PAMANTASAN NG LUNGSOD NG MARIKINA COLLEGE OF NURSING

LESSON PLAN

In Partial Fulfillment of the Requirements for the Degree BACHELOR OF SCIENCE IN NURSING In Related Learning Experience

Submitted to: Prof. Vilma S. Cordova, RN, MAN (LEVEL COORDINATOR)

Submitted by: Bucala, Jeffrey C. BSN 401 GROUP 1

December 18, 8, 2013

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I.

TOPIC Medical Hand Washing, Donning and Removing Gloves

II.

SEMESTER 2nd Semester, 2013-2014

III.

REFERENCE Erb and Koziers Fundamentals of Nursing: Concepts, Process, and Practice, 8 th Edition

IV.

OBJECTIVES In teaching these topics, the students will able to: Utilize the nursing process in the holistic care of client for the promotion and maintenance of health Assess all the things needed in the skills. Plan and implement appropriate performance in doing the proper way of hand washing, donning and removing gloves. Know the significant of the skills to the nurse, client and others. Learn how to proper way of performing the skills. Describe the purposes of the skills involved. Maintain the quality of life.

V.

ENGAGEMENT and EXPLORATION Applying questions and give additional information related to the topics are being discussed Giving appropriate acknowledgement to the student who perform and answer the questions correctly

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Highlight the point of view of the subject matter to prevent information overload.

VI.

Having an evaluation after the skills performed

EXPLANATION

A. Description: Hand Washing It is considered one of the most effective infection control measures. Any client may harbor microorganisms that are currently harmless to the client yet potentially harmful to other person or to the same patient if they find a portal of entry. It is important in every setting, including hospital. Purpose: To reduce the number of microorganisms on the hands. To reduce the risk of transmission of microorganisms to clients. To reduce the risk of cross-contamination among client.

Assessment Determine the clients: 1. Presence of factors increasing susceptibility to infection. 2. Use of immunosuppressant medication. 3. Recent diagnostic procedures or treatments that penetrate the skin or body cavity. 4. Current nutritional status 5. Signs and symptoms including the presence of infection.

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Localized sign, such as swelling, redness, pain or tenderness with movement, palpable heat at site, loss of function of affected body part, presence of exudates.

Systemic indications, such as fever, increased pulse and respiratory rates, lack of energy, anorexia, enlarged lymph nodes.

Planning Determine the location of running water and soap or soap substitutes.

Equipments: Soap Warm running water Disposable or sanitized towel

Implementation: Assess the hands. 1. Nails should keep short Natural nails are less likely to harbor microorganisms, scratch a client, or puncture gloves. 2. Removal all jewelry microorganisms are can lodge in the setting of jewelry and under rings. Removal facilitates proper cleaning of hands and arms. 3. Check hands for breaks in the skin, such as hangnails or cuts a nurse who has open sores may require a work assignment with decreased risk for transmission of infection organisms.

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Performance: 1. If you are washing your hands where the client can observe you, explain to the client what you are going to do and why it is necessary.

2. Roll up sleeves above wrist make sure that your sleeves is you roll up to avoid wet to your sleeves when you perform the hand washing.

3. Stand in front of the sink, keeping the uniform and hands away from your sink throughout the activity.

4. Turn on the faucet and adjust the flow. There are four common types of faucet controls: a. Hand-operated handles b. Move knee level with knee c. Press foot pedals with the foot to regulate flow and temperature d. For infrared control, motion in front of the sensor causes water to start and the soap flowing automatically. e. Be sure to adjust flow so that water is warm.

5. Wet the hands throughout by hold them under the running water. Hold hands lower than the elbows so that water flows from the arms to the fingertips. The water should flow from the least contaminated to the most contaminated area, the hands generally considered more contaminated than the lower arms.

6. Apply soap to the hands: a. If the soap is liquid, apply 2-4 ml from the dispenser.

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b. If it is bar soap, latter or rub them firmly between the hands. Rinse the bar soap and return to soap dish.

7. Thoroughly wash and rinse the hands: a. Use firm, rubbing and circular movement. b. Palm to palm. c. The non dominant palm put over the back of the dominant hand. d. The dominant palm put over the non-dominant palm. e. Interlace the fingers and thumbs then move backhands and forth for both hands. f. Interlace the fingers and thumbs palm to palm. g. Rub knuckles of the hands then each fingers of both hand. h. Rub the wrist of both hands then the fingertips against the palm of the opposite hands. i. j. Use a clean orange stick to clean the under fingernails (optional) Rinse the hands by washing up the forearms at least as high as contamination is likely to be present. k. Rinse starting from wrist to fingers.

8. Throughout dry the hands and arms: a. Pat dry hands and arms thoroughly with paper towel. Moist skin become chapped readily and chapped produces lesions. b. Discard the paper towel in the appropriate container.

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9. Turn off the water: a. Use a new paper towel to grasp a hand-operated control. This prevents the nurse from picking up microorganisms from the faucet handles. b. Discard the paper towel in the appropriate containe

Donning and Removing gloves

Sterile gloves May be donned by the open methods or closed methods. The open method is most frequently using outside the operating room because the close method requires that the nurse wear a sterile glove. Gloves are wear during many procedures to maintain the sterility of equipment and to protect a clients wound.

Purposes: To enable the nurse to handle or touch sterile objects freely without contaminating them. To prevent transmission potentially infective organism from the nurses hands to client at high risk of infection

Skill Competency Preparation Check client record and ask the client about latex allergies.

Equipment: Packages of sterile gloves

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Assemble: Ensure the sterility of the package of gloves. Be sure that our use gloves are sterile so make it sure, that it cannot be touch in not order procedure to maintain the sterility of the gloves.

Implementation 1. Introduce yourself and verify the clients identity. Explain to the client what you are going to do. Why it is necessary, and how the client will cooperate.

2. Observe other appropriate infection control procedures.

3. Provide for client privacy.

4. Open the package of sterile gloves: a. Place the sterile glove package on clean, dry surface above waist. Any moist on the surface could contaminate the gloves. b. Open the outside wrapper by carefully peeling down the top layer. c. Remove the inner package, handling only the outside of it. d. Carefully open the inner package and expose the sterile gloves with the cuff and close to you.

5. Put the first gloves on the dominant hand: a. With the thumb and forefinger of non dominant hand, grasp the top edge of the folded cuff of the sterile glove for dominant hand ( on the palmar side only touch the inside cuff.

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b. Lift and hold gloves with fingers down. Be careful that it does not touch any unsterile thing. c. Carefully insert the dominant hand to glove and pull glove on leave cuff folded down until other hand is gloved. d. Holding the thumb outward, side fingers of gloved hand under cuff of remaining glove and lift glove upward. e. Carefully insert non-dominant hand into glove adjust gloves on both hands touching only the sterile areas. f. With gloved hands, interlock the fingers to fit the gloves onto each other.

Removal: 6. Wash soiled gloved hand.

7. Grasp the outer part of the glove at the wrist of the non-dominant hand.

8. Pull the glove down to the fingers and then expose the thumb.

9. Slip the uncovered thumb into the opposite glove at the wrist, allowing only the glove-covered fingers of the hand to touch the spoiled glove.

10. Pull the glove down over the dominant hand almost the fingertips and slip the glove onto the other hand.

11. With the dominant hand touching only the inside of the other glove, pull the glove over the dominant hand so that only the inside part is exposed.

12. Discard soiled gloves.

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13. Wash hand or hand hygiene.

14. Document the sterile technique used in the performance of the procedure.

VIII. ELABORATION A. (12.18.13) 1. It is consider one of the most effective infection control measures. 2. Give at least 2 purposes of hand washing 3 4 Two types of hand washing. 5. Why should hold the hands lower than the elbows so that the water flows from the arms to the fingertips? 6. Why you should use a new paper towel to grasp a hand-operated faucet? 7,8,9,10. Four types of faucet. B. (12.18.13) 1)-2) Two methods of donning. 3)-4) Two purposes of wearing gloves. 5) Why should be ensure the sterility of the package of gloves? 6) Where do you place the sterile glove package? 7) Is it possible to use clean gloves in the operating room? Why? 8 )What is the first step when putting or wearing the sterile gloves? 9) With gloved hands, why should interlock the finger? 10) What is the last step of donning and removing gloves?

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IX.

EVALUATION I am very glad to say that my handle students have potential to be a nurse in the future. Almost has 83% - 94% during his/her demonstration of the skills. However, some of them have failed because they do not know how to perform or they forgot some steps in the procedure.

X.

REFLECTION Being a PCI is a big opportunity for me and I reflected myself to my handle students when I was in first year. I remembered that the feeling of anxiety, nervous, and effort to memorize all the skills as well as experiencing of my handle students. I learned that students have different ways of learning, understanding and performing the skills. However, sad to say that some of the students did not knew how to perform some skills. At the end of the day, I realized that you should give main concern your study than wasting of time in non-important things. After all of these, I enjoyed and experienced this kind of chance being a PCI for the past 2 weeks of our duty. I hope that I try it again.