm across the chest
8. Leave thermometer in place for ten minutes
9. Remove and wipe the thermometer from stem to bulb
10. Read at eye level
11. Place the thermometer in the container
12. Record on a paper
13. Fix the sleeves of the client
14. Wash hands

RADIAL PULSE

1. Wear watch with swift second hand
2. Explain procedure to patient
3. Place patient's arm across the chest
4. With gentle pressure, place first three fingers against the radial artery
5. Feel for pulsation
6. Count for one full minute
7. Record on a paper

RESPIRATION

1. With fingers still in place, after taking pulse rate, note the rise and fall of the pateint's chest
2. Count for one full minute
3. Record for one full minute
4. Transfer the readings in the patient's chart
   

BLOOD PRESSURE TAKING: PERFORMANCE CHECK LIST

I. Definition
Blood Pressure - the force exerted by the blood against the walls of the blood vessels as it flows through them.

II. Preparation
A tray with the lining containing the following:

1. Sphygmomanometer
2. Stethoscope
3. Cotton balls soaked in alcohol
4. Wash cloth or hand towel
5. Waste container
6. Tissue paper to line the BP cuff

III. Performance check list

1. Wash hands and gather equipment
2. Wipe the earpieces of the stethoscope with cotton balls
3. Explain the procedure to the patient
4. Apply blood pressure cuff on arm
5. Locate patient's brachial artery.
6. Place earpieces of stethoscope into the ears
7. Close valve on hand bulb.
8. Place diaphragm of the stethoscope over the brachial artery
9. Pump hand bulb to 30 mmHG. Above last beat heard.
10. Note first sound, muffling and last sound heard.
11. Remove cuff from patient's arm and earpieces of the stethoscope from own ears.
12. Wipe earpieces with cotton balls soaked in alcohol
13. Record appropriately, including narrative if necessary.
14. Return the apparatus to its proper place.
15. Wash hands.
    

ROUTINE DAILY CARE FOR THE PATIENT: BED BATH

Purpose:

1. To clean the skin thus eliminate waste products
2. To stimulate circulation through slightly active or entirely passive exercises
3. To refresh the patient by relieving fatigue and discomfort

I. Preparation
Equipments: A tray containing the following:

1. Basin with warm water of 105-110 degrees Fahrenheit
2. Two (2) bath towels
3. Two (2) wash cloth
4. Drinking glass
5. Toilet articles
6. Hair brush
7. Comb
8. Tooth brush and tooth paste
9. Scissors
10. Powder
11. Toilet Soap
12. Deodorant
13. Bath blanket
14. Two (2) pitchers
15. Bath thermometer

II. Procedure

1. Wash your hands (as always.. hmm..)
2. Screen the bed
3. Replace top sheet with bath blanket
4. Remove gown
5. Put one towel under patient's head and one on the chest
6. Test temperature of water
7. Dip washcloth in warm water. Sponge face, ears, neck. Rinse and dry.
8. Place bath towel under arm and shoulder from you. Sponge axilla. Rinse and dry.
9. Soak hands in basin of water. Soap and rinse.
10. Drape chest and abdomen with bath towel. Sponge, rinse and dry.
11. Turn patient towards you. Cover back after sponge. Massage. Use firm long strokes.
12. Place towel under leg. Drape well. Sponge, soap, rinse and dry.
13. "FINISH THE BATH" (you may be asking what "finish the bath means", i'll post it next.^_^)
14. Apply deodorant. Remake bed. Comb patient's hair, clean nails.
15. Leave until unit is neat, order and clean.

I'll post some pictures too.. I have no more time now. Gotta go to sleep! hehe! Hope this can help! ^_^

BEDMAKING

I. Definition

1. Bed making - is the art of arranging linens
2. Closed Bed - is used to designate the hospital bed which remains empty after admission of another patient.
3. Open bed - used to designate the hospital bed when it is occupied or about to be occupied by a patient.
4. Ether bed or anesthetic bed - is one which it is made ready to receive a patient who has undergone anesthesia.

II. Preparation

1. 2 white sheets
2. 1 draw sheet
3. 1 rubber sheet
4. 1 bath towel
5. 1 hand towel
6. 1 face towel
7. 1 pillow
8. 1 pillow case
9. 1 bedspread
10. 1 blanket

III. Procedure

CLOSED BED

1. Arrange the linens in order as they are needed
2. Bring the preparation to the bedside of the patient
3. Take the bottom sheet; spread it on the mattress, placing the smaller hem at the foot part. Place it lengthwise on the middle of the mattress with the side equidistant from the center
4. Tuck the sheet under the head of the mattress. Miter the corner along the near side.
5. Place the rubber sheet 18 inches from the head part of the mattress. Place the draw sheet.
6. Spread top sheet on the mattress with wrong side up, making even the edges of the bed. Draw all linens tight and tuck under the mattress.
7. Fold top sheet back to 18 inches
8. Place the pillow case and put it at the head part of the bed. Cover with top sheet.
9. Fold the towel into three sections and fold into two.
10. Hang over at the top of the bed with free or loose ends out of sight

OPEN BED

1. Prepare the materials needed (same as closed bed)
2. Replace the top sheet with bath blanket. Loosen all the bed linens from all sides of bed. Go to opposite side of bed and draw the patient towards you. Return to the work side of the bed.
3. Fanfold the bottom sheet, rubber and draw sheets in irregular folds to the center of the bed.
4. Place a clean bottom sheet, the rubber sheet and the draw sheet on the bed in the position described for closed bed.
5. Tuck the top sheet, miter the corner then pull the loose ends on the bed and the draw sheet. Tuck in together with the bottom sheet.
6. Fanfold the halt of the clean sheet close to the patient along with the half of the rubber sheet and the draw sheet.
7. Roll the patient gently over the folded sheets to the near side of the bed.
8. Go around to the other side of the bed, remove the soiled bottom sheet and pull the fan folded sheet at the side and make bed as it was done on the opposite side. Fold the soiled linens and place it at the foot part of the bed.
9. Remove the bath blanket and put on the top sheet. Miter the corner as in the closed bed but care is taken that they are loose enough at the foot top to prevent pressure on the patient's feet.
10. Straighten the upper edge of the cover, fold neatly and put clean pillow
11. Change the soiled wash cloth, bath and hand towels with fresh ones.
12. Rerturn chair and bedside table to proper place
13. Place all soiled linens in the linen hamper.
    

NURSING CARE PLAN (NCP)

Nursing
- diagnosis and treatment of human responses to actual & potential health problems

Nursing Process

- the way one thinks like a nurse
- foundation & the essential enduring skill that has characterized nursing from the beginning of the profession
- systematic method that directs the nurse and client as they determine the need for nursing care plan, and implement the care and evaluate results

Nursing Assessment

- a systematic, dynamic process by which the nurse through interaction with the client, significant others, and health care providers, collects and analyzes data about the client
- involves collection, validation & communication of client's data.

Nursing Care Plan

- outlines the nursing care to be provided to a patient. It is a set of actions the nurse will implement to resolve nursing problems identified by assessment. The creation of the plan is an intermediate stage of the nursing process. It guides in the ongoing provision of nursing care and assists in the evaluation of that care.

WAAA! 2nd year nursing students! Our duty in the hospital or in the community is coming! NCP and SOAPIE here and there! waaa! Goodluck to us all Nursesters! ^_^

THE EVER BELOVED,EVER FAMOUS, HANDWASHING!

HANDWASHING
- is the single most important, least expensive method in preventing and controlling transmission of infections

PURPOSE:

1. Reduce number of resident and transient bacteria from the hands
2. Prevent transfer of microorganisms from hospital environment to patient and from patient to hospital personnel

Handwashing was our 2nd exposure to RLE.

MISSION 2:
HANDWASHING:
MISSION ACCOMPLISHED

weee! congratz! hehe! ^_^