LESSON PLAN ON BACK CARE

Name of the Student Teacher: Ms. Deepika David Name of the Supervisor: Prof. ( Mrs.) K.J. Toppo Subject: Advance Nursing Practice Topic: Back Care Place: College of Nursing, MDOCT & Research Foundation, Ludhiana Group: B.Sc (N) 1st Year Date: 20.10.10 Time: 9:00 10:30 am Language: English Method of Teaching: Lecture cum Demonstration Duration: 11/2 hour A.V. Aids used: Black board, Poster, Transparencies, OHP, Flash cards, Roller Board and Demonstration.

General objectives:At the end of teaching the group of students will be able to re-demonstrate the procedure of back care.

Specific objectives:At the end of discussion the group of students will be able to: Understand about the content of back care. Explain the definition of back care. Enlist the risk factors for pressure sores. Describe the contributing factors of pressure sores. Identify the common sites of pressure ulcers. Identify the stages of bed sores. Explain the prevention of bed sores. Demonstrate the procedure of back care. Describe the back massage techniques. Discuss positions to prevent bed sores.

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Specific objectives

Time

Establises 2min the rapport and announcem ent of the topic.

Teaching learning experience Self-Introduction & Attendance:- Introducing Myself Ms. Deepika . I am M.Sc (N) 1st self & topic. Year student. As a part of our curriculum, today I will be conducting a classroom teaching. So please attend to your roll call. Announcement of the topic:The topic which I am going to discuss with you is, Back care.

Subject matter

A.V. Aids

2.

Assess the 1min previous knowledge of the group Introduce the topic 1min

Assessment of previous Asking knowledge:questions 1. What do you mean by back care? 2. What are the purposes of back care? Introduction:Back care is the special care given to the patients who are bed ridden and who are likely to develop pressure sores, if not properly cared for.

3.

4.

Explain the 3min definition of back care Explain the 3 min purposes of back care

R O Definition of back care:What do you L Back care means cleaning and mean by L messaging an individuals back as a back care? E therapeutic and comfort measure. R What are the To prevent bed sore. purposes of To stimulate circulation. To detect early signs of bed back care? sores. To keep the skin clean and dry. To refresh the patient and relieve fatigue. C H A R T

B O A R D

5.

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Specific objectives

Time

Subject matter To relieve pressure from pressure points and to change positions to prevent from pressure sores.

Teaching learning activities

A.V. Aids

6.

Explain the 2min definition of pressure points

Pressure points are the prominent bony areas of the body where there is no rich blood supply or nourishment and also the skin layer is too thin.

7.

Explain the definition of pressure sores / bed sores

2min

T R A N S P What do A Pressure sore or decubitus ulcer- The pressure sore is a localized area of tissue you mean R E necrosis that tends to develop when soft by N tissue is compressed between a bony pressure sores? C prominence and an external surface for a Y prolonged period. These are called bed sores. Causes of pressure sores: Pressure Friction Moisture Alteration in level of Consciousness. 1. Patients with casts and traction. 2. Impaired motor functions 3. Impaired sensory output What are the causes of pressure sores? What are the risk factors for pressure sores? B--B O A R D C H A R T

What do you mean by pressure points?

8.

Describe the causes of pressure sores

2min

9.

Describe 4min the risk factors for pressure sores

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specific objectives

Time

Subject matter 1.Infection and Fever 2.Shearing Force 3.Poor Nutrition 4.Anemia 5.Old age 6. Obesity 7.Cachexia 8.Edema 9.Moisture Supine: Occiput Scapula Sacral region Heels Lateral: Ears Acromian process of shoulder Elbow Greater trochanter of hip Medial and lateral condyles of knee Malleolus of the ankle joint Heels Prone: Elbow Ears Breast Greater trochanter Genitalia Knees Toes

9.

Enlist the 5min Contributin g factors for pressure sores

Teaching learning activities What are the contributing factors for pressure sores?

A.V. Aids F L A S H C A R D S

10.

Discuss the 5min common sites of pressure ulcers

What are the common sites of pressure ulcers? T R A N S P A R E N C Y

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Specific objectives

Time

Enlist the 7min the stages of pressure sores.

Teaching A.V. learning Aids activities Stage 1:What are the The skin is not broken but the stages of T colour of the skin changes. pressure R Stage 2:sores? A The top layer of the skin and N the skin just below it are damaged. S Stage 3:P The damage to the tissue has A gone all the way into the fatty layer, R and looks like a deep crater. The E crater under the skin may be wider N than the hole at the top of the skin. C Stage 4:Y The pressure sore is a very deep wound that goes all of the way down into muscle, or to the bone.

Subject matter

12.

Explain the 2min prevention of pressure sores

1. Back care How pressure 2. Positioning sores can be 3. Use of therapeutic beds & prevented? mattresses.

B L A C K B O A R D

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Specific objectives

time

Subject matter Articles 1. Screen A trolley containing:Upper shelf:A basin Sponge cloth Spirit / oil Powder A towel

Enlist the 7min articles required for back care.

Teaching A.V. learning Aids activities Rationale Which articles 1. To provide are required for privacy to back care? the patient. To take warm water. To remove soap To apply after drying the skin To prevent the friction To dry the skin

A jug containing extra If needed during water. procedure Soap To apply on back for the purpose of cleaning.

T R A N S P A R E N C Y

Lower shelf:Mackintosh with draw To prevent the sheet. linen from being spoiled Bucket To discard dirty water. Kidney tray / paper bag To receive the waste.

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Specific objectives

Time

Describe the 1min preparation of the patient.

Teaching A.V. learning Aids objectives 1. Assess the need for back care in the How you will patient. prepare the 2. Explain the procedure to the patient. patient? 3. Provide privacy by placing a screen

Subject matter

15.

Steps of 10min procedure

Steps of procedure

Rationale

1. Fold the top bed What are the clothes neatly at steps of the foot of bed. procedure? D 2. Put the patient in For easy access E lateral or prone to back M position O N 3. Expose the To prevent S patients back, unnecessary T shoulder, upper exposure of body R arm and buttocks parts A only. T I 4. Spread mackintosh To prevent linen O and drawsheet. from being N spoiled. 5. Wash hands warm Water. in To make touch Comfortable for the patient as cold causes muscle tension.

6. Moisten patients back with the help of a sponge cloth from scapula to sacral region.

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Specific objectives

Time

Subject matter

Teaching learning activities

A.V. Aids

7.Apply soap and rub/ massage back, using circular movements of both hands. 8.Remove soap completely and dry the skin thoroughly and observe for any discolouration. 9.Apply powder again using circular movements of both hands. 10.Remove mackintosh and drawsheet and change bed sheet if needed. 11.Put on clothes of the patient. 12. Make the patient comfortable.

16.

Discuss the 1min after care of the articles

After care: Replace articles after cleaning. Wash hands. Recording & reporting: Time of procedure. Any discolouration of patients skin should be reported to the senior and recorded.

How you will do after care of articles?

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Specific objectives

Time

17.

Strenghteni 2min ng the knowledge of the group

Teaching learning activities Summarization:Summariz In todays class we have discussed about the e the topic procedure of back care, indications and contra-indications of back care & decubitis ulcers. Recaptulization:Asking 1. What is back care? questions 2. What are the indications of back care? 3. What are pressure sores? 4. What are the contra-indications of back care? Assignment:List down the bony prominences of body and Giving explain the preventive measures to prevent assignmen bed sores. t.

Subject matter

A.V Aids B L A C K B O A R D

18.

Assess the 3min knowledge gained by the group

19.

Evaluates 1min the knowledge of the group

20.

Enhances further knowledge by providing references

Bibliography:1. Gowda nanjunde SN,(2010), st Foundations of nursing, 1 edition, jaypee brothers medical publishers Pvt. Ltd: Pp-202-204. 2. Erbs & kozier,(2008), fundamentals of nursing, 8th edition, dorling Kindersley (india) Pvt. Ltd: Pp-336-337. 3. Wilkins & Williams Lippincott,(2008), fundamentals of nursing volume-2, 6th edition, wolters kluwer (india)Pvt. Ltd: Pp-1404-1406. 4. Swarankar keshav, (2007), nursing practicals and procedures, 3rd edition, N.R. brothers publishers: Pp- 117-121 5. TNAI, (2005), fundamentals of nursing, a procedure manual , 1st edition, Pp176-181. 6. Pennsylvania springhouse,(2007), nursing procedures made incredibly easy, 1st edition, printed in USA : Pp51-54.