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Using Activities of Daily Living To Obtain Information About The Patient


As part of the admission procedure where I do my nurse training we use a list of ADLs to get as much background information we can about the patient who is being admitted onto the ward.

Sometimes this just seems like a tick list to me, and brief answers have been given - but the idea of it is as I mentioned above, to get as much information about the patient as possible, so simple answers like "no problems" is really not enough.

I decided to put this page on the site as I hope it might help students when they are admitting patients onto their wards, as when I first started training I thought it was okay to put "no problems" under each heading as I had been shown by qualified nurses, and I suppose it depends on the staff you are working with, but some like to see lots of details and it does make sense to ask lots of questions as the results of these will help you to devise your care plan for the patient.


Maintaining A Safe Environment

Does the patient have a history of falls, fits, ear infections that may affect his or her balance. Does he or she have any known allergies e.t.c.

Communicating

Is the patient hard of hearing, does he or she wear a hearing aid. Is he or she articulate, confused, have speech problems e.t.c.

Breathing

Has the patient had any recent history of chest infections, lung diseases, asthma, shortness of breath e.t.c.

Eating and Drinking

Is the patient a diabetic and if so is he or she insulin or tablet controlled? Does the patient enjoy a good normal appetite, what sort of food does he or she dislike e.t.c. Do they drink enough each day, what types of drinks do they enjoy, if they enjoy alcohol, how much roughly per week do they consume.

Elimination

Has the patient had any history of urinary tract infections, if so is it a recurring problem, how is it being treated e.t.c. Does the patient suffer incontinence, urgency e.t.c. Does the patient have any special equipment at home to help with elimination such as bottles, adapted toilet e.t.c.

Does the patient open his or her bowells regularly, and when. Do they suffer from constipation, irritable bowell syndrome e.t.c.

Does the patient have a stoma, if so where is it sited, how long has it been in situ, does the patient experience any problems with it.

Personal Cleansing And Dressing

Does the patient have difficulty bathing, do they use any special equipment in order to facilitate bathing i.e. bath chairs, bath hoists e.t.c. Do they prefer a bath or a shower, do they have trouble getting in and out.

Are they able to dress themselves, do they have problems with buttons, laces e.t.c. Do they use any aids to assist them when dressing.

Skin Condition

A lot of nurses will just judge a patient by his immediate appearance and write down that he may have healthy, dry or papery skin. Itís a good idea to ask the patient if he has any scratches, bruises, sores or wounds anywhere on his body and to make a note of them if applicable. Also you could ask the patient if he suffers from eczema, psoriasis e.t.c. and if anything aggravates these conditions.

Mobility

Is the patient independently mobile. Does he use a stick, walking frame, crutches, wheelchair, motorised chair e.t.c. to mobilise in. Does the patient suffer any illness which may affect his mobility such as chronic obstructive pulmonary disease e.t.c.

Work and Play

What is the patients job, is he able to carry it out without any problems. What hobbies or interests does the patient have.

Sleep

Does the patient take any tablets, alcoholic or milky drinks, to help him sleep. Is the patients sleep pattern regular, does he or she get up to go to the toilet during the night, if so how often, how many hours does the patient usually sleep for.

Anxieties

Does the patient have any worries or anxieties about being in hospital, these can be anything at all ranging from the patient might be worried about leaving pets or family members alone whilst he or she is in hospital or they might be frightened about the hospital environment and what is going to happen to them. It is a good idea at this point to show the patient around the ward, if possible, and to explain to the patient why he or she is in hospital and what treatment he or she may expect. Show the patient how to use the nurse call system, explain to him or her the procedure for ordering meals e.t.c. Always reassure the patient and try to make them feel more comfortable both physically and emotionally.

Note:

This list is used where I currently train in order to get as much information about the patient as possible, in addition to the patients notes e.t.c. This is based on the 12 Activities of Daily Living by Roper, Logan and Tierney. You will notice that Sexualty and Dying have been left out and that patients at our hospital are not asked for any information under these headings. There is some research regarding these topics and how many medical professionals find them taboo subjects to discuss with their patients. I personally would discuss sexualty with a young person who perhaps suffered with asthma or emphysema, as these illness are going to affect their sexual lives and will affect their relationship with their partner. It might be worth looking at your own hospital policies, and to find out if patients are asked about these subjects, if not, try to find out why not. This is a subject that you might be able


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