CH 8: Promoting Safety

RRT

Rapid Response Team

workplace violence

violent acts (including assault and threat of assault) directed toward persons at work or while on duty

contraindication for abdominal thrusts

1. not used for the very obese persons or pregnant women 2. chest thrusts are used

coma

a state of being unaware of one's surroundings and being unable to react or respond to people, places, or things

disaster

a sudden catastrophic event in which people are injured and killed and property is destroyed

hazardous substance

any chemical in the workplace that can cause harm

FBAO

foreign-body airway obstruction

ID

identification

paralysis

loss of muscle function, loss of sensation, or loss of both muscle function and sensation

MSDS

material safety data sheet

suffocation

when breathing stops from the lack of oxygen

safety measures are needed where oxygen is used and stored:

1. "no smoking" signs are placed on the door and near the bed 2. person and visitors are reminded not to smoke in the room 3. smoking materials are removed from the room 4. wool blankets and synthetic fabrics that cause static electricity are removed from the person's room 5. person wears a cotton gown or pajamas 6. materials that ignite easily are removed from the room

To safely use color-coded wristbands:

1. Color may vary among agencies. 2. Check the care plan and your assignment sheet when you see a color-coded wristband. 3. Check for wristbands on persons transferred from another agency. The nurse needs to remove wristbands from another agency. 4. Tell the nurse if you think a person needs a color-coded wristband.

Risk management, intent is to:

1. Protect everyone in the agency--patients, residents, visitors, and staff 2. Protect agency property from harm or danger. 3. Protect the person's valuables. 4. Prevent accidents and injuries.

What to do during a fire: RACE

1. R--for rescue. Rescue persons in immediate danger. Move them to a safe place. 2. A--for alarm. Sound the nearest fire alarm. Notify the switchboard operator. 3. C--for confine. Close doors and windows to confine the fire. Turn off oxygen or electrical items used in the general area of the fire. 4. E--for extinguish. Use a fire extinguisher on a small fire that has not spread to a larger area.

Color-coded wristbands:

1. Red--means an "allergy alert." 2. Yellow--means a "fall risk." 3. Purple--means the person has a "do not resuscitate" (DNR) order.

Incidents include:

1. accidents involving patients, residents, visitors, or staff 2. errors in care 3. broken or lost items owned by the person 4. lost money or clothing 5. hazardous substance incidents 6. workplace violence

promoting safety and comfort: identifying the person

1. always identify the person right before you begin a task or procedure 2. do not identify the person and then leave the room to collect supplies and equipment 3. make sure you can read the information on the ID bracelet; if you cannot, tell the nurse

stretcher safety (1 of 2):

1. ask two co-workers to help you transfer the person to or from the stretcher 2. lock the stretcher wheels before the transfer 3. fasten the safety straps when the person is properly positioned on the stretcher 4. ask a co-worker to help with the transport 5. raise the side rails; keep them up during the transport

safety measures to prevent burns (1 of 2):

1. be sure people smoke only in smoking areas 2. check the person's care plan about leaving smoking materials at the bedside 3. supervise the smoking of persons who cannot protect themselves 4. do not allow smoking in bed 5. do not allow smoking where oxygen is used or stored 6. be alert to ashes that may fall onto a person

wheelchair safety (1 of 3):

1. check the wheel locks (brakes); make sure you can lock and unlock them 2. check for lat or loose tires; a wheel lock will not work on flat or loose tire 3. make sure the wheel spokes are intact; damaged, broken, or loose spokes can interfere with moving the wheelchair or locking the wheels 4. make sure the casters point forward; this keeps the wheelchair balanced and stable 5. position the person's feet on the footplates 6. make sure the person's feet are on the footplates before moving the chair

to identify the person:

1. compare identifying information on the assignment sheet with that on the ID bracelet 2. use at least two identifiers; cannot be the person's room or bed number; always follow agency policy 3. call the person by name when checking the ID bracelet

Personal belongings for valuables:

1. count the money with the person 2. Put money and each jewelry item in the envelope with the person watching. Seal the envelope. Sign the envelope like a personal belongings list. 3. Give the envelope to the nurse. The nurse takes it to the safe or sends it home with the family.

safety measures to prevent suffocation (1 of 2):

1. cut food into small, bite-sized pieces for persons who cannot do so themselves 2. make sure dentures fit properly and are in place 3. make sure the person can chew and shallow the food served 4. report loose teeth or dentures 5. check the care plan for swallowing problems before serving snakes or fluids 6. tell the nurse at once if the person has swallowing problems 7. do not give oral food or fluids to persons with feeding tubes

electrical safety (3 of 3):

1. do not use water to put out an electrical fire; if possible turn off or unplug the item 2. do not touch a person who is experiencing an electrical shock; if possible, turn off or unplug the item; call for help at once 3. keep electrical cords away from heating vents and other heat sources 4. turn off the electrical device when done using the item 5. unplug all electrical devices when not in use 6. turn off equipment before unplugging it; sparks occur when electrical items are unplugged while turned on

hazardous substances include:

1. drugs used in cancer therapy (chemotherapy, anti-cancer drugs) 2. anesthesia gases 3. gases used to sterilize equipment 4. oxygen 5. disinfectants and cleaning agents 6. radiation used for x-rays and cancer treatments 7. mercury

material safety data sheets

1. every hazardous substance has a material safety data sheet 2. check the MSDS before using a hazardous substance, cleaning up a leak or spill, or disposing of the substance 3. tell the nurse about a leak or spill right away 4. do not leave a leak or spill unattended

safety measures to prevent suffocation (2 of 2):

1. follow aspiration precautions 2. do not leave a person unattended in a bathtub or shower 3. move all persons from the area if you smell smoke 4. position the person in bed properly 5. use bed rails correctly 6. use restraints correctly 7. prevent entrapment in the bed system

electrical safety (1 of 3):

1. inspect electrical cords and appliances for damage 2. use three-pronged plugs on all electrical devices 3. do not cover power cords with rugs, carpets, linens, or other materials; do not run power cords under rugs 4. connect a bed power cord directly to a wall outlet; do not connect a bed power cord to an extension cord or outlet strip 5. do not use electrical items owned by the person until they are safety checked; maintenance staff does this 6. keep electrical items away from water

safety measures to prevent burns (2 of 2):

1. keep hot food and liquids away from counter and table edges 2. do not pour hot liquids near a person 3. turn on cold water first, then hot water; turn off hot water first, then cold water 4. measure bath or shower water temperature; check it before a person gets into the tub or shower 5. check for "hot spots" in bath water; move your hand back and forth 6. do not let the person use a heating pad or an electric blanket 7. follow safety guidelines when applying heat and cold

electrical safety (2 of 3):

1. keep work areas clean and dry; wipe up spills right away 2. do not touch electrical items if you are wet, if your hands are wet, or if you are standing in water 3. do not put a finder or any item into an outlet 4. hold onto the plug (not the cord) when removing it from an outlet 5. do not give showers or tub baths during electrical storms; lightning can travel through pipes 6. do not use electrical items or phones during storms

to prevent poisoning:

1. make sure patients and residents cannot reach hazardous materials 2. follow agency policy for storing personal care items

stretcher safety (2 of 2):

1. make sure the person's arms, hands, legs, and feet do not dangle through the side rail bars 2. stand at the head of the stretcher; your co-worker stands at the foot of the stretcher 3. move the stretcher feet first 4. do not leave the person alone 5. follow the safety measures to prevent equipment accidents

warning labels identify:

1. physical and health hazards 2. precaution measures 3. what personal protective equipment to wear--gown, mask, gloves, goggles, and so on 4. how to use the substance safely 5. storage and disposal information

Using a fire extinguisher

1. pull the fire alarm 2. get the nearest fire extinguisher 3. carry it upright 4. take it to the fire 5. follow the word PASS: a) P--for pull the safety pin. This unlocks the handle. b) A--for aim low. Direct the hose or nozzle at the base of the fire. Do not try to spray the top of the flames. c) S--for squeeze the lever. Squeeze or push down on the lever, or button to start the stream. Release the lever, handle, or button to stop the stream. d) S--for sweep back and forth. Sweep the stream back and forth (side to side) at the base of fire.

wheelchair safety (2 of 3):

1. push the chair forward when transporting the person; do not pull the chair backward unless going through a doorway 2. lock both wheels before you transfer a person to or from the wheelchair 3. follow the care plan for keeping the wheels locked when not moving the wheelchair (may be considered a restraint) 4. do not let the person stand on the footplates 5. do not let the footplates fall back onto the person's legs 6. make sure the person has needed wheelchair accessories--safety belt, pouch, tray, lapboard, cushion

wheelchair safety (3 of 3):

1. remove the armrest (if removable) when the person transfers to the bed, toilet, commode, tub, or car 2. swing front rigging out of the way for transfers to and from the wheelchair; some front rigging detach for transfers 3. clean the wheelchair according to agency policy 4. ask a nurse or physical therapist to show you how to propel wheelchairs up steps and ramps and over curbs 5. follow the safety measures to prevent equipment accidents

reporting incidents

1. report accidents and errors at once 2. complete an incident report as soon as possible

warning signs of a faulty electrical item include:

1. shocks. 2. loss of power or a power outage 3. dimming or flickering lights 4. sparks 5. sizzling or buzzing sounds 6. burning odor 7. loose plugs

three things need for a fire

1. spark or flame 2. material that will burn 3. oxygen

to help a person with mild airway obstruction:

1. stay with the person 2. encourage the person to keep coughing to expel the object 3. do not interrupt the person's efforts to clear the airway; if the person is breathing and coughing, abdominal thrusts are not needed 4. if the obstruction persists, call for help

OHSA

Occupational Safety and Health Administration

AED

automated external defibrillator

CPR

cardiopulmonary resuscitation

EMS

emergency medical services

dementia

the loss of cognitive and social function cause by changes in the brain