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The role of nurses in providing health-protective mode, creating a safe hospital environment. Medical and security service in medical facilities - is a mode that provides optimal conditions for the patient stays in hospital, his suffering facilitates and accelerates the healing process. Leading role in its maintenance and improvement has the nursing staff in professional whose function are •direct provision of medical diagnostic process • medical care, • ongoing monitoring of the patients. A nurse is a health care professional who is engaged in the practice of nursing. Nurses are responsible—along with other health care professionals—for the treatment, safety, and recovery of acutely or chronically ill or injured people, health maintenance of the healthy, and treatment of life-threatening emergencies in a wide range of health care settings. Nurses may also be involved in medical and nursing research and perform a wide range of nonclinical functions necessary to the delivery of health care. “Nurses dispense comfort, compassion, And caring without even a prescription” Val Saintbury Caring For The Patient Underpinning all of the responsibilities of a nurse is the duty of care to their patients. They make sure that the patient is comfortable, ensures that the patient is getting enough food and drink and they help the patient to get sufficient rest and sleep. The nurse is responsible for taking care of the elimination of waste fluids from a patient when they are not able to go to the toilet. They will wash and bathe them and ensure that the patient does not suffer with any pain. They will help to keep the patient as mobile as possible to avoid the consequences of things like pressure sores and stiff muscles and joints and they will also offer emotional support to the patient on the road to recovery. Work with the doctor to cure the Patient • A nurse’s role encompasses far more than simply care. They will work alongside the doctor and/or surgeon to support them in the actual medical treatment of the patient. For example, a surgeon may well have performed the operation but it will be the nurse who will set up things like an intravenous line to administer drugs and the nurse will be the person who changes dressings, gives the patient any injections and who administers other pain killing medication. Of course, all of the treatment will have been authorised by the doctor or surgeon first but it will be the nurse who often determines when certain procedures post-surgery are carried out and it will also be their responsibility to closely monitor the patient’s progress and to feed that information back to the doctor/surgeon Coordinate the care of the patient • The nurse will be at the very heart of the joint team effort in ensuring that a patient makes a full recovery. They will work alongside doctors and other nurses as well as physiotherapists and other members of the medical team co-ordinating all of the various follow-up treatments and sessions which the patient needs to attend whilst in hospital. Protect the patient • The nurse will ultimately be responsible for the protection of the patient whilst they are in hospital. This is demonstrated in numerous ways. For example, they will liase with cleaning and housekeeping staff to ensure that the patient’s living space is kept clean and free from infection and will also ensure that the patient cannot come to any harm in terms of helping them walk without tripping, making sure they can get and off the toilet and, in general, they make sure that the patient stays safe as well as protecting their dignity, when it comes to things like having to wash and dress the patient. Teach the patient and family • Although the patient will receive advice from surgeons and the likes of therapists, it will often be the nurse’s role to ensure that the patient fully understands what is expected of them if they want to get well and carry on with all of their usual activities as quickly as possible. So, a nurse will often be the person who will reinforce the rehabilitation program to the patient and who will give them and their family as much advice as possible about things like exercise, nutrition and the importance of rest and sleep and not overdoing things once the patient is able to go home. Advocate for the patient Nurses are with people during the most critical times of their lives. Nurses are with people when they are born, when they are injured or ill, when they die. People share the most intimate details of their lives with nurses; they undress for nurses, and trust them to perform painful procedures. Nurses are at the bedside of the sick and suffering 24 hours a day. They are there when patients cannot sleep because of pain or fear or loneliness. They are there to feed patients, bathe them, and to support them. Nurses have a long history of caring for the patient and speaking for his or her needs. That is what advocacy is about: supporting the patient, speaking on that person’s behalf, and interceding when necessary. This advocacy is a part of the nurse's caring and a part of the closeness and trust between nurse and patient that gives nursing a very special place in health care. Hospital design should ensure that patients, especially immunocompromised patients, are at no greater risk for infection within the hospital than outside. Because the microbial flora of a health-care facility can be influenced by its design, infection control professionals play a major role in this aspect. Healthcare facilities are, of course, most exposed to the risk of crossinfections due to the presence of conditions facilitating the expansion and spreading of pathogenic microorganisms. These occurrences of a pathogenic nature are due to various factors such as being in the same room as diseased persons, flows of visitors, activities that facilitate the spread of infectious agents, the selection of resistant and particularly virulent micro-organisms. The survival of microbes on carpeting, however, is different: they are present in larger numbers on this surface and they pose a greater risk for infection. Therefore, carpets should be vacuumed daily and periodically steam cleaned. Carpeting should be avoided in high-risk areas because the cleaning process may aerosolize fungal spores. Regardless of the flooring chosen, it should be easily cleanable and water resistant. Nurses’ uniforms can act as a reservoir of infections, with the areas around the pockets, cuffs and aprons the most contaminated. Investigators compared the contamination levels as well as measured the influence of the number of shifts a uniform was used in its contamination. A person who takes care of the patient should always be smart, calm, restrained, patient and at the same time demanding the implementation of all doctor's prescriptions. Bacteria on hospital floors predominantly consist of skin organisms, e.g., coagulase-negative staphylococci, Bacillus spp., and diptheroids; S. aureus and Clostridium spp. can also be cultured. However, infection risk from contaminated floors is small. Gram-negative bacteria are rarely found on dry floors, but may be present after cleaning or a spill. Nevertheless, these organisms tend to disappear as the surface dries. For successful treatment and rapid recovery of patients necessary favorable conditions of stay: light, heat, sufficient space is well ventilated and insolovana House, a comfortable bed, quiet environment conditions, healthy recreation, management and clinical nutrition, good health and safety services, adequate planting area for walks in the fresh air, full of somatic and mental comfort. • In general, pathogenic microorganisms do not readily adhere to walls or ceilings unless the surface becomes moist, sticky, or damaged. Little evidence exists that walls and ceilings are a major source for hospital infection. Wall coverings should be fluid resistant and easily cleaned, especially in areas where contact with blood or body fluids may occur (e.g., laboratories, operating rooms). Finishings around plumbing fixtures should be smooth and water resistant. • Wards Wards are considered risk areas mainly due to the continuous coming and going of people (patients, visitors, healthcare personnel) and due to the presence of various potentially contaminating biologic fluids. • Waiting rooms In the waiting rooms of a hospital or surgery where the number of people passing through is very high, it is necessary to guarantee a good level of sanitising in order to prevent pathogenic microorganisms passing from one person to another, and thus infecting people who are already in poor health. • Corridors Corridors are places that make it particularly easy for microorganisms to spread from one area to another, since they connect areas featuring different levels of contamination, such as wards, lifts, toilets and doors leading outside. • Toilets In hospitals as elsewhere, toilets are a repository for germs that can aggravate the clinical conditions of people already hospitalised, thus leading to the onset of nosocomial infections. • Handwashing is the single most important method to prevent hospital infections. Each patient room, examination room, and procedure room needs at least one sink. • Implementation of patient care practices for infection control is the role of the nursing staff. Nurses should be familiar with practices to prevent the occurrence and spread of infection, and maintain appropriate practices for all patients throughout the duration of the it hospital stay. Role of the nursing staff The senior nursing administrator is responsible for: • participating in the Infection Control Committee • promoting the development and improvement of nursing techniques, and ongoing review of aseptic nursing policies, with approval by the Infection Control Committee • developing training programmes for members of the nursing staff • supervising the implementation of techniques for the prevention of infections in specialized areas such as the operating suite, the intensive care unit, the maternity unit and newborns • monitoring of nursing adherence to policies. The nurse in charge of infection control is a member of the infection control team and responsible for : • • • • • • _ identifying nosocomial infections _ investigation of the type of infection and infecting organism _ participating in training of personnel _ surveillance of hospital infections _ participating in outbreak investigation _ development of infection control policy and review and approval of patient care policies relevant to infection control • _ ensuring compliance with local and national regulations • _ liaison with public health and with other facilities where appropriate • _ providing expert consultative advice to staff health and other appropriate hospital programmes in matters relating to transmission of infections. The nurse in charge of a ward is responsible for: • _ maintaining hygiene, consistent with hospital policies and good nursing practice on the ward • _ monitoring aseptic techniques, including handwashing and use of isolation • _ reporting promptly to the attending physician any evidence of infection in patients under the nurse’s care • _ initiating patient isolation and ordering culture specimens from any patient showing signs of a communicable disease, when the physician is not immediately available • _ limiting patient exposure to infections from visitors, hospital staff, other patients, or equipment used for diagnosis or treatment • _ maintaining a safe and adequate supply of ward equipment, drugs and patient care supplies.