Download Lecture 6

The Subject: Medical
protection. Health of the sister
and safety on worker place
The Purpose to lectures:
 This lecture is dedicated to study aspect health of the
nurse and safety on worker place. The Knowledge
some factor, which can inflict the harm an здоровью
nurses, as well as offers in respect of that, as with this
manage not causing itself harm, will help the student
hereinafter to do the private life and worker situation
more stressful and more safe.
 Teach the student to correct address with patient, what
reduce to minimum disadvantage influence
токсических material and bad микробиологических
factor, preventive maintenance stress.
The Problems:
 Consider with student skills, which necessary when
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referencing with patient to reduce the risk a backache and
traumas in operation?
Discuss with student of the influence токсических
material; radiation and bad микробиологических factor.
Discuss the student what reduce to minimum disadvantage
influence токсических material, radiation and bad
микробиологических factor.
Discuss with student questions stress and nervious
exhaustion.
Consider with student mechanisms checking and
preventive maintenances stress.
The Plan Contents to lectures:
 Address with patient.
 The Toxic material. The Bad микробиологические
factors.
 The Irradiation.
 The Bad микробиологические factors.
 The Stress and nervious exhaustion.
1. Address with patient/client.
 The Term address is in this instance used for
description all action, when patient raise, carry,
support and move in process of the realization
сестринского care.
 Address with patient is dominating reason of the
traumas of the back and backache in process of the
granting сестринского care. So it is important to use
the methods of the address, which is designed to
reduce the pressure on spine and trunk, and,
consequently, reduce the unnecessary pain and loss to
professions many perspective and careful сестер.
To warn the backache and traumas, caused by address
with patient, first necessary to understand the reason
Backache
Otsut.
Eg..
The Traumas of the
Reason backache possible to reduce to three factors:
absence of the experience in given sort to work,
connected with pose, voltage and trauma.
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When referencing with patient in
the following events:
 A)but) Moving the patient in beds
 B) Povorachivanie patient in beds in)
 V)Moving the patient with beds on chair, with chair in
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toilet and etc, conversely
G) Moving the patient with beds on каталку
D) Displacement, connected with procedure of the
bathing
E) patient Support when walking
Z) Support with falling or tumbled by patient.
Preparation.
 Previously, than begin to move the patient, assign itself following questions:
 As purpose of the motion and as condition of the patient (really necessary to move
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the patient in him(it) or her(its) condition on given moment?)
What mechanical auxiliary facilities for realization given movement there are in
presence?
If no facilities in presence no, what way of the address is best and how much
colleagues must help? When need two or more colleagues, for the best if they will
be one growing. If needs the additional procedure during address with patient, for
instance, substitute the ship or оберегать damaged limb, will take one more sister.
Who in group will execute the role of the leader, giving clear instructions all
participating in procedure and explaining patient that occurs?
No some dangers in surrounding situation? Furniture, which disturbs, follows to
take away, каталку to put(deliver) on brake, height to beds and easy chairs-каталки
must be alike, droppers and bedclothes are prepared.
Preparation.
 Value the patient previously than address with patient,
necessary to value, as he or she can most safely and
approaching image to be prepared to realization of the
certain problem. The Sister must so know the medical
condition of the patient, form the opinion in respect of
him(it) or her(its) weight and value need for additional
help; be aware of sensitive and painful area (for instance,
patients with пролежнями, which are subjected to the risk
of the damage of the skin by way надавливания or
перекатывания); presence of the droppers, constant
catheter, drainages and equipment, checking physiological
condition; define, insofar can or must patient to help and
explain the patient that occurs to get his(its) confidence.
 The Cloth. And cloth of the sister, and cloth of the
patient must be thought-out and any, connected with
her restrictions, are taken into account. The Footwear
must be on low heel and on нескользкой to sole for
provision of the most stability. The Footwear on high
heel and with band to carry it is impossible and it is
necessary to be careful, when carry the galoshes or
plastic boats. The Irrelevant size and shabby slippers
patient present the danger.
 Preparation surrounding situations to address with patient.
Any dangerous moments in surrounding patient to
situation such as water on floor, slippers patient, or
something that fell with beds or night tables, it is necessary
to take away. Emphases it is necessary to turn on stands for
intravenous infusion, lines of the presenting the oxygen,
drainages and дренажные to capacities. The Sister must
check, there is beside beds, каталок and кресел-каталок
brake, and make sure, as bed, and каталка, and easy chairкаталка are put(deliver)ed on brake. The Covered oilcloth
mattresses, which can easy slither, present the obvious
danger. If sister moves the patient between bed, каталкой,
easy chair-каталкой, chair or стульчиком, she must make
sure that between them no space, in which patient can
slide down.
After you understand with all вышеупомянутым,
use the following main rule.
 1. The Auxiliary facilities of the lifting and lifting device.
 The having Valued problem in respect of address with patient,
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sister must use any approaching or have available auxiliary
facility or lifting device.
2. The Legs.
The Position of the legs of the sister is very important for safe
address with patient. She must get up in position of the leg
врозь, keeping balance in respect of weight of the patient and
directions of the motion.
3. The Hands.
The Comfort for patient avoiding sensitive and painful places,
confidence of the person, addressing with patient, in abilities to
hold, are a main критериями when considering given moment.
 4. The Position of the patient/client.
 Before that, what raise the patient, it is necessary
always to bring him(it) or her(it) in the most suitable
position.
 5. The Position of the back.
 During address with patient spine sisters always must
be direct, shoulder, insofar this possible, must be on
one level and be made for the same side , as basin. As
to rule and stage to technical methods, when you
realize lifting by one hand, free hand must be used for
maintenance of the balance trunk and, consequently,
positions of the back. Such image free hand is used as
full tilts to remove the load with spine when lifting by
means of shoulder.
2.Токсичные material
 The Workmans of the public health are subjected to the
influence of the enormous spectrum toxic material, being
kept in pharmaceuticalses, chemical preparation and gas,
with which they work. So employers are obliged to provide
free and conducted within the framework of usual uptime
corresponding to education in respect of address with toxic
chemical material. The Dangers, which present these
material, particularly remote results of their action, often
are not realized even their producer, and beside people,
which happens to to have with them deal, can not appear
the thoughts to the periodic headaches, skin
manifestations, dizziness or feeling of the sickness with its
work.
2.Токсичные material
 Each day of the sister deal with enormous spectrum
chemical preparation: дезинфектантами, solvent,
defogger, which can cause local and system toxic
reactions. With many from these preparation so
introduce;make familiar with, both building, and on
work that it is difficult to them with some
disadvantage manifestations. Since there are deep
motives for use selected chemical preparation, in the
same time, little spreads information in respect of
potentially bad factor and more so, as itself to protect
from their influences.
 The Chemical preparations can fall into organism in
the manner of dust or vapour(pair)s, be absorbed
through skin; fall into eye or mouth. Their influences
can reveal itself in the manner of skin reaction,
dizzinesses, headaches and отдышки. Such diseases,
as asthma and eczema, probably, are aggravated under
influence chemical preparation. The Remote result of
the influence of the consequent low doses can be a
miscarriages, sterility and innate pathology; the
disease heart, light or liver; the defeat bud; the cancer.
Dermatit can cause three groups
material:
 I. The Primary irrotants of the skin.
 They cause the direct inflammation of the skin only on
area of the direct contact with material. Here enter
chlorine- and фенолосодержащие material such as
дезинфектанты.
 II. Sensibilizatory.
 These material cause the specific allergic reaction, the
known as сенсибилизация. Usually, it is necessary several
episodes of the influence, and person, beside which there
is sensitivity to determined material, can really gain raised
sensitivity after variety of years influence these material did
not cause no problems. However, once upon a time gain
raised sensitivity to material, beside nurses, probably, s this
reaction, проявляясь in the manner of localized
дерматита, caused by concrete material under minimum
contact even. The Result of the influence can leave for
frames of the direct contact, causing edema of the lips, age
and person, sickness or retching. In group
сенсибилизирующих material enter some
pharmaceuticalses (particularly antibiotics) and
антибактериальное soap.
 III. Fotosensibilizatory.
 These material can be or irrotant, or
сенсибилизатоами, but they are required sunshine or
ultraviolet radiation to stimulate the influence.
Simptomy, connected with overweening influence some
toxic chemical preparation:
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Professional дерматит;
The Headaches;
Petulance;
the sickness and retching;
The Dizziness;.
The Irritation in the field of nose cavity and blazed;.
Weariness;
The Insomnia;
Pulimonologicheskie diseases;
Aggravating asthmatic and экзематозных of the conditions;
The Breach репродуктивной to functions;
The Disease heart, light, liver;
The Defeat bud;
Cancer
The Preventive maintenance.
 The Ithaca, possible do to reduce to the minimum risk,
litter about that that majority though and not all, from
these chemical preparation are a necessary part to lifes
of the hospital or clinics? For decision of this question
is recommended following:
A) Chemical preparations
checking list action.
 1) Necessary to get information on material, with
which nurse has a deal. Full information on all
chemical preparation must be provided and given by
organ, hiring on work. Ensuring the similar sort by
information is a key duty of the employer. carry AND
International Organization of the Labour (the
SPENDTHRIFT) requires this.
 Information, which must be given, includes: chemical
name material, trade indication, his(its) bad factors,
precautionary measure at keeping and use.
 Where possible, potential irrotants must be replaced
on harmless material. The Oxide of the ethylene, for
instance, is presently considered so dangerous
(carcinogenic!) that she in general anymore must be
used. All m/s must be careful even though materialsubstitute and not in such degree is harmed. The
Formaldehyde is often used as substitute and though
he not often only dangerous, all have some serious side
influences. The Chemical material, possessing
disinfecting characteristic, often not necessary
cleaning facility and высокотемпературная
desinfection can have equal or greater efficiency and
be more cheap.
 Use the defensive cloth. As person of the measure
defensive cloth reduces the contact of the skin with
toxic material, but masks provide the certain level of
protection from toxic dust and aerosols. The
Additional cloth can include the gloves, robes, aprons,
dashboard for eye or defensive spectacles and shoe in
accordance with nature of the work and level to
dangers. The Rubber gloves beside personnel with
raised by sensitivity hereto material can cause the
inflammation or practically provoke дерматит.
 Provide the ventilation. The Worker place must be
aired out the corresponding to image, including
systems to mechanical ventilation in places of storage,
preparations and using greater amount chemical
preparation.
A) Chemical preparations
checking list action.
 Undertaking the education med. personnel rule address with chemical
material. The Personnel, using known irrotants, сенсибилизаторы or
carcinogenic material like цитостатикам, must be it is correct is
trained to address and safe procedure, including use the defensive
cloth and precautionary measure at keeping and transportation.
 Necessary to report and fix all events дерматита and other skin
manifestations. Their source must be completely studied and need of
additional protection must be considered local organ, concerning with
professional questions of the personnel(frames).
 Ensuring the care for skin. Necessary to swab all are reeked and
scratches. When possible, it is necessary to use the soft soap for
washing the hands and what should вытирайте the hands. Defensive
cream, вероятнее whole, are not a preventive maintenance against
allergic contact дерматита, can not help to relieve and soften the
process of the defogging of the skin. Moistenning cream can help to
restore the natural fatty layer of the skin, deleted under influence of
some solvents.
 Install regular checking for picture of health. For personnel,
being subjected to known bad professional factor, have an
influence upon health, it is necessary to lead the observation.
Here can enter the physical examinations, blood test and urines,
skin tests and checking function light, liver and bud depending
on used chemical preparation and level of their influence. The
Persons, having in анамнезе skin diseases, must be acquainted
with danger before begin work.
 Know how to render the first aid at accident. If in eye has got the
chemical preparation, immediately and carefully it is necessary
to wash the eye by big amount of cool water. If in mouth has got
some material, necessary to wash the mouth by water. Is it
Usually recommended also drink the big amount of water, but
this not always acceptable. It is Necessary to report on incident
and apply for medical help immediately. The Chemical
preparations попавшие on skin, it is necessary immediately to
wash off. If chemical preparation has got on cloth or overalls, it is
necessary to change her(it) before that, as they get through it on
skin.
anesthetizing gas on picture of
health.
 Several called on examinations and experiment on
animal have installed that even low level departure
anesthetizing gas can have a serious influence on
репродуктивные of the functions both men, and
women(woman). Their influence possible also to with
doggy style and diseases liver.
 Persuasively their relationship is proved with
репродуктивной by activity, particularly spontaneous
abortion. One of the observations for sister, regularly
being subjected to influence anesthetizing gas, has
revealled increase double numbers выкидышей.