Ch.13 Provisions for a Safe Enviroment Flashcards
What are three key points of fire saftey?
- Keep open spaces free of clutter.
- Clearly mark fire exits.
- Know the locations of all firearms, exits, and extinguishers.
What are the two priority nursing action in the event of a fire?
Pass & Race
P.A.S.S
Get the firewstinguisher and :
Pull the pin
Aim at the base of the fire
Squeeze the estinguisher handle
Sweep at the base of the fire side to side. (not at the top of the flames)
R.A.C.E
Rescue clients who are in immediate danger.
Activate the fire alarm
Confine the fire.
Estinguish the fire.
Type A fire estinguishers are for?
Wood,cloth,paper, rubbish, plastic
Type B fire estinguishers are for
Chemical fires from gases, oils, tar etc.
Type C estinguishers are for?
Electrical equipment
What do you need to know to report a fire?
Telephone number
What should you know in the event of a fire for evacuation?
The facilities evacuation plan.
What should be turned off in the vicinity of the fire?
Oxegen equipment.
What should you never use in the event of a fire?
An elevator.
How should you handle a client in life support in the event of a fire?
Maintain respiratory status with a Ambu bag(recitation bag) until they are removed away from the fire.
How do you deal with amblitory client in the event of a fire?
Direct them in a safe direction, in some cases they can push others with them.
How do you help bedridden client in the event of a fire?
Stretcher, bed, or wheelcahir.
What if they need to be carried?
You need to use proper technique.
How must electrical equipment be maintained?
Must be maintained in good working order and must be ground.
What kind of electrical cords must be used?
Three pronged.
How does a three pronged electrical cord work?
The Thor prong linger is the ground. Why the other two carry the electricity.
What should be done with electrical cords?
Make sure they are not exposed, frayed, or damaged wires.
How should electrical circuit be treated?
Never overloaded.
How do you work with all electrical equipment?
Always read the directions; NEVER work with equipment you don’t know how to use.
How should you handle extension cords?
Use only when nessary and tape them down to the floor with electrical tape.
Where should you never place electrical wiring?
Covered up.
How should you unplug a plug?
Never pull the cord only pull the plug itself.
Where should you never use electrical appliances?
Near sinks,bathtubs, or other water shources.
What do you did if the client takes an electrical shock?
Turn off the electricity before touching the client.
What must be done with any electrical equipment brought to the facility?
It must be inspected for safety before use.
How do you know how to deal with radiation?
Know the protocols and guidelines of the healthcare agency.
If it potentially radiation what should be done with it?
It should be labeled.
What are the top three ways to prevent radiation illness?
- Limit time near the source.
- Make your distance from the source as great as possible.
- Use a shielding device such as a lead apron.
How can you monitor ration exposure?
Film badge. (Dosimeter).
Where should people that just had radiation be put?
In there own room.
What do you never do with dislodged radiation implants?
Never touch them.
What should not be removed from the room before the implants are removed?
Anything even linens.
How do you dispose of infectious wastes?
- Handle all wastes as hazard.
- Dispose of waste in designated areas.
- Label it correctly.
- dispose of all sharps immediately after used in a sharps container or a puncture proof container(like a milk jug.)
Sharps
Needles
What should never be done with needles?
Recapped, Brent, broken due to risk of a needle stick.
What are some physiological changes that put patients at risk for falls?
Miscoskeletal changes
Neurological changes
Sensory changes
Gerontological changes
How do muscoskeletal changes increases fall risk?
Strength/function of muscle decrease.
Bones brittle and joint function decrease.
Postural changes and limited range of motion.
Nervous system ch ages that increase fall risk?
Voluntary and autonomic reflexes become slower.
Decreased ability to respond to multiple stimuli occurs.
Decreased sensitivity to touch occurs.
Sensory changes that increase fall risk?
Decreased vision and lens accommodation and cataracts develop.
Delayed transmission of hot and cold impulses occurs.
Impaired hearing develops, with high-frequency tones less perceptible.
Genitourinary Changes increase fall risk?
Genitourinary Changes
Increased nocturia and occurrences of incontinence may occur.
Nocturna
Peeing during the night.
F. Risk for falls assessment 🔺(6 items)
- Should be client-centered and include the use of a fall risk scale per agency procedures
- Include the client’s own perceptions of their risk factors for falls and their method to adapt to these factors. Areas of concern may include gait stability, muscle strength and coordination, balance, and vision.
- Assess for any previous accidents.
- Assess with the client any concerns about their immediate environment, including stairs, use of throw rugs, grab bars, a raised toilet seat, or environmental lighting.
- Review/analyze the medications, both prescription and nonprescription, that the client is taking that could have side/adverse effects that could place the client at risk for a fall.
- Determine any scheduled procedures that pose risks to the client.
What are some measurements to be taken to prevent falls?
Assess the client’s risk for falling; use agency fall risk assessment scale.
▪Assign the client at risk for falling to a room near the nurses’ station.
▪Alert all personnel to the client’s risk for falling; use agency fall risk alert procedures and methods as necessary.
▪Assess the client frequently.
▪Orient the client to physical surroundings.
▪Instruct the client to seek assistance when getting up.
▪Explain the use of the nurse call system.
▪Use safety devices such as floor pads, and bed or chair alarms that alert health care personnel of the person getting out of bed or a chair.
▪Keep the bed in the low position with side rails adjusted to a safe position (follow agency policy).
▪Lock all beds, wheelchairs, and stretchers.
▪Keep clients’ personal items within their reach.
▪Eliminate clutter and obstacles in the client’s room.
▪Provide adequate lighting.
▪Reduce bathroom hazards.
▪Maintain the client’s toileting schedule throughout the day.
Measures to promote safety in ambulation for the client? What is mainly used? Steps of use?
- Gait belt may be used to keep the center of gravity midline.
a. Place the belt on the client prior to ambulation.
b. Encircle the client’s waist with the belt.
c. Hold on to the side or back of the belt so that the client does not lean to one side.
d. Return the client to bed or a nearby chair if the client develops dizziness or becomes unsteady.
e. When finished safely ambulating the client, remove belt and replace it in its appropriate storage area.
What are The Joint Commission: National Patient Safety Goals 2018?
▪Improve the accuracy of client identification.
▪Improve the effectiveness of communication among caregivers
▪Improve the safety of using medications
▪Focus on the risk points related to medication reconciliation
▪Reduce the harm associated with clinical alarm systems
▪Reduce the risk of health care–associated infections
▪Identify client safety risks
▪Prevent mistakes in surgery
🔺 Steps to prevent injury to the health care worker? (4)
▪Use available safety equipment.
▪Keep the weight to be lifted as close to the body as possible.
▪Bend at the knees.
▪Tighten abdominal muscles and tuck the pelvis.
▪Maintain the trunk erect and knees bent so that multiple muscle groups work together in a coordinated manner.
🔺 restraints are?
Restraints (safety devices) are protective devices used to limit the physical activity of a client or to immobilize a client or an extremity.
🔺what four things need to be done with restraints?
a. The agency policy should be checked and followed when using side rails.
b. The use of side rails is not considered a restraint when they are used to prevent a sedated client from falling out of bed.
c. The client must be able to exit the bed easily in case of an emergency when using side rails. Only the top two side rails should be used.
d. The bed must be kept in the lowest position.
Physical restraints?
Restrict client movement through the application of a device.
Chemical restraints are?
Chemical restraints are medications given to inhibit a specific behavior or movement.
Before you use restraints what should be done?
Use alternative devices, such as pressure-sensitive beds or chair pads with alarms or other types of bed or chair alarms, whenever possible.
If restraints are necessary, the primary health care provider’s (PHCP’s) prescriptions should state?
The type of restraint, identify specific client behaviors for which restraints are to be used, and identify a limited time frame for use.
The PHCP’s prescriptions for restraints should be renewed within?
A specific time frame according to agency policy.
Restraints are not to be prescribed as?
Restraints are not to be prescribed PRN (as needed).
What should be documented Edith rest aunts and who should be told?
The reason for the safety device should be given to the client and the family, and their permission should be sought and documented.
Restraints should not interfere with?
Any treatments or affect the client’s health problem.
What should be used when securing a saftey device?
Use a half-bow, a safety knot (quick release tie), or a restraint with a quick release buckle to secure the device to the bed frame or chair.
Where can you not tie restraints?
not to a movable part of bed (including the side rails).
How much slack should be in the straps?
Enough to move the body part.
What should you asses for when they are in restraints? How often?
Assess skin integrity and neurovascular and circulatory status every 30 minutes.
How often should you remove restraints?
remove the safety device at least every 2 hours to permit muscle exercise and to promote circulation (follow agency policies).
What should be documented when using a saftey device? (7)
▪Reason for safety device
▪Method of use for safety device
▪Date and time of application of safety device
▪Duration of use of safety device and client’s response
▪Release from safety device with periodic exercise and circulatory, neurovascular, and skin assessment
▪Assessment of continued need for safety device
▪Evaluation of client’s response
How often should you offer fluids for restraints?
2 hours
How often should you offer toileting?
Every two hours.
🔺What is always needed when using a restraint?
Doctors order.