COMFORT DEVICES USED IN HOSPITAL

COMFORT DEVICES USED IN HOSPITAL (Definition, Purpose, Principles, Preparation, Factors influencing Comfort and Types)

Comfort is a sense of mental and physical well being. Physical comfort gets affected due to a dirty and wet bed and lack of body alignment. High temperature and humidity, poor ventilation too much noise, unpleasant odors and glaring lighting make the patient uncomfortable. To promote comfort for the patients, certain mechanical devices can be used.

Pillows can be used for giving support for the various part of the body. Sometimes – patient feels comfortable in a propped up position. In a hospital, a backrest is provided for the patient to keep him in a sitting position. For relaxation of abdominal muscles, when patients are in pain or after an abdominal operation, knees can be kept flexed by means of a knee rest. Comfort devices are mechanical devices which are used to provide comfort to the patient

DEFINITION

  • Comfort is a state of free from pain and discomfort tension and anxiety
  • Comfort is defined as the contented enjoyment in physical or mental well being freedom from pain or trouble
  • Discomfort is defined as want of comfort or ease due to pain or annoyance
  • Comfort devices are the mechanical devices to promote comfort to the patient
  • Comfort devices are invented articles which would add to the comfort of the patient when used in the appropriate manner, by relieving the discomfort and helping to maintain correct posture

PURPOSE

  • To promote comfort
  • To prevent discomfort
  • To alleviate discomfort
  • To ensure that the patient has rest
  • To assist the patient to obtain an adequate sleep to meet his requirement
  • To maintain correct posture

PRINCIPLES OF COMFORT

  • Definite periods of sleep are a essential component of the circadian rhythm in human being
  • Adequate amounts of sleep are needed for optimal physical and psycho-social functioning of the individual
  • Individual needs for sleep vary with age, growth patterns, health status and individual differences
  • Lack of sufficient sleep impairs a person’s physical functioning, his mental alertness and his social relationship
  • Individual habits vary with regard to bed time rituals
  • Sleep pattern may be disturbed by changes in person’s normal daily living patterns by social and emotional problems by physical problems and by minor irritation or discomforts
  • Sleeps at terms are almost invariable disturbed by illness

PREPARATION OF AIDS

The use of aids for positioning helps to keep the patient in the desired position so as to avoid pressure ulcers developing as well as facilitate the moving of the patient.

  • Aids that help to keep the patient in the desired position, or prevent pressure ulcers developing
  • Decubitus pad or mattress
  • Small or large cushions
  • Feet or elbow pads (or foam rings) for reducing pressure on the skin
  • Trochander roll or other aids to prevent external rotation of the hip
  • A roll (e.g. inflatable) placed under knee
  • Block (box) of foam or inflatable

FACTORS INFLUENCING COMFORT

  • Pain
  • Restriction of movements due to weakness
  • Wrinkled soiled and wet sheets
  • Delayed or inadequate attention to meet the personal needs
  • Lack of exercise
  • Temperature extremes
  • Too bright lights and glares
  • Fear and anxiety due to illness
  • Insecurity feeling
  • Lack of sleep
  • Uncomfortable position
  • Indigestion and irregular bowel movements

The ‘English word ‘hospital’ originates from the Latin word “HOSPILE” and also some viewed that it comes from the French word “hospitale.”

Types of Comfort

  • Relief – the state of having a specific comfort need met
  • Ease – the state of calm or contentment
  • Transcendence – the state in which one can rise above problems of pain

Context in which Comfort Occurs

Physical – pertaining to bodily sensations, homeostatic mechanisms, immune function, etc

Psychospiritual – pertaining to internal awareness of self, including esteem, identity, sexuality, meaning in one’s life, and one’s understood relationship to a higher order or being

Environmental – pertaining to the external background of human experience (temperature, light, sound, odor, color, furniture, landscape, etc)

Sociocultural – pertaining to interpersonal, family, and societal relationships (finances, teaching, healthcare personnel, etc). Also to family traditions, rituals, and religious practices

COMFORT DEVICES/MECHANICAL DEVICES

  • PILLOW – used for support to maintain correct body alignment. Used under head, arms, legs and along spine or abdomen. Correct positioning reduces strain on muscles and joints back rest. Support patients back at an angle, so that he may maintain a sitting position. Can be adjusted to desired angle. Extra pillows are needed. Arms of patient are well supported. Used for patients suffering with cardiac and pulmonary distress

Purposes:

  1. To relieve dyspnea
  2. To promote drainage from abdominal cavity
  3. To provide a comfortable change of position
  • Backrest – it is a mechanical device which provides support for the patient in sitting position
  • Cardiac cradle – it is a frame used to hold the bed linen from touching the patient. It is used to prevent pressure from the weight of linen. It is used to allow air to circulate around lower limbs. Cradle is often a semicircular frame of metal. Maybe made of wood or bamboo. It may be made into a rectangular shape
  • Cardiac table – usually for patients who are propped up in a sitting position for change of position. Bed table placed in front with a pillow on it, patient can lean forward and take rest. Table without pillow is used for writing and meals. It is used for patients with cardiac conditions and asthma. Make it possible to use accessory muscles of respiration. Position should be changed to relieve fatigue and prevent embolism
  • Bed boards – boards are usually made of wood and are placed under the mattress to provide support chairs bed. Beds can be placed into the position of chair for patients who cannot move from the bed but require a sitting position
  • Knee rest – knee rest may be substituted by a pillow, gives relaxation and thus relieves pain on abdominal muscles and tendons beneath the knees
  • Foot rest/board – foot board is the device that is placed towards the foot of patient’s bed to serve as support for his feet. Some fit onto the sides of bed frame and rest on the mattress at any point along the bed. Usually made up of wood/plastic/heavy canvas 
  • Trapeze bar – trapeze bar is suspended from an overhead frame that extends from the foot to head of bed. Patient can grasp the bar to raise the trunk off the bed surface, or to move up in bed
  • Fracture board – fracture board is a support that is placed under patient’s mattress to give added rigidity to the mattress. Usually made of wood/canvas and is constructed to fit the standard hospital bed
  • Balkan frame – Balkan frame is made of wood or metal that extends lengthwise above the bed and is supported at either ends by a pole. Trapeze may be attached to the frame just above patient’s head as an aid to the pt in lifting himself up in bed fracture board
  • Bradford frame – it is a canvas stretcher like device that is supported by blocks on the foundation of bed. It used to immobilize patients who have injured spines. Canvas is divided into 3 parts so that small center portion can be removed to insert a bedpan
  • Trochanter board – trochanter rolls prevents external rotation of legs when patient is in supine position. A cotton bath blanket/sheet is folded lengthwise to width extending from greater trochanter of femur to lower border of popliteal space blanket is placed under the patient until thigh is in neutral position with patella facing upward Bradford frame
  • Sand bags – it provides support and shape to body contours. Immobilize extremities and maintain specific body alignment. They are filled plastic bags that can be shaped to body contours. It can be used in place of or in addition to trochanter rolls
  • Hand rolls – hand rolls maintain thumb in slightly adducted and in opposition to fingers. Maintain fingers in slightly flexed position. It can be made by folding a washcloth in half, rolling in lengthwise and securing roll with rape. Roll is placed against palmar surface of hand sand bags
  • Hand-wrist splints – individually molded for the patient to maintain proper alignment of the thumb in slight adduction and wrist in slight dorsiflexion. These splints should be used for the patient whom the splint was made.
  • Side rails – side-rails are bars positioned along the sides of the length of the bed. Ensure patient’s safety and are useful for increasing mobility. Provide assistance in rolling from side-to-side or sitting up in bed
  • Air and water mattress – these are used for very thin, obese and those who are prone to bed sores. The principle exerted on the bony prominences will be equally distributed in all directions, thus pressure against bony prominences or areas subject to develop pressure sores will be reduced
  • Rubber and cotton rings – it is used to relieve pressure on certain parts of the body like elbows and heels
  • Air cushions – it is used to take off the weight of the body and to relieve pressure on certain parts of the body. Air cushion should not be used directly in contact with the skin. They should have covers
  • Bed blocks – these are made of wood, may be high or low. These are placed under the foot of the bed for various reasons, e.g. surgical shock, traction and postural drainage. This may be placed under the head of bed to promote drainage and improve cerebral circulation. It is used to prevent shock, to arrest hemorrhage, to retain enema and after giving spinal anesthesia
  • Thigh rolls – these are made by folding a sheet to a desired length of 23 feet and then rolled into a tight cylinder. These are used to support the hips and thighs, preventing them outward rotation and keeping the feet in good alignment, in case of paralysis, fracture of the femur or hip surgery. To use the roll, place the lose end (flap) under the patients hips and thighs with the role under the flap end and then tucking snugly along the hip and thigh

TYPES OF COMFORT DEVICES

COLD APPLICATION

HOT APPLICATION

COMFORT DEVICES USED IN HOSPITAL (Definition, Purpose, Principles, Preparation, Factors influencing Comfort and Types)
COMFORT DEVICES USED IN HOSPITAL (Definition, Purpose, Principles, Preparation, Factors influencing Comfort and Types)

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