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ACOC Module 3: Using your senses to indentify an ACOC

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Rebecca Moonah

on 5 December 2012

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Transcript of ACOC Module 3: Using your senses to indentify an ACOC

Module 3:
Using your senses to
identify an ACOC Prepared by:
Diane MacEachern RN(EC) BScN NP-PHC MScN(c)
Central East Community Care Access Centre, NPSTAT Acute Change Of Condition (ACOC) in Long-Term Care: What front-line caregivers nurses and PSWs need to know Recall: What is an ACOC? Why worry about an ACOC? Examples of indicators of an ACOC... Observe for changes to: Level of alertness:
Acute change in mental status
Drowsy, confused
Seeing or hearing things that are not real Behaviour:
Agitation, aggressiveness,
Irritability,
Refusing care
Tired, withdrawn Function:
ADLs,
Speech, swallowing,
Mobility,
General weakness New or increased breathlessness, cough wheeze, unusual noises, pain Chest, jaw, left arm pain
Upper abdominal pain, radiating pain
Indigestion, belching Nausea, vomiting
Palpitations Irregular pulse
Dizziness when standing up Swallowing problems
New abdominal pain Increased thirst or hunger
Changes to odour of breath Bloating, distention
Black stool Constipation
Lack of bowel sounds Bleeding
Diarrhea Pain passing stool
Prolapse Pale, cold, dusky, blue
Clammy, sweaty
Pay attention to the lips… Swelling of feet, ankles
Fluid leaking from the lower legs
New rash, breaks in skin, redness, heat New or increased:
Bleeding, discharge, prolapse
Itching, rash New or increased:
Swelling
Pain in genital area Watch for:
Concentrated, foul-smelling urine
Pain or difficulty passing urine
Poor urine output Watch for:
No urine output
Changes to the odour or colour of the urine Watch for:
Concentrated, foul-smelling urine
Pain or difficulty passing urine
Poor urine output Watch for:
No urine output
Changes to the odour of the urine Remember:
use all of your senses and follow your gut! Alessi, C.A., & Harker, J.O. (1998). A prospective study of acute illness in the nursing home. Aging Clin. Exp. Res., 10 (6), 479-489.

American Medical Directors Association. (2003). Acute change of condition in long-term care setting. Clinical practice guideline. Columbia, MD: Author. Retrieved from: www.amda.com

Boockvar, K., Brodie, H.D., & Lachs, M. (2000). Nursing assistants detect behavior changes in nursing home residents that precede acute illness: Development and validation of an illness warning instrument. Journal of the American Geriatrics Society, 48, 1086-1091.

Boockvar, K., & Lachs, M. (2002). Development of definitions for acute illness. Journal of the American Medical Directors Association, 2, 279-284.
Hamilton Long-Term Care Best Practices Workgroup . (2007). Best Practices Approach to Acute Change of Condition in LTC Homes Resource Kit. Central South Ministry of Health and Long-Term Care .

Longo, D.R., Young, J., Mehr, D., Lindbloom, E., & Salerno, L. (2004). Barriers to timely care of acute infections in nursing homes: A preliminary qualitative study. Journal of the American Medical Directors Association, 5, S5-S10. References Hospital sign image
http://4.bp.blogspot.com/_upumhjQ4s1w/TCDJfy5K5HI/AAAAAAAAADI/FKVmh7mmVUQ/s1600/NoHospital.jpg
Brain
http://www.roots.group.cam.ac.uk/images/brain.jpg
Lungs
http://fds.oup.com/www.oup.co.uk/images/oxed/children/yoes/humans/lungs.jpg
Heart
http://wbom.files.wordpress.com/2012/02/red-heart.png
Stomach
http://blog.tsemtulku.com/wp-content/uploads/2012/04/stomach-flu.jpg
Bowels
http://4.bp.blogspot.com/-T9jkn-dM5ps/Tdj8EArF-gI/AAAAAAAAGiw/v_BpabTi7Ck/s760/_intestines.gifhttp://kidshealth.org/kid/stay_healthy/body/headers_77261/bowels.gifhttp://m.gmgrd.co.uk/res/288.$plit/C_71_article_1069626_image_list_image_list_item_0_image.jpg?29%2F09%2F2008%2014%3A59%3A28%3A135
Skin
http://ineradicablestain.com/skin-closeup-sm.jpg
Reproductive organs
http://www.clipart.dk.co.uk/DKImages/exp_humanbody/exp_human006.jpg
http://images.clipartof.com/small/4146-Religious-Adam-Covering-His-Sexual-Organ-Penis-With-A-Leaf-Clipart.jpg
Bladder/kidneys
http://www.cooledwater.com/common/images/kidneys.gif
http://www.findanaturopath.com.au/files/9613/1457/7073/kidney--bladder-pic.jpg Links to photos: New or thicker sputum, bloody sputum Change in breathing pattern – fast, shallow, deep, slow, unusual
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