Factors Affecting the Environment Flashcards

1
Q

Florence Nightingale wrote about
environmental factors that needed to be
controlled more than a century ago

A

Temperature
Ventilation and humidity
Lighting
Odor control
Noise
Interior design
Neatness
Privacy

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2
Q

Environmental Factors

A

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

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3
Q

Environmental Factors

A

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

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4
Q

Environmental Factors

A

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

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5
Q

Environmental Factors

A

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

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6
Q

Environmental Factors

A

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

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7
Q

Environmental Factors

A

⬤ 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

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8
Q

Patient Units

A

⬤ 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

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9
Q

Patient Units

A

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.

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10
Q

Florence Nightingale described six elements of
environment. They are:

A

2) temperature, ventilation, safety, lighting, odor, and
noise.

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11
Q

Which of the following is not an appropriate?
guideline for bed-making?

A

1) Check to make sure the bed wheels are
locked.

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12
Q

1) Check to make sure the bed wheels are
locked.

A

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.

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13
Q

Prevention, Containment, and Protection (Slide 2 of 2)

A

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.

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14
Q

Safety

A

⬤ 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

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15
Q

Most common patient accidents/incidents:***

A

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

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16
Q

⬤ Three common factors

A

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

17
Q

Burns

A

⬤ 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

18
Q

Smoking

A

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.

19
Q

Fire

A

⬤ 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.

20
Q

Types of Fire Extinguisher

A
  • 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..

21
Q

Nursing Actions to Promote
Patient Safety in the Health Care Facility

A

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.

22
Q

Nursing Actions to Promote Patient Safety in the Health Care Facility

A

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.

23
Q

Nursing Actions to Promote Patient Safety in the Health Care Facility

A

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.

24
Q

Nursing Actions to Promote
Patient Safety in the Home***

A

★ 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.

25
Q

Biohazards

A

A biologic agent, chemical, or condition that can be
harmful to a person’s health
⬤ OSHA publishes specific guidelines for labeling,
handling, cleaning spills, and disposing of these
materials
⬤ Material safety data sheet (MSDS) consulted for
recommended methods of storage, labeling, handling
spills, and disposal.

26
Q

Bioterrorism and Other Terrorism Agents

A

Bioterrorism: the release of pathogenic
microorganisms into a community to achieve
political and/or military goals
⬤ Chemical terrorism: use of certain compounds to
cause destruction to achieve political and/or
military goals
Pulmonary agents, cyanide agents, nerve agents,
vesicants, and incapacitating agents

⬤ Radioactive substances attached to an explosive
device (a “dirty bomb”) disperse radiation

27
Q

Common Diseases Spread Through Bioterrorism

A

⬤ Anthrax
⬤ Botulism
⬤ Ebola virus
⬤ Lassa fever
⬤ Plague
⬤ Ricin
⬤ Smallpox
⬤ Tularemia

28
Q

Decontamination

A

Staff must wear masks and protective clothing that are
impervious to chemicals and cover all skin surfaces.
❖ Military mission-oriented protective posture (MOPP)
suits may be used.
❖ A chemical mask with filtered respirator must be worn
with the suit.
❖ There is an emergency protocol from the local health
department’s disaster response plan that is followed to
decontaminate victims before they enter the hospital
building.
❖ Thorough scrubbing of the all of the person’s skin is often
part of the protocol.

29
Q

Triage and Treatment

A

Assessed and labeled according to the priority of care
as “immediate,” “delayed,” “minimal,” or “expectant” .
⬤ Triage priorities are based on the premise that limited
medical resources should be used on those patients who
will most likely live if they receive treatment. ***
⬤ Treatment based on type of agent to which the
patient was exposed and degree of exposure
Antibiotics used for some biologic agents
Antidotes used for some of the chemicals and
poisonous gases
Otherwise, treatment is directed at supporting

30
Q

Poisons

A

A substance that when ingested inhaled, absorbed,
applied, injected, or developed within the body, may
cause functional or structural disturbances *
⬤ Treatments and antidotes obtained from a poison
control center or listed on some containers.
⬤ Do not try to induce vomiting until conferring with Poison
Control.
⬤ In the event of a suspected poisoning:
*

Contact the poison control center; have the label of the
product in front of you and be ready to report:
* Name of the product
* Patient’s age
* Amount you believe is involved
* Any symptoms involved

Slide 35

31
Q

Protective Devices

A

Behavioral indications
Psychiatric setting
Sudden change in mental status/behavior

⬤ Nonbehavioral indications

Continuation of medical treatments

⬤ It is your responsibility to be aware of and
follow the regulations in your facility

32
Q

Legal Implications of Using Protective Devices

A

Federal and local laws mandate:

Protect the patient from physical and mental
abuse and from physical and chemical restraints
Except those that are authorized by a physician, in
writing, for a specified and limited period of time,
or that are needed in an emergency situation
The Joint Commission supports the use of
protective devices if clinically necessary, but only
as a last resort.
The devices must be applied by licensed, qualified
personnel.

33
Q

Alternatives to Protective Devices

A

⬤ The goal is to move to a less-restrictive
environment
⬤ Health care workers are encouraged to find
alternatives to the use of protective devices
⬤ Family and friends of a patient who is
confused can be encouraged to sit with the
patient to promote safety

34
Q
A