NVQ evidence

Margaret was a 76 year-old lady who had been admitted with a urinary tract infection. She was very confused and disorientated. Their day this observation took place, was the second that I had looked after Margaret.
I noticed that Margaret was uncovering herself and was agitated. I went up to her, covered her up, and asked her what the problem was. She was not able to tell me what was wrong. I suspected that Margaret had been incontinent.
I summoned my assessor her and asked her if she would not mind helping me to check on a Margaret. She agreed. As Margaret was so confused and disorientated, it was important that we communicated with Margaret in a simple but not patronising manner. It was very important that we did not frighten Margaret. I told her that we needed to check her bed to see if she had had "an accident". She understood this. She also let us know that this was OK. I asked her if she did not mind me helping her rather than another female nurse. She stated that she did not mind the presence of a male carer.
I collected all the materials that were required:-

• A towel
• Clean sheets
• A ball of warm water
• Soap
• A bowel of warm water.
• Disposable watch costs
• A disposable small yellow bag
• Incontinence pads and Net-pants
  

She had been there for her to time that I had changed Margaret within five hours.
I commenced assisting Magaret to get changed.
I explained all steps to Margaret as we were about to do them and asked throughout whether anything I was doing all going to do was not acceptable to her.

I washed and dried my hands

I applied disposable latex gloves and plastic apron prior to the commencement of the task.

I checked to see if Margaret had been incontinent. She had been, doubly so.

It was prescribed in her care plan for her to lay on incontience sheets. These hard rucked up and the incontinence had seeped through to the bottom sheet. Margaret's nighty was also soiled.

I suggested to my Assessor that it may be more suitable for Margaret to use pad and pants rather than incontinence sheets. She aggreed.

As Margaret was confused, I explained each step as I did it and observed for any signs of distress, thoughout the procedure. I ensured that I gained a valid consent for anything that I did thoughout the procedure. This required making sure that Margaret understood all that I was going to do when I explained what I was going to do.

I first washed and dried Margaret's hands as she had contaminated them. I washed them using soap and water, rincing off the soap prior to drying them with the towel. Although Margaret had a flannel, I explained to her that it was better for me to use disposable wipes due to the infective nature of the products of incontinence. Once, I had used a wipe, I disguarded it in a yellow bag used for clinical waste.

With the help of my assessor, I removed the soiled nightie of maintaining Margaret's dignity the best I could. I then washed and dried Margaret, keeping her covered up the best I could to maintain her warmth and dignity. I put a new a path new nightie on her and changed the bottom sheet. While I did this, I inserted a a clean incontinence pad and put net pants on her also. I had gained her consent for this prior to doing it.

I recorded all that I had done Margaret's care plan.
Margaret was incontinent twice more during the shift, however, the pad and pants did not cause any strike through onto the sheet. I recorded all incidents of incontinence in Margaret's care plan. I noted that there was no strike through onto the sheet and reported this to my assessor. As a result of this, my assessor changed to the prescription in Margaret's care plan to the use of pad and pants rather than incontinence sheets.

Units covered

Z12

.1

.1 .2 .3 .7

Range

1a 1b

.2

.1 .2