Safety Ch. 14 Flashcards Preview

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Flashcards in Safety Ch. 14 Deck (57):

What does a safe environment imply?

Freedom from injury with focus on preventing falls, electrical injuries, fires, burns and poisoning.


What must the nurse be aware of and what is their responsibility?

Be aware of potential safety problems.

How to report and respond when safety is threatened

Providing and maintaining a safe environment

Both protection and education are primary a nursing responsibility


Sentinel event

Any unexpected occupancy involving death or serious physical or psychological injury, or the riskof


When do the majority of patients fall?

During transfers


Who is the most at risk to fall?

The very young
Older adults
Individuals who become ill or who are injured
Unfamiliar environment
History of falls


To ensure the safety and protection of the environment of infants and children requires what?

Protection of the child and education of the parents


Accidents involving children and largely preventable or not preventable?
But what?

Parents and caregivers need to be aware of specific dangers each stage of growth and development


What changes associated with aging increase risk of falls

Unsteadiness in gait belt
Vision changes may affect the ability to see the height of stairs
Vertigo may occur due to disease and or medicine


Prevention process

-Physical and psychological assessment
- medication review
- medical history review
- inspection of patient environment
- documentation
- patient re- orientation
- beds in low position
- well lit rooms
- call bells within reach
- in service for staff


Gait belts

- ambulating patients
- apply gait belt securely around patients waist
- walk to the side of the patient, one arm around waist and hand on the belt . Walk on weaker side
- also considered as a safety reminder device


safety reminder device (SRD)

-Devices used to immobilize a patient or part of the patient's body, such as arms or hands
- restraints
- lap buddy
- prevent or reduce the risk of falls
- restrict movements


SRDs today

- current trend is to decrease the use of SRDs due to legal and ethical issues
- restraint free environment
-- orientation to surrounding
-- increased supervision
-- routine activities
-- increase activities
-- evaluate medications
-- use of weight sensitive/ electronic devices


What are some things in the work place that can cause accidents?

- biologic, chemical, and physical hazards
- laser
- blood and body fluids
- contaminated needles
- radiation
- vaccine- preventable diseases
- violence


the national institute for occupational safety and health (NIOSH) focuses on what?

Safety and issues related to heath


Hazard communication act of the occupational safety and health administration (OSHA)

- a federal organization that provides guidelines to help reduce safety hazards in the work place
- requires hospitals to inform employees about the presence of or potential for harmful exposures and how to reduce the risk of exposure


Center for disease control and prevention (CDC)

- federal agency that provides facilities and services for the investigation, identification, prevention, and control of disease
- provides guidelines for working with infectious patients


Material safety data sheets

All employers require to make this manual available to all employees
- list all chemicals used in facility
- contains chemical info
- contains safety info for each chemical
- address and phone number for chemical manufacture


OSHA and workplace violence

-According to OSHA more assaults occurs in health care setting than in other industries

- OSHA provides guidelines for violence prevention programs


Work place violence involves...

Hitting/ kicking
Name calling/ gestures


Work place violence is the ..

The fourth leAding cause of fatal occupational injury in the US


Work place violence risk factors

- possession of handguns
- violent people seeking health care
- mentally ill
- pharmacies are targeted
- gangs
- agitated family members


Fire safety
What's mandatory and preventions

- an established fire safety program is mandatory
- prevention includes good housekeeping, maintenance, and employee discipline
- all employees should know the telephone number and procedure for reporting a fire, as well as the location of the nearest firefighting equipment
- health care workers must know their roles in the overall evacuation plan


Fire safety risk factors

- smoking in bed
- faculty electrical equipment
-- overloaded outlets
-- faulty wiring
-- damaged/ misused electrical cords

- fire/ burns are the leading cause of injury related death for children ages 1-4



Rescue and remove all patients in immediate danger

Activate the alarm

Confine the fire

Extinguish the fire using the extinguish



- swing carry method
- don't use elevators
- moving non ambulatory residents
- moving sensory and mentally impaired residents



Second step is to sound the alarm
Pull the alarm
Call 911
Never hang up with dispatcher until dispatcher has repeated your message



Close all doors, windows and vertical opening
Stuff damp towels under door to keep smoke out
Shut off oxygen/ gas if you are directed by fire department



If the fire is in a trash can or ashtray, another it with a pillow, towel, rug or blanket
- if residents clothes on fire wrap patient tightly in large blanket to extinguish flans
- If piece of equipment catches on fire, unplug if possible
- shut off oxygen and remove any patient from immediate danger



Pull the pin
Aim at the base
Squeeze the handles
Sweep from side to side


Type A extinguisher

For paper, wood , or clothes fire


Type B

For flammable liquid fires- grease and anesthetics


Type c

For electrical


Type ABC

Any type of fire


Disaster situation

An uncontrolled, unexpected, psychologically shocking event

- earthquakes, hurricanes, floods, tornadoes, bombings, arson, riots, and hostage taking

- health care facilities are expected to receive victims and survivors and to assist rescuers


External disaster

Originates outside the health care facility and results in an influx of casualties brought to the facility


Internal disaster

Represents an extraordinary situation that is brought about by events within the health care facility


Disaster manual

Specifies department responsibilities; chain of command


Earthquake preparedness

Building checks
-- inspect gas, electricity, water shut off valves

Protect yourself/ patients
-- duck and cover
-- emergency food and water supplies


Disaster manual

Emergency operations plan
Emergency management plan



System of notification to be transmitted rapidly



The condition or physical state produced by the ingestion, injection, inhalation, or exposure of a poisonous(toxic) substance


Accidental poisoning

childhood poisoning is one of the major causes of death in children under 5 years of age

According to national safety council, there are 400,000 children under the age of 6 who suffer from too much lead in their blood


Accidental poisoning

Changes associated with aging interfere with the individuals ability to absorb or excrete drugs
- the older adult may share drugs with friends
- changes in eyesight may lead to accidental ingestion


Accidental poisoning
(Hospitalized patients and those in other health care facilities can be at risk)

Cleaning solution


Preventing poisoning

Romove toxic agents from areas where poisoning could occur

Toxins or poisonous substances should not be removed from their original containers

Poisonous substances should be labeled conspicuously and stored properly


Who is a valuable sources of info when poisoning is suspected or does occur?

Poison control centera


If poison occurs:

Obtain history
Access the patient
Call poison control center and follow protocols
Do not induce vomiting
Wash your hands


Prevention Infant abductions

- attach secure identically numbered bands to the infant, mother and father or sig other immediately after birth
- footprint the infant, take color photograph, and record physical exam within 2 hours of birth
- implement an infant security tag or abduction alarm system, like car cording system; which triggers alarm, locks doors and freezes elevators if the infant comes within 4 feet of an exit it elevator
- transport infants only In bassinets
- establish a tracking system to document where the infants are at all times
- require staff to wear up to date conspicuous, color photo ID badges and require staff in direct contact with infants to wear a second form of unique ID
- don't publish birth announcements in local newspaper
- control access to the maternity unit for instance, keep all unit exit doors locked and make sure they're monitored by video surveillance cameras with date and time stamp



A violent or dangerous act used to intimidate or coerce a person or government to further a political or social agenda

A new potential environmental health threat is the possibility of a terrorist attack

-- biological, chemical, or nuclear weapons



The use of biological agents to create fear and threat

May be overt (announced) or covert (unannounced)


Features that should alert nurses o the possibility of a bioterrorism related outbreak include:

- a rapidly increasing incidence of a disease
- an unusual increase in the number of people seeking care
- an endemic disease rapidly emerging at an uncharacteristic time or in an unusual pattern
- lower attacks rates among patients who had been indoors compares with people who had been outdoors
- clusters of patients arriving from a single locale
- large number of rapidly fatal cases


Terrorism by nuclear exposure

- attack on domestic nuclear weapon facility
- "dirty bomb"
- source of radiation on the contaminated patient : on the body or clothing, ingested or absorbed through a skin opening
- less than .75 Gy absored- usually no symptoms
-8 Gy- usually fatal
- more than 30 Gy- always fatal
- absorbs more than .75 Gy can develops acute radiation symptoms



Loss of mucosal barrier and cells lining the intestine


Cerebrovascular/ central nervous system

Cerebral edema, hyperpyrexia, hypotension, confusion and disorientation



Loss of epidermis and possibly the dermis



The expected or normal incidence native to or occurring naturally to a specific area or environment



Disease that emerges rapidly at an uncharacteristic time or in an unusual pattern