183 Unit 1 Flashcards
Factors that affact safety
Developmental levels, lifestyle, Mobility, sensory perception, knowledge level, communication ability, physical health state, and psychosocial state
Factors that may be safety hazard in the patient environment
High crimes neighborhood proven to be more hazardous, Threat to physical security and emotional well-being.Weapons that are visible in the home, history of past violent behavior, high crime buildings or neighborhoods, substance abuse by either the patient or family members, or situation in which a child is being considered for removal from an abusive environment. Any Limitation in Mobility is potentially unsafe.Any alternation in sensory perception impairment in sight, hearing, smell, taste, touch.Lack of knowledge regarding safety and security precaution for example adhered to medication regimen or follow safety precaution when oxygen is in use. Ability to communicate, fatigue, stress, medication, language barrier. Psychosocial health state, Depression may result in confusion and disorientation accompanied by reduce awareness or concerned about environmental hazard social isolation or lack of social contact may lead to reduce level of concentration error in judgment and a diminish awareness of external stimuli.
Falls
Leading cause of injuries among adults older than 65 years of age. Most common injuries are hip or other fractures, head trauma or soft tissue injuries. Many falls not reported because fear of activity restriction, loss of independence, or placement in a long-term care facility. The fear of falling causes anxiety and panic which leads to a higher chance of a fall.Assessment of risk for falling include use of nursing history and physical examination. Characteristic of high risk for a fall, age older than 65, History of falls, impaired vision or sense of balance, altered gAit or posture,Medication regimen and that includes diuretics, tranquilizer, See dative, hypnotic, analgesic.Posterior hypotension, slow reaction time, confusion, impaired mobility, weakness and physical frailty,And unfamiliar environment. Falls in order adults can be prevented if they can be predicted therefore continuous surveillance for environmental hazard is crucial in the healthcare facility and a home environment. Children 14 and younger high risk for fall.
contributions to a person safety
Occupation and work environment. people who work in certain occupations may experience and exposure to health hazards such as excessive noise pollution toxic chemicals or vapors or infectious agent. Ex. Nurses working in the OR or regularly exposed to surgical smoke, a byproduct of laser and electro cautery procedure. Nurses in general Serious risk for needlestick injury and blood borne infectious disease.
Preventing Falls
The stairway clear and uncluttered. Maintain walkways and stairs and rails in good repair. Keep stairs hallways outside walkways and working area well lit.Install safety gates at top and bottom of the stairways. Paint the bottom step of the stair a different color. Apply a nonslip adhesive step at the bottom surface of the tub or shower. Have a raise toilet seat with support arms available. Provide grab bar next to the toilet and tub. Use sturdy chair that have armrests.Lemonade scatter rugs or secure them with adhesive strip.
Restraints
Physical device used to limit the patient movement. Side rails, geriatric chairs with a Tatch trays, and appliance tied at the waist, ankle, or Wrist are type of physical restraints. Drugs that are used to control behavior and are not included in the person normal Medical regimen or consider chemical restraints. Physical restraint increase the possibility of serious injury due to a fall they do not prevent falls.
DAME
D - Drug and alcohol use. A - Age related physiologic status. M - medical problems. E - environment. Use by at home healthcare nurse To assess the risk for falling in older adults at home.
Hazard associated with the restraints
Increase the possibility of serious injury due to fall, skin breakdown, contractures,Incontinence, depression, delirium, anxiety, aspiration and respiration difficulties, and death.
Alternatives to restraints
Determine whether behavior pattern exist. Assessed for pain and treat. Rule out causes for Agitation. Involve the family and patient care.We do stimulation. Distract and redirect. Use simple clear explanation. Check environment for hazards. Use nightlight. Identify door of room. Use an electronica alarm system to warn of unassisted activity. Allow restless patient to walk.Use low height beds. Please floormat on each side of bed. Consider relocating the patient closer to nursing station. Encourage daily exercise. Offer diversional activities. Use therapeutic touch.Make environment as homelike as possible.
Rules apply for restraints
Long term care setting - The patient family must be consulted and involved in the plan of care before applying restraint. They must be in form of an agency policy regarding applying and removing restraint and may be asked to sign a release form to protect the agency from a liability. Requires an order from a position or a licensed independent practitioner the order should include the type of restraint, justification for the restraint, and criteria for removal. In an emergency the physical restraint can be applied but in order for my position or Leison independent practitioner must be obtain immediately or within a few minutes according to Joint commission standards the order must state the intended ration of use the patient must be monitor and assess at least every hour or according to agency policy. Each order for restraint or seclusion use for the management of Violent or self-destructive behavior that jeopardize the immediate physical safety of the patient, a staff member, or others may be Renewed in accordance with the following limit for up to a total of 24 hours - 4 hr for adults and older, 2 for 9-17, 1 for 9 under. Ensures that two finger can be inserted between the restraint and the patient extremity. Remove the restraint at least every Two hours or according to agency policy and patient means. Keep the call bell within the patient reach. Use a quick release not to tie the restraint to the bed frame not the rail.
Regulate the temperature in the environment 68 to 74° average
Offer fluid if the person is a person perspiring Heavily due to heat. Offer fan or heater. Add extra blanket to increase heat. Give a cooling blanket to reduce heat. Give an alcohol rub to reduce heat. Use k pad to increase Heat and hypothermia blanket to decrease heat. Adjust thermostat or air conditioning.
Regulate the humidity in the environment 30 to 50% is average
Increase humidity by using a vaporizer or humidifier
Adjuster ventilation in the environment
Open the window or door to increase cross ventilation. Use screen to prevent draft. Use blanket for clothing to prevent drafts or chills
Adjust the light in the environment
Keep the lights Soft. Adjust shades and blinds or drapes to reduce light for sleep. Provide nightlight.
Adjust the color in the environment
Provide subdued, pastel color through uniform, drapes, wall covering, furniture
Control the noise in the environment
Keep voice moderate avoid loud talking and laughing. Advise other people in the environment to reduce noise. Minimize noise from supplies and equipment.
Organize the space and maintain order in the environment
Remove excess furniture. Remove use or soil equipment. Remove excess bedside supplies. Wipe over bed table and bedside stand top daily. Keep soil linen off floor.
Regulate the odor in the environment
Dispose of refuse Properly. Empty and clean equipment. Provide frequent hygiene. Provide cross ventilation. Attend to your personal hygiene.
Provide privacy in the environment
Always knock before entering room. Identify yourself before initiating care. Cover a patient with a bath blanket during procedure. Screen patient to prevent embarrassment with curtains door or screens
Prevent fires
Restrict smokin to designated area only. Do not permit smoking while in bed. Do not allow smoking in any area where oxygen is being administer. Remove cigarettes and matches from the sedated, confused, disoriented or irrational patient. When oxygen is in use clearly label with no smoking signs.Inspected all electrical plugs, CoresAnd equipment before use. Check to be sure that all electrical equipment for use in patient area is grounded with a three prong plug. Send any electrical appliances which the patient brings with him to the hospital to the hospital electrician so that the appliances can be thoroughly inspected. Store oily Rags and other combustible material in metal containers which have air tight lids. Clearly label or containers which contains oxygen or other gas under pressure.
No the fire rules and procedures in your health care unit
Learn to observe and remember the location of fire extinguisher and fire doors in all patient areas. Know the specific procedure for fire reporting and evacuation. Learn fire code name for the agency where you work. There is usually a cool name to report the fire to personnel. Follow general procedure in this order of priority evacuate person from intimate danger, activate the fire alarm,Notified the fire department, use acronym race, rescue, alarm, contain, evacuate.
Prevent burns
Adapt temperature of treatment to the skin of the individual, the elderly and infirm skin is more sensitive to temperature. Give heat treatment for specific time only.
Prevent equipment related accident
Check to be sure that all electrical equipment is properly grounded with a three prong plug. Checked all equipment, Drugs, and solution to be sure that the expiration date is not passed. Check and return to supply office any equipment which 18 years defected. Use equipment only for the use it was intended. Do not operate any equipment with which you are unfamiliar. Handle all equipment with care and respect. Do not twist or sharply been electrical cord. Do not use extension cord which are longer than 10 feet.
Assume only that responsibility for which prepared (When confronted with a change in assessment, condition or orders)
Use problem-solving approach. Ask appropriate questions.
Respond appropriately to emergency situation by seeking help from instructor or staff
Check textbook for most common emergency situation for her own care assignment before clinical. Call for help without Alarming patient. Stay with patient. Assess and alleviate as much of situation as prepared to handle. Verify and follow directions given by personnel in charge. Reports and records sequence of events accurately.
Practice principle of medical asepsis To prevent spread of micro organisms
Use handwashing technique for medical a sepsis. Use principal of a sepsis such as Wash hands frequently but especially before handling food, before eating, after using a handkerchief, After going to the toilet, and after each patient contact. He soiled items and equipment from touching your uniform. Dispose of soil or use items directly into appropriate container or holders. Pour liquid which are to be discarded directly into the drain so as to avoid splattering. Send items to be sterilized which are suspected of having pathogen.
Safety event report
A confidential document formally referred to as an incident report which objectively describe the circumstance of the accident or incident
Infection
A disease state that result from the presence of pathogen (Disease producing micro organism)In or on the body
Infection cycle
Infectious agent, reservoir, portal of exit, means of transmission, portals of entry, susceptible host
Infectious agent
Bacteria, viruses, fungi
Bacteria
Most significant and most commonly observe infection causing agent in healthcare institutions can be categorized in various ways by shape as spiracle, rod shape, or corkscrew shaped. Bacteria can be categorized as either gram-positive or gram-negative.Bacteria require oxygen to live and grow therefore referred to as aerobic those that can live without oxygen or anaerobic.
Virus
Smallest of all micro organisms visible only with an electron microscope. Causes common cold hepatitis B and C and immunodeficiency syndrome(aids). Antibiotics have no Effects on virus.
Fungi
Plant like organism there also can cause infection or present in the air soil and water cause athlete foot ringworm and Yeast infection.Treated with anti-fungal medication
Potential to cause disease depends on
Numbers of organisms,virulence ( organism ability to cause disease or infection) Of the organism, competence of the person immune system, length and intimacy of contact by the person and the micro organism.
Infectious agent
This is the disease causing organisms. For many illness and disease this is a virus or bacteria. In order to break this link various methods can be used including the past reservation of milk, the chlorination of drinking water, or the use of disinfectant.
