Progressive Patient
Care
Prof.Sofiya Princess Hema.S
PSG College of Nursing
Introduction
• The nursing care is delivered based on patient needs.
• The continued care of the patient is directed towards the prevention of
complications, rehabilitation and return to normal living
• A system of care in which patients are placed in units on the basis of
their needs.
Definition
Progressive patient care is defined as the organization of hospital
facilities, services and staff as per the medical and nursing needs,
nursing practice based on the needs of the patient.
The basic principle of PPC
The basic principle of PPC is based on the nursing needs of the patient
rather than by traditional hospital grouping according to economic
status , age, sex, or type of illness.
Major concept of PPC
• Better care through better organization
• Right patient, in the right bed with the right services at right time
Origin
The concept of PPC is quiet old and started in Military Hospitals and by
Florence Nightingale in 1800 AD
Objectives of PPC
1. Provide optimum level of care
2. Raise the level of patient care of those critically ill patients with
effective use of nursing personnel and facilities.
3. Control cost with provision of nursing care as per need of various
patients.
Characteristics of PPC
• Decreased risk of life threatening event
• A decreased need for invasive monitoring
• Increased stability
• An increased ability to participate in their care
Intensive care or critical care
Patients who require close monitoring and intensive care round the
clock, eg. Patients with acute MI, fatal dysrhythmias.
Intermediate care
Critically ill patients are shifted to intermediate care units when their
vital signs and general condition stabilizes, e.g cardiac care ward
Convalescent and self care
Patients are taught administration of drugs, life style modification,
exercises, ambulation, self administration of insulin, checking pulse and
dietary management
Ambulatory care/OPD care
Ambulatory patients visit hospital for follow up, diagnostic, curative
rehabilitative and preventive services . These areas are out patient
departments, clinics, diagnostic centers, day care centers etc.
Home care
Some hospital/centers have home care services. A hospital based home
care package provides staff, equipment and supplies for care of patient
at home, e.g. paralyzed patients, post operative, mentally
retarded/spastic patient and patient on long chemotherapy.
Long term care
• Chronically ill, disabled and helpless patients are cared for in these units.
• Nurses and other therapists help the patients and family members in
coping, ambulation, physical therapy and occupational therapy along
with ADL
Educational requirements of nurses
in PPC monitoring skill
• Dysrhythmia
• Basic and advanced life support
• Drug calculation and monitoring
• Pre, intra and post procedure care
• Hemodynamic monitoring
• Assessment of indication for ventilation
• ABG interpretation
• Care of ventilator patient
• Weaning of ventilation
• Recognize indication & complication of enteral and parenteral nutrition
Benefits of PPC
Patients
Hospital Benefits of PPC Nurses
Physician
Benefits for Patients
• The patient receives the specialized care.
• The patients who are not critically ill are not deprived of nursing and
medical attention.
Benefits for Physician
• The physician is given a greater assurance that his patient is
receiving a high quality nursing care.
• Emergency treatment if necessary is in the immediate vicinity
Benefits for Nurses
• The nurse makes an effective use of her special capabilities.
• The problem of providing services by the nurses to critically ill patient
is reduced when the patients are divided to various groups according
to the degree of illness.
• It helps the nurses to plan the nursing care for the patients better as
the needs are of almost same degree in each unit.
Benefits for Hospital
• The beds, physical facilities, supplies and funds available may be used
efficiently.
• Improves public image of the hospital in community.
• Home care program as a part of PPC helps the
hospital to coordinate its activities with the
community health and social services.
Steps in Introduction of PPC
• Familiarity with the PPC
• Development of Team work
• Evaluation of Needs
• Orient Staff
• Estimation of Costs
• Provide Flexibility
• Adequate Staffing
• Instruct Patients
• Inform or Communicate Public
Merits
• Efficient use is made of personnel
• Clients are in best place to receive the care they require.
• Use of nursing skills and expertise are maximized
• Clients are moved towards self care as independence is fostered.
• Efficient use and placement of equipment is possible.
• Personnel have greater probability to function towards their fullest
capacity.
Demerits
• There may be discomfort to clients who are moved often.
• Continuity of care is difficult.
• Long term nurse/client relationships are
difficult to arrange.
• Great emphasis is placed on comprehensive, written care plan.
• Difficulty in meeting administrative need of the organization, staffing
evaluation and accreditation
Conclusion
PPC is a system of nursing care in which patients are
placed in units on the basis of their needs for care as
determined by the degree of illness rather than on the
basis of a medical specialty. Organization of medical and
nursing care according to the degree of illness and care
