Ch 20 Persons Unit Persons Unit Personal space

Ch. 20 Person’s Unit

Person’s Unit Personal space Furniture Equipment Private area Semi-private room – 2 people

Comfort What affects comfort? Age Illness Activity Temperature Ventilation Noise Odors Lighting

Long-Term Care OBRA (Omnibus Budget Reconciliation Act of 1987) and CMS (Centers for Medicare & Medicaid Services) Guidelines for resident rooms Designed for full privacy Room temperature between 71 – 81 degrees Fahrenheit Clean & orderly Closet space Toilet facilities in room or nearby Bathing area have functioning call system “Comfortable” sound level Comfortable lighting

Temperature & Ventilation Most healthy people are comfortable in temperatures 68 – 74 degrees Fahrenheit Higher temps for older people & those who are ill Ventilation systems provide fresh air & move air Drafts – infants, elderly, & ill patients are sensitive Protect from draft: Enough clothing Robes Blankets Move from draft area

Why are older patients more sensitive to cold? Poor layer circulation and loss of skin’s fatty tissue

Odors Food aromas Flower scents Bowel movements Urine Draining wounds Vomitus Body, breath, & smoking odors

Odors How to reduce odors: ? Empty, clean, disinfect bedpans, urinals, commodes, kidney basin Clean patients Remove soiled linens Laundry containers closed Dispose of incontinence & ostomy products promptly Good hygiene Deodorizers depending on facility policy

Noise “Comfortable” sound level: promotes privacy Does not interfere with person’s hearing Sounds that may disturb patients and residents: ringing phones, clatter of dishes, loud voices, TV, radios, intercom systems, signal lights, squeaky wheels on equipment Common – loud talking and laughter in hallways & nurse’s station could be frightening or make patient feel insecure

Lighting Comfortable lighting Lessens glare Patient able to control intensity, location, & direction of light Visually impaired patients maintain or increase independent functioning Good lighting needed for safety and comfort Falls, headaches, and eyestrain result from dull lighting Dementia Soft, pt. – lighting adjusted to control agitation and aggression non-glare lights are relaxing

Bariatric Beds Wide frame, some can be adjusted to height to prevent sliding Weight capacity 500 to 1000 lbs Chair position – bed converts to chair Power transport – patient transported in bed and not transferred to a stretcher Pressure relief surface – prevent pressure ulcers Trapeze Built in scale

Overbed Table Used for meals, writing, reading Some have storage area for beauty, hair care, shaving, or personal items Used as work area by nursing team Never place bedpan, urinal, or soiled linens on overbed table.

Bedside Stand Top drawer Money, eyeglasses, books, other items Middle drawer Wash basin: soap, powder, lotion, deodorant, wash cloth, towel, bath blanket, sleepwear Kidney Bottom basin: oral hygiene items (can be in top or middle drawer) drawer Bedpan, Top urinal, toilet paper of stand Tissues, personal items, clock, photos, flowers, cards

Privacy Curtains Always pull completely around before giving care Full visual privacy – completely free from public view while in bed

Personal Care Items Agency provided Bedpan/urinal Wash basin Kidney basin Water pitcher/cup Soap/soap dish Some provide… powder, lotion, toothbrush, toothpaste, mouthwash, tissues, comb

Call System Allows patient to signal for help Intercom system allows staff to talk with patient from nurse’s station May be difficult for hard of hearing patients Confidentiality Teach patient how to use call system on admission Should ALWAYS be in patient’s reach Place on patient’s strong side Answer signal light promptly

Call System Do you answer signal lights for co-workers? What other devices can be used as a call system in a home?

Bathroom All rooms have toilet facilities Toilet, sink, call system, and mirror – standard equipment Grab bars by toilet for safety Standing Raised toilet seats Helpful Makes Signal or sitting for patients with joint problems transfers to wheelchair easier light usually next to toilet Button Sound or pull cord at nurse’s station different from room signal

Closet and Drawer Space Closet must have shelves and clothes rack Patient has free access to closet at all times Must have patient’s permission to go in closet or drawers Hoarding of drugs, napkins, straws, food, sugar, salt, pepper, etc. May cause safety or health risk May inspect closet or drawers is hoarding suspected Patient informed of inspection Patient should be present along with a co-worker during inspection