Promoting Healthy Physiologic ResponsesPromoting Healthy Physiologic Responses

Safety

Concepts of Nursing NUR 212

Safety Culture

Safety is a functional concern of nurses from the bedside to the home and community.

Excellent nursing care is safe for both the clients receiving the care, and the workers involved in the delivery of health care.

Factors Affecting Client Safety

1. Age:• Fetus: maternal exposure e.g. drugs and smoking

• Infants: falling, suffocation, burns. Poisoning, and electrical shock

• Toddlers: falling, sharp object injury, automobile accident, poisoning, electrical shock

• Preschooler: injuries, suffocation, poisoning, burn, automobile accidents

• Adolescent: Vehicle accident, Suicide, sport injuries, substance abuse

• Adults: accidents (occupational or vehicle), fire burns, suicide

• Elderly: falling, burns, automobile accidents

Factors Affecting Client Safety

2. Lifestyle:• Unsafe work environment• Residence with high crime rates• Low income

3. Sensory and Perceptual Alterations: problem in senses

4. Mobility and health status: paralysis, patient after surgery

5. Emotional State: stress, or depressed

6. Cognitive awareness: unconscious, under narcotic

7. Ability to communicate: unable to read, speak

International Patient safety Goals

1. Correct Patient Identification.

2. Improve the effectiveness of communication.

3. Improve the safety of medication administration.

4. Reduce the risk of health care-associated infections.

5. Reduce the risk of patient harm resulting from falls.

6. Reduce the risk of surgical fires.

7. Prevent health care-associated pressure ulcers.

Focus of Safety Assessments

The individual

The environment

Specific risk factors• Falls• Fires• Poisoning• Suffocation and choking• Firearm injuries

Potential Occupational Hazards

Chemical and biological exposures

Physical exposures (lasers, radiation, noise)

Psychosocial stressors (shift work, threat of workplace violence)

Ergonomic stressors (lifting and moving clients)

Potential Occupational Hazards

Routes of Exposure

• Methods by which chemical and biological substances are assimilated into the body:

- Inhalation- Ingestion- Injection- Skin contact- Skin absorption

Latex Allergy• Irritant contact dermatitis

• Allergic contact dermatitis

Hand Hygiene

• Any dermatitis should be promptly reported to Employee Health.

• Barrier creams or special soaps are available.

• Strict guidelines on nail care and nail coverings should be implemented and followed.

Factors that Contribute to Falls

Age >65

History of falls

Impaired vision or balance

Altered gait or posture, impaired mobility

Postural hypotension

Confusion or disorientation

Unfamiliar environment

Nursing Diagnosis

Risk for Injury

• Risk for Suffocation: inadequate air available for inhalation

• Risk for Poisoning

• Risk for Trauma: wound, burn, fracture

• Risk for Aspiration: Entry of solids, liquids, into airway passages

• Risk for Disuse Syndrome: e.g. musculoskeletal inactivity

• Latex Allergy Response: hypersensitivity to the natural latex

Nursing Diagnosis

Risk for Infection Related to

• Invasive procedures

• Trauma

• Rupture of amniotic membranes

• Insufficient knowledge to avoid exposure to pathogens

Outcome Identification and Planning

Identification of actual or potential hazards

Reduction of the risk of injury and infection

Client/caregiver education regarding safety measures and modification of an unsafe environment

Implementation

Raise Safety Awareness and Knowledge

Bed Safety

Prevent Falls• Apply restraints• Ensure adequate lighting• Remove obstacles

33-15

Implementation

Types of physical restraints

A. Jacket

B. Belt

C. Mitten or Hand

D. Elbow

E. Limb or Extremity

F. Mummy

Implementation

Reduce Bathroom Hazards

Prevent Fire • Common causes of fire

• Fire prevention

• Protection of clients during a fire

• Institutional policies and procedures for fire containment and evacuation

Implementation

Ensure safe operation of electrical equipment.

• Three-pronged electrical plug that is grounded

• Warning labels on all equipment

• Electrical shock

Implementation

Reduce exposure to radiation.

• Both the client and the nurse are at risk for injury.

• Radiation injury can occur from overexposure or exposure to radioactive materials.

• General principles of radiation exposure and protection are based on time, distance, and using the shielding such as lead aprons

Implementation

Prevent poisoning.

• A poison is any substance that causes an alteration in the client’s health when inhaled, injected, ingested, or absorbed by the body.

• Antidotes and treatments are available for some but not all types of poisonings.

• Client education

Implementation

Reduce Noise Pollution

• Sensory overload can alter a client’s recovery by increasing anxiety, paranoia, hallucinations, and depression.

• Levels of 85-95 decibels for several hours can lead to progressive hearing loss.

• Safety measures include maintaining a quiet environment, traffic control, and providing earplugs.