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ENVIRONMENTAL HYGIENE Today’s public is very much aware of the en- vironment and its effect on the health and com- fort of human beings. The health care setting is a unique environment and has a distinct character of its own. The health care provider must be aware of that character and ensure that the environment is one that will support the optimum in health maintenance, care, and rehabilitation. In the context of the environment, hygiene may best be described as those practices that are conducive to providing a healthy environment. Basically, this includes the following three areas of concern: safety (which has already been ad- dressed), environmental comfort and stimuli, and finally infection control (which will be discussed under “Pathogenic Organism Control”). The health care provider has certain responsibilities to control the facility’s general environment as well as the patient’s immediate surroundings. Maintaining cleanliness not only provides for patient comfort and a positive stimulus, it also impacts on infection control. Cleanliness is a ma- jor responsibility of all members of the health care team, regardless of their position on the team. As a provider, the hospital corpsman, who has the most direct and frequent contact with the patient, becomes very familiar with concurrent and ter- minal cleaning. Concurrent cleaning ensures that the patient’s individual unit is kept neat and clean during hospitalization. Terminal cleaning is per- formed when 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 psycho- logical outlook but also contribute to both efficient physical care and control of the complica- tions of illness and injury. 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. At one time almost all health care facilities used white as a basic color for walls and even bedside equipment. Research has shown that the use of color is quieting and restful to the patient, and rest is a very important healing agent in any kind of illness. Noise control is another environmental aspect that requires the health care provider’s constant attention. The usual number of people and equipment traffic in a facility creates a high noise level and must be monitored. Add to that the noise of multiple radios and televi- sions, and it is understandable why noise control is necessary if a healing environment is to be created and maintained. Another important aspect of environmental hygiene is climate control. Many facilities use air-conditioning or similar control systems to maintain proper ventilation, humidity, and tem- perature control. In facilities without air- conditioning, open windows from the top and bottom to provide for cross ventilation. Ensure that the patient is not located in a draft area. Win- dowsill deflectors or patient screens are often used to redirect drafty airflows. Maintain facility tem- peratures 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 controll- ing 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 are best controlled by proper personal hygiene and clean clothing. 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. Ad- just shades or blinds for the patient’s comfort. Artificial light should be strong enough to pre- vent eyestrain and diffuse enough to prevent glare. Whenever possible, provide a bedlamp for the pa- tient. As discussed under “Safety Aspects,” a dim light is valuable as a comfort and safety measure at night. It 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. A night light may help orient elderly patients if they are confused as to their surroundings upon awakening. In conclusion, it is important that the health care provider understand the effects of the en- vironment on the patient. Most persons are more sensitive to excessive stimuli in the environment when they are ill and often become irritable and unable to cooperate in their care because of these excesses. This is because their body is already under stress due to their illness and does not have the energy to cope with added stimuli. This is par- ticularly apparent in critical care areas (e.g., in CCUs and ICUs) and isolation, terminal, and geriatric units. It is important that all health care 5-15


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