Safety and Comfort in Nursing Services

 Introduction:

The environment which the patient is placed should be comfortable and safe, it should contribute to its well being and not retard his recovery.

Patient safety can be defined as the absence of preventable harm to a patient and reduction of risk of unnecessary harm associated with health care to an acceptable minimum. First, do not harm is the most fundamental principles of any health care services. The goal of comfort based nursing practice is to help the patient attain a complete recovery from their illness in a comfortable environment.

Types of safety

Medical Safety

• Clear doctors order
• Identification of patient with similar names
• Proper handling and taking over during change of shift
• Check oxygen flow and empty cylinder
• Check drip flow speed, drip sets, air bubbles etc
• Avoid wrong medication
• Discourage telephonic order

Surgical Safety

• Proper patient identification
• Performance of correct procedure at correct body site
• Improved hand hygiene
• Avoid wrong connections of tubings. eg. catheters
• Check safety code
• Red – allergy
• Yellow – fall risk
• Purple – do not resuscitate

Laboratory Safety

• Single use of syringe
• Avoid needle prick
• Avoid spilling of blood
• Care in handling acids and inflammable substances

Electrical Safety

• Safety fuses with each equipment
• No loose wires or connection.
• Connection Properly plugged and fixed
• If short circuit call electrician

Fire Safety

• Use fire proof material for construction
• Have fire exit in all buildings
• Smoke detection and water sprinklers on the root of all floors
• Fire extinguisher in all areas
• Training in fire management

Equipment and Installation Safety

• Regular checking of equipment
• Proper earthling to avoid shock
• Regular maintenance and repair
• Training nurses and mechanicals of possible hazards.

Blood Safety

• Proper grouping and cross matching
• Test HIV and hepatitis

Environmental Safety

• Adequate light and ventilation
• Stairs with hand rails
• Slip preventing floors
• Fire extinguishers and alarms
• Prevent noise pollution
• Safe wheel chairs and trolleys
• No water logging in bathroom
• Call bell system
• Adequate number of screens

b. Safeguarding Patient’s Personal Belongings

• When documenting valuables make sure to use words like white/yellow metal not gold. Clear stone not diamonds and rubies
• Have a witness
• Have nurse and patient sign valuable list
• Inform the patient that he will get back his valuables on discharge

Sanitation and Infection Control

• Proper segregation transport and disposal of biomedical waste
• Use of sterile procedure
• Formation of hospital infection control committee
• Use of proper disinfection in right dose in right time
• Safely dispose in needle destroyer
• Reorientation of Doctors and nurses of infection control

Patient Comfort During Hospital Stays:

• Provide Privacy (Shut Door, Pull curtain)
• Assist if needed to remove clothing & put hospital gown
• Provide Extra blankets if requested
• Hospitals provide the patient with the right to not only accept their visitors, but also to deny them. It doesn’t help a patient’s recovery if the visitor is someone who will only bring them added stress.
• Visitors are allowed to stay as long as they want, even overnight.
• Provide wireless access along with the usual TV’s and comfortable chairs.
• Counselling services and places to pray and meditate.
• Make waiting time more productive— or at least less boring.
• Help people connect more easily with hospital billing, physicians, scheduling, etc.
• Learn more about your patients and visitors—and about their hospital experiences

Physiological Comfort

Our body responds to injuries and diseases in various ways, and each patient has a different threshold of pain. Relieving pain is a key factor in keeping a patient comfortable. Further, attending to a patient’s bodily functions such as bowel and bladder care, preventing and treating nausea, and keeping the patient active aids in their healing process. Physiological comfort is equally important as physical comfort for better patient outcomes. 

Physiological comfort can be achieved through:

• Understanding the patient’s pain threshold
• Initiating a pain management protocol by:

i. Patients should be asked about their history of pain.

ii. Home pain control measures as part of the admission.

iii. Initiation of pain control orders without delay.

iv. Administering adequate medications.

v. Maintaining allowed activities to improve functional status.

Bowel and bladder care

Advancing nutrition as tolerated by the patient.

Psychological Comfort

Psychological or emotional comfort is an essential part of nursing care in hospital settings. Being away from home, family, and friends causes psychological discomfort in most people. Along with the anxiety of seclusion, being surrounded by unfamiliar people, in an unfamiliar environment, and undergoing physical distress can increase psychological discomfort in a patient.

Psychological comfort can be achieved by:

• Seeing them as humans first, and patients second.
• Providing patient-centered care: Include the patient in the decision making and plan of care.
• Provide care in a way that makes the patient feel respected and valued.
• Provide kind and compassionate care.
• Show empathy in all our actions.
• Ensure effective communication by giving time for the patients to verbalize their concerns and providing answers as honestly as possible.
• Show a listening/ caring attitude.
• Spending meaningful time with patients.
• Include family with the permission of patients in the conversation.
• Provide social opportunities to keep the patient engaged while in the hospital.
• Build trust in healthcare providers through a positive approach.

By knowing these elements, healthcare providers can plan their care accordingly to maximize patient comfort. They are human first and foremost, patient second. Identify their hobbies and plan to provide the same or equivalent opportunity in the hospital. For example, dog visits for dog lovers, musicians for music lovers, and books from the library for those who enjoy reading. By knowing a patient’s favorite snack, nurses can order that for them from the cafeteria if it is permitted in their diet by the physician. Showing willingness to listen to patients and helping patients with medical memory to face time with family members and talk to their dear ones has a great impact on a patient’s psychological comfort. Nurses can be a part of this conversation and answer any questions or concerns of the family and friends.

Spiritual Comfort

Assessing and meeting the spiritual needs of the patient and meeting those needs while the patient is in the hospital provides a better healing environment. Providing an opportunity for the priest/ spiritual leader to visit and prayers can help healing.

Conclusion

Nurses spend the most time with their patients and come to know them as people better than any other member on the healthcare team. Nurses see the anxiety and distress in patients while they are in the hospital and the joy and happiness in patients when they talk to their family and friends. Along with keeping patients safe and comfortable nurses are responsible to prevent any further harm to patients. Moving forward, hospitals and nurses should innovate ways to incorporate physical, physiological, psychological, and spiritual care along with nursing theories and models all to fully ensure patient comfort and healing.

References

1. Ackley, B.J., Ladwig, G.B.,& Makic, M.B.F. (2017). Nursing diagnosis handbook: An evidence-based guide to planning care (11th ed.). Elsevier.
2. Bhargava, J.& Hurley, J.A. (2022). Fibromyalgia. StatPearls. https://www.ncbi.nlm.nih.gov/books/NBK540974/
3. Carpenito, L.J. (2013). Nursing diagnosis: Application to clinical practice (14th ed.). Lippincott Williams & Wilkins.
4. Clark, M. (2020, July 11). 11 Fast and Easy Ways for Hospitals to Boost Patient Comfort. Etactics. https://etactics.com/blog/patient-comfort