CONCURRENT AND TERMINAL CLEANING
Maintaining cleanliness is a major responsibility
of all members of the healthcare team, regardless of
their position on the team. Cleanliness not
only provides for patient comfort and a
positive stimulus, it also impacts on
infection control. The Hospital
Corpsman is often directly responsible for the
maintenance of patient care areas. The management of
cleanliness in patient care areas is
conducted concurrently and terminally. Concurrent
cleaning is the disinfection and
sterilization of patient supplies and
equipment during hospitalization. Terminal
cleaning is the disinfection and sterilization of patient
supplies and equipment after the patient is
discharged from the unit or hospital.
Both concurrent and terminal cleaning
are extremely important procedures that not
only aid the patient's comfort and psychological
outlook, but also contribute to both
efficient physical care and control of
the complications of illness and
injury.
AESTHETICS
Aesthetically, an uncluttered look is far more
appealing to the eye than an untidy one. Other
environmental factors,such as color and
noise, can also enhance or hinder the
progress of a person's physical
condition. In the past, almost all healthcare facilities
used white as a basic color for walls and
bedside equipment. However, research
has shown that the use of color is
calming and restful to the patient, and, as has
been previously stated, rest is a very important healing
agent in any kind of illness. Noise control
is another environmental element that
requires your attention. The large
number of people and the amount of
equipment traffic in a facility serve to create a high
noise level that must be monitored. Add to
that the noise of multiple radios and
televisions, and it is understandable
why noise control is necessary if a
healing environment is to be created and maintained.
CLIMATE CONTROL
Another important aspect of environmental
hygiene is climate control. Many facilities use air
conditioning or similar control systems to
maintain proper ventilation, humidity,
and temperature control. In facilities
without air conditioning, windows should
be opened from the top and bottom to provide for
cross-ventilation. Ensure that patients are
not located in a drafty area. Window
sill deflectors or patient screens are
often used to redirect drafty airflows.
Maintain facility temperatures at recommended
energy-conservation levels that are also acceptable as
health-promoting temperatures. In addition
to maintaining a healthy climate, good
ventilation is necessary in controlling
and eliminating disagreeable odors. In
cases where airflow does not control odors,
room fresheners should be discretely used. Offensive,
odor-producing articles (such as soiled
dressings, used bedpans, and urinals)
should be removed to appropriate
disposal and disinfecting areas as rapidly
as possible. Objectionable odors (such as bad breath or
perspiration of patients) are best
controlled by proper personal hygiene
and clean clothing.
LIGHTING
Natural light is important in the care of the sick.
Sunlight usually brightens the area and
helps to improve the mental well-being
of the patient. However, light can be a
source of irritation if it shines
directly in the patient's eyes or produces a glare from
the furniture, linen, or walls. Adjust
shades or blinds for the patient's
comfort. Artificial light should be
strong enough to prevent eyestrain and diffuse enough
to prevent glare. Whenever possible, provide
a bed lamp for the patient. As
discussed earlier under "Safety
Aspect," a dim light is valuable as a comfort
and safety measure at night. This light should be
situated so it will not shine in the
patient's eyes and yet provide
sufficient light along the floor so that all
obstructions can be seen. Anight light may help orient
elderly patients if they are confused as to
their surroundings upon awakening.
In conclusion, it is important that you understand
the effects of the environment on patients. People are
more sensitive to excessive stimuli in the
environment when they are ill, and they
often become irritable and unable to
cooperate in their care because of these
yes"> excesses. This is particularly apparent in critical care
areas (e.g., in CCUs and ICUs) and
isolation, terminal, and geriatric
units. You must realize and respond to the
vital importance of the environment in the total
medical management plan of your patients.
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