T1: Chapter 24: Promoting Safety- JM Flashcards by Rachel Mason

Why is safety important to the patient?

It is a basic human need

-second only to survival (Maslow’s)

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What are the four leading causes of accidental death in the US?

poisoning
motor vehicle accidents
firearms
FALLS
* * Accidental/unintentional injuries are the 5th leading cause of DEATH**

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Who publishes safety goals for healthcare facilities?

The Joint Commission

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Who recommends six major policy changes to raise quality of healthcare?

ANA–American Nurse’s Association

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What is the leading cause of death for infants/toddlers?

Drowning (ages 1-4)

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What are some safety concerns with toddlers?

they are completely dependent on others for care

- falls, choking, SIDS, and ingesting poisons are among the top issues

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What is choking or ingesting poison a fear with toddlers?

They explore the environment by PUTTING THINGS IN THEIR MOUTH at this age

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What is the leading cause of death or preschoolers? What about nonfatal injuries?

Motor vehicle (drowning, fires, poison)
-Nonfatal: FALLS

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What is the leading cause of death of school-aged children? Nonfatal injuries?

Motor vehicle

-Nonfatal: FALLS (more activity result in more bone and muscle injury–sports)

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What is the leading cause of death for adolescents?

Motor vehicle and homicide associated with ALCOHOL and DRUGS

teenagers feel invincible, yet lack wisdom
risk-taking behaviors

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What is the leading cause of death for adults (35-64 years old)?

Unintentional poisoning

-lifestyles injuries (stress, abuse, decline in strength)

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As adults age, what are they more at risk for?

falls, burns, car accidents

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What are adults age 65 and adult most at risk for?>

FALLS

50% at home

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What are the safety hazards in the HOME?

poisoning
carbon monoxide exposure
scalds and burns
fires
firearm injuries
falls
suffocation/asphyxiation

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What is included in a patient’s environment?

physical AND psychosocial factors that contribute to the life and well0being of each person.

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What are some individual factors that influence safety?

lifestyle
cognitive awareness
sensoriperceptual status
ability to communicate
mobility status
sensory losses (hearing/vision)

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When do most fatal home fires occur?

When the occupants are asleep

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Related to fires, what do most deaths result from?

smoke inhilation

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How can scalds/burns occur in the home?

scald injuries: hot water, steam, grease
warming food or formula in microwave
sunburn
contact burn: touching stove or hot pan
chemical burn

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How can suffocation occur in the home?

in the crib
drowning in tub
choking on foreign object
inhaling gas/smoke

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What food items can a child choke on?

hot dogs
raw veggies
popcorn
hard candy
grapes
nuts

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What nonfood items can children choke on?

plastic baggies

- latex balloons

What are some community hazards that can occur?

motor vehicle accidents
pathogens
improper sanitation
pollution
electrical storm

What are hazardous substances transported from the workplace to the home?

Take-home toxins:

direct skin-to-skin contact
arthropod vectors
dust particles

A nonspecific term that describes illness caused by ingesting bacteria and other microorganisms, or their toxins, in food.

Food poisoning

What are the different typrs of pollution?

1. Air (motor vehicle emissions) 2. water (lakes, rivers, streams) 3. Noise (stress, hearing loss, high BP, not sleep) 4. Soil

What are the safety hazards in a healthcare agency?

- FALLS - equipment-related accidents - fires - electrical hazards - restraints - mercury exposure - biological hazards

What are never events?

These can cause serious injury or death to patients and should NEVER happen in a hospital

Examples of never events:

- Foreign ibject left in body after surgery (sponge) - air embolism - administering wrong type of blood - sever pressure ulcers - falls and trauma - injuries from burns, restraints, bedrails - infections: catheters (urinary and IV) - symptoms from poorly controlled blood levels - surgical site infections - DVT or pulmonary embolism

What are the main aspects of a Root Cause Analysis (RCA)?

1. What happened? 2. Why did it happen? 3. What can be done to keep it from happening again?

Who is more at risk for falls?

- Infants and older adults!!!! - poor vision - cognitive impairment - difficulty walking/balance - orthostatic hypotension - weakness/dizziness - drowsiness from meds

A device or method used for the purpose of restricting a patient's freedom of movement or access to his own body, with or without permission.

Restraint

What practice should occur with restraints?

AVOID if possible--use alternative interventions first | -saves time, money, and reduces patient injuries

How often are restraints to be checked? How often must a prescription be renewed?

checked: Every 30 minutes renewed: every 24 hours by prescriber

How many siderails need to be up on the patient's bed?

2-3 | --4 is considered a restraint

What workplace hazards can happen to healthcare workers?

- back injuries - needlestick injuries - radiation injury - violence

When working with a patient who is getting radiation, what do you need to keep in mind?

-Time: limit amount -Distance: stay away if possible Shielding: wear protective gear

What type of patient should be assessed for falls?

ALL OF THEM!!! | -Especially after a change in medication or health status (this is constantly being updated)

What can a nurse do to help decrease violence in the workplace?

Identify anxiety--this is where it normally starts | -You may be able to intervene before a patient becomes aggressive

What test needs to be preformed when determining how likely a patient is to fall?

Morse Fall Scale

How can you assess home safety prior to discharge of a patient?

CLIENT TEACHING!!!!!! - Create a home safety checklist - Safety Assessment Scale (SAS)--good for patients with cognitive and memory deficits

How can you assess the risk for violence?

Recognize early warning signs 1. What increases aggression? 2. Assess for anxiety

What are some factors that increase aggression?

- mental disorders - drugs or alcohol - withdrawal - history of violence - clinical conditions: high fever, epilepsy. head trauma, hypoglycemia

What are some signs a patient is experiencing anxiety? What may this lead to?

May lead to violence!! - agitation & restlessness - pacing - talking loudly, speaking rapidly - gesturing wildly

What nursing intervention can be used to promote safety in the home?

Focus is on TEACHING

What nursing intervention can b used to promote safety in the healthcare facility?

- Assess Risk | - Create a safe environment

How can you help prevent fires?

- have a warning system - have an escape plan - have a preventative frame of mind - promote electrical safety - know what to do if fire occurs

How can FALLS be prevented at home?

- exercise regularly - take your time - don't trip yourself up: proper shoes, not rugs - clear a path: - use caution on stairs - minimize bathroom hazards - childproof home

How do the Heimlich and the American Red Cross maneuver for choking differ?

Heimlich: only abdominal thrusts (not back blows) American Red Cross: alternates 5 back blows with 5 abdominal thrusts

What do you need to teach patients about food safety?

"4 C's of Food Safety": 1. Clean 2. Cook 3. Combat cross-contamination 4. Chill

How to yout\ properly dispose of solid waste?

1. Reduce 2. Reuse 3. Recycle 4. Respond (educate others)

How do you respond to a fire in the hospital?

R rescue the patient A activated the alarm C confine the fire E extinguish the fire

What safety interventions can you delegate?

- Remove and reapply restraints--NOT assess them | - observe for skin excoriation under or around restraint and report