R. VAN DEE RN, MSN PROCARE HOSPICE 2015

Importance of Vital Signs

Certified Nursing Assistant Guide to Vital Signs

2 hours Continuing Nurse Education Credits upon completion

R. VAN DEE RN, MSN PROCARE HOSPICE 2015

Why take vital signs for hospice patients

• Hospice is palliative medicine helps patients manage pain and symptoms

• Improve quality of life . • Patients receive appropriate care in the last

phase of life.• Changes in vital signs can indicate infection in

early stages, preventing hospital admits

R. VAN DEE RN, MSN PROCARE HOSPICE 2015

Cleaning equipment

• Cleaning your equipment prevents transmission of infection.

• If equipment does not touch mucus membranes use an EPA-registered low- or intermediate-level disinfectant before an after use with each patient.

• Recommended use of PDI super sani-cloth germicidal disposable wipes for disinfecting equipment

R. VAN DEE RN, MSN PROCARE HOSPICE 2015

Temperature (report temperatures under 96 or over 99

degrees• Taking temperature in the ear (tympanic): Read instructions

depending on the type/brand of thermometer. Method involves placing instrument gently into ear canal.

• Temporal: Follow manufacture instructions. Always clean equipment before use. Method involves sliding thermometer across patients forehead.

• Oral: Method involves placing thermometer in patient’s mouth. Avoid using glass that can break. If patient is a mouth breathing, reading will not be accurate.

• Axillary: Method is used using oral thermometer placed under patient’s armpit. This is an inaccurate method measuring lower than actual temperature.

• Rectal: We do not do rectal temperatures at our company

R. VAN DEE RN, MSN PROCARE HOSPICE 2015

Pulse Rate and Respirations

• Using finger tips not your thumb place underneath patient’s wrist until you feel their pulse. Begin counting for 60 seconds

• Report pulse rate under 50 or over 100• Respirations can be done immediately after or

before taking the pulse. Observe patient’s chest moving as they breath, count for 60 seconds. Respirations under 16 or over 30 need to be reported

R. VAN DEE RN, MSN PROCARE HOSPICE 2015

Blood Pressure

• Digital: is easy but can be inaccurate as irregular heart beat or patient movement can change accuracy.

• Manual: Using correct size for patient, Measure patients arm 7-9 inches use small cuff, 9-13 inches use regular cuff, 13-17 inches use large cuff.

• Line up artery marker on cuff points to brachial artery, wrap cuff around arm

• Palpate antecubital for pulse , place stethoscope over pulse• Inflate cuff to 200 then slowly release pressure listening for

systolic pressure the first sound you hear, then continue listening until you cannot hear heart beat, the last sound you hear is the diastolic

R. VAN DEE RN, MSN PROCARE HOSPICE 2015

Reporting Blood Pressure

• Report blood pressure that is significantly higher or lower than patient’s baseline

• Systolic pressure over 200 patient is dizzy complaining of headache

• Systolic pressure under 90 • Diastolic pressure over 90

R. VAN DEE RN, MSN PROCARE HOSPICE 2015

Reference

• Guidelines for disinfection and sterilization in healthcare (2008) Centers for Disease Control http://www.cdc.gov/hicpac/disinfection_sterilization/3_4surfacedisinfection.html

R. VAN DEE RN, MSN PROCARE HOSPICE 2015

Post Test

• After you have reviewed the handout you will need to actually take vital signs you have two choices:

• 1. Take patient’s vital signs with nurse present to observe and sign you off

• 2. Take another staff member’s vital signs to be checked off

R. VAN DEE RN, MSN PROCARE HOSPICE 2015

Observed SkillNurse to observe skill set, circle pass or requires further

training (put in Rose’s mailbox when complete)

• Temperature pass needs further training• Pulse pass needs further training• Respirations pass needs further training• Blood pressure

Manual pass needs further trainingdigital pass needs further training

• CNA (print) ___________________ Date_______Nurse (print)_______________ Signature________