Medical surgical asepsis

Medical surgical asepsis

Asepsis - 

              It is the condition of being free from disease producing microorganism.
Asepsis is the method by which we prevent microbial continuation during invasive procedure or care of breaches in skin integrity.

Medical asepsis - 

               medical asepsis is the state of being free from disease causing microorganism. 

Its concern with spreading of microorganisms through facility practices such as sterilizing or disinfecting. The technique used to maintain medical asepsis include hand washing, growing, and wearing facial mask and providing information to patients about basics hygiene practice. 

Basic principle of medical asepsis 

1: Wash hands frequently, but especially before handling foods, before eating after using a handkerchief, after going to the toilet, before and after each clint contact and after removing gloves. 

2: Keep soiled items and equipment from touching the clothing. 

Do not place soiled bed linen or any other items on to the floor. 

3: Avoid having client's cough, sneeze or breath directly on others. 

4: Move equipment away from you when brushing, dusting or scrubbing articles. 

5: Clean the least soiled area first then more soiled ones. 

6: Dispose soiled or used items directly into appropriate containers. 

7: pour liquid that act to be discarded directly into the drink so as to avoid splitting in the sink and on to you. 

8: Avoid learning against sink, supplies and equipments. 

9: Avoid touching your eyes, face, nose, or mouth. 

10: Use practices of personal grooming that help prevent spreading of microorganisms. 

11: Follow guidelines contently for isolation or burrier technique as prescribe. 

Surgical Asepsis :-

 Surgical asepsis is a strict process and include procedure to eliminate microorganism from an area and is practiced by nurses and other health workers in operation theatre and some other treatment areas. 

It is appropriate in wards and other departments for invasive procedure such as insertion of central venous catheter .

Basic principle of surgical asepsis 

Only sterile object can touch other sterile object. All material in contact with the surgical wound or used within the field must be sterile. 

Open sterile packages so that the first edge of the rapper is directed away from the worker to avoid the possibility of a sterile surface touching unsterile clothing. 

The outside of sterile package is consider contaminated.

* gowns of the surgical team are considered sterile in from the chest to the level of the sterile field, the sleeves are also consider sterile from 2 inches above the elbow to the stockinette cuff.

* sterile drapes are used to create a sterile field. 

During draping of a table or a patient the sterile drape is held well above the surface to be covered and is position from front to back. 

* Avoid spilling any solution on a cloth or paper used as field for a sterile setup. 

The moisture penetrate through the sterile clothes and carries organism by capillary action to contaminate the field. A wet field in contaminated if the surface immediately below is not sterile. 

* Hold sterile object above the level of the wrist this will help to ensure keeping the object within site and prevent accidental contamination.

Nurses work with doctor to cure the patient

Nurses work with the Doctor to cure the Patient

1: Nurses play a large role in evaluating patient and detecting problems.

In some rulers area nurses admit patient and manage their care and referring only the most critical patient to distant medical centers.

2: In every hospital nurses carry out many of the treatment prescribed for the patient.

Example :- IV infusion and administration of medication.

3: Coordinate the care of the patient - the nurse collaborate with the other members of the health care team in providing of the patient.

The nurse also plans and supervises the care given by nursing assistance, checks on the work of house keeping staff assigned clean the patient rule and ensure a healthy diet for the patient.

The nurse also ensures the laboratory investigation are done and if any referrals are needed and made before the patient is discharged.

4: Protect the patient - when a person is ill and weak, he or she is more vulnerable to injection and injury.

One of the measure responsibility of the nurse is to protect the patient by ensuring that the environment is safe and healthy. 

The nurse takes every precaution to prevent the spread of infection from one patient to another. 

The nurse see that the patient room is clean, needles, and other materials used for processor are sterile, soiled material are kept away from the patient and used needles and other sharp objects are placed in safety conteners after use.

The nurse washes carefully before and after patient care and between patients. 

The nurse protect the patients dignity and maintain privacy. 

The nurse also make sure that the patient is physically safe, cannot fall out of bed, or fall when trying to walk or slip on the wet floor.

5: Teach the patient and family - Teaching is a measure role of the nurse in restoring health, promoting health and preventing illness.

When a person is ill the nurse demonstrate the thing the patient can do to help with recovery. 

Example - nurses teach patient to cough and breath deeply after surgery to prevent lungs complication.

They show patient how to walk on crutches, they teach people with diabetes to monitor their blood sugar.

Nurses teach both patient and their family about proper diet and nutrition, cleanness and hygiene, exercise, sleep and rest and all the other aspects of healthy life.

6: Advocate for the patient - Nurses are at the bedside of the sick and suffering 24 hours a day. People share the most intermittent details of their life with nurses and trust them to perform painful processor.

They are the to do fed patient, bath them and to support them. 

Role and responsibility of a nurse in medical surgical setting Out patient department (OPD)

Role and responsibility of a nurse in medical surgical setting

                    Out patient  department (OPD) 

Out patient department where patient goes first when he feels ill or where a patient goes with an accident then the out patient department (opd) doctor will decide what to do he will either treat the patient or let him go home or refer him to relevant specialist if needed.

The department is designed with the prime idea of reducing patient time for registration and admission, consultant and investigation.

Many facilities are provided at opd level like, ECG, Plaster, injection and immunisation rule, and contraception and minor surgical intervention, physiotherapy, bronchoscopy, and endoscopy etc.

Medical fitness or medical examination and other such certificate are issue after paying requisite fees. 

The out patient department (opd) system includes the following models :

1: central registration

2: appointment

3: reception and enquiry help

4: billing and cash management

5: management information system

Inpatient department (IPD) or inpatient service (IP)

If OPD is the show window of the hospital, the IPD is the heart of the hospital. The IPD provides lodging, dite and medical care.

Inpatient mean that procedure secure the patient to admitted to the hospital. 

Primarily show that he or she can closely monitor during the procedure and after wards after recovery. 

A patient is admitted to the hospital and stays overnight or for an indeterminate time usually several days or weeks.

(though some cases like coma patient have to stay in hospital for years)

Conveniently, it can divided into :

* wards and rooms

* nurses station

* dietary services

* sanitary facilities and other requirements

Wards can be - intensive care unit (ICU)

                         -  intermediate care wards

                         - isolation wards

Role of nurse 

Care for the patient 

* nurses care for patient continually 24 hrs a day. 

Nurses carry out numerous procedure including patient evaluation, monitoring patients, vital signs and managing medication.

Nurses take care of their patients making sure that they can breathe properly, seen that they get enough fluid and enough nourishment, helping them rest and sleep, making sure that they are comfortable, taking care of their needs to eliminate waste from there body and helping them to avoid the harmful consequences of being immobile like stiff joint and pressure sore. 

The nurse often make independent decision about the care of the patient. 

Example :- the nurse may decide that in order to prevent pressure sore, the patient need to be turned every two hours. 

The nurse not only takes the care of patient but also gives comfort and support to the patient and his family. 

Role of nurse, and family in care of patient

Role of nurse, patient and family in care of adult patient

Role of nurse

Nurses provide care and support, the recovery of patients suffering from acute and long term illness and diseases are those requiring surgery. they focus on the leads of the patient and promote good health and wellbeing through education.

Typical work activity of nurse include :

* writing patient care plans

* implementing plans through task such as preparing patient for operation, wound treatment and monitoring pulse, blood pressure (BP), temperature.

* observing and recording the condition of patient

* checking and administering drugs

* setting IV infusion and blood transfusion

* assessing with diagnostic test and evaluation
* carrying out routine investigation
* responding quickly to emergency
* planning discharges from hospital and liaising with community nurses, social workers and other members of health care team

* advocating on behalf of patient
* contribute to medical decision making
* educating patient about their health

* mentoring student and junior nurses
* mentioning patient records
* making ethical decisions related to coincidence and confidentiality 

Role of family in adult patient care

Family play a very significant role in the care of adult patient.

The contribution of family in the care of adult patient may be in the following aspects

* family acts as an important and reliable source of data pertaining to patient past and present health history.

* in situation patient is incapable (such as unconscious, addicted mentally ill) of giving health related information it can be obtained only from the family members

* presence of family members with the patient contributes consider in reducing the anxiety of the patient which may contribute significantly in treatment outcomes.

* they are a source of motivation for the patient and thus aids significantly in the recovery of the patient.

Family helps in mentioning the continuity in health care services, having an emotional bound with patient, family prevent any harm or injury to the patient due to any untoward activity of the health organization.

In situation of Terminal illness, family helps in enhancing acceptance and coping. 

thus family acts as a link between the hospital and the community. 

Concept of illness and disease

Concept of illness and disease

Disease -

The term disease means without ease, the opposite of ease, when something is wrong with bodily function. 

Disease is a physiological or psychological disfunction.

Sickness refers to a state of social disfunction. 

Illness is the inability of an individual adaptive responses to maintain physical and emotional balance that subsequently results in an impairment of functional abilities.

There are two measure classification of illness.

1: Acute 

2: Chronic 

1: Acute - An Acute illness is a disruption in functional ability usually characteristics by a rapid onset, instance Mainfaction and a relatively short duration.

Signs of Acute illness onset rapidly.

Examples - nausea , vomiting, diarrhea, headache, coughing, pain, confusion, skin rash.

2: Chronic - A chronic illness is a disruption of functional ability usually characterises by a gradual insidious onset. with life long changes that are usually irreversible.

Chronic illness last a long time frequently throughout the individual life.

Chronic illness slow onset usually longer than 6 months.

Examples - AIDS , Cancer, TB etc.

Concept of health and illness

Concept of health and illness

Health - health is a state of complete physical, mental, emotional, social well-being and not merely the absence of disease.

This definition emphasis health as a positive state of well-being and not just absent of disease.

Aspects of good health (1) physical health

                                         (2) mental health

1: physical health - physical health can be defined as a state in which all the body parts are anatomically intact and are performing their physiological function perfectly and harmoniously.

A person is physically healthy if he or she looks alert and responsive . it is a very simplistic definition but it basically covers the following,

* All the body parts should be present 

* All of them are in there natural place and position.

* Weight normal for age and height.

*None of them has any pathological defect.

*All of them are doing their physiological function perfectly and harmoniously.

2: Mental health - it is a state of emotional, psychological and social wellness evidence by satisfying interpersonal relationship effective behavior and coping, positive self concept and emotional stability.

mental health can be influenced by a wide variety of factors which can be categorised as individual, interpersonal, social or cultural.

Individual factor include persons biology makeup, sense of harmony in light, vitality, ability to find meaning in life etc.

Interpersonal factor include effective communication, ability to help other,

intemasy etc.

Social or cultural factor include sense of community access to educate resources Intoleranceof violence
A person is mentally healthy if he or she is relaxed and free from any worries.

Social health - social health indicates how person interact with other people as well as the consequences or benefit of such interaction in relation to the well-being of that person.
Social health deals with how people relate to each other and how an individual is able to socialize with other people and form relationship.

A person with good social health
*Gets along well with people around
* Have pleasant manners
*Helps others and fulfills responsibility towards other 

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Medical surgical nursing 

Current trained in medical surgical nursing

1• population changes- over the last
decades the democratic profile of acquiring nursing care has change dramatically.

Increase with number of people infected with HIV , Hospital services to elderly has also significantly increases. All of these factors impact greatly on nursing care which leads to changing role of nurses.

2• advanced nursing practice- professional nursing is adapting to meet changing Health Care needs and expectation one method is advance practice role which has developed in In response to need for improved distribution of Healthcare services.

The nurse who function in advance practice role provide direct care to patients through independent practice or practice within health agency.

This new role amended to give nurse authority to perform function that words previously restricted to practice of medicine so now nurse must be skilled in decision making, interviewing, observation , physical assessment and examination, evaluation outcome of care and implementing measures to promote cost effectiveness.

3•Healthcare reform - over the years Healthcare become increasing expensive, insurance premium have client and business have been less inclind to offer health benefits to all through government programs.

4• computerisation - use of computerized record has helped in a speed Record Keeping and allows nurse to spend more time with their client.

Institutions are using computer in many ways such as ordering supply and services, storing and providing immediate access to diagnostic test result document nursing access and care and development individualized client of care.

5• expansion of knowledge- medical surgical nurse assume diverse roles and Barry responsibility so they must have a special skill to look after the special needs of clients.

The nurse acquire skill of understanding the behaviour pattern and ability to promote problem solving skill individual family and groups.

There are different specialist area within acute care setting which provide numbers medical surgical opportunity like, advance nursing, cardiovascular nursing, orthopedic nursing, infection control nursing, genetic nursing and Oncology nursing.
6• Evidence based practice - it is concept use to improve care to achieve client outcome effectively uses research finding that are grounded in science along with client services to guide clinical practice there by practice being directed by tradition.

7• consumer orientation - main goal of medical surgical nurse is promotion of health, prevention of illness, restoration of health when illness occur.
During care given to client she is oriented to clients, physical ,emotional, spiritual and psychological nature.
8• Ethical concern - it is important trend which is growing among patients and nurses.
Ethical issues sprout when question arises ask to who is right and who is right to prevail.
nurses applied ethics during care for terminally ill or care for dieing patient.she should be aware of the rights of patient and different ethics.

Change in role of medical surgical nurse 

Vast role of medical surgical nurse are as follow:

1• care givers - increased education of nurses research and development of knowledge causes a shift in role of nurses from dependent to independent and collaborating.

2• Educator - nurse access learning needs, plans and implement teaching strategies to meet those needs.

3• Advocate - Nurse actively promote patients right to autonomy and free choice.thus speaking for patient and protecting patient right for self-determination.

4• Leader and manager - All nurses practice leadership and manage time, people and resources.