Health Assessment, part 42: Ending the Assessment

Hi, I'm Meris. And in this video, I'm going to be talking to you about how to conclude an assessment and how to provide for your patient safety as you leave the room. I'm going to be following along using our health assessment flashcards. These are available on our website, leveluprn.com, if you want to grab a set for yourself. Or if you are more of a fan of digital products, I would invite you to check out Flashables, which is the digital version of all of our flashcards. It's awesome. All right. Let's go ahead and get started.

All right. So you have concluded your very in-depth head-to-toe assessment like the good nurse that you are, and you are ready to leave this patient, go document your findings, and move on to the next. So what is the best way to do that? Well, first and foremost, I just want you to remember that while you've been performing this assessment, it's very possible that this patient is already in pain and that performing the assessment might have elicited some more pain or worsened the pain that they were having. So it's very important for you to reassess their pain level and if it's appropriate to administer pain medication, if that is something that they need. Let the patient know that you're done with the exam and ask them if they have any questions. I always end to by saying like, "All right. I'm all done here. I'm going to go document. I'm going to get that all written down in your chart. Do you have any questions for me?" And then I also say, "And is there anything I can get you right now before I leave?" Because what's going to happen is, I'm going to go sit down at the desk and start charting, and then their call light is going to go off, right? So I want to address any needs that they have right here in this moment while I can address them for you. And sometimes I will give them suggestions. "Do you need a warm blanket? You got enough water? Anything else I can get for you?" That is very helpful to them to know that I'm providing for their needs and I'm being considerate of their needs. And it's very helpful to me so that I can move on with my day without getting interrupted.

The other thing is, you're about to leave this patient, and that means that you need to provide for their safety. You always need to provide for their safety, but when you are leaving the patient's room is a good time to do some safety checks. So you probably had that bed up to working height if you listened to my advice in the first couple of videos. You brought that bed up to working height. That's not safe for your patient. What if they need to get up to go to the bathroom? Or what if they were to, God forbid, fall out of bed? We need to make sure to lower the bed to the lowest possible setting. Make sure that the wheels are locked. So the bed needs to be locked and low. I also need to make sure that my patient has their call light within reach. How are they going to let me know that they need something? And also, if that call light is not within reach, they're going to try to reach it. Trying to reach it is a great way for them to get hurt, to fall, or for something bad to happen. So I want to make sure-- and I always loop that call light around and tie it with enough slack so that they can actually still use it. But I want to make sure that it's not going to fall down in between the side railing and the mattress, for instance. Whatever I can do to keep my patients safe. And you might think, "Meris, that's so infantilizing to tie it on the side rail." It's not about infantilizing them. It's about this isn't their environment, and I need to make sure that they have access to the device that they can use to contact me if they need help without possibly hurting themselves worse.

Then I also, lastly, need to make sure that the correct number of side rails are up. Remember, this could be per policy. My facility policy tells me a certain number of side rails should be up, or this could be based on order. Does the patient have an order for all four side rails to be up? Then it needs to be that all four side rails are up when you leave them. Just make sure that you are following your facility policy or that patient's specific order. This is going to be the best thing I can do for them: bed locked and low with a call light in reach, and the appropriate number of side rails up. This is the best thing I can do for this patient to ensure their safety. I also take it a step further. I like to ensure their comfort. I want to make sure that I tuck them back into bed or to the chair or wherever it is that we are leaving them safely and comfortably. I want them to not feel like I came in, got them all out of sorts, rustled their jimmies, and then just left, right? I don't want to do that. I want to tuck them in nicely. I want to leave them feeling settled and safe and calm. Of course, I'm going to thank them for their time. And then most importantly, aside from the safety stuff, is I'm going to perform hand hygiene upon exiting. Remember, hand hygiene is patient-specific. The context is patient-specific. Whether I use foaming hand sanitizer or soap and water depends on the situation. It is never wrong to use soap and water. That is always an appropriate choice. However, it may be incorrect to use foaming hand sanitizer if my patient is on contact plus precautions for something such as C. difficile or if I have visibly soiled hands. Did I touch them and roll them and move them and I got some bodily fluids on me? I must use soap and water. It is not appropriate to use foaming hand sanitizer only in that sort of a situation. So just keep that in mind. Soap and water is always appropriate. Hand sanitizer, maybe not.

All right. I have one quick question to test your knowledge of key facts provided in this video, but otherwise, man, we did it. We have fully assessed this patient. All right. Let me ask you this one question, and we'll get you on out of here. Describe how the nurse should leave the patient at the end of the assessment before leaving the room. Call bell in reach, bed locked and in the lowest position, and the appropriate number of side rails up either per policy or per order. All right. That is it for this video and for the health assessment playlist. I really hope you learned something. And if you did, it would mean the world to me and the whole team if you would leave us a comment. We see every single one, and I cannot tell you how much it means to me. And of course, if you have a great way to remember something that I didn't mention, I want to see it, and I know that it helps other learners as well. All right. Thanks so much for your time and happy studying.