BASIC NEEDS { ACTIVITIES OF DAILY LIVING }

A professional nurse meets the needs artfully with compassion. The objective
of the nurse is to meet the daily activities of the patient. The basic needs are :

1. Physical needs : these are closely related to body functions and are sometimes
referred to as primary or physiological drive. Physical needs include,
 Oxygen food
 Water shelter for body warmth and protection
 Elimination clothing
 Activity, sensory and motor stimulation including sex, physical
exercise and rest
2. Emotional needs : emotional needs are closely interrelated with physical needs
and are met in interaction with significant others. They include :
 Love, including approval and esteem
 Importance, including recognition and respect
 Adequacy, including self sufficiency and the need to be needed and
wanted
 Productivity, including work and creative pursuits
3. Social needs: social needs grow out of the culture and society of which one is
amember. They include:
 Identification or belongings
 Recreation or play
 Education or learning
 Religion or worship

MASLOW’S HIERARCHY OF NEEDS

Psychologist Abraham Maslow defined basic human needs as a Hierarchy, a

progression from simple physical needs to more complex emotional needs.
Types of needs:

 Physiological : food, shelter, water, sleep, oxygen

 Safety : security, stability, order, physical safety
 Love and belongings : affection, identification, companionship.
 Esteem and recognition : self esteem, self respect, prestige , success, esteem of others.
 Aesthetic : beauty, harmony, spiritual.

Relationship between levels of needs

1. According to Maslow, the basic physiological needs related to survival { food,

water, etc } must be met first.
2. These basic physiological needs have a greater priority over those higher on the
pyramid. They must be met before the person can move on to higher level needs.
In other words, a person who is starving will not be concentrating on building his
self esteem. A patient in severe pain will not be concerned with improving his
interpersonal relationships.
3. In general, each lower level must be achieved before the next higher level and can
be focused upon.

COMPARISON OF BASIC HUMAN NEEDS AND MASLOWS HIERARCHY OF NEEDS

Maslows hierarchy of needs Basic human needs

Physiological : food, shelter, water, sleep,
oxygen
Safety : security, stability, order, physical
safety
Love and belongings: affection,
identification, companionship.
Esteem and recognition : self esteem, self
respect, prestige, success, esteem of others.
Self actualization : self fulfillment, achieving
ones capabilities.
Aesthetic: beauty, harmony, spiritual
Physical needs : food, water, oxygen,
elimination, clothing and shelterfor body
Warmth and protection, activity, or sensory
and motor stimulation including sex, physical
exercise and rest
Emotional needs : love including approval
and esteem.
Importance including recognition and
respect.
Adequacy including self sufficiency
Social needs: identification or bbelongings,
education or learning, religion or spiritual,
recreation or play
 THERAPEUTIC ENVIRONMENT / PROVIDING SAFE AND CLEAN
ENVIRONMENT

Introduction

The hospital must be constructed, arranged and maintained to ensure the safety of yhe
patient, and to provide facilities for diagnosis and treatment and for special hospital services
appropriate to the needs of the community.

Meaning of safety

A safe and comfortable environment5 is one which contributes to the wellbeing of

patient. A safe environment implies freedom from injury or possibility of injury of any type.
Comfortable environment is concerned with atmospheric conditions such as temperatue,
humidity,ventilation and lighting etc

1. Physical environment :
Physical environment of hospital should be free from noise, well ventilated with good
lighting, suitable temperature and humidity and also free from vermin pests to avoid
physical hazards to patients, staff and visitors.
A ] Temperature : It should be sufficiently warm enough to cause perspirations. A
room temperature ranging from 68- 72֯ F { 20 - 22֯ C } is considered comfortable.
B ] Humidity : It is the amount of moisture in the air. It affects the evaporation of
moisture from the skin. Humidity of 40 -60 % is considered comfortable.

C ] Noise : The place should not be too much populated. It must be situated in a place
free or away from populated area and noises. It produces irritability, restlessness,
fatigue and exhaustion. In an acutely ill client, noise interferes with sleep. The degree
of noise may be reduced by various methods :
 Noise caused by friction may be reduced by lubrication.
 Use of rubber tires and castors for the trolleys and the wheel chairs
reduced the sound when moving furniture.
 Make eco proof rooms, avoid dropping objects. Control the radio,
television etc during the rest hours. Loud talking heavy walking with
shoes within the hearing of ill persons should be avoided.

D ] Ventilation : There must be an open space to provide proper light and ventilation to
the patients. Ventilation means movement in the air. The chief purpose of ventilation is to
supply and to maintain a proper humidity.

 The walls and floors should be non absorbent, non porous, shock absorbing, fire
resistant, attractive and durable for safety of the patient.
 The floor area should be adequate according to the number of beds.
 The windows and doors should be placed in such a way that there is adequate
availability of natural light to all patients and proper ventilation.
  The construction of the rooms should be made in such a way that it facilitates
fumigation.
 The toilets or latrines should be clean and should be placed away from the general
wards. They should be cleaned twice a day to prevent any type of infection and any
type of bad odour.
 The reception counter and the inpatient department should be near to the main entrance
of the hospital for easy access.
 The kitchen and the dining rooms should be away from the rest of the wards to maintain
hygiene and prevent any type of infection from the patients and ward.
 There should be provision for the isolation of the patients who are having any type of
infection or suspected to infection for preventing spread of disease to other patients.
 There must be provision of emergency doors in the hospital to protect the patients and
other staff in case of fire hazards.
 There must be provision of railings along the sides of open corridors and stairs to
prevent any type of accidents by falling.
 The stairs should be straight and not in circular shape for easy movement of patient and
public.
 There must be provision of good electricity in all the wards.
 There must be provision of good, safe and clean water supply to all the wards.
 There must be provision of both hot and cold water according to the need of the
patients.
 There must be provision of side rails to all beds of the patients.
 There must be separate parking place for the vehicles and it should be away from the
hospital to prevent any type of loud noise to disturb the patients.
 The excreta and refusal should be collected and discarded safely to prevent spred of
infections.
 There must be facility of good drainage system. The toilets and flush should be in good
working conditions.
 There must be control of arthropods, vermin and animal pests by;
 Avoiding any type of stagnation of water near to the hospitals.
 All the water coolers and tanks should be cleaned regularly and daily refilled
to prevent stagnation of water.
 By regular spraying of medicines and fumigation to prevent breeding of
vermins and pests.
 The cracks in the walls and floors should be repaired quickly to prevent
breeding of vermins and pests.

E ] Evacuation plans for internal emergencies : various internal emergencies including,

fire, explosion and bomb threat may require evacuation of all or parts of hospital. Well
documented and rehearsed evacuation plans are required to ensure the safe evacuation of
disabled’ immobilized or otherwise helpless patients.
 F ] Food safety : hospital kitchen prepares meals for inpatients and in many cases
prepare meals for the staff canteen. It is obviously imperative that food storage, handling and
preparation is done to the highest standards and poses non risk to already sick or
compromised patients.

ROLE OF A NURSE IN PROVIDING SAFE AND CLEAN ENVIRONMENT

Nurse is the personnel who is responsible for the health of the patient in the hospital.
She will provide the curative services to the patient but side by side she must provide the
preventive services to the patient which help to avoid further complications.

The environment plays wide role in the promotion of health of the patient. It is the duty
of a nurse that she will provide the environment which is health promotive in future.

a] unit cleaning : it is the important factor. Nurse will do carbolization with the antiseptic
solution { savlon / Lysol }. All the things which come in contact with the patient must be
carbolized properly like locker, cardiac table, bed, IV stand, etc

b] physical set up of the unit must be proper. There must be sufficient space ie 6 feet
between the beds to avoid cross infection. There must be one chair or table with bed and
locker. Extra things must be removed from the unit.

C] noise free environment : to reduce noise in the ward , restrict the entry of more relatives
in the ward because in the hospital the chances of the cross infection are more and the noise
will disturb the sleep of the client. So relatives must be allowed according to the policies of
the hospitals.

D] prevent the spread of infection : a health care facility may adopt its own infection
control policies and practices.

 Aseptic techniques : use of aseptic techniques, if there is an infected patient in

the ward, then it is the responsibility of the nurse to keep them in the isolated
unit and treat them using aseptic techniques.
 After discharge of the patient, the room must be cleaned with antiseptic solution
{ carbolization of the unit }.
 Two methods are used to reduce or eliminate the presence of micro organisms
and thus prevent infections. These two methods are called surgical asepsis and
medical asepsis.
 Surgical asepsis : refer to the practice that eliminates the presence of all micro
organisms { bacteria, viruses , fungi, yeasts, moulds, rickettesia and protozoa } .
This practice is sterilization.
 Medical asepsis : refers to practices that helps to reduce the number and inhibit
the growth of microorganisms, especially pathogens that cause infections or
contagious diseases. Medical asepsis, also called clean technique, includes use of
antimicrobial agents, handwashing, cleaning, supplies and equipments and
disinfection.
  Fumigation : it is the duty of the nurse that after some specific time period
fumigation of each unit must be done. It helps remove the infection from
environment.

E } Protect the patients at risk for injury :

Identify patients at risk for injury. Those at special risk include :

 Elderly or confused patients.

 Patients with impaired vision or hearing
 Patients with impaired mobility { wheelchairs, walkers and partial paralysis }.
 Patients with history of fall.
 Patients with a history of substance abuse.
 Patients receiving medications that interfers with reasoning or motor
functions.

To prevent falls:


Place the bed in the low position.

Keep the side rails up when the patients is not receiving bed side care.

Advice the patient to wear low heeled shoes that fit well when walking.

Ensure that nonskid strips or mats are affixed to the bottom of bathtubs
and shower floors.
 Ensure that bathtubs have sturdy handrails and shower stools are in place
when needed. Warn patients and relatives when floors are wet and
slippery.
2. PREVENTION OF HAZARDS
Add assignment content...