Chapter 15

The Resident’s Unit

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A Resident Unit

A resident unit is the personal space, furniture, and equipment provided for the person by the nursing center.

The person’s room or area of the room is private. It is treated like the person’s home.The intent is to have resident units as personal

and home-like as possible.

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Comfort

Temperature and ventilationMost healthy people are comfortable when the

temperature is 68 to 74 F.Older and chronically ill persons may need higher

temperatures.OBRA requires that nursing centers maintain a

temperature range of 71 to 81 F.

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Comfort (Cont’d)

To protect persons from drafts: Make sure they wear the correct 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.

Good nursing care, ventilation, and housekeeping practices help prevent odors.

Smoke odors present special problems.

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Smoking

If you smoke: Follow the center’s policy. Practice hand washing after handling smoking

materials and before giving care. Give careful attention to your uniforms, hair, and

breath.

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Noise Control

The Centers for Medicaid Services (CMS) requires comfortable sound levels.

A comfortable sound level: Does not interfere with a person’s hearing Promotes privacy when privacy is desired Allows the person to take part in social activities

To decrease noise: Control your voice. Handle equipment carefully. Keep equipment in good working order. Answer phones, call lights, and intercoms promptly.

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Lighting

The CMS requires comfortable lighting. Comfortable lighting:

Lessens glare. Allows the resident to control the intensity, location, and

direction of light. Allows persons who are visually impaired to maintain or

increase independent functioning. Good lighting is needed for safety and comfort.

Adjust lighting to meet the person’s changing needs. Always keep light controls within the person’s reach.

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Room Furniture and Equipment

Rooms are furnished and equipped to meet basic needs. The room has furniture and equipment for comfort, sleep,

elimination, nutrition, hygiene, and activity. Equipment to communicate with staff, family, and friends is

included. The bed

Beds have electrical or manual controls. Beds are raised horizontally to give care. The lowest horizontal position lets the person get out of bed

with ease. The head of the bed is flat or raised varying degrees.

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Bed Positions

The six basic bed positions are: Flat Fowler’s position (a semi-sitting position) High-Fowler’s position Semi-Fowler’s position Trendelenburg’s position

• A doctor orders this position.

Reverse Trendelenburg’s position• This position requires a doctor’s order.

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Bed Safety

The FDA defines the hospital bed system as the bed frame and

its parts. The mattress

Bed rails

Head- and foot-boards

Bed attachments

The person can get caught, trapped, or entangled in spaces

created by: Bed rails

The mattress

The bed frame

The head-boards and foot-boards

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Persons at Risk for Entrapment

Persons at greatest risk of 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

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The Seven Entrapment Zones

Hospital bed systems have seven 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 head-board or foot-board

Zone 7: Between the head-board or foot-board and the end

of the mattress

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Unit Furniture

The overbed table is: Placed over the bed by sliding the base under the bed Raised or lowered for the person in bed or in a chair Used for meals, writing, reading, and other activities

The bedside stand is used to store personal items and personal care equipment.

The resident’s unit has at least one chair for personal and visitor use. It must be comfortable and sturdy. It must not move or tip during transfers. The person should be able to get in and out of the chair with

ease.

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Unit Equipment

Each person has the right to full visual privacy. Full visual privacy means that a person has a means to be

completely free from public view while in bed. Always pull the privacy curtain completely around the bed

before giving care.

The bathroom A toilet, sink, call system, and mirror are standard

equipment. Grab bars are by the toilet for the person’s safety. Some bathrooms have raised toilet seats. Towel racks, toilet paper, soap, paper towel dispenser, and

the wastebasket are placed within easy reach of the person.

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The call system lets the person signal for help. When using an intercom, remember confidentiality. Some people cannot use call lights.

• Check the care plan for special communication measures.

• Check these persons often.

To promote safety, 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.

Call System

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Closets, Drawers, and Other Equipment

Closet and drawer space Each person is provided with closet and drawer

space. The closet space must have shelves and a clothes

rack. The person must have free access to the closet

and its contents. Other equipment Nursing centers may allow residents to bring

furniture and other items from home. TVs, radios, clocks, photos, and other small items help residents feel “at home” in their units.

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Quality of Life

The center is the person’s home. A home-like setting is important.

Personal choice is always allowed in arranging items. The health team must help the person feel safe,

secure, and comfortable. Everyone involved in the person’s care must keep the

unit clean, neat, safe, and comfortable. OBRA and the CMS serve to promote quality of life.

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