Psychology unit 3

 Part 8

Theories of learning

2. Theory of Operant Conditioning

The theory of learning by operant conditioning was given by BF Skinner. He said that the man is an active organism , and not a victim of his environment. He does not wait for the stimulus ; instead he acts or operates on the environment, so as to change it in some way. Thus , he called it as operant behaviour. 

According to Skinner, operant behaviour is determined by the events or consequences  that follow the response. If the consequences favourable , the individual repeat the same, it this case, the consequences are said to have provided to positive reinforcement and cause repetition of the behaviour. If the  consequences favourable, the individual repeat the same, in this case, the consequences are said to have provided to positive reinforcement and cause repetition of behaviour . If the consequences are unfavourable, they reduced the chance of the same behaviour from getting repeated . In such cases , the  consequences are said to have provided negative reinforcement and reduce the chances of the behaviour  from recurring again.

Operant conditioning is also called a type - R conditioning, to emphasize the effect of the response on future behaviour . In this way, Skinner said that learning is shaped and maintained by its consequences.

Educational implication of operant conditioning theory

1. The key concept of Skinner theory is reinforcement ( the process by which a stimulus increases that probability that preceding behaviour will be repeated ). In order to enable an individual to learn , the correct responses must be suitably rewarded or positively reinforced.

2. The principle of operant conditioning may be successfully applied in behaviour modification. We have to find something , which is rewarding for the individual whose behaviour we wish to modify , wait until the desired behaviour occurs immediately reward him when it does.

3. This theory emphasizes the importance of schedules, in trying to teach a particular behaviour , great care should be taken for the proper planning of the schedules of  training.

4. This theory advocate the avoidance of punishment of unlearning of undesirable behaviour and for shaping the desirable behaviour.

5. This theory also state that......

The learning material is so design that it produces fever chances for failure and more opportunity for success.

6. The learner is given the feedback concerning the accuracy of his learning.

7. The learner is able to learn at his own space.

4. Theory of insightful learning (gestalts psychology)

Gestalt psychology was founded in Germany in 1912 by Max Wertheimer and his colleagues.

 The basic idea behind the registered idea that anything cannot understand by a study of its parts , but only by viewing in its totality.

The learner while learning always perceives the situation as a whole. After studying and evaluating the different relationship in the situation , he takes the proper decision in an intelligent way.

Gestalt psychologist used the term insight to describe the perception of the whole situation by the learner and his intelligence in responding to the proper relationships.

According to this theory insight is depending upon the following factors.....

* Past experiences

* Basic intelligence of learner.

* Repetition

* Trial and error process in the initial stage does not last long.

Educational implications of the theory of insightful learning

This theory states that trial and error learning must be minimised.

Subject must be presented in Gestalt form, also in organisation of the syllabus and planning of the curriculum, the Gestalt principle should be applied.

This theory has bought motivation to the forefront. The child should be motivated by arousing interest and curiosity, in order to make learning goal-oriented and effective.

The learner should give plenty of opportunity to use mental abilities.

5. Cognitive theory of learning (observational learning) or learning through imitation (social learning theory)

According to psychologist Albert Bandurs ,  a major part of human learning consists of observational learning ; learning through observing the behaviour of another person called a model.

According to bandura observational learning takes place in four step........

1. Paying attention to perceiving the features of the another person behaviour.

2. Remembering the behaviour.

3. Reproducing the behaviour.

4. Being motivated and carried out the behaviour.

Summary of various theory of learning

Nutrition

Part 3

Importance of Nutrition and Dietetics in Nursing

The word nursing  from the same root word 'nutritious' means to nourish , to cherish, to protect , to supply . It also means to train , to educate and to supply with the essentials growth. We can define nursing as comprehensive as possible that nursing is process of recognising , understanding , interpreting  and meeting the health needs of any person or society.

Nurses constitute an important component of health care system and they are supposed to provide comprehensive services to community. When we say nursing each meeting the health needs of the people , we must know the health and factors affecting it . Today's nutrition is considered as one of the important factor affecting the human health and malnutrition is one of the leading causes of mortality and morbidity in India. Diet is as important as medicine in the treatment of diseases .

We can say that the diet therapy is very important part of treatment.  Nurses should give more attention to the nutrition of patients, otherwise the prognosis of disease will be poor. In   metabolic disorders, diet plays an important role and to some extent we can control such type of diseases with therapeutic diets without medicines. So it has become very important for nurses and other health personnel to study the subject of nutrition during their education so that they can apply the principles  of nutrition and use their technical skills while working in hospital and community.

Objective of Learning Nutrients in Nursing

After completion of the study of Nutrition student nurses will be able to___

- Apply the principles of nutrition and dietetics in health and sickness.

- Make the nutrition as an integral part of their daily nursing practices.

- Recognise the values of nutrition in maintaining personal and patients health.

- Educate the patient and his family about normal and therapeutic diets.

- Plan and prepare the normal and therapeutic diets for different types of patients.

Function of nutrients in nursing

1. Promotion of health

2. Specific protection

3. Prevention of nutritional deficiency diseases

4. Early detection and treatment of deficiency diseases

5. Modification of diets

6. Preparation of therapeutic diets

7. Health education and counseling

1. Promotion of Health

Health promotion is the process of enabling the people to increase control over and improve health. Nutrition is an important factor affecting our health. So nursing efforts should be directed towards pregnant and lactating mothers. These efforts will include nutrition, education, distribution of supplements ,extra protein, calcium , iron and folic acid these can contribute to promotion of health by the following ways :----

* Promotion of breastfeeding

* Development of low cost weaning

* Measures to improve family diet

* Encouragement for kitchen gardens and Home economies

* Guide about cheap and best sources of nutrition , method of cooking and preservation and feeding practices of the people.

2. Specific Protection

While guiding the parents , nurses should make sure that child's diet must contain bodybuilding and protective foods in required amount milk, cheese, eggs and flesh fruits if possible.

    Nurses can guide them about the methods of food fortification to supplement the nutrients. Proper immunization along with vitamin A a prophylaxis can prevent vitamin A deficiency diseases and provide immunity.

3.  Prevention of Nutritional Deficiency Diseases

Number of nutritional diseases can be prevented in the community by nursing efforts. Premature deliveries , low birth weight , abortion and congenital malformations and stillbirths can be prevented by improving the diet of pregnant women. There number of National Nutritional Programs but people are not aware of these programs . Nurses and other community workers can provide proper awareness about these supplemental programs. This can help to reduce the prevalence of protein energy  malnutrition,  anemia , thyroid , disorders , rickets, osteomalacia and xerophthalmia, etc.

4. Early Diagnosis and Treatment

Because the nurses are direct care provider in the hospitals , health centres and in the families, they can detect the malnourished people   in the families as well as in the baby clinics, antenatal and postnatal clinics.  School health nurses have good opportunity to detect  undernourished children.  There are a number of anthropometric  measurements such as weight, height ,arm circumference, head circumference etc. Which   can be used to assess nutritional status of the children "Road to health" cards can be used for the purpose . Other methods are periodical surveillance, early diagnosis and treatment of infectious diseases , oral rehydration of children suffering from diarrhea, deworming  the infested people , developed of   supplementary feeding programs during endemic.  After diagnosis , nurse can play a vital role in the treatment of such cases . These can guide them to prepare therapeutic diets and the different ways of diet modification as required by the sufferings.

5. Modification of Diets

The normal hospital diet which provides a patient with the energy and nutrients is intended for the patient   whose condition does not required a therapeutic diet . This regular diet may be modified with regard to selection, methods of preparation and consistency for patient who cannot tolerate a regular diet but do not require a therapeutic diet .  These modification are liquid diet , soft diet and semi solid diet. Nurses should know different types of modification of diet in the hospital because they are responsible to prepare and administer the nutritional need according to  types of disease, age ,income,  region, customs and food habits of individual  patients.

6. Preparation of Therapeutic Diets for Patients

For everyone, eating food is an enjoyment. When the person is sick the food intake becomes a problem.  The nurses responsibilities in regard to nutrition can be analysed into these areas.

Assisting the patient with his special problems in preparing and acceptance therapeutic diets salt free diet and bland diet

a) Assisting the patients with special problems in preparing and accepting therapeutic diet , i.e. salt free diet and bland diet . 

b)  Assisting the patients; to obtain nurishment either through  feeding ( tube feeding) or assisting helpless patient in eating.

c) For motivating the patient to eat in therapeutic environment, nurses must know the principle of meal therapy, different types of therapeutic diets for the patients with different disease because diet therapy is a part of treatment in these days.

7. Health Education and Counselling

Health education serve as an important tool for prevention of malnutrition . The aim of education is to get people to choose optimum and balance diets, to remove prejudices  and promote good dietary habits . Some common nutritional problem can be minimized by nutrition education and counseling in case of delayed  weaning, ignorance about breastfeeding  and our traditional misconcept about certain foods. In the recent years , the link between dietary habits and certain chronic diseases  has been recognised i.e. obesity, diabetes and cardiovascular diseases . So nutritional education is a measured intervention in the hand of nurses for prevention of such diseases.

Nutrition

Part 3

Health

Health is defined by the World Health Organisation of United Nations as a "state of complete physical , mental and social well-being and not merely an absence of disease or infirmity.

Food

Food may be defined as anything eaten for drunk which meets for energy , building , regulation and protection of the body . In short food is raw material from which our body is made.

Dietetics

"Dietetics is the practical application of the principles of Nutrition . It includes the planning of meals for will and the sick."

Good nutrition means " maintaining a nutritional status that enable us to grow well and enjoy good health".

Nutrients

Nutrients are organic and inorganic complexes contained in the food we eat daily. These include water proteins carbohydrates vitamins and minerals etc. There are 50 different nutrients which are normally supplied through the food. These are of two types__

 

* Macronutrients

* Micronutrients

Macronutrients

Protein fat and carbohydrates are macronutrients. These are called proximate principles because they form the bulk of our food. In Indian diets , they contribute to the total energy in the following proportions Protein : 10 to 15 % , Fats : 10 to 30% , CHO : 60 to 80%

Micronutrients

Vitamins and minerals are micronutrients because they are required in small amount. Micronutrients do not supply energy but they play an important role in regulation of metabolic activities and helps in utilisation of macronutrients.

Nutritional status

Nutritional status is the condition of health of the individual as influenced by the utilisation of the nutrients or it is a state of our body as a result of food we consume . Nutritional status can be good , fair or poor.

Energy

Energy is defined as the capacity to do work. Energy is a prime requisite for body function and growth . The energy  produced in the body may be measured and expressed in units of work (joule) and unit of heat (kilocalories).

Kilocalories

A Kcal is the amount of heat required to raise the temperature of of 1 litre of water by 1 degree Celsius (1°C).

1 Kcal =4184 joules = 4.184 kJ

The nutritional value of protein CHO , Protein and Fats eaten in the diet may be expressed in kilojoules per gram or kcal per gram.

1 gm of carbohydrates provides 4 Kcal (17kilojoules)

1 gm of Protein provides 4 Kcal (17kilojoules)

1 gm of Fats provides 9 Kcal (37kilojoules)

Metabolism

Metabolism is the sum total of building up reactions (anabolism) and breakdown reactions (catabolism) going on inside the body of a living organism.

Metabolic Rate

Metabolic rate is the rate at which energy is released from the fuel molecules inside the cells. This  rate can be estimated by measuring oxygen uptake or carbon dioxide excretion.

BMR ( Basal metabolic rate)

Basal metabolic rate is the amount of of energy expressed in calories that a person needs to keep the body functioning at rest.

Men = 66 + (13.8 *  weight in kg ) + (5 * Height in cm ) -. 6.8 * Age

Women = 655 + ( 9.6 * weight in kg ) + ( 1.8 * Height) - ( 4.7 * Age )

Psychology unit 3

 Part 7

Theories of learning

1. Trial and error theory of learning

This theory was propagated by Edward Lee Thorndike, according to this theory; learning is nothing but the stamping in the correct responses and stamping out of the incorrect responses through trial and error.

Thorndike said that the following components or elements are involved in the process of learning.....

 Drive 

Goal

Barrier

Random attempts to overcome the barriers.

Selection of the correct responses.

Fixation of the correct responses.

Based on this theory, thorndike put forward the following laws of learning.....

1. The law of readiness

2. The law of exercise or practice

3. The law of multiple responses

4. The law of attitude

5. The law of associative shifting

Educational implication of thorndike theory.......

1. According to this theory , when a child is ready to learn , he learns more quickly and effectively. He warns the child should not be forced to learn when he is not ready and also not to miss any opportunity of providing the right learning experiences , when the child is ready to learn.

2. The task of the teacher is to motivate the students by arousing their attention , interest and curiosity so that they want to learn.

3. The teacher must try to strengthen the connection between the stimuli and responses , through repetition and practice.

4. The child must be provided with learning experience, which gives him a sense of satisfaction. The child must be suitable recorded as relevant to make learning effective.

5. The learner should try to see the similarities and dissimilarities between different kinds of responses to stimuli and by comparison, and try to apply I the learning from one situation to the the problem before arriving the correct one.

6. The learners should be encouraged to perform his task independently , he must try various solution to the the problem before arriving the correct one.

2. Theory of classical conditioning

Theory of classical conditioning was proposed by Ivan Pavlov , a Russian physiologist . Pavlov while studying the physiology of digestion , found that behaviour can be classical conditioned.

Classical conditioning

A type of learning, in which a neutral stimulus comes to bring about a response after it is paired with a stimulus that naturally bring about that response.

Neutral stimulus

Stimulus that before conditioning does not naturally bring about the response of interest.

Unconditioned stimulus

Response that is natural and needs no training.

Conditioned stimulus

A neutral stimulus that has been paired with  an unconditional stimulus ( UCS ) to bring about a response only by unconditional stimulus.

Conditioned response

A response that , after conditioning , a previously , neutral stimulus.

Extension

The decrease in frequency and eventual disappearance , of previously conditioned response ; one of the basic phenomena of learning.

Spontaneous recovery

The re - emergence of an extinguished conditioned response after a period of rest.

Pavlov theory has also been called type S conditioning to give the importance of stimulus. The theory of conditions as advocate by Pavlov, considers learning as habit formation and it is a stimulus - response learning  , where in place of a natural stimulus like food , water , sexual contact , is etc…@ and artificial stimulus like the sound of the well , sight of the light of a definite colour , etc… Can evoke a response when both the artificial  stimulus and natural stimulus are brought together several times , the learner  becomes conditioned to response to the situation.

Educational implication of classical conditioning theory

* Fear , love or hater towards a particular subject is created through conditioning.

* On the other hand , intresting and effective methodology in teaching along with sympathetic treatment can have a desirable impact on the students through the process of conditioning.

* The theory of classical conditioning emphasizes that the students should be exposed to positive stimuli in order to develop desirable habits ,  interests and attitudes in them.

* Condition can also be used to remove  unhealthy attitudes , superstitions , attitudes and fears from the mind of the students by exposing them to positive stimuli.

Nutrition

 Part 2

 Relationship of Nutrition with Health and Nursing  

Nutrition and health

Adequate nutrition is the foundation of good health. Good nutrient is considered as a basic components of health. Nutrients effect human health from birth to death. If we want to make a people healthy , nutritional need of the vulnerable groups such as infants , children pregnant and lactating women and elderly must be met. Promotion of breastfeeding and appropriate weaning practice contribute to normal growth and development. The relation of nutrition to health may be seen from the following view point.

Growth and Development

Good nutrition is essential for attainment of normal growth and development during fetal life and childhood. Physical growth and intellectual development, learning and behaviour all are affected by malnutrition. Adequate nutrition is also needed in adult life for the maintenance of optimum health and efficiency. Elder people needs special nutrition due to their chronological changes. Pregnant and lactating mother requires more proteins, calories and some others nutrients to prevent abortion, growth retardation and low birth weight babies.

Nutritional deficiency diseases

Malnutrition is directly responsible for the certain specific nutritional deficiency diseases. The commonly reported other ones in India are protein energy malnutrition , blindness , goitre , anemia , beri-beri and rickets , etc. There are increased incidence of abortion , prematurity , stillbirth and low birth weight in malnourished mother. So good nutrition is the essential for prevention of specific nutritional deficiency diseases promotion of Health and treatment of deficiency diseases.

Resistance of infection

Nutrition rich in protein , vitamins and minerals prevents infection like tuberculosis. Infection in turn may aggravates by affecting the food intake, absorption and the metabolism of nutrients. So we need well balanced diet throught life to protect ourselves from such  opportunistic infection. Good nutrition also enhances wound healing in the patient with different type of surgical operations.

 Mortality And Morbidity

Malnutrition contribute a lot of general death rate , infant mortality rates , stillbirth and premature deliveries.  Prematurity is the main cause of infant death . Servers malnutrition in mothers during first trimester of pregnancy may cause fetal malformation. On the other hand over nutrition which is another type of malnutrition responsible for obesity, hypertension , cardiovascular and renal diseases , liver disorder and gallbladder diseases.

To reduce the incidence of nutritional deficiency diseases, our government has launched several nutritional programmes.

e.g 

Mid - day school meal, Integrated Child Development Scheme, anaemia Control programme and iodine deficiency disorder Control programme, etc.

 

Nutrition

 Part 1

                               Unit 1

Introduction to Nutrition

Food is the basic necessity of life. Life cannot be sustained without adequate nourishment. We need food for growth and development. Healthy food choices are vital to preventing illness. Particularly chronic illness such as diabetes and heart diseases. Proper  nutrition is not only important for preventing disease , it is also crucial to the recovery process of any disease.

Nutrition

Nutrition is the process by which food is used by the body to produce energy and heat , maintain body function and the structure and promote growth.

Process of Nutrition

1. The process of Nutrition begins with the eating food.

2. The food swallowed is then digested as it is passed through the stomach and small intestine.

3. During digestion the food is broken up into the simple substances.

4. These are absorbed into blood stream and carried out to the liver.

5. Where they are either stored or changed further or sent out to other part of the body for use as required.

Function of food

* Food supplies heat and energy for work and play

* It supplies material for growth and repair of body.

* It supplies material for regulation or control of the body process and for protection of body.

Elements of Nutrition

Food contains organic and inorganic complex is known as element of nutrients. These are also called nutrient for food factors. There  are 50 different elements or nutrients including water which are normally supplied by the food we eat. Each element has a specific function in the body. Most natural food contains more than one nutrient element. They are needed to build and maintain body cells , regulate body process and supply energy.

These elements are classified into two groups____

Macronutrients :- these are protein , fats and carbohydrates.

Micronutrients :- these group includes vitamins and minerals.

 

Hospital admission and discharge

 Part 3

Points to remember___

Ensure that no dues certificate is taken before handing over the step to patient.

Inform relatives about  discharge in audience.

Change the dressing when the patient is ready for discharge.

 

Provide clear instruction regarding use of drugs, diet.

Keep the patients record in safe custody.

Discharge Procedure

* The physician should write the patient name who is being discharged on chart.

* Patient personal belongings should be returned.

* The articles in patient units should be checked and ensure that they are completed.

* Check the payment of hospital bills.

* Arrange wheelchair , if patient is not able to 

walk.

* Complete all records of the patients.

Nurses Responsibility In Discharging Patient

* Inform the patient and relatives a day before discharge.

* Get the discharge slip prepared after checking the vital signs.

* The nurses should be that the patient personal hygiene is maintained.

* Hand over patient belongings.

* Complete the admission unit and discharge register sheet.

* Hand over case sheet and other records to medical record department.

* Hand over the discharge sleep to the patient or relatives.

* Ensure that the patient receive old medicine as for discharge slip.

* Place the patient on wheelchair as per patients condition.

* Immediately after the patient leaves, reorganize the patient's.

Transferring the patients

It refers to the patient may require transfer either from the unit to another or to  other health Care institution according to condition of patient.

 Transferring procedure

* Check the order of transfer to another unit.

* Assess the unit where patient is to be shifted.

* Explain the procedure of transfer to patient.

* Review the checklist of patient belonging so that all things are transferred with patient.

* Transfer patient by using wheelchair.

Assess and gather equipment that will be transferred with patient

E.g. infusion pump

* Document time of transfer and patient condition medications.

Transfer to extended care facility

1. Make sure that physician has written the transfer order on patient chart and transfer form.

2. Complete the nursing summary.

3. Attach a copy of transfer form and nursing notes with patient chair.

Care of unit after discharge

1. After the patient is discharged and before admitting another patient,  the room is cleaned windows and doors are opened.

2. Disposable things are discarded and linens are send to laundry.

3. Hatters pellows, blanket are posed to sunlight .

4. In case of communicable disease fumigation of room and articles is done.

5. Sanititation of bed, cabinet and the general area of the patient care unit with germicidal agent after patient is discharged.

Purpose of cleaning

1. Prevention of spread from microorganism.

 

2. Removal of body waste from mattress .

3. Deodrizing the bed tray mattress and pillows.

Guideline for cleaning

1. Review ward policies.

2. Use only authorised detergent or solution for cleaning.

3. Check bedside cabinet is cleared from any valuable of patient.

 4. Check bed linens for personal cleams ( money, contact lense).

5. Replace torn mattress or pillow.

6. Allowed the mattress and pillow to dry thoroughly before making bed.

7. Prevent spread of microorganism by carefully removing linen from bed.

Medico legal case (MLC)

Medico legal case are the cases requiring medical statement , by the same time involve information to law enforcing authorities is called medico legal case.

Types of MLC_____

* All road traffic accident

 * Bomb blast

* Poisoning

* Sexual offence

* Domestic violence

* Criminal abortion

* Attempts suicide

* Bullet injuries

Skeleton System

 Part 1

Unit 2

        Skeleton System

Introduction

Bone :- It is a strong and durable type of connective tissue.

Skeletal system is composed of bone associated cartilages, ligaments, tendons and joints of human body.

Skeleton provide hard framework of human body for protection of smooth argan.

The study of bone and associated structure called osteology.

Two bone articulate together and forms joints.

Joints make the hard and rigid skeleton allow different types of movement at different location.

Human skeletal system composed of 206 bones is divided into two parts_____

1. Axial skeletal system ( 80 bone )

2. Appendicular skeletal system ( 126 bone )

Components of skeletal system

Human skeletal is composed of five main components bones , cartilages , tendon, ligaments and joints.

Bone :- Bone is a tough and rigid form of connective tissue . It is the weight wearing organ of human body and it is responsible for all  strength of human skeletal.

Cartilage :- It is also a form of connective tissue but it is not tough and rigid as bone

Tendons :- A fibrous band of connective tissue that is bonded to bone and connects muscle to bone.

Ligaments: Bands of strong connective tissue called payments hold bone together.

Joints :- A joint is where two or more bone in the body come together.

Composition of bone

Bone consists of ___

Water = 25%

Organic constituents mainly osteon and bone cell = 25%

Inorganic constituents mainly calcium and phosphate = 50%

Types of Bones____

Bone of The Skeleton are classified as_____

Long bone :- it consists of a shaft and two extremities.

Long bone are found in the limbs.

e.g. femur , tibia and fibula

Short Bone 

These bones have no shaft  but they contain a spongy substance covered by a shell  of compact bone.

 They are cubicle in shape. e.g :- carpels (wrist)

The smallest bone of the body is stapes .  It present in middle ears.

Flat bone

They are thin and flattened bones they contain two layer of compact bone with a sponge substance in between. 

e.g. Sternum, ribs and most of the skull bone.

Irregular Bone :- they don't have regular size, shape.

e.g. vertebral bones and bones of the faces.

Sesamoid :- Sesamoid bone are small bone with developed in tendon of muscles.

e.g. patela bone of knee bone 

Some important point

 

Some Important Points to Remember

Hematology ______ study of blood

Hepatology ______ study of liver

Incthyotology ______ study of fishes

Kalology ______ study of human beauty

Odontology _____ study of teeth and gum

Osteology _____ study of bone

Ornithology _____ study of bird

Ophthalmology ______ study of eyes

Some Acid in Food

Citric acid _______ lemon's or  orange

Lactic acid _____sour milk

Butyric acid _____ rancid butter

Tartaric acid _____ grapes

Acetic acid  ____ vinegar

Malic acid ____ Apple

Carbonic acid  ____ soda water

Stearic acid   ____ fats

Oxalic acid   ____ tomato wood sarrell

Some invention and inventor

Bicycle       ____   k. Macmillan

Scooter         _____ G. Bradshaw

Bicycle Tyre      ______ J.B. Dunlop

Tractor      _____  J. Frailich

Watch    ______    AL Breguet

Dynamo       ______ Michael Faradey

Hospital admission and discharge

 Part 2

Nurses responsibility during admission of patient

In outpatient department

When patient comes receive with kindness and courtesy and offer a chair , if very ill patient come for the examination.

Fill the particulars form name, age ,sex, religion, address, husband or father's name date of admission.

Check vital sign and observe general conditions to determine patient condition.

Get the patient examined and admission slip completed by doctor.

Educate patient or relatives and assess the assess the patients body.

Take the patient along with case sheet to the ward.

In wards

When patient come take the case sheet and receive the patient in the admission bade

 

If patient is ill inform the doctor incharge immediately.

 

Complete admission register 

Makes general observation from here to toe.

Give bath to the patient .

Dress the patient in clear hospital  clothes .

Hand over patient belonging to relatives or ward incharge.

 

If patient is admitted for operation or any treatment take the consent.

 

Proper orientation should be done .

 If patient mentally upset , give psychological support.

Discharge The Patients

Discharge is the process when the patient is shifted from the hospital to home.

                  Or

"Discharge means permitting the patient to let go from hospital to his home"

Objectives of Discharge

To ensure medical care after discharge .

To motivate patient and relative .

To promote good public relation.

Types of discharge________

Cured and discharge

This discharge is initiated by physician who advice the patient that he is well enough to leave the hospital, patient is satisfied and leaves.

Discharge to another hospital or another unit (Referral)

In this physician refer the patient to other hospital for better treatment.

When they do not have appropriate staff and equipments.

This is done to just save life of patients.

Discharge against medical advice (DAMA) (LAMA)

In this case the patient leaves the hospital against medical officer advice.

 

When a patient is kept from hospital without knowledge of hospital staff he is treated as absconded in hospital records

Absconded

When patient leaves hospital without any prior information on to staff , and without clearing dues.

DOR (Discharge on Request)

Discharge is given on personal request of client when he/ she is not willing to take treatment from hospital.

Death

When the patient does not recovered from the health problems and dies in hospital the doctors handover body to relatives.

Discharge planning

An effective discharge requires careful planning and continuous assessment of patient needs during hospitalization.

IDEAL discharge planning

I : Include patient and family members as partners in discharge process.

D : Discuss key areas to prevent problems

* Management of disease

* Explain test results

* Medication

* Follow up

E : Educate family and patient about discharge process.

A : Assess whether patient is able to understand the process.

L : Listen to patient and family members respect their difference.