Ch 27 Safety, security, emergency preparedness Flashcards
What kind of concern is safety
Safety is a paramount concern underlying all nursing care
What are factors that affect safety
-Developmental considerations
- lifestyle : use of drugs and alcohol/ occupation
 - social behavior: any drinking or driving?
- environment
- mobility : how is their gait? , any DME
-sensory perception : DM with paresthesia or Cataracts

-knowledge : is patient aware, any security issues
-ability to communicate : what is the mode of communication
-physical and psychosocial health states:
Give appropriate devices and consider patient anxiousness depression to provide appropriate care
What is the primary focus of safety assessment
-what do we want to ask about the patient’s mobility
What are the three focuses of the safety assessment
Patient is the most important!!!
- any balance/visual issues, can patient speak? can they maneuver?
3 focuses:
- Person
- environment: is it unfamiliar, any stairs? 
- specific Risk factors
- electrical
- fire burn issues
- prevent poisoning
- falls
- firearms
- abuse
- safety belt
 what are nursing actions you can do to decrease hospital risk factors
Bed position Side rails Call Bell Room Personal items Alarm
-bed in lowest position
-side rails down
•document of up
-make sure the call bell is within reach and answered
-orient patient’s room
-have all items within reach
-activate the bed alarm: to prevent falls
As far as discharge planning what do we immediately do as soon as patient is within our care
-why do we do this
- give 2 examples
Immediately within our care necessities that the patient will have when they go home
-done to assess if they will be safe
what is the lighting, no rugs
When doing a nursing history on the patient what do you want to assess for in regards to security and safety
Assess for history of falls
assistive devices
drug are alcohol abuse
obtain knowledge of family support systems and home environment
What patient is a Highfall risK
Upon mentioning assistive devices how should a person use a cane (what side) what are gait belts used for
Why do we assess the knowledge of a family support and home environment
If a patient has a history of falling they are a high full risk
Upon assistive devices:
- Canes used on unaffected side
- Gait belt used to hold, ambulate, and assist patient to floor
When assessing family support and home environment we do this to plan for safe return home
What are fall prevention interventions we can do for the patient in the hospital
With your family support and home environment what do we want to look for specifically that may increase fall risks
We can put nonskid socks and clear the pathway
Look for any polypharmacy
-specifically tranquilizers, sedatives, hypnotics due to drowsiness
Age, unfamiliarity
Postural hypertension
Slow reaction time
When we assess using the Morse scale questionnaire how do we know patient is at increased risk of
What are two things you want to assess for
What kind of status do you want to check
What’s the score on the Morse scale questionnaire equivalents to Highfall risk
Using Morse for questionnaire:
-if patient had a last fall within three months there it increased risk for falls
- Assess for any Iv/saline locks or secondary diagnosis is
- Check mental status
A score of over 51 means high fall risk
What is the leading cause of injury among elders
What kind of events are falls leading to injury fatality
Leading cause of injury: falls number one for injuries and fatalities
Falls leading to injury fatalities are sentinel events:
they do not happen often!!!
In assessing for ability to communicate what does using the call light mean if the patient cannot speak and what must you do
What must you ALWAYS assess for in a patient in regards to safety
What is a specific population to target for sensory perception assessments
If a patient is using call light but cannot speak you get up and go assess the patient, but it shows awareness among patient
In regards to safety always assess level of orientation ALWAYSSSS
Assess diabetics to see if neuropathy affects safety
What are examples of potential hazards within a hospital
If a patient brings equipment from home what must be done and what must the equipment have
What is the one equipment from home you want the patient to bring to the hospital
Examples of potential hazards:
- equipment that does not work
- equipment from home 
If the patient bring equipment from home it must be checked by the biomedical department and it must have a safety sticker
Patients with CPAP machines should bring from home to use in hospitals
During the physical examination as you assess for domestic violence or neglect what are signs and symptoms to be aware for
-Violence (5)
-Sexual abuse
emotional abuse
Neglect
Violence: 1. Unexplained injuries 2. bruises in different healing stages 3.Head injuries 4. burn configurations 5biting
Sexual abuse:
- genital pain
- vaginal discharge young
- STI/UTI
- difficulty sitting
- regression
- patient coming in for unrelated assessment says they have been raped
Emotional abuse: -difficulty sleeping stomach/headache -low self-esteem -avoiding activities
 Neglect: disheveled
When you report abuse what are you reporting what do you not have to do
-how is the report of abuse done
When reporting abuse you report the findings you do not have to prove abuse and it was done in good faith
What are factors that contribute to Falls in your elderly
Weakness Poor feetmeds dizziness hazards
Lower body weakness Poor vision/gait/balance issues Problems with feet or shoes - sores, they don’t fit properly Psychoactive medications -stimulants, antidepressant, narcotics postural dizziness Home and community hazards
How do we keep the environment safe for our elderly
- water
- light
- path
- rug
What is our goal in relation to hazards
To ensure a safe environment:
Clean any water on floor
Use good lighting
Avoid clutter (free pathway)
Remove rugs
Nurses goal is to minimize hazards
If a nurse is reasonable and prudent with behavior that is similar to those expected of another nurse under similar circumstance are they liable if a patient falls
A nurse who is reasonable, prudent and behaves in a similar way that another nurse would under the same circumstance is not found liable if a patient falls
-we did our best it is understandable a patient may fall
Regarding risk factor assessments
How does one explain patient’s falling even if nurse is prudent and what may be activated
Why are most people killed in fires and what do most fires result from a
What is the first action to do if there is a concern of poisoning
At times despite our efforts a patient may still fall and depending on facility you may have to activate rapid response or a fall alert
Most people killed in fires due to smoke inhalation and most fires result because of cooking
If poison concern #1 intervention is to pcall center for poison control
If there is a fall what are the actions to take
How do you want to fill out the safety occurrence report
1 ASSESS PT!!! Patient is #1
If a fall occurs:
- Tell Doc/tell nursing supervisor
3 fill out safety occurrence report
-fill out safety occurrence report objectively from where you found the patient
Regarding risk factor assessment
 What may Commonly cause suffocation what may commonly cause choking
-How do you prevent adult and child choking
What are the three rules to prevent fire arm injuries
Suffocation caused by drowning choking caused by pillow, plastics , balloons, little toys, grapes
- adult: Heimlich maneuver
- Child: five back five compression pats
Preventing firearm injuries:
- Keep locked
- keep unloaded
- keep safe
