Standard precautions Standard precautions are used whenever blood and body fluids may be encountered and when patient hygiene is provided.

Confidentiality Information about the patient, including details of his/her illness and treatments are shared only with those parties specifically designated by the patient.

Communication with patients, families and other supportive persons The patient and his/her significant others are encouraged to express their concerns; questions they have are answered honestly or referred to the appropriate member of the health team for answers; support, comfort and encouragement are offered to assist the patient and family to cope with the stresses of illness and therapy.

Empathy The patient’s emotional status is assessed regularly. Emotional and psychological support for the patient and significant others is offered on an ongoing basis, with referral for specialized therapy if needed.

Monitoring Vital signs, fluid and electrolyte balance (including all fluid intake, urine and all other fluid output), weight, ventilation, cardiovascular, gastrointestinal (including food intake, bowel sounds, and bowel activity), neuromuscular, neurological, and pain status are monitored. Changes in status are recorded and reported.

Rest and activity Environmental stimuli (especially noise and light) are minimized to assist the patient to rest, and relaxation and verbalization of concerns are encouraged. The patient is assisted to turn and reposition in good body alignment while in bed, and is aided to sit in a chair and to ambulate using prescribed assistive devices at prescribed frequencies and lengths of time. Hygienic care is encouraged and provided for patients unable to care for themselves.

Preparation for diagnostic tests and treatments The patient is prepared for diagnostic testing by explaining all procedures and sensations that are expected to occur, including their duration and intensity, as well as common side effects. The patient is advised to report any sensations outside the norm for the particular test and anything that concerns him/her. (See individual tests and treatments for specific information.)

Medication administration All prescribed medications are reviewed with the patient (and a family member as necessary), including prescribed dosage and dosing schedules, desired actions, potential for drug interactions, and common adverse and allergic reactions. This review may involve collaboration and clarification from other health care professionals, including nurse specialists, pharmacists, and the medication prescriber.

Pain management Pain status re location, quality, severity, and duration is monitored frequently, prescribed analgesics are administered and the patient assessed for effectiveness (in both situations using a #1-10 severity scale). Noninvasive pain relief strategies such as application of ice or heat, relaxation techniques, imagery, repositioning, massage, or music therapy may be effective adjuncts for individual conditions/patients.

Postoperative concerns The surgical site is assessed and cared for based on the agency’s or specific surgeon’s protocol for the particular surgical procedure. Surgical drains and associated hardware also require assessment, management, and recordkeeping. The patient is monitored for nausea and vomiting, fluid balance, and body temperature.

Patient education The education of patients (and their significant others as necessary) emphasizes self-care procedures, signs and symptoms to report immediately to the primary caregiver, activities and restrictions, nutrition, and the potential emotional impact of illness, treatment, and recovery. Effective coping strategies related to the patient’s condition are explained. Desired outcomes include an understanding of and compliance with the prescribed treatment regimen.

Support groups The patient and family are encouraged to talk with others in similar circumstances, e.g., by contacting and enrolling in available and appropriate support groups and services.

Referrals Referrals for rehabilitative services or home health care specific to the particular illness problem may be prescribed or may be needed to help the chronically ill patient manage activities of daily living. Hospice referrals may be initiated for end of life care.