saftey
DESCRIPTION
TRANSCRIPT
Safety
NURSE’S RESPONSIBILITY
It is the nurse’s responsibility to assess each patient for real and potential risks associated with safety and include injury prevention in each client’s plan of care. Injuries and accidents can be minimized with appropriate assessment, precaution, planning, intervention, and evaluation.
BASIC NEEDS
Physiologic needs sufficient amounts of: Oxygen – The Client requires adequate
oxygen for cell metabolism, this can be decreased by air pollution or disease like lung disease
Carbon Monoxide poisoning would also result inadequate oxygen
Nutrition – the correct amount of calories, protein, carbohydrates, fats, vitamins and minerals to avoid over or underweight and deficiencies
Temperature – temperature that are either too hot or two cold pose threats to clients in hypo or hyperthermia
Humidity – too much humidity can make it difficult to breath and too little can result in dryness
Consider the following:
PHYSICAL HAZARDS
Lighting needs to be sufficient so the client can see where they are stepping and potential obstacles
Obstacles are objects which can trip clients like light cords, step stools, area rugs
Bathroom hazards result when clients attempt to get in and out of the bathtub or toilet resulting in falling
Security hazards occur when intrusion threatens a client
What about the environment?
TRANSMISSION OF PATHOGENS
Immunizations stop the transmission
Hand washing breaks the chain of infection
Asepsis maintains sterility of essential patient care supplies to prevent infection
Personal Protection Equipment when used correctly decreases the transmission of germs from client to client and client to care provider
TRANSMISSION CONTINUED
Cleanliness should be maintained daily and between clients so pathogens do not have an opportunity to grow
Isolation precautions should be adhered to so pathogens do not migrate from one client to the next
Infection Control initiatives should be adhered to minimize nosocomial infections
POLLUTION
Air –including passive exposure to smoke can promote disease
Land through improper disposal of waste and use of pesticides which threaten to make clients ill
Water from recreation emissions from water craft along with agricultural, industrial, and improper disposal of human waste
Noise with exposure to sounds like traffic, lawn mowers jet plans elevate blood pressure and result in loss of sleep
DEVELOPMENTAL FACTORS
Safety concerns vary by type and incidence according to developmental level.
The nurse must evaluate the specific age of any client to ensure the developmental and actual ages are consistent.
Groups include Infant/toddler, Preschooler, School-age child, adolescent, adult and older adult.
INFANT AND TODDLER
Choking – they are curious and put most things in their mouths to explore.
Falling- they are initially unsteady on their feet as they learn to walk, once toddlers they climb and wander to explore their world.
OLDER ADULT
Physiological changes associated with aging place the older adult at risk of injury which include decreased muscle strength, joint immobility's, slowing reflexes, decreased ability to respond to multiple stimuli, sensory loss like hearing and vision.
OLDER ADULT
These physiological changes increase risk for:
Falls related to these factors, most common cause of accidents after the age of 50
Area rugs leads to tripping or sliding Inadequate lighting where they are unable to see
obstacles and trip Electrical cords that get tangled in their feet Urgency to get to the bathroom for elimination
Burns related to leaving the stove on or slow reactions
MORSE FALL SCALE
Tool used to assess if a client is at risk of falling. 1. Does the person have a history of falling? 2. Does the person have more than one medical
diagnosis? 3. Does the person use ambulatory aids like crutches
or a walker? 4. Does the person have an IV or saline lock? 5. Is the person’s gait normal or stooped or otherwise
impaired? 6. What is the person’s mental status? Disoriented?
TJC PATIENT SAFETY INITIATIVES
Body site marking for operative site while the patient is awake by the surgeon to avoid wrong site surgery
“Time out "when all members of the surgical or procedural team must stop and acknowledge the right patient, right side, right procedure
Medication reconciliation to review all medications and supplements the patient is taking so the provider takes a comprehensive look
Aggressive Hand Hygiene to avoid infections
Needless systems to avoid needle stick of health care providers
RACE – FIRE RESPONSE
R – rescue and remove clients in immediate danger of fire
A – activate alarm C – confine the fire –
close doors and windows and turn off oxygen
E – extinguish fire using fire extinguisher or escape
SPEAK-UP
A patient safety campaign by TJC to decrease medical errors
S- Speak –up if you have questions or concerns P- Pay attention to the care you are receiving E- Educate yourself about your situation A- Ask a trusted person to be your advocate K- Know your medications U-Use a hospital, clinic, care center that is surveyed
and meets high standards P-Participate in all of the decisions about your
treatment
USE OF RESTRAINTS
Restraint – anything used to restrict freedom of movement or access to a person’s body
Potentially very dangerous, patients injured or strangled getting tangled in restraint– Avoid use unless client at risk of injury
Least restrictive measures – many types select the restraint that limits their movement the least while keeping them safe
All restraints require a physician order The physician order must be renewed at least every 24 hours The nurse must assess the patient and document every 2 hours Behavioral restraint use more restrictive with every 15 minute
assessment and documentation
EQUIPMENT-RELATED ACCIDENTS
Appropriate use of equipment should include:
Thorough knowledge from training how to use it
Ensure it is properly inspected
Ensure it is functioning properly
In the event it is not functioning properly remove it from service and tag it
Make sure the client’s room is free from clutter and equipment not in use is removed promptly
NEVER EVENTS LISTED
Foreign objects left in a patient after surgery Air embolism Administration of the wrong kind of blood Severe pressure ulcers Falls and trauma Infections related to urinary catheters Infections associated with intravenous catheters (continue on next slide)
Safety first at all times
NEVER EVENTS CONTINUED
Symptoms resulting from poorly controlled blood sugar levels
Surgical site infections following certain elective procedures (orthopedic and bariatric)
Deep vein thrombosis or pulmonary embolism following total knee or hip replacement
SAFETY AT ALL TIMES!