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The true value of nursing: Video

A video that highlights the value of nursing and also contrasts with the reality of the profession in these times.

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Theoretical Models of Nursing II

Nursing models are the theoretical bases that support the professional work over time. A theory is a set of concepts, definitions, relationships, and assumptions or proposals to project an objective and systematic view of phenomena enos, designing specific relationships between concepts, with descriptive, explanatory and predictive.

A nursing theory is the conceptualization some aspects of nursing expressed in order to describe, explain, predict and / or require nursing care.

These models clarify the nature of nursing care by identifying the objective pursued by the nurse (or) and its independent role. The model concepts concretized seeking clarity less abstract discipline, acts as a guide for action and provides the nurse (o), a framework that allows you to implement and evaluate interventions.

The theory allows the nursing staff to plan and implement care, with a specific purpose and proactively. The need for theoretical models in nursing is important because the theoretical thinking is an integral part of all roles facing the discipline.

Nursing is a learned profession, a science and an art. That's why you need a theoretical basis to illustrate the science and art of the profession when we pursue the welfare and health of patients, either an individual, a family or community.

OBJECTIVES OF NURSING THEORETICAL MODELS

• objectives Identify the domain and nurses.
• provide knowledge to improve the administration, practice, education and research nurses.
• guide the development of the nursing service.
• Develop a structure and systematic basis for nursing activities.
• Establish criteria for measuring quality of care, education and nursing research.

MODELS OF NURSING
1. ENVIRONMENT-INTERACTION MODEL OF PATIENT: Florence Nightingale

The birth of modern nursing is produced by Florence Nightingale. In the nineteenth century when sanitation was the main health problem, Nightingale east preventive care and humanistic profession, including scientific knowledge, technical competences and self-regulation.

The task of Nightingale in the Crimea had significantly lower mortality systematically applied in the care of the injured, and sanitary measures lavish comprehensive nursing care. Demonstrating the importance of independent work of the nurse. His pioneering work founded the modern concept of Nursing and provides the basis for nursing care as an independent profession of nursing as a discipline.

Florence Nightingale in his book "Notes on Nursing" said the foundations of professional nursing. The main objective of their model is to preserve patient's vital energy and action based on the nature exerts on individuals , put it in the best possible to act on it. His theory focuses on the environment, he believed that in a healthy environment was necessary to employ a proper nursing care.

She says: "What's five key areas to ensure the health, pure air, pure water, efficient drainage, cleanliness and light." Another of his contributions refers to the need for home care, for nurses to teach patients and their families to continue care for themselves. Thus, Nightingale's theory has significantly influenced other theories.

2. SUPPLEMENTARY AND COMPLEMENTARY MODEL: Virginia Henderson

Virginia Henderson is considered the founder Nursing Science. Henderson argues that the proper role of the nurse is to assist the individual, healthy or sick, in carrying out activities that contribute to their health or recovery (in other cases of death in peace), activities that the person would perform in s help if you have the strength, will or knowledge necessary, all this must be done to help the patient gain independence as soon as possible.

Henderson believes that nursing is independent of medicine, the patient needs help to achieve independence, emphasizes the art of nursing, and identifies what human beings need fourteen meet basic needs.

Henderson joined physiological and psychopathological principles to their concept of nursing. Given these fourteen requirements, seven are related to physiology, two to safety, both with affection and belonging, and three self-realization. These needs are:

• Need to breathe normally
• Need to drink and eat properly
• need to eliminate bodily waste
• need to move and maintain proper posture
• need for sleep and rest
• need to select appropriate clothing: dressing and undressing
• need to maintain body temperature within normal limits, adjusting clothing and modifying the environment
Need
• be clean, neat and protect the integument
• Avoidance environmental hazards and prevent them from harming others
• need to communicate to express emotions, needs, fears and opinions
Need
• to observe the worship according to their faith and act on their beliefs and values.
• need to work so that there is a sense of self
• need to participate in various recreational activities
• need to learn, discover and satisfy the curiosity that leads to normal development and health
  
  

This theory seeks the independence of the person through the promotion and health education in the healthy and the sick by nursing care. Establishing the need for a Plan Nursing Care in writing, based on the achievement of achievement of the 14 basic needs and in the registration to get individualized care for the person.

3. UNIT MODEL HUMANS: Martha Rogers

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relation to nursing as art and science. Science of unitary human beings that he considers his unique knowledge base of scientific research and logical analysis moves to practice the profession.

Nurses who follow this model should enhance the awareness and integrity of humans, and direct or redirect the existing patterns of interaction between man and his environment. Nursing care is provided through a planned process that includes collecting data, nursing diagnosis, the establishment of short and long term nursing care most appropriate to achieve them. The actions are intended to assist the individual in the remodeling of his relationship with himself and his environment so that you optimize your health.

The method used by Rogers is mainly deductive and logical. It has very advanced ideas and concerns that nursing requires a new worldview and system new thinking, focusing on the truth that is concerned.

4. MODEL OF SELF: Dorothea Orem

Explains self-care as a human, which is essential addressed each person to achieve their own advantage: to sustain life or restore health. Includes the promotion and maintenance of health, disease treatment and prevention of complications. As nursing care is synonymous with the objective of discipline is to "help people meet the demands of therapeutic self-care."

If we practice Orem's theory, we must follow the following steps:

- Examine factors, health problems and self-care deficit.
- Make the collection of data about problems and assessment of the knowledge, skills, motivation and guidance to the patient.
- Analyze data to discover any self-care deficit.
- Design and planning how to enable and encourage patient participation.
- Set the nursing system in action, and assume the role of caregiver and counselor.

Orem considers three categories of nursing care requirements:

Universal
• : Those who require all individuals to preserve their overall functioning as human beings.
• development of personal care: arise as a result of developmental processes or conditions that affect human development.
• Personal Care Health Disorders: The derived trauma, disability, diagnosis and treatment and involve the need for changes in lifestyle. This model is intended, has specific goals, being initiated and guided by the same person. It is effective, promoting independence.

Nursing's role is to influence people in achieving self avoiding interference from people, objects and circumstances.

5. MODEL OF ADAPTATION: Sister Callista Roy

Individuals are biopsychosocial beings who are in constant interaction with the environment and are adaptive ways based on the physiological needs of self. Highlights the role and interdependence through two adaptive mechanisms, one controller and one cognitive. The individual can show adaptive responses or ineffective responses that require the help of Nursing.

Adaptive capacity depends on the stimuli they are exposed and their level of adaptation, there are three types of stimuli:

- Focus: The faces immediately.
- Context: All the other stimuli present.
- Waste: Those experienced in the past.

Roy emphasizes that in his speech, nursing must always be aware of the responsibility as the patient actively participate in their own care when able. The objective of the model is to facilitate the adaptation of the individual by strengthening coping mechanisms and modes of adaptation.

Nursing's role is to promote adaptive behaviors of the person requiring care.

MODELS OF NURSING

NAME	THEORY	ROL
F. Nightingale	-Interaction environment and patient. - Preventive care humanistic - Creates the theory, technique and competence. Formula a code of ethics. Create	scientific and technical knowledge to improve the quality of care.
V. Henderson	- considers that nursing is independent, so the patient must achieve independence. - Man must meet 14 fundamental needs.	maintain independence with the satisfaction of the fourteen needs.
I. King	- The patient is a personal system within other: 1. The individual (personal sist.) 2. Groups (sist. interpersonal) 3.La society (social sist.)	facilitate the process of interaction.
M. Rogers	-Nursing is science and art. - Science of unitary human beings. - The knowledge base is the research and logical analysis	develop models to accommodate changes in the environment with the person-environment relationships to avoid conflicts.
D. Orem	Self-care as a human need for their own benefit.	influence people for the achievement of self avoiding interference.
M. Levine	- The human being is holistic. - Describe the skills and activities to achieve the patient's adaptation to its environment. - The person is the center of the activities of Nursing. Therapeutic	, helping the patient to their welfare.
N. Pender	- cognitive-perceptual factors. - Factors modifiers.	identify individual factors to promote proper health.
Sister Callista Roy	- The man is a biopsychosocial being in constant interaction with the environment. - Fits in accordance with the satisfaction of physiological needs, interdependence and role.	promote adaptive behaviors of individuals.
D. Johnson	- Behavioral System for the balance of the individual. - is associated with eight subsystems: Unit, success, achievement, associate, aggressive, ingestive, eliminative and sexual.	Check stability and equilibrium behavior.
B. Newman	- The patient is considered as a whole, with variable physiological, psychological and sociocultural development. - also raises aid to patients, families and groups.	Identify stressors, inter, intra and extra-personal, and help maintain balance.
R. parietal	- It is based on humanism. - feelings, values \u200b\u200band viewpoints.	Helping patients to identify changes in the rhythms of everyday life.

Finally, the main objective and primary nursing care focuses on meeting the individual needs of each patient. For that, we must follow in identifying their needs, respecting their opinions and choices in order to ensure quality care without losing the autonomy of the patient.

All our patients have the right to receive the best treatment, care and support available, regardless of social, political and economic. In addition it is also our duty to encourage the active participation of the patient, family and community in the prevention, restoration and maintenance of health.

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Handwashing Handwashing

Here are two very informative videos about hand washing:

- Handwashing Technique Clinical

- "Its in your hands," very explanatory video about the importance of handwashing in the clinical work of health personnel.

Campaigns like this should be imitated by all governments.

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is a hygienic practices to prevent and control the spread of infection. It is also one of the oldest techniques, simple and important, to be performed by health personnel in all service units, to minimize the transmission of infections among patients and staff, between patients and others, or between and other staff. OBJECTIVES

The purpose of handwashing is to remove dirt and transient microorganisms from hands and reduce long-term total microbial counts, through mechanical removal of organic matter and in some cases, along with the use of antiseptic agents.

DEFINITIONS TO CONSIDER

• Flora
  transient: Also called colonizing flora or contaminants. Are germs that are present on the surface of the skin, temporary or transitional, which is acquired through contact with patients or staff infected or colonized or contaminated surfaces, easy to remove by hand hygiene. Estos organismos sobreviven en la piel por varios periodos (desde unos minutos hasta varias horas o días).
• Flora Residente: También llamada colonizante. Son aquellos gérmenes que se hallan en capas profundas de la piel y se aíslan en la mayoría de las personas, se consideran permanentes residentes, y son de difícil remoción por la fricción mecánica.
  Esta flora puede sobrevivir y multiplicarse en capas superficiales de la piel.

• Jabón: Sustancia a base de ésteres de grasa que disuelve materia orgánica. Su propósito es la remoción física de la suciedad y microorganismos contaminants. The soap has no bactericidal activity.

• antimicrobial soap: Soap contains a chemical ingredient with activity against superficial skin flora.

• Antiseptic: A chemical that is applied to living tissue in order to eliminate or inactivate pathogenic virus.

• skin antisepsis: is all that procedure significantly reduces the microbial flora of the skin or mucous membranes.

• Disinfectant: Chemical applied on surfaces or inanimate or inert material in order to kill microorganisms.

• Hand decontamination: Reducing bacterial counts of the hands by performing antiseptic friction.

• persistent or residual antimicrobial activity: Prolonged antimicrobial activity that prevents, inhibits the proliferation or survival of microorganisms after application of a product.

CONDITIONS FOR WASHING HANDS

• should not wear rings, bracelets and watches, regardless of the material they are made.
• Nails should be clean and short, about 3 mm or not more than a fingertip.
• enamel should not be used, even one who has no color (transparent).
• Avoid using artificial nails.

SITUATIONS IN WHICH we wash our hands

• At the beginning and end of the workday.
• When hands are visibly soiled.
• Before and after touching the patient.
• After contacting a source of microorganisms (blood or body fluids, mucous membrane, non-intact skin or inanimate objects that may be contaminated).
• Before and after any procedure or technique performed on the patient, but more so in the case of an invasive procedure and / or aggressive.
• After removing gloves.
• When a patient and interact with each other.

TYPES OF HAND WASHING

We have three types of hand washing:

1. HAND WASHING SOCIAL OR ROUTINE:

handwashing is routinely defined as the mechanical removal of dirt and reduction of transient microorganisms on the skin. This requires hand washing plain soap, preferably liquid, which must be vigorously with a duration of not less than 15 seconds.

Objective: Remove dirt and organic material capable of reducing the concentrations of bacteria or transient flora acquired by recent contact with patients or contaminated material.

Technique:

- Use liquid antimicrobial soap and water.

- Wet hands with water vigorously

- Rub all surfaces of hands, between fingers, at least between 10-15 "reaching up to 10 cm. below the crease of the wrist. Putting emphasis on the nail washing

- Rinse with water.

- to dry hands with disposable paper towels.

- For the closure of the key use the same towel to prevent recontamination.

The total time for the procedure is about 30 sec.

2. CLINICAL HAND WASH

which is done with an antiseptic soap solution microbial spectrum, which is fast acting, non-irritating and is designed for use in critical areas, invasive procedures, and areas of immunosuppressed patients.

Objective: Remove or eliminate transient microorganisms acquired by recent contact with patients or contaminated material.

Technique:

- Wet hands with water.
- Apply 3 to 5 ml of antiseptic soap.
- Rub vigorously for 15 to 30 seconds covering all surfaces of the hand, spaces between to the wrist.
- then dry with a paper towel by hand.
- Use towel to turn off the tap, if necessary.

3. SURGICAL HAND WASHING

washing is done by the surgical team before entering the operating room, is always given an antiseptic soap. Remember that the use of brushing is not necessary to reduce the microbial load when used antiseptic with residual effects.

Objective: To prevent pollution surgical site through the removal and destruction of transient microorganisms and reduce resident flora on the hands del equipo quirúrgico.

Técnica:

- La llave se accionara con pedal o con el codo o célula fotoeléctrica.
- Mojar las manos con agua, aplicar el jabón antiséptico 3- 5ml, restregar enérgicamente por un periodo de 5 min. en el primer lavado y de 3 min. en los lavados siguientes.
- Frotar las manos , palma con palma, palma derecha con dorso de mano izquierda y palma izquierda con dorso de mano derec ha, los espacios interdigitales de mano derecha y luego de mano izquierda.
- Con movimientos rotatorios descienda por el antebrazo derecho hasta 6 cm por encima del codo y luego antebrazo izquierdo.
- Limpie uña por nail, hand and then the other. Brushing is recommended surgery, including the nail beds and fingertips, for 2 minutes.
- Rinse hands to lift it on his elbows.
- During the procedure is recommended to keep the arms up and away from the body by promoting the runoff to the elbows. It is important not to touch surfaces or elements.
- This procedure is performed twice.
- The procedure takes 5 minutes
- Dry hands with sterile towels and forearms.
- Enter the operating room with his back to the door.

IMPORTANT:

Gloves never replace hand washing.

This simple practice is the cornerstone in the fight against nosocomial infections. The hands of health personnel are the main vehicle for exogenous contamination of nosocomial infections, associated even with the spread of multiresistant germs.

Therefore, hand hygiene constitutes an antiseptic practices more important than we realize.