Steps to Care

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सोधपुछ तथा परामर्स सेवा

Steps to Care मा स्वास्थ्य उपचारको वारेमा जानकारी तथा सल्लाह दिनको लागि हरेक दिन विहान ७ बजे देखि बेलुका ८ बजे सम्म हाम्रो टिम उपलब्ध हुनेछ । हामी संग नियमित अपडेट गरिएको जानकारी तथा सुचना केन्द्रवाट हजुरहरुलाई स्वास्थ्य उपचारसंग आवश्यक पर्ने सम्पुर्ण जानकारी पाउन सक्नुहुनेछ । आफुलाई परेको स्वास्थ्य समस्याको लागि कुन विशेषज्ञ सेवा र कहाँ उपचार गराउन उचित हुन्छ भन्ने वारेमा जानकारी तथा परामर्स । विभिन्न अस्पताल तथा क्लिनिकहरुको सेवाको विवरण, समय, शुल्क तथा खर्च, प्रकृया र डाक्टर तथा प्राविधिकहरुको वारेमा जानकारी । स्वास्थ्य उपचार सम्वन्धि जुनसुकै जानकारीको लागि सम्पर्क गर्न सकिन्छ । हामी सक्दो सहयोगका लागि तपाईको सेवामा छौ । जानकारी तथा परामर्स सेवाको कुनै शुल्क लाग्दैन । सम्पर्क गर्ने माध्यम र समय — https://stepstocare.com/ मा विरामीको र सम्पर्क गर्ने ब्यक्तिको विवरण भर्नुहोस् । विवरण प्राप्त भैसके पछि हामी तपाईलाई सम्पर्क गर्ने छौ । जुनसुकै समयमा हामीलाई info@stepstocare.com मा वा steps2care@gmail.com मा आफुलाई लागेको कुरा email मार्फत पठाउन सक्नुहुनेछ । तत्काल कुरा गर्नुपर्ने भएमा 015915760 वा 9851327027 मा सम्पर्क गर्नुहोस् ।

Outpatient Service at STC Clinic

विशेषज्ञ डाक्टरको ओ.पि.डी सेवा

विशेषज्ञ डाक्टरहरुको ओ.पि.डी सेवा विहान ७ बजे देखि बेलुका ८ बजे सम्म Steps to Care- STC Clinic Ekantakuna मा हरेक दिन संचालन हुन्छ । नाम दर्ता गर्नको लागि क्लिनिकको नम्वरमा सिधै सम्पर्क गर्नुहोला । विशेषताहरु विरामी केन्द्रित सेवा (आफ्नो स्वास्थ्य समस्याको वारेमा विशेषज्ञ चिकित्सक संग प्रयाप्त छलफल गर्नुहोस् । अत्यावश्यक मात्र टेस्टहरु गर्नुहोस् । कुनै संकोच नलिनुहोला तथा आवश्यक समय लिनुहोस् । ) विशेषज्ञ चिकित्सकहरु दक्ष हुनुका साथै खुला र सहयोगी हुनुहुन्छ । हरेक विरामीलाई प्रयाप्त समय दिईने । विरामीको सहज समयमा ओपिडि संचालन (सवेरै विहान देखि अवेर सांझ सम्म) विरामीलाई आदर पुर्वक सेवा प्रदान गर्ने छिटो तथा छरितो सेवा (कुर्नु नपर्ने) शाान्त, सफा, फराकिलो तथा आरामदायी हरेक विरामीको गोपनियता कायम गरिने प्रयाप्त पार्किङ्गको सुविधा (निशुल्क) विशेषज्ञ डाक्टरहरुको सुची Dr. Navin Devkota, Consultant Psychiatrist, Mental Hospital Lagankhel Dr. Sabina KC, Consultant Ob/Gyn, Prashuti Hospital, Thapathali Dr. Amit Poudel, Consultant Orthopedics, Medicity Hospital Dr. Bikash Sahani, Consultant Medicine, Bir Hospital Dr. Roshan Parajuli, General Physician, APF Hospital Dr. Vikash Poudel, Consultant Dermatologist, Patan Hospital Dr. Kaleb Budha, Consultant Pediatrician, Anandaban Hospital Dr. Uttam Gautam, Consultant Radiologist, Medicity Hospital नोटः ओ.पि.डी. सेवा लिनको लागि एक दिन अगावै नाम दर्ता गर्नुहोला ।

Lab, ECG, Ultrasound, and Pharmacy

Basic procedures at home

दैनिक ड्रेसिङ्ग, सुचर निकाल्ने, क्याथेटर राख्ने वा निकाल्ने, सुई लगाईदिने जस्ता सेवा

घरमै दैनिक ड्रेसिङ्ग सेवा घरमै दैनिक ड्रेसिङ्ग गर्नुपर्ने विरामीहरुको लागि स्टेराईल सेटको प्रयोग गरि अनुभवि नर्सहरुले हजुरहरुको घरमै आई दैनिक सेवा प्रदान गर्नुहुनेछ । स्टिचहरु निकाल्ने, घाउ सफा गर्ने, ब्यान्डेज गर्ने लगायतका कामहरु स्ट्यान्डर्ड विधीवाट गर्ने हुँदा निश्चिन्त भई सेवा लिन सक्नुहुने छ । सेवा लिनको लागि Online Booking गरि वा Steps to Care मा फोन सम्पर्क गर्न सक्नुहुनेछ । घरमै क्याथेटर राख्ने वा निकाल्ने सेवा Catheterization गर्नुपर्ने विरामीहरुको लागि स्टेराईल सेटको प्रयोग गरि अनुभवि नर्सहरुले हजुरहरुको घरमै आई दैनिक सेवा प्रदान गर्नुहुनेछ । सेवा लिनको लागि Online Booking गरि वा Steps to Care मा फोन सम्पर्क गर्न सक्नुहुनेछ । घरमै Injection दिने सेवा औषधी सुई वाट दिनु पर्ने विरामीलाई घरमै आई औषधी दिने तथा विभिन्न भ्याक्सिनहरु दिने सेवाका लागि हामीलाई सम्पर्क गर्नुहोला ।

Laboratory sample collection from Home

Nursing Care at Home

घरमै नर्सिङ्ग सेवा

गुणस्तरीय र professional नर्सिङ्ग सेवाका लागि दक्ष र तालिम प्राप्त सेवा कर्मी को साथै individual Care Plan जरुरी हुन्छ । सेवा आवश्यक भएमा Online booking वा Steps to Care मा सम्पर्क गर्नुहोला । विशेषताहरु दक्ष नर्सहरुवाट गुणस्तरीय सेवा ब्यक्तिगत आवश्यकता अनुसारको Care Plan मा आधारित सेवा सुपरभाईजरको निरन्तर निगरानी तथा फलोअप अन्तराट्रिय स्तरको तथ्यमा आधारित सेवा घरमै नर्सिङ्ग सेवा प्रदान गर्दा अपनाईने चरणहरु सेवाग्राहीको अनुरोध प्राप्त भैसकेपछि Supervisor ले Visit गर्ने, Assessment गर्ने र Care plan तयार गर्ने सेवाग्राहीको तर्फवाट सम्झौता पत्रमा सहमत भै हस्ताक्षर गर्ने, अग्रीम शुल्क तिर्ने उपयुक्त सेवा प्रदायकलाई खटाउने, Contract गर्ने, र Care Plan को वारेमा Orientation गर्ने Supervisor ले प्रत्येक ७ देखि १० दिनमा Follow-up गर्ने, care plan revision गर्ने र गुणस्तरको वारे reporting गर्ने Nursing Care at Home Day Care – 12 hrs shift मा Registered Nurse ले सेवा प्रदान गर्ने । Supervisor ले weekly care plan तयार गरिदिने र सोही अनुरुप सेवा प्रदान गर्ने । 24 hour care – Registered Nurse ले सेवा प्रदान गर्ने । Supervisor ले weekly care plan तयार गरिदिने । shift change सहितको duty posting plan तयार गरिदिने र सोही अनुरुप सेवा प्रदान गर्ने । हरेक विरामीको specific need अनुसार सेवालाई customize गरिनु पर्ने हुन्छ । हामी गुणस्तर र professional सेवालाई निरन्तर सुधार गर्नको लागि यहाँहरुको प्रतिकृयाको प्रतिक्षामा रहने छौ ।

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Training Opportunity

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Baby-Sitting Training

Description:

Baby-sitting is a big responsibility, challenging as well as worth doing (fun) job. Precious gift of god is in your hands from parents. You are the charge to care. Baby sitting training is there to help you understand the baby, your role, your responsibility, prepared for adverse situations, prepared for life saving skills when needed.

Steps to Care is launched training for Baby Sitting in Nepal for the first time. Although, basic knowledge and skill of baby-sitting are widely helpful for everyone who involve in baby care, we highly encourage to be parents to get this training for better prepared for baby care and teenagers to take responsibility, learn making money and being professional.

Learning objectives:

Describe key role and responsibilities of baby sitters
Outline the basic concept of leadership and prefessional care
Identify key area of safety issues for babies
Describe the stages and milestones of baby
Engage baby with play and help to behave
Demonstrate skills related to baby care -feeding, diapering dressing and bathing
Demonstrate skills for emergency first aid - Cardio pulmonery resuscitation, AED and choking
Perform the games, activities, songs, and project works

Participants

Anyone who are willing to involve in babysit. We encourage teenagers to have this training to grow themselves as responsible citizen by showing the professional, disciplined and responsible person in their leisure time between academic breaks. Similary, we hope this training is benificial for parents to be for better understanding the issues regarding babysittings. The criteria for participants must be literate, familiar with basic technologies.

Trainers:

Good command on facilitation skills
Proficient in the content to be taught
Interested and good faith on training

Training Duration: 3 days

Number of Participants per batch: 16

Training Method:

Group based training, Interactive discussion sessions along with exercise, project work, video demonstration, and skill practice with manikin.


Course Outline:

	Topic	Contents covered	Method of learning
1	Leadership	It is a Big responsibility. you are the master. How you deal with different situation that comes to you? You are the only to deal with. Style of leadership fit for baby-sitting- democratic, hands-off and sympathetic Role modeling Respect Communication Motivation Decision making and taking Action	-Sharing and discussion -Scenario discussion on leadership role -FIND decision making exercise
2	Professional Behavior	Follow the household rules Interact respectfully Respect time and promises Take the job seriously Treat families like customers Appropriately dressed up and take necessities with you Don’t use things like phone when you are in duty Stay attentive while you are in duty Limit or avoid personal talks, calls, meeting outsiders while you are in duty Do not smoke, alcohol or drug Always be thankful for the job or opportunity Maintain confidentiality of each family matters If you see any issue serious talk to the appropriate persons only	-Discussion -Situation exercise -list out the benefits of professional behaviors
3	Safety first	Most important responsibility Identify when and whom to call. Make each conversation short, straightforward and with complete message Do not call, text message or use social media while you are on duty Never give access to any strangers. Ask delivery personnel to come when parents are there. Clearly understand electricity and fire safety instructions Make a list of possible hazards in the house Lock the doors properly. Never leave the house without permission.	Discussion Safely inspection checklist exercise Hazard hunt exercise
4	Safety issues	Bites and stings Burns Kitchen fires Choking and breathing dangers Drowning Falls Fire Illness Poisoning Wounds Floods, earthquakes, and other emergency situations Violence and crime	Discussion Safety toy exercise
5	Stages and Milestones	Infant (newborn to 12 months old) Toddler (1 and 2 Years Old) Pre-schooler (3-4 years old) Younger school age child (5, 6 and 7 years old) Older school age child (8, 9 and 10 years old)	Physical, Social and Mental stages and milestones Milestone plotting exercise
6	Play	Appropriately choose play for each stage	Create play sheet exercise
7	Helping Children Behave	Encourage positive behavior Correcting the behavior (do nothing, say something and physically do something) Consequences (natural consequences, logical consequences, withholding privileges, time-out) Temper Tantrums (gentle motion, soothing sounds, visual delights and distractions) Crying Breath holding (involuntary action of temper tantrums) Colic Hitting, Biting and kicking Attention Deficit Hyperactivity Disorder (ADHD) Sibling Rivalry	Discuss Never shake is the baby hungry, tired, need diaper change, too hot or cold? FIND exercise for helping behavioral change in the given case
8	Feeding	Handwashing (baby sitter and children) Check before feeding (temperature, size of piece, feeding cup)	Practice with skill sheet Handwashing skill practice
9	Diapering	Handwashing after diapering Always clean from the front to back and folds of skin Pay attention to the signs for bathroom use (clutching, shivering or jumping)	Practice with skill sheet
10	Dressing	Give enough time, never rush Ensure appropriately fit, encourage and involve children Aware of ribbon or fastening clothing	Practice with skill sheet
11	Bathing toddlers	Not recommended to bath neonates by baby sitters hold continuously, arrange things beforehand Tilt the child head back while shampoo or ringed	Never hurry, be watchful and attentive Let the baby play and get ready for bath Never force
12	Rest and Sleep	Follow the routine Prepare the child for nap 15 min ahead Ensure bedtime safety issues Put infants sleep in their back Be kind and firm to follow rest and sleep Check sleeping baby half hourly Sudden Infant Death Syndrome (SIDS)	Discuss Practice Holding Infants cradle hold Practice infants shoulder hold Practice holding toddlers upright carry
13	Emergency	Check-Call-Care Call first for 12yrs old or probable cardiac case Care first for breathing emergencies Signals of breathing emergencies Asthma Choking Checking unconscious child ABCs Recovery position Taking care of fever, burns and wounds	Conscious chocking child skill sheet Conscious chocking infant skill sheet Checking Unconscious child or infant skill sheet Rescue breathing skill sheet Controlling external bleeding skill shest
14	First Aid, CPR and AED	Moving a child or infant (do not further harm) Avoid twisting of bending neck and back with possible injuries Pack strap carry, Two-person seat carry, cloth or blanket drag, foot drag Cardiac Chain of survival (Early Access- Early CPR- Early Defibrillation- Early advanced medical care) CPR cycle of 30 chest compressions and 2 breaths (1-12 yrs) Need of CPR in infants is not common except major accidents and SIDS AED with pediatric AED pads deliver lower level of shock needed for below 8 years Giving continuous chest compression is better than doing nothing. Unconscious choking child or infants need continuous CPR until definitive management Splinting	Practice using skill sheet Pack strap carry Two-person seat carry Blanket drag Foot drag Child CPR Infant CPR Automated Electric Defibrillators (AED) Applying Soft splint skill sheet Applying a sling skill sheet
	Sudden illness	Fainting Seizure Diabetic emergencies Poisoning Allergic reaction Heat cramps, heat exhaustion Hypothermia	Discussion and list-out the needed actions
	Ways to engage	Activities, Games, projects, Songs and rhymes	Exercise

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Nursing Care at Home (Home care)

Longer hospital stay for old age patients is generally risky due to chance of cross infection which is termed as nosocomial infection. This infection rates are higher even in highly maintained hospitals as well. Not all medical and surgical conditions are manageable at home but major bulk of care can be managed at home with comparatively lower cost than that of Hospitals. The recovery rates at home with their own environment and family members are shown higher by several studies. It reduces the stress of hospital stay.

List of cares that can be carried out with Nursing Care at Home

Parenteral medications – medicines through injection or IV lines in situ.
Vital Monitoring – regular vital monitoring which includes Blood pressure, Pluse, Respiration rate, Oxygen saturation, Blood glucose, Input and output. Especially urine output via catheter and urobag
Personal care – bowel, bladder care, bath, Oral care, feeding, dress change, position change, massage, walking, talk, companion etc
Perform procedures- dressing changes, catheter change, IV line establish, NG tube insertion, NG feeding, Oxygen delivery setups, Bipap
Physiotherapy exercise recommended
Report or discuss with treating physician, follow-up visits, evaluates progress, plan for further

Steps to Care provide Nursing Care at Home for Kathmandu Valley since Jan 2023. The total 136 Nursing care at home provided from Jan 2023 to Oct 2024 from Steps to Care. The average care provision period is 37 days.

Procedure to have Nursing Care at Home:

Contact to Steps to Care through Phone call, email, Whatsapp, Viber, Messenger etc.
Assessment visit by Supervisor – we visit to the residence where care is provided, detail assessment of client condition, specific care plan is developed
Introduction of duty nurse by supervisor with complete handover, provide coaching for certain skills, behaviors etc
Daily report of patient care in given template.
Weekly supervision- meet with the duty nurse, review the documents, patient, supplies. talk with nurse, family members, coach on gaps identified.

Challenges:

Nursing care at home is a costly intervention although it is cheaper than hospital stay. People fail to weigh the benefits of service. It gives family members freedom for work and earnings along with far better care.
Elders are not in priority for expenditure especially at non recovery conditions in contrast; more care is needed at that time.
Professional and skilled nurses availability; we are overcoming this issue by onsite training and coaching.

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सेवा लिनको लागी विवरण भर्नुहोस्

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Baby-Sitting Training

Nursing Care at Home (Home care)

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विशेषज्ञ डाक्टरको ओ.पि.डी सेवा

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दैनिक ड्रेसिङ्ग, सुचर निकाल्ने, क्याथेटर राख्ने वा निकाल्ने, सुई लगाईदिने जस्ता सेवा

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घरमै नर्सिङ्ग सेवा

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Baby-Sitting Training

Nursing Care at Home (Home care)