exam 2: chapter 28 (client safety)

Question 1

what are the factors affecting a client’s safety?

Answer 1

• developmental considerations (children, adolescents)
• lifestyle (occupation, risk takers)
• environment (high crime areas)
• knowledge (awareness of safety)
• psychological state (stress, depression)
• mobility
• sensory perception alterations
• ability to communicate
• physical health state

Question 2

what are the risk factors for injury?

Answer 2

• lower body weakness
• poor vision
• gait and/or balance issues
• problems with feet and/or shoes
• use of psychoactive medications
• postural dizziness
• hazards in the home (and community)

Question 3

how do we prevent falls in clinical facilities?

Answer 3

• hourly patient rounding
• complete risk assessment and communicate if patient at risk
• keep bed low position and locked
• call bell and needed items within reach
• eliminate physical obstacles
• non-skid footwear
• cognitive assessment-report any changes

Question 4

what are 3 safety devices used to prevent falls?

Answer 4

• side rails
• locking devices on wheeled equipment
• nonskid slippers

Question 5

what should restraints NOT do?

Answer 5

• interfere with physiologic function
• limit physical activity to the point of immobilization
• interfere with respiratory function

Question 6

what are the general guidelines for side rail usage?

Answer 6

• must be able to raise and lower rails
• health care facilities must check them for safety
• know your hospital/agency policy

Question 7

what are physical restraint policies?

Answer 7

• use least restrictive option first
• not for staff convenience
• long-term care (involves family before using them)
• require written order from physician/licensed independent practitioner (type of restraint, justification, criteria for removal, never a prn)

Question 8

what must you do in an emergency if physical restraints are needed?

Answer 8

• get order immediately

Question 9

what are the 3 physical restraints standards?

Answer 9

• emergency: order restraints immediately
• monitor and assess pt every hour (know agency guidelines)
• documentation

Question 10

what is required in documentation for physical restraints?

Answer 10

• type of restraint
• when it was applied
• alternatives attempted
• pt, family & physician notification
• frequency of assessments (and findings)
• regular intervals of release
• nursing interventions

Question 11

what are some alternative restraints?

Answer 11

• toileting schedule
• reduce stimulation
• conceal tubing with gauze
• use of pillows
• bed alarm

Question 12

what does RACE stand for?

Answer 12

R- rescue and remove all pt’s from danger
A - activate alarm
C -confine fire by closing doors, turn off O2 and equipment
E - extinguish fire with appropriate extinguisher

Question 13

what do safety event reports/incident reports do?

Answer 13

• must be completed after any accident/incident
• describes circumstances of accident/incident
• details pt responses to exam and treatment
• primary concern: pt’s well being
• disclosure to pt - check agency policy
• not part of medical record