PROGRESSIVE PATIENT CARE Progressive patient care is defined as the organization

of hospital facilities, services and staff as per the medical and nursing needs of the
patient.-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. The concept of PPC is quite old and started in Military Hospitals and by Florence
Night angle in 1800 AD. Modern application of PPC in hospitals started in 1950 to
provide optimum level of care to the patient as per nursing needs.
3. OBJECTIVE OF PPCPPC is to provide optimum level of care to the patient as per
need in minimum cost. To raise the level of patient care of those critically ill patients with
effective use of nursing personnel and facilities by grouping the patients as per their
nursing care need.PPC is also seen as an important method of controlling cost with
provision of nursing care as per need of various patients.
4. ELEMENTS OF PPCINTENSIVE CARE INTERMEDIATE
CARECONVALESCENTORSELF CAREPPCAMBULATORY &OPD CARE HOME
CARELONG TERM CARE
5. INTENSIVE CAREIt is concentrated around the patient. Who are unable to
communicate their needs. Who requires extensive nursing care. Require constant
observation and supervision. Require ventilatory support. Round the clock equipped and
skilled service facilities. Facilities for mobilization of more resource on demand.
Restriction of visitors to the area. MI, Head injury, shock, burns, premature babies etc.
6. INTERMEDIATE CAREWho requires moderate amount of Nursing Care (High end
care)Patients are conscious and can express their needs. Constant observation not needed.
Segregation of such patient in one area help distribution of Nursing Care. The vitals are
under control and does not require constant monitoring. Cardiac Ward, renal, chest and
paediatric surgery.
7. CONVALESCENT OR SELF CARE1.Patients requiring convalescent care or
diagnosis. They are physically self sufficient. Require least nursing and observation.
Services are purely educational and supervisory such as diet, self medication, change in
life style, exercises, physiotherapy etc. Patients are allowed a home type environment.
Pre-surgery patients or patient prepare to discharge.
8. LONG TERM CAREThey require skills and services not available at home.
Convalescent patients from ICU. Post operative case with infection. Patients with poor
progress but require skilled palliative treatment such as cancer cases, occupational
therapy, physiotherapy. 5. Though nursing care is mandatory not repeated, only regular
periodic assessment is needed.
9. HOME CAREThe hospital services extends to home (Out reach services).Provision of
community care services though social workers. The intensity of disease is less without
requiring emergency attention like TB, leprosy, fracture cases, ANC cases, Delivery
Cases. AMBULATORY OR OPD CARE Post operatives follow up. Promotive,
preventive and rehabilitation services. Diagnosis and treatment and investigation.
 10. BENIFIT OF PPCDOCTORNURSE Effective use of skills Better time utilization
Scheduling of care Close contact with patient Nursing care as per needAssures good
careBetter Nursing Immediate Therapy Mechanical SupportHOSPITAL
PATIENTSpecialized attention as per needAssisted in getting adjusted to hospital
community and homeEffectiveness use of hospital bedBetter utilization of skilled man
power Improve image Participation in community care

PLANNING OF PPC
Depends on hospital lay out
Need of people served by hospital

Principles and objective of different level of care

Developing procedure and policies of implementation
Existing patient care facilities
Modification needed
Orientation and motivation of staff
Scheduling of doctors and staff

RESISTANCE TO PPC
Acceptance of some staff to PPC was not welcomed and slow.
Rapid change of area and treating staff cuts away the patient staff relation.
Patient not accepting self care service in the hospital.
Observation of Nursing Care inadequate in long term care area.
Patients resistance to being transferred between units.
No separate male and female wards in different care areas.
Level and Nature of duties of Nursing