KHARADAR GENERAL HOSPITAL SCHOOL OF NURSING

MANUAL
FUNDAMENTAL OF NURSING PROCEDURES
4-YEAR BSC NURSING
Index
 YEAR-1 SEMESTER-I
Fundamental of Nursing-I 4 CH

S.NO COURSE TITLE THEORY CLINICAL SKILLS/LAB TOTAL CREDIT

1 FUNDAMENTAL OF NURSING-I 2.00 - 2.00 4.00

Course Schedule

S. No Unites TOPIC HOURS

1 Unit- I History of Nursing & Development of Nursing

2 Unit- II Role of the Nurse in Health Care
3 Unit-III Goals of Nursing and Related Concepts
4 Unit-IV Communication
5 Unit- V Nursing Skills (Vital Signs)
6 Unit-VI Skin Management
7 Unit-VII Concept of Safety: Risk Management
8 Unit-VIII Concept of Teaching and Learning
9 Unit-IX Oxygenation: Respiratory Function and Cardiovascular System
10 Unit X Activity And Exercise Pattern:
11 Unit XI Process of Hospitalization
List of Skills Labs:

S. NO LIST OF SKILL LAB HOURS

1 CPR Certifications BLS

2 Preparing of different beds
3 Bathing a patient in bed
4 Measuring body temperature
5 Assessment of pulse
6 Assessment of Respiration
7 Monitoring of Blood pressure
8 Mouth care of unconscious patient
9 Measurement of Height & Weight
10 Admission of a patient in hospital
11 Discharge of patient in hospital
 Clinical Objectives of Fundamental of Nursing I
1. Identify the roles and functions of health care team members.
2. Describe the functions of the various departments in a hospital.
3. Describe the physical setup of a ward.
4. Utilize techniques of therapeutic communication skills with Patient and health team
members.
5. Collect patients’ data through interview.
6. Observe the coordination of patients’ care between the health Team members.
7. Identify different forms used for documentation in patients’ Care.
8. Utilize appropriate hospital forms for documentation.
9. Assess, document and identify variations in Vital Signs
10. Discuss the observations for different Vital Signs pattern.
11. Develop problem list based on patients’ assessments and rationalize each problem
identified.
12. Document assessment of patients’ problems/needs by using Maslow’s Hierarchy of
human needs at a beginning level.
13. Develop Nursing care plan based on priority patients’ problem by following all the six
components of nursing process.
14. Observe the process of admission of a patient in hospital.
15. Orient a patient to hospital environment.
16. Assist in transfer of patients from one unit to another unit and department.
17. Assist in preparing patients and family for discharge.
18. Document the discharge of patients from the hospital.
19. Observe various legal forms/documents used in the admission process
20. Observe patients’ reactions to hospitalization and give assistance as needed.
21. Demonstrate occupied and unoccupied bed making.
22. Assess the need of personal hygiene care for selected patients and provide care accordingly.
23. Document patients’ assessment and care provided.
24. Utilize skills to maintain healthy nails and feet
25. Demonstrate use of following safety measures for patients:
26. Side rails
27. Restraints
28. Hand washing
29. Demonstrate application of body mechanics when moving and lifting patient.
30. Demonstrate range of motion exercises on a patient.
31. Provide back care to bed ridden patients.
32. Assist in transferring patients from bed to bed, bed to chair and bed to stretcher.
33. Utilize different comfort devices in patients’ care.
34. Assist patients with different types of positions.
35. Demonstrate characteristics of a professional nurse.
36. Assist patients in maintaining proper body alignment in bed.

Reference:
1. Carpinito L. J. (1998). Nursing Care Plans & Documentation: Nursing Diagnosis
and Collaborative Problem (3rd ed) Philadelphia: Lippincott

2. Craven, R. F., & Hirnle, C. J. (2000). Fundamentals of Nursing: Human Health and
Function. (3rd ed). New York: Lippincott.
3. Delaune, S. C., & Ladner, P. K. (2002). Fundamentals of Nursing: Standards and
Practice. (2nd ed) Canada: Delmar.
4. Erb, G. K., B. (2000). Fundamentals of Nursing: Concepts, Process and Practice
(5th ed) Addison: Wesley.

5. Potter, P. A & Perry, A. G. (2003). Basic Nursing: Essentials for Practice (5th ed) St.
Louis Mosby.
 KHARADAR GENERAL HOSPITAL
SCHOOL OF NURSING
FUNDAMENTAL OF NURSING
1st Year
CLINICAL SKILLS
Basic Nursing Skills

SNO TOPICS PAGE NO

1 Receiving and admission.
2 Bathing in bed and general observation of the patient in the
bathroom.
3 Care of hair.
4 Treatment of pedicle.
5 Care of hands/feet.
6 Care of mouth and teeth.
7 Care of nose, eyes, ears.
8 Care of genitals.
9 Care of skin (back care).
10 Care of belongings and valuables of patient.(Make a list of
valuables, get signature on list and keep valuables in locked
cupboards).
11 Orientation of the patient and relatives to hospital care.
12 Health teaching to patients and relatives.
13 Taking and recording weight and height measurements.
14 Testing, recording and reporting of albumin or sugar in urine
specimen.
15 Discharge protocol
a Discussion of discharge plan with patient and family.
b Discharge teachings/care of patients at home.
 c Follow up visit if necessary/required.
d Completion of discharge documents and farewell to patient.

Comfort Measures
Bed making
-Unoccupied bed.
-Patient in bed following admission.
- Patient in bed following an operation.
-Patient in bed with orthopedic disability.
-Patient in bed with cardiac condition.
-Patient in bed following an amputation.

Protective Measures
-Side rails on beds.

-Safety measures in the use of oxygen/ electrical equipment.

-Turning, moving, changing positions of the patient.
-Active and passive exercises.
-Deep breathing and coughing exercises.

Vital Signs

TPR, BP, taking and recording/reporting.

Cold and Hot applications

-Filling and care of hot water bottles, ice bags and air cushions.

Administration of Drugs

1. Abbreviation and symbols, weights and measures.

2. Storage of drugs, care and recording.
3. Rules for administration of drugs.
 4. Various routes of drug administration:

- Oral
- Subcutaneous
- Intramuscular
- Inhalation
- Eye ,ear ,nose drops
- Rectal suppositories or medications.

Communication Skills
1. Verbal and non – verbal with patients and families.
2. Written communication on patient records, reports.

Problems related to Bowel Function

1. Enemas- plain water soap water glycerin medicated (retained)
2. How to give and remove bed pans.
3. Use of flatus tube.
4. Insertion of rectal suppository.

Collection, observation and reporting of specimens

1. Stool
2. Urine Sputum
3. Vomitus
4. Culture swabs

First Aids

1. Drowning resuscitation (mouth-to-mouth).

2. Snake, dog bites.
3. Choking.
4. Hemorrhage.
5. Poisoning.
6. Burns.
7. Electrical shock.
 8. Artificial respiration.
9. Seizures , fainting
10. Fractures, dislocations, sprains.
11. Bandaging
-Rules
-Types
-Applications

KHARADAR GENERAL HOSPITAL

SCHOOL OF NURSING
FUNDAMENTAL OF NURSING
4 YEAR (GENERIC) BSCN PROGRAMME
Semester I

S No List of skill lab Hours

1 CPR Certifications BLS
2 Preparing of different beds
3 Bathing a patient in bed
4 Measuring body temperature
5 Assessment of pulse
6 Assessment of Respiration
7 Monitoring of Blood pressure
8 Mouth care of unconscious patient
9 Measurement of Height & Weight
10 Admission of a patient in hospital
11 Discharge of patient in hospital
 KHARADAR GENERAL HOSPITAL
SCHOOL OF NURSING
FUNDAMENTAL OF NURSING
4 YEAR (GENERIC) BSCN PROGRAMME

Semester II

SNO List of skill lab Hours

1 Application of hot water bag
2 Application of Cold Compresses
3 Applying bandages including wound dressing
4 Performing nebulization/steam therapy
5 . Apply suction therapy.
6 Care of drainage bags (catheter)
7 Sitz bath
8 Elimination: Suppositories, Enema, Flatus Tube, Manual extraction
9 Specimen Collection
10 .Urine Testing through dipstick

Preparing of different beds

O Introduction:

Bed making is an art. It is a way of preparing the

appropriate bed based on the condition of the patient which
adopts scientific principles of nursing. Skillful bed making
promotes comfort for the patient. Nurses need to be able to
prepare hospital beds in different ways for specific
purposes. In most instances, bed are made after a client
receives certain care and when beds are unoccupied. At
times, nurses need to make an occupied bed or prepare a
bed for a client who is having surgery can anesthetic post-
operative, or surgical bed

Types of Bed:

Bed is of two types.

1. Simple Beds.
2. Special Beds.

Simple Beds:

1. Closed Bed.

2. Open Bed.

3. Occupied Bed.

Special Beds:
1. Operation Bed.

2. Cardiac Bed.

3. Blanket Bed.

4. Amputation Bed.

5. Fracture Bed.

1. Closed Bed:

It is an empty bed in which the top covers are so arranged that all linen
beneath the spread is fully protected from dust and dirt.

Purposes of Closed Bed:

1. To provide the patient with a comfortable and safe bed to take rest and
sleep.

2. To give the unit or ward a neat appearance.

3. To give medical and nursing treatment to the patient.

4. To prevent bed sores.

5. To promote cleanliness.

6. To provide active and passive movements to the patient.

7. To create an effective nurse-patient relationship.

Equipments:
1. Two large sheets.

2. Draw sheet.

3. Blankets.

4. Bed spread.

5. Pillow cases.

6. Rubber Mackintosh.

7. Linen Hamper.

8. Bedside Table.

9. Disposable Gloves.

Procedure:

1. wash hands and wear disposable gloves.

2. Assemble and arrange equipment on bed side table.

3. Fold and keep reversible linens such as blanket or bedspread on bedside

table.

4. Bundle all soiled linen in bottom sheet and directly place into the laundry bag.

5. Place the bottom sheet with its center fold in the center of bed and towards
the top to have sufficient sheet to tuck under the head of the mattress.

6. Unfold the bottom sheet, spread it over the mattress and tuck in severly with
mitered corner.

7. Spread the mackintosh at the center of the bed and tuck it along the side.

8. Place the draw sheets over the mackintosh and tuck it along the side.

9. Move the opposite side and tuck the sheets.

 10. Place the blanket over the top sheet about 6 inches below the top of the
sheet.

11. If the bed spread is used place it over the blanket.

12. Tuck the top sheet, blanket and bed spread under the foot of the bed on the
side close to you and miter the corners.

13. Fold the upper 6 inches of the top sheet down over the spread and make a
cuff.

14. Move to otherside and follow the same procedure for screening top sheets.

15. Put the pillow case and place the pillow at the head end.

16. Fanfold or pie fold top linens.

17. Rearrange furniture and place personal items within easy reach.

18. Adjust the bed to a comfortable height.

19. Dispose off soiled linen and wash hands

2. Open Bed:

The term open bed is used to designate the hospital bed when it is about to
be occupied by a client.

Purposes of Open Bed:

1. To prevent bed sores.

2. To economize time, material and effort.

3. To help the relatives to learn to take care of the sick at home.

4. To give to the unit or ward a neat appearance.

5. To provide comfort and security.

6. To provide rest and sleep.

7. To establish an effective nurse patient relationship.

Articles:

1. Bottom Sheet. 2. 36 inch Mackintosh. 3. 36 inch Draw sheet. 4. Top Sheet. 5.

Blanket. 6. Bed Spread. 7. Pillow case. 8. Duster - 2.

Procedure:

1. wash hands and collect required linen.

2. Arrange linen on chair in manner in which it is going to be used.

3. Explain procedure to the patient and relatives.

4. Screen patient, if necessary and loosen top bedding.

5. Lift patients head and remove extra pillow.

6. Loosen bottom bedding and remove top sheet by pulling it down from under
cover.

7. Brush off the mackintosh and roll it back loosely over patient.

8. Roll bottom sheet as far under patients back as possible.

9. Place the clean sheet on the mattress with length wise fold at centre of the
bed.

10. Adjust sheet and tuck in at the top making a square corner. Then tuck in at
the side.

11. Bring back mackintosh lying over the patient.

 12. Place clean drawsheet at the centre of the bed.

13. Pull and tighten bottom sheet and tuck in at top making a square corner.

14. Pull and tighten mackintosh and drawsheet and tuck in well.

15. Turn the top of the counter pan and top sheet back over the blanket.

16. Return to the other side, fold and tuck in top bedding as on the first side.

17. Change the pillow case and put it under patient’s head and shoulders.

18. Discard soiled linen in dirty box.

19. Make the patient comfortable.

20. Wash hands.

ccupied Bed:

This is to make a bed with the client in. This is made for a client who cannot get out of
the bed.

Purpose Of Occupied Bed:

1. To provide active and passive exercises to the client.

2. To Promote cleanliness.

3. To establish effective nurse client relationship.

4. To prevent bed sores.

5. To observe the clients. E.g. bed sore, oral hygiene, clients ability for self case etc.

6. To economize time, material and effort.

7. To provide the clients with safe and comfortable bed to take rest and sleep.
Articles:

1. Top Sheet. 2. Blanket. 3. Pillow Case. 4. Bottom Sheet. 5. 36 inch Mackintosh. 6.

36 inch Drawsheet. 7. counter pane. 8. Duster - 2.

Procedure:

1. Assemble the equipment and arrange the linen within the easy reach.

2. Loosen the bedding on all sides and remove the spread and the blanket leaving the
top sheet over the client.

3. Fanfold the drawsheet to the clients and push it as close to the client as possible.

4. Dust the mattress with a dry duster. Then by raising the mattress, clean the cot
with a damp duster.

5. Place the clean bottom sheet over the mattress making sure that the middle fold is
in the middle of the bed.

6. Bringing the mackintosh back into the place and tuck it tightly under the mattress.

7. Turn the client back over the folded linen and then towards you. Go to the opposite
side of the bed.

8. Remove the soiled linen and put them in the laundry bag.

9. Turn the client back to the middle of the bed. Place a clean top sheet over the
client and remove the soiled top sheet.

10. Replace the blanket and spread over the top sheet and make the bed as in an
open bed.

11. Tuck the foot end giving enough freedom for movement.

12. Place a foot board or cradle at the foot of the bed.

13. Put the clean pillow cases and place the pillows in position and leave the client
comfortable.
Operation Bed:

It is one which is prepared for a client who is recovering from the effects of
anesthesia following a surgical operation.

Purposes Of Operation Bed:

1. To receive the patient in a warm, and comfortable bed.

2. To give him necessary position, which is suitable for the operation.

3. To protect the patient from being chilled.

4. To be prepared to meet any emergency.

5. To protect the mattress and bedding from bleeding, vomiting, drainage or

discharges.

Articles:

1. Gauze, pieces, narrow Mackintosh and narrow sheet. 2. Artery forceps. 3. mouth
gag, air way. 4. TPR Tray B.P. apparatus. 5. Bed Blocks - 2. 6. hot water bags with
cover. 7. I.V stand. 8. Kidney tray and paper tray. 9. Suction apparatus and oxygen
cylinder.

Procedure:

1. Prepare the foundation of the bed as simple bed.

2. Put narrow mackintosh and narrow sheet at the head end to protect the bed from
soiling the linen by vomitus.

3. The foot end of the top linen are left untucked.

4. The upper bedding is fan folded to one side, opposite the stretcher.

5. Post anesthetic tray, bed blocks, I.V. stand etc are kept ready at hand.

6. The pillow is used to protect the patient from injury by hitting against the bars at the
head end of the bed.
7. Hot water bags are used to keep the bed warm and they are removed before
receiving the patient in the bed.

Cardiac Bed:

Cardiac bed prepared for heart cases.

Purpose:

1. To relieve dyspnoea caused by cardiac diseases.

2. To provide comfort with least stain.

3. To Prevent complications.

Articles:

1. Bed sheet. 2. 36 inch mackintosh. 3. 36 inch drawsheet. 4. top sheet. 5. blanket. 6.

bed spread. 7. pillow case. 8. duster - 2. 9. cardiac table. 10. extra pillows. 11. back
rest. 12. foot rest, air cushion.

Procedure:

1. prepare the bed as open bed, with foot rest at foot of the bed.

2. Place back rest at patients back, and arrange pillows in comfortable positon.

3. Keep the patient in bed and cover properly.

4. Adjust the air cushion in place. Place the knee pillow under the knees to prevent
slipping of the patient.

5. Place cardiac table in front of the patient with the pillow on it. So that the patient
may lean forward to rest his head and arms on it.

6. Make the patient comfortable.

Blanket Bed:

Blanket bed is prepared for a patient with renal diseases or rheumatism.

Purposes:

1. To promote elimination through the skin.

2. To Provide absorption of patients perspiration.

3. To carry the weight of the bed clothes off the painful joints.

4. To provide extra warmth to the body.

Articles:

1. Bed sheet. 2. drawsheet 3. top sheet. 4. blanket 5. bed spread. 6. pillow case. 7.
duster. 8. extra pillow. 9. two old wooden blankets. 10. narrow mackintosh and sheet.

Procedure:

1. The bed is prepared as usual.

2. Cover the bed with blanket instead the bottom sheet.

3. Place narrow mackintosh and narrow sheet in the usual manner.

4. Place second bath blanket over the patient.

5. Cradle is used to take off the weight of the top linen off the painful joints.

6. Sand bags are used to immobilise the painful joints.

Amputation Bed:

Amputation bed is prepared for a patient with amputation of the leg to take off the
weight of the bed clothes off site of the operation.

Purposes:

1. To Keep the stump in good position.

2. To be able to watch the stump for haemorrhage and apply tourniquet instantly if
necessary.

3. To allow the nurse to do repeated procedures such as bladder irrigation, without

exposing the patient.

4. To allow the nurse to make frequent observations. I.e. after amputation of the leg
without disturbing the patient.

Articles;

1. Set of top extra bedding. 2. blankets and counter pane. 3. bed cradle. 4. tourniquet.
5. pillow and plastic cover. 6. sand bags and draw sheet.

Procedure:

1. prepare the bed as simple open bed.

2. Make bottom half of the bed. Fold sheet crosswise at the center of the bed at
bottom tuck in and make corners. Make upper half of the bed. The other set of the top
linen starts from the stump; but overlapping the first one and the excess is tucked
under the mattress at the foot.

3. When the patient is brought back from the operation theatre, fan fold the two sets
of linen one side of the bed and receive the patient on the bed.

4. Bed cradle is used to take off the weight of the top linen.

5. Cover the patient and keep him warm and comfortable.

6. Amputation bed is usually used for amputation of the leg, operation bed is used for
an amputation of the hand.

7. The two sections of the top linen should overlap each other atleast by 8 to 10
inches. So that it can easily lifted to observe the stump and also to prevent
unnecessary exposure of the patient.

Fracture Bed:

Fracture Bed is prepared for patient with fracture of the trunk and extremities. A hard
firm board is used to give support.

Purposes:

1. To give firm, even support to the fracture limbs and back.

2. To maintain position.

3. To immobilize the fractured so that the pain is less.

4. To make the patient comfortable.

Articles:

1. Bed Sheet. 2. drawsheet. 3. topsheet. 4. blanket. 5. bed spread. 6. pillow case. 7.

duster. 8. fracture board. 9. sand bags with cover. 10. bed cradle. 11. extra pillows.

Procedure:

1. place the fracture board directly over the bed springs.

2. Place a thin firm mattress or pad over the fracture board.

3. The bed is prepared as simple open bed.

MORE NURSING PROCEDURE CLICK

HERE
Methods of Bed Making and Beds - A Simple Nursing
procedure.
Introduction:

Bed making is an art. It is a way of preparing the

appropriate bed based on the condition of the patient which
adopts scientific principles of nursing. Skillful bed making
promotes comfort for the patient. Nurses need to be able to
prepare hospital beds in different ways for specific
purposes. In most instances, bed are made after a client
receives certain care and when beds are unoccupied. At
times, nurses need to make an occupied bed or prepare a
bed for a client who is having surgery can anesthetic post
operative, or surgical bed.

Types of Bed:

Bed is of two types.

1. Simple Beds.
2. Special Beds.

Simple Beds:

1. Closed Bed.

2. Open Bed.
3. Occupied Bed.

Special Beds:

1. Operation Bed.

2. Cardiac Bed.

3. Blanket Bed.

4. Amputation Bed.

5. Fracture Bed.
AUTHOR: AMRITA MANDAL
 Comfort Devices Used for Patient in
Hospital.
Hold and Cold Application - Nursing
procedure.
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Perineal Care – A Simple Nursing

Procedure.
1. Closed Bed:

It is an empty bed in which the top covers are so arranged that all linen beneath the
spread is fully protected from dust and dirt.

Purposes of Closed Bed:

1. To provide the patient with a comfortable and safe bed to take rest and sleep.

2. To give the unit or ward a neat appearance.

3. To give medical and nursing treatment to the patient.

4. To prevent bed sores.

5. To promote cleanliness.

6. To provide active and passive movements to the patient.

7. To create an effective nurse-patient relationship.

Equipments:

1. Two large sheets.

2. Draw sheet.

3. Blankets.

4. Bed spread.

5. Pillow cases.

6. Rubber Mackintosh.

7. Linen Hamper.

8. Bedside Table.

9. Disposable Gloves.

Procedure:

1. wash hands and wear disposable gloves.

2. Assemble and arrange equipment on bed side table.

3. Fold and keep reversible linens such as blanket or bedspread on bedside table.

4. Bundle all soiled linen in bottom sheet and directly place into the laundry bag.

5. Place the bottom sheet with its center fold in the center of bed and towards the top
to have sufficient sheet to tuck under the head of the mattress.

6. Unfold the bottom sheet, spread it over the mattress and tuck in severly with
mitered corner.

7. Spread the mackintosh at the center of the bed and tuck it along the side.

8. Place the draw sheets over the mackintosh and tuck it along the side.

9. Move the opposite side and tuck the sheets.

10. Place the blanket over the top sheet about 6 inches below the top of the sheet.

11. If the bed spread is used place it over the blanket.

12. Tuck the top sheet, blanket and bed spread under the foot of the bed on the side
close to you and miter the corners.

13. Fold the upper 6 inches of the top sheet down over the spread and make a cuff.

14. Move to otherside and follow the same procedure for screening top sheets.

15. Put the pillow case and place the pillow at the head end.

16. Fanfold or pie fold top linens.

17. Rearrange furniture and place personal items within easy reach.

18. Adjust the bed to a comfortable height.

19. Dispose off soiled linen and wash hands.

2. Open Bed:

The term open bed is used to designate the hospital bed when it is about to be
occupied by a client.

Purposes of Open Bed:

1. To prevent bed sores.

2. To economize time, material and effort.

3. To help the relatives to learn to take care of the sick at home.

4. To give to the unit or ward a neat appearance.

5. To provide comfort and security.

6. To provide rest and sleep.

7. To establish an effective nurse patient relationship.

Articles:

1. Bottom Sheet. 2. 36 inch Mackintosh. 3. 36 inch Draw sheet. 4. Top Sheet. 5.

Blanket. 6. Bed Spread. 7. Pillow case. 8. Duster - 2.

Procedure:

1. wash hands and collect required linen.

2. Arrange linen on chair in manner in which it is going to be used.

3. Explain procedure to the patient and relatives.

4. Screen patient, if necessary and loosen top bedding.

5. Lift patients head and remove extra pillow.

6. Loosen bottom bedding and remove top sheet by pulling it down from under cover.

7. Brush off the mackintosh and roll it back loosely over patient.

8. Roll bottom sheet as far under patients back as possible.

9. Place the clean sheet on the mattress with length wise fold at centre of the bed.

10. Adjust sheet and tuck in at the top making a square corner. Then tuck in at the
side.

11. Bring back mackintosh lying over the patient.

12. Place clean drawsheet at the centre of the bed.

13. Pull and tighten bottom sheet and tuck in at top making a square corner.

14. Pull and tighten mackintosh and drawsheet and tuck in well.

15. Turn the top of the counter pan and top sheet back over the blanket.

16. Return to the other side, fold and tuck in top bedding as on the first side.
17. Change the pillow case and put it under patient’s head and shoulders.

18. Discard soiled linen in dirty box.

19. Make the patient comfortable.