Functional duties of the nurse of the infectious disease department

The infectious diseases hospital includes several departments: an admission department, treatment units for the treatment of patients with various infections. Also in the device of the infectious hospital there must be a laundry, a sanitary pass, a disinfection chamber. In some distance from the medical building there are sanitary-technical and household buildings, food block. In an infectious disease hospital, there must be at least three infectious departments, and they must be isolated. In each infectious ward , there are several rooms for patients with an unspecified infection or a mixed infection. Also, in a hospital with a bed fund of 100 or more beds, it is necessary to have a diagnostic department. In the work of the infectious disease hospital, the flow-through principle is applied, when the patient is hospitalized sequentially and at the same time does not return to them.

All patients with infectious diseases first of all enter the admission department, which is isolated from medical. In the admission department, the patient's history is recorded, the doctor examines it, and after hygienic treatment of the patient in the bathroom, if a pediculosis is found, the scalp is treated with special means by the patient to the department. The personal belongings of the patient are subject to inventory and sent for disinfection. Then the patient enters the infectious disease department, where he will be treated according to his illness. They spend the final disinfection. The patient is placed in the infectious room or box.

The device of an infectious chamber should correspond to hygienic norms and standards. It should be spacious, one patient must have 18-22 m2, the distance between the beds should be at least 1 m. The room should be well lit, with supply and exhaust ventilation, windows should have a grid of insects.

The box is designed to ensure that patients with different infections are not met. In the box should be a bed, bedside table, toilet room. In front of the entrance to the box there is a sanitary access point, where there is a personnel washbasin, a medical robe, which is put on when entering the box and removed when exiting it. There should also be medications for medical care, disinfection facilities for instruments, sterile swabs for swabs from the mouth and nose for diphtheria, feces to identify pathogens of intestinal infections.

In the treatment of patients with infectious diseases, care for them is of great importance. Especially in care need patients with severe forms of infectious diseases. Proper care is required to improve the moral and physical condition of the patient, which contributes to a faster recovery.

There should be several nursing posts in the department. There should be a procedural and regular nurses. The procedural nurse performs parenteral administration of medications: intravenous fluid and drip, subcutaneous, intramuscular injection. The nurse gives out tableted medicines, performs various manipulations( setting enemas, measuring temperature, preparing for various studies), monitoring the condition of patients. In offices for special procedures( sigmoidoscopy, fibrogastroscopy, etc.), a specially trained nurse works.

When a patient enters the infectious disease department, a nurse meets him, tells him about the separation regime, hygiene rules, proper nutrition. She defines him in the ward, informs about the necessary research. The nurse must supervise the sanitation of the sanitary and hygienic separation regime. In the infectious disease department, the wards and the boxes must be cleaned daily. Cleaning is carried out with the use of disinfectants, wipe all the horizontal surfaces( windowsills, bedside tables), doors, pens, floors wash twice a day. After eating, the dishes are washed with the addition of disinfectants, then boiled and dried. Food waste before discharge is covered with bleach. Patients once a week are also subjected to sanitary and hygienic treatment, they are washed and replaced by bed linen and bed linen. Patients in a serious condition are wiped, follow the skin, perform prophylaxis of pressure sores.

The nurse must monitor the condition of the patients, she should immediately notify the doctor about her changes and be able to provide emergency assistance if necessary. Patients excrete pathogens into the environment, in order to prevent the spread of infection, the nurse must know the features of the course of infectious diseases, ways of spreading the infection, ways of transmission of infection to healthy people, methods of treating infectious diseases. Against the background of the infectious process, patients often experience fever, intoxication. Many infections occur with the development of toxic damage to the central nervous system of the patient, this can lead to the development of neuropsychiatric disorders. Such patients need a special approach, the nurse must be able to calm the patient, find a common language with him. It must be remembered that the mental health of the patient plays a big role in his recovery.

During the recovery period, the infectious patient is exhausted, weakened, he has digestive disorders, cardiovascular system, other systems, but the patient's condition is often satisfactory. An infectious patient needs a high-grade, high-calorie diet. The nurse should know about this and monitor the patient's diet. Severely ill require regular feeding, in small portions, but often. Usually, such patients can not eat independently because of severe weakness and intoxication, the nurse should help them, showing patience and care. Rational nutrition is also important for convalescent patients. Patients should take food four times a day for certain hours, which are indicated in the mode of the day. Food should be rich in vitamins, as they are necessary for the treatment and recovery of the patient. In the diet of the patient must be present fruit juices, if there are no contraindications, the patient is allowed fresh vegetables and fruits. With ulcerative bowel disease( typhoid fever), patients need a sparing diet. Many infectious diseases occur with fever, intoxication, dehydration( frequent diarrhea, vomiting).Such patients require an abundant drink to remove toxins from the body, to replenish the lost fluid. The nurse must ensure that patients drink at least 2 liters per day, patients can drink juices, fruit drinks, tea with lemon, herbal tea. If the patient can not use the liquid on his own with the expressed dehydration of the organism( with food toxicoinfections, cholera), intravenous injection of saline solutions, physiological solution, glucose solutions is necessary. With botulism, encephalitis, typhus, poliomyelitis in patients develop dysphagia( a violation of swallowing).In this case, it is necessary to feed through a probe or the use of nutritional enemas. For probe feeding, a duodenal probe is used, which is injected into the patient's stomach and nutrient fluid is injected through it( various ready-mixed compounds are currently used).Nutritional mixtures are also introduced with the help of a nutritional enema, a cleansing enema is made beforehand for the patient. It is also necessary to monitor the transmission to patients, so that they do not bring products prohibited for this disease.

The nurse must constantly monitor the patient's condition, measure his pressure, pulse rate, respiration, and conduct thermometry. The temperature is measured every day in the morning and in the evening in the armpit 10 minutes. With malaria, the temperature should be measured after 2-3 hours. The used thermometers are treated with disinfectants, and they are also stored in a container with disinfectants. Thermometry data must be entered into the temperature sheet, all changes in the patient's condition should be reported to the attending physician. The nurse should monitor the patient's breathing rate, the frequency and nature of breathing, the presence of cough and sputum. If the patient has sputum, the nurse must give the patient a special clean jar for sputum collection for the study. It is important to control the pulse rate and blood pressure, under certain conditions( temperature drop), the patient may develop collapse: blood pressure decreases, the pulse becomes faster. The nurse should inform the doctor about this, to enter cardiological preparations( cordiamin).Some infectious diseases occur with the development of impaired consciousness and the development of psychosis. The nurse should especially observe the condition of such patients, with mental excitement the patient should be fixed in bed, administered sedatives, and urgently called a doctor.

Many infectious patients can have intense headaches, insomnia. With a persistent headache, the patient is parenterally injected with anesthetics, an ice pack is placed on the forehead for 20 minutes with interruptions for 20-30 minutes. In case of insomnia, the patient is recommended to drink warm sweet tea before bedtime, sedatives and hypnotic medicines are also used. Patients who have been in the infectious department for a long time, exhausted, weakened patients need preventive maintenance of bedsores, development of stagnant( hypostatic) pneumonia. For the prophylaxis of pressure sores, the patient is regularly washed or wiped, changed bed linens and bed linens, watches the cleanliness of the bed, wipes the place of compression( neck, scapula, elbows, buttocks, shins, heel areas) with camphor alcohol, and rubber circles are put under them. For the prevention of hypostatic pneumonia, the patient needs to constantly change position in bed, recommend the patient to inflate the rubber balls for a few minutes a day, carry out respiratory gymnastics, and it is also important to quartze the chambers regularly.

With various intestinal infections, special attention should be paid to the work of the gastrointestinal tract, to carry out proper care, to prevent complications. Such patients should regularly brush their teeth, rinse the mouth after eating. For patients who can not take care of themselves, the nurse should wipe the mouth with a cotton swab moistened with a 2% solution of boric acid several times a day, and care must be taken not to injure the mucous membrane. When the tongue is dry, it should be lubricated with glycerin, half diluted with water. Such treatment of the oral cavity is very important for the prevention of complications, for example the development of purulent parotitis in typhoid fever. Patients with intestinal infections( typhoid) often have constipation and gas retention( flatulence), with patients complaining of a feeling of heaviness in the abdomen, nausea, weakness, headache, since the products of decay are sucked in the stagnation of kapovye masses in the intestine. In such cases, the nurse makes a cleansing enema with cool water, using Esmarch's mug, with gas meteorism using a gas pipe. Patients with intestinal infections are allocated individual vessels, which are regularly treated with disinfectants. Patients with intestinal infections often experience diarrhea( frequent loose stools).They need special care. After each act of defecation, the patient should wash the area of ​​the anus with warm water. Exercises of the patient must be disinfected before draining into the sewer, they are covered with chlorine lime. Patients with diarrhea should empty the intestine into the vessel so that the nurse can examine the feces for pathological impurities( such as mucus, blood, pus, parasites, pieces of undigested food).Also, patients may develop vomiting, while the patient's head should be turned sideways and replaced with a tray to prevent aspiration of vomit and the development of aspiration pneumonia. After the patient has vomited, the nurse should wipe his face with a damp towel, and the lips with a napkin. If vomiting is caused by poisoning, the patient should wash the stomach to clean rinsing water. If a patient has blood in the emetic masses, the nurse must urgently call the doctor, the patient should be placed and a bubble with ice should be put on the epigastric region, the patient should not eat or drink.

All manipulations and studies should be carried out with strict adherence to the rules of aseptic and antiseptic, as it is possible to spread the infection, the patient has secondary infection due to reduced immunity.

A nurse must monitor the disinfection of the patients' linen, care items. The patient and bed linen of patients, stained with stool, soaked in a solution of chloramine, after that the laundry is subjected to boiling and washing. The care items( heating pad, vessel, pots) are also soaked in chloramine solution. In the infectious ward, after each discharge of the patient's bowel movements with intestinal infection, it is necessary to handle the disinfectant with door handles, the handle of the drain tank, the toilet bowl, the floor in the toilet. Household tools( buckets, rags, mops) must be treated with a disinfectant. After discharge of the patient, the mattress from its bed is disinfected in the disinfection room and only then applied again.

Properly organized care, adequate treatment allows the patient to recover health more quickly, even in the most severe cases. The sensitive and caring attitude of medical personnel plays the same important role in alleviating the condition and recovery of the patient, as is etiopathogenic treatment.