1. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Textbook for Nursing Assistants Chapter 13: The Patient or Resident Environment

2. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins The Patient or Resident Unit

3. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Patient or resident rooms in a health care facility will vary according to the purpose of the facility and the needs of the person being cared for in the room A patient room in a hospital is a person’s temporary home A resident room in a long-term care or assisted-living facility usually becomes a person’s permanent home Patient or Resident Unit

4. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Patient rooms in the hospital vary, depending on the needs of the patient. For example –A typical double-occupancy room –A room in the intensive care unit (ICU) –A birthing suite in the maternity ward –A room in the subacute care unit Hospitals

5. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Patients staying in double-occupancy rooms are those who are recovering from –An illness –A surgery Hospital Rooms: Double-Occupancy

6. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Patients staying in an intensive care unit are those who –Are very ill –Need special equipment to monitor vital signs such as heart beat, blood pressure –Need special equipment to support their vital functions such as breathing Hospital Rooms: Intensive Care Unit

7. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins A room where new mothers and babies receive care before, during, and after the birthing process Very home-like, with curtains, attractive furniture A special bed designed to make the process of labor and delivery easier Hospital Rooms: Birthing Suite

8. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins A unit for patients who are not quite well enough to go home, but not quite sick enough to be in a typical hospital room Designed to be more home-like, and may include – A common dining room – Activity rooms for the patients Hospital Rooms: Subacute Care Unit

9. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Provide care for people who are not able to care for themselves independently In most cases, a person moving into a long-term care facility is making a permanent move into what is truly a new home For most people, moving into a long-term care facility is very emotional People who are moving into a long-term care facility are allowed to furnish their rooms with one or two favorite pieces of furniture and various personal items to help ease the transition Long-Term Care Facilities

10. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Each room in a long-term care facility may have –A full private bath, consisting of a shower or tub, a toilet, and a sink OR –A partial bath, consisting of a toilet and a sink, shared between two rooms OR –A communal bath area, designed to accommodate the bathing of several residents at the same time A bathroom with special modifications, such as handrails and a means of calling for help Common rooms to socialize, such as –Dining rooms –Activity rooms A small chapel where religious services are conducted Patios and gardens to allow the residents access to outdoor activities Long-Term Care Facilities

11. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Residents in an assisted-living facilities are usually more independent Private apartments consisting of a common area, one or two bedrooms, a bathroom, and possibly even a small kitchen Suites consisting of a private bedroom and bath, with communal dining and activity rooms Assisted-Living Facilities

12. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Ensuring Comfort

13. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins The following aspects of the resident’s environment are regulated by OBRA: –The size –The lighting –The temperature –The measures taken to maintain air quality –The measures taken to control noise –The types of furnishings and equipment –Equipment to ensure safety (such as handrails and a call light or intercom system in the bathroom) –The minimal amount of personal space for storage of belongings that each resident is entitled to –Privacy when requested for phone calls and visitors OBRA Regulations

14. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Furniture and Equipment

15. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins The physical environment of a health care facility contributes to a person’s overall comfort, health, and well-being You have a responsibility to keep the environment safe, clean, and comfortable Responsibility

16. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins “Standard” furniture for a patient’s or resident’s room includes: –An adjustable or nonadjustable bed –Chairs –An over-bed table –A storage unit –A call light and intercom system –Privacy curtains and room dividers Furniture

17. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Two types of beds –Adjustable beds Electrically operated Manually operated Have side rails and casters (wheels) –Regular beds Some assisted-living and long-term care facilities allow people to bring their own beds from home, if they prefer Furniture: Beds

18. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Precautions to be taken when using adjustable beds include the following: –Ensure the safety of electrically operated beds –Fold the cranks down and away under the bed after you are finished using manually operated beds –Use side rails according to your facility’s policies and the person’s individual care plan, as side rails are a form of restraint –Make sure the bed’s wheels are locked Furniture: Beds

19. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins One or two chairs for the person and visitors People with disabilities require special chairs –Geri-chairs –Wheelchairs –Chairs with special lifting devices that help the person to get in and out of the chair easily A person recovering from hip or spinal surgery may need a chair that has firm upholstery, a straight back, and no armrests Many residents of long-term care facilities will bring a favorite chair or two from home Furniture: Chairs

20. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Used to hold basins and other articles when carrying out personal care for a patient or resident Used as a writing surface Used for eating a meal or snack Place to keep a water pitcher and other items the person may want close by Considered a “clean” area, so: – Items placed there should be either sterile or clean – Dirty items, such as bedpans or soiled linens, are never placed on the over-bed table Furniture: Over-Bed Tables

21. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Bedside tables have drawers or a combination of drawers and closed shelves –Personal care items in top drawer –Basins, bedpans, and other care equipment stored neatly underneath in the lower drawers or shelves –The telephone, a flower arrangement, and other personal items may be placed on top of the bedside table A closet is provided in the long term care facility Storage space is considered private Furniture: Storage Units

22. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Call light and intercom systems are used for communication The call light system allows patients or residents to signal that they need help The intercom system allows members of the health care team to communicate with patients or residents without leaving the nurses’ station Call Light and Intercom System

23. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Used to help maintain a resident’s or patient’s privacy when care is being given Do little to keep voices and other sounds private, so door to room should also be closed Privacy Curtains and Room Dividers

24. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins Hanging intravenous (IV) poles Outlets for oxygen and suction devices Personal protective equipment (PPE) – Gloves – Disposal equipment – A wall-mounted sharps disposal box – A wall-mounted box of disposable gloves Equipment

25. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins People entering a health care facility may want to bring personal items to add a “touch of home” Personal items may express a person’s hobbies, ancestry, culture, religion, or career Asking a patient or resident about the significance of these items shows that person that the nursing assistant is interested in “who” that person really is Health care workers must always show as much care for the patients’ or residents’ personal items as they would for their own most treasured belongings Personal Belongings

26. Copyright © 2012 Wolters Kluwer Health | Lippincott Williams & Wilkins End of Presentation