ppt chapter 19

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Chapter 19

Safety


National Patient Safety GoalsNational Patient Safety Goals

• Description

• Purpose

• Potential methods for implementation


SafetySafety

• Major nursing responsibility

• Death from hospital errors: ranked between 5th – 8th leading cause of death by National Center for Health Statistics


Age-Related Safety Factors Age-Related Safety Factors

• Infants

– Falling off changing tables

– Unrestrained in automobiles

• Toddlers

– Climbing; accidental poisoning; falling downstairs or from high chairs; burns; electrocution; drowning


Age Related Safety Factors (cont’d)Age Related Safety Factors (cont’d)

• School-aged children and adolescents

– School-aged children: play-related injuries

– Adolescents: sports-related injuries

• Adults: ignoring safety issues, fatigue, sensory changes, effects of disease


Environmental HazardsEnvironmental Hazards

• Latex sensitization

• Thermal burns

• Asphyxiation

• Electrical shock

• Poisoning

• Falls


QuestionQuestion

•Is the following statement true or false?

Poisoning is a common hazard found only in homes.


AnswerAnswer

False.

Poisoning is a common hazard found in the home and health care environment.


Environmental Hazards (cont’d)Environmental Hazards (cont’d)

• Latex sensitization: allergic response to the latex proteins

– Latex is natural rubber sap

– Component of many household items

– Predisposition to latex sensitivity



• Types of latex reactions

– Contact dermatitis

– Immediate hypersensitivity

– Possible cross-reaction to fruits or vegetables



• Preparing a latex-free room

– Stock room with latex-free equipment, including gloves, client care equipment, and resuscitation equipment

– Wipe room clean of glove powder

– Communicate with other departments the need to use only latex-free equipment


Question Question


People with latex allergy may develop a cross-reaction to certain foods.


AnswerAnswer

True.

People with latex allergy may develop a cross-reaction to certain fruits and vegetables.



• Safeguarding clients and personnel

– Prevent latex sensitization

– If using latex gloves, avoid oil-based hand creams

– Wash hands thoroughly after removing gloves


Question Question


When using latex gloves, a nurse should use oil-based hand creams.


AnswerAnswer

False.

When using latex gloves a nurse should avoid the use of oil-based creams.



• Burns

– Thermal burns or chemical burns

– Burn prevention: exits identified, lighted, unlocked; ensure functioning sprinkler system

– Fire plans



• Burns (cont’d)

– Fire management: RACE

o Rescue

o Alarm

o Contain

o Extinguish




– Roles and responsibilities at and away from fire’s origin

– Use of fire alarm system

– Agency fire plan concepts




– Rescue and evacuation; proper use of equipment

– Building compartmentalization for containing smoke and fire

– Fire extinguishers




– Fire extinguishers

• Class A: wood, paper

• Class B: liquids, grease

• Class C: electrical

• Class ABC: combination


Evacuation of Clients Evacuation of Clients



• Asphyxiation

– Airway obstruction

– Carbon monoxide (CO)

o CO binds with hemoglobin

o CO poisoning: symptoms similar to flu, except for cherry-red skin color



• Drowning– Fluid occupies airway, interferes with

ventilation– Accidental drownings – Resuscitation– Immediate CPR – CPR certification in nurses



• Electrical shock

– Body prone to electric shock

– Macroshock; microshock

– Grounded equipment reduces electrical shock potential

– Measures to prevent electrical shock



• Poisoning

– Caused by ingestion, inhalation, or absorption of toxic substance

– More common in homes than in health care institutions

– Accidental poisonings; medication errors



• Poisoning prevention

– Educate children; teach parents

– Cognitive-impaired adults: use prefilled medication containers

– American Association of Poison Control Centers



• Falls

– Most common accident with the most serious consequences in older adults

– Contributing factors: visual impairments; disorders affecting gait, balance, and coordination; medications to lower blood pressure



• Falls (cont’d)

– Contributing factors (cont’d)

o Urinary urgency

o Social, environmental factors

o Accumulation of clutter

o Hospitalization

o Confusion, impaired judgment



• Assessment

– Determine risk factors

– Fall prevention measures

– Keep emergency numbers near phone

– Daily phone tree

– Personal response services


RestraintsRestraints• Physical restraints

• Chemical restraints

• Purpose: client or staff safety

• Use of restraints is closely regulated

• Restraints may not be used for disciplinary reasons

• Last intervention used after all others exhausted


Restraints (cont’d)Restraints (cont’d)

• Risks of use:

– Increase client confusion

– Cause chronic constipation, incontinence, infections (pneumonia)

– May cause pressure ulcers

– Experience progressive decline in ability to perform ADLs independently



• Legislation

– Law incorporated; compliance mandatory since 1990

• Accreditation standards

– Restraint protocol; medical orders; monitoring and documentation



• Restraint alternatives: protective or adaptive devices that promote client safety and postural support which the client can release independently


Nursing ImplicationsNursing Implications

• Recognize safety hazards

• Identify clients at greatest risk for injury

• Identify several nursing diagnoses

• Client safety; allegations of malpractice


General Gerontologic ConsiderationsGeneral Gerontologic Considerations

• Number of falls and severity of injury

• Falls rob client of independence

• Well-fitting enclosed shoes, nonskid soles

• Most falls occur in clients 65 years or older, at home


General Gerontologic Considerations (cont’d)

General Gerontologic Considerations (cont’d)

• Factors contributing to falls in older adults: health conditions; situations such as environmental hazards, inadequate lighting, general clutter, assistive devices

• Osteoporosis

• Fear of falling; history of falling

• Cognitive impairment

ppt chapter 19

Business

health statistics

latex proteins latex

health care environment

latex gloves

contd rescue

contd roles

latex allergy

latex sensitivity