Factors Affecting the Environment Flashcards
(34 cards)
Florence Nightingale wrote about
environmental factors that needed to be
controlled more than a century ago
Temperature
Ventilation and humidity
Lighting
Odor control
Noise
Interior design
Neatness
Privacy
Environmental Factors
Temperature
Infants and older adults require warmer rooms
Room temperature should be between 68°and 74°F
Operating rooms and critical care areas slightly
cooler
⬤ Ventilation—supplying a room with fresh air
continually
Fans are discouraged because of infection control
concerns
Do not open windows in the hospital
Slide 6
Environmental Factors
Humidity—amount of moisture in the air
From 30% to 50% is comfortable.
Studies show that rooms under 40% relative humidity (RH)
can cause water molecules to rapidly lose 90% of their water
volume, resulting in airborne bacteria that floats around and
can reach another host. (www.ultrapureus.com).
Too little humidity will dry respiratory passages
⬤ Lighting
Should be adequate to perform tasks and prevent
accidents and injury
Should be bright enough to see, but soft enough to
prevent sharp shadows
Patient should be able to control lights independently
Environmental Factors
Odor
To control odors:
Empty and rinse bedpans, bedside commodes, and
urinals promptly
Dispose of dressings and used equipment
Nothing odorous should be placed in trash in a
patient’s room
Avoid the sources of odors
Remove old flowers and stagnant water
Perfumes, scented lotions, or scented cosmetics
should not be worn in patient areas
Environmental Factors
Noise
The main source in a hospital is people
Patient may experience sensory overload from
noise
Soft, pleasant background music can mask other
sounds and promote relaxation
Reduce noise by:
* Avoiding long conversations in the hallways
* Encouraging staff to speak in lowered voices
* Avoiding jokes and laughter at the nurses’ station
* Answering alarms on IV pumps and equipment promptly
Slide 9
Environmental Factors
Interior design
Patients’ rooms and public areas look more like a hotel
now as opposed to the stark white of the past
Rooms have draperies and colorful bedspreads
These changes are to promote comfort by providing a
homelike environment for the patient
⬤ Neatness
Straighten the patient’s unit after making the bed
and whenever appropriate
Remove trays and dishes promptly after meals
Keep the over-the-bed table clear
Environmental Factors
⬤ Privacy: essential for patient’s well-being
Always knock gently and identify yourself before
entering the room
In multiple-patient rooms, close the curtain around
the patient for personal tasks such as using a
bedpan and bathing
Post a sign on the door informing others of such
tasks to discourage them from entering the room
Patient Units
⬤ Beds
Usually have a firm mattress covered with a
material that allows easy cleaning between
patients; side rails should not present a hazard
May use an overlay to prevent pressure ulcer
formation
Always lock wheels on a bed when not moving it
and leave it in the low position when not
performing a procedure on a patient
Patient Units
Unoccupied bed
Made when the patient is out of bed in the chair or out
of the room for a diagnostic procedure or therapy
⬤ Occupied bed
Made only if the patient absolutely cannot be out of
bed
⬤ Bed linens should be neat, orderly, and free from
wrinkles.
Florence Nightingale described six elements of
environment. They are:
2) temperature, ventilation, safety, lighting, odor, and
noise.
Which of the following is not an appropriate?
guideline for bed-making?
1) Check to make sure the bed wheels are
locked.
1) Check to make sure the bed wheels are
locked.
Theory
4) Describe methods to prevent mechanical and
thermal accidents and injury in health care facilities
and the home.
5) Discuss the various forms of bioterrorism, safety
measures to be taken, signs and symptoms of
agents used, and measures to treat or contain the
threat.
6) Discuss the principles for using protective devices.
7) Demonstrate knowledge of the legal implications of
using protective devices.
Prevention, Containment, and Protection (Slide 2 of 2)
Clinical Practice
3) Explain, according to your facility’s
procedures, how to clean up a biohazard
spill.
4) Discuss your clinical facility’s response plan
to a bioterrorism threat.
5) Given an emergency scenario, practice
triaging the victims.
6) Correctly apply an extremity immobilizer.
Safety
⬤ Most common patient accidents/incidents:***
Falls
Burns
Cuts and bruises»usually from falls or procedures
Fights with others
Loss of possessions
Choking
Electrical shock- improper use of hosp.elect. equip
Most common patient accidents/incidents:***
Falls
Burns
Cuts and bruises»usually from falls or procedures
Fights with others
Loss of possessions
Choking
Electrical shock- improper use of hosp.elect. equip
⬤ Three common factors
Impaired physical mobility
Altered mental status
Sensory and/or motor deficits
⬤ Patients at risk for falls may need a leg or bed
alarm
Sense a change in position or pressure and sound
an alarm to alert health care workers or family
members that patients are attempting to get out of
bed or a chair
Burns
⬤ Prevention includes protecting the patient from
thermal injury.
⬤ Can be caused by hot or cold materials.
⬤ Diabetic patients, paralyzed patients, or patients with
altered mental awareness at risk for burns.
⬤ The nurse should check the temperature of liquids
before giving them to the patient.
⬤ The nurse should caution the patient about sleeping
on a heating pad or a cold pack.
⬤ Inspect electrical cords for frayed or broken areas that
may cause sparks or fires.
⬤ Nurses and patients should never use a heating pad
Smoking
Banned in most health care facilities.
⬤ Some long-term care agencies allow smoking in
designated areas.
⬤ Carefully supervise the patient who wants to smoke
and is sedated, confused, or irrational.
⬤ Smoking is never allowed when oxygen is in use
because a spark could cause a fire.
⬤ Any equipment that might cause a spark is also
prohibited near oxygen.
Fire
⬤ Know and be familiar with your institution’s fire
regulations
⬤ Know the location of the fire extinguishers, fire
alarms, and escape routes, and how to notify
the telephone operator of a fire in your area
⬤ Should a fire occur,you must***
Rescue any patients in immediate danger by
removing them from the area.
Activate the fire alarm system.
Contain the fire by closing doors and windows.
Extinguish flames with an appropriate extinguisher.
Types of Fire Extinguisher
- Four types of extinguishers***
- Type A—Water under pressure; used for
paper, wood and cloth fires*** - Type B—Contains CO2
; used for
gasoline, oil, paint, and flammable liquids
* Type C—Used for electrical fires
* Type ABC—Can be used on any type of
fire
Fire drill in the nursing facility
is conducted quarterly..
Nursing Actions to Promote
Patient Safety in the Health Care Facility
Orient the patient to the unit on admission.
⬤ Assess patient’s gait and risk for falling on
admission.
⬤ Evaluate patient’s drug regimen for side
effects that increase the risk for falling.
⬤ Keep bed in low position when not giving
direct care.
⬤ Toilet the patient on a regular schedule.
Nursing Actions to Promote Patient Safety in the Health Care Facility
Lock the wheels on the bed.
➔ Provide a night-light for going to the
bathroom.
➔ Encourage the use of non skid slippers.
➔ Answer call lights promptly.
➔ Tell the patient when you will next check in.
➔ Encourage the use of grab bars.
Nursing Actions to Promote Patient Safety in the Health Care Facility
Place high-risk patients in a room close to the
nurses’ station..
❖ Be sure the patient’s call bell is within reach.
❖ Stay with confused or unsteady patients when
they are up.
❖ Provide diversionary activities for confused
patients.
❖ Make sure wheelchair brakes are locked.
Nursing Actions to Promote
Patient Safety in the Home***
★ Place a non skid bath mat in the tub or shower.
★ Use night-lights to help patient find the
bathroom.
★ Suggest installation of grab bars.
★ Install door buzzers or bed alarms.
★ Maintain the same furniture arrangement.
★ Encourage removal of extension cords.
★ Caution the patient about toys and animals.
★ Provide appropriate community resources.
