HYGIENIC ASSESSMENT OF THE CONDITIONS OF PSYCHIATRIC MEDICAL STAFF IN HEALTH CARE FACILITIE

The article presents an analysis of the incidence of mental disorders in Ukraine and European countries, describes the WHO action plans for the mental health of the planet, and ways to overcome the incidence of mental and behavioral disorders. The complication of deinstitutionalization (reduction of psychiatric hospitals and reduction of days in them) in European countries and the creation of new institutions, conditions of stay in a nearby “therapeutic/healing environment”, which return about 90% of patients to independent living in the community. In Ukraine, the process of deinstitutionalization reduced psychiatric facilities by 34.7% but, no new premises have been building, and the old premises of psychiatric hospitals, which have been building from 1786 to 2013, were not reconstructed according to the old sanitary and hygienic requirements – the socalled “corridor system”, which did not take into account the comfort for mentally ill patients, but only stay/treatment for a long time up to 53 days (up to 33 days in the Ministry of Health) for 20 days in European countries. With an increased incidence of mental disorders in Ukraine (2015) by 9.4% compared to European countries – 3.8% of the total population, the staff decreased to 21.4% for the period 2010/2017. In Ukraine, which leads to the use of existing hospitals with their overcapacity and higher workload of health workers, and conditions for both the mentally ill and medical staff have not improved.

Seclusion in an enriched environment versus seclusion as usual: A quasi-experimental study using mixed methods

Background For patients, seclusion during psychiatric treatment is often a traumatic experience. To prevent such experiences, adjustments in the design of seclusion rooms have been recommended. Methods As there have been no empirical studies on the matter, we used a quasi-experimental design to compare the experiences in seclusion of two groups of patients: 26 who had been secluded in a room designed according to the principles of healing environment, a so called ‘Enriched Environment Seclusion room’ (EES), and 27 who had been secluded in a regular seclusion (RS) room. The enrichment included audio-visual facilities, a fixed toilet, a couch and a self-service system to adjust light, colour, blinds and temperature according to the patient’s preferences. Insight into their experiences was obtained using the Patient View-of-Seclusion Questionnaire, which comprises nine statements on seclusion, supplemented with open-ended questions. Results The responses regarding seclusion experiences between the two groups did not differ significantly (U = 280.00, p = .21, r = -.17). Although those who had been secluded in the specially designed room had greatly appreciated the opportunities for distraction, and those who had been secluded in a regular seclusion room expressed the need for more distracting activities during seclusion, both groups described seclusion as a dreadful experience. If seclusion cannot be avoided, patients recommend facilities for distraction (such as those provided in an enriched environment seclusion room) to be available. Conclusion Whatever the physical environment and facilities of a seclusion room, we may thus conclude that seclusion is a burdensome experience.

Achieving effective patient outcomes with PolyMem® Silicone Border

Clinicians are under increasing pressure to provide high-quality patient outcomes at a reduced cost. Increasingly, community staff must acquire knowledge on advanced wound care products to cope with the growing caseload demands. This article describes the use of PolyMem® dressings to reduce pain, inflammation, oedema and bruising and their ability to debride and absorb exudate while providing an optimum healing environment. The PolyMem range includes multifunctional dressings for various painful chronic wounds. This article also presents five case studies with particularly good patient outcomes where PolyMem dressings were the primary dressing. All five patients were holistically assessed to enable consistent evidence-based treatment decisions. In four cases, the new PolyMem Silicone Border dressing was used. The patients found the PolyMem Silicone Border dressing comfortable and gentle on removal even when the skin was extremely fragile. The right dressing used at the right time on the right patient can improve patient outcomes.

Design of a cancer shelter with a healing environment approach

Indonesia, in an increasingly modern era of globalization, is also increasingly changing people’s lifestyles into entirely instant. The pattern of consuming fast food due to dense activities without considering the effects caused by these foods is one kind of modern lifestyle in Indonesia. Cancer is a disease that is quite malignant and feared by many people. In Jakarta, the prevalence is moderate for cancer, which is 1.9%, with the number of hospitals in West Jakarta, namely the hospital. Dharmais hospital, which is a national cancer centre in Jakarta. Therefore, due to limited hospital facilities and to help people living with cancer at the same time help provide temporary shelter while waiting for a therapeutic schedule at the hospital and also help cure cancer patients by applying the healing environment situation through this thesis entitled Planning a Cancer Shelter with Healing Approach Environment in the Dharmais hospital area, West Jakarta.

Prevention and management of moisture-associated skin damage

Disruption to the integrity of the skin can reduce patient wellbeing and quality of life. A major cause of skin breakdown is prolonged exposure to moisture, but this is often overlooked. When skin is wet, it becomes more susceptible to damage from friction and shearing forces, and skin flora can penetrate the disrupted barrier, causing further irritation and inflammation. If untreated, moisture-associated skin damage (MASD) can rapidly lead to excoriation and skin breakdown. MASD includes incontinence-associated dermatitis (IAD), which is caused by prolonged skin exposure to urine and stool, particularly liquid stool. For patients at a high risk of developing IAD, preventive measures should be instituted as soon as possible. The main one is to prevent excessive contact of the skin with moisture. Optimal skin care should be provided to patients with any form of MASD. It should be based on a structured regimen and include the use of a gentle skin cleanser, a barrier product and moisturiser. Derma Protective Plus is a liquid barrier that gives long-lasting protection against chafing or ingress of urine and stool into the skin. This product is less greasy than others, and provides a barrier and a healing environment, with resistance to further maceration from IAD or persistent loose stools.