Safety & Security
Terms
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- Developmental Considerations
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Nurse and the patient or family should work together to eliminate or reduce accident risks in the home, community or healthcare setting.
Educate to promote awareness of dangerous situations must begin as early as possible & continue throughout the life span. - Lifestyle
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OSHA identifies risks and develops standards to prevent serious injuries and illnesses due to work-related musculoskeletal disorders resulting from repetitive motions.
Stress may precipitate an unhealthful lifestyle that involves drug or alcohol abuse.
Security measures such as locks, security systems and exterior lighting can promote safety. - Mobility
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Patient with an unsteady gait is more prone to falling.
Supportive devices, such as canes, walkerrs, and wheelchairs, may facilitate movement, but they require careful patient instruction and preparation for safe use.
Nurses must assess a pt's risk for injury w/ a view toward maintaing independence and fostering self-esteem while providing a safe and predictable environment. - Sensory Preception
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Visual changes may cause a erson to stumble, lose balance and fall.
Hearing defict may prevent hearing safery alarms, automobile horns, and sirens and may not hear healthcare instruction.
Smelling loss reduces abiility to detect leaking gas or smoke.
Taste loss may result in unsafe eating habits or may eat tainted food. - Knowledge
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Safety & security precautions is curcial for promoting and maintaining wellness.
Assessment: Id and recognize potentially threatening circumstances. - Ability to Communicate
- The nurse must assess any factor that influences the patient's ability to receive and send messages
- Physical Health State
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Pay particular attentoin to health teaching concerning the person's ability to maintain a sense of balance and carefully assists the pt with ambulation to prevent falls.
Many pt's who fall have a primary or secondary Dx of cardiovascular disease, such as stroke.
Maximize pt's potential by considering safety factors in all phases of the illness and recovery experience. - Psychosocial Health State
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Stressful situations tend to narrow a person's attention span & make them more prone to accidents.
Effects tend to be more devasting in the person's later years.
Depression may result in confusion & disorientation, accompanied by reduced awareness or concern about environmental hazard. - Assessing the Individual
- Consists of a Nursing History & Physical Exam
- Nursing History
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Be alert to history of falls or accidents.
A person w/ a history is likely to fall again.
Note any assistive devices (cans or walkers)
Be alert to any history of drug or alcohol abuse.
Knowledge of family support systems and the home environment. - Physical Examination
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Assess the pt’s mobility status, ability to communicate, level of awareness or orientation and sensory perception in the physical examination.
Recognize any manifestations that suggest domestic violence or neglect. - Assessing the Environment
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Assessment of the environment requires the same attention to safety.
Risk in the home, community, and healthcare agency may cause injury.
Assessment includes identifying individuals at risk & recognizing unsafe situations.
Recognizing these factors helps the nurse develop an individual plan of care and nursing interventions for protecting the pt.
Focus assessment on the pt’s developmental level and health status.
Assess your own environmental safety when visiting unfamiliar areas. - Falls: High Risk Factors
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1) Age of 65 or older
2) History of falls
3) Impaired vision or sense of balance
4) Altered gait or posture
5) Meds regimen that include diuretics, tranquilizers, sedatives, hypnotics or analgesics
6) Postural Hypotension
7) Slow reaction time
8) Confusion or disorientation - Fires: Risk Factors
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1) Smoking in bed or falling asleep while smoking on a sofa or chair
2) Kitchen Stoves
3) Candles
4) Electric Heaters
5) Faulty Wiring
6) Unsafe electrical equipment - Poisoning: Risk Factors & Facts
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1) Childhood poisoning has been reduced drastically in the past 10yrs
2) Young children: Ingestion of household chemicals
3) Older children: Swallowing meds in a suicide attempt
4) Preschoolers: Ingestion of lead-containing substances in home
5) Adolescents & Young Adults: Experimenting with drugs may suffer accidental poisoning and death
6) Inhalants on store shelves & in homes may provide the opportunity for kids to “sniff’ or “huff’ these dangerous substances.
7) Older person may inadvertently take an overdose of a medication - Suffocation and Choking: Risk Factors
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1)Drowning
2)Choking on a foreign substance inhaled into the trachea
3)Gas or smoke poisoning
4)Infant may suffocate when a pillow or a piece of plastic inadvertently covers the nose or mouth - Firearm Injuries
- Young children are curious and like to explore their surroundings and when they encounter a loaded gun the outcome is often tragic
- Neonate and Infant Safety
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Smoking lowers birthweight.
Alcohol & drugs may cause adverse effects that are apparent at birth.
Never leave infants unattended. Use crib rails & monitor the setting for objefcts that can be swallowed.
Rear facing carseat if under 1yr & less than 20lbs.
Air bags in cars can casue injury to kids in front seat.
Most parents don't facing carseats or harness straps tight enough. - Toddler & Preschooler Safety
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Childproof the home environment.
Ingestion of poisons or meds is major threat.
Protecting kids are also includes being alert to manifestations that indicate child abuse.
Abuse can be physical, sexual or emotional and may also be a result of neglect. - Adolescent Safety
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At risk for MVA
Important to wear seat belt & discuss drugs & alcohol.
Education regarding smoking can prevent them from starting.
Body piercing popular sites: ears, nose, eyebrows, lips, tongue, nipples, navel & genitals.
Risk for infection is real.
Gun is most common form of suicide.
Encouragement & education about ways to solve arguments w/o guns & violence.
Guidance & direction for developing a healthful lifestyle while coping w/ the stresses of daily living. - Older Adult Safety
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Most accidents are preventable.
Vision changes, slowed reaction & impaired thinking due to mental illness are concerns.
Keep auto's in optimal driving condition to prevent accidents.
Regular eye exams, wear corrective lenses if needed
Keep noise (radio & others equip) to a minimum.
Accidental overdosing on meds, related to poor eyesight & confusion.
Med trays can be pre-filled to lower Over dosing. - Orienting the Person to Surroundings
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Being familiar with surroundings is less likely to suffer an accidental injury.
Orient the pt to the safety features & equip room.
Explain and demonstrate the adjustable bed & side rails, call sys, telephone, TV and bathroom.
Stress to family the importance of orienting older people with new surroundings. - Using Restraints
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Restraints are physical devices that limit pt's movement.
Use of restraints for purposes of protecting pt from harm in know seen as questionable.
Hazards of restraints:
1) Danger of Suffocation from entrapment in side rails or improperly applied vest.
2) Impaired Circulation
3) Altered skin intergrity
4) Pressure ulcer & contractures
5) Diminished muscle & bone mass
6) Fractures
7) Altered nutrition & hydration
8) Aspiration & breathing difficulties
9) Incontinence
10) Changes in mental status - Side Rail as Restraints
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Side rail is not considered a restraint if pt asked for it to be raised.
Pt must be able to raise & lower it themselves.
If family memeber asks for side rails to be used for a pt, the nurse must review benefits & risks assoc w/ thier use and periodically evaluate the reason for their use.