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A Nursing Round is one which presents an overview of certain aspects of the nursing or medical care of all patients on the ward or of selected patients.
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ADICHUNCHANAGIRI COLLEGE OF NURSING Topic:Nursing Rounds , Protocols , Manual Mr. Dipankar Maiti ACN
Definition A Nursing Round is one which presents an overview of certain aspects of the nursing or medical care of all patients on the ward or of selected patients. -GABERSON
Purposes To acquaint nurse with all patients on the more purposeful care may be achieved for each patient. To help nurse to introduce with new patient. To carry out demonstration of therapeutic procedures on/for the patients. To illustrate skillful Nursing care. To learn about disease, patterns of care & treatment. To demonstrate the effect of drugs used in treatment. To observe the physical & mental condition of the patient. To orient the nurse/Student in taking charge of the patient’s treatment & status of the patient. To check any preventable condition in patient such as Bed Sore, Foot Drops etc. To check emergency equipment near the patient for safety or working order. To prescribe any medication in nursing action.
Types Rounds with Doctors Rounds to check psychological problem of patient. Social Service Rounds Medical round for Nurses Round with the physical therapist. Nursing Rounds
Way of conducting rounds When ward rounds are conducted, the teacher goes to the patient’s room with the group of nurse. Outside of the door, out of his hearing, the discuss the objectives, after which they go in to see the patient & talk for a few moments with him. They than move on to the next patient. The discussion must necessarily by brief including only the outstanding points if the purpose is to visit all the patient in the ward. Nursing rounds are done in a reporting style regarding the patient’s condition, nursing care, medical care & prognosis.
Nurses role in nursinvg rounds o n A c i t
Advocate • Adequately preparing for the ward round. • Empowering the patient to ask questions on ward round. • Communicating with multidisciplinary team after a ward round Chaperon • Preparing the patient for examination through communication & positioning. • Taking responsibility for dignity & Privacy. • Minimizing any anxiety & potential embarrassment. • Respecting cultural wishes throughout the process.
Transitions • Noting any ongoing investigations & communicating these to the patient & team. • For patient transfers, documenting any incomplete investigations/actions on a handover checklist • For patient discharges, documenting any relevant information on the discharge • checklist • For specialty referrals, completing a management plan indicating any next steps in the care pathway. Informative • Recheck information during or after a ward round • Prepare the patient for the next steps in the care pathway • Explain anything that the patient may not understand • Encourage the patient to ask questions or express corners • Report back to the nursing team
Organizer • Delegating effectively to different team members • Arranging transport & medication to take home • Requesting specific items of equipment that are required • Organizing care packages Nurse-Centered A nurse responsible for explaining the next nurse who will undertake the ward round for those patients.
Areas Supervised During Rounds • Quality patient care. • Assignment & utilization of personnel. • Work performance. • Physical facilities of nursing personnel • Safety & Security measures • Records & reports maintained by nursing personnel. • Communication system • Interpersonal, human & Public Relationship
Merits • Helps in maintain interpersonal & human relations. • Helps in providing quality care to patients. • Helps in minimizing the problems faced by nursing personnel during the delivery of health care • Enhance the skills, knowledge & aptitude of nursing personnel. • Helps in good communication & public relation. • Helps in punctuality of the employees • Facilitates in cleanliness & house keeping
deMerits The confidentiality of patient is hampered The patient Example
Definition • Standing order are specific instruction regarding treatment for condition that nurses & other Health workers may encounter in home, school & industries where doctor is not readily available. • The standing order are intended to provide treatment only in emergencies & temporarily in the absence of a doctor ,they should be limited.
Purposes • To meet emergency situation in rural area • To deliver care at home ,School , Community. • To provide temporary treatment in the absence of a doctor • To promote health services in community
General Standing Order Instructions • Standing order instructions should be issued jointly by an authorized medical officer & a nurse or a committee with a nurse representative. • The community health nurse working in rural areas may be only qualified professional person readily available to the family , so standing instruction must be used with caution & discretion.
Standing orders are those to promote health services in the community • The medical officer is legally responsible for issuing standing order,& he should have faith in the sound judgement of his staff. • They reduce danger in acute condition. • They create the feeling of responsibility among the members of the health team. • Every health service should issue standing instruction to meet the health need of the areas.
Role of Nurse in Standing Order • The community health nurse should be skillful in recording the history & in physical examination in order to detect abnormality. • The community health nurse should be promt in detecting appropriate action for particular situation. • The nurse should maintain a record of vitals & other care given to the patient. • The nurse should have thorough knowledge to identify the actual problem of the patient & to plan appropriate nursing interventions. • The nurse should intervene with services according to the given community standing order. • The nurse should develop a good therapeutic relationship with the individual & family. • The nurse should use referral system if it is possible. • The nurse should inform the health officer immediately if there is a communicable disease. • He / She should keep the medication safe & ready to follow standing orders. • He / She should ensure a safe & healthy environment for the patient. • Recording & reporting is an essential part of community health services.
Institutional Standing Order • They are meant keeping in mind available resources, Staff position & the objectives of a medical institution or hospital • Ex- standing order of PHC can be different from those of district hospital. Specific standing Order • These orders are meant for trained medical personnel, mainly the nurses, technical knowledge & specific skills are to implement these orders. • Ex- Giving care at home , Injections, Oxygen therapy
General Standing Orders • Owning to a large population, vast geographical area & the shortage of resources , some standing order are used to propagate health care messages to the masses. • Ex-Preventive measures against AIDS.
Advantages of Standing Order • Community standing orders provides timely treatment during emergencies. • They enhances the quality & activity of health services. • They provide a feeling of confidence & responsibility in the nursing staff & other health workers. • They help to decentralize the health responsibilities. • They help to strength the primary service in the community.
Definition Manual means reference book . A book which is prepared by nursing authority & nursing professionals related to particular subject , how to perform the procedures & activities is called Nursing Manuals.
Manuals in Nursing TNAI(Trained Nurses’ Association Of India) manual of Community Health nursing Manual of SOP(Standard Operative Procedure) in fundamental of Nursing & Disaster Management Manual. Purposes To set a standard Establish criteria for SOP Take action if deviation/any malpractice is there.
Benefits University of procedures. Helps in performance appraisal in organization. Help in quality care Enhance skills of Employees/Nursing Personnel
bibliography A Text Book of Management of Nursing Services & 2Education;Neelam Kumari; Page 254-258 Textbook of Nursing Management & Services ; Kamaljit Kaur; 248-268
Presented By Dipankar Maiti Cordially Thanks to Mrs. Shilpa Madam
