Chapter 10 & 11: Safety Reminder Devices & Admission, Transfer, Discharge of the Patient

What procedure should the nurse follow when applying a safety reminder device (SRD)?

1. review physician's order 2. introduce yourself and identify the patient 3. explain the procedure and reasoning 4. provide privacy and appropriately apply the SRD 5. document the procedure 6. monitor for complications; skin impairment, cognitive impairment

Gait (transfer) Belt

device used to assist a patient who is unsteady or with standing, walking or transferring

Admission

entry of a patient into the health care facility

Separation Anxiety

fears and apprehension caused by separation from familiar surroundings and significant people

Patient Self-Determination Act of 1990

federal law that requires hospitals and other health care providers to provide written information to patients regarding their rights under state law to make medical decisions and execute advance directives

What is the procedure for identifying an unconscious patient upon admission to a health care facility?

identification is delayed until a family member or legal guardian is present to identify the patient

Empathy

identification with and understanding of another's situation, feelings, and motives

Transfer

moving a patient from one unit to another or moving a patient from one facility to another

Against Medical Advice (AMA)

noncompliant patient leaves a hospital without physician's consent

Third-Party Payer

private or government organization that insures or pays for health care on behalf of beneficiaries; entities other than the health care facility/provider or the patient receiving care that are responsible for payment of services

Discharge

release from care of a health care facility or provider

What is the appropriate area of the hospital bed for attaching a safety reminder device (SRD)?

secure the SRD to the moveable portion of the bedframe allowing the SRD to move with the patient and when the bed is adjusted; prevents injury

Discharge Planning

systematic process of preparing the patient to leave the health care facility and for maintaining continuity of care; an interdisciplinary process started by nurse at time of admission and is conducted with both client and client's family for optimal results

WanderGaurd

type of SRD that alerts staff to the whereabouts of a patient within set borders such as hospitals, nursing homes and senior living homes; helps prevent cases of elopement

Quick-Release Knot

type of knot used to tie a restraint where the strap is bent into a u-shape, leaving the end accessible so that pulling on it unties the knot quickly

Elopement

when a person under care leaves the agency without staff knowledge; a resident exiting the facility whose whereabouts are unknown to the staff

Describe the differences in policy when it comes to patient valuables in the acute care facility vs that of the memory or long term care facility?

acute care facility; patients are encouraged to give valuables to family members to take home. Otherwise, valuables are locked in the facility safe memory care facility or long term care facility; the facility assumes some responsibly for patient's belongings (do to the patient not being competent to do so). Sometimes creating a list and description of patient's property upon admission

Home Health Agency

agency that provides nursing and non-nursing services to patients in their homes; patients are known as clients

Bed/Chair Alarms

alarms that alert facility staff if a patient attempts to get out of a bed or chair without proper assistance; helps to reduce the risk of patient falls

Health Care Facility

any agency that provides health care

Safety Reminder Device (SRD)

any of the numerous devices used to immobilize a patient or part of the patient's body, such as arms or hands' formerly referred to as restraints

Continuity of Care

continuation of care smoothly from one provider or facility to another; an ongoing coordination of a resident's care over time, during which the care team is regularly exchanging information and is working toward shared goals

What are the potential risks associated with the use of SRDs?

1. restlessness 2. disorientation 3. agitation 4. anxiety 5. feeling of powerlessness - all factors that contribute to patient immobility and associated problems such as dehydration

What considerations should the nurse make when a new patient is admitted to the unit?

1. assess for acute distress; pain, shortness of breath, severe anxiety 2. introduce patient who will occupy the same room

What are (4) common reactions to admission to a health care facility?

1. confusion 2. fear of the unknown 3. loss of identity 4. separation anxiety

What is the procedure for admitting a new patient to the health care facility?

1. obtain demographic and identifying information 2. obtain insurance/payer information 3. place ID wristband on the patient

What are nursing interventions related to patient admission to a health care facility?

1. orient the patient to the facility 2. establish the nurse-patient relationship 3. identify patient risk factors 4. confirm patient understanding of policies and procedures 5. monitor patient's ability to ambulate; assess fall risk 6. monitor patient's ability to operate hospital bed, call light, and the emergency call button

What interventions should the nurse perform to alleviate much of the fear and anxiety felt by the patient upon admission to a health care facility?

1. orient the patient to their environment 2. explain facility policies/procedures 3. answer simple questions; what time is dinner? what time are visitors allowed?

What is the role of the licensed practical nurse (LPN) as stated in the nursing process?

1. participate in the planning of care for patients based on patient needs 2. review patient's plan of care and recommend revisions as needed 3. review and follow defined prioritization for patient care 4. use clinical pathways, care maps, or care plans to guide and review patient care

What is included in the collection of a patient's health history?

1. reason for admission 2. signs and symptoms 3. past illnesses 4. past surgical procedures 5. past hospitalizations 6. medications (RX and OTC) 7. allergies (food, medications, other) 8. urinary/bowel patterns 9. sleep routine 10. activity/exercise habits - also includes spoken language, family member/emergency contact/significant other information, interests, home situation, occupation, and ability to perform self care and ADLs

How are SRDs that restrain the use a limb typically used in each of of the following healthcare settings? A. Mental Health B. Pediatric C. Intensive Care

A. B. C.

How should the nurse address a newly admitted patient to the health care facility?

by their surname unless otherwise directed by the patient

Posey

common type of SRD is the soft restraint. named offer the company that manufactures this type of restraints

What form must a patient sign that grand a health care facility or provider permission to treat them?

consent (consent to treat) form; patients are also provided with a copy of the patient bill of rights