MSN INTRODUCTION TRENDS ISSUES HISTORY.pptx

NURSING

1. Historical development of Medical- Surgical Nursing Evolution of MEDICAL SURGICAL NURSING PREPARED BY : MS. KINJAL RATHOD NURSING TUTOR AHMEDABAD SCHOOL OF NURSING

2. Introduction Medical surgical Nursing is a nursing speciality which is concerned with care of adult patients in a broad range of settings. Advances in medicine and surgery have resulted in medical- surgical nursing evolving into its own specialty. The ACADEMY OF MEDICAL SURGICAL NURSES (AMSN) is a specialty nursing organisation dedicated to nurturing medical- surgical nurses as they advance their careers.

3. DEFINATION Medical-surgical nursing involves the nursing  care of adult patients whose conditions or disorders are treated medically /pharmacologically , or surgically It is also defined as the diagnosis and treatment of human responses of individuals and groups to actual or potential health problems.

4. In the history of Indian medicine begins from 3000 BC In 2000 BC the RIGVEDA marks the beginning of Indian system of medicine. In 272 BC king Ashoka built number of hospitals. He had given his emphasis on the prevention of the diseases. Doctors, Nurses and the Midwifes were also available in that time. Nalanda and Thaxaxila were the two famous medical schools.

5. In 100 B C, the surgical field was the well known by surgeons Sushruta and Charaka. Especially two types of operation at those times were outstanding, Removal of the gall bladder stone and the plastic surgery of the nose

6. Nursing in India: In the beginning the nursing was hindered by many difficulties like the cast system among the Hindus, the Pardha system among the Muslims and the low status of the women . The military nursing was the earliest type of the nursing in 1664 the British east India a hospi t a l f o r compan y helpe d t o start soldiers in madras (St. George HOSPITAL)

7. 1854 T h e go v e r nm e n t sanctione d training school for the midwives. 1864 St. Stephens Hospital Delhi First to train Indian girls as nurses. 1871 Th e government, ge n e ral h o s p i t al of madras t o o k a plan to train the nurses

8. 1905 T .N .A . I e st ablish ed 1926 Madras state formed the first registration council 1946 First four year Basic Bachelor degree program established in R.A.K 1947- 49 The Indian Nursing Council was passed by ordinance on December 31, 1947 and was constituted in 1949.

9. History of Surgical Nursing 1840s - Operate on a client who was free from pain. It was a revolution for surgery. Development of safer anaesthetic gases allowed surgeons to conduct longer operative procedures. All the surgery was conducted in hospital setting and nurses are required special training for new responsibilities such as assisting, preparing, caring for a patient in surgical unit. 1876s- In Massachusetts, general hospital provided the first operating room education for nurses. The trend continued to 1900s as nursing schools included operating room experience in each nurses clinical instruction.

10. 1956 - The association of operating room nurses was formed to gain knowledge of surgical principles and explore methods to improve nursing care of surgical clients. The associations of operating room nurses overcame the idea that operating room nurses were only technically skilled practitioners. This organisation also developed standard of nursing practice to establish the need for registered nurses in the operating room. 1970 s-A change occurred in nursing education with a focus on the importance em ph a s i s on of nurses acquiring a broad knowledge base, resulted in less operatin g roo m techniques . Ther e ha s als o bee n a new development in the setting for operative procedures: • Ambulatory surgery: It was also referred to as outpatient.

11. One-day surgery : This health care service is presently growing rapidly in numbers and various types of procedures such as invasive, non invasive procedures are performed. Ambulatory surgery is a scheduled surgical procedure provided for a client who does not remain overnight in a hospital, e.g. biopsies, cosmetic surgery, cataract extractions.

12. H e a l t h WHO Definition Health A classic definition of health is that health is a state of complete p h ysic a l, men t a l, a n d soci a l w ell- b ein g , n ot mere l y t h e a b sen ce of d ise a se or infirmity (World Health Organization, 1974).

13. C A U S E S O F D IS E AS E • M E C H ANI C AL CAUSES • B IO L O G I C AL CAUSES • NORMATIVE C A U S E S ( P ysicolo g ic a l) • NU T R IT IO NAL CAUSES • E NV I R O N M E N T AL CAUSES

14. International Classification of Diseases ICD

15. I C D The International Classification of Diseases (ICD) is the standard diagnostic tool for epidemiology, health management and clinical purposes.

16. This includes the analysis of the general health situation of population groups. It is used to monitor the incidence and prevalence of diseases and other health problems. It is used to classify diseases and other health problems and vital records including death certificates and health records.

17. A system for classification of diseases is needed whereby diseases could be grouped according to certain common characteristics, that would facilitate the statistical study of disease phenomena.

18. Certain infectious and parasitic diseases(A00-B99) Neoplasm(C00-D48) D i s ea s e s of t he b l ood a nd b l ood for mi ng o r g a ns a nd ce r tai n d i sord e rs involving the immune mechanism(D50-D89) Endocrine, nutritional and metabolic diseases(E00-E90) Mental and behavioural disorders (F00-F99) Disease of the nervous system(G00-G99)

19. Diseases of the eye and adnexa(H00-H59) Diseases of the ear and mastoid process(H60- H95) Diseases of the circulatory system (I00-I99) Diseases of the respiratory system(J00-J99)

20. Diseases of digestive system(K00-K93). Disease of the skin and subcutaneous tissue(L00-L99). Diseases of musculoskeletal system and connective tissue(M00-M99). Diseases of genitourinary system(N00-N99).

21. Pregnancy, childbirth and puerperium(O00-O99). Certain conditions originating in perinatal period(P00-P96). Cong e n ita l mal for mati ons, d e for mati ons a nd c hro m oso ma l a bnor malitie s (Q00- Q99). wher e Symptoms , sign s an d abnorma l clinica l an d laborator y finding s classified(R00-R99). Injury, poising and certain other consequences of external causes(S00-T98). External causes of morbidity and mortality(V01-Y90). Factors influencing health status and contact with health services(Z00-Z99).

22. Wellness Wellness, a term often used interchangeably with health, is an active state of being healthy by living a lifestyle that promotes good physical, mental, a n d emo t ion a l h e a l t h .

23. Illness State in which a person's physical, emotional, intellectual, social developmental or spiritual functioning is diminished or impaired. It is a condition characterised by a deviation from a normal, healthy state.

24. Classifications of Illness Illnesses are classified as either acute or chronic or terminal. Acute Illness An acute illness usually has a rapid onset of symptoms and lasts only a relatively short time. Although some acute illnesses are life threatening, with self-treatment and use of over-the-counter medications simple acute illnesses, such as the common cold or diarrhoea, do not usually require medical Treatment.

25. Ch r o ni c Il l ne s s Chronic illness is a broad term that encompasses many different physical and mental alterations in health, with one or more of the following characteristics: • It is a permanent change. • It ca us e s, or i s ca us e d b y , i rr e v e rs i b l e alte r ati ons i n nor ma l a n at o m y a nd physiology. • It requires special patient education for rehabilitation. • It requires a long period of care or support.

26. T e r min a l illn ess End stage disease is a disease that cannot be cured or treated, eventualy that results in death.for eg; cancer

27. Age related illness Cancer Cardiovascular disease Diabetes Obesity Alzheimer’s disease Arthritis

28. TRENDS & ISSUES IN MEDICAL SURGICAL NURSING

29. INTRODUCTION The entire field of health care is changing day by day. These changes occurs at rapid rate. The focus of medical –surgical nursing is not limited to a disease or a body system but focus on holistic in nature. Medical –surgical nursing is a speciality of nursing that requires a specific skills such as analytical, technical,administrative and organizational skills. According to academy of medical –surgical nurses, it is evolving as a speciality and is the largest group of practicing professional.

30. D E F I N I T I O N S Trend: A general direction in which a situation is changing or developing. - Ox f ord Ad v a n c e d Lea r n e rs Dictio n ary Issues: An important topic that people are discussing. A problem or worry that somebody has with some thing

31. TRENDS IN MEDICAL SURGICAL NURSING Quantification of nursing care costs Reduced length of stay Increasing Reliance On High Technology Requirement of advanced nursing knowledge Need for collaboration and communication Innovation in care planning through computerization Unification of practice and education

32. TRENDS IN MEDICAL SURGICAL NURSING Greater investment in research and development Role blurring and shared competencies New areas of nursing specialization Nursing seen as a cost effective approach to health Telenursing Robotic nursing Aerospace nursing Community based nursing

33. MEDICAL SURGICAL NURSING Quantification of nursing costs Quantification of nursing contribution to patient care can be used to determine the cost of providing care to specific patients Quantifying nursing time requires the identification of the level of nursing care necessary for each patient. The patient care plan is an integral part of the justification of nursing care costs

34. MEDICAL SURGICAL NURSING Reduced length of stay The provision of personalized care must be planned and provided with continuity as the quality of care time decreases. Many patients who leave the hospital earlier are still need of health care. Aggressive discharge planning must begin on admission. An effective coordinated plan of care can help ensure continuity of care .

35. MEDICAL SURGICAL NURSING Increase reliance on high technology The evolving technological advances in nursing are the wave of the future in healthcare. Emerging new technologies in EHRs, AI, apps and software development are becoming increasingly popular as more hospitals and facilities integrate them into their health system.

36. MEDICAL SURGICAL NURSING Requirement of advanced nursing knowledge The medical –surgical nurse needs greater clinical expertise, maturity, clinical thinking ability, assertiveness and patient management skills to handle patients. Certification acknowledges the nurses attaintment of predetermined standards established by the certifying groups .

37. MEDICAL SURGICAL NURSING NEED FOR COLLABORATION AND COMMUNICATION The health care delivery becomes more complex and economically centered that need communication and collaboration among health care professionals. Only through collaboration between departments, services, and facilities the nursing care can be delivered effectively.

38. MEDICAL SURGICAL NURSING Innovation in planning care through computerisation Nurses believe that their better time can be spend at the bedside giving patient care rather than filling out paperwork Studies shows that institutions using computers reports increases number of plan of care being generated

39. MEDICAL SURGICAL NURSING Unification of practice and education The Unification Model directs nursing education, research, and practice. Unification is not only a philosophical approach but also an organizational structure that operationalizes the interdependence among education, research and practice.

40. MEDICAL SURGICAL NURSING Greater investments and developments In the recent years the budget allocation for nursing research has been increased in the view of increasing the quality of nursing care

41. MEDICAL SURGICAL NURSING Role blurring and shared competencies Nowadays the role of nurses is not clearly defined The work of nurses are shared with other departments

42. MEDICAL SURGICAL NURSING Nursing –cost effective approach The nursing procedures we are doing are evidenced based and cost effective whwn compare to medical treatment and procedures.

43. MEDICAL SURGICAL NURSING telenursing Tele nursing or telehealth nursing uses technologies to provide nursing services through computers and mobile devices It allows patients to connect with their nurses through mobiles devices,computers,applications etc…..

44. MEDICAL SURGICAL NURSING Robotic nursing Robots are used in nursing for monitoring elderly patient via video ,helps in positioning,feeding,shifting etc…..

45. MEDICAL SURGICAL NURSING Community based nursing The health care delivery concept is now changing from hospital centered to community based nursing

46. MEDICAL SURGICAL NURSING Issues in medical surgical nursing Staff shortage Meeting patients expectations Long work hours Workplace violence Workplace hazards Scope of practice Personal health

47. MEDICAL SURGICAL NURSING Staff shortages The world health organization estimates that there will be shortage of 1.1 million nurses throught out the world. This may cause disturbances in health care system

48. MEDICAL SURGICAL NURSING Meeting the patients expectations Due to advanced technology and awareness, the patients expectation are not met. This causes job dissatisfaction among nurses.

49. MEDICAL SURGICAL NURSING Long w or k hours Shortage of nurses forces the nurses to work for long hours which causes physical and mental disturbances

50. MEDICAL SURGICAL NURSING Workplace hazards Needle stick injuries,sharp tools, and heavy equipments may risk the nurses health and life.

51. MEDICAL SURGICAL NURSING Scope of practice The scope of practice for nurses makes nurses to work in a defined area of practice. Till now there is no prescribed scope of practice for nurses in India.

52. MEDICAL SURGICAL NURSING Personal health Working in a stressfull health care system causes physical and mental disequilibrium.

53. MEDICAL SURGICAL NURSING THANKYOU