7 Safety and Body Mechanics 1. Define important words in this chapter aspiration: inhaling food or drink into the lungs. atrophy: weakening or wasting

7Safety and Body Mechanics

1. Define important words in this chapteraspiration:

inhaling food or drink into the lungs.

atrophy: weakening or wasting of muscles.

body mechanics: the way the parts of the body work together when you move.

chemical restraint: medications used to control a person’s behavior.


1. Define important words in this chapter (con’t)combustion:

the process of burning.

cyanosis: blue or pale skin and/or mucous membranes due to decreased oxygen in the blood.

disorientation: confusion about person, place and time.

dysphagia: difficulty in swallowing.


1. Define important words in this chapter (con’t)flammable:

easily ignited and capable of burning quickly.

hoarding: collecting and putting things away in a guarded way.

Material Safety Data Sheet (MSDS): sheets that provide information on the safe use, hazards, and emergency steps to take when using chemicals.

PASS: acronym for use of a fire extinguisher; stands for Pull-Aim-Squeeze-Sweep.


1. Define important words in this chapter (con’t)postural support:

device that maintains good posture or body alignment; also considered a restraint.

protective device: device that maintains good posture or body alignment; also considered a restraint.

RACE: acronym for steps taken during a fire; stands for Remove-Activate-Contain-Extinguish.

restraint: a physical or chemical way to restrict voluntary movement or behavior.


1. Define important words in this chapter (con’t)restraint alternatives:

measures used instead of physical or chemical restraints.

restraint-free: an environment in which restraints are not kept or used for any reason.

scalds: burns caused by very hot liquids.

slip knot: a special quick-release knot used to tie restraints.


1. Define important words in this chapter (con’t)suffocation:

death from a lack of air or oxygen.

synthetic: artificial or man-made.


2. List common accidents in facilities and ways to prevent them

Common accidents in facilities include:

• Falls

• Resident Misidentification

• Burns/Scalds

• Poisoning

• Choking

• Cuts and Other Injuries


3. Explain the Material Safety Date Sheet (MSDS)

OSHA requires that all dangerous chemicals have an MSDS.

The information the MSDS provides includes:

• The chemical ingredients of the product

• The dangers of the product

• The protective items to wear when using the product

• The correct method of using and cleaning up the product

• The emergency response needed when the product is spilled or splashed

• The safe handling procedures for the product


4. Describe safety guidelines for sharps and biohazard containers

For safe use of sharps and biohazard containers:

• Always wear gloves.

• Keep your hands above the opening of the biohazard container.

• Only touch the bottom of a biohazard container.

• Replace the sharps container when it’s ¾ full.

• Use the biohazard container for anything contaminated with infectious waste.

• Wash your hands after putting anything into the sharps container or biohazard container.


5. Explain the principles of body mechanics and apply them to daily activity

Body mechanics is the way the parts of the body work together when you move.

The basic principles of body mechanics are:

• Alignment

• Center of gravity

• Base of support

7 Safety and Body Mechanics

Transparency 7-1: Body Alignment


Transparency 7-2: Lifting Heavy Objects from the Floor


Transparency 7-3: When a Resident is Restrained

• The resident must be checked at least every 15 minutes. At least every two hours the following must be done:

• Release the restraint for at least 15 minutes.• Offer assistance with toileting. Check for

episodes of incontinence and provide care.• Offer fluids.• Reposition the resident.• Ambulate resident if able.


6. Define two types of restraints and discuss problems associated with restraints

• Physical restraints restrict voluntary movement or behavior.

• Chemical restraints are medications used to control a person’s behavior.


7. Define the terms “restraint free” and “restraint alternatives” and list examples of restraint alternatives

Restraint-free care means that restraints are not kept or used for any reason.

Restraint alternatives are creative ideas that help avoid the need for restraints and include:

• Taking the resident for a walk

• Answering the call light immediately

• Getting the resident involved with hobbies, etc.


8. Describe beginning and ending steps in care procedures

Beginning steps (for most care procedures)

• Identify yourself by name. Identify the resident. Greet the resident by name.

• Wash your hands.

• Explain the procedure to resident.

• Provide for the resident’s privacy with a curtain, screen, or door.

• Practice good body mechanics.


8. Describe beginning and ending steps in care procedures (con’t)

Ending steps (for most care procedures)

• Make resident comfortable.

• Return bed to low position, if raised. Ensure resident’s safety. Remove privacy measures.

• Leave call light within resident’s reach.

• Wash your hands.

• Report any changes in the resident to the nurse. Document procedure using facility guidelines.


9. Identify what must be done if a restraint is ordered

Restraints are used only after everything else has been ruled out and only with a doctor’s orders.

Guidelines for restraints:

• Know your state’s laws.

• Follow manufacturer’s instructions.

• Use the correct size and style of restraint.

• Always use a slip knot.

• Never tie the restraint to side rails.


9. Identify what must be done if a restraint is ordered (con’t)

Guidelines for restraints (con’t):

• Ensure that the restraint is not too tight.

• Apply vest or belt restraint over clothing.

• Place the call light within resident’s reach.

• Document all information.

Applying a Physical Restraint Tie Safely

Equipment: correct size and type of restraint

1. Identify yourself by name. Identify the resident. Greet the resident by name.

2. Wash your hands.

3. Explain procedure to the resident. Speak clearly, slowly, and directly. Maintain face-to-face contact whenever possible. Encourage resident to assist if possible.


4. Provide for the resident’s privacy with a curtain, screen, or door.

5. Apply the restraint carefully. Follow manufacturer’s directions and facility policy. For each type of restraint, make sure that it is not too tight.

6. CHEST or BELT-STYLE RESTRAINTS: Make sure you do not catch breasts or skin in the restraints. Double-check before actually tying together or attaching buckle.


7. VEST: The criss-cross in the vest restraint must be placed on the front of the body.

8. MITT: Place a rolled-up washcloth or commercial hand roll in the mitt restraint. This helps the hand stay in proper alignment and helps prevent contractures (permanent and painful shortening of a muscle).


9. WRIST/ANKLE: Make sure the restraint will not slide off the wrist or ankle.

10. Use slip knot to tie the restraint. Make sure it is not too tight. If restraint is used on a resident who is in bed, tie it to the movable part of the bed frame. Do not tie it to the side rail.

11. Make resident comfortable.


12. Be courteous and respectful at all times.

13. Report any changes in the resident to the nurse. Document procedure using facility guidelines.

14. Check resident every 15 minutes. (Residents with mitt restraints must be checked every five minutes because they are unable to use the call light.)


(con’t) Release the restraint(s) every two hours for at least 15 minutes and provide all care, such as giving fluids, toileting, walking (if ambulatory), or range of motion exercises.


10. List safety guidelines for oxygen use

Guidelines for safety with oxygen:

• Post “No Smoking” and “Oxygen in Use” signs.

• Remove fire hazards from the room.

• Remove flammable liquids from the room.

• Do not allow candles, lighters, or matches around oxygen.

• Residents must not wear wool, nylon, or other synthetic clothing.

• Check the residents nasal area and behind the ears for irritation.

• Learn how to turn off oxygen in case of fire.


11. Identify safety guidelines for intravenous (IV) lines

Do not:

• Take blood pressure on an arm with an IV.

• Get the IV site wet.

• Pull on or catch the tubing.

• Leave the tubing kinked.

• Lower the IV bag below the IV site.

• Touch the clamp.

• Disconnect the IV or the alarm.


11. Identify safety guidelines for intravenous (IV) lines (con’t)

Notify nurse if the following occurs:

• The needle or catheter has fallen out or moves out of the vein.

• The armboard becomes loose.

• The tubing is disconnected.

• Blood appears in the tubing.

• The IV fluid in the bag is gone or almost gone.

• The IV pump is beeping, etc.


12. Discuss fire safety and explain the “RACE” and “PASS” acronyms

RACE – in case of fire:

• Remove residents from danger

• Activate alarm (or call 911)

• Contain the fire by closing doors and windows, if possible

• Extinguish the fire

PASS – to use an extinguisher

• Pull the pin

• Aim at the base of the fire when spraying

• Squeeze the handle

• Sweep back and forth at the base of fire


13. List general safety steps to protect yourself and residents in a facility

• Keep valuable personal items at home.

• Ask the nurse to lock up residents’ valuable items.

• If a visitor or staff member makes you uneasy, do not leave resident alone with him.

• Follow guidelines for number of visitors allowed at one time in a resident’s room.

• Do not share staff or resident information with anyone.

Documents

7 Safety and Body Mechanics 1. Define important words in this chapter aspiration: inhaling food or drink into the lungs. atrophy: weakening or wasting