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Assisting
With
Comfort
The Person's Unit
 Patient and resident rooms are designed to
provide comfort, safety, and privacy.
 The person’s unit is the personal space,
furniture, and equipment provided for the person
by the agency.
The Person's Unit, cont'd.
 Temperature and ventilation
 Most healthy people are comfortable when the
temperature is 68 F (Fahrenheit) to 74 F.
 The Omnibus Budget Reconciliation Act of 1987 (OBRA)
requires that nursing centers maintain a temperature range
of 71 F to 81 F.
 To protect older and ill persons from cool areas and drafts:
• Keep room temperatures warm.
• Make sure they wear the correct 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.
The Person's Unit, cont'd.
 Odors
 To reduce odors:
• Empty, clean, and disinfect bedpans, urinals, commodes, and
kidney basins promptly.
• Make sure toilets are flushed.
• Check incontinent persons often.
• Clean persons who are wet or soiled from urine, feces, vomitus,
or wound drainage.
• Change wet or soiled linens and clothing promptly.
• Keep laundry containers closed.
• Follow agency policy for wet or soiled linens and clothing.
• Dispose of incontinence and ostomy products promptly.
• Provide good hygiene to prevent body and breath odors.
• Use room deodorizers as needed and allowed by agency policy
The Person's Unit, cont'd.
 If you smoke:
 Follow the agency’s policy.
 Practice hand washing after handling smoking
materials and before giving care.
 Give careful attention to your uniforms, hair, and
breath.
The Person's Unit, cont'd.
 Noise
 Common health care sounds may disturb patients
and residents.
 To decrease noise:
• Control your voice.
• Handle equipment carefully.
• Keep equipment in good working order.
• Answer phones, call lights, and intercoms promptly.
The Person's Unit, cont'd.
 Lighting
 Good lighting is needed for safety and comfort.
 Adjust lighting and window coverings to meet the
person’s changing needs.
 Keep light controls within the person’s reach.
• This protects the right to personal choice.
The Person's Unit, cont'd.
 Room furniture and equipment
 The bed
• Beds have electrical or manual controls.
• Beds are raised horizontally to reduce bending and reaching
when giving care.
• The lowest horizontal position lets the person get out of bed with
ease.
• The head of the bed is flat or raised to varying degrees.
 Electric beds may have:
• Controls on a side panel, bed rail, or the foot-board
• Hand-held devices
 Manual beds have cranks at the foot of the bed.
• The cranks are pulled up for use.
• They are kept down at all other times.
Bed Positions
 The six basic bed positions are:
 The flat position
 Fowler’s position
 High-Fowler’s position
 Semi-Fowler’s position
 Trendelenburg’s position
 Reverse Trendelenburg’s position
Bed Safety
 Bed safety involves the hospital bed system.
 Hospital bed systems have seven entrapment zones.
 Entrapment means that the person can get caught, trapped, or
entangled in spaces created by bed rails, the mattress, the bed
frame, the head-board, or foot-board.
 Persons at greatest risk for entrapment 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
 Always check the person for entrapment.
Furniture and Equipment
 The over-bed table
 The over-bed table is placed over the bed by sliding the
base under the bed.
 Only clean and sterile items are placed on the table.
 Clean the table after using it for a work surface.
 The bedside stand
 The bedside stand has a top drawer and a lower cabinet
with shelves or drawers.
 Place only clean and sterile items on top of the bedside
stand.
 If you use the bedside stand for a work surface, clean it
when you are done.
Furniture and Equipment, cont'd.
 Chairs
 The person’s unit always has at least one chair.
 The chair must:
• Be comfortable and sturdy
• Not move or tip during transfers
• Allow the person to get in and out of it with ease
 Privacy curtains
 Each person has the right to full visual privacy (to be
completely free from public view while in bed).
 Always pull the privacy curtain completely around the bed
before giving care.
 Remember, privacy curtains do not block sounds or
conversations.
Furniture and Equipment, cont'd.
 The call system
 The call system lets the person signal for help.
 Always keep the call light within the person’s reach.
 An intercom system lets a nursing team member talk
with the person from the nurses’ station.
• When using an intercom, remember confidentiality.
 Persons with limited hand mobility may need a call
light that is turned on by tapping it with a hand or fist.
Furniture and Equipment, cont'd.
 Some people cannot use call lights.
 Check the care plan for special communication measures.
 Check these persons often.
 Make sure their needs are met.
 You must:
 Keep the call light within the person’s reach.
 Place the call light on the person’s strong side.
 Remind the person to signal when help is needed.
 Answer call lights promptly.
 Answer bathroom and shower or tub room call lights at
once.
Furniture and Equipment, cont'd.
 The bathroom
 A toilet, sink, call system, and mirror are standard
equipment in bathrooms.
 For safety, grab bars are by the toilet.
 Some bathrooms have raised toilet seats.
• They make wheelchair transfers easier.
• They are helpful for persons with joint problems.
 The bathroom call light flashes above the room door
and at the nurses’ station.
• The sound at the nurses’ station is different from the sound
made by call lights in rooms.
Furniture and Equipment, cont'd.
 Closet and drawer space are provided.
 OBRA requires closet space for each nursing center
resident.
 The 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.
 Many agencies furnish rooms with other equipment.
 Residents may bring some furniture and other items
from home.
Bedmaking
 Clean, dry, and wrinkle-free linens:
 Promote comfort
 Prevent skin breakdown and pressure ulcers
 To keep beds neat and clean:
 Straighten linens whenever loose or wrinkled and at
bedtime.
 Check for and remove food and crumbs after meals.
 Check linens for dentures, eyeglasses, hearing aids, sharp
objects, and other items.
 Change linens whenever they become wet, soiled, or
damp.
 Follow Standard Precautions and the Bloodborne
Pathogen Standard.
Bedmaking, cont'd.
 Types of beds
 A closed bed is not in use.
• The bed is ready for a new patient or resident.
• In nursing centers, closed beds are made for residents who
are up during the day.
 An open bed is in use.
• Top linens are fan-folded back so the person can get into
bed.
 An occupied bed is made with the person in it.
 A surgical bed is made:
• To transfer a person from a stretcher
• For persons who arrive by ambulance
Bedmaking, cont'd.
 Linens
 Collect linens in the order you will use them.
 Place the clean linen on a clean surface.
 Remove dirty linen one piece at a time.
• Roll each piece away from you.
• Discard each piece into the laundry bag.
 Wet, damp, or soiled linens are changed right away.
• Wear gloves and follow Standard Precautions and the
Bloodborne Pathogen Standard.
Bedmaking, cont'd.
 Drawsheets
 A drawsheet is a small sheet placed over the middle of the
bottom sheet.
 A cotton drawsheet helps keep the mattress and bottom
linens clean.
 A waterproof drawsheet is placed between the bottom
sheet and the cotton drawsheet.
 Many agencies use incontinence products, waterproof
pads, or disposable bed protectors.
 Cotton drawsheets are often used without waterproof
drawsheets.
 When cotton drawsheets are used as assist devices, do
not tuck them in at the sides.
Bedmaking, cont'd.
 Making beds
 The closed bed is made:
• After a person is discharged
• For a new patient or resident
• In nursing centers, for residents who are up for most or all of
the day
 The open bed is made for:
• Newly admitted persons arriving by wheelchair
• Persons who are getting ready for bed
• Persons who are out of bed for a short time
Bedmaking, cont'd.
 You make an occupied bed when the person stays
in bed.
 Keep the person in good alignment.
 Follow restrictions or limits in the person’s movement or
position.
 Explain each procedure step to the person before it is
done.
 The surgical bed (recovery bed or post-operative
bed) is made for persons:
 Returning to their rooms from surgery
 Arriving at the agency by ambulance
 Taken by stretcher to treatment or therapy areas
 Using portable tubs
Assisting With Pain Relief
 Pain means to ache, hurt, or be sore.
 Pain is subjective.
 You must rely on what the person says.
 The nurse uses the nursing process to promote
comfort and relieve pain.
 Report the person’s complaints and your
observations to the nurse.
Factors Affecting Pain
 Factors affecting pain
 Past experience
 Anxiety
 Rest and sleep
 Personal and family duties
 The value or meaning of pain
 Support from others
 Culture
 Illness
 Age
The Back Massage
 The back massage (back rub):
 Relaxes muscles and stimulates circulation
 Is given after the bath and with evening care
 Can be given after repositioning or helping the person
to relax
 Lasts 3 to 5 minutes
The Back Massage, cont'd.
 Before giving the massage, observe the skin for:
 Breaks in the skin
 Bruises
 Reddened areas
 Other signs of skin breakdown
 Lotion reduces friction during the massage.
 During the massage:
 Use firm strokes
 Keep your hands in contact with the person’s skin
Promoting Sleep
 Sleep is a basic need.
 The mind and body rest.
 The body saves energy.
 Body functions slow.
 Vital signs are lower than when awake.
 Tissue healing and repair occur.
 Sleep lowers stress, tension, and anxiety.
 It refreshes and renews the person.
 The person regains energy and mental alertness.
Promoting Sleep, cont'd.
 Sleep is a basic need.
 The mind and body rest.
 The body saves energy.
 Body functions slow.
 Vital signs are lower than when awake.
 Tissue healing and repair occur.
 Sleep lowers stress, tension, and anxiety.
 It refreshes and renews the person.
 The person regains energy and mental alertness.
Promoting Sleep, cont'd.
 Sleep disorders involve repeated sleep
problems.
 The amount and quality of sleep are affected.
 Insomnia is a chronic condition in which the
person cannot sleep or stay asleep all night.
 Sleep deprivation means that the amount and
quality of sleep are decreased.
 Sleep is interrupted.
 Sleepwalking is when the person leaves the bed
and walks about.

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Avante 11 finalAvante 11 final
Avante 11 final
 
Avante 10 final
Avante 10 finalAvante 10 final
Avante 10 final
 
Avante 9 final
Avante 9 finalAvante 9 final
Avante 9 final
 
Avante 8 final
Avante 8 finalAvante 8 final
Avante 8 final
 
Avante 6 final
Avante 6 finalAvante 6 final
Avante 6 final
 
Avante 5 final
Avante 5 finalAvante 5 final
Avante 5 final
 
Avante 4 final
Avante 4 finalAvante 4 final
Avante 4 final
 
Avante 3 final
Avante 3 finalAvante 3 final
Avante 3 final
 
Avante 2 final
Avante 2 finalAvante 2 final
Avante 2 final
 
Section 6 assisting with end-of-life care (1)
Section 6  assisting with end-of-life care (1)Section 6  assisting with end-of-life care (1)
Section 6 assisting with end-of-life care (1)
 
Section 4 assisting with wound care (1)
Section 4  assisting with wound care (1)Section 4  assisting with wound care (1)
Section 4 assisting with wound care (1)
 
Section 3 assisting with hygiene (1)
Section 3  assisting with hygiene (1)Section 3  assisting with hygiene (1)
Section 3 assisting with hygiene (1)
 
Section 2 preventing infection (1)
Section 2  preventing infection (1)Section 2  preventing infection (1)
Section 2 preventing infection (1)
 
Section 1 assisting with assessment (1)
Section 1  assisting with assessment (1)Section 1  assisting with assessment (1)
Section 1 assisting with assessment (1)
 
Section 6 assisting with bowel elimination-1
Section 6  assisting with bowel elimination-1Section 6  assisting with bowel elimination-1
Section 6 assisting with bowel elimination-1
 
Section 5 assisting with urinary elimination-2
Section 5  assisting with urinary elimination-2Section 5  assisting with urinary elimination-2
Section 5 assisting with urinary elimination-2
 
Section 4 assisting with nutrition and fluids-1
Section 4  assisting with nutrition and fluids-1Section 4  assisting with nutrition and fluids-1
Section 4 assisting with nutrition and fluids-1
 
Section 3 assisting with exercise and activity-1
Section 3  assisting with exercise and activity-1Section 3  assisting with exercise and activity-1
Section 3 assisting with exercise and activity-1
 

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Section 5 assisting with comfort (1)

  • 2. The Person's Unit  Patient and resident rooms are designed to provide comfort, safety, and privacy.  The person’s unit is the personal space, furniture, and equipment provided for the person by the agency.
  • 3. The Person's Unit, cont'd.  Temperature and ventilation  Most healthy people are comfortable when the temperature is 68 F (Fahrenheit) to 74 F.  The Omnibus Budget Reconciliation Act of 1987 (OBRA) requires that nursing centers maintain a temperature range of 71 F to 81 F.  To protect older and ill persons from cool areas and drafts: • Keep room temperatures warm. • Make sure they wear the correct 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.
  • 4. The Person's Unit, cont'd.  Odors  To reduce odors: • Empty, clean, and disinfect bedpans, urinals, commodes, and kidney basins promptly. • Make sure toilets are flushed. • Check incontinent persons often. • Clean persons who are wet or soiled from urine, feces, vomitus, or wound drainage. • Change wet or soiled linens and clothing promptly. • Keep laundry containers closed. • Follow agency policy for wet or soiled linens and clothing. • Dispose of incontinence and ostomy products promptly. • Provide good hygiene to prevent body and breath odors. • Use room deodorizers as needed and allowed by agency policy
  • 5. The Person's Unit, cont'd.  If you smoke:  Follow the agency’s policy.  Practice hand washing after handling smoking materials and before giving care.  Give careful attention to your uniforms, hair, and breath.
  • 6. The Person's Unit, cont'd.  Noise  Common health care sounds may disturb patients and residents.  To decrease noise: • Control your voice. • Handle equipment carefully. • Keep equipment in good working order. • Answer phones, call lights, and intercoms promptly.
  • 7. The Person's Unit, cont'd.  Lighting  Good lighting is needed for safety and comfort.  Adjust lighting and window coverings to meet the person’s changing needs.  Keep light controls within the person’s reach. • This protects the right to personal choice.
  • 8. The Person's Unit, cont'd.  Room furniture and equipment  The bed • Beds have electrical or manual controls. • Beds are raised horizontally to reduce bending and reaching when giving care. • The lowest horizontal position lets the person get out of bed with ease. • The head of the bed is flat or raised to varying degrees.  Electric beds may have: • Controls on a side panel, bed rail, or the foot-board • Hand-held devices  Manual beds have cranks at the foot of the bed. • The cranks are pulled up for use. • They are kept down at all other times.
  • 9. Bed Positions  The six basic bed positions are:  The flat position  Fowler’s position  High-Fowler’s position  Semi-Fowler’s position  Trendelenburg’s position  Reverse Trendelenburg’s position
  • 10. Bed Safety  Bed safety involves the hospital bed system.  Hospital bed systems have seven entrapment zones.  Entrapment means that the person can get caught, trapped, or entangled in spaces created by bed rails, the mattress, the bed frame, the head-board, or foot-board.  Persons at greatest risk for entrapment 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  Always check the person for entrapment.
  • 11. Furniture and Equipment  The over-bed table  The over-bed table is placed over the bed by sliding the base under the bed.  Only clean and sterile items are placed on the table.  Clean the table after using it for a work surface.  The bedside stand  The bedside stand has a top drawer and a lower cabinet with shelves or drawers.  Place only clean and sterile items on top of the bedside stand.  If you use the bedside stand for a work surface, clean it when you are done.
  • 12. Furniture and Equipment, cont'd.  Chairs  The person’s unit always has at least one chair.  The chair must: • Be comfortable and sturdy • Not move or tip during transfers • Allow the person to get in and out of it with ease  Privacy curtains  Each person has the right to full visual privacy (to be completely free from public view while in bed).  Always pull the privacy curtain completely around the bed before giving care.  Remember, privacy curtains do not block sounds or conversations.
  • 13. Furniture and Equipment, cont'd.  The call system  The call system lets the person signal for help.  Always keep the call light within the person’s reach.  An intercom system lets a nursing team member talk with the person from the nurses’ station. • When using an intercom, remember confidentiality.  Persons with limited hand mobility may need a call light that is turned on by tapping it with a hand or fist.
  • 14. Furniture and Equipment, cont'd.  Some people cannot use call lights.  Check the care plan for special communication measures.  Check these persons often.  Make sure their needs are met.  You must:  Keep the call light within the person’s reach.  Place the call light on the person’s strong side.  Remind the person to signal when help is needed.  Answer call lights promptly.  Answer bathroom and shower or tub room call lights at once.
  • 15. Furniture and Equipment, cont'd.  The bathroom  A toilet, sink, call system, and mirror are standard equipment in bathrooms.  For safety, grab bars are by the toilet.  Some bathrooms have raised toilet seats. • They make wheelchair transfers easier. • They are helpful for persons with joint problems.  The bathroom call light flashes above the room door and at the nurses’ station. • The sound at the nurses’ station is different from the sound made by call lights in rooms.
  • 16. Furniture and Equipment, cont'd.  Closet and drawer space are provided.  OBRA requires closet space for each nursing center resident.  The 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.  Many agencies furnish rooms with other equipment.  Residents may bring some furniture and other items from home.
  • 17. Bedmaking  Clean, dry, and wrinkle-free linens:  Promote comfort  Prevent skin breakdown and pressure ulcers  To keep beds neat and clean:  Straighten linens whenever loose or wrinkled and at bedtime.  Check for and remove food and crumbs after meals.  Check linens for dentures, eyeglasses, hearing aids, sharp objects, and other items.  Change linens whenever they become wet, soiled, or damp.  Follow Standard Precautions and the Bloodborne Pathogen Standard.
  • 18. Bedmaking, cont'd.  Types of beds  A closed bed is not in use. • The bed is ready for a new patient or resident. • In nursing centers, closed beds are made for residents who are up during the day.  An open bed is in use. • Top linens are fan-folded back so the person can get into bed.  An occupied bed is made with the person in it.  A surgical bed is made: • To transfer a person from a stretcher • For persons who arrive by ambulance
  • 19. Bedmaking, cont'd.  Linens  Collect linens in the order you will use them.  Place the clean linen on a clean surface.  Remove dirty linen one piece at a time. • Roll each piece away from you. • Discard each piece into the laundry bag.  Wet, damp, or soiled linens are changed right away. • Wear gloves and follow Standard Precautions and the Bloodborne Pathogen Standard.
  • 20. Bedmaking, cont'd.  Drawsheets  A drawsheet is a small sheet placed over the middle of the bottom sheet.  A cotton drawsheet helps keep the mattress and bottom linens clean.  A waterproof drawsheet is placed between the bottom sheet and the cotton drawsheet.  Many agencies use incontinence products, waterproof pads, or disposable bed protectors.  Cotton drawsheets are often used without waterproof drawsheets.  When cotton drawsheets are used as assist devices, do not tuck them in at the sides.
  • 21. Bedmaking, cont'd.  Making beds  The closed bed is made: • After a person is discharged • For a new patient or resident • In nursing centers, for residents who are up for most or all of the day  The open bed is made for: • Newly admitted persons arriving by wheelchair • Persons who are getting ready for bed • Persons who are out of bed for a short time
  • 22. Bedmaking, cont'd.  You make an occupied bed when the person stays in bed.  Keep the person in good alignment.  Follow restrictions or limits in the person’s movement or position.  Explain each procedure step to the person before it is done.  The surgical bed (recovery bed or post-operative bed) is made for persons:  Returning to their rooms from surgery  Arriving at the agency by ambulance  Taken by stretcher to treatment or therapy areas  Using portable tubs
  • 23. Assisting With Pain Relief  Pain means to ache, hurt, or be sore.  Pain is subjective.  You must rely on what the person says.  The nurse uses the nursing process to promote comfort and relieve pain.  Report the person’s complaints and your observations to the nurse.
  • 24. Factors Affecting Pain  Factors affecting pain  Past experience  Anxiety  Rest and sleep  Personal and family duties  The value or meaning of pain  Support from others  Culture  Illness  Age
  • 25. The Back Massage  The back massage (back rub):  Relaxes muscles and stimulates circulation  Is given after the bath and with evening care  Can be given after repositioning or helping the person to relax  Lasts 3 to 5 minutes
  • 26. The Back Massage, cont'd.  Before giving the massage, observe the skin for:  Breaks in the skin  Bruises  Reddened areas  Other signs of skin breakdown  Lotion reduces friction during the massage.  During the massage:  Use firm strokes  Keep your hands in contact with the person’s skin
  • 27. Promoting Sleep  Sleep is a basic need.  The mind and body rest.  The body saves energy.  Body functions slow.  Vital signs are lower than when awake.  Tissue healing and repair occur.  Sleep lowers stress, tension, and anxiety.  It refreshes and renews the person.  The person regains energy and mental alertness.
  • 28. Promoting Sleep, cont'd.  Sleep is a basic need.  The mind and body rest.  The body saves energy.  Body functions slow.  Vital signs are lower than when awake.  Tissue healing and repair occur.  Sleep lowers stress, tension, and anxiety.  It refreshes and renews the person.  The person regains energy and mental alertness.
  • 29. Promoting Sleep, cont'd.  Sleep disorders involve repeated sleep problems.  The amount and quality of sleep are affected.  Insomnia is a chronic condition in which the person cannot sleep or stay asleep all night.  Sleep deprivation means that the amount and quality of sleep are decreased.  Sleep is interrupted.  Sleepwalking is when the person leaves the bed and walks about.