Safe Environment Nursing 1
Terms
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- What is Safety?
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Freedom from actual or perceived psychological and physical injury
Basic needs for the patient's well-being and survival are met. - Where is the Environment?
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A place in which the nurse and patient interact
Home
Community
Hospital
Long-term care facility
Clinic - Nurse Assessment for Characteristics of Safe Environment
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Basic needs are met
Physical hazards reduced
Transmission of pathogens is reduced
Pollution is controlled
Sanitation is maintained
Integrity of skin is maintained
Staff safey
Nervous and immune systems function
Feeling of well being- "Feeling safe" - Basic Needs
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Oxygen
Temperature and humidity
Nutrition - What are Hazards?
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Physical hazards
Chemical hazards
Biological hazards
Environmental hazards
Radiation
Thermal - Physical Hazards
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Falls and accidents
Restraints
Side rails
Lighting
Obstacles and clutter
Temperature control - Nursing Interventions
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Minimize exposure to radiation: time and distance and shielding
Minimize use of Portable CXR
Know instructional policy reguarding
radiation - Restraints
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Indications for use:
Risk of injury to self or others
Interruption of treatment
Disruptive or disturbing behavior
Types:
Physical
Chemical
Seclusion - Nursing considerations when using restraints
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Restraint free environment it optimum
Alternative methods
Agency policy
Patient Assessment
Circulation checks, ROM
Hygiene, food, and fluid, elimination needs
Must have a Physician order for use and renewed every 24 hours - Chemical Hazards
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Poisons
Chemicals
Medications - Chemical Warfare
- The tactics and technique of conducting warfare by using toxic chemical agents. The chemicals include nerve gases; agents that cause temporary blindness, paralysis, hallucinations of deafness; eye and lung irritants; blistering agents, including mustard gas; defoliants; and herbicides
- Biological Hazards
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Microorganisms
Bacteria, virus, fungi, rickettsiae, protozoa, spirochete
Genetic - The nurse knows that biological safety is maintained when:
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Transmission of pathogens is reduced
Normal defense mechanisms of the body are supported
Inflammatory process (normal body response to the invasion of pathogens) is functioning
Skin and mucous membranes are intact - The Nurse always practices correct Handwashing
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Handwashing
Between patient contact
After contact with blood and body fluid
After contact with equipment or articles
contaminated with them
Immediately after gloves are removed
Before procudures
Soap and water versus alcohol base cleaners - Nurse always practices Asepsis
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Medical Asepsis
Clean technique
Reduction and prevention of the spread of microorganisms by:
Handwashing, clean gloves, cleaning/disinfecting
Surgical Asepsis
Sterile techniqe
ALL microorganisms including pathogens and spores are eliminated through sterilization procedures - The Nurse always follows Standard Precautions
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Always Maintain Standard Precautions to reduce the risk of transmission of blood-borne and other pathogens
Blood
All body fluids, secretions, excretions
Non-intact skin
Mucous membranes - The Nurse Wears the Appropriate Personal Protective Equipment
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Masks: droplet or airborne protection
Goggles: splashing or spraying
Gowns: barrier protection, fluid-resistant
Gloves: Clean, touching blood, body fluids, contaminated items
Shoe Protectors and Bonnets when appropriate - The Nurse Properly Uses and Disposes of Sharps
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Sharps are needles, scalpel blades, glass slides, sutures, test tubes
Disposed in rigid, leak and puncture proof labeled containers as near to the point of use as possible
OSHA guidelines: needless systems, retractable needle, protective devices,
DO NOT RECAP - The Nurse Provides Hygienic Care
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Bathing and skin care (Perineal)
Back rub
Foot & Nail care
Oral hygience
Hair & Scalp
Eyes, ears, nose - Basic principles of safety when providing hygenic care
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Capillary action carries microorgansims through wet surface
Friction will remove transient bacteria
Soaps and detergents decrease surface tension and act as emulsifying agents
A clean object becomes contaminated when in contact with a dirty one
Pathogens can be transmitted by direct or indirect contact. - Principles of Hygienic Care
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Miroorganism are transmitted by air currents
Bacteria multiply in we warm dark places
Barriers can be used to contain or exclude pathogens
All body secretions are considered contaminated - The Nurse creates a comforable environment
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Planning ahead, timeliness
Room Temperature, ventilation, noise
Odors
Pain
Neatness and organization
Cultural considerations in variations in frequency and type of bathing - The nurse assesses the patient for effects of poor hygiene
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Buildup of micoorganisms and resultant infections
Change in pH of skin
Gigivitis
Corneal abrasions
Skin breakdown
Social isolation and implications - Biological Warfare
- Warefare in which disease-producing microoransims, toxins, or organic biocides (anthrax, brucellosis, plague) are deliberately used to destroy, injure, or immobilize livestock, vegetation or human life.
- Environment Hazards
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Pollution
Air
Land
Water
Noise
Evidence of perception of crime - Thermal Hazards
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Fire
Electrical
Hypothermia
Hyperthermia - Nurisng Interventions
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Fire Safety: Use RACE acronym to set priorities
Rescue
Activate
Contain
Extinguish