progressive patient care presentation

Progressive Patient CareConcept

Pooja Maitre

Pooja Maitre (MN) 2

INTRODUCTION

The continued care of the patient is directed towards the prevention of complications, rehabilitation and a return to normal living.

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DEFINITIONA system of care in which patients are placed in units on the basis

of their needs.

The American Association of Critical Care Nurses recognizes progressive care as part of the continuum of critical care.

It defines nursing practice based on the needs of the patient and the characteristics of the nurse to attain optimal patient outcomes.

Progressive care defines the care that is delivered to patients whose needs fall along the less acute end of that continuum. Progressive care patients are moderately stable with less complexity, require moderate resources and require intermittent nursing vigilance.

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CHARACTERISTICS OF PPCDecreased risk of a life threatening event,

A decreased need for invasive monitoring,

Increased stability; and

An increased ability to participate in their care.

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PHILOSOPHY OF PPC Initially, progressive care units housed post myocardial infarction

patients requiring cardiac monitoring, but not requiring intensive care and observation. With the changing healthcare environment, the acuity of patients admitted to hospitals steadily increased and caused an increase in the demand for critical care beds. With the increased demand and decreased availability of critical care beds, patients were often transferred from critical care units while still requiring an increased level of nursing care and vigilance. Patients admitted to critical care units five to ten years ago are now routinely admitted to progressive care.

Progressive care is the term the American Association of Critical‐Care Nurses (AACN) uses to collectively describe areas that are also referred to as Intermediate Care Units, Direct Observation Units, Step‐down Units, Telemetry Units, or Transitional Care Units as well as to define a specific level of patient care.

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BENEFITS OF PPC - Patients

The patient receives the specialized care.

The patients who are not critically ill are not deprived of nursing and medical attention.

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BENEFITS OF PPC - Physician

The physician is given a greater assurance that his patient is receiving a high quality nursing care.

Emergency treatment if necessary is in the immediate vicinity

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BENEFITS OF PPC - NursesThe nurse makes an effective use of her

special capabilities.The problem of providing services by the

nurses to critically ill patient is reduced when the patients are divided to various groups according to the degree of illness.

It helps the nurses to plan the nursing care for the patients better as the needs are of almost same degree in each unit.

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BENEFITS OF PPC - HospitalThe beds, physical facilities, supplies and

funds available may be used efficiently.Improves public image of the hospital in

community.Home care program as a part of PPC helps

the hospital to coordinate its activities with the community health and social services.

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STAGES OF PROGRESSIVE PATIENT CARE

1. Intensive care,

2. Intermediate care, and

3. Minimal care.


INTENSIVE CARE UNITType of ICU :-

Generalized ICUSpecialized ICU

Type of Patients :-Any patient in a serious condition who has the

slightest chance of recovery.It is desirable not to admit patients here who

are in the terminal stage of disease.


INTENSIVE CARE UNITEquipments:

Sound-proofing and Air Conditioning.Centrally Placed Nurses’ Station.Sterile Equipments like Trays etc.Piped Oxygen and Piped Suction Apparatus.Multi-parameter Monitors.

ICU Layouts:Patients AreaAncillary AreaAuxiliary Area


INTENSIVE CARE UNIT


INTERMEDIATE CARE UNITFor Moderately ill Patients or Palliative Care.May also have patients transferred from ICU.It accommodates 60 – 70% of total

hospitalized patients. A large number of patients are admitted and

discharged directly from this unit.


INTERMEDIATE CARE UNITIntermediate Care Layout:

Bed Arrangement – Single, Double and 4-6 beds in a room.

Ancillary Area Nurses’ Station Clean Room Treatment Room, etc.

Supportive Area, like: Clinical Teaching Room Side Laboratory Doctors’ Room, etc.


MINIMAL CARE UNITCan be classified into

Self Care

Long Term Care

Home Care

Ambulatory Care


MINIMAL CARE UNIT – Self CareFor Ambulant and Self Sufficient Patients.Primarily for Supervisory or Health

Education Purpose.More of Home Like Environment as patients

for diagnostic procedures, special treatments (like radiotherapy) or preparation for major surgery are admitted.

Helps in easy transition of Patient between Hospital & Home environment.


MINIMAL C.U. – Long Term CareFor Restorative or Rehabilitative care.When care is required for a Prolonged Period.Nurses’ Role :

Serves as administrator.Coordinates care provided by others.Provides direct careMakes referrals.Teaches patient and family.Plans, implements and evaluates plan of care.


MINIMAL C.U. – Home CareFor Preventive and Promotive Care of the Community.Hospital based Home Care programs for patients can

best be cared at home with extended services from the Hospital.

Nurses’ Role:Assesses home environment and patient.Develops relationship based on mutual trust.Provides direct care.Plans, implements and evaluates plan of care.Makes referrals.Teaches patient and family and provide support to them.


MINIMAL C.U. – Ambulatory CareCare of the ambulatory patient requiring

diagnostic, curative, preventive and rehabilitative services.

Categories:General OutpatientReferred OutpatientEmergency Outpatient


Steps for Introduction of PPC1. Familiarity with the PPC2. Development of Teamwork3. Evaluation of Needs4. Orient Staff5. Estimation of Costs6. Formulation of Policies7. Provide Flexibility8. Adequate Staffing9. Instruct Patients10.Inform or Communicate Public

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Thank You

Pooja Maitre (MN)

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