2016 School District of Pittsburgh

Transcription

1 2016 School District of Pittsburgh Health Careers Skill Name: Accurately Measures, Records and Reports Client s Oral Temperature ROADMAP: 20 min (vitals, height and weight) EQUIPMENT NEEDED: facility/materials for handwashing, gloves, oral thermometer, record sheet 1. Wash hands before contact with client 2. Identify yourself to client by name and address client by name 3. Explain procedure to client speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible 4. Provide privacy 5. Put on gloves 6. Hold oral thermometer by stem, shake down to below 96 degrees Fahrenheit 7. Apply thermometer cover 8. Place thermometer in client s mouth under tongue 9. Instruct client to keep mouth closed and leave in for 3 minutes 10. Remove thermometer and remove cover-discard the cover 11. Read thermometer 12. Leave client comfortable with call bell within reach 13. Clean thermometer 14. Return thermometer to proper container/location 15. Remove gloves, discard and wash hands 16. Record oral temperature 17. Report the temperature to the nurse if it is elevated PROCEDURE EVALUATION CHECKLIST: ACCURATELY MEASURES, RECORDS AND REPORTS CLIENT S PULSE

2 2016 School District of Pittsburgh Health Careers Skill Name: Accurately Measures, Records and Reports Client s Pulse ROADMAP: 20 min (vitals, height and weight) EQUIPMENT NEEDED: facility/materials for handwashing, gloves, record sheet 1. Wash hands before contact with client 2. Identify yourself to client by name and address client by name 3. Explain procedure to client speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible 4. Provide privacy 5. Place fingertips on thumb side of client s wrist to locate pulse 6. Count beats for one full minute 7. Leave the client comfortable with call bell in reach 8. Wash hands 9. Record pulse rate 10. Record any irregularity 11. Report if the radial pulse is irregular, above or below normal range PROCEDURE EVALUATION CHECKLIST: ACCURATELY MEASURES, RECORDS AND REPORTS CLIENT S PULSE

3 Skill Name: Accurately Measures, Records and Reports Client s Blood Pressure ROADMAP: 20 min (vitals, height and weight) EQUIPMENT NEEDED: facility/materials for handwashing, gloves, stethoscope, sphygmomanometer, record sheet 1. Wash hands before contact with client 2. Identify yourself to client by name and address client by name 3. Explain procedure to client speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible 4. Provide privacy and make client comfortable sitting or lying 5. Apply blood pressure cuff snugly to client's upper arm 1 inch above elbow; adjust gauge so it can be read easily 6. Clean diaphragm and earpieces of stethoscope before using 7. With palm up, find brachial artery 8. Tighten valve of sphygmomanometer 9. Locate radial pulse with fingertips 10. Inflate cuff to no more than 30 mm Hg above where pulse is last felt 11. Deflate the cuff slowly 12. Place diaphragm of stethoscope over brachial artery; place earpieces of stethoscope in ears 13. Inflate cuff slowly to approximately 30 mm Hg above point where pulse was no longer felt 14. Deflate cuff slowly and evenly, noting the point where sound is first heard --systolic pressure 15. Continue to deflate cuff and note where sound changes or disappears - diastolic pressure 16. Leave client comfortable with call bell within reach 17. Wash hands 18. Record results 19. Report any abnormalities

4 Skill Name: Accurately Measures, Records and Reports Client s Height and Weight ROADMAP: 20 min (vitals, height and weight) EQUIPMENT NEEDED: facility/materials for handwashing, gloves, scale, record sheet 1. Wash hands 2. Identify the client and introduce yourself 3. Explain the procedure 4. Provide for privacy 5. Assist client to the scale (Note: same time of day, weight of clothing) 6. Balance the bar of the scale so that the balance pointer is in the middle 7. Raise the height bar 8. Assist client to stand in the center of the scale platform, arms at their side (follow facility policy for using the chair or lift scale) 9. Move the weights until the pointer is balanced 10. Record the weight 11. Ask client to stand as straight as possible 12. Lower the height bar until it rests on the clients head 13. Record the height 14. Assist the client off of the scale 15. Return the client to their room 16. Provide for comfort 17. Place the call bell within reach 18. Return the scale to it proper place 19. Wash hands 20. Report measurements and observations to the nurse

5 Skill Name: Accurately Measures, Records and Reports Client s Respirations ROADMAP: 20 min (vitals, height and weight) EQUIPMENT NEEDED: facility/materials for handwashing, gloves, record sheet 1. Wash hands before contact with client 2. Identify yourself to client by name and address client by name 3. Explain procedure to client speaking clearly, slowly, and directly, maintaining face-to-face contact whenever possible 4. Provide privacy 5. Place client s arm over chest-do not tell client you are going to count their respirations, as this will affect how they breathe 6. Observe the rise and fall of the chest-each rise and fall = 1 resp. 7. Count respirations for one full minute 8. Record respirations 9. Note any irregularity 10. Leave the client comfortable with call bell in reach 11. Wash hands 12. Report if the respirations are irregular, shallow, abdominal, or difficult

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7 Skill Name: Transfer Client from Bed to Wheelchair ROADMAP: 15 min. EQUIPMENT NEEDED: facility/materials for handwashing, gloves, wheelchair, patient bed, gait belt (if needed), record sheet 1. Wash hands before contact with client 2. Gather supplies 3. Knock on door and introduce self 4. Identify the client and address by name 5. Explain procedure to client, speaking clearly, slowly, and directly maintaining face-to-face contact whenever possible 6. Provide for privacy during procedure with curtain, screen, or door 7. Lock wheels of bed 8. Position wheelchair or chair close to bed with arm of wheelchair or chair almost touching bed, lock wheelchair and position back of wheelchair even with the bed footboard. (gauge according to client s height) Note: Chair is positioned based on room set-up, client s preference, or medical necessity 9. Place cushion or appropriate device on seat of wheelchair or chair, if needed 10. Remove footrests from wheelchair or fold up, depending on wheelchair 11. Position bed at a safe and appropriate level for client 12. Instruct or assist client to move to the side of the bed closest to you 13. Elevate head of bed if possible and allow client to remain in sitting position for several minutes 14. Fanfold top linens to bottom of bed 15. Support client s back and hips and assist client to sitting position with feel flat on the floor-allow to sit at side of bed for a short period of time 16. Put on non-skid footwear and securely fasten. (Can also be done prior to sitting at bedside.) 17. With transfer (gait) belt: Stand in front of client, positioning self to ensure safety of candidate and client during transfer (e.g., knees bent, feet apart, back straight). Place belt around client's waist, and grasp belt. Ask client to safely inch out to edge of bed. Without transfer belt: Stand in front of client, positioning self to ensure safety of candidate and client during transfer (e.g., knees bent, feet apart, back straight, arms around client s torso under the arms.) Ask client to safely inch out to the edge of the bed.

8 18. Provide instructions to enable client to assist in transfer 19. Brace client s lower extremities to prevent slipping 20. Count to three (or other pre-arranged signal) to alert client to begin transfer 21. On signal, gradually assist client to stand 22. Assist client to pivot to front of wheelchair or chair with back of client s legs against seat 23. Have client reach back and grasp arms of wheelchair or chair 24. Lower client into wheelchair or chair to a sitting position 25. Reposition client with hips touching back of wheelchair or chair and remove transfer belt if used. 26. Position client s feet on footrests of wheelchair 27. Ensure comfort 28. Place signaling device within client s reach 29. Cover legs and lap with blanket, per client s preference 30. Position wheelchair in room to promote socialization 31. Un-screen client 32. Ensure client s room is in proper order 33. Wash hands 34. Report your actions and any unusual observations

9 Skill Name: Demonstrates Handwashing ROADMAP: 15 min. (w/ppe) EQUIPMENT NEEDED: facility/materials for handwashing 1. Stand away from the sink-your uniform and hands must not touch the sink 2. Turn on water with a dry paper towel-adjust water to a warm, comfortable temperature 3. Wet hands, keeping your fingertips pointed down 4. Apply soap over hands and wrists working into lather 5. Use friction when washing hands, fingers and wrists 6. Rub hands under water for at least seconds 7. Rinse hands under running water 8. Do not shake water from hands 9. Dry hands with a clean, paper towel. Discard properly 10. Turn off faucets using clean, paper towel 11. Discard the paper towel in the waste container

10 Skill Name: Demonstrates Donning and Removing PPE ROADMAP: 15 min. (w/handwashing) EQUIPMENT NEEDED: gown, gloves, mask and handwashing facilities A. Procedure for gowning, gloving, and masking using disposable gown, gloves and mask 1. Remove your watch and place it on a clean paper towel-carry your watch with you into the isolation room on the paper towel 2. Wash your hands and dry them thoroughly 3. Put a mask on, and adjust it over your nose and mouth. Tie the mask securely at the back of your head 4. Put on a gown 5. Tie the neckties 6. Tie the waist ties of the gown, making certain the gown is overlapping and covering your uniform 7. Put on gloves covering the cuffs of the gown with the top edge of the glove B. Procedure for removal of gloves and mask 1. Make sure that all jobs in the isolation unit are complete and that the client is comfortable and safe 2. Remove gloves by turning them inside out and dispose of them in the biohazardous, waste can 3. Untie the waste ties of the gown. Note: If waist ties are in the front, untie the waist ties before removing gloves. If ties are in the back, remove gloves before untying waist ties Page 1 of 2

11 4. Remove a clean paper towel and turn on the faucet-wash and dry your hands-turn off the faucet with a clean, paper towel 5. Remove the mask by grasping only the ties. Untie the bottom tie first, then the top tie 6. Discard the mask in the covered trash container C. Procedure for removal of gown. 1. Untie the neck ties of the gown and loosen the gown at the shoulders 2. Slip the fingers of one hand under the cuff of the gown of the opposite arm-do not touch the outside of the gown-pull the cuff down over your hands 3. With your hand inside the gown, pull gown off the other arm 4. Fold and roll the gown away from your body, with the contaminated side in 5. Dispose of the gown in the covered biohazardous, waste container 6. Remove a clean, paper towel and turn on the faucet 7. Wash and dry your hands. Turn off the faucet with a clean, paper towel 8. Open the door with a paper towel 9. Repeat hand washing if this is your facility s policy

12 Skill Name: Change a Patient Gown ROADMAP: 15 min. EQUIPMENT NEEDED: gown, gloves and handwashing facilities 1. Identify patient. 2. Introduce self and explain procedure. 3. Retrieve clean gown. 4. Verbalize need for handwashing. 5. Wash hands. 6. Maintain patient's dignity and right to privacy by not exposing body. 7. Untie soiled gown 8. Remove patient's arms from gown, unaffected arm first. 9. Roll soiled gown from neck down and remove 10. Appropriately dispose soiled gown. 11. Slide patient's arms into clean gown, affected arm first 12. Tie gown 13. Perform final steps (i.e. lower bed height and position side rails as appropriate, place call light and water within patient s reach., ask patient if anything else is needed, thank patient 14. Verbalize need for handwashing 15. Wash hands