12 ATI - Client Safety Flashcards
_____ is freedom from injury. Providing for safety and preventing injury are major nursing responsibilities.
safety
Many factors affect the client’s ability to protect himself. Those factors include the client’s age, with the young and old at greater risk, ______, cognitive and sensory awareness, emotional state, ability to communicate, and lifestyle and ______.
mobility
safety awareness
It is the provider’s responsibility to assess, report, and document clients’ allergies and to provide care that avoids exposure to ______.
allergens
Use risk assessment tools to evaluate clients and their ______ for safety.
environment
Encourage clients to _____ and take an active role in their health care and in preventing errors.
speak up
Create a culture of ______ to avoid errors when working in stressful circumstances.
checks and balances
Communicate _____ and plans of care to clients, family, and other staff.
risk factors
Use _____ for responding to dangerous situations.
protocols
Adopt quality care _____ from the National Quality Forum, including “Never Events.”
priorities
Use current evidence to promote a culture of safety, while using the ______ as a guide.
National Patient Safety Goals
Know the facility’s disaster plan, understand the chain of command and roles , and use common _______ when communicating with the team.
terminology
Identify and document incidents and responses according to the facility’s policy. These reports help identify _____, patterns, and the root cause of adverse events.
trends
Know the location of _____ and hazardous chemicals in the environment.
safety data sheets
Use equipment only after adequate instruction and _____.
safety inspection
Older adult clients can be at an increased risk for falls due to _______, impaired mobility and balance, improper use of mobility aids, unsafe clothing, environmental hazards, endurance limitations, and decreased sensory perception.
decreased strength
Other clients at increased risk for falls include those with decreased visual acuity, generalized weakness, urinary frequency, gait, balance problems, and _______.
cognitive dysfunction
Adverse effects of medications can also increase the risk for ____.
falls
Clients are at greater risk for falls when they have more than one ______.
risk factor
Prevention of client falls is a ____ nursing priority. Nurses must evaluate all clients in health care facilities. for risk factors for falls and implement _____ accordingly.
major
preventative measures
______ to prevent falls are essential for settings that provide services to older adult clients.
Programs
Health care facilities must _____ prevent falls, especially because Medicare and Medicaid no longer reimburse for treating injuries resulting from falls.
actively
Complete a _____ for each client at admission and at regular intervals. Individualize the plan for each client according to the results of the ________.
fall risk assessment
fall risk assessment
Be sure the client knows how to use the _____ ( by giving a return demo) that is in reach and to encourage its use.
call light
_____ to call lights in a timely manner.
respond
Use fall risk alerts, such as ____.
color coded wrist bands
Provide regular toileting and _______ of clients who have cognitive impairment.
orientation
Provide adequate _____ to prevent falls.
light
Orient client to the setting to make sure they know how to use all _____ and can locate necessary items to prevent falls.
assistive devices (grab bars)
Place clients at risk for falls near the _____.
nurses station
Provide ____ rounding to prevent falls.
hourly
Make sure bedside tables, overbed tables, and frequent use items (telephone, water, facial tissues) are ______ to prevent falls.
within reach
Keep the bed in the _____ and lock the brakes to prevent falls.
low position
For clients who are sedated, unconscious, or otherwise compromised, keep the ______ to prevent falls.
keep the side rails up
Avoid the use of full side rails for clients who get out of bed or attempt to get out of bed without ______ when trying to prevent falls.
assistance
Provide _____ and nonskid bath mats for use in tubs and showers to prevent falls.
nonskid footwear
Use ____ and additional safety equipment when moving clients to prevent falls.
gait belts
Keep the floor clean, dry, and ______ with a clear path to the bathroom to prevent falls.
free from clutter
Keep assistive devices ____ after validation of safe use (eyeglasses, walkers, transfer devices ) to prevent falls.
nearby
Educate the client and family about safety risks and the plan of care. Clients and family who are aware of risks are more likely to ______.
call for assistance
Lock the wheels on beds, wheelchairs and carts to prevent them from ____ during transfers or stops.
rolling
Use _____ devices, such as chair or bed sensors, for clients at risk for getting up without assistance to alert staff of independent ambulation.
electronic safety monitoring
Report and document all incidents. This provides valuable information that can help prevent ____.
similar incidents
A _____ is a sudden surge of electrical activity in the brain. It can occur at any time due to epilepsy, fever, or a variety of medical problems.
seizure
Partial seizures, also called _____ are due to electrical surges in one part of the brain, and generalized seizures involve the _____.
focal seizures
entire brain
Status epilepticus, _______, is a medical emergency.
a prolonged seizure
Seizure precautions, measures to protect clients from injury during a seizure, are imperative for clients who have a ____ of seizures that involve the entire body and/or result in unconsciousness.
history
Make sure rescue equipment is at the bedside, including, oxygen, an oral airway, _____, and padding for the side rails for patients with a history of seizures.
suction equipment
Clients at high risk for generalized seizures should have a ____ in place for immediate IV access
saline lock
Ensure rapid intervention to maintain _____ patency for patients with a history of seizures..
airway
Inspect the client’s environment for items that could cause injury during a seizure,and remove items that are not necessary for ______ patients with a history of seizures.
current
Assist clients at risk for seizures with ambulation and transferring to reduce the risk of _____ for patients with a history of seizures.
injury
Advise all caregivers and family not to put anything in the client’s _____ (except an airway for status epilepticus) during a seizure.
mouth
Advise all caregivers and family not to restrain the client during a seizure but to lower him or her to the ____ or bed, protect his head, remove nearby furniture, provide privacy, put him/her on their _____ with their head flexed slightly forward if possible and loosen his clothing.
floor
side
During a seizure _____ with the client and call for help.
stay
During a seizure maintain airway patency and _____ PRN.
suction
During a seizure ____ medications.
administer
During a seizure note the duration of the seizure and the sequence and _____.
types of movements
After a seizure, determine mental status and measure oxygenation saturation and _____. Explain what happened, and provide comfort, understanding and a quiet environment for recovery.
vital signs
Document the seizure with any ________ and a description of the event (movements, injuries, duration of seizures, aura, postical state), and report to the provider.
precipitating behavior
Nurses must know and follow federal, state, and facility policies for the use of ____.
restraints
Some clients require seclusion rooms and or ____.
restraints
In general, use seclusion or restraints for the shortest duration necessary and only if less ______ measures are not sufficient. They are for the physical protection of the client or the protection of other clients or staff.
restrictive measures
Clients may voluntarily request temporary seclusion if the environment is ______ or seems too stimulating.
disturbing
Restraints can be either physical or _____.
chemical
Restraints can cause ______, including pneumonia, incontinence, and pressure ulcers.
complications
It is inappropriate to use seclusion or restraints for: convenience of the staff; punishment for the client; clients who are extremely physically or mentally unstable; clients who cannot tolerate the ______ of a seclusion room.
decreased stimulation
Restraints should never ____ w/ treatment
interfere
Restrains should restrict movement as _____ as is necessary.
little
Restraints should fit properly and be as _____ as possible.
discreet
Restraints should be _____ to remove or change.
easy
When all other less restrictive means have failed to prevent a client from harming himself or others, the following much occur before using seclusion or restraints. The provider must prescribe seclusion or restraints in writing, after a ______ assessment. The prescription must include the reason for the restraints, the type of restraints, the location of the restraints, how long to use the restraints, and the type of behavior that warrants using the restraints. The prescription allows only ___ hr of restraints for an adult, 2 hours for clients ages 9-17 and 1 hour for clients under 9 years of age. Providers may renew these prescriptions with a maximum of 24 consecutive hours. Providers cannot write _____ for restraints.
face to face
4 hours
PRN prescriptions
Explain he need for the restraints to the client and family, emphasizing that the restrains keep the client safe and are ___.
temporary
Ask the client or guardian to sign a _____ for restraints.
consent form
Review the ____ for correct application of restraints.
manufacturer’s instructions
Nurses should assess skin integrity, and provide skin care according to the facility’s protocol, usually every _____.
2 hours
Nurses should offer people in restraints food and fluid. Also, provide a means for hygeine and _______ .
elimination
Nurses should monitor _____of those in restraints and offer range of motion exercises of extremities.
vital signs
For patients in restraints ____ bony proinences to prevent skin breakdown.
pad
Use a _____ knot to tie the restraints to the bed frame where they will not tighten when raising or lowering the bed.
quick release
Make sure the restraints are _____ enough for range of motion and that there is enough room to fit ___ fingers between the restraints and the client.
loose
2
Remove or replace restraints frequently to ensure good _____ to the area and allow for full range of motion to the limbs.
circulation
Conduct an ______ of the client in restraints.
ongoing evaluation
Regularly _____ the need to continue using the restraints.
determine
Never leave the client alone without the ____.
restraints
Document ____ and behavior of the client prior to seclusion or restraints.
precipitating events
Document alternative actions to avoid seclusion and ____.
restraints
Document _____ of application and removal of the restraints.
time
Document the ___ of restraints and location
type
Document the _____ while in restraints.
client’s behavior
Document the type and _____ (ROM, removal, integumentary checks)
frequency of care
Document the ____ of the body part in restraints.
condition
Document the client’s response at _____ of restraints.
removal
Document all _____ administration.
medication
____ in health care facilities are usually due to problems with electrical or anesthetic equipment, or from smoking.
fires
In reference to fire safety, all staff must know the location of exits, alarms, fire extinguishers, and ______. Make sure equipment does not block fire doors. Know the _____ for the unit and the facility.
oxygen shut off valves
evacuation plan
RACE stands for…
Rescue and protect clients in close proximity to the fire by moving them to a safer location.
Activate the alarm system and then report the fire details and location
Contain/Confine the fire by closing the doors and window and turning off any sources of oxygen and any electrical devices.
Extinguish the fire if possible
To use a fire extinguisher, use the PASS sequence.
Pull the pin
Aim at the base of the fire
Squeeze the handle
Sweep the extinguisher from side to side, covering the area of the fire.
What are the classes of fire extinguishers?
A, B, C
Class ____ fire extinguishers is fro combustibles such as paper, wood, upholstery, rags, and other types of trash fires.
A
Class ____ fire extinguishers is for flammable liquids and gas fires.
B
Class ____ fire extinguishers are for electrical fires.
C
