CHAPTER EIGHT

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CHAPTER EIGHT
PROMOTING SAFETY
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RISK FACTOR

• AGE
• CHILDREN AND THE ELDERLY NEED TO BE PROTECTED
  FROM INJURY
• PHYSICAL CHANGES OF AGING PUT OLDER PERSONS AT
  RISK OF ACCIDENTS
• MOVEMENTS ARE SLOWER AND LESS STEADY. BALANCE
  IS AFFECTED.
• HAVE DECREASED STRENGTH
• DECREASED SENSITIVITY TO HEAT AND COLD
• POOR VISION AND HEARING

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RISK FACTOR

• DECREASED MENTAL AWARENESS
• CONFUSED PATIENTS MAY PLACE THEMSELVES IN DANGER
  BECAUSE THEIR JUDGEMENT IS IMPAIRED
• A PERSON IN A COMA ( UNCONSCIOUS ) IS TOTALLY
  HELPLESS AND DEPENDENT ON OTHERS FOR SAFETY

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RISK FACTOR

• IMPAIRED VISION
• MAY NOT BE ABLE TO SEE THINGS IN THEIR WAY. MAY
  BE ACCIDENTALLY POISONED
• IMPAIRED HEARING
• MAY NOT HEAR WARNING SINALS OR FIRE ALARMS
• IMPAIRED SMELL AND TOUCH
• MAY NOT DETECT SMOKE OR GAS ODORS
• DECREASED SENSITIVITY TO HEAT AND COLD

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RISK FACTOR

• IMPAIRED MOBILITY
• SOME DISEASES AND INJURIES AFFECT MOBILITY
• PERSON MAY BE AWARE OF DANGER BUT UNABLE TO
  MOVE TO SAFETY

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RISK FACTOR

• MEDICATIONS
• MEDICATIONS MAY CAUSE WEAKNESS, DIZZINESS, OR
  CONFUSION
• MEDICATIONS USED TO INDUCE URINATION OR
  DEFECATION MAY CAUSE THE PATIENT TO FALL WHILE
  HURRYING TO THE TOLIET

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RISK FACTOR

• STAFF NEGLIGENCE
• FAILURE TO CLEAN UP A SPILL
• INCORRECT MOVING AND LIFTING TECHNIQUES
• IMPROPER USE OF RESTRAINTS
• NOT ANSWERING CALL LIGHTS PROMPTLY

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THE MOST FREQUENT ACCIDENT IN A HEALTH FACILITY
IS A FALL AND THE MOST COMMON CAUSE OF A FALL IS
WET, SLIPPERY FLOORS.
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IDENTIFY THE PATIENT BY CHECKING THE ID BRACLET
BEFORE YOU GIVE CARE
THE BRACLET HAS THE PERSONS NAME, ROOM AND BED
NUMBER, BIRTH DATE, AGE, AND OTHER IDENTIFYING
INFORMATION
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ACCIDENT PREVENTION
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ACCIDENT PREVENTION
ALWAYS ANSWER CALL LIGHTS PROMPTLY
SIDE RAILS HELP PREVENT THE PATIENT FROM FALLING
OUT OF BED
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SAFETY MEASURES TO PREVENT FALLS

• HELP WITH ELIMINATION NEEDS
• USE CORRECT PROCEDURES AND EQUIPMENT FOR
  TRANSFERS
• GRAB BARS IN SHOWERS AND BATHROOMS
• KEEP BED IN LOWEST HORIZONTAL POSITION
• BED RAILS ARE USED ACCORDING TO THE CARE PLAN
• CRUTCHES, CANES, AND WALKERS HAVE NON-SKID TIPS
• WHEEL LOCKS ON BEDS AND WHEELCHAIRS
• NON-SKID FOOTWEAR USED WHEN UP
• RESPOND PROMPTLY TO BED AND CHAIR ALARMS

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FALL STATISTICS

• MOST FALLS OCCUR IN THE EVENING
• A HISTORY OF FALLS INCREASES THE RISK OF
  FALLING AGAIN
• FALLS ARE ALSO LIKELY TO OCCUR AT SHIFT CHANGE

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BED RAILS
THE NURSE AND THE CARE PLAN WILL TELL YOU WHEN TO
RAISE THE BED RAILS BED RAILS PREVENT THE PERSON
FROM GETTING OUT OF BED ARE CONSIDERED
RESTRAINTS THE PERSON MUST GIVE CONSENT FOR BED
RAILS TO BE USED RESTRAINTS MUST HAVE A DOCTORS
ORDER YOU MAY LOWER THE RAILS TO GIVE CARE, BUT
RAISE THEM BEFORE YOU LEAVE THE BEDSIDE ALWAYS
LOWER THE BED TO THE LOWEST POSITION WHEN
FINISHED GIVING CARE
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HAND RAILS AND GRAB BARS
HAND RAILS ARE PLACED IN HALLWAYS TO HELP SUPPORT
PERSONS WHO ARE WEAK OR UNSTEADY GRAB BARS ARE IN
BATHROOMS AND IN SHOWER AND TUB ROOMS
WHEEL LOCKS
LOCK WHEELS ON BED WHEN GIVING BESIDE CARE OR
WHEN TRANSFERRING TO AND FROM BED WHEELCHAIR AND
STRETCHER WHEELS ARE LOCKED DURING TRANSFERS
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REPORTING ACCIDENTS AND ERRORS
ACCIDENTS ARE RECORDED ON A SPECIAL FORM CALLED
AN INCIDENT REPORT.
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PREVENTING BURNS

• SMOKE ONLY IN SMOKING AREA
• DO NOT LEAVE SMOKING MATERIAL AT BEDSIDE
• DO NOT ALLOW PERSON TO SMOKE IN BED
• DO NOT ALLOW PERSON TO SMOKE NEAR OXYGEN
• SUPERVISE HEATING PAD USE
• MEASURE BATH WATER TEMPERATURE

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PREVENTING POISONING

• MAY BE CAUSED BY CONFUSION OR POOR VISION WHEN
  READING LABELS
• CLEANING AGENTS AND HAZARDOUS MATERIALS SHOULD
  BE KEPT IN LOCKED CABINETS
• KEEP PERSONAL CARE ITEMS (SHAMPOO, MOUTHWASH,
  DEODORANT) AWAY FROM CONFUSED RESIDENTS

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PREVENTING SUFFOCATION

• CUT FOOD INTO SMALL PIECES
• MAKE SURE DENTURES ARE IN PLACE. REPORT LOOSE
  FITTING DENTURES
• REPORT PERSONS WITH SWALLOWING DIFFICULTIES
• DO NOT GIVE FLUIDS TO PERSONS WITH FEEDING
  TUBES
• POSITION THE PERSON PROPERLY IN BED
• USE RESTRAINTS AND SIDE RAILS CORRECTLY

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PREVENTING EQUIPMENT ACCIDENTS
DO NOT USE EQUIPMENT WITH FRAYED CORDS DO NOT
OVERLOAD ELECTRICAL OUTLETS
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SAFETY MEASURES TO PREVENT EQUIPMENT ACCIDENTS

• FOLLOW MANUFACTURERS INSTRUCTIONS
• DO NOT USE UNFAMILIAR ITEMS WITHOUT TRAINING
• USE ITEM ONLY FOR ITS INTENDED PURPOSE
• REPORT BROKEN OR DAMAGED ITEMS
• TURN OFF EQUIPMENT BEFORE UNPLUGGING IT

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SAFETY MEASURES WITH WHEELCHAIRS

• ALWAYS PLACE THE PATIENTS FEET ON THE
  FOOTPLATES
• ALWAYS LOCK THE WHEELS WHEN TRANSFERRING
• CLEAN THE WHEELCHAIR ON A REGULAR BASIS
• MOVE THE FRONT RIGGING OUT OF THE WAY WHEN
  TRANSFERRING

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BACK INTO THE ELEVATOR SO THE PATIENT FACES THE
FRONT
BACK DOWN A RAMP WITH A WHEELCHAIR
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STRETCHER SAFETY

• IT TAKES TWO WORKERS TO SAFELY TRANSFER A PERSON
  ON A STRETCHER
• FASTEN THE SAFETY STRAPS WHEN A PERSON IS ON A
  STRETCHER
• ALWAYS RAISE THE SIDERAILS ON THE STRETCHER
• MAKE SURE THE PERSONS ARMS AND HANDS ARE
  INSIDE THE RAIL
• PUSH THE STRETCHER FEET FIRST
• ONE PERSON STANDS AT THE HEAD AND ONE AT THE FOOT
• NEVER LEAVE THE PERSON UNATTENDED

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TRANSFER THE PATIENT FEET FIRST DOWN A RAMP
ENTER THE ELEVATOR HEAD FIRST
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THE FALLING PATIENT
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HAZARDOUS SUBSTANCES
A HAZARDOUS SUBSTANCE IS ANY CHEMICAL IN THE
WORKPLACE THAT CAN CAUSE HARM HAZARDOUS
SUBSTANCES MUST HAVE WARNING LABELS MATERIAL
SAFETY DATA SHEETS (MSDS) AN INFORMATION SHEET
ABOUT THE HAZARDOUS CHEMICAL
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FIRE SAFETY
EXAMPLES OF FIRE HAZARDS
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FIND THE SAFETY HAZARDS
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FIRE
TRIANGLE

• THREE THINGS ARE NEEDED FOR A FIRE
• A SPARK OR FLAME
• A MATERIAL THAT WILL BURN
• OXYGEN

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OXYGEN SAFETY

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YOUR FIRST RESPONSIBILITY IS TO REMOVE ALL
PATIENTS WHO ARE IN IMMEDIATE DANGER. CLOSE ALL
DOORS AND CLEAR THE HALLWAY OF EQUIPMENT DO NOT
USE THE ELEVATOR IN A FIRE
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KNOW WHERE THE EXITS ARE LOCATED
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FIRE EXTINGUISHERS
TYPE A IS USED ON PAPER, WOOD, OR TRASH CAN
FIRES TYPE B IS USED ON FLAMING LIQUIDS, SUCH
AS OIL OR GREASE TYPE C IS USED FOR ELECTRICAL
FIRES TYPE ABC IS USED FOR ALL KINDS OF FIRES
AND IS THE MOST COMMON TYPE FOUND IN HEALTH CARE
FACILITIES
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• TO USE A FIRE EXTINGUISHER
• P- PULL THE SAFETY PIN
• A- AIM THE EXTINGUISHER TOWARD THE BASE OF THE
  FIRE
• S -SQUEEZE DOWN ON THE HANDLE
• S- USE A SWEEPING MOTION OVER THE BASE OF THE
  FIRE

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RESCUE TECHNIQUES
ONE PERSON ONE RESCUER
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RESCUE TECHNIQUES
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RESCUE TECHNIQUES
TWO RESCUER TECHNIQUE
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WORKPLACE VIOLENCE

• VIOLENT ACTS DIRECTED TOWARD PERSONS AT WORK
• TO DEAL WITH AGGRESIVE PERSONS
• STAND AWAY FROM THE PERSON
• STAND CLOSE TO THE DOOR
• KEEP YOUR HANDS FREE
• STAY CALM
• DO NOT TOUCH THE PERSON
• LEAVE THE ROOM AS SOON AS YOU CAN
• TELL THE NURSE OR SECURITY OFFICER