Patient Care and Assistance with Daily Living
What this domain tests
Patient Care and Assistance with Daily Living tests bed making, positioning, mobility, feeding, hygiene, elimination, pressure-ulcer prevention and accurate documentation. The exam wants safe, dignified assistance rather than doing everything for the patient.
Core rules and concepts
- Promote independence: assist only what the patient cannot do, and explain each step.
- Maintain privacy: screen or close the door, expose only the area being cared for, and gain consent.
- Reposition a bed-bound patient at least every 2 hours; check skin for redness, especially over heels, sacrum, hips and shoulders.
- Use correct body mechanics: widen your stance, bend your knees, keep the load close and avoid twisting. Use a slide sheet or hoist rather than dragging.
- Bed making: gather clean linen, wash hands, keep soiled linen away from your uniform and never shake linen in the ward.
- Record intake and output, bowel and bladder habits, and any change in skin or behaviour.
- Measure vital signs correctly and report abnormal values promptly.
Worked example. A patient has been lying on his back for four hours and has a red area over the sacrum. Reasoning: the redness suggests early pressure damage. The assistant should report it, reposition the patient onto his side using a two-hourly turning schedule, keep the area clean and dry, avoid massaging the red area, and document the site, size and appearance. A pressure-relieving mattress may be needed.
Traps that cost marks
Do not drag a patient up the bed. Do not leave bed brakes off. Do not document care that was not given. Do not expose the patient unnecessarily. Do not ignore a red pressure area because it is only redness.