Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Chapter 17 The Person’s Unit

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 2  The person’s unit is the personal space, furniture, and equipment provided for the person by the agency.  The person’s room is a private area.  Patient and resident rooms are designed to provide comfort, safety, and privacy.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 3  COMFORT  Temperature and ventilation Most healthy people are comfortable when the room temperature is 68  F to 74  F. Most healthy people are comfortable when the room temperature is 68  F to 74  F.  Infants, older persons, and those who are ill may need higher temperatures. To protect infants, older persons, and persons who are ill from drafts: To protect infants, older persons, and persons who are ill from drafts:  Make sure they wear the proper clothing.  Make sure they wear enough clothing.  Offer lap robes to those in chairs and wheelchairs.  Provide enough blankets for warmth.  Cover them with bath blankets when giving care.  Move them from drafty areas.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 4  Many odors occur in health care agencies. Bowel movements, urine, draining wounds, and vomitus create embarrassing odors. Bowel movements, urine, draining wounds, and vomitus create embarrassing odors. Body, breath, and smoking odors may offend others. Body, breath, and smoking odors may offend others. Smoke odors present special problems. Smoke odors present special problems.  Patients, residents, and staff must follow agency policy.  If you smoke, practice hand washing after handling smoking materials and before giving care.  If you smoke, give careful attention to your uniforms, hair, and breath. Good nursing care, ventilation, and housekeeping practices help prevent odors. Good nursing care, ventilation, and housekeeping practices help prevent odors.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 5  Noise Ill and many older persons are sensitive to noises and sounds. Ill and many older persons are sensitive to noises and sounds. People want to know the cause and meaning of new sounds. People want to know the cause and meaning of new sounds. To decrease noise: To decrease noise:  Control your voice.  Handle equipment carefully.  Keep equipment in good working order.  Answer phones, signal lights, and intercoms promptly.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 6  Lighting Good lighting is needed for safety and comfort. Good lighting is needed for safety and comfort. Adjust lighting to meet the person’s changing needs. Adjust lighting to meet the person’s changing needs. Always keep light controls within the person’s reach. Always keep light controls within the person’s reach.  This protects the right to personal choice.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 7  ROOM FURNITURE AND EQUIPMENT  Rooms are furnished and equipped to meet basic needs. The right to privacy is considered. The right to privacy is considered.  The bed Beds have electrical or manual controls. Beds have electrical or manual controls. Beds are raised horizontally to give care. Beds are raised horizontally to give care. The lowest horizontal position lets the person get out of bed with ease. The lowest horizontal position lets the person get out of bed with ease. The head of the bed is flat or is raised varying degrees. The head of the bed is flat or is raised varying degrees.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 8 Electric beds Electric beds  Controls are on a side panel, bed rail, or the foot board.  Patients and residents are taught to use controls safely. Manual beds have cranks at the foot of the bed. Manual beds have cranks at the foot of the bed.  The cranks are pulled up for use and kept down at all other times. The six basic bed positions are: The six basic bed positions are:  Flat  Fowler’s position  High-Fowler’s position  Semi-Fowler’s position  Trendelenburg’s position  Reverse Trendelenburg’s position

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 9 Bed safety involves the hospital bed system. Bed safety involves the hospital bed system. The FDA defines the hospital bed system as the bed frame and its parts. The FDA defines the hospital bed system as the bed frame and its parts.  The mattress  Bed rails  Headboard and footboard  Bed attachments The person can get caught, trapped, or entangled in spaces created by: The person can get caught, trapped, or entangled in spaces created by:  Bed rails  The mattress  The bed frame  The headboard or footboard

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 10 Serious injuries and deaths have occurred from head, neck, and chest entrapment. Serious injuries and deaths have occurred from head, neck, and chest entrapment.  Arm and leg entrapment also can occur. Persons at greatest risk include persons who: Persons at greatest risk include persons who:  Are older  Are frail  Are confused or disoriented  Are restless  Have uncontrolled body movements  Have poor muscle control  Are small in size  Are restrained

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 11 Hospital bed systems have 7 entrapment zones. Hospital bed systems have 7 entrapment zones.  Zone 1: Within the bed rail  Zone 2: Between the top of the compressed mattress and the bottom of the bed rail and between the rail supports  Zone 3: Between the bed rail and the mattress  Zone 4: Between the top of the compressed mattress and the bottom of the bed rail and at the end of the bed rail  Zone 5: Between the split bed rails  Zone 6: Between the end of the bed rail and the side edge of the headboard or footboard  Zone 7: Between the headboard or footboard and the end of the mattress

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 12  The overbed table is placed over the bed by sliding the base under the bed. It is raised or lowered for the person in bed or in a chair. It is raised or lowered for the person in bed or in a chair. It is used for meals, writing, reading, and other activities. It is used for meals, writing, reading, and other activities. The nursing team uses the overbed table as a work area. The nursing team uses the overbed table as a work area. Only clean and sterile items are placed on the table. Only clean and sterile items are placed on the table.  The bedside stand is next to the bed. It is used to store personal items and personal care equipment. It is used to store personal items and personal care equipment. Place only clean and sterile items on top of it. Place only clean and sterile items on top of it.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 13  The person’s unit always has at least one chair for personal and visitor use. The chair must be comfortable and sturdy. The chair must be comfortable and sturdy. It must not move or tip during transfers. It must not move or tip during transfers. It must not be too low or too soft. It must not be too low or too soft.  Rooms have privacy curtains. Always pull the curtain completely around the bed before giving care. Always pull the curtain completely around the bed before giving care. Privacy curtains do not block sound or conversations. Privacy curtains do not block sound or conversations.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 14  Personal care items Personal care items are used for hygiene and elimination. Personal care items are used for hygiene and elimination. The agency provides: The agency provides:  A bedpan and urinal  A wash basin, kidney basin, water pitcher and cup, and soap and a soap dish Some persons bring their own personal care products. Some persons bring their own personal care products.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 15  The call system lets the person signal for help. When using an intercom system, remember confidentiality. When using an intercom system, remember confidentiality. Persons with limited hand mobility may need a signal light that is turned on by tapping it with a hand or fist. Persons with limited hand mobility may need a signal light that is turned on by tapping it with a hand or fist. Some people cannot use signal lights. Some people cannot use signal lights.  Check the care plan for special communication measures.  Check these persons often. You must: You must:  Keep the signal light within the person’s reach.  Place the signal light on the person’s strong side.  Remind the person to signal when help is needed.  Answer signal lights promptly.  Answer bathroom and shower or tub room signal lights at once.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 16  The bathroom A toilet, sink, call system, and mirror are standard equipment. A toilet, sink, call system, and mirror are standard equipment. Grab bars are by the toilet for the person’s safety. Grab bars are by the toilet for the person’s safety. Some bathrooms have raised toilet seats. Some bathrooms have raised toilet seats. Towel racks, toilet paper, soap, paper towel dispenser, and a wastebasket are placed within easy reach of the person. Towel racks, toilet paper, soap, paper towel dispenser, and a wastebasket are placed within easy reach of the person. The sound at the nurses’ station is different from signal lights in rooms. The sound at the nurses’ station is different from signal lights in rooms.  Someone must respond at once when a person needs help in a bathroom.

Mosby items and derived items © 2008 by Mosby, Inc., an affiliate of Elsevier Inc. Slide 17  Closet and drawer space OBRA requires that nursing centers provide each person with closet space. OBRA requires that nursing centers provide each person with closet space.  The closet space must have shelves and a clothes rack.  The person must have free access to the closet and its contents. Items in closets and drawers are the person’s private property. Items in closets and drawers are the person’s private property.  You must have the person’s permission to open or search closets or drawers.  The person’s unit is kept clean, neat, safe, and comfortable.