latest draft of nursing policies

8/11/2019 LATEST Draft of Nursing Policies

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NURSING SERVICE POLICIES AND GUIDELINES

Health is a right of every Filipino citizen and the State is duty-bound to ensure that all Filipinos have equitable access toeffective health care services (Philippine 1 !" #onstitution$

MISSION:

%he &ursing Service ensures to provide equitable' sustainableand quality health for all Filipinos' especially the poor' and tolead the quest for e cellence in health)

CORE VALUES:

*ntegrity + cellence #o,passion

The implementation of Universal Health Care Kalusu anPan !alahatan" is directed towards ensuring that all Filipinos,especially the disadvantaged group, have equitable access to healthcare. The Nursing Service Policies, Guidelines and Proceduretherefore should gear towards the achievement of the health system

goals of etter health outco,es .esponsive health syste, +quitable health financing

S%./%+0*+S

!. HUMAN RESOURCES " ensure availability of adequate, competent healthcare providers by hiring highly qualified staff and enhancing their capabilitiesand values thru training. Provide mechanism for the development of

professional nurses.#. HEAL#H $INANCING " advocate the shift to new provider payment

mechanisms, secure fiscal autonomy and financial ris$ protection. %dvocateenrollment to P&'(&)%(T& and other means of health financing. )nsureappropriate utili*ation of resources.

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+. DRUGS AND #ECHNOLOG% " regulation and availability of affordablequality drugs and medical equipment. )nsure proper use and maintenance of equipments and regular inventory of drugs and supplies. 'mplement Generic%ct to secure affordable quality drugs.

. IN$ORMA#ION S%S#EM " ma-imi*e information system technology for

immediate and efficient provision of health services. evelop systems indocumentation./. GOVERNANCE " establish mechanisms for efficiency and accountability0

conduct performance evaluation, gather feedbac$ from clients and maintainquality audit and management systems.

PAR# I& ADMINIS#RA#IVE POLICIES

Arti'le I& GUIDING PRINCIPLES!. 't is the responsibility of all nursing personnel to strictly observe the

&ospital and Nursing Service policies.

#. The general administration of nursing service personnel, policies and practices is the responsibility of the 1hief Nurse.+. The 1hief Nurse, %ssistant 1hief Nurse and Supervisors have full

authority to delegate duties and responsibilities to their staff.

Arti'le II& RECRUI#MEN#( SELEC#ION( HIRING O$ EMPLO%EES

S)1T'2N !. Nursing applicants should meet the following requirementsa. 3ust be a Filipino citi*en0

b. 3ust have graduated from an accredited school or college of Nursing0c. 3ust have passed the Nurse4s 5oard )-amination and licensed to

practice nursing in the Philippines by the Professional 6egulation1ommission 5oard of Nursing0d. 3ust be in good physical and mental condition0e. 7ith good moral character0 andf. 3ust have passed the written and oral e-am to be given by the Nursing

2ffice8Personnel Selection 1ommittee.g. Preferably with 5asic (ife Support 95(S: and 'ntravenous Therapy

Training 9';T:h. Preferably between #!


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S)1T'2N +. EMPLO%MEN# PROCEDURE $OR NURSING PERSONNEL

+.! Nursing ivision

a. %ccepts applicants0

b. 6ecommends appointment for interview0c. Gives oral and written e-amination.

+.# Screening 1ommittee of 6AN63&

a. )valuates general professional and personal qualification0 b. 'nterviews and screens applicants0c. 6ecommends acceptance or reBection of applicants

+.+ %dministrative 2ffice8Personnel 2ffice

a. 'nforms applicants who have satisfactory met the requirements0 b. 'nforms applicants of the other requirement papers for appointment0c. Prepares appointment papers 9%ll requirements and processing

should follow the procedure set by the 1ivil Service 1ommission:.

S)1T'2N . Un,er Arti'le VI( Se'ti+n -. of the 1ivil Service 6ules and (aws on6ecruitment and Selection of )mployees

State that

2pportunity for government employment shall be open to all qualifiedciti*ens and positive efforts shall be e-erted to attra't the )est /uali*ie, to enter theservice.

S)1T'2N /. 'n hiring new employees, the Nursing ivision 2ffice can giveconsideration for those who have been rendering voluntary service and possesses thedesired qualifications0 however, being a volunteer is not an assurance that she8he will

be hired.

Arti'le III& 0O1 DESCRIP#IONS O$ NURSING SERVICE PERSONNEL

POSI#ION #I#LE: CHIE$ NURSE 2NURSE VI3

%. )F'N'T'2N 1hief Nurse is the e-ecutive head of the Nursing ivision.

5. A25 SC33%6D Cnder irection

1arries full administrative responsibility and authority for the entirenursing service of the hospital Participates in formulating hospital policies, in

+


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developing and evaluating programs and services %ssume full authority andresponsibility for the development of nursing service policies0 organi*es, direct,coordinates, evaluates activities of the Nursing ivision Staff which allow for

patient4s satisfaction and professional growth Provides means and methods bywhich nursing personnel can interpret the goals and policies of hospital and nursing

service to the patient and to the public 'nitiate and directs studies, evaluates procedures for the improvement of nursing relation to the total care of the patients. irects planning and implementation of staff development programs for different categories of nursing personnel irects nursing personnel in functionsrelated to the clinical training program of nursing students and other affiliates.Prepares with her supervisory staff budget proposal for the nursing personnelefines Bob description for each category of nursing personnel recruits andrecommends personnel for appointment, promotion or dismissal depending onstaffing needs of the services.

C& 4UALI$ICA#ION RE4UIRMEN#S:

!. )ducation 3aster of %rts in Nursing %dministration.

#. Training and )-periences

a: 1&')F NC6S) % minimum of / years e-perience which has been spentin supervisory position as a Supervisor and8or %ssistant 1hief Nurse.emonstrated professional competence in clinical practice and

administration. 1ompleted 1hief Nurse Training 1ourse or its equivalentand a graduate of 3aster of %rts in Nursing %dministration.

+. Aob Enowledge. 7ith broad $nowledge and understanding of principles of nursing practice

based on physical, biological and social sciences and their application to nursing carefor the solution of nursing problem. 7ith adequate $nowledge and understanding of the principles of supervision, administration and research and thorough $nowledge of the organi*ational structure of nursing service as well as organi*ation, functions,

policies, regulations and procedures of hospital. Enowledge and e-perience inreconciling needs and goals of nursing practitioners, with the obBective of nursingservice.

D& 0O1 RELA#IONSHIPS

!. Source of wor$ers


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+. Prepares Nursing ivision budget to provide adequate personnel, equipment and physical facilities needed and submits to administrative office.

. 'nterviews and screens all applicants for the nursing division and evaluate their qualifications and e-periences.

/. 2bserves and evaluates the performance of personnel, as well as analy*es and

evaluates the nursing activities to determine whether they are meeting desiredstandards.. Formulates and recommends policies for improvement of patient care,

participates in planning of personnel policies and interprets to the 1hief of &ospital the needs and interest of the nursing personnel.

. Promotes and maintains cordial relationship with patient, their families and thecommunity and provides opportunities for nursing staff to wor$ with other groups so that the aims of the hospital can be interpreted to mean goodinterpersonal and interdepartmental relationship.

H. Promotes individual growth and development by maintaining a program of staff education, conducts monthly meetings of nurses and nursing aides.

I. Participate in the hospital outreach program8medical missions.!@. Participates in professional meetings as the representative of the nursing division personnel. SubBect Jto call Jas need arises.

!!. aily ward rounds to gain insight to the problems and needs as presented by the patient and the family, the nurses and other health disciplines

!#. %pproves schedule of duties and off duties prepared by the %ssistant 1hief Nurse8Supervisor.

!+. Signs aily time records.! . Performs other duties as required by the 1hief of &ospital.!/. %ttends local and national seminar wor$shops.! . 1onducts monthly meetings for nurses and nursing aides.! . &elps promote healthful living condition for nursing personnel.

POSI#ION #I#LE: ASSIS#AN# CHIE$ NURSE 2NURSE V3

Cnder the direction of the 1hief Nurse, with the same qualification requirements and performs specific and actual activities of the 1hief Nurse as directed, or in his8her absence.

SPECI$IC AND AC#UAL $UNC#IONS AND AC#IVI#IES!. %ssist the 1hief Nurse in the planning of over all activities on the nursing

service.#. %ssist in the formulation, revision, and implementation of hospital and

nursing policies.+. %ssist in the budget preparation for equipment, supplies, physical facilities

and personnel.. 3a$es general rounds to all wards and special departments noting down

the needs and problems of patient, personnel and unit as a whole.

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/. 1hec$s and review the # hour report on the actual total number of patients4 admission, discharges, deaths, number treated, and number ofsurgery done.

. %ssist in planning and organi*ing continuous staff development program.

. %ssist in screening applicants for the nursing service.

H. %ssist in budget preparation in the nursing service.I. %ssist in monitoring discipline through proper counseling of nursing personnel.

!@. %ssist in the preparation and evaluation of personnel performance rating.!!. %ssist in performing 1K' activities in the hospital.!#. %ssume function of the 1hief Nurse as delegated by the 3edical 1enter

1hief in the absence of the 1hief Nurse.

POS#ION #I#LE: SUPERVISING NURSE 2NURSE III3

EDUCA#ION5#RAINING5E6PERIENCE RE4UIREMEN#S

5SN graduate with I units in 3aster of %rts in Nursing %dministration, at least # yearse-perience in supervision.

SPECI$IC AND AC#UAL $UNC#IONS AND AC#IVI#IES

'. Supervision of Patient 1are1hec$s the Senior Nurse4s plan for patient care and sees to itthat they are properly e-ecuted.Eeeps herself informed of patient4s needs and problems.6einforces health instructions given to patients and their

families as the need arises.;erifies implementation of request of referrals to evaluatecontinuity of care.Serve as consultant and adviser to the Senior Nurse indeveloping, devising and adopting wor$ techniques andmethods for the solution of problems related to patient care.

''. Personnel 3anagement'nterprets standard operating and new procedures and policies,review wor$ performance of personnel to determine if it

conforms to the recogni*ed standards.Plans the programs and wor$ of all the nursing personnel.irects arrangements of schedule of duties, off


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Prepares the plan for counseling of co


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A25 P)6F263%N1)

!. %dministrative head of the 1entral Supply 6oom Cnit and gives assignment toher personnel.

#. Plans, directs and supervises the activities of the 1entral Supply 6oom.

+. Supervises the effective use of sterile supplies and equipment in the wards andfrequently chec$s all equipment for immediate repair or replacement.. 1onfers with department heads in order to answer their needs./. 'n charge of all equipment, apparatus, instruments and supplies in the 1entral

Supply 6oom Cnit.. Supervises the dispensing and handling of sterile supplies and equipment.. Standardi*es the pac$ing of linens, instruments, gloves, etc., for Treatment

6oom, 2perating 6oom, elivery 6oom, 2ut


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!#. Sees to it that all equipment is in order and properly $ept and supplies areavailable.

!+. 3a$es wee$ly schedules and daily assignment.! . 1hec$s and countersigns recording done by the staff nurses.!/. 2rients the clinical instructor on all department policies and evaluate their

performance every three months.! . Sees to it that doctor4s orders are carried out properly and intelligently by the

staff.! . Plans and supervises all nursing activities in her ward.!H. )valuates performance of her staff every si- months.!I. 1oordinates ward activities in the administration of nursing division with all

hospital services.#@. Participates in the orientation of new staff and nursing students.

POSI#ION #I#LE: S#A$$ NURSE 2Nurse I3

S#A$$ NURSE #linical /reas

Kualification 6equirements

)ducation % holder of a 5achelor of Science in Nursingegree

(icensure ;alid and current licensure in the Philippines

3embership PN%8National (eague of Government Nurses

Training and )-perience 2rientation upon entrance to dutyAob escription

!. 2rients patients8relatives to the room8ward, its facilities, including unit policies, personnel and hospital rules and regulations and the patient4s bill of rights0

#. 3a$es frequent rounds to all patients, identifies problems and implementsappropriate nursing action according to priority of needs0

+. 'nvolves the patient and family in the plan of care0. Provides s$illful, safe, effective nursing care to patients0/. %dministers prescribed medications following the ten 9!@: rights, procedure

and technique in drug administration based on his8her $nowledge of action,dosage, side effects and nursing implications0

. %dministers prescribed treatments following the correct procedures based onscientific principles0

. 3a$es referrals to other members of the health team0H. 1ommunicates effectively with incoming shifts regarding status of the unit and

the patient 9proper endorsement:0I. 'nforms immediate superior of problematic8difficult situations0!@. %ssists physician with diagnostic and therapeutic procedures0

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!!. 'nstructs patient8family about rationale for the limitation of activities, dietaryregimen, measurement of inta$e and output0

!#. Ta$es vital signs, urine and stool records accurately0!+. 6ecords pertinent observations, medications and treatments, its reaction and

evaluation of nursing care 9documentation:0

! . Gives health teaching related to home care management upon discharge of patient0 and!/. %cts as a head nurse when so delegated.

S#A$$ NURSE 2Nurse I3 +,ergency .oo,


)ducation % holder of 5achelor of Science in Nursing

(icensure ;alid and current license to practice Nursing in thePhilippines

3embership PN%8National (eague of Government Nurses

Training ? )-perience 3ust have e-perience in the 1linical %rea as Nurse ' forone or more years

Aob escription!. %ssess vital signs, chec$ %51 Ls .Provides the immediate physical and

psychological needs of patients0#. Prepares instruments, supplies and equipment for surgical procedures0+. %ssists surgeon in surgical8emergency procedures0. 6ecords patient4s data, treatment8management and medications accurately0/. )ndorse admitted patient to ward nurse0. Preserves and labels operative specimen for laboratory analysis0. 1oordinates nursing activities with medical and paramedical staff0H. 1hec$s inventory of supplies and equipment every shift0I. )nsures that area is clean, orderly and!@. isseminates information to public see$ing assistance and information.

S#A$$ NURSE 2NURSE I3 Out7atient De7art8ent


)ducation % holder of 5achelor of Science in Nursing

(icensure ;alid and current licensure to practice nursing in the Philippines 6egular renewal of license.

Physical emands Physically and mentally fit, has stamina to wor$ effectively underadverse conditions.

!@


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3embership PN% ? National (eague of Govt.Nurses

Training and )-perience 3ust have an e-perience in the clinical area as Nurse '9!: or more years.

Aob escription

SP)1'F'1 %N %1TC%( FCN1T'2NS %N %1T';'T')S

!. Gives direct nursing care to patients in the area assigned 9treatment, surgery,medication:

#. 'dentifies nursing needs of patients and report observation to proper individuals. +. Gives emotional and spiritual support to patients. . 1ommunicates and acts as liaison between patients and the hospital personnel. /. 'nterprets to the patient and his family, their role in promoting successful therapy

and rehabilitation. . 1arries out doctor4s order in conformity with hospital policies and its legallimitations.

. %ssists the physician when e-amining patients. H. Prepares accurate records pertaining to 2P patients, programs and activities. I. 2bserves aseptic technique in preparing and assisting treatments, e-aminations,

and sterili*ation of instruments. !@. Participates in maintaining the unit clean at all times. !!. Participates in the dissemination of information regarding hospital rules and

regulations.!#. 1onduct health education activities and implement 2& program thrust.!+. 3onitor medical equipment and supplies, maintain proper inventory.! . %ssists patients in moving, maintaining proper alignment of patient body using

body mechanics.!/. 2bserves signs and symptoms, institutes remedial action when appropriate and

records these in her chart.! . Performs irrigations, catheteri*ation and gives enemas.! . %dministers medications to patients.!H. 'nstructs patient and families.!I. )nsures proper care and maintenance of equipments.#@. Teaches and directs non


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efinition % nursing attendant is one who operates at a level of a wor$er trained on the Bob to assist the professional nursing staff by performing routine duties in ta$ing care of hospitali*ed patients.


)ducation Preferably 3idwifery8Nursing under board8 Nursing %ide8Practical Nursing%ssistant81aregiver 1ourse graduate or those with comprehensive training as nursingassistant.

Training and )-perience 7ith comprehensive training as nursing assistant.

SP)1'F'1 8%1TC%( FCN1T'2NS %N %1T';'T')S

. Aob escription!. Performs direct care

a. %ssist in admission "prepares bed, participate in the orientation of patients8relatives. b. Provide 8assist patient in personal hygiene and comfort

Provide bed bath, hair shampoo, oral hygiene, and perineal care to patientswhen necessary.

#. 3aintains cleanliness and orderliness of the area.+. Prepares and sterili*es diagnostic and therapeutic pac$s, sets and linens.. 'ssue supplies and equipment needed in the wards and special departments./. 3a$es and pac$s medical supplies such as cotton balls, 2S, dressing pac$s, eye

pac$s, gau*e, sil$ sutures and cotton pledgets.. 5rings soiled linens to the linen section for replacement.. Prepares solution for disinfections for use of the wards.H. 'nform staff nurse on equipments, facilities that needs maintenance chec$ up.I. Participates in the orientation of new nursing staff.!@. 1hec$s and receives endorsements from outgoing aide.!!. %ttends rounds with the ward nurse.!#. Performs simple procedures li$e perineal care, SS enema, etc.!+. 3easures and records inta$e and output.! . 3onitors and records vital signs.!/. Provides specimen vials, collects urine and stool specimen and send them to the

laboratory.! . Provides clean linen and ma$es bed.

! . Shaves patient for surgery.!H. 3aintains cleanliness and orderliness of the patient4s unit at all times.!I. 6emoves8cleans8arranged all unused equipment from patient areas and returns them

to designated area.#@. 2rgani*es beds and bedside tables, counters, cabinets and chair.#!. %nswers patient calls and deliver messages.##. Submits all charges to billing section at the end of every shift.#+. Prepares diet list of patients.

!#


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POSI#ION #I#LE: 9ARD CLERK

efinition 7ard 1ler$ are trained on the Bob to assist the professional nursing staff by performing routine duties in the review of records and required documents of hospitali*ed patients, inventory of drugs and supplies, facilitate admission, billing and

discharge.


)ducation Preferably 3idwifery8Nursing %ide8Practical Nursing%ssistant81aregiver 1ourse graduate or those with comprehensivetraining8understanding of medical and nursing terms.

Training and )-perience 1omputer literate, with comprehensive training as 1ler$,$nowledge in preparation of reports and communication letters.

SP)1'F'1 8%1TC%( FCN1T'2NS %N %1T';'T')SAob escription

!. 6eviews patient4s chart for accuracy, completeness and proper arrangements.#. Gather patient4s personal data to complete needed information. Submits the

completed charts to record section every morning.+. 6eceives labels and stoc$s incoming deliveries and supplies from the supply

and property section for use of the wards and other special sections.. Submits required report of supplies inventory and updates stoc$ level to the 1S6./. Submits patient4s census to medical records section everyday at H @@am.. Facilitate 8follow up required documents of P&'(&)%(T& and Pay patients.. Gives information8education to patients and families regarding hospital rules and

regulations.H. %ssist in the preparation of death certificate, and birth certificate.I. Prepare reports and perform other functions as ordered.

ORGANI A#IONAL S#RUC#URE O$ #HE DR0NRMHNURSING SERVICE

Chief Nurse

!+1hief Nurse

T6%'N'NG? 6esearch

1hief of &ospital


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Arti'le IV& CODE O$ CONDUC#:

!. )veryone should be aware of her8his Bob description.#. There should be strict adherences to hospital rules and regulation.+. No visitors should be allowed during tour of duty.. Silence within hospital premises should be observed./. %rguments with co


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I. %ll employees should be aware of and fully understand the &ospital policies0ignorance of the policies e-cuses no one.

!@. New employees should be properly oriented on &ospital Policies by the headof the Personnel Section and by the Nurse Supervisor in their respective areasof assignment.

!!. %ll employees shall show courtesy, respect and compassion to all patients,visitors and co


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H. The profession of nursing, as represented by associations and their members, isresponsible for articulating nursing values, for maintaining the integrity of the

profession and its practice and for shaping social policy.

Arti'le VI& GENERAL POLICIES

!. There are +


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!#. %ll nurses and nursing attendants reporting for duty should wear theofficial uniform. For NC6S)S white uniform with collar and white rubber shoes, e-cept )68'1C8 68268P) '%8Nursery, must wear the prescribeduniform. For NC6S'NG %TT)N %NTS Green blouse and pants, and

blac$ shoes.!+. %ll nurses must be informed on JN2 3) '1%( %556);'%T'2N

P2('1DJ. 't should be spelled out on patient4s chart.! . on4t leave space in the chart. 'f with space, underline it, and then write

the initial8signature of the nurse on duty.!/. Professional ethics should be strictly observed. )very personnel should be

addressed with respect. Nurses, nursing attendants and other hospital staff must practice courtesy to patient, relatives, and co


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hospital use, equipments8supplies should not be brought home for personalconsumption. 1+rr+;in +* +er( +ther 8e,i'ale/ui78ents to be brought home for continuous use is not allowed but for humanitarian reason, the employee may as$ the approval of thedirector8representative 9property department: for #


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prior to Printing to chec$ if the request were granted or not and to clarifyother issues.

#I. 2fficial receipts for Professional Fee must be provided by the attending private physician especially for reimbursement of P&'(&)%(T& patients.

Nursing ivision staff is not allowed to receive professional fee of privateattending physician.

+@. Problems, suggestions, and complain with co


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during their tour of duty. % locator slip must be accomplished each time an employeeleaves the hospital while on duty.

S)1T'2N #. O$$ DU#IES Nursing personnel who will render H hours per duty for #!


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filed in advance, as much as possible / days before and not later than the preparation of duties for the ne-t shifting.

%5S)N1)S!. Filling of sic$ leave, maternity leave, vacation leave and privileged leave

should be in accordance with the civil service rules and regulations subBect tothe recommendation of the 1hief Nurse of the hospital.

#. 'n case of sic$ness he8she should notify his8her supervisors immediately andshould see$ consultation preferably in 6AN63&.

Arti'le I6& UNI$ORM 5GROOMING

%ll nursing personnel must report to duty in proper prescribed uniform.Scrub suit should be worn only at the )6, 6, 26866, '1C and Nursery. Goodgrooming should always be maintained. 2nly light ma$e


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Arti'le 6I& POLIC% ON VOLUN#AR% SERVICE 2See ?MOA *+r V+luntar=Servi'e3

S)1T'2N !. % professional nurse, midwife, nurse aide who is willing to render voluntary service must submit an application letter and meet the following

requirements

a. Passed the board e-amination and licensed by the P61 to practice her profession0 and

b. 5e in good physical and mental condition.

S)1T'2N #. 2nly those who passed the Nursing ivision Screening 1ommittee of this hospital will be accepted as volunteer of the Nursing ivision .The Screening1ommittee will be responsible in processing the records and certificate on voluntaryservice. The Training 1ommittee will be the one in


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certificate for voluntary service will be issued only upon presentation of aily Time6ecord.

Arti'le 6II& ORIEN#A#ION PROGRAM $OR #HE NE9 NURSINGDIVISION S#A$$

2rientation should cover the overall physical setting and organi*ationalstructure, overview of the mission, vision, philosophy, policies and standards of thehospital and nursing service, Bob description, and the relationship with the communityand other agency. 't also includes 1S1 (aw, 1ode of )thics, 7aste Segregation,Performance )valuation Policies, Patient Service Policies, Safety, 'nfection 1ontroland other important updates.

Arti'le 6III&RESPONSI1ILI#% AND ACCOUN#A1ILI#% O$ SENIOR NURSE

!. Senior Nurses shall be accountable for the action and inactions of theirsubordinates. They shall be responsible in ensuring that their staffs performtheir respective tas$s and responsibilities.

#. 'ssues and concerns shall be settled first within the section. 'f unsettled, thematter should be raised to the Supervisor81hief Nurse.

+. 1hief Nurse shall be accountable and responsible for the action and inaction ofthe Supervisors, Senior Nurse and the entire Nursing ivision.

. %ll communications and tas$s that need action shall be acted upon within !/days. Tas$s and communications that need action as soon as possible shall beacted upon within + days.

/. ifferent committees must be responsible for their designated tas$s andresponsibilities.

Arti'le 6IV& NURSING DIVISION S#ANDING COMMI##EES

The utili*ation of standing committees whose main purpose is toestablish standards for safe and effective nursing care is one of the many toolscontributing to the performance of the Nursing ivision . (Membership with thecommittees will have a term of 2 years for the chairman and 1 year for themembers, except for committees that requires special training for theirmembers

The different standing committees within the Nursing ivision are thefollowing

!. Policies and Procedures 1ommittee.#. Screening and Performance )valuation 1ommittee.+. Staff evelopment 1ommittee.. Nursing %udit 1ommittee.

#+


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/. 1omplaints and Grievances 1ommittee.. 6esearch 1ommittee.. 6eligious 1oncern 1ommitteeH. &ealth , Safety, and 1ontinuing Kuality 'mprovement 91K': 1ommitteeI. 'nfection 1ontrol 1ommittee

!@. &ospital 7aste 1ommittee!!. Non


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This committee plans for short


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This committee enhances patient care through systematic assessmentand improvement of the quality of care rendered by the Nursing Servicestaff.

I. 'nfection 1ontrol 1ommittee

This committee initiates development, implementation, evaluation,review and updating of written guidelines, policies, and procedures thataddresses infection prevention, detection and control of health carefacilities 9refer to 2& 'nfection 1ontrol 3anual:

!@. &ealth and Safety 1ommitteeThis committee assures that condition in the wor$ environment isconducive for the health and safety of personnel.

!!. 1ommittee on Programs and 2ther &ospital %ctivitiesThis committee will be in


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and to coordinate with (GC for follow


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c.Preference shall be given to nurses and midwives residing in thelocalities where the recipient 2& hospitals or health facilities aresited.

d. Nurse and midwife volunteers, trainees, or those e-posed in6AN63& shall be given priority.

e. Nurses and midwives must be physically and mentally fit. % medicalcertificate from a government hospital is required.

f. To enhance and provide focus for the clinical and public healthrotations, competences shall be anchored on courses geared towardsspecialty modules with continuing professional units as required byP61.

g. 6eplacements shall be allowed in case of drop


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f. Penalties for all administrative offenses shall be based on the guidelines provided for under the 1ivil Service (aws 931 No. +@4s !IHI: P No.H@ and 1ode of 1onduct 6% No. !+, classified into grave, lessgrave, and light and their corresponding penalties.

g. ;iolation of the other Nursing ivision policies stated above of this

3anual shall have corresponding penalties.

Ste7s +* Pr+ ressiveDis'i7line

DE$INI#ION O$ #ERMS

.epri,and means warning in oral or written form. &owever, for the purpose of proper administration of employee offenses, official reprimand must always be in writing,with a copy furnished by the Personnel 6elations Section for the employee4s #@! file.

Suspension means that laying


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*nfractions are grouped into three categories8classes based on their relativeseriousness. )ach class is to be treated separately based on guidelines specified in the

policy on the 6ules and 1onduct and isciplinary %ction.

a. 1lass '8(ight 2ffense

These are relatively minor offenses and generally call for a series of progressive disciplinary measures. They are classified lighter generallyeasy to correct.

b. 1lass ''8(ess Grave

These are generally light offenses but slightly more serious that adocumented action is immediately necessary on the first commission.

c. 1lass ' ''8Grave

These are very serious in nature and call for, generally, immediatedischarge upon commission. isciplinary action ta$en for 1lass '''infractions should be given particular attention and must beadministered swiftly without preBudice to observance of due process. 'ncertain circumstances based on meritorious grounds, the penalty may bechanged or reduced after a meeting of all concerned parties.

Arti'le 6VII& COMMUNICA#ION $LO9 IN #HE NURSING SERVICE

1ommunication flows between, in and out of the organi*ation including patients, visitors, families, friends and the community, that nurses are e-pected tounderstand and be able to answer queries as they proBect the image of AN63&.

Formal and official channels of communication between individuals in the Nursing Service, between heads of the different services will be based on theorgani*ational charts. D+;n;ar, '+88uni'ati+n flow comes from higher to lower authority, the 1hief Nurse and his8her %ssistant communicate with all supervisingnurses. 'n their absence, the person ne-t in ran$ ta$es their place. 7rittencommunication from the 1hief Nurse to nursing personnel is coursed across the linethrough the Supervising Nurses and the Senior Nurse.

7hen a Supervisor or &ead Nurse gives bac$ written reports or informationu7;ar, '+88uni'ati+n is applied. )-change of ideas usually ta$es place duringmeetings, rounds and conferences. 5oo$lets, memos, brochures, and periodicals arealso effective in disseminating information and will be utili*ed as needed.

%ll information regarding the patient should be regarded as confidential unless it is a policy matter. 'n which case, the hospital administrator may release the information

+@


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required. The patient himself8herself may also request through the %dministrative2ffice, information he8she may need for Philhealth, insurance and retirement.

PAR# II& PA#IEN# SERVICE POLICIES

Arti'le I& Ea'h ;ar, +r unit 8ust have ;ritten Stan,ar,s +* Pr+'e,ure an,P+li'ies 2Cust+,ial 9ar,( ER( Me,i'al 9ar,( OPD( OR5DR( Nurser=( CSR( O1G=ne( Pe,iatri's( NICU( ICU( Sur er=( an, #rainin Servi'e *+r Nursin an,Other A**iliates&3

In eneral the *+ll+;in 8ust )e +)serve,:

S)1T'2N !. % '+nsent form must be sign by the patient8relatives before initiation of care and before admission and special procedures. The patient8relatives must sign the1onsent Form for %dmission ( 2A77en,i< 3 and 1onsent for 2peration ? SpecialProcedures, 9 A77en,i< - :.

Patient8relatives must be properly informed of the hospital policies, rates, and given acopy of the J'nstruction Guidelines or Paunawa FormM 9 A77en,i< . :.

a. Pananagutan ng Pasyente o (egal na Nangangalaga b. 3ga Earapatan at Pananagutan ng Pasyente

S)1T'2N #. Proper en,+rse8ent of patient must be done at bedside by the outgoing Nurse to the incoming Nurse and shall endorse using the updated $arde- 8)ndorsementSheet8Patient4s 1hart.

S)1T'2N +. Me,i'ati+ns an, treat8ent must be charted only after the nurseconcerned has administered the drugs. Standard 2perating Procedures onocumentation of medications on therapeutic sheets must be observed. 2A,a7te,*r+8 the Manual +n Nursin Stan,ar,s +n Intraven+us Pra'ti'e B th E,iti+n(ANSAP GUIDELINES $OR DRUG ADMINIS#RA#ION3 1ounterchec$ the medication card against the doctor4s written order.

!. 2bserve !@ 6s when preparing and administering medication.#. )-plain procedure to patient 9the name of medicine and action8interaction of

medication: before administration.+. 7ash hand before and after the procedure 9use gloves especially for

chemotherapeutic drugs:.. %ll nurses must possess a valid P61 license and preferably have attended

training on '; therapy./. Proper identification of patient should be observed. The Nurse will as$ the

competent patient to state his8her name.. For patient with altered mental status, the nurse should chec$ the bracelet or

name tag on patient4s wrist or verify to the watcher the name of the patient.

+!


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. Golden 6ules should be observed at all times.Ri ht Or,er& D+'t+r s +r,er is al;a=s ;ritten( ,ate, an, si ne, )=

the +r,erin 7h=si'ian&Ri ht Me,i'ine& Me,i'ines 8a= have si8ilar na8es& 1e 'are*ul in

e


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12(26 12 'NG

OD 4 J

1ID 4

#ID 4 @

4 -

PRN

DRUG NAME

%mpicillin /@@ mg

%mpicillin !gram

1lo-acillin /@@mg8 !gram

1efuro-ime /@ mg

Pen G Na ! million 'C

&ydrocortisone !@@mg

1eftria-one /@@mg

1eftria-one ! gram

1hloramphenicol ! gram

++


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S/3P6+ 3+7*#/%*5& #/.7

DELA CRUZ, JUAN R . Amoxicillin 500mg PO TID

Ham " ! pm " pm

DELA CRU ( 0UAN R& 1efuro-ime /@mg T'; qH 9


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. Nurse trainees are allowed to administer parenteral medications, properly

chec$ed and supervised by a senior nurse observing patient4s rights in giving

medications./. Trainees will be assigned wor$ing schedules 9errands, medication, or

documentation: to prevent overlapping of functions and duties.. Trainees should be evaluated after training.

S)1T'2N . Nurses and nursing attendants are not allowed to do the followings7e'ial 7r+'e,ures e


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S)1T'2N !#. Unuse, 8e,i'ines an, su77lies brought by the patient should be given bac$ to them or their relatives 8 pharmacy. D+nate, unused drugs must be recorded properly. 6ecipient of donated drugs must sign once they received8used the drugs.9Please see inter,e7art8ental 7+li'= ;ith the Phar8a'=3&

S)1T'2N !+. % request, properly signed by the doctor, must accompany all laboratoryand radiology e-amination. Nurses are not allowed to sign in the 7res'ri7ti+n(la)+rat+r= and ra,i+l+ = re/uest e-cept during emergency, which later on must becountersigned by doctor on duty. octors will be accountable for pre


37/152


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forwarded as soon as possible to the 1hief of &ospital and ivision &ead for immediate action 2A77en,i< - 3

S)1T'2N # . The patient 8a= re/uest 7rivate 7h=si'ian to handle his8 her care but,the consultants must be duly recogni*ed by this hospital, have written 32% with

6AN63&. %dmitting doctor must e-plain clearly regarding professional fee, hospital bills and other charges if they choose to have private doctor.

S)1T'2N #/. RELEASE O$ CADAVER 2A77en,i< - $l+; Chart3

!. 7ard8Cnit

Nurse8Nursing %ttendant on duty verifies the following in the chart of the deceasedand writes down this information in the ward8unit logboo$.

a. 1omplete name, age, se-, diagnosis, address b. Pronouncement of death

c. Time of deathd. Name of the attending physician

Nurse on duty interviews patient4s relatives and accomplish the pertinent data on the first page of the deathcertificate. She sees to it that all parties concerned have signed the four pagesof the death certificate 9nearest relative of legal age and the attending

physician:. #he nurse ;h+ 7re7ares the 'erti*i'ate sh+ul, als+ si n( )utthe *inal t=7in ;ill )e the res7+nsi)ilit= +* the Me,i'al Re'+r, Se'ti+n&

Nurse on duty is required to properly filled up two 9#: cadaver information tag whichinclude the following

a. Name b. %gec. Se-d. ate ? time of deathe. &ospital number f. Cnit8wardg. iagnosis

Note 2ne tag is tied in the right wrist. The body is then wrapped withlinen while the other tag is attached to the chest area.

#. Nurse on uty notifies the following departments8personnel

%dmitting8'nformation Section%dmitting Section processes the papers prior to the release of

the cadaver. 1ler$ as$s the nearest of $in to get clearance bill from thecashier.

+H


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1ashiers sign the clearance form upon payment of charges. 'ndigent patients will bereferred to the Social Service for assistance.

+. Nurse inquires whether a funeral parlor or the parents8relativesthemselves will attend to the processing of the cadaver4s release.

For a funeral parlora. % calling card and proper identification form must be

submitted. b. The funeral representative and the nearest $in sign

authori*ation form.c. The funeral parlor then ta$es the responsibility of registering

the death certificate.d. Three copies of the 6elease of 1adaver forms are signed by

the funeral parlor and relative witnessed by thenurse8security guard assigned in the area.

7ithout a funeral parlorThe nearest $in secures the cadaver release form and register thedeath certificate. 6elatives must also be properly identified andsigned the release form, witnessed by the nurse8security on duty.

. Cpon presenting the above forms 9clearance and the cadaver releaseform: the Security 2fficer releases the body to the patient4s nearest of $intogether with the authori*ed funeral parlor representative, both of themmust sign in the logboo$.

/. 2ther matters

Storage of unclaimed cadaversThe nurse see$s the assistance of the Social Service to loo$ for

the relatives of unclaimed bodies. 1adavers unclaimed after hoursfrom the time of death shall be referred to accredited mortuaries for safe$eeping8proper storage.

6equest for autopsy should be prepared by the attending physician with consent duly signed by the nearestof $in who are of legal age.

%ll medico


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b. 6equest for viewing of the body by media, etc. should be coursed to the1hief of &ospital81hief of 1linic during the office hours and Senior &ouse 2fficer after office hours.

c. Cnpaid bills cannot be a reason to delay the release of the cadaver.6elatives are then requested to arrange with the Social Service for

assistance.

d. eath 1ertificate of 2% patients are signed by authori*ed 3unicipal&ealth 2fficer. Funeral parlor representative duly authori*ed by therelatives may facilitate the processing of papers. % 1linical %bstractmust be prepared and be given to patient4s relatives.

e. 6elease of cadaver is done by the authori*ed officer 9Nurse onuty8Security 2fficer on duty: after completion of cadaver releaseform, clearance, clinical discharge summary and consent from thenearest of $in or guardian of patient.

f. Temporary storage of unclaimed personal belongings, such as clothing,electrical appliances, pillows, linens, thermos, plates8glasses and other materials used during patient4s stay is being discouraged, however, if unavoidable , relatives are given only # hours 9! day : to retrieve their

belongings or else , it will considered as waste for garbage disposal.6elatives should be properly informed regarding this policy.

S)1T'2N # . 1IR#H CER#I$ICA#E

!. The nurse who assisted the doctor during delivery will be the oneresponsible for writing the following data 3other4s maiden name and the father4s name ate and time of delivery Se-, type of birth, birth weight Name of the doctor who attended the delivery

#. %ll other information needed in the birth certificate will be theresponsibility of the ward nurse who will receive the patient from thedelivery room. 7ard 1ler$ can be utili*ed for chec$ing8reviewing andensuring that all pages of the birth certificate have been completed, with

accurate information properly signed by the attending physician and theinformant. %lways as$ the mother to sign as informant especially if theyare not married.

+. Cpon completion of data, the ward nurse who received and interviewedthe patient will be the one to sign in the P6)P%6) 5D portion of the

birth certificate. The responsibility of interviewing patient can be

@


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delegated to the nursing attendant8ward cler$ but the ward nurse will still be held responsible for the accuracy of the data and the signatures.

. The draft form should be properly accomplished and validated8signed bythe informant. The draft form and official form should be forwarded to

3edical 6ecord Section.

S)1T'2N # & #HE -J HOUR CENSUS $ORM

a. The nurse on duty in each area must accomplish the #


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. 1harting must be in Focus ata %ction 6esponse 9F %6: Style at alltimes. 1harts must be accomplished before the end of the shift. N2 isnot allowed to leave without completing the charts. Proper chartarrangement must be observed. Failure to complete the chart on time will

be dealt with accordingly. %ll charts must be audited and signed by head

nurse 8supervisor of the area prior to final submission to the Nursing2ffice8 Statistic 2ffice8 3edical 6ecord Section. 1harts of discharges anddeaths are e-pected to be submitted every I @@ %3 daily after reviewingits entry in the # hours census report and nursing audit of thesupervisors.

H. % medical record 8chart are a collection of information about the personyou are caring for. 't is a legal and confidential record with pertinentinformation of the care provided. 'f it is not recorded, it did not happen. 'f it is recorded incorrectly, it happened incorrectly. This is why it is soimportant to be accurate when documenting.

S)1T'2N #I RE$ERRALS O$ PA#IEN#S

a. The decision to send a referral is made by the senior house0 b. %ll patient must have chart and e-amined first by Physician "in


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POLIC%:The spiritual and religious care of the patient is to be considered an integral

part of the overall care of every patient. 6espect for religious belief and practices must be observed as long as it will not affect, harm other patients8personnel of this hospital.

1AP#ISM: EMERGENC% POLIC%

Nurses of all faiths may bapti*e according to the philosophy of the hospital baptism should be administered when in doubt of life or whether tissue is embryo or fetus.

LAS# SACRAMEN#S

POLIC%:The last sacrament for any patient who dies in the )6, for any patient who is

dead on arrival, and for critically ill patients may be given by the patient4s family

regardless of religious orientation.

CLERG% SERVICE:

1atechists of any religion are allowed to conduct religious services.6eligious services of the sic$ and dying should be referred to Social 7or$er.&oly mass is scheduled at the 1hapel every first Friday of the month at !! @@ am.

S)1T'2N +# & R+utine Va inal Internal E


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!. )-tract slugs, bullets, or any foreignobBect from the patient. Place mar$ingli$e initial of the resident physician.

#. 6eceive and label the slugs, darts, etc.and logs it in the )6 logboo$.

+. Forwards and endorses slugs, dart, etc.in the morning to the medical recordsofficer.

. 6eceives the endorsed bullets, darts,for safe$eeping until properly claimed

by police authorities.

S)1T'2N + < PRESS5MEDIA

POLIC%:

Tri


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S)1T'2N +H. Patients ;ith s7e'ial nee,s must be treated accordingly, a referral for special assistance could be done after initial assessment .7e don4t do internal vaginale-amination for suspected rape victims.

S)1T'2N +I. 1l++, re/uest must be fully accomplished by doctor prior to

submission to laboratory department. Please refer to 7ard S2P4S in 5loodTransfusion for more information & 2A77en,i< @3

S)1T'2N @. Inta!e an, Out7ut should be strictly done by ml as unit of measure.

S)1T'2N ! & In*e'ti+n '+ntr+l 7r+t+'+ls should be strictly implemented tominimi*e the ris$ of disease transmission. Standard precautions shall be practicedduring care of ALL patients regardless of diagnosis. The Manual +* 1asi' In*e'ti+nC+ntr+l P+li'ies an, Pr+'e,ures - E,iti+n 7re7are, )= Phili77ine H+s7italIn*e'ti+n C+ntr+l S+'iet= 2PHICS3( 'nc. can be used as reference materials and whenapplicable can be adapted. 'n general, the following should be observed

a.'solation Precaution< warned8informed staff directly involved in the care of patients with highly transmissible infectious diseases about the infectionstatus of patients so that appropriate precautions, isolation measures areobserved.

1odes can be used asA


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d. Face mas$ and eye shield during procedures and patient


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a& %dmitting form with complete data, diagnosis and signature of theadmitting physician

)& Face sheet8cover sheet signed by the admitting physician and withadmitting diagnosis0

'& 1onsent for admission signed by patient8relative0,& 1omplete set of patient chart including the hospital number, &ospital' 8registration and inde- card0 and

e& Two 9#: copies of admission and discharge sheet 9one copy for the%dmitting Section, and another copy for the 7ard Nurse: signed by theadmitting physician.

. 6efer patient or relative to the 3edical Social Service wor$er for classificationand assistance.

. Prepare charges8order of payment for all the drugs, supplies and other billsconsumed at the )6. Payment86eplacement of used supplies will be depending

on the patient4s classifications c8o Social ServiceH. Notify ward of new admission 97ard Nurse8N% prepares the bed and othernecessities:.

I. irect patient to the designated ward together with the chart and endorse to the7ard Nurse including unfinished doctor4s order.

!@. %ccount all the drugs and supplies consumed at the )6, and record them in themonitoring logboo$.

!!. 6ecord at the )6 logboo$ the name of patient, disposition date and time ofadmission, address, age, admitting diagnosis and the physician


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%ll medicines within the )mergency 6oom are $ept in the designated medicinecabinet. The staff nurse is responsible for safe$eeping the stoc$ or any losses of medicines within his8her area of assignment. Safe$eeping of narcotic drugs is theresponsibility of the head8charge nurse.

%ll prescribed medicines must be in generic. %dministering of '; meds must be done by an '; trained nurse, or by the physician. 'f the prescribed drugs8medicinesare not available at the pharmacy, the nurse will notify the attending physicians of anysubstitute medicine. 'f drugs8medicines are still not available, prescription will begiven to the relatives.

PROCEDURES S#EPS

!. %ccomplishes the prescription, withcomplete data including doctor4s name ?license number 9trodat with signature:.

#. 6eceives8chec$s the prescription.Patients8relatives signed at the bac$ of the

prescription. Nurse will countersign, prepare and administer the drug.

H

Me,i'alO**i'er5Ph=si'ian

NURSE

NURSINGA##ENDAN#


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+. Get the drug8medicine from the pharmacy as replacement to maintain thestoc$.

. 6eceives8chec$s medicines ta$en fromthe pharmacy, $eeps a correct list of available medicine.

ADMISSION POLICIES!. 'f the patient is for admission, doctor4s JstatM orders should be immediately

carried out.#. Patient8relative should be given an admitting slip by the Nurse on uty which

should be presented to the admitting cler$.+. S$in testing and other procedure should be done at the )mergency 6oom.. 7ard should be notified of admission by the %dmitting 1ler$ and )6 Nurse./. %ttach patient4s tag.. Proper endorsement including patient chart and available medicines should be

done by the Nurse on uty to Staff Nurse at the ward8 268 6.. %ll admitting consent and waiver should be signed by the patient or patient4s

relative. 9See %nne- :

9ARD POLICIES AND PROCEDURES

I& ADMISSION #O 9ARD

A& U7+n n+ti'e +* a,8issi+n!. 5ased on the information from the admitting unit and )682P nurseendorsement, ward nurse prepares bed assignment, supplies, and materialsneeded.

#. Nursing %ttendant 9N%: prepare patient4s unit 9bed and hospital linen, bedtag, wristband, bedside table, '; stand, o-ygen etc.:

+. 6223 %SS'GN3)NTS


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1& U7+n arrival +* 7atient in the ;ar,

9ARD NURSE

!. Cpon notice of admission the ward nurse and or nursing attendant

prepares assigned bed, medical supplies, and materials needed according to patient4s condition and information from the admitting unit, and the)682P nurse endorsement. Nurse accompanies the patient to designatedunit, assesses his8her condition and record finding in the chart using5(C)85(%1E ball pen during %3 " P3 shift and 6) during nightshift. 2rient patient ? relatives on hospital policies, physical set up andward staff.

REMINDER:ON LINEN POLICIESa& L+ss linen ;ill )e 'har e t+ the sta** +n ,ut= in the area i* the 'ause

+* l+ss is ,ue t+ ne li en'e&)& Chan in +* linen ;ill )e ,+ne ,ail= +r as nee,e,&'& Seni+r Nurse ;ill )e res7+nsi)le *+r 8+nit+rin the invent+r=

re7+rt ,+ne )= Nursin Atten,ant&,& Nursin Atten,ant ;ill )e the +ne t+ as! 7atient5relatives t+ si n

the Linen 1+rr+;er s Char e Sli7" an, t+ u7,ate the lineninvent+r= l+ )++! ever= )e innin an, en, +* shi*t& Patient 8relatives must sign the 1harge85orrower4s slip for linen 9PH@@.@@8per linen: upon admission in the ward ,should the patient8relatives failed toreturn the linen due to losses, then the PH@@.@@ will be added to the

patient4s hospital bill.

SAMPLE 1ORRO9ER S5CHARGE SLIP

/@

6AN63&('N)N 526627)64S81&%6G) S('P

Pangalan ng Pasyente Petsa Silid87ard

%$o po ay nanghiram ng bilang ng$umot8linen mula sa ospital upang ito aya$ing gamitin habang nasa pagamutan.Tung$ulin $o na ito ay ingatan at ibali$

bago umuwi.%ng bawat isang 9!: linen aynag$a$ahalaga ng PH@@.@@ na a$ing

babayaran 9isasama sa hospital bill:$apag ito ay nawala o nasira.%ng a$ing paglagda ay $atunayan nga$ing pagpayag at a$ing naunawaan anglahat.

Pangalan ng Pasyente8Eamag


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D)((27 < q %3, !#NN, P3, !#3idnightP'NE < qH %38#P38!@P36) < P6N5(C) < T' H%3, !P3, P326%NG) < q!#, round the cloc$ %3, P3

Note &GT monitoring " +@ minutes pre meals.

H. 1harts observations, measures, and medications administered to the patient.I. )nter patient4s name in the daily ward census, E%6 )O and diet list.!@. Cpdate4s ward directory.!!. Nursing attendant forwards diet list to the dietary unit. C& Dail= 7atient nursin 'are 8ust )e ,+ne a''+r,in t+ the *+'us nee,s +* the 7atient& Pr+7er ,+'u8entati+n ;ill )e i87le8ente, usin the $+'usData A'ti+n Res7+nse 2$DAR3 re'+88en,e, )= the De7art8ent +*

Health & 2I87le8entati+n +* $DAR ;ill start Ma= ( - - a*ter th+r+u h+rientati+n +* sta** )ase, *r+8 the ne; DOH Manual t+ stan,ar,i>e,*+r8s5*+r8at that ;ill )e utili>e,&3

DAIL% PA#IEN# CARE:

!. 'f the patient is ambulatory, morning care and evening care should be done by

the patient. 'f not, he8she will be assisted by the nursing attendant.#. (inens should be change daily by the house$eeping section.

+. 1hart observations, vital signs and medications administered to the patientchronologically. %ll entries are accomplished accurately, legibly with date, time

and properly signed & 9HA# IS NO# 9RI##EN( CONSIDERED NO#

DONE&. 'f there are changes or additional entry, write the word Jaddendum to careM put

the date and time the entry was made then signature8initial of the nurse on duty./. 6efer patient to Physician


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!#. The supervisor8 senior nurse should ma$e rounds of the patient.a. Supervises nursing care provided by ward nurse.

b. 2bserve staff nurses to determine their level of competency.c. 2versee the utili*ation of supplies and equipments.d. %ssists ward nurse when needed.

#HE 9ARD NURSE

!. See to it that all emergency drugs8medicine8supplies are available at all

times and equipments are well maintained.#. %ssesses and records patient4s condition in the chart. on4t leave space in

the chart. 'f with space, underline it then write the initialQsignature of the

nurse on duty.+. Plan nursing care and should include health education activities with respect

to patient rights. ')1 materials should be available in the wards fordistribution. iscusses with patient or companion the nursing care plan and

e-tent of his8her participation including the $eeping of cleanliness in the

ward.. 7atchers are not allowed for uncomplicated8non


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from pay to charity shall be referred to Physician


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CUS#ODIAL 9ARD: COLOR CODING O$ PA#IEN# S CHAR#S AND

SPECIAL NURSING CARE POLICIES5GUIDELINES $OR LEPROS%

PA#IEN#S 2A,a7te, *r+8 DR0NRMH Re*eren'e Manual V+lu8e II3

Person 4ith leprosy change a lot' often' per,anently' the change is usually

instantaneous' it usually occurs at the point of diagnosis) %he co,bined factors of

the age old stig,a and the ,ind pictures of stereotype leprosy patient causes the

person diagnosed to feel different and ,arginalized and at the 4orst inferior and

ostracized) /s a result' person diagnoses 4ith leprosy hide the fact until it can no

longer be denied)

PREVEN#ION O$ IMPAIRMEN#S AND DISA1ILI#IES 2POID3 IN

LEPROS%Disa)ilities in le7r+s= are in,ire'tl= )r+u ht a)+ut )= the ,e*+r8ities resultin

*r+8 7eri7heral nerve inv+lve8ent +r ,a8a e +* e=es( han,s an, *++t nerves an,

7la'e the 7atient at a li*el+n ris! +* ,evel+7in se'+n,ar= i87air8ents su'h as

s!in 'ra'!s( inFuries( sti**ness an, )lin,ness& #he *+ll+;in are iven e87hasis:!. preservation of nerve function#. preservation of vision+. the daily practice of self


56/152

(eprosy patients usually do not ta$e to their beds e-cept when they

have developed inter current disease or leprosy reactions. Care *+r the 7atient ;ith inter 'urrent ,isease< Personal hygiene and daily care of patient< Positioning with special focus on maintaining the functional position< Prevention of bedsores< %ttention to the e-cretory functions< Seeing to it that ancillary procedures needed for the therapy are done

adequately, correctly and regularly< 2bservation and recording8reporting of symptoms which are li$ely to

affect the care and treatment of the patient

Care +* the Patient ;ith Rea'ti+ns< 3edical treatment is focused on continuing 3 T and the

Budicious regimen of steroids to suppress the reactive process< %ll the foregoing elements for the acutely ill patient with inter formalin solution in a wide mouth bottlecontainer, which is properly labeled with the following information

o name, age, se- ? case number of patiento $ind of specimeno date specimen was ta$en

. 3edico


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Note Forceps should not be employed on removing a pellet from body as it produces false striae. % pellet covered with blood should not be washed or wiped.'t should be placed on a piece of gau*e on its original condition.

;'' 'NT6%CT)6'N) F)T%( )%T&


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! @@ P3< ! @@ P3

))NT < 3onday ! @@ P3 Gastro )nterologist < Tues.8Thursday ! @@ P3< @@

P3 Crologist < Tuesday / @@ pm< @@ P3 3edicine < Sat. I @@ %3

. P6)S16'PT'2N " The &ospital 3anagement emphasi*es adherence to theGeneric (aw of !IHH. %ll prescriptions should therefore be in generic and inconformity with the National 8 &ospital rug Formulary.

H. 2& P6'26'TD &)%(T& P62G6%3S %T T&) 2P ? 2TS JTuto$ GamutanM " The hospital provides free counseling and medications to patientswho are found to be positive for %F5 on sputum e-am and or chest -


68/152

babies born at AN63& will be immuni*ed every 7ednesday after well babychec$ "up of a physician.

!!. 'S)%S) SC6;)'((%N1)< 6eports of cases encountered duringconsultation must be forwarded to 6)SC of 1&


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P62G6%

A& PROGRAM DIREC#OR The 1hief of &ospital acts as the Program irector who is responsible for the

overall administrative management and operations of the program.

P62G6%3 1226 'N%T26S The 25 Program 1oordinator together with the 1hief of Nurse is responsible for the technical and administrative supervision of all hospital services involved in theimplementation of the 5reastfeeding Program in the hospital.

1. Service coordinators will be designated by the P62G6%3 '6)1T26 from the

medical and non


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!. 5reastfeeding shall be started soon after delivery as the condition of the mother andthe infant permits.

#. 5abies with complicated cases shall be placed in their corresponding units. +. The following newborn babies are roomed


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ST%N %6 2P)6%T'NG P621) C6)S 9%ppendi- !I:1)NT6%( SCPP(D 6223

The 1entral Supply 6oom is an allied service of the 2perating 6oom. 't is a part

of the hospital where supplies, equipment and articles for ready use to patients arestored, prepared and dispensed.

'. 25A)1T';)S

GeneralTo provide adequate equipment, surgical supplies and other professional

supplies and materials to all clinical areas of the hospital, necessary for better patientcare.

Specific

!. To provide proper storage, prepare and control the use of supplies, materialsand equipment in order that these will be immediately and constantly availablefor routine and emergency use.

#. To standardi*e techniques in order to ensure economy of time, effort andmaterials for efficiency of service.

+. To maintain proper aseptic technique.

''. 5orrowing of %rticles and 6equisitioning of Supplies

!. 6equisitions of supplies for use in all clinical areas are made every morning between H @@ and !@ @@ %3. )nough supplies are requisitioned for the wholetwenty four hours and are done by nursing attendant.

#. &ospital personnel with permanent appointment, medical and nursing affiliatesand trainees in the hospital are allowed to requisition supplies and borrowarticles necessary for patient care. Patients, visitors and all others notconcerned with the hospital are not entitled to this privilege. 1asual employeesmay be allowed to requisition supplies, but they are not allowed to borrowequipments and apparatus e-cept when they present a written permission fromthe Senior Nurse or permanently employed Staff Nurse. Nursing %ttendant9N%: prepares requisition slip and forwards it to 1S6 &ead.

+. Cnder no circumstances should supplies, materials and equipment issued fromthe 1entral Supply be brought outside the hospital premises e-cept upon

previous approval by the 1hief of &ospital or in his absence by any of hisauthori*ed representatives " the %dministrative 2fficer, 1hief of 1linic, or 1hief Nurse, in the order of their availability.

. To avoid confusion in the endorsement, no borrowing of dressing trays andother articles is allowed 9e-cept in urgent cases: fifteen 9!/: minutes beforeand fifteen 9!/: minutes after change of shifts.

/. 5orrowers must sign their full names legibly on the borrower4s boo$ to enablethe 1entral Supply 6oom staff to readily trace delayed return of articles.

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. %ll borrowed articles must be returned immediately after use on or before theend of the shift. Non


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;. Storage and 3aintenance of Facilities

!. Sterile articles should be $ept in cabinet inside the sterile storage room and allothers in cabinet provided for them. The 1entral Supply 6oom staff should$now the source of all supplies, materials and equipment for circulation to

avoid confusion in locating them and to ensure an adequate supply of allarticles all the time. This is accomplished with inventory control andsystematic storage.

#. 't is the responsibility of the 1entral Supply 6oom staff on duty to follow upall borrowed articles not returned before the end of her shift. %ll articlesincluding those not returned at the change of the shifts must be properlyendorsed to the succeeding staff on duty.

+. The 1entral Supply 6oom staff must notify the supervisor of destroyedequipment and facilities for repair and of supplies for requisitioning.

. 't is the responsibility of the Nurse Supervisor to determine and maintain theadequacy of the equipment and stoc$ supplies and see to it that all destroyedequipment and facilities are repaired or replaced. For supplies below /@>instruct or prepare 6'; and forward it to supply officer for timely action.

;'. 6ecording and 6eporting

!. %ll articles borrowed are recorded in a record boo$ provided for the purpose. %separate borrower4s boo$ is provided for each of the following sterile articles,non


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POLICIES AND PROCEDURES IN #HE IN#ENSIVE CARE UNI# 2ICU3

CONCEP# O$ IN#ENSIVE CARE UNI#

(21%T'2N 7ithin the P&'(&)%(T& 5uilding< %dBacent to Pay 7ard

5) 1%P%1'TD Four 9 : beds

12N1)PT The 'ntensive 1are Cnit 9'1C: is a hospital facility for careof critically< ill clients at a more intensive level, staffed by speciali*ed health care

providers which contain a comple- assortment of monitors and life support equipmentthat can sustain life in once


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To provide a concentration of specially trained staff that has the education,training, and personality to render services and give attention to processes necessary tolife.

3aintain consolidation of all maBor life support devices essential for meeting

the needs of the acutely and critically ill clients.To provide a sympathetic understanding of the apprehension and tension whicha clients family undergoes during critical period.

Provide opportunities for professional development of both the medical andnursing staff.

P2('1')S The Section 1hief of the '1C shall be responsible for the

management of the unit. For Private 1lients, the %ttending Physician shall be primarily

responsible for the management of his8her client at all times. For Service 1lients, the '1C Physician


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The coordination of the unit, training of personnel, andgeneral responsibility for level of care will be under the directsupervision of the '1C Section &ead.

&ouse staff coverage, consisting of attending physician and physician


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Gangrenous wounds )nd stage malignancy 3illiary T5 )S6 %F5 9 : SPCTC3 )nd stage liver disease 3eningococcemia Prolonged 16%. !/

minutes Septic shoc$ clients 1omatose 5urn client4s Poor prognosis

'n private cases, the %ttending Physician retains control of his client,and ma$es all the necessary decisions unless he requests transfer ofclient to the '1C.

The client8 any responsible, legal and related member of the family willsign the J12NS)NT F263M, and then the Nurse


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%ll patients must be connected to cardiac monitor.$lui,s:

% dependable ';F line is /w unless changed by the physician. Fluid inta$e shall be determined by 'nta$e and 2utput recording.

Urine an, 1+;el: %ll patients are placed on complete bed rest unless ordered by the physician.

Ph=si'al Care: '1C nurse 6outine physical hygiene including daily sponge bath, oral care,

dressing of wound, and linen changes are done by the Nightduty nurse.

The may be allowed to change or maintain dressing aseptically.)g. 1;P, 1ut down, Tracheotomy care

C& #rans*er ?+ut: The prescribed length of stay in the '1C will be set at five 9/:days as average unless maBor cardiac arrhythmias, shoc$, severe pain and pulmonaryedema are present

paro-ysmal atria 8 tachycardia Nodal rhythmuncontrolled atrial flutter8 atrial fibrillation # nd +rd degree %; 5loc$ atrial standstill Frequent P;14s%; issociation 3ultifocal P;1

Nodal tachycardia ;entricular tachycardia

'n case of private client, the '1C &ead with the consent of the attending physician will determine when the client has to be transferred out.

1lient who may no longer need intensive care management, a transfer slipsigned by the nurse


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2nly immediate family members, wife, husband, legal guardian, ne-t of $inshall be allowed to enter the '1C one or two at a time within the specifiedvisiting hour.

1hildren under !# years of age are not allowed to visit unless e-ceptions aremade by the attending physician.

'nformation about the clients4 condition will be given to the immediate family2N(D.

Taped 3usic maybe allowed for the patient provided that it is battery operated.

Visitin H+urs:!@ @@ %3 < !# @@ NN / @@ P3 < @@ P3

Newspapers, maga*ines, televisions, flowers, and foods for the client areS#RIC#L% P62&'5'T) inside the '1C.

Get well soon messages maybe posted with permission from the Senior Nurse.

#O PREVEN# CROSS IN$EC#ION ,the visitors must wash hands withsoap and water or dispense %lcohol @> into the hands, rub together until dry

before entering and e-iting the unit.

ICU LOUNGE5GALLER% ? Serves as ;aitin area *+r 7atient s relativel+'ate, )esi,e the 'ha7el5'+rner +* PHILHEAL#H ;ar,&

T72 9#: relative are not allowed to sleep at the gallery 6elatives are requested to maintain S'()N1)S, 1()%N('N)SS %N

26 )6('N)SS%T %(( T'3)S.

6)1&%6G'NG 2F )()1T6'1%( G% G)TS 91)((P&2N)S, 6% '2S,)T1: %T T&) G%(()6D 2CT()T 'S P62&'5'T) . 2verloading can affectthe function of cardiac monitors and respirator attached to the patient.

1ommunication to the '1C is made through 1%(( from the staff nurses.

DO NO# $ORGE# HAND9ASHING" Han, ;ashin )e*+re an, a*ter atten,in'lients& Han, ;ashin )e*+re an, a*ter enterin 7atient s unit&

$& ORDERLINESS:

Strictly JN2 S32E'NGM. S'()N1) is strictly enforced. ;isitors and &ealth 1are Providers 3CST 7)%6 '1C G27NS 8 %P62N and

S('PP)6S before entering the unit.

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DRUGS an, SUPPLIES used after the emergency should be identified andlisted for immediate replacement by the N2 in the %3 shift.

LIS# O$ ICU DRUGSGeneri'5 1ran, Na8e 4uantit= E alcohol

Patient, visitors, slipper efibrillator measuring cup, basin,3edicine glass

!# " (ead )1G 3achine urinals, bedpan, and urine bagSyringe pump penlight, flash light, etc.Portable suction apparatus3echanical ventilator 1entral 3onitor in the Nurses4 Station

$OR MONI#ORING:

Me'hani'al Ventilat+r

To provide ventilator support and monitoring for infant, pediatric, andadult clients with respiratory failure 8 insufficiency.

To assist breathing through an )T tube 8 tracheotomy.

Car,ia' M+nit+r # o monitor electrocardiography, heart rate, pulse rate, blood pressure

9systolic, diastolic, and mean arterial pressure


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Cse in the administration of total protein nutrition and drug therapysuch as those used in chemotherapy, anti

prompts, audible alerts, and visible indicators.

Manual Resus'itat+r 's made of silicone, rubber8P;1 materials, late- free used to

ventilate patients with apnea or used for spontaneously breathingclients to augment ventilation or o-ygen delivery. 't is also use asadvice for artificial ventilation and cardiopulmonary resuscitation.

1l++, Pressure 21P3 A77aratus Is designed as a non< invasive method of measuring blood pressure

on healthy s$in of the upper arm or thigh region only.

Su'ti+n A77aratus The aspiration of secretions often through a rubber or polyethylene

catheter connected to a suction machine.

Or+7har=n eal 5 Nas+7har=n eal Su'ti+n % method of aspirating mucus or other secretions or fluids from the

nose, mouth, and pharyn- using a suction catheter attached to thesuction apparatus.

#ra'he+t+8= tu)e su'ti+nin

H#


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'nsertion of a double tracheotomy tube in the opening or incisionmade in the trachea to remove the secretions unable to e-pel8cough,to provide air for clients to breathe.

En,+ tra'heal su'ti+nin % deep suctioning by the use of catheter which is inserted farther

into the trachea usually #@cm8Hin. of the catheter to maintain patentairway by stimulating cough refle-.

Lines( #u)es( Drains P6'26 to treatment0 chec$ all these connections to prevent

dislodging during treatment and mobility. )G Feeding Tubes, 1hestTubes, 'F1s, pacema$er, 1;P, arterial lines and '; lines.

$+r E8er en'= Use,:efibrillator 1ut down 8 1;P set

6espiratory 6esuscitative )quipment '; Solutions2-ygen supply with gauge '; catheter, 3acro set, Syringes, plaster1ardiac 5oard 5andages, gloves, sutures, blades(aryngoscope 5P %pparatus w8 StethoscopeSuction apparatus Tourniquet

9HA# IS CRI#ICAL CARE NURSING

7hen people hear critical health care patient, most of the time, theseare patients that have life


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NURSING ROLES IN ADMISSION( PA#IEN# CARE MANAGEMEN#(AND DISCHARGE O$ #HE PA#IEN#

1ritical care nursing is a specialty within the nursing field. The number of lives saved

with this speciali*ed care can be directly related to the competence of the nurses in theintensive care unit.

To clearly define nursing role it is important first to consider the total duties andresponsibilities of the 1ritical 1are Nurse followed by the nursing procedures onadmission to discharge.

DU#IES AND RESPONSI1ILI#IES:&1ontinuous assessment of the patients4 condition and cardiac status.

Cse of monitoring equipment.The nurse responds with confidence and adapts to rapidly changing patient

condition. &e 8She must be aware of the heart rhythm and be able to identifysignificant arrhythmias, tachycardia at their onset. 't also requires the use of soundclinical Budgment 9$nowledge, s$ills, logic, and common sense: and understandingthe principles and operation of the monitoring devices.

6epeated direct observation of the patient.The nurse must closely monitor the activity of the heart thru the parameters

appearing on the screen of the device. Ta$ing and recording of the vital signs hourlythen refer the patient accordingly.

#. 6outine nursing care must be observed. Generally routine nursing activities must be done at night shift such

as bed bathe, sponge bath, and oral care, changing dressings,diapers and feedings at her own scheduled time or discretion.

The nurse manages comprehensive care of the patient.+. Nursing measures of patient with cardiac problems.

The nurse must be able to perform the therapeutic measures such as< %dministration of 2# T&)6%PD< begin access line< prepare and anticipate drugs and supplies for emergency situation< 'n case of v< tachycardia8fibrillation, prepare defibrillator for a shoc$

or begin compression if fatal arrhythmia is present before the physician arrives.

< ta$e !#


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/. 1ommunication< being an advocate. The nurse e-plains the gadgets attached to the patient, its uses

and rationale, the medications Laction why it is prescribed, thenursing procedures to be done to gain cooperation.

The nurse collaborates with other multidisciplinary team for

referrals, diagnostics, etc.

/. 6ecords $eeping and provides patient and family teaching.

NURSING ROLE IN #HE ADMISSION O$ PA#IEN#S IN #HE IN#ENSIVECARE UNI#

S$illed nursing management of a critically "ill patient operates on many levels.The critical care nurses4 s$ill level is dependent upon their $nowledge, e-perience of,and e-posure to critically "ill patients.

!. Notify '1C physicians as soon as the patient arrives.3edical treatment must be started promptly because the earlier the therapy, the

better the survival rate.#. Start o-ygen administration via nasal catheter.

% routine procedure done to all acutely ill patients. This must be ready at alltimes to save time.+. Perform a !#< lead )1G and obtain the rhythm strips.

%n incidence of fatal arrhythmias is very high.. %ttach the patient cardiac monitor to the patient4

3ost death occurs within the first +@ minutes after admission due toarrhythmia.

/. 1hec$ and record vital signs. 1areful recording of the parameters 5P, 16, 66,Temperature, P6 are essential and serve as the baseline data for evaluating patients4course situation.

. 1ontinuous assessment and observation " an important function. 6educe patients4 ris$ of precipitous deterioration. Prevent their confusion8 agitation leading to harm.

. %ssist the 3 during physical e-amination.H. Start the drug therapy as ordered &

%dministration of medication must be timely and the availability of drugs

saves life.

B& H+listi' '+88uni'ati+n& The nurse often is the $ey provider of information to patients4 relative

and other members of the team. The nurse must orient the relative on the policy, rules and regulation of

the unit especially visiting hour schedule, infection control measures

H/


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9use of gown, no street slippers8shoes inside the unit, &%N&DG')N) before and after entering the patients4 room:.

Give emotional support to the patient and the family.

NURSING ROLES IN PA#IEN# CARE MANAGEMEN#

1e,si,e nursin 'are is *le


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Tell the patient and family member what patient can and cannot do0< 5ed rest


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Dr+7li ht NICU PICU - 5shi*tQ 5 ,a=Is+lette 2Pe,ia( NICU( PICU3 - 5shi*tQ 5 ,a=Ra,iant 9ar8er - 5shi*tQ 5 ,a=In'u)at+r 5,a=Su'ti+n Ma'hine - 5use,

PROCEDURES PER$ORMED:C P R ;5 A8)u)a in P 57r+'e,ureE# inserti+n *ee - 57r+'e,ureNG# Inserti+n $ee 57r+'e,ureGastri' Lava e - 57r+'e,ure

In,;ellin $+le= Catheter Inserti+n 57r+'e,ureSu'ti+nin $ee 57r+'e,ureIV$ Inserti+n - 5 7r+'e,ureNe)uli>ati+n *ee - 57r+'e,ure9+un, Dressin 5,ressin

O


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Ca)les sh+ul, never )e t;iste,( )rai,e,( stret'he,( 7inne, +r han e,& Al;a=s han,le 'a)les )= their '+nne'ti+ns& Av+i, usin a,hesive ta7e( 7laster t+ )un,le '+nne'ti+ns& Av+i, ste77in +n the ;ires +r 'a)les& Ins7e't 'a)les re ularl= *+r si ns +* 'ra'!&

ELEC#RODES: Ele'tr+,es sh+ul, )e ;ashe, ;ith ;ater an, s+a7 )e*+re st+rin & Kee7 the ele'tr+,e sur*a'e 'lean an, )ri ht& Never 'lean the ele'tr+,e sur*a'e ;ith san, 7a7er&

S#RAPS: Al;a=s ,is'+nne't stra7 *r+8 ele'tr+,es )e*+re st+ra e& Av+i, stret'hin stra7s& Av+i, st+rin the8 in a h+t envir+n8ent

PLUGS: Ins7e't 7lu s're; an, ti hten it i* ne'essar=& Never ,eta'h r+un, 7r+n *r+8 the ;ire 7lu s& Av+i, t;istin an, )en,in the 7lu s&

ADAP#ORS: Ins7e't a,a7t+r '+nne'ti+n t+ the 7lu an, ti hten it i* ne'essar=& Never ,eta'h the a,a7t+r *r+8 the 7lu '+nne'ti+n& Av+i, ,r+77in the a,a7t+rs +n har, sur*a'es

OPERA#ION O$ #HE MACHINE5 E4UIPMEN#:

PS%CHOLOGICAL PREPARA#ION: E


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Che'! the 8a'hine i* it is *un'ti+nal an, ;ell r+un,e,& Che'! PO9ER an, all+; 8a'hine t+ ;ar8 a)+ut . se'+n,s& C+nne't 'a)le( ele'tr+,es t+ the 'lient at the 7r+7er sites as in,i'ate,

D+n t +7erate the 8a'hine near a hi h v+lta e ,evi'e& Av+i, +7eratin 8a'hine *r+8 +ne 2 3 e


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All in*e'te, s+ile, linens 8ust )e ;ashe, ;ith er8i'i,al ,eter ents+luti+n&

DISIN$EC#ION: #his a77lies t+ all ,iseases an, is in,i'ate, ;hen 'lient isalrea,= ,is'har e, +r trans*erre, t+ +ther unit:

AIR #HE ROOM $OR -J HOURS

CLEAN ALL SOILED E4UIPMEN#S( LINENS( O#HER MA#ERIALS USED1% #HE CLIEN# 9I#H GERMICIDAL DE#ERGEN# SOAP OR SOLU#ION&

POLIC% ON REPLACEMEN# O$ EMERGENC% DRUGS(

MEDICINES AND SUPPLIES

!. )mergency drugs, medicines, and supplies should be available at all times.

Proper endorsement by the nurse on duty should be done after each shift.#. %ll emergency drugs, medicines and supplies used by the patient should be

accounted for and replaced accordingly.+. The nurse on duty is accountable for any lost or damage of emergency drugs,

medicines and supplies.MF'6ST 'N, F'6ST 2CTM policy shall be observed.. 1onsumption report must be submitted to the pharmacy the following day for

replacement./. )-cess medicines donated by patients should be turned over the pharmacy.. Nearly e-piry medicine should be returned to the pharmacy three months

before the e-piration date.

POLICIES AND PROCEDURES ON IN$ORMING PA#IEN#S ONAVAILA1ILI#% O$ DOC#ORS OR AN% CAUSE O$ DELA% O$

SERVICES

!. The Physician< in 1harge should do daily bedside rounds in the morning but if

any case a question about patients4 condition arises after the doctor4s rounds, it

should be clearly e-plained by the nurses to the patient8relatives that it would

be entertained once the doctor is available.#. For patients on cardiac or respiratory arrest, if the Physician "in 1harge is not

visibly around, the nurse on duty will air J12 )M so that whoever 3edical

2fficer is available will attend the patient.+. 6eferral of patients should be from doctor to doctor.

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ON ISOLA#ION ROOM

!. 1ommunicable diseases if confirmed or suspected should be admitted in

isolation room. 'n the event that no isolation room is available, the nurse

should inform the admitting section who in turn will inform the Physician


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ENVIRONMEN#AL CARE )nsure that standard procedures for routine care, cleaning and disinfection ofenvironmental surfaces, especially frequent touched surfaces in patient

9household bleach: or a disinfectant with appropriate activity.d. Gloves should be worn. 6elease of chlorine gas from disinfection of

large spillage can be ha*ardous to staff.e. 'f spillage is immediately removed, general disinfection of the room

is not necessary0 thorough cleaning will do.f. 7alls do not accumulate dust and associated contaminants and do

not need to be cleaned frequently.g. &ori*ontal surfaces such as floors, and simple devices such as ';

poles and bed frames, can be maintained by cleaning with water and adetergent.

h. Some devices or areas that are repeatedly touched may need morefrequent and intensive cleaning, including disinfection. )-amples are

bedrails, door handles, and areas li$ely to receive spatter.

DISIN$EC#ION O$ SUR$ACES

Soiled surfaces may be cleaned of visible spillage and disinfected with achemical agent suitable for the tas$. 2n a clean surface alcohol is rapidly

bactericidal and rinsing is not required

I+


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Pr+'e,ures +n Re'='lin an, Re use +* E/ui78ent

The central processing areas should consist of decontamination, pac$aging,sterili*ation and storage areas.

De'+nta8inati+n

6eceive materials, sort, clean and preferably disinfect. 7ear appropriate gloveand plastic aprons. Gown sleeves that are fluide, an, unre'+ ni>e, s+ur'es +* in*e'ti+n&

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Standard precautions are intended to be applied to the care of all 7atients in allhealthcare settings, regardless of the suspected or confirmed presence of an infectiousagent.

'mplementation of Standard Precautions constitutes the 7ri8ar= strate = for

successful prevention of healthcare


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NEEDLE S#ICK IN0UR% ? MANAGEMEN# O$ E6POSED PERSON

& REVIE9 #HE CIRCUMS#ANCES O$ #HE E6POSUREa. etermine how long ago the incident occurred.

b. etermine the nature and degree of e-posure< whether s$in was punctured, bleedingoccurred 9e-amine for s$in perforation: " depth of needle penetration< whether theneedle or syringe was visibly blood contaminated.

c. etermine First %id response " was the site washed immediately, howU " wash,disinfect and consider surgical treatment if the wound is tetanus prone.

-& ASSESS RISK( COUNSEL AND EDUCA#E PA#IEN#a. %ssess the degree of e-posure.

b. 6eassure the patient that the ris$ of disease transmission is small.c. %dvice that consideration should be given to the following < no need to

avoid donating blood, organs or semen < possibility of ris$sassociated with breast feeding, pregnancy.

d. )-plain precautions to avert disease transmission to close contacts, e.g.safe se-, no sharing of toothbrushe

latest draft of nursing policies

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