SAFETY

• Safe care is a basic need of all clients regardless of the setting
• Nurses are responsible for

  Providing the client with a safe environment through the delivery of professional, quality nursing care that incorporates safety precautions
• Safety


  • Has a positive association with health promotion and illness prevention
  • Reduces the risk of accidents
  • Reduces subsequent alterations in health and lifestyle
  • Reduces the cost of health care services
• Factors affecting safety


  • Age
  • Lifestyle
  • Sensory and perceptual alterations
  • Mobility
  • Emotional state
• Types of accidents


  • Client behavior accidents
  • Therapeutic procedure accidents
  • Equipment accidents
• All accidents and incident reports must be fully documented according to institutional protocol
• Potential occupational hazards for nurses and other healthcare providers

  • Latex allergy
  • Blood-borne pathogens
  • Work-related musculoskeletal disorders
  • Chemotherapeutic agents
  • Environmental pollution
  • Violence
• Nosocomial infections are infections acquired in the hospital or other health care facilities that were not present or incubating at the time of the client's admission
• Most nosocomial infections are transmitted by health care personnel who fail to practice proper hand-washing procedures or change gloves between client contacts
• Blood-borne pathogens


  The risk for blood-borne pathogens in the health care setting is an increasing concern for health care providers
• Nursing practice standards for safety

  • Perform a client injury risk appraisal
  • Eliminate or modify risk elements
  • Implement environmental precautions
  • Use infection control practices
  • Maintain intravenous access
  • Implement emergency measures for CPR and life support
  • Know and comply with institution's guidelines
  • Implement emergency measures during fires and disasters
  • Use equipment according to guidelines
  • Use a multidisciplinary approach
• Home safety risk appraisal for different age groups


  • Infant
  • Toddler/Preschooler
  • School-Age Child
  • Adolescent
  • Adult
  • Older Adult
• Raise safety awareness and knowledge

  • Nurses must demonstrate awareness of safety hazards and teach clients accordingly
  • Clients must be aware of and knowledgeable about safety precautions to prevent injuries
• Measures to prevent falls

  • Good supervision
  • Orienting clients to environment and call system
  • Providing ambulatory aids
  • Placing personal belongings near bed
  • Keeping beds low with side rails up
  • Using non-slip mats and rugs
  • Illuminating the environment
• Restraints


  Protective devices used to limit physical activity or immobilize a client to protect the client, allow treatment in a safe environment, and reduce risk of injury to others
• Nursing interventions to prevent falls

  • Prevent Falls
  • Good supervision
  • Orienting clients to the environment and call system
  • Providing ambulatory aids (wheelchairs or walkers)
  • Placing personal belongings on tables near the bed
  • Keeping hospital beds in lowest position with side rails up
  • Using nonslip mats and rugs
  • Illuminating the environment
• Restraints


  Protective devices used to limit the physical activity of a client or to immobilize a client or extremity
• Reasons for using restraints

  • To protect the client
  • To allow treatment in a safe environment
  • To reduce the risk of injury to others
• Applying and caring for clients in restraints

  1. Document according to institutional protocol

  2. Restraints can be physical or chemical
• Types of physical restraints

  • Jacket (body restraint)
  • Belt
  • Mitten or hand
  • Elbow
  • Limb or extremity
  • Mummy
• Safety measures when using restraint devices

  • Restraints can be changed and released easily, using only a clove hitch knot
  • Restraints should not interfere with any treatments or aggravate the client's health problem
  • There should be enough slack on the straps so that the client can move both arms and legs and for range-of-motion exercises
  • At least once every 2 hours, the nurse must perform circulation and neurological exams, assessing the color, sensation, temperature, motion, and capillary refill in the area distal to the restraint
  • There should be a provision for psychological support of client and significant others
• Adequate lighting


  Assists in the visualization of environmental hazards
• Reducing obstacles


  • Keep hallways clear
  • Remove excess furniture from heavily traveled areas
  • Remove all electrical cords or tape cords securely to the floor
  • Remove throw rugs
  • Apply nonslip pads to rugs
  • Clean up spills immediately
  • Remove objects that could fall from the tops of appliances
• Reducing bathroom hazards


  • Use grab bars near the tub, shower, and toilet
  • Use nonslip mats in the tub and shower
  • Use a secured bathroom rug near the tub or shower
  • Check the temperature of the water before entering tub or shower
  • Check the thermostat setting on the water heater
  • Store medications in a locked cabinet, out of reach of children or disoriented or confused adults
• Preventing fire


  • Clearly mark fire exits
  • Know locations of fire extinguishers and their operation
  • Practice fire evacuation procedures
  • Post emergency phone numbers by all telephones
  • Keep open spaces and hallways clear of clutter
  • Check electrical cords and outlets for exposed or damaged wires
  • Report identified electrical hazards
  • Educate clients about fire hazards
• Responding to electrical shock

  • Turn off or remove the electric source before touching the client
  • Check the client's pulse
  • If no pulse, initiate CPR
  • If pulse, assess vital signs, mental status, and skin integrity for burns
  • Notify a physician of the event
  • Note points of entry and exit of electrical current to assess for potential complications
• Reducing radiation exposure


  • Minimize time in contact with radiation source
  • Maximize distance from radiation source
  • Use appropriate radiation shields
  • Monitor radiation exposure with a film badge
  • Label all potentially radioactive material
  • Never touch dislodged implants or body fluids of client
• Reducing client's risk from radiation therapy

  • Educate the client about radiation treatment and necessary precautions
  • Place the client in a private room
  • Provide a lead apron when necessary to protect non targeted body tissues
• Reducing nurse's risk from radiation

  • Observe all radioactive labels
  • Wear gloves when handling radioactive body discharges
  • Wash hands
  • Wear lead aprons
  • Dispose of radioactive substances in special containers
  • Reduce time of client contact
  • Wear badges that measure the amount of radiation exposure
• Poison


  Any substance that causes an alteration in the client's health, such as injury or death, when inhaled, injected, ingested, or absorbed by the body
• Causes of poisonings


  • Inadequate supervision of children
  • Ingestion of household plants
  • Improper storage of toxic substances
  • Insect or snake bites
  • Accidental ingestion of a toxic substance or medication overdose
• Client teaching to prevent accidental poisonings

  • Store medications in child-resistant containers
  • Do not take medications in front of children
  • Never call medicine candy
  • Limit the number of tablets in a medicine container
  • Place toxic substances in a locked cabinet out of reach of children
  • Never remove labels from containers
  • Do not place poisonous substances in food or beverage containers
  • Place poison stickers on toxic substances
  • Display poison control center phone numbers near telephones
• Noise pollution


  A situation that results when the noise level becomes uncomfortable for the client or staff
• Effects of noise pollution

  • Can result in an unorganized environment, hearing loss, and sensory overload
  • Sensory overload can alter a client's recovery by increasing anxiety, paranoia, hallucinations, and depression
• Reducing noise pollution


  • Maintain a quiet environment
  • Control traffic
  • Provide earplugs
• Asepsis


  The absence of microorganisms
• Aseptic technique


  The infection control practice used to prevent the transmission of pathogens
• Medical asepsis


  Uses practices to reduce the number, growth, and spread of microorganisms
• Clean objects


  Have the presence of some microorganisms that are usually not pathogenic
• Dirty (soiled) objects


  Have a high number of microorganisms, with some that are potentially pathogenic