Unit 8  Safety and Comfort

Chapter 1  SafetyPrevention Injuries in Hospital

Nursing strategies that identify potential hazards and promote wellness evolve from an awareness of the various factors that affect safety in the environment.

☆ Mechanical injuries

Falls are the most common of mechanical injuries, including falling from bed or chair. Person who have paralysis, muscle weakness), and poor balance or coordination are obviously prone to injury. Hemiplegics patients（偏瘫) or patients with leg casts often have poor balance and fall easily.

☆ Thermal injuries

Temperature causing accidents includes heat and cold. Injury of heat is mainly caused by fire, heating devices or breakdown of circuit.

☆ Chemical injuries

Chemical injuries of accidents happen usually owing to using appropriately or wrongly of medicine.

☆ Biological injuries

These injuries include of microorganism and insects. Pathogenic（病原性) microorganism intruding into body can bring all kinds of diseases out, which will threaten patient’s safety.

☆ Hospital-acquired injuries（医院获得性损伤)

   The injuries in mentality and physiology happen because nurses are usually not discreet（慎重) in words and deeds（语言和行为).

Side Rails and Restraints （床栏和约束带)

Falls are common not only among the very young and among elderly people but also occur frequently among the ill or injured who are weakened and frequently lose their balance.

Chapter 2  Comfort

 Definition of Pain

Pain is a highly unpleasant and very personal sensation that cannot be shared with others. It can occupy all of one’s thinking, direct one’s activities, and change one’s life.

Pain Perception

Assessing Pain

☆ Component of pain assessment

Characteristics of pain generally assessed include the following:

医学三基●  The client’s verbalization and description of the pain

●  Duration of the pain

●  The location of the pain

●  The quantity and intensity of the pain

医学.全在线www.med126.com●  The quality of the pain

☆ Types of pain

●  Duration

Acute   An episode that lasts for seconds to less than about 6 months.

Chronic  An episode of pain that lasts for 6 months or longer. The pain may be intermittent or continuous.

●  Quality

Sharp Pain that is sticking in nature and that is intense

Dull  Pain that is not as intense or acute as sharp pain, possibly more annoying than painful. It is usually more diffuse（弥散) than sharp pain.

Diffuse Pain that covers a large area. Usually the client is unable to point to a specific area without moving the hand over a large surface, such as the entire abdomen.

Shifting Pain that moves from one area to another, such as from the lower abdomen to the area over the stomach.

●  Severity

Severe or excruciating    These terms depend on the client’s interpretation of pain. Behavioral and physicalogic signs help assess the severity of pain on a scale of 1 to10, and severe pain between about 8 and 10.

Moderate Moderate pain between about 4 and 7.

Slight or mild  Slight or mild pain could be described as being between about 1 and 3.

●  Periodicity  (定期性)

Continuous  Pain that does not stop

Intermittent   Pain that stops and starts again

Brief or transient  Pain that passes quickly

Intervention for pain

 ☆ Relaxation

Relaxation techniques are effective primarily for chronic pain and provide many benefits:

●  Relaxation reduces anxiety related to pain or stress.

●  Eases muscle tension pain.

●  Helps the person dissociate from（分离) pain.

●  Promotes maximum benefits from rest and sleep periods.

● Enhances the effectiveness of other pain therapies.

● Relieves hopelessness and depression associated with pain.

☆ Skin stimulation

☆ Analgesics  Analgesics（止痛药) alter perception and interpretation of pain by depressing the central nervous system at the thalamus（丘脑) and cerebral cortex（大脑皮层).

☆ Placebos  A placebo is any form of treatment, e.g., medication or nursing intervention that produces an effect in the patient because of its intent rather than its physical or chemical properties.

Medical Intervention

☆ Nerve blocks  A nerve block is chemical interruption of a nerve pathway, effected by injecting a local anesthetic.

☆ Electric stimulation Electric stimulation is sometimes used to combat certain intractable（顽固性) pain.

☆ Surgery