Resident Rooms Research Articles

Microbial burden on environmental surfaces in long-term care facilities: a quantitative analysis.

We conducted a quantitative analysis of the microbial burden and prevalence of epidemiologically important pathogens (EIP) found on long-term care facilities (LTCF) environmental surfaces. Microbiological samples were collected using Rodac plates (25cm2/plate) from resident rooms and common areas in five LTCFs. EIP were defined as MRSA, VRE, C. difficile and multidrug-resistant (MDR) Gram-negative rods (GNRs). Rooms of residents with reported colonization had much greater EIP counts per Rodac (8.32 CFU, 95% CI 8.05, 8.60) than rooms of non-colonized residents (0.78 CFU, 95% CI 0.70, 0.86). Sixty-five percent of the resident rooms and 50% of the common areas were positive for at least one EIP. If a resident was labeled by the facility as colonized with an EIP, we only found that EIP in 30% of the rooms. MRSA was the most common EIP recovered, followed by C. difficile and MDR-GNR. We found frequent environmental contamination with EIP in LTCFs. Colonization status of a resident was a strong predictor of higher levels of EIP being recovered from his/her room.

Sinop Balatlar Excavation Pebble Mosaic Pavement

During the 2022 Sinop Balatlar Excavation, a pebble stone mosaic floor was unearthed. The design of the mosaic, which adorns the andron room of a private residence, is U-shaped and the east-west kline sections are planned without decoration. The pebble floor placed horizontally and vertically on a pink nucleus is called the “hedgehog” model. Surrounded by ranke, wave and palmette motifs, a small part of the mosaic, which we think shows a flying Eros and his wingtips on it, has been preserved in the southwestern corner of the main panel. It is very important with the placement technique of the stones on it and the pattern repertoire created with white pebbles on a black ground. Compared to contemporary examples, the pebble mosaic dated to the end of the 5th century BC includes the Gordion and Olynthos mosaics, where the mosaic tradition in Asia Minor dates back, it occupies an important place in the ancient mosaic chronology as it indicates its existence in the 5th century BC.

A coronavirus disease 2019 outbreak in a residential living facility with suboptimal ventilation in resident rooms

We report a large outbreak of severe acute respiratory syndrome coronavirus 2 in a residential living facility. Measurements of carbon dioxide levels, aerosol particle clearance, and airflow were used to identify and remediate areas with suboptimal ventilation. A simple intervention involving continuous operation of bathroom fans was effective in significantly improving ventilation in resident rooms.

Containment of a KPC-CRE Outbreak Associated with Premise Plumbing in a Long-Term Care Facility— Minnesota, 2022-2023

Background: On March 23, 2022, the Minnesota Department of Health (MDH) was notified of Klebsiella pneumoniae carbapenemase (KPC)-producing Klebsiella oxytoca isolated from a resident’s urine in long-term care facility A (LTCF-A). Carbapenem-resistant Enterobacterales (CRE) are reportable statewide with required isolate submission to MDH Public Health Laboratory (MDH-PHL), where carbapenemase production and mechanism identification is confirmed. Methods: MDH partnered with LTCF-A on a containment response, including infection prevention and control (IPC) measures, KPC-CRE education, and colonization screening. Rectal swabs were screened for carbapenemase genes by real-time PCR (Cepheid Xpert Carba-R), with positive specimens undergoing culture, isolation, and whole genome sequencing (WGS). MDH-PHL conducted WGS including multilocus sequence typing (MLST) and single nucleotide polymorphism (SNP) analysis to describe genetic relationships among isolates. When screening indicated a potential environmental source, due to species diversity and ongoing resident transmission, an environmental screening plan was developed including collection of premise plumbing samples from room faucets, aerators, sinks, toilets, and shared shower drains. Results: KPC-CRE was detected in 23 residents (urine, n=2; rectal swab, n=21) during March 2022–November 2023. 21 isolates comprising 10 Enterobacterales species were cultured from KPC-positive screening specimens. SNP analysis performed on bacteria of the same species demonstrated 5 distinct clusters of relatedness comprising 2-3 residents per cluster (Cluster 1: Klebsiella oxytoca, n=3; Cluster 2: Klebsiella oxytoca, n=3; Cluster 3: Escherichia coli, n=2; Cluster 4: Klebsiella pneumoniae, n=2; Cluster 5: Raoultella planticola, n=2). 7 KPC-positive resident specimens did not yield a culturable organism. KPC-CRE was detected throughout the premise plumbing including 8 of 9 shared shower room drains and 6 of 75 resident room sink drains. WGS and SNP analysis suggest relatedness among resident and environmental KPC-CRE isolates. Gaps in IPC measures including hand hygiene, use of personal protective equipment (PPE), environmental cleaning and disinfection, and sink hygiene practices were observed during onsite assessments. Use of an EPA-registered biofilm disinfectant in facility drains and repeated environmental sampling has demonstrated a decrease in KPC-harboring bacteria within the premise plumbing, but not complete elimination. Conclusion: Containing the spread of KPC-CRE within LTCF-A has been challenging due to environmental reservoirs of KPC-CRE along with insufficient implementation of IPC practices. Continued colonization screening has been necessary to detect newly colonized residents and reinforce efforts to increase IPC compliance. Strict implementation and adherence to IPC measures, including those that minimize the spread of KPC-CRE from facility premise plumbing, are needed to fully halt KPC-CRE transmission within LTCF-A.

Reducing Stool Ova and Parasite Testing in Patients Admitted to the Hospital with Acute Diarrhea

Introduction & Background: A significant number of patients are either admitted to the hospital for acute diarrhea or develop diarrhea during their admission. Frequently stool O&P testing is ordered as part of the workup for acute diarrhea when it is not clinically indicated, leading to an increased financial burden on both the patient and the hospital. Aim & Significance: To reduce the overuse of inpatient stool O&P testing by instructing residents on the appropriate criteria for ordering this test in patients with acute diarrhea. Methods & Design: Infectious Disease Society of America and American College of Gastroenterology guidelines for acute diarrheal infections in adults were reviewed and a simplified flowsheet was created based upon their recommendations for indications for Stool O&P testing. The flowsheets were then placed in easy to view locations in the resident work rooms. Baseline data was collected by pulling the number of stool O&P tests ordered by the resident teaching service for the 3 months leading up to the intervention. Data from the same teaching services were pulled once again 3 months after the intervention had been performed. Results: After the intervention, there was an 18% decrease in stool O&P orders placed by the resident teaching services. Discussion: Overutilization of stool O&P testing and the associated financial burden can be reduced by providing education regarding the appropriate indications for ordering this test in patients with acute diarrhea.

Zeal Nexus - Student Abode

Abstract: Effective and thorough processes are critical to the successful operation and management of hostel facilities in the field of hostel management. An effective hostel administration system called Zeal Nexus was created. to use the MERN stack technology to meet these goals. Scalability, usability, and integration possibilities are frequently hampered by the complexity of the current hostel administration systems. These difficulties may make it more difficult to manage hostel operations effectively, which could have an impact on both resident satisfaction and administrative effectiveness. We suggest building the Zeal Nexus, a cutting-edge, comprehensive hostel management system that makes use of the MERN stack—MongoDB, Express.js, React, and Node.js—in order to address these problems. This potent technology stack will be used in our project to create a scalable, responsive, and intuitive Platform. It simplifies the administration of hostels. A wide range of tools for handling resident data, room assignments, maintenance requests, and financial transactions will be available through the Zeal Nexus, all inside a single, easily navigable interface.

The impact of facility and staff characteristics on infection control of COVID-19: Perceptions of elder care home managers in Stockholm, Sweden.

To examine the perceptions of managers of elder care homes on the impact of facility and staff characteristics on infection control of COVID-19. Case study. Six purposively sampled care home managers in the city of Stockholm were interviewed. Through content analysis, three categories and nine subcategories were identified. According to the interviewed care home managers, a home-like environment that allows for isolation of residents and possibilities for staff to get changed and store personal protective equipment outside each resident's room was considered ideal. Experienced employees were reported as invaluable when facing an infectious outbreak. A mix of permanent and temporary staff was considered essential although some thought that temporary staff who work in multiple care homes might negatively influence the spread of infection. Language barriers among staff were considered an obstacle when trying to disseminate information.

Analysis of conditions and nature of work of therapists: A literature review

Introduction: Currently, insufficient attention is paid to nonspecific negative factors of the working environment of therapists, such as exposure to electromagnetic fields from electronic devices, lack of standards for the area of working premises (residence rooms), and non-compliance with the optimal work/rest schedule. Objective: Based on the analysis of literature data, to identify contemporary nonspecific risk factors at workplaces of general practitioners and outline the main ways of their prevention. Materials and methods: We have reviewed scientific publications indexed in international (Web of Science, Scopus, PubMed) and domestic (RSCI) databases for 2014–2023. Of more than 2,000 sources found, we selected 89 given the keywords and then included 49 papers published over the past 5 years in the review. Results: Modern therapists are exposed to combined physical and biological factors and experience psychological stress, leading to a higher incidence of work-related diseases. Long-term exposures to risk factors of the work environment increase the risk of job burnout and psychological maladjustment resulting in negative personality changes, deterioration of health and relationships with colleagues, patients, relatives and, ultimately, a decrease in the effectiveness and quality of medical care provided. Conclusions: We have considered and systematized factors of the work environment of therapists with a focus on less studied, but no less significant current nonspecific negative factors, and outlined the main directions for solving the problem of maintaining health of medical professionals.

RECRUITMENT OF PERSONS WITH COGNITIVE IMPAIRMENT FROM LONG-TERM CARE SETTINGS

Abstract Research that includes persons with cognitive impairment is important to develop evidence-based care to improve outcomes. Long -term care settings have a large proportion of residents with cognitive impairment; but recruitment is known to be difficult. The purpose of this study was to compare the effectiveness of recruitment methods for a randomized controlled clinical trial of persons with cognitive impairment in 15 long-term care communities. This study utilized a retrospective, descriptive design. Sites were recruited and site characteristics recorded. Residents were recruited to participate in the study based on combinations of 12 recruitment strategies. Recruitment data was analyzed at the level of site, research staff member, and participant level. Over the study period, 279 older adults were screened and 172 enrolled. The participants were cognitively impaired. Research staff spent 39-89 hours recruiting at each site and utilized an average of four different recruitment methods per site. The most common and efficacious method was introductions of participants by site contacts. Cost of recruiting averaged $1490 per site and was correlated to the number of resident rooms (r=.60, p=0.17). Those sites with a recruiter enrolled more participants (M=14.67, S.D. 4.55) than those without a recruiter (M=9.3, S.D. 2.55), t(13) = -2.92, p=.012. Recruitment of older adults with cognitive impairment from long term care communities requires multiple methods of recruitment; skilled recruitment staff, and trust with the LTC community staff and potential participants.

Contactless fall detection with radio frequency sensors for the aging population

AbstractBackgroundFalls remain a primary concern for People with Dementia (PwD) living in long‐term care facilities (LTCFs) despite many prevention and intervention methods that have tried. Current fall detection monitoring systems use wearable or vision‐based sensors. The problem is research has shown that many seniors will not consistently wear a device on their body or allow cameras in their living space because of privacy concerns that severely limit the technology user acceptance. The current standard of care is self‐report or eyewitness and therefore fall events are often undetected and underreported due to human error. Hence, we are proposing a solution to address this unmet need with a novel fall management system engineered with radio frequency (RF) sensors that do not require an individual to wear or interact with a device.MethodSix healthy participants simulated three types of falls, medial and lateral, anterior and posterior, and collapse in the Dementia and Elderly Care Robotics and Sensing (DECRS) Lab, University of Minnesota Duluth. The sensor was installed in the lab as it would be in the resident room of an LCTF. The simulated room included a bed, chair, and mattress on the floor to protect the participants.ResultOur study found that the contactless fall detection and activity system identified falls at overall sensitivity rate of 89% with a specificity of 100% in 748 tests and activity was identified at 90%. Our system identified “medial and lateral” falls with a 92% sensitivity, “anterior and posterior” falls with a 91% sensitivity, and “collapse” falls with a 75% sensitivity.ConclusionContactless sensing holds tremendous potential for monitoring individuals living with AD/ADRD and the elderly population for aging in place. LTCFs that are short staffed could benefit by utilizing tools that augment the capabilities of nurses with a continuous collection of patient‐generated health data (PGHD) and a notification system that is integrated with existing workflows and only send alerts for potential events that would require immediate attention.

Contactless fall detection with radio frequency sensors for the aging population

AbstractBackgroundFalls remain a primary concern for People with Dementia (PwD) living in long‐term care facilities (LTCFs) despite many prevention and intervention methods that have tried. Current fall detection monitoring systems use wearable or vision‐based sensors. The problem is research has shown that many seniors will not consistently wear a device on their body or allow cameras in their living space because of privacy concerns that severely limit the technology user acceptance. The current standard of care is self‐report or eyewitness and therefore fall events are often undetected and underreported due to human error. Hence, we are proposing a solution to address this unmet need with a novel fall management system engineered with radio frequency (RF) sensors that do not require an individual to wear or interact with a device.MethodSix healthy participants simulated three types of falls, medial and lateral, anterior and posterior, and collapse in the Dementia and Elderly Care Robotics and Sensing (DECRS) Lab, University of Minnesota Duluth. The sensor was installed in the lab as it would be in the resident room of an LCTF. The simulated room included a bed, chair, and mattress on the floor to protect the participants.ResultOur study found that the contactless fall detection and activity system identified falls at overall sensitivity rate of 89% with a specificity of 100% in 748 tests and activity was identified at 90%. Our system identified “medial and lateral” falls with a 92% sensitivity, “anterior and posterior” falls with a 91% sensitivity, and “collapse” falls with a 75% sensitivity.ConclusionContactless sensing holds tremendous potential for monitoring individuals living with AD/ADRD and the elderly population for aging in place. LTCFs that are short staffed could benefit by utilizing tools that augment the capabilities of nurses with a continuous collection of patient‐generated health data (PGHD) and a notification system that is integrated with existing workflows and only send alerts for potential events that would require immediate attention.

Predictors of multidrug-resistant tuberculosis in a teaching hospital in Ghana: A case-control study.

Multidrug-resistant Tuberculosis (MDR-TB) remains a global health concern. The disease results in a prolonged treatment and hence, poses a financial burden to affected individuals and their families. The Ghana National TB Control Programme (NTP) has made extensive efforts to control the menace, however, it remains a concern. This study, therefore, aimed to determine the predictors of multidrug-resistant TB in the Cape Coast Teaching Hospital of Ghana. An unmatched case-control study involving 37 cases and 111 controls was conducted using data of TB cases registered for treatment between January 2018 and December 2020 at the Cape Coast Teaching Hospital. Socio-demographic, individual level and social characteristics information were collected from respondents through telephone surveys, face-to-face interviews and review of records using a structured questionnaire built in the Kobo Collect Toolbox. The data was exported to Stata version 16.0 for analysis. Chi-square test and multiple logistic regression were used to determine the predictors of MDR-TB. Associations were considered statistically significant at a 95% confidence interval with a p-value of less than 0.05. The results revealed that the majority (25 [67.6%]) of MDR-TB cases and controls (76 [68.5%]) were aged 30 years and above with a median age of 36.5 (IQR: 28-50) years for all respondents, while 20 (54.1%) of MDR-TB cases and 33 (29.7%) of controls lived in households with one room residences for their families. The following predictors for MDR-TB were identified: BCG vaccination status (AOR = 0.17,95% CI:0.07-0.45), long distance to health facility (AOR = 4.11, 95% CI: 1.55-10.87), number of rooms in residence (AOR = 0.37,95% CI: 0.14-0.99) and first place of visit upon noticing TB symptom (AOR = 4.22,95% CI:1.31-13.64). Predictors of MDR-TB in the current study were multi-faceted. Measures to control MDR-TB should target socio-demographic, health-seeking behaviour and social-related concerns.

Air purifiers for reducing the incidence of acute respiratory infections in australian residential aged care facilities: A study protocol for a randomised control trial.

Adults living in Residential Aged Care Facilities (RACFs) are highly susceptible to seasonal respiratory infections. Evidence indicates that the aerosols contaminated with virus particles in closed indoor spaces may play a significant role in the transmission of respiratory infections. In this protocol paper, we outline details of a planned RCT which aims to evaluate the effectiveness of portable in room air purifiers in reducing the risk of ARIs among residents in Australian RACFs. This study uses a multi-centre double-blind randomised crossover design. Three RACFs in a regional area of New South Wales will be invited to participate in the study. Air purifiers with or without high-efficiency particulate absorbing (HEPA) filters will be placed in the rooms of residents who are enrolled in the trial. The primary outcome will be a reduction in the incidence of ARI and the secondary outcomes will be the time to first infection, number of emergency department admissions, hospital admissions, and medical consultations due to an ARI. To our knowledge, this will be the first RCT using air purifiers in resident rooms to identify their effect in reducing ARIs in RACFs. If our findings indicate some potential benefit for in-room air purification, it will help provide support and justification for larger trials, which may include a facility wide approach to air purification.

"THE RHINOCEROS" BY EUGÈNE IONESCO AND "TANGO" BY SLAVOMYR MROŻEK: SPECIFIC FEATURES OF THE SPACE-TIME ORGANIZATION

The article analyzes the characteristic features of organizing artistic time and space on the example of the plays "Rhinoceros" by E. Ionesco and "Tango" by S. Mrożek, which are traditionally considered classic examples of European theatre of the absurd. The basis of the nature of the theatre of the absurd is the destruction of the stage illusion, which manifests itself in various formal and content categories, among which the key role belongs to the chronotope.
 Common to the dramas of both authors is the space-time, which can mostly be characterized as conditional, undefined and without specific historical signs. Actors who function in such a chronotope are to a certain extent abstract, devoid of individual features. In the drama "Rhinoceros" time is outlined only cursorily in the remarks, which makes it impossible to determine a specific historical dimension and transports the viewer into a certain kind of conditional timelessness, emphasizing the universality of the idea. The artistic space, subject to the general logic of the plot, thickens with each action, shrinks from the size of the square of a provincial town to a room, and the main character, finding themself in a dead end, realizes their doom and the only possible need to fight for the preservation of their own human nature.
 In the drama "Tango" the mixing of time layers can be traced in an arbitrary way, which is additionally emphasized by a specific construction of space, the main feature of which is chaos. The first and second acts represent the living room of a solid residence of a Polish middle-class family of the early twentieth century, but all the interior elements are in complete disarray, which is a reflection of the anarchic views of the characters, permissiveness and leveling of traditions. In the third act, instead, we see the previous living room, in which order and coziness reign, but this very demonstratively ordered space contrasts sharply with the attempt to make death and violence an integral part of the ideology.

Using Lean Six Sigma Methodology to Improve Resident Engagement

An engagement survey was administered in 2018 to all physicians at our institution, including residents and fellows. The results showed very low engagement scores among trainees, which focused the attention of hospital administration. In response, the Process Improvement Office (PIO) was tasked by administration to collect information about residents' concerns. A Lean Six Sigma performance improvement technique, the “waste walk,” was chosen. Lean Six Sigma is a management technique originally developed in the manufacturing sector, but now frequently used in health care settings. Lean methodology identifies specified wastes that lead to inefficiency in production, and Six Sigma methodology aims to decrease error.1,2 A waste walk is a structured visit to the workplace (the hospital, in this case) to identify 8 Lean waste types (defects, overproduction, waiting, non-utilized talent, transportation, inventory, motion, and extra processing), in order to prioritize improvement opportunities.The PIO conducted a series of waste walks to cover areas of the hospital where inefficiencies were expected or where it was suspected that waste would impact patient care. Specific programs with large hospital-based services were included, with residents selected to be included in the observations by their program directors and chief residents. Evening and overnight shifts were included in the sampling. Observations were conducted by staff from the PIO and included Lean Six Sigma Green Belts (intermediate) and Black Belts (management). Observers shadowed the resident for all clinical activities during their shift, including their interactions with patients and other staff. Observers made note of all Lean wastes noted. Over a 1-month period, 23 residents covering 20 different services and representing 16 training programs were observed, constituting 183 hours of shadowing by PIO staff. The observations were collated and categorized to the 8 Lean waste types. All trainees were then able to vote on the issues that were of greatest importance to them.Opportunities identified included issues with communication, availability of equipment, admission process for transfer patients, residents performing duties outside their scope, (eg, cleaning equipment, making appointments), and resident staffing issues. Most residents identified procedure scheduling and transfer of patients as major issues to be addressed. Tangible results of the process included improvements in information availability in the electronic medical record for outside transfers, allocation of resources to improve a resident work room, and establishment of a working group to improve handoffs. In the 2 years following the intervention, there were 12 resident-run quality improvement projects concerning communication. Education vs service scores in the Accreditation Council for Graduate Medical Education Resident/Fellow Survey improved from the 72nd percentile in 2019 to the 93rd percentile in 2020. Resident engagement scores in the 2 years following improved to a score of 4.08 out of 5. While the sources of these improvements were multifactorial, the waste walk was a tangible demonstration to the residents of the institution's commitment to them and its interest in their voices. The walks also educated the administration in the day-to-day systemic obstacles residents face in providing care.The authors acknowledge the assistance of the staff of the Process Improvement Office of Cooper Health System.

Handle Selection of Storage Furniture for Modern Minimalist Residence at Lavon Swan City, Tangerang

Furniture design is very influential on the overall appearance in interior design. The selection of models, 
 materials, finishing, to accessories such as handles is a determining aspect that will affect furniture design. Storage 
 function is the most important function of a furniture. Storage systems in furniture have several aspects of 
 consideration such as the size of the storage area, the open-close system of the storage area, including the 
 model and material of the handle. Harmonization of handle design and the furniture would strengthen the furniture 
 impression received by the user and the observer. The purpose of this research is to determine the characteristics of 
 storage furniture handle for living room of modern minimalist residence at Lavon Swan City, Tangerang. Qualitative 
 method with collection and analysis based on relevant theories and reviewing similar research is used in the process 
 of making the study by referring to the Kilmer design method. Thereupon from this study, it can be seen that 
 furniture handle designs that are suitable for designing modern minimalist house storage furniture Lavon Swan City 
 are cut-out and tip-on-swing type handleless design.

Effects of portable air filtration on submicrometer- and micrometer-sized particle deposition and concentration in a natural ventilated skilled nursing facility

Older adults are highly vulnerable to respiratory diseases. Effective engineering controls are critical to reduce transmission risk via airborne particles, particularly in spaces where older adults reside (e.g., skilled nursing facilities; SNF). We thus investigated how recirculating portable air filtration (PAF) units and natural ventilation influenced airborne particle travel via the direct aerosol (i.e., representing airborne transmission) and indirect aerosol (i.e., representing fomite transmission) routes. A breathing simulator atomized fluorescein-tagged submicrometer- (0.6–0.7 μm) and micrometer-sized (2 μm) particles simultaneously utilizing a physiologically-correct inhalation-exhalation waveform, with the breathing simulator outlet connected to an anatomically-correct respiratory manikin. Experiments involved two SNF resident rooms, the ‘infector’ and ‘susceptible’ rooms, with the former room containing the breathing simulator (i.e., proxy infected resident) and the latter room representing a susceptible resident's room. Observations revealed that despite PAF units enhancing deposition velocities for submicrometer- and micrometer-sized particles, effective deposition fluxes of submicrometer-sized particles were significantly lower during PAF use versus the Baseline Condition. Further, PAF units increased the effective air exchange rate by ∼3.7–4.5x for submicrometer- and micrometer-sized particles, respectively, resulting in significantly lower particle concentrations (>60%) for these particle sizes versus the Baseline Condition. While natural ventilation significantly reduced submicrometer- and micrometer-sized particle concentration and deposition, cross contamination between rooms was identified when natural ventilation was the singular ventilation solution. Observations validated our previous studies in that particle deposition is non-negligible in smaller rooms with poor ventilation and that PAF units are recommended to supplement natural ventilation and best limit airborne particle concentration and deposition.

The Effects of an Advanced Air Purification Technology on Environmental and Clinical Outcomes in a Long-Term Care Facility.

Long-term care facilities (LTCFs) are constantly working to reduce sources of infectious pathogens to improve resident care. LTCF residents are particularly susceptible to health care-associated infections (HAIs), many of which originate from the air. An advanced air purification technology (AAPT) was designed to comprehensively remediate volatile organic compounds (VOCs) and all airborne pathogens including all airborne bacteria, fungi, and viruses. The AAPT contains a unique combination of proprietary filter media, high-dose ultraviolet germicidal irradiation, and high-efficiency particulate air (HEPA) filtration. The AAPT was installed in an LTCF's heating, ventilation, and air-conditioning ductwork and 2 floors were studied: the study floor with comprehensive AAPT remediation and HEPA filtration and the control floor with only HEPA filtration. VOC loading and airborne and surface pathogen loading were measured in 5 locations on both floors. Clinical metrics such as HAI rates were also studied. There was a statistically significant 98.83% reduction in airborne pathogens, which are responsible for illness and infection, an 89.88% reduction in VOCs, and a 39.6% reduction in HAIs. Surface pathogen loading was reduced in all locations except 1 resident room where the detected pathogens were linked to direct touch. The removal of airborne and surface pathogens by the AAPT led to a dramatic reduction in HAIs. The comprehensive removal of airborne contaminants has a direct positive impact on resident wellness and quality of life. It is critical that LTCFs incorporate aggressive airborne purification methods with their current infection control protocols.

HANDLE SELECTION OF STORAGE FURNITURE FOR MODERN MINIMALIST RESIDENCE AT LAVON SWAN CITY, TANGERANG

Furniture design is very influential on the overall appearance in interior design. The selection of models, materials, finishing, to accessories such as handles is a determining aspect that will affect furniture design. Storage function is the most important function of a furniture. Storage systems in furniture have several aspects of consideration such as the size of the storage area, the open-close system of the storage area, including the model and material of the handle. Harmonization of handle design and the furniture would strengthen the furniture impression received by the user and the observer. The purpose of this research is to determine the characteristics of storage furniture handle for living room of modern minimalist residence at Lavon Swan City, Tangerang. Qualitative method with collection and analysis based on relevant theories and reviewing similar research is used in the process of making the study by referring to the Kilmer design method. Thereupon from this study, it can be seen that furniture handle designs that are suitable for designing modern minimalist house storage furniture Lavon Swan City are cut-out and tip-on-swing type handleless design.

COMMUNICATION AND WORKFLOW ON A TYPICAL DAY IN NH VERSUS A DAY WITH A CHANGE IN RESIDENT CONDITION

Abstract A major reason technologic innovations for nursing home (NH) communication have not worked is because testing of technology fails to consider workflow of the environment. The aim of this observational study was to examine communication and workflow surrounding assessment of NH residents on a dementia care unit with suspected UTI to establish baseline data prior to introduction of technology to enhance NH staff communication. The flow of communication between CNAs, LVNs, and PCPs was recorded using a structured observation on an online survey platform. For a 3-month period, 3 days a week, an observation period from 7am to 11am was chosen to reflect one peak staff interaction time. Field notes describing the environment and what was being talked about during communication events were analyzed using content analysis. A total of 185 communication events were recorded by 3 trained observers, yielding 22 assessments for change in condition (pain, UTI, falls). The LVN was the center of 44% of communication. After the LVN assessed the resident, 43% of the time no further action was taken by the LVN; 17% of the time the PCP was texted about a change in condition. Types of change in condition was limited. Workflow surrounding LVN collection of information on days related to change in condition reflected focused communication among staff occurring away from resident rooms and nurses’ station. The NH is a stable environment for provision of nursing care, thus suggesting communication technology can be accepted by staff and added into the care routine.