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SAFETY RISK FACTORS

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SAFETY RISK FACTORS SAFETY Freedom from psychological and physical injury Essential for a client s well-being Critical thinking skills and nursing process used by ... – PowerPoint PPT presentation

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Title: SAFETY RISK FACTORS


1
SAFETY RISK FACTORS
2
SAFETY
  • Freedom from psychological and physical injury
  • Essential for a clients well-being
  • Critical thinking skills and nursing process used
    by nurses for assessment of environmental hazards

3
ENVIRONMENTAL SAFETY
  • Includes all physical and psychosocial factors
    that influence the life and survival of a client.
  • Includes home, school, clinic, hospital,
    community center , long-term care facility

4
BASIC NEEDS MET IN A SAFE ENVIRONMENT
  • Physical hazards reduced
  • Transmission of pathogens reduced
  • Sanitation is maintained
  • Pollution is controlled
  • Threat of attack prevented

5
ENVIRONMENTAL HAZARDS
  • Oxygen-essential for life
  • Improperly functioning heating system may produce
    carbon monoxide
  • Symptoms may include nausea, dizziness, headache,
    decreased concentration
  • Fatigue

6
Environmental Hazards Contd
  • Nutrition-using nutrients to carry on essential
    body functions
  • Food poisoning- can result from improperly
    prepared or stored food

7
Environmental Hazards Contd
  • Temperature Humidity comfort zone (18.3
    23.9 C or 65 75 F)
  • Exposure to severe cold frostbite hypothermia
  • Exposure to extreme heat-heatstroke/ exhaustion
  • Humidity- amount of water vapor in air (60-70)

8
Control of Physical Hazards
  • Adequate lighting
  • Obstacles-extrinsic (remove small rugs)
    intrinsic(illness, drug therapy)
  • Bathroom hazards-grab bars
  • Security system
  • Smoke detectors

9
Transmission of Pathogens
  • Definitions
  • Pathogen-any microorganism capable of producing
    an illness
  • Immunization
  • Active immunity
  • Passive immunity
  • Human Immunodeficiency Virus (HIV)
  • Safe sex practices

10
Pollution
  • Air pollution
  • Land pollution
  • Water pollution
  • Noise pollution
  • Bio-terrorism
  • Department of Homeland Security

11
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12
DEVELOPMENTAL STAGES
  • Infant, toddler, preschooler- injuries are
    leading cause of death
  • School-age child- safety depends on instruction
    by parents, teachers, and nurses

13
DEVELOPMENTAL STAGES CONTINUED
  • Adolescent- greater independence may engage in
    risk-taking behaviors
  • Adults-threats related to lifestyle habits
  • Older adult- risks due to physiological changes
    that occur

14
DEVELOPMENTAL STAGES CONTD
  • Clients in all developmental stages may be
    subject to abuse.
  • Types child abuse, domestic violence, elder
    abuse
  • Nurses must be aware
  • Must be reported if abuse suspected

15
INDIVIDUAL RISK FACTORS(THREATS SAFETY)
  • Lifestyle-usage of drugs alcohol, risk takers
  • Impaired mobility-from muscle weakness
  • Sensory or communication impairment- visual,
    hearing , tactile

16
HEALTH CARE AGENCY(FALLS/ ACCIDENTS)
  • Environmental safety
  • Medical errors-8th leading cause of death
  • Errors due to system failures
  • Material Safety Data Sheets
  • Incident report

17
Environmental Safety Contd
  • Falls- 90 of reported incidents in hospitals
  • Increase in elderly due to age, gait problems
  • Bed to toilet transfers
  • Drug and drug interactions
  • Hip fractures-most serious

18
Client Inherent Accidents
  • Client primary reason for accident
    (self-inflicted cuts, injuries, ingestion or
    injection of foreign substance)
  • Seizure-hyper-excitation and disorderly discharge
    of neurons in brain leading to involuntary muscle
    contractions

19
PROCEDURE-RELATED ACCIDENTS
  • Medication and fluid administration errors
  • Preventive measures
  • Follow policy procedure for meds administration
  • Maintain surgical asepsis for sterile dressings

20
Equipment-Related Accidents
  • Result from malfunction, disrepair or misuse of
    equipment, from electrical hazards
  • Preventive measures
  • Read instructions before use
  • Safety checklist

21
PRINCIPLES OF BODY MECHANICS
  • Includes the knowledge of the actions of various
    muscle groups, understanding of the factors
    involved in the coordination of body movement,
    and familiarity with the integrated functioning
    of the skeletal, muscular, and nervous systems.

22
Body Mechanics Contd
  • Body Alignment
  • Body balance
  • Coordinated body movement

23
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24
BASIC POSITIONS
  • Supported Fowlers Position
  • Supine Position
  • Prone Position
  • Side-Lying Position
  • Sims Position

25
Positioning Devices
  • Pillows
  • Footboard
  • Trochanter roll
  • Trapeze bar

26
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28
TRANFERS
  • Positioning changes
  • Moving up in bed
  • Transferring from bed to chair
  • Transferring from bed to stretcher
  • Utilizing proper body mechanics

29
Transfers Contd
  • Moving clients-require various levels of
    assistance
  • Transfer bed to chair with one nurse requires
    patient assistance
  • Bed to stretcher-three person carry

30
AMBULATION
  • Independent
  • Assisted-assess activity tolerance
  • Assess tolerance to upright position
  • Assess strength
  • Assess presence of pain
  • Explain procedure

31
Assistive Devices
  • Clients recovering from a lengthy illness may
    require assistive devices.
  • Walkers
  • Canes
  • Crutches

32
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35
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36
SAFETY RESTRAINTS
  • A mechanical or physical device used to
    immobilize a client or extremity, restricts the
    freedom of movement or normal access to a
    persons body

37
Restraints Contd
  • Explain purpose to client family
  • Explain expected care
  • Explain precautions taken to avoid injury
  • Explain restraints are temporary
  • May need informed consent from family

38
Objectives for Physical Restraints
  • Reduce the risk of client injury
  • Prevent interruption of therapy
  • Prevent confused or combative client from
    removing life support
  • Reduce the risk of injury to others

39
Guidelines and Risk Factors for Using Physical
Restraints
  • Assess need for restraint
  • Assess behavior
  • Review agency policies
  • Inspect area where restraint is to be placed
  • Approach client in a calm manner
  • Provide privacy
  • Apply appropriate size restraints

40
Legal/ Policies Issues
  • Nurse is responsible for assessment of clients
    safety needs
  • Know agencys specific policy procedure
  • Must be clinically justified and part of medical
    treatment and plan of care

41
Legal Contd
  • Physicians order is required
  • Order must state type of restraint, location, and
    specific behaviors for which restraints are to be
    used and must have a limited time frame
  • Ongoing assessment by nurse

42
Recording /Reporting
  • Proper documentation should include behaviors
    that necessitated the use of restraints
  • Procedure used in restraining
  • Condition of the body part restrained
  • Evaluation of clients response
  • Remove prn for ROM etc..

43
Restraint Alternatives
  • Orient client family to surrounding
  • Encourage family or friends to stay
  • Provide appropriate visual and auditory stimuli
  • Use relaxation techniques
  • Evaluate all meds
  • Exercise or ambulate to a schedule

44
Unexpected Outcomes
  • Client has signs of impaired skin integrity
  • Assess skin provide appropriate therapy
  • Notify MD reassess the need for contd use of
    restraint
  • Client has altered neurovascular status

45
DISASTER MANAGEMENT
  • Federal Emergency Management Agency
    (FEMA)-central federal agency for emergency
    planning
  • Health Care Facility-follow facilitys policy
    procedure on management of large scale disasters

46
Internal Disasters
  • Nurse protects client from immediate injury
  • Setting priorities in case of fire using RACE
    mnemonic
  • R-rescue remove all clients in immediate danger
  • A-activate the alarm
  • C-confine the fire
  • E extinguish the fire

47
External Disaster
  • Nurses play important roles in planning
    implementing disaster relief efforts
  • Collaborate with community agencies
  • ANA-along with other agencies enhance nurses
    role
  • Focus on primary prevention
  • Bio-terrorism

48
Four Phases in Emergency Management
  • Mitigation identifies the kinds of emergency
    situations that may occur
  • Preparedness-steps taken to manage situations
  • Response-steps taken by staff in event of
    emergency
  • Recovery- steps taken to restore essential
    services

49
RISK MANAGEMENT
  • A system of ensuring appropriate nursing care
    that attempts to identify potential hazards and
    eliminate them before harm occurs

50
Risk Management Nurse
  • Identify possible risks
  • Analyze the risk
  • Act to reduce the risk
  • Evaluate the steps taken
  • Accurately document assessments and findings
  • Report significant changes in clients condition

51
Incident Reporting
  • Incident report or occurrence report is one tool
    used in risk management
  • Incident is any event that is not consistent with
    the routine operation of a health care unit or
    routine care of client
  • Follow policies procedures of agency

52
Types of Asepsis
  • Asepsis is the absence of pathogenic
    microorganisms.
  • Medical (clean) technique-includes procedures to
    reduce and prevent the spread of microorganisms
  • Surgical(sterile)- eliminates all microorganisms

53
Medical Aseptic Procedures
  • Hand Hygiene
  • Alcohol-based waterless antiseptic
  • Clean dressing procedures

54
Surgical Asepsis
  • Used during procedures that intentionally break
    the skin (IVs)
  • Surgical trauma or burns
  • Procedures that involve involve insertion of
    catheters into sterile body cavities

55
Principles of Surgical Asepsis
  • A sterile object is sterile only when touched by
    another sterile object
  • Only sterile objects placed on sterile field
  • Sterile field contaminated by prolonged exposure
    to air
  • 1 inch or 2.5 cm around border is considered
    contaminated

56
Chain of Infection
  • An infectious agent or pathogen
  • Reservoir
  • Portal of exit
  • Mode of transmission
  • Portal of entry
  • Susceptible host

57
The Infectious Process
  • Localized-client may experience localized
    symptoms such as pain tenderness at the wound
    site
  • Systemic-affects the entire body instead of just
    a single organ. Can be fatal

58
Stages of Infection
  • Incubation Period-interval between entrance of
    pathogen into body and appearance of first
    symptoms
  • Prodromal Stage-interval from onset of
    nonspecific s/s (tired)
  • Illness stage-client shows s/s (sore throat)
  • Convalescence-acute symptoms disappear

59
The Inflammatory Process
  • A protective reaction that neutralizes pathogens
    and repairs body cells.
  • Normal flora
  • Body systems defenses
  • Inflammation
  • Vascular cellular response
  • Inflammatory exudates
  • Tissue repair
  • General Adaptation Syndrome (GAS)

60
Stages of GAS
  • Alarm reaction stage-rising hormone levels result
    in increase blood volume, blood glucose levels
    etc
  • Resistance stage-body stabilizes
  • Exhaustion stage-body can no longer resist the
    effects of the stressor

61
OSHA GUIDELINES FOR HEALTH CARE PROVIDERS
  • Universal precautions shall be observed to
    prevent contact with blood or other potentially
    infectious material
  • Work practice control to eliminate employee
    exposure
  • Accessible hand-washing facilities
  • Hand-hygiene practices
  • No food kept where blood products are present

62
STANDARD PRECAUTIONS
  • Tier one
  • Hands are washed
  • Gloves are worn when touching body fluids
  • Masks are worn for splash occurrences
  • Gowns are worn if soiling of clothing is likely
  • Equipment is cleaned properly
  • Discard sharps instruments properly

63
Standard Precautions Contd
  • Tier two
  • Airborne precautions-mask (measles)
  • Droplet precautions- mask (mumps)
  • Contact precautions-gloves gown (respiratory
    synctial virus (RSV), scabies)

64
Personal Protective Equipment
  • Gowning- prevents soiling of clothes
  • Full face protection-when splashing may occur
  • Gloves- prevents transmission of pathogens by
    direct or indirect contact

65
Measures to Ensure a Safe Environment
  • Fire- smoke fire alarms plan of action in case
    of fire
  • Electrical-electrical equipment in good working
    order
  • Chemicals- out of reach of children stored
    properly

66
DOCUMENTATION PROCESSES
  • Documentation should be accurate, factual,
    complete, current, organized
  • Material Safety Data Sheet (MSDS)-provide workers
    ER personnel with the proper procedures for
    handling or working with a particular substance
  • Policies procedures-conform to state federal
    laws

67
Process for Reporting
  • Breaches in safety security
  • Ethics committee
  • Chain of command
  • Incident reports-risk management tool
  • Health Insurance Portability and Accountability
    Act (HIPPA)
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