CARE OF PATIENT UNIT

DEFINITION

• Care of patient unit is defined as keeping the

patients unit clean, neat and tidy. It also helps
to provide maximum comfort to the patient
• Patients unit is the area furnished and
equipped according to the need to give
adequate care to the patient
• Sufficient air movement to evaporate sweats
and favors vascular changes within the skin
• Atmospheric pressure within man’s tolerance
• Provision for disposed of refuse/excreta
• Removal of dust. Injurious chemicals and
pathogenic bacteria from the atmospheric air
• Reasonable cleanliness of all surface and
furnishing that the individual is likely to handle
• A dwelling place free from insects, animal pests,
fire hazards, mechanical injuries, electric
shocks, radiation and poisons
• Freedom from disagreeable odors and noises,
harmony of town and design in the immediate
surroundings, provision of privacy etc
 PURPOSE OF THE UNIT CARE

• To provide comfort to patient

• To prevent cross infection
• To keep the unit clean and neat
• To keep the unit away from microorganisms
• To keep the articles ready for use
• To prolong the life of the articles
 PRINCIPLES OF GOOD
HOUSEKEEPING

• Wear gloves before cleaning the unit

• Use a damp dusting
• Dust with firm and even strokes
• Use disinfectant for cleaning
• Use a brush to clean grooved surface
• Remove albuminous materials such as sputum with cold
water
• Expose cleaned area to sunlight as it helps destroy bacteria
• Keep the cleaned articles in an orderly fashion
 INFLUENCE OF EXTERNAL
ENVIRONMENT

• Atmospheric temperature: in an ideal temperature,

the person does not feel chilly, but it should be
sufficiently warm enough to cause perspiration. A
room temperature ranging from 68 to 72 degree F
(20-22 degree Celcius) is considered comfortable
• Humidity: humidity is the amount of moisture in
the air. It affects the evaporation of moisture from
the skin. A humidity of 40-60% considered
comfortable
 Air Movement

• Ventilation means movement in the air. The chief

purpose of ventilation is to supply fresh air and to
maintain a proper humidity. Air in motion increases
the radiation of heat from the skin and improves
circulation and respiration. The velocity of the air
movement should be 15-45 feet/minute or 1-3
miles/hour
• Air may keep in motion by opening doors and
windows, and by the use of fans and air
conditioners. The air movement should not be
much to cause draughts.
 Lighting

• The amount of light is an important factor in comfort. It

is provided by natural or artificial light. Avoid direct light
on the face and eyes. Prevent glare. Artificial light should
not be too strong for reading. Remember, it is difficult for
a patient to rest when there is excessive light.
• He will not be able to read and write when there is dim
light. The amount of light depends upon the use of light,
the kind of work being done, conditions of the patient,
age of the patient and the time of the day. The patient if
conscious should have within his reach a light, which he
can control
 Noise

• Noise produces irritability, restlessness, fatigue, and

exhaustion. In an acutely ill patient noise interfere with
sleep. On the contrary, a melodious sound induces
pleasure. The degree of noise may be reduced by various
measures. Noise caused by friction may be reduced by
various measures. Noise caused by friction may be
reduced by lubrication. Use of rubber tyres and castors for
trolleys and wheel chairs reduce the sound when moving
furniture. Make echo proof rooms. Avoid dropping object.
Loud talking, laughing and heavy walking with shoes
should be avoided. Whispering is also not good, as it tends
to cause apprehension and uncertainty in the patient
 Purity of the Air

• Dust cause significant hazards to patients. Dust in

hospital may be laden with microorganisms, which
cause infection in addition to irritation of the respiratory
tract of precipitating allergic reaction
• To control the dust, it is important to avoid those
activities that stirrup dust such as dusting and dry duster
and sweeping damp dusting and cleaning, folding bed
linen and gently shaking them rather than flapping them,
restricting the cigarette smoking and above all providing
proper ventilation and ample spacing of bed maintains
the purity of air.
 Elimination of Unpleasant Odors
• Good ventilation, cleanliness, proper
disposal of excreta and rubbish are
necessary to eliminate unpleasant
odors

Water Supply and Sewage

Disposal
• There should be provision for safe
water supply and disposal of excreta
 Esthetic Factor

• The environment becomes attractive it appeals to the

series whether we are conscious or not, the design or
arrangement of the room contributes to its harmony.
Through skillful use of color, the room can be made
attractive. Color preferences vary with age, sex and race.
Flower vase, picture and curtains add to the pleasant
outlook of the room
• Esthetic considerations should include freedom from
unpleasant sights, bedpans, urinals, soiled dressings and
used linen, etc, should be removed from the sick room
immediately.
 Optimum Environment for the
Patient
• Influence of external environment are atmospheric
temperature, humidity, air movement, lighting, noise, purity
of air, elimination of unpleasant odors, water supply and
sewage disposal and esthetic factors.
• Factors of safety include freedom from mechanical injury,
thermal injury, chemical injury, radiation, bacteriologic
ingests, allergens, free from vermin, insects and animal pests.
• Furnishing for the patients unit are cot, spread over bed,
table, bedside locker, bedside table, chair and stool, bedside
commode, bed pans, and urinals, sputum cup, kidney trays,
water flasks, and drinking glasses, plate, spoon, fork, knives
and toilet articles.
 Carliolization
• Carliolization is a process of disinfecting the
whole external environment of the patient and
rendering it free from pathogenic organisms.

Vermin and Insects

• Clean the patients unit regularly. Eliminate all
the breeding places. Keep garbage well-
covered and dispose of all refuse properly
• Store food properly. Use fly screens on
windows and doors.
 FURNISHING PATIENT UNIT

• Cot or bedstead: the hospital beds are made up of

metal, simple in design, light and easily moveable,
easy to clean, and strong durable with hard rubber
castors. Some bed will have side rails to prevent
the patient from falling.
• Over bed table or cardiac table: generally, this is
used for patients suffering from cardiac diseases to
lean and rest forward when he has breathing
difficulty. It can also use for eating, reading, and
writing and for placing articles for self care.
• Bedside locker: it is used to store the patient
personal articles
• Bedside table: it can be used for taking the
meals and other purposes.
• Chair and stool: the chair can be used for the
patients when he is out of bed, i.e. while
changing the bed linens or bathing the
patients. The workers and visitors should sit on
the chair and not on the patient’s bed.
• Bedside commode: it is a chair or wheelchair
that has opening in the center of a seat under
which a bedpan can be inserted. It is used for
defecation and urination.
• Bedpan and urinals: for a bedridden patient,
these are used for defecation and urination.
• Sputum cup: it is used to collect the sputum
and spitting
• Kidney tray: it is used to collect vomits body
fluids and soiled dressings
• Water flask and drinking glasses: the water flask
is filled with drinking water and is given to the
patient within his reach.
• Plate, spoon, fork, knifes, etc: these are used to
serve the meals for the patient and is kept in-
patients unit
• Call signal: a bell is kept near the patient to call
the nurse in his need
• Toilet articles: soap with soap dish, toothbrush
and toothpaste, mouthwash, comb, etc. are kept in
patients unit. Bucket, mug, basin, etc. are kept in
bathroom.
• Waste basket: it is used to collect the rubbish
• Bedding and bed linens: the mattresses and pillows
should be firm, thick and smooth and all should
have a washable cover. It gives support to the
patients. Bed sheets are made up of strong cotton
material, which are used to protect the mattress
from soiling and to cover the patients; draw
Mackintosh sheet, extents from the patient shoulder
to below knee, made up of rubber or plastic
material, which is used to protect the mattress and
bottom sheet from soiling. Sometimes, Kelley’s
pads are used in place of a Mackintosh.
 TYPES OF WARDS IN
PATIENT UNIT & PRINCIPLES
OF CLEANLINESS
TYPES OF WARDS IN-PATIENT UNIT

• Private room: bed room with all other toilet

facilities
• Cubicles: small or large, the partition may be a
wall or curtains
• General ward: where several patients are
placed
 Principles of Cleanliness
• Plan your work for cleanliness, to avoid waste
of your energy and time
• Do dusting after sweeping
• Dust with a clean duster
• Use a damp dusting for collecting dust
• Soap and water or phenol 1:60
• Dusting should be done from top to bottom
• Dusting should be done with firm and even
stroke
• Use covered dustbin to collect the dust and
waste material
• Growth of bacteria is high in dark, moist and
unclean places. So care should be taken while
cleaning the congested places
• Use brush when cleaning grooved surfaces
• Replace all the equipments used for cleaning
• Wash hands after dusting
 Types of Cleaning

• Daily cleaning: two to three times a day (floor,

articles, furniture, dustbin and cupboards)
• Weekly: roof, walls, ceiling fans, cobwebs
• Annually: the ward should be emptied,
repaired, white washed, painted, cleaned and
washed
 Equipment

• Mops/Rags
• Brooms/Brushes
• Lotions (Detergents and disinfectants)
• Vim and glass cleaner
• Newspapers
• Basins
 Cleaning Activities

• Sweep and mop the floor at least twice a day

• Clean the floor with antiseptic solution
• Keep the unit well ventilated and do not close
the top ventilating windows
• Dust the walls and roof from time to time in
order to remove cobwebs
• Clean the windows and doors regularly
 Furniture

• Bed steads: dust everyday while making the bed.

Carbolize or wash with soap and water and dry well after
discharge of the patients
• Lockers: dust every morning and evening when tiding
the ward. Keep the bed side locker always clean and neat
• Cupboards: keep clean and tidy. Arrange the supplies
after drying absolutely. Use naphthalene balls to protect
• Bed cradles, back-rests, over bed tables, chairs and stools
are to be cleaned every day. Iron furniture is cleaned
with a dry duster to prevent rusting
• Bathrooms: scrub and wash the floors every day. Avoid
stagnation of water on the floors. Dispose the waste
material properly in dustbins
• Lavatories: check the flushing system is in working
condition. Clean it with cleaning powder using a brush
scrub and wash the floors daily. Teach the patients and
relatives regarding the proper use of lavatory
• Wash basins: clean them twice a day with cleaning
powder using a brush. Remove the spots with some spot
removing agent. Pour boiling water down the wash basin
drains every day
• Cabinet for sanitary wares: keep the racks clean, neat
and tidy. Store the sanitary wares in racks neat and tidy
and ready for use
 Vermin and Insects

• Clean the patients unit regularly. Eliminate all

the breeding places. Keep garbage well
covered and dispose of all refuse
• Store food properly. Use fly screens on
windows and doors
DISINFECTION
OF THE
PATIENT UNIT
 DISINFECTION OF THE
UNIT

• Disinfectants defined as the agent or solutions

used to kill or destroy the growth of
microorganisms
• Disinfectants are the agent that free from
infection. The term is usually applied to a
chemical or physical agents kills vegetative
forms of microorganisms
 Common Disinfectants Used

• Dettol (chloroxylenol): 1:2 to 1:1000 strength

• Hibitane (chlorhexidine): 1:100 strength
• Eusol (sodium hypochlorite): 1: 80 strength
• Lysol (cresol and soap solution): 1:40 strength
• Savlon (0.3% chlorhexidine and 3% cetrimide) –
1:20
• Sodium Hypochloride Solution : 1% of sodium
hypochloride solution, 1litre of sodium hypochloride
solution should be added in 4litres of water.
• Phenol (carbolic acid) – 1:10 to 1:20 strength
• Formalin (formaldehyde) 50 g/l liter of water
• Betadine (iodine) – 1: 40 strength
• H2O2 (liberates O2) – 1:80 strength
• Dilution formula: the volume of stock solution
to be used.
• Formula: strength of lotion required/strength
of stock solution (multiply) volume of solution
required
 Responsibilities of Nursing
Personnel
• To delegate the responsibilities to other
• To supervise the ward cleanliness
• To provide adequate supplies for cleaning
• To make the patients environment safe
• To replace or repair the damages article
• To keep the environment pleasant to promote
comfort of the patient
• To maintain the unit attractive and free from
physical, chemical and biological hazards
 Environment Setting

• Atmospheric: temperature of 20-22 degree Celsius is

considered comfortable
• Humidity of 40 – 60 % is more suitable
• The room should be well ventilated
• Adequate and artificial light should be provided
• Noise should be minimum as it interferes with the rest and
sleep of the patient. Damp dusting is done to maintain the
purity of air
• Eliminate unpleasant odors by maintaining proper cleanliness
• Provide good water supply
• Sewage system must be in working order
 TERMINAL CLEANING OF PATIENT
CARE UNIT

• The sanitation of the bed, bedside cabinet, and

general area of the patient care unit with a
detergent/germicidal agent after the patient is
discharged or transferred from the nursing care
unit
• Performed at every patient care unit before the
area is prepared for the next patient
 Reasons for Terminal Cleaning of
the Patient Care Unit

• Prevention of the spread of microorganisms

• Removal of encrusted secretions from
framework or bedside rails
• Removal of residue of body wastes from the
mattress
• Deodorizing of the bed frame, mattress, and
pillow
 Guidelines for Terminal
Cleaning
• Review wards standard operating procedure
(SOP) for specific procedures
• Use only authorized disinfectant/detergent or
germicidal solution for cleaning
• Check to ensure the bedside cabinet is cleared of
any valuables belonging to the patient
• Check bed linens for personal items (dentures,
contact lenses, money, jewelry, etc.) belonging to
the patient
• Prevent spread of microorganisms by carefully
removing linen from the bed
• Use caution when cleaning the under frame
and bedsprings
• Replace any torn mattress or pillow covers
• Allow the mattress and pillow to air-dry
thoroughly before remaking the bed
 Rules for use of disposal or non-
reusable items:
• Do not attempt to reuse (for another patient) or re-
sterilize disposables
• Sterile disposables are considered sterile providing the
wrapper is not broken or torn or the expiration date has
not passed
• Sterile disposables with torn or broken wrappers must
be discarded
• Use disposables for the specific purpose(s) for which
they were designed
• Follow manufacturer’s directions when using
disposables
Terminal Cleaning Procedure
• Assemble the equipment in the utility room and take it to the
patient unit
• Clear the bedside cabinet (and over bed table if used). Check for
any personal articles left by the patient and turn them into the
ward master. Place all utensils and any reusable treatment
equipment on the cart. Discard waste in the waste bucket. Place
any unused linen in the unit in the laundry hamper.
• Strip the bed. Remove the pillow, placing the pillow on the
chair and the pillowcase in the hamper. Lower the Gatch bed.
Loosen the bedding all around, walking around the bed and
lifting the mattress edge to release the linens without snagging
it on the bedsprings
• Check to see that no articles are concealed in the linen folds. Roll each
piece toward the foot of the bed. Check the pocket of discarded
pajamas and bathrobe. Place all linens in the hamper. Fold woolen
blankets, if used, and place them on the cart for special laundry
• Clean the bed. Wash the top of the plastic mattress cover and inspect it
for any tears. Rinse the cloth frequently and use it damp but not
dripping wet. Replace any damaged cover. Turn the clean surfaces of
the mattress together, toward the head of the bed. Wash the bottom half
of the bed frame and all crevices. Lower the Gatch bed at the knee. By
grasping the clean fold of the mattress, lift and swing its clean side
crosswise on the clean half of the spring and wash the exposed surface
• Place the pillow on the unwashed upper half of the spring. Wash the
top surface of the pillow. Place the pillow clean side down on the clean
mattress surface and wash the other side. Wash the upper spring,
raising the head portion of the bed, to complete bed cleansing.
• Wash the cabinet, inside and out. Complete the unit cleaning
by washing the chair, bed lamp (cord unplugged), signal
cord, and over bed table.
• If you responsible for the floor, sweep and mop it and wash
the windowsills. Wash hands when the cleaning is
completed and remake the bed for a new occupant
• Discard the waste. If cleaning cloths are to be reused, place
them in the laundry hamper
• Wash the collected utensils and place them in the utensil
boiler (sanitizer) for a 30-minute boiling period. Wash the
utility cart and return it to the storage place
• Wash hands
• Remove the clean utensils from the utensils boiler. Dry and
return them to the storage shelf