patient safety ch 27
TRANSCRIPT
-
8/20/2019 Patient Safety Ch 27
1/35
Client SafetyFree from
Harm
-
8/20/2019 Patient Safety Ch 27
2/35
Environmental
Physical Needs – Oxygen
– Nutrition
– temperature
Psychosocial Needs – Acceptance
– Safety
– Sense of well being
-
8/20/2019 Patient Safety Ch 27
3/35
Physical Haards
!"A#s $alls%% Poisoning &rownings $ires 'urns
%%$alls are the most common admissioncriteria for older adults
-
8/20/2019 Patient Safety Ch 27
4/35
Prevention
Ade(uate lighting
)emove obstacles
Provide assistance e(uipment
Secure environment
-
8/20/2019 Patient Safety Ch 27
5/35
Psychosocial Haards
Carbon monoxide
Poor nutrition
*emperature extremes
-
8/20/2019 Patient Safety Ch 27
6/35
+nterventions
Educate – +nspect home e(uipment
– S,S of carbon monoxide poisoning
Home assessment Handwashing
Physical assessment
-
8/20/2019 Patient Safety Ch 27
7/35
Other EnvironmentalHaards *ransmission of pathogens Pollution
– Air- .and- /ater- Noise
*errorism – 'ioterrorism
-
8/20/2019 Patient Safety Ch 27
8/35
Safety )is0s of
&evelopmentalStages
-
8/20/2019 Patient Safety Ch 27
9/35
+nfant- *oddler- Preschooler
+n1uries are leading cause of death inchildren 2 3 yr old
Poisoning Accidents,$alls
-
8/20/2019 Patient Safety Ch 27
10/35
School Age Child
Stranger danger Sports in1uries
'i0e in1uries%% – %%3,4 of all bicycle fatalities occur with
children b,t 5637yrs
-
8/20/2019 Patient Safety Ch 27
11/35
Adolescent
)is06ta0ing behaviors – Smo0ing
– &rugs
– Promiscuity
!"A#s &rownings
-
8/20/2019 Patient Safety Ch 27
12/35
Adult
.ifestyle Habits – Alcohol
– Smo0ing
– &rugs
– Stress
-
8/20/2019 Patient Safety Ch 27
13/35
Older adult
$alls !"A#s
'urns !edication errors
-
8/20/2019 Patient Safety Ch 27
14/35
Physical Assessment $indings that+ncrease )is0s in Older Adults
!usculos0eletal changes – &ecrease strength and function
Nervous system changes – Slower reaction time- decrease
sensitivities
Sensory changes – Cataracts- impaired hearing,sight
89 changes – Nocturia- incontinence
-
8/20/2019 Patient Safety Ch 27
15/35
)is0s in the Health CareSetting !edical errors $alls
Accidents – Client
– Procedure
– E(uipment
-
8/20/2019 Patient Safety Ch 27
16/35
Nursing +nterventions
Assessment – Attain a good history :p 4;
-
8/20/2019 Patient Safety Ch 27
17/35
&ecreasing the !edicalError )is0s
National Patient Safety 8oals from ?CAHO
!edication safety procedures Hand6o@ reports &ocumentation
Healthcare associated infections Surgical re ris0s &ecrease $lu,Pneu ris0s for
institutionalied patients
-
8/20/2019 Patient Safety Ch 27
18/35
Nursing +nterventions
&iagnosis – )eview collected data
– +dentify related factors,dening
characteristics – $ormulate nsg diagnoses
-
8/20/2019 Patient Safety Ch 27
19/35
Nursing &iagnoses
+mpaired home maintenance )is0 for +n1ury
Bnowledge decit DDDDDDDDDDDDD &isturbed thought processes )is0 for poisoning
-
8/20/2019 Patient Safety Ch 27
20/35
Nurse#s Plan
Planning – /hat areas can help> :ex Home health-
P*=
– +nclude client – Have everyone collaborate together
– Prioritie
– Educate
-
8/20/2019 Patient Safety Ch 27
21/35
Nurse#s Plan
+mplementation
– Health Promotion
– &evelopmental +nterventions
– Environmental +nterventions
-
8/20/2019 Patient Safety Ch 27
22/35
EducateFFFFF
-
8/20/2019 Patient Safety Ch 27
23/35
Environmental +nterventions
$alls )estraints
Side rails Seiures $ires
-
8/20/2019 Patient Safety Ch 27
24/35
)estraints
9se as a last resort
Bnow agency policy
Attach to bed frame only
Guic0 release tie $re(uent assessment of :usually (3h=
– S0in- color- temp- sensation
–
Pulses distal to the restraint – 'athroom needs
– Oral needs :water- food- etc=
-
8/20/2019 Patient Safety Ch 27
25/35
)estraints cont#
)emove restraints (
-
8/20/2019 Patient Safety Ch 27
26/35
Heat andCold
Application
-
8/20/2019 Patient Safety Ch 27
27/35
*herapeutic E@ectsHeat
"asodilation )educed blood viscosity
)educed muscle tension +ncreased tissue metabolism +ncreased capillary permeability
-
8/20/2019 Patient Safety Ch 27
28/35
*herapeutic E@ectsCold
"asoconstriction .ocal anesthesia
)educed cell metabolism +ncreased blood viscosity &ecreased muscle tension
-
8/20/2019 Patient Safety Ch 27
29/35
"ariables to *olerance
.ittle body fat Open wounds- bro0en s0in- stomas
Edema I,or immature scar tissue P"& Confusion,unconscious state
Spinal cord in1ury .ocalied infection
-
8/20/2019 Patient Safety Ch 27
30/35
*ypes of Heat and ColdApplications
!oist hot compress Sit bath,warm soa0
A(uathermia pads Hypo,hyperthermia blan0ets Cold
–
!oist- cold compress – +ce application
– Polar pac0
-
8/20/2019 Patient Safety Ch 27
31/35
Safety )is0s +nterventions
Protect damaged s0in *ime application *est temperature and set Sensitive areas Chec0 fre(uently Bnow the ris0 factors Safely position client
– Call light%%%
Educate of reason and location to be
treated
-
8/20/2019 Patient Safety Ch 27
32/35
$ire Safety
Alarms Plan of action
– )6rescue and remove all clients indanger
– A6activate the alarm
– C6conne the re close all
doors,windows- cut o@ oxygen supply – E6extinguish the re
-
8/20/2019 Patient Safety Ch 27
33/35
Poison
Child resistant caps Beep poisonous agents out of reach
!edicine,Pill organier
Call the Poison Control Center
immediately
-
8/20/2019 Patient Safety Ch 27
34/35
Seiures
Assess history Pad side rails and headboard Have airway and suction ready
Side6lying if possible Call !& when seiure begins Stay at 'S- note time began and ended +nform pt what happened Status Epilepticus6medical emergency-
oral airway if possible :p 4J;=
-
8/20/2019 Patient Safety Ch 27
35/35
Education is the key!!