Providing Healthy environment is the prime responsibility of all health care providers.

2. By:-
Mrs. Babitha K Devu
Asstt. Professor
SMVDCoN
Providing Safe
&
Clean Environment
Mrs. Babitha K Devu, Asstt. Professor

3. At the end of this session the participants
should be able to conceptualize:
1. health in its physical, mental, social and
spiritual context;
2. environment to be an important factor in the
interaction of agent and host in the
epidemiological or ecological triad;
3. the physical, biological and psychosocial
environment and understand their impact on
health.
Mrs. Babitha K Devu, Asstt. Professor

4. “Healthy people are those who live
in healthy homes on a healthy
diet; in an environment equally
fit for birth, growth, work,
healing, and dying... Healthy
people need no bureaucratic
interference to mate, give birth,
share the human condition, and
die.”
-Ivan Illich
Mrs. Babitha K Devu, Asstt. Professor

5. It is a state of complete
physical, mental and social
well-being and not merely
the absence of disease or
infirmity.
Mrs. Babitha K Devu, Asstt. Professor

6. It is a condition under which the
individual is able to mobilize all
his resources, intellect,
emotional and physical- for
optimum living.
Mrs. Babitha K Devu, Asstt. Professor

7. This concept recognizes the strength of
social, economic, political and
environmental influences on health.
Mrs. Babitha K Devu, Asstt. Professor

8. Heredity
Welfare services
Environment
Socio-economic conditions
Health and family
Life-style
Mrs. Babitha K Devu, Asstt. Professor

9. Disease is a result from complex interaction
between man, an agent and the
environment.
From ecological point of view, disease is
defined as “maladjustment of the human
organism to the environment”.
Mrs. Babitha K Devu, Asstt. Professor

10. Environment
Vector
Agent Host
Mrs. Babitha K Devu, Asstt. Professor

11. Environment
(Physical, biological and psychosocial)
Human activities health of individual
Mrs. Babitha K Devu, Asstt. Professor

12. Health-care settings are environments with
a high prevalence of infectious disease
agents. Patients, staff, carers and
neighbours of the health-care setting
face unacceptable risks of infection if
environmental health is inadequate. The
health-care setting might even become
the epicentre of outbreaks of certain
diseases, such as typhus or diarrhoea.
Mrs. Babitha K Devu, Asstt. Professor

13. Health-care settings are environments with
a high prevalence of infectious disease
agents. Patients, staff, carers and
neighbours of the health-care setting
face unacceptable risks of infection if
environmental health is inadequate. The
health-care setting might even become
the epicentre of outbreaks of certain
diseases, such as typhus or diarrhoea.
Mrs. Babitha K Devu, Asstt. Professor

14.  This unit helps you to understand nurse
aide’s role in creating a safe and clean
environment that fosters resident
independence, contentment and self-
esteem.
 Surroundings that are pleasant and contain
personal possessions
add to the residents’
comfort and sense of
well-being.
Mrs. Babitha K Devu, Asstt. Professor

15. All of the external factors affecting an organism.
These factors may be other living organisms (biotic
factors) or nonliving variables (abiotic factors),
such as temperature, rainfall, day length, wind, and
ocean currents.
The interactions of organisms with biotic and abiotic
factors form an ecosystem.Mrs. Babitha K Devu, Asstt. Professor

16. Macro-environment or the external
environment
-is said to be responsible for millions of
preventable diseases originating in it.
Micro-environment
-is the Domestic environment in which man lives.
Internal environment
-is some time used for the environment inside the
bodyMrs. Babitha K Devu, Asstt. Professor

17. PHYSICAL:
Air, water, soil, housing, climate, geography, heat, light,
noise, debris, radiation, etc.
BIOLOGICAL:
Man, viruses, microbial agents, insects, rodents,
animals and plants, etc.
PSYCHOSOCIAL:
Cultural values, customs, beliefs, habits, attitudes,
morals, religion, education, lifestyles, community
life, health services, social and political organization.Mrs. Babitha K Devu, Asstt. Professor

18. Mrs. Babitha K Devu, Asstt. Professor

19. This indicator reviews:
 environmental control,
 the resident’s room,
 cleaning the unit,
 and bed making.
Mrs. Babitha K Devu, Asstt. Professor

20.  Older people often feels chilly
• Sweaters, lap robes and shawls provide
warmth
• Drapes, shades and screens are used to block
drafts
• Extra blankets used when sleeping
- Temperature: The temperature of air varies in
different parts of the day and also in the different
seasons. The factors which influence the
temperature are latitude of the place, altitude,
direction of wind and proximity to sea. The air
temperature, humidity and airflow in the health-
care setting provide a comfortable environment
for patients, staff and carers.
Mrs. Babitha K Devu, Asstt. Professor

21.  Sufficient lighting is provided during all working hours
to allow safe movement of staff, patients and carers,
and normal undertaking of medical activities. It is
essential for efficient vision. For this the following light
factors are essential:
1. Sufficiency – an illumination of 15 to 20 foot candles
is accepted as a basic minimum for satisfactory
vision.
2. Distribution – should be uniform, having the same
intensity, over the whole field of work.
3. Absence of glare – it is excessive contrast.
4. Absence of sharp shadows – cause confusion to eyes.
5. Steadiness and colour of light
6. Surroundings
– Safe/Comfortable Lighting:
Mrs. Babitha K Devu, Asstt. Professor

22.  Adjust to meet needs
• Use shades and drapes to control bright, natural
light
• Provide adequate light for reading
• Control glare and shadowed areas if possible
 Use the maximum availability
of natural lighting and
supplement with artificial
illumination.
 Artificial lighting should be as
close as possible to daylight
in composition.
Mrs. Babitha K Devu, Asstt. Professor

23. – Preventing Odors:
 Good ventilation helps to control odors
• Wastes should be removed and discarded as
soon as possible
• Good personal hygiene practices
Mrs. Babitha K Devu, Asstt. Professor

24. – Prevent Noise Pollution:
Noise is defined as “ wrong sound, in the wrong
place at the wrong time”. Residents easily
disturbed by unfamiliar noises. Staff should avoid
loud laughter and loud talking.
 To improve acoustic insulation of building – the
best arrangement is construction of detached
buildings rather than a single large building.
 Control of noise at source.
Mrs. Babitha K Devu, Asstt. Professor

25. – Keeping Floors Maintained:
Floors and other washed surfaces should be made of a
suitable, non-porous material that is resistant to repeated
cleaning with hot water and detergents or disinfectants. This
may be achieved by classifying areas of the health-care
setting into three areas, each with a specific cleaning routine
(WHO, 2002b):
• Sweeping: offices and other non-patient areas; normal daily
domestic cleaning.
• Wet mopping daily: waiting areas, consulting rooms, non-
infectious disease wards,
pharmacy.
• Cleaning with a detergent or disinfectant solution, with separate
cleaning equipment for each room daily, whenever soiled and after
each intervention (in the case of operating suites and delivery
rooms): infectious disease or isolation wards, protective isolation
wards for highly susceptible patients and protected areas, such as
operating suites, delivery rooms, intensive care units, premature
baby units, casualty departments, haemodialysis units, laboratory,
laundry, kitchen, sterilization services.
Mrs. Babitha K Devu, Asstt. Professor

26. – Keeping Floors Maintained:
•Clean, but not slippery
from wax
•Clear of clutter and pills
•Don’t throw rugs
•Make repair of floor on
time
•All surfaces should be easy
to clean by wet mopping
and should be able to
withstand
repeated exposure to hot
water, detergents and
disinfectants.
Mrs. Babitha K Devu, Asstt. Professor

27. – Maintaining Cleanliness:
 Provide cleaning facilities that enable staff to
routinely clean surfaces and fittings to ensure
that the health-care environment is visibly clean
and free from dust and soil.
 Approximately 90% of microorganisms are
present within visible dirt; the purpose of
cleaning is to eliminate this dirt.
 Toilets should be cleaned whenever they are
dirty, and at least twice per day, with a
disinfectant.
 Laundry and surfaces in the health-care
environment are kept clean.
Mrs. Babitha K Devu, Asstt. Professor

28. – Maintaining Cleanliness:
 Remove meal trays and dishes after
use
• Remove crumbs and clean eating areas after use
• Removing dirt and dust controlled by
housekeeping
• Waste containers should be emptied promptly
 Routine programmed cleaning of surfaces and
fittings is carried out to ensure that the health-
care environment is visibly clean, and free from
dust and soil. All horizontal surfaces are cleaned
at least daily and whenever they are soiled.
Mrs. Babitha K Devu, Asstt. Professor

29. – Controlling Pest:
 Remove open food left in units
that will attract rodents and
insects, as well as
microorganisms
•Family and visitors should consult
with charge nurse before bringing
in food for residents
•Ensure proper disposal of food
and waste materials
 Reduce the population density of
disease vectors. Proper waste
disposal, food hygiene, waste
water drainage, and a clean
environment are key activities for
controlling the presence of
vectors. Mrs. Babitha K Devu, Asstt. Professor

30. – Faulty Equipment and Unsafe Conditions:
 Spilled fluids - wiped up immediately
 Any areas contaminated with blood or body
fluids are cleaned and disinfected immediately.
 Chlorine solution (1%) is adequate for cleaning
and disinfecting blood or body fluid spills. Large
spills should first be removed with absorbent
material before disinfecting and cleaning.
 Frayed electrical cords – unplug and remove
 Defective outlets – report immediately and do not
use
 Malfunctioning equipment – remove and do not
use
Mrs. Babitha K Devu, Asstt. Professor

31. – Faulty Equipment and Unsafe Conditions:
 Broken glass - clean up immediately
• Beds or wheelchairs that won’t lock - remove
and do not use
• Faulty toilets – report
 Leaks in bathrooms – wipe
up and report
• Burned out light bulbs -report
• Faulty call signals – replace
immediately
• Defective furniture – remove
if possible and report
Mrs. Babitha K Devu, Asstt. Professor

32. – Faulty Equipment and Unsafe Conditions:
 Structure problems – alert resident to danger and
report to supervisor immediately:
• loose floor tiles frayed or loose carpet
• loose fixtures and hand rails
 doors that stick or don’t latch properly
• damaged paint or wallpaper
Mrs. Babitha K Devu, Asstt. Professor

33. – Water quality:
 Water for drinking, cooking, personal hygiene,
medical activities, cleaning and laundry is safe
for the purpose intended.
 Provide safe drinking-water from a protected
groundwater source (spring, well or borehole), or
from a treated supply, and keep it safe until it is
drunk or used. Untreated water from unprotected
sources can be made safer by simple means such
as boiling or filtering and disinfection.
• Provide water for hand washing after going to
the toilet and before handling food, before and
after performing health care.
Mrs. Babitha K Devu, Asstt. Professor

34. – Water quality:
Minimum water quantity required in the health-care
setting
 Outpatients - 5 litres/consultation
 Inpatients - 40–60 litres/patient/day
 Operating theatre or maternity unit - 100
litres/intervention
 Dry or supplementary feeding centre - 0.5–5
litres/consultation (depending on waiting time)
 Wet supplementary feeding centre - 15
litres/consultation
 Inpatient therapeutic feeding centre - 30
litres/patient/day
 Cholera treatment centre - 60 litres/patient/day
 Severe acute respiratory diseases isolation centre -
100 litres/patient/day
 Viral haemorrhagic fever isolation centre - 300–400
litres/patient/day
Mrs. Babitha K Devu, Asstt. Professor

35. – Ventilation:
 In addition to basic construction and operation
measures, heating, ventilation and air-conditioning, or
filters may be required for specific areas or activities of
the health-care setting.
 All occupied areas of the health-care facility should be
adequately ventilated to meet comfort requirements.
Where infected and susceptible people share the same
air space and there is a risk of airborne transmission of
infection, ventilation rates should be maximized to
dilute and remove any infectious particles.
 Where possible, air should flow into rooms from the top
and out of the room from the bottom (near the floor,
which is generally the most likely contaminated part of
the room), and natural ventilation should be optimized
wherever feasible.
Mrs. Babitha K Devu, Asstt. Professor

36. – Humidity:
Humidity or moisture is always present in
the atmosphere. The amount of moisture
which air can hold depends upon its
temperature. If the relative humidity
exceeds 65 %, the air inside the room feels
sticky and uncomfortable. The relative
humidity below 30 % is also unpleasant.
Mrs. Babitha K Devu, Asstt. Professor

37.  Have we got it?
 Let’s check and see
The Resident’s Room – Furniture
 Note: The student needs to be aware that
each facility has different equipment and
room set-ups.
 Safety features in the resident’s room,
furniture, and equipment is of paramount
importance.
Mrs. Babitha K Devu, Asstt. Professor

38.  BED
• electric or manual controls (gatch)
• side rails (if used)
• positions bed can be in other than flat:
– Fowlers
– Semi-Fowlers
– Trendelenburg
 Wheels that lock
Mrs. Babitha K Devu, Asstt. Professor

39.  OVER-BED TABLE
• Adjusts to various heights
• used for eating, writing, and other activities
• may contain storage area for personal
grooming articles
• may by used by nursing team as work area
Mrs. Babitha K Devu, Asstt. Professor

40.  BEDSIDE STAND
• storage area for personal belongings and
personal care items
• drawer on top
• cabinet with shelf below drawer
Mrs. Babitha K Devu, Asstt. Professor

41.  BEDSIDE STAND CONTAINS
• urinal/bedpan and covers
• wash basin
• emesis basin
• soap dish and soap
• bath blanket
• toilet paper
• personal hygiene items
Mrs. Babitha K Devu, Asstt. Professor

42.  BEDSIDE STAND TOP
 Top used for various items:
• telephone
• tissues
• flowers
• cards
• other items as resident
desires
Mrs. Babitha K Devu, Asstt. Professor

43. CHAIRS
• upholstered with arms
• straight-backed with no
arms
Mrs. Babitha K Devu, Asstt. Professor

44.  PRIVACY CURTAINS
• provide privacy
• cubicle curtain between
beds in semiprivate rooms
• privacy always provided
when care given
Mrs. Babitha K Devu, Asstt. Professor

45. Personal care items
 Call signal
• to request assistance
• bell, light, or intercom
system
• placed within reach at all
times
Mrs. Babitha K Devu, Asstt. Professor

46.  Bathrooms
– contain call signals
– contain handrails
– Contain towel racks
Mrs. Babitha K Devu, Asstt. Professor

47.  Concurrent Cleaning
• Occurs daily
• Also called scheduled
or
routine cleaning
Mrs. Babitha K Devu, Asstt. Professor

48.  Changed completely on bath days, usually once
or twice weekly, according to facility policy
• Pillowcases may be changed more frequently
• Soiled linens should be replaced immediately
Mrs. Babitha K Devu, Asstt. Professor